Raising her three sons, Nancy Makowski expected to encounter some parenting battles over underage drinking — maybe marijuana, too — when the boys reached their teenage years.
But when her sister called four years ago to tell her that her middle son — Wyatt, 16 at the time — had admitted to smoking heroin, Makowski was floored.
“Heroin — it’s kind of like the kiss of death of drugs,” said the Worthington mom, who works as an emergency-room nurse.
“The one time you try it, you’re addicted.
“How could I miss this?”
The shock quickly turned to anger — at her son for using the drugs and at herself for not having realized the problem.
She felt ashamed, alone and overwhelmed.
To whom could she confide? Where might she turn for help? How was she going to save her son?
Successful substance-abuse treatment for teens, experts say, begins with early identification and intervention.
“Parents need to remember that it is a treatable disease — and No. 1, that it is a disease,” said Dr. Steven Matson, an addiction physician at Nationwide Children’s Hospital. “It’s not a mental or moral failure.
“The sooner we can catch these kids and the less amount of time they are using, the better chance we have for a good outcome.”
Recognizing early signs — and, notably, how they differ from typical moody teen behavior — is paramount.
Changes might occur in many aspects of a child’s life: behavior, personality and physical appearance.
Parents might see a drop in grades or unexplained absences from school, said Paul Coleman, president of Maryhaven, a treatment facility on the East Side with 52 inpatient beds and 75 outpatient slots for adolescents.
An outgoing teen who is abusing drugs might become withdrawn. A son once passionate about football might quit the team, or a daughter might start showing interest in dark music.
“The best way to test children for drugs is with their own eyes,” Coleman said. “And the major thing parents need to watch — and watch like a hawk — is a change in friends.”
Friendships become very important during adolescence, and peers serve as the biggest influence on one another, Coleman said. If friends change — especially if the new friends are kids whom parents haven’t met — consider the shift a red flag.
It’s akin to the adage “Show me your friends, and I’ll show you your future,” Franklin County Sheriff Zach Scott said.
Physical signs of drug use, Scott said, include bloodshot eyes, an unkempt appearance, tiredness and slurring.
A teen might use incense to cover up the smell of smoke. Parents might find unusual paraphernalia in a child’s bedroom.
Teens might hide drugs in a number of places, including in everyday items — a computer mouse, aspirin bottle or lunchbox — with hidden compartments.
He has even seen a hockey puck double as a pipe.
Parents might notice money and gifts missing or pills disappear from a medicine cabinet.
“The first people drug users victimize are their family,” Scott said.
When drugs are involved, Matson said, more than one realm — appearance, social circles, school performance, interests — are typically affected, thus allowing parents to discern between a potential substance-abuse problem and normal teenage irritability.
“If they’re being crabby at home and not getting along with parents but are still doing well at school and on the football team,” Matson said of adolescents, “we don’t have concern until those other areas go.”
As a middle-school and high-school student, Makowski said, her son Wyatt was likable and earned good grades.
She did recall a period during the seventh grade, though, when she noticed him sleeping more than usual. He had new friends and began listening to “screechy” music.
Although she asked her family doctor about the tiredness and expressed concern to some colleagues, she eventually chalked it up to his age.
“Is the school calling? Is he sneaking out? No, none of that,” Makowski said. “The doctor told me with puberty and everything that is going on, a lot of parents bring in their kids and less than half are on drugs.”
Yet Wyatt had, in fact, begun taking his older brother’s prescribed pain medication in the seventh grade. He began buying other drugs at school, and, when the pills became too expensive, he turned to heroin.
His mother didn’t recognize the problem until Wyatt’s sophomore year, when her son was caught stealing from his grandfather while visiting his grandparents in New York with his aunt .
Although she is unsure whether she could have done more to prevent the progression of his drug use, she acknowledged that she missed some signs.
“Oh, my gosh, teaspoons were missing — you don’t make that correlation,” she said. “Aluminum foil — you go to the grocery store (and buy it) and then look at it and it’s empty.”
She could have had her son tested for drugs earlier, she said, or dug deeper into his cellphone texts and calls.
“The thing is, these kids are so good — so creative — at hiding it,” she said. “You as a parent want to believe them. You don’t want to be the parent of that child.”
Last year in the United States, 36 percent of 12th-graders smoked marijuana, according to the National Institute on Drug Abuse.
Fifteen percent used prescription drugs illegally, and more than a fourth had gotten drunk within the past month.
Area experts implore parents not to treat underage alcohol use lightly, what with 5,000 people younger than 21 dying each year of injuries related to underage drinking.
The age of trial continues to drop: It is now as early as 10 or 11, Maryhaven’s Coleman said.
“No one should assume that because they live in one place or another, their children are immune to this,” he said.
Denial is usually the first barrier that parents must overcome, said Rochelle Dunn, a mental-health coordinator for the Gahanna-Jefferson school district.
“The hardest thing for us as schools is to be in the long haul with the parents as they get past the denial — and, then, we can serve as a resource,” Dunn said. “The first time substance abuse comes up, parents almost always say ‘Not my kid.’”
Parents who suspect that a child is using drugs, experts say, shouldn’t hesitate to talk with teachers or the child’s pediatrician — or to have the child evaluated.
If parents find hard evidence, Coleman said, they should seek outside help and not downplay the seriousness. Grounding or other forms of punishment won’t help, he said.
“If you find it, chances are it’s been going on a long time. There are very few diseases that get better when you do nothing.”
A number of places in town, he said, offer inpatient and outpatient services — including his facility, Maryhaven; Children’s; Ohio State University’s Wexner Medical Center; and smaller venues.
Such programs, Matson said, give adolescents someone to talk with beyond a parent. He stresses confidentiality with his patients.
“I approach them as improving their health, not telling them what to do as an adult,” Matson said. “I help them understand their spectrum of use. If they’re smoking three blunts a day, we show them that they’re way, way far off the spectrum.”
Besides treatment, other resources are available to help those with less-serious abuse issues.
Dunn recommends that parents take their teen to an Alcoholics or Narcotics Anonymous meeting.
“Sit with them and let them hear people’s recovery stories,” Dunn said. “Let them see what this path could have for them.”
The Educational Service Center of Central Ohio offers the High School Saturday Family Workshop, to which schools can refer students and their families.
And the Franklin County sheriff’s office offers Street Smart, a drug-education program that teaches parents and other adults who work with teens what to look for, where to go for help and how to broach the subject of drug and alcohol abuse with children.
“The key is talking,” Sheriff Scott said. “It’s not fun. It can make the children mad. Although it’s uncomfortable and you want to back away from it, you can’t back away from this.”
Although Makowski has health insurance, she still struggled to find treatment programs specializing in adolescent drug abuse with the proper credentials.
“You just can’t go in willy-nilly to get them in a place,” she said. “Check them out. It might cost a little more, but there are certain things you can’t cut corners on.” Makowski took Wyatt to Talbot Hall at the Wexner Medical Center. (The group program is no longer available, but the center still sees adolescents individually.)
He and his family met with counselors three times a week for six weeks and had weekly follow-up appointments for months.
Still, that following summer, Makowski began to see track marks on her son’s arms. Friends of his left notes telling her that he had relapsed.
When she tested him for drugs, his urine was clean — but it was also cold, leading her to believe that the test couldn’t be trusted.
“You will go to desperate measures (to hide drug use),” she said, referring to abusers.
During the ensuing year, Wyatt relapsed twice more before Makowski got him in a program at Children’s with Matson. He began taking the prescription drug Suboxone, which curbs cravings and reduces the high.
“Don’t make it easier on them,” she said. “Don’t be afraid to drug-test. Tear things apart. If they have a cell and you’re paying for it, it’s yours. Go through book bags. Check with friends.”
Essentially, she said, she was in her son’s face often.
“He told me that ‘Sometimes, mom, it was just easier being clean.’”
Her son also told her that his drug problem was not her fault — that she wasn’t a bad mother and that he didn’t have a bad childhood.
“Parents need to get over themselves and realize that no matter what you do with this, it is on the child,” she said. “Be an advocate. If they’re young, get them into help, because once they’re 18, they’ll tell you, ‘I’m 18, and I don’t have to do anything.’”
Wyatt, now 20, has been clean for more than 26 months and no longer takes Suboxone. He is taking online college courses, has a job and is considering renting an apartment with friends.
“It’s been a battle,” Makowski said. “It’s not over. I have people say he did it, but I still worry.”
Which is why she celebrates each Oct. 18 — the anniversary of the start of her son’s recovery.
Makowski’s advice? She would tell other parents that they’re not alone and to keep fighting for their child.
“It can be done.