A day in the life of a teen: decisions at every turn.

On the way to school

... Wonder if I should go tonight?

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Homeroom

Connect with friends in between classes

... Should I finish studying for the quiz instead of talking with friends?

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Break for lunch

... Should I invite the new kid?

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Study Hall

... Do homework, then read?

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After-school activities

... Do I ask if I'm starting on Saturday?

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On the way home from school

... R U going tonight? ...

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Homework

Dinner

... Is it a good time to tell Mom and Dad about the dent in the car?

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Surf internet and check e-mail

... Should I tell him about the party

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Get together with friends

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HEADS UP:

The Way to Go

As a teen, you lead a life jampacked with a thousand things. All day long you may participate in activities and interactions in and out of school, including team sports, going to parties, going to the library, hanging out with friends at the mall, studying, surfing the Internet, group activities, and text-messaging. The list goes on and on. If you think about it, you make a lot of choices while you're doing these activities and during the rest of your day. Some are big and some are small, but everything you do and say involves making a decision.

While you may not ever be faced with this situation, someday you may be confronted by a friend or a stranger with an offer to take drugs. What would you do? This article discusses making tough decisions in social settings where drugs may be offered to you, as well as the harmful effects that those drugs cause. A big factor in deciding what to do is understanding what can happen--the outcome or consequence of your choices.

You'll find out the facts and dangers of drug abuse as you continue reading, and you'll learn what you can do--and say--to protect yourself and navigate through social situations. Malting decisions that seem uncool in front of your peers can be hard. But making decisions that can harm you can lead to dangerous consequences--short-term and long-term.

HEADS UP:

You're Normal

As part of their public-health mission to research the health effects and impact of drugs, scientists at the National Institute on Drug Abuse (NIDA) study trends on the number of teens abusing drugs, the kinds of drugs they abuse, and teens' perceptions of drug availability and the harmfulness of using drugs.

NIDA's mission is scientific but also includes sharing its research findings with the public, so its scientists seek to educate young people on the damage that drug abuse and addiction can cause to their bodies and lives. Elizabeth Robertson, NIDA's chief of prevention research, says that "teens tend to believe that other teens are using a lot more drugs, alcohol, and tobacco than they are." In fact, researchers from the annual NIDA-funded Monitoring the Future (MTF) study found that more than 70 percent of 10th-graders in 2005 had not used illicit drugs in the year prior to their being surveyed. This is important to know. When you don't abuse drugs, you are in the majority with other teens around the country. That's the good news. The reality is that one person using drugs is one too many: Drug abuse may destroy not only the life of the abuser, but the lives of those around him or her as well.

The MTF study also reveals the drugs that are most frequently abused by teens: prescription drugs, marijuana, alcohol, nicotine,0 methalnphetamine, inhalants, and MDMA (ecstasy). While these may seem like harmless "party drugs," each carries serious side effects, both in the short and long term. Drug abuse can wreak havoc on your body, your current and future health, and your social circles, which most teens want to preserve.

Percentage of Teens Surveyed in 2005 Who did Not Try Any Illicit Drug in the Past 12 Months*--and Those Who Did?

               Did not try   Did try

8th-Graders         84%       16%
10th-Graders        70%       30%
12th-Graders        62%       39%

Note: Table made from bar graph.

This information is from the 2005 Monitoring the Future survey, a yearly study of the behaviors, attitudes, and values of teens in America. For more survey findings, see www.monitoringthefuture.org.

* "Illicit refers to any drug that is illegal or used illegally. The results above do not include cigarettes or alcohol.

HEADS UP:

It's All in Your Head

When you're with your friends, why does it seem so hard to say or do something other than what they're doing? A big reason has to do with the way your brain is wired. "The brain is built to learn by imitating," says Jay Giedd, MD, who has spent a lot of time researching teenagers' brains (see sidebar). "Young children imitate their parents; adolescents imitate their peers."

Dr. Giedd used brain-scanning techniques to determine that the prefrontal cortex--that's the part of the brain responsible for impulse control and decision making--does not fully develop in most people until around age 25.

Knowing this, picture yourself at a party watching friends abuse drugs. "Whatever else you might be reading or hearing, your brain is thinking, 'This is what my group does, and this is what I need to do to fit in,'" says Dr. Giedd. But is it?

Because a teen's prefrontal cortex is not fully developed, his or her brain relies on the limbic systems to make decisions. The limbic system is responsible for emotional reactions, especially those involving pleasure or excitement. But it also helps create feelings of drive and motivation, so that if you put your mind to something, you can accomplish it.

HEADS UP:

The Shape of Things

Research shows that when teens think things through, they make good choices about risk. That's important to know, because when you're a teenager, the pathways in your brain are strengthened each time you repeat an activity or skill. Your daily experiences--and decisions--actually shape your brain. As you grow, the brain trims away pathways that aren't used. Those nerve connections that are used frequently through repeating skills or experiences are made stronger. So, the key is to make your experiences as positive and safe as possible--and that means thinking about things beforehand. If someone offers you drugs, you'll be more likely to give the answer you want if you've planned it out in advance.

HEADS UP:

Make a Plan

How do you plan it out in advance? There are many different strategies and ways to say no to drugs. One person who has studied what influences kids to abuse drugs is NIDA-sponsored researcher Gilbert J. Botvin, Ph.D., professor at Weill Medical College of Cornell University and director of the school's Institute for Prevention Research. Dr. Botvin has developed successful prevention programs based on his research. He has proved that teaching kids to practice saying "no" in social settings is one of the best ways to help them avoid abusing drugs.

Most teens start using drugs in social situations. The first thing to do is learn how to say "no, thanks" in a casual way. You might think that other kids will make a big deal of it, but that's unlikely. "Kids and adults have an exaggerated view of the extent to which people are likely to pressure them to use substances," Dr. Botvin says.

But if you feel that a simple "no" won't work, you have other choices. Dr. Botvin and his colleagues have developed some approaches that are presented in the chart below. These techniques have been tested with thousands of teens--and they work. Dr. Botvin says that kids who learn these techniques and use them are 50 to 60 percent less likely than others to abuse drugs.

HEADS UP:

The choice Yours

Now that you have the facts about what drugs can do to you, it's time to give serious thought to how you'll handle social situations that may involve drugs. Talk about the techniques below with your friends and others close to you. Plan and practice what you will do in advance. And remember, the vast majority of teens make the smart choice for their bodies and their minds: They don't use drugs.

For help with a drug problem or to locate treatment centers, go to www.findtreatment.samsha.gov,or call the national hotline at 1-800-662-HELP.

The Teen Brain: A Work in Progress

Jay Giedd, MD, and his colleagues at the National Institute of Mental Health spent 15 years using MRI (magnetic resonance imaging) to map teens' brains. From early childhood through the teen years, participants came in every two years to have their brains scanned and studied.

This cutting-edge research gives the first-ever look inside the teen brain. It reveals that the teen brain is a work in progress. "The fact that your brain is still changing creates enormous abilities to learn," says Dr. Giedd, adding, "Following the living, growing brain in the same individuals over time really has been the key to understanding the path of development."

Symptoms of Drug Overdose: Why You Must Immediately

If you suspect a friend may be suffering from an overdose or a toxic reaction to a drug, you must act. Call 911 or get to a hospital. You or your friend might get in trouble when an adult finds out that you've been around drugs, but that's far better than your friend being dead, or in a coma.

It's not possible for someone to sleep off an overdose. Taking a cold shower or drinking coffee will not help either. Drug and alcohol overdoses can stop the heart from beating or the lungs from breathing.

Drug overdose symptoms vary widely depending on the specific drug(s) used, but may include:

* Abnormal pupil size (either too small or too large)

* Sweating

* Agitation (restlessness, increased tension, irritability)

* Tremors (involuntary shaking movements)

* Seizures

* Problems with walking

* Difficulty breathing

* Drowsiness

* Unconsciousness

* Hallucinations * Delusional or paranoid behavior

* Violent or aggressive behavior

Remember, if you suspect a friend may be suffering from a drug overdose, get help immediately.

These images show 15 years of brain development for a healthy person, aged 5 to 20. The areas in red show parts of the brain that are still changing; the blue shows areas that are developed. The prefrontal cortex, indicated by the red circles, is the last part of the brain to develop. It is responsible for decision making and impulse control. As a person grows, his or her brain develops and matures, as the progression of the blue area shows.

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Ways to Give Drugs the Brush-off

The Technique                 What to say

A Simple No

Don't make it a big deal.     No, thanks
Be polite.

Tell It Like It Is

Be yourself and say it        No, thanks. I don't drink
in a language that            or I don't do drugs.
you're comfortable with.

Give an Excuse                I have to meet my friend or
People make excuses           I'll get kicked off the team.
all the time.

Change the Subject            No, thanks. Hey--did you see that
This can distract people.     strange outfit. Mary was wearing?

Walk Away or Leave the        Say no, then walk to another group.
Situation
It's common at parties to
have a brief interaction,
then wander off or
leave entirely.

The Big Stall                  No, maybe later.
This works with escalating
pressure. It doesn't
mean you will actually try
it later.

The Broken Record              No, thanks--it makes me sick.
Give one reason, then repeat   Repeat it if a person pressures you.
the reason, but don't
get into a debate or
argument--it doesn't help.