…with apologies to Bill Shakespeare...
Let's face it, as a parent of a teenager, you likely have enough battles on your hands. Asking your teen to take a drug screen is probably way down on the list of things you'd like to do. But if you suspect your teen is using drugs, how can you know for sure? You could ask them I suppose. You might get the truth... but if your teen is using drugs, it's all but guaranteed that you won’t.
If you suspect your teen may be using drugs or drinking and you're making an attempt to do something about it, you're already doing a great job. A desire to help your teen make positive decisions and avoid negative consequences is, of course, the hallmark of good parenting. But like anything we want to accomplish, we need to have a plan. We also need to involve our teen in the creation of the plan. Granted, your teen may refuse to cooperate. That's OK. What’s important though, whether they cooperate or not, is that they know we have a plan and that we intend on following through with it. Before we move on, however, a question. Are you committed to following through with holding your teen accountable? If you can't be 100% sure you’ll follow through, don't try it. If you don't follow through, you’ll be showing your teen that you can't or won’t hold him or her accountable. So, let's talk about what that plan might look like.
The subject of drug testing creates a lot of very strong feelings for many people. Some view drug testing as an invasion of privacy, others (especially teens) will say that if you drug test them, you obviously don't trust them. This is typically a rouse to get you on the defensive. If it works, you'll suddenly find yourself professing how much you do trust them instead of continuing to discuss their potential drug use. But, like it or not, drug testing is THE ONLY WAY to be certain that your teen is not using drugs.
Teens who use drugs become adept at hiding their use, masking their intoxication, and covering their tracks. If you don’t drug test, you'll most likely have to stumble upon drugs in their pockets to find out. Just to provide an example, I was masterful at hiding my own drug use in my adolescence... much to my eventual misery. My parents were super-smart and very alert people.. but they probably didn't really want to find out I was using and I certainly wasn't going to volunteer that information. So... you have to drug test your teen if you want to know. If you're reading this and you’re thinking you really don't want to know or that it’s just too hard to tackle this issue, let me assure you that you can do this.
The plan itself is relatively simple. Your teen submits to random and ongoing drug screens as long as you have even the slightest suspicion he or she may be using drugs. If they refuse to take the screen, you count that as a positive result. If they have a positive result, there are specific consequences tied to this. In this way, you're modeling the real world for your teen but without the harsh penalties often imposed by the justice system. You, as parents, formally enact a "Family Substance Abuse Policy" that applies to all kids in the home. The point of this policy is to make it more unpleasant for your teen to continue to use drugs than it is to stop. Now, having said all that, if you think your teen has moved beyond experimentation or use tied hand-in-hand with defiant and rebellious behavior, you need to get professional help. Like now...
1. Take your teen to a counseling center or other facility for drug screens. Make sure this facility sends these tests off to a certified lab and can give you a report of the levels of most any substance in your teen's urine. This will come in very handy... especially with marijuana use.
2. Along those same lines, DO NOT use home dipstick tests and DO NOT just let your teen take a cup and go in the bathroom. You or the facility staff need to literally watch them urinate in the cup. There are plenty of ways to fake a clean screen and dipstick tests are VERY easy to beat.
Maybe it's just me... but when a kid comes to see me, having already been given an ODD diagnosis, I'm immediately suspicious. Why? In my experience, there's almost always another problem that better explains the child's behavior. I'll get into that in a sec. First, let's talk about the ODD diagnosis itself. Rather than list out all the criteria for the diagnosis, I'll just list the 3 core categories: Angry/irritable mood; Argumentative/defiant behavior; and Vindictiveness. These symptoms need to have lasted for at least 6 months for a diagnosis. I think this sums up the diagnosis well without getting too far into the weeds.
One of the problems with the ODD diagnosis is that it's tautological. In other words, someone has ODD because they're oppositional and irritable... why are they oppositional and irritable? Because they have ODD. See how that works? It's often the case that therapists giving a child an ODD diagnosis have missed less prominent symptoms that may better explain a child's behavior. ADHD, depression, bipolar disorder, and others can absolutely cause the behavioral and emotional problems seen in ODD... especially if these conditions are untreated.
Let's be clear though, ODD is a valid diagnosis. Is it often mis-diagnosed? Yes. Are there typically underlying issues that account for ODD behavior and emotions? In my experience, yes. ODD is what we in the mental health profession often call a "catch-all" diagnosis. It's too broad and vague in its criteria. Because of this, kids with other conditions that may mimic ODD symptoms are "caught" in the diagnosis.
The moral of the story is this... If your therapist discusses giving your child an ODD diagnosis, ask a lot of questions. Ask about other conditions that can cause the behavioral and emotional problems seen in ODD. Ask your therapist to rule out these conditions prior to giving your child an ODD diagnosis. After all, the initial diagnosis tends to drive treatment, and being on the wrong road can get you lost fast.