Teenage Drug Use: When There's a Blurred Line Between 'Fun' and Fatal

“I’ve got two tabs of acid in my car.” He lobs this fact across the coffee table at me with a bashful smile that spreads in slow waves to the edges of his face.

I roll my head back and groan. We’re not friends and I’m not amused.

“Ethan*, why are you telling me this?”

“What’s the point of coming here if I don’t tell you the truth?”

I give a half-shrug. “But why that truth, Ethan? Why do you want me know about the acid?”

His thick, unruly curls lend a boyish look to his 6-foot-3-inch frame. He turns his head in search of distraction and notices the paint swatches on my desk.

“You redecorating, Doc? I like the blue. My mom’s an interior designer and she says blue relaxes people. It’s like Zen or some shit.”

Ethan gets under my skin in a way I can’t quite pin down. He’s both offensively arrogant: “This ain’t my first rodeo, Doc. I know how this therapy thing works,”and heartbreakingly vulnerable: “Can I get a piece of paper? I want to write down what you just said.”

When he was 11 years old and jumping around in the backseat, his mother punched him in the face so hard she broke his nose. Late for a business trip, she dropped him at school with a napkin for the blood. “Stop crying, Ethan. Your friends will think you’re a baby.” Ethan didn’t see his mother for a week and the incident was never discussed. When he tells stories like this, I have to fight the urge to hug him like I would my own child.

“Why’d you tell me about the acid, Ethan?”

“I don’t know. Because I’m going to the beach this weekend and I’m gonna trip my balls off?” His smile fades as he looks up. “Seriously, though. You ever tripped?”

I could tell him about the time I took mushrooms in college and went snowboarding. How it took us two hours to buy lift tickets because we couldn’t stop laughing. How the snow looked like pixie dust and how I dominated the black diamond slopes like Shaun Palmer. How later I learned I had merely lumbered down the bunny hill.

I want to tell him: I get it. Drugs are really fun. Right up until they’re not. I want to tell him about James.

“Ethan, I’ve known other people who thought they were having fun with drugs until the drugs caught up with them. I don’t want that to happen to you.”

“You think I have a problem, don’t you, Doc? You think I’m an addict.”

Ethan is taking a gap year because his Ivy League admission was rescinded following his expulsion from high school for drinking on campus. So problem? Yeah. Addict is tougher to define.

“It’s interesting you use the word addict, Ethan? What do you think?”

“I think I don’t like being sober. Do you?”

I meet his third deflection with what I hope comes across as a warm, nonjudgmental smile. After a few moments, he can’t take the silence.

“Look, Doc, I know when I need to be sober. I got a 3.8 last semester. Now I have two jobs and I never miss a day. I work hard!”

He leans forward, palms up, like a defendant on the stand. In his mind, I am both judge and jury. He doesn’t know how often I second-guess myself with him.

“Let’s review, Ethan. How come you’re not in school right now?”

He drops his gaze. “Because I’m unlucky, Doc. I’m always the one who gets caught.”

“Unlucky?” I ask, surprised by the sharpness of my tone. “Ethan, if you speed one time and get caught, that’s unlucky. If you speed every day for a year and get pulled over, that’s the Law of Averages catching up with you.”

At 19, Ethan is neurologically an adolescent. His pre-frontal cortex, the part of his brain controlling reason and planning, is still developing and trumped by the hormone dopamine, which triggers feelings of happiness when taking risks. Since he is legally an adult, I can’t disclose his risky behaviors, unless he reports a plan to intentionally harm himself. So I ask him.

“Are you trying to kill yourself, Ethan?”

“What? Doc, No! I’m just trying to have fun. Don’t you ever just want to party?”

I think of the Halloween party turned real life horror show the night James killed himself. Everyone had taken mushrooms. Costumed and perma-grinning from the drugs, we were dancing to House of Pain’s “Jump Around” when we heard the shot.

“I know you miss your friends, Ethan, but this party sounds ripe with opportunity to get ‘unlucky’ again.”

“Come on, Doc. Don’t tell me not to go. I really need this.”

Professionally, I can’t grant or deny permission. I can only point out the conflict between his goals and behaviors. His goals include graduating from college, landing a job that pays him shitloads of money and marrying Gisele Bündchen. (Remember, he’s 19). I ask him a series of questions and together we develop an algorithm that looks something like this: (lots of) drug taking equals getting kicked out of school, which equals no college, a crappy job, no money and living in a rusty van, down by the river.

“I get it, Doc. I do. Living in a rusty van does not equal dating supermodels.”

We laugh. He leaves. I have no idea if our conversation landed. As I type up the session notes, my fingers pause on the word progress. Has Ethan made any tangible progress? Am I helping him? My mind catapulted to my own child, who is still in diapers. The mother in me wished I’d grabbed Ethan by the shoulders and wrapped my arms around him in the same way I’d embrace my toddler to stop him from stumbling down the stairs.

I consider my college friends. Like Ethan, we partied, but then we graduated, cultivated careers and traded in the partying for potty-training, except James. He couldn’t stop and we hadn’t seen his pain. No drug could blunt our anguish that Halloween night. Our once-festive costumes drooping and our party make-up gruesome from hours of crying, we watched uniformed men carry him down the steps in a body bag.

Is Ethan like us or like James?

I pick up the paint swatches and worry I let Ethan leave too quickly. Should I have yielded to my maternal instincts and told him directly not to go to the party?

“I forgot my umbrella.” A voice at the door shakes me from my thoughts. “You OK, Doc? I know that face. You’re torn, aren’t you?”

“Excuse me?”

“Go with the blue. Definitely the blue. See ya next week.”

*Name has been changed.