Once the issue of confidentiality has been cleared up, it is important to take a family history. Ask about alcohol or drug problems, prescription or nonprescription. Include the grandparents, uncles, aunts, brothers and sisters, and cousins, as well as the parents. Other important parts of the history include asking the adolescent how he spends his time. Ask him to describe a typical day. Ask what he and his friends do Saturday night. Ask about his peer group, about their age, activities, drug and alcohol use. Ask how they are seen and described by other groups in the high school, and then ask about his own use of drugs and alcohol. Ask about parental relationships. Ask about sleep, appetite, depression.The fact that adolescent alcohol abuse can go on for as long as 6 years without being diagnosed is a tribute to the ability of these adolescents to hide their problems, to the ability of parents to avoid recognizing problems in their children, and to the ability of school systems to ignore or expel problem children. It is not unusual for parents to be actively protecting, rescuing, and taking care of a substance-abusing adolescent without realizing that this supports and prolongs the abuse. They make good on forged checks. They hire lawyers or pay to have legal charges dropped. They go to bat for them at school or blame school authorities for the problems. In our experience, parents must stop protecting these children and seek help for them instead.When asking about drug and alcohol use begin by asking about the first time he or she was drunk, how much they drink now, how often, if they have ever tried to stop or cut down. Ask about blackouts, legal problems, and school problems. Finally, don’t assume that an adolescent is providing a wholly accurate history about drug and alcohol use. Denial is a central characteristic of adolescent alcohol or drug abuse. It is important to get information from parents and teachers whenever you are concerned about adolescent alcohol or drug problems.*151\331\2*

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