Addiction seems to be at an all-time high in the United States. According to the Centers for Disease Control and Prevention (CDC), there were over 81,000 deaths from drug overdoses in a 12-month period ending in May of 2020, the highest number of deaths from overdose ever recorded in a 12-month period. At the same time, there are indications that depression and suicide, especially among young people, are also on the rise.

The good news is that there are concrete steps that families like yours and mine can take to help our children live their best lives and not succumb to addiction.

Though some aspects of addiction are out of our control — like genetics and peer-pressure — we parents can set the stage for an addiction-free life. This is not to say that parents are at fault if our children become addicts. We’re not, but there are several very clear things that we can and should do to mitigate the risks.

1. Avoid Epidural Anesthesia During Childbirth

Even women who want a natural, non-medicated childbirth are often urged to accept epidural anesthesia. That’s what happened to me during the birth of my first child. What my doctor and the labor and delivery nurses didn’t tell me was that epidurals contain a cocktail of pain-relieving drugs that often includes fentanyl, a highly-addictive and fast-acting opioid.

Indeed, epidurals contain a combination of drugs: an anesthesia like bupivacaine, chloroprocaine, or lidocaine, and an opioid narcotic like fentanyl, morphine, or sufentanil.

There has been a lot of media attention about the dangers of fentanyl. Just this month a grieving mom in Texas bought a billboard to warn parents after her 22-year-old daughter died from taking just one pill. But very little has been written about how exposing newborns during labor to highly addictive drugs may prime them for drug addiction later in life.

We don’t have good longitudinal data. It is simply assumed to be safe. But we do know that the FDA does not recommend babies be exposed to fentanyl, that health-conscious expectant moms would never take fentanyl or heroin during pregnancy, and that in 2015, scientists at Columbia University in New York found the use of epidural is associated with changes in the volume of an infant’s brain.

I don’t know about you but that’s enough to give me and my colleague and co-author, Dr. Paul Thomas, M.D., a pediatrician based in Portland, Oregon, pause. We both recommend that to give your baby the best start in life and to avoid potentially priming your baby’s brain for addiction, it is safest and best to stay away from opioid pain relievers during labor.

2. Foster Routines, Not Chaos

Chaos is a key aspect of addiction. Though addiction crosses gender, socio-economic, and racial boundaries, it is also true that children who come from chaotic homes are more likely to succumb. Young people who become addicted are often inadvertently recreating the drama, dysfunction, and chaos of their early lives.

However, there is no avoiding the fact that children are chaotic. We humans are messy emotional beings who create chaos as we are learning and growing and developing. It’s your child’s job, in some ways, to push back against the rules, test the boundaries, and pitch fits. But as parents, we can mitigate the chaos inherent in the human experience by providing structure and boundaries in our childrens’ lives.

Children thrive off of routines (it turns out adults do too). When we know what to expect on a day to day basis, we feel less stress and a greater sense of security. So be sure to implement healthy routines with your children from a young age. Having a fixed bedtime and a bedtime routine is especially important. Your children will feel a sense of safety if you make sure they get ready for bed at the same time each night and in the same order. Try to start your bedtime ritual 45 minutes to an hour before the sun goes down. So, depending on the time of year, a healthy bedtime routine for toddlers and young kids might go something like this:

  • 7:00 pm: Put on pajamas
  • 7:05 pm: Brush teeth
  • 7:10 pm: Read two books out loud
  • 7:30 pm: Sing lullabies
  • 7:35 pm: Sleepy massage
  • 7:40 pm: Lots of sleepy kisses and lights out

If you are blessed with obstinate children who challenge you at every turn, find creative ways to implement your bedtime ritual. Be loving and firm but not authoritarian. Have a race to see who can get their PJs on first (let your toddler win). Play “Who’s In Your Mouth?” as you brush their teeth (“There’s Winnie-the-Pooh on the top, let me give him a good brush! Oh, wait, I see Tigger on the bottom over there!”). Make bedtime loving and fun even as you stick to a schedule.

3. Eat Dinner as a Family

Food matters. Lifestyle choices matter. When we humans are healthy and thriving, eating well and getting enough sleep (see #2), we’re less likely to turn to abusing drugs and alcohol.

What’s also true is that many — perhaps most — Americans stand at the open refrigerator and shovel food into their gullets instead of taking our time, enjoying supper as a family, and expressing gratitude as we eat.

Not only is it helpful to eat dinner together every night, or as often as possible, it is also important to encourage your children to do chores and help prepare meals. Even the youngest children can join you in the kitchen. Participating in the household upkeep in age appropriate ways, as Christine Gross-Loh writes about in her book, Parenting Without Borders, gives children a sense of responsibility and a feeling of connectedness. Both these feelings help protect against future addiction.

In today’s busy, work-oriented world, it is easy to skip meals and rationalize being absent during dinner. Don’t do that. Instead show up for your family as often as you can, even when your kids (and your spouse) are driving you crazy.

Think about it: alcoholics often hide their addiction and drink alone so no one will know how much they’re actually drinking. Food addicts often use the same tactic. Eating together as a family is a way to get your children in the habit of enjoying healthy food together as well as being with emotionally healthy and available loved ones who care about them and see them for who they are.

4. Talk Openly About Addiction

When your children are old enough to ask questions, answer them honestly. If addiction has harmed your family, let them know. Don’t glorify drinking or drug use by bragging or boasting about all the times you were drunk or high and all the funny albeit stupid things you did while you were in that altered state. Instead talk about your feelings about addiction and your worries and concerns.

Depending on the age of your children, you might open a conversation at the dinner table (see #3) about addiction with something like this:

“I just finished reading A Beautiful Boy. The book made me really sad. It was written by a father who went through a really bad divorce, got remarried, and had two more children. His oldest son started smoking marijuana when he was only twelve and then spiraled down into drug addiction. He ended up becoming a meth addict. And his dad felt so, so bad. Which is why he wrote a book about it.”

Or you could say, “I worry because Dad’s mom is an alcoholic and I read in the paper about a 13-year-old girl who died of alcohol poisoning…What would you do if you were at a sleepover and someone offered you a drink?”

If you start a heart-felt, open-ended conversation, be sure to listen without judgment. If your child confesses that they know someone who has been drinking, for example, don’t attack that child or their family. Instead ask more questions and tell your child or children how you feel. You might share that it makes you really sad to hear that Sierra has been sneaking alcohol out of her parent’s liquor cabinet. A judgmental or punitive attitude will shut down the conversation, and you want your children to be honest with you.

As your children get older, it’s important to keep open the lines of communication. Don’t plan to have just one conversation about addiction and how to avoid it. Make it a point to talk honestly and openly about hard topics like this at least once a week.

5. Find Healthy Joyful Activities for Your Kids

The more healthy interests a child has, the less likely they will become addicted to drugs, alcohol, video gaming, and the like as a teenager or later in life. We humans have a need to connect with others. When we form strong bonds outside the family with people who love the same things we do, it protects us against addiction. This is why it’s good to help your child find a sport they love, play a musical instrument, or learn to do art.

It’s not about over-scheduling your child or wanting them to be the “best” or to “achieve.” Don’t make the mistake of always pushing them to excel. (Children who are pressured in this way will often “make their parents proud” and be high achievers at the cost of their own mental health, a problem which will come back when they are older, often in the form of depression or addiction or both.)

It is about helping your children find interests — bowling, drawing, European cultures, a foreign language, hip hop dance, martial arts, outdoor survival skills, reading, rock climbing, watercolors, writing…the possibilities are endless — that make them feel happy, introduce them to other well-adjusted people of a variety of ages, and satisfy the very human need to belong in a healthy way.

Jennifer Margulis, Ph.D., is a science journalist based in Oregon and co-author, with Paul Thomas, M.D. of The Addiction Spectrum: A Compassionate, Holistic Approach to Recovery. Sign up for her free weekly email and learn more about her work at www.JenniferMargulis.net.

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