1. What constitutes an addiction?
Criteria for a substance-related addiction include a strong to compulsive desire to consume a substance and a reduced ability to control when to start, how much to consume and when to stop.
Another typical feature is the need to increase the dose over time in order to achieve the original effect, as well as neglecting other interests or social contacts in favour of consumption – which continues even though it has harmful consequences for the person affected and their environment. Addiction is not a weakness of will, as is often claimed, but a chronic illness that cannot be easily cured.
Philip Bruggmann, Chief Physician, Arud Centre for Addiction Medicine, Zurich
2. What is the deal with so-called gateway drugs?
It used to be said that cannabis was a gateway drug. Today we know that there is no scientific evidence to show that there is a causal link between smoking cannabis as a teenager and later using so-called hard drugs. Of course, there are cases where people started by smoking cannabis before moving on to cocaine, for example.
According to this logic, tobacco would also have to be classified as a gateway drug, as would alcohol – which is the first psychoactive substance most young people come into contact with. This would also make no sense, because it would mean that alcohol or tobacco were responsible for a person later turning to other drugs. As already mentioned, such a causal link cannot be proven for any substance.
Philip Bruggmann
3. Which substances do young people in this country consume most frequently?
The latest data from 2022 shows that one in three 15-year-olds had consumed at least one tobacco or nicotine product in the 30 days prior to the survey. The highest increase was observed for e-cigarettes, with an increase of almost 5 per cent among boys and 12 per cent among girls compared to 2018. Alcohol consumption remains at a similar level to before the pandemic: 43 per cent of 15-year-old boys and the same percentage of girls of the same age stated that they had drunk alcohol at least once in the 30 days prior to the survey.
It is striking that 9 per cent of girls and 5 per cent of boys have mixed medication with alcohol at least once in their lives.
Monique Portner-Helfer, media spokesperson for Addiction Switzerland
A quarter also said they had consumed five or more alcoholic drinks on a single occasion at least once during this period, which is considered binge drinking. Meanwhile, around 12 per cent of 15-year-old boys and 8 per cent of girls of the same age had smoked cannabis at least once, which is the same as in 2018. It is striking that 9 per cent of girls and 5 per cent of boys have mixed medication with alcohol at least once in their lives.
Monique Portner-Helfer, media spokesperson for Addiction Switzerland
4. When and how should I talk to my child about drugs?
If there is a current event, such as a commuter newspaper, radio programme or online article covering the topic, for example reporting on the crack scene in cities, this is a good opportunity to talk to your child, whether at the dinner table or in the car: What did the residents who spoke up say about the drug scene? What problems are they facing?
As a parent, I can share what I have heard and read or what is unclear to me. And I can ask: What do you know about this? Perhaps the child also has questions and I don't have the answers, in which case we can research it together. I don't have to give a lecture on drugs – there are many situations in everyday life that provide opportunities to talk about it using specific examples. At the village festival, for example, when there are dozens of cocktail variations and three non-alcoholic alternatives to drink: what's the deal with that?
Julia Rüdiger, specialist at Samowar Prevention and Youth Counselling, Horgen district, Zurich
5. How can I talk my child out of using addictive substances?
The addiction prevention services in the canton of Zurich advise: don't just say no, explain to your child why we don't want them to consume addictive substances. And do so by relating to their world, rather than warning them about the long-term consequences. You could say, for example: «I have good reasons why you shouldn't consume these substances.» Here are a few concrete examples:
- You protect your brain from damage. It develops rapidly during puberty and is much more sensitive to substances than the adult brain.
- People who regularly consume addictive substances die younger and are more likely to become seriously ill. Nicotine, cannabis and alcohol are highly addictive. This leads to problems: intoxication increases the number of accidents, arguments, fights and rapes.
- People who drink or smoke cannabis frequently find it harder to concentrate and often encounter problems at school or in their apprenticeships.
- Addicts always need more. That costs money, and you'll be missing that money for other things.
- Tobacco products cause wrinkled skin and brown teeth, and other substances also make you look old. Without them, you will remain fitter and more beautiful.
- The tobacco and alcohol industries profit from addicts – do you want to give them your pocket money?
Addiction prevention centres in the canton of Zurich, parents' brochure «Alcohol, cannabis, nicotine» (quoted here in slightly abridged form)
6. My child consumes addictive substances at least occasionally, even though I do not approve of this. How should I deal with this?
I try to engage in conversation and tell him that I don't approve of his consumption. At the same time, I listen and take an interest in his motivations. I insist on rules that are important to me – such as not consuming at home.
If you get the impression that smoking cannabis is a way of coping with stressful feelings, alternative coping strategies should be discussed.
Nina Kalman, specialist at Samowar Prevention and Youth Counselling, Horgen district, Zurich
It makes sense, especially with older teenagers, to discuss safer use rules that specialist agencies have compiled for different substances: For example, eating properly before a boozy party and drinking water in between drinks; mixing cannabis well and smoking it slowly; or making use of drug-checking services, which pharmacologically test psychoactive substances free of charge in order to limit the risk for young consumers.
Nina Kalman, specialist at Samowar Prevention and Youth Counselling, Horgen district, Zurich
7. How should I react if my teenager is hanging over the toilet after the party?
Then, to quote Tom Jones, it's time for some tender loving care: put the child to bed, set up a basin, offer them water. Now is not the right time to talk. If you're tempted to throw your hands up in frustration, pause for a moment and ask yourself: what does it mean that my child is seeking refuge at home? Or rather: what would happen if they went somewhere else in this state?
Sure, the whole thing is no cause for celebration. But it's good that we are the safe haven our child turns to in their misery. Once the hangover has passed, it's time to ask a few questions: What happened? What triggered this experience? How can you make sure that the next party ends without any trouble?
Kinga Gloor, psychotherapist and deputy head of counselling/treatment at the Centre for Addiction Disorders (FABB), Bülach, Canton of Zurich
8. I rummaged through my teenager's belongings and found cannabis. What now?
Don't bombard your child with accusations, but take a deep breath and observe: what impression do I have of them? Do they maintain relationships and interests, do they participate in family life, are they doing reasonably well at school or in their apprenticeship? Then it's time to find out their perspective – in a calm moment. Be honest: «I looked through your things and found cannabis. I'm sorry for invading your privacy. I did it out of concern.» The child should know: «This is not an interrogation, I'm interested in how you are doing.» They will have their reasons for smoking cannabis.
Honest, open questions can help you find out: What are the advantages? When and with whom does your child consume cannabis? If it's about having fun and experimenting, and your child seems stable and socially integrated, that's a good thing. If you get the impression that smoking cannabis is an outlet for stressful feelings, alternative coping strategies should be discussed. A specialist centre can also help. If teenagers do not want to go, parents can seek advice. This helps to assess the situation and, if necessary, plan further steps.
Nina Kalman
9. How do I talk to my child if I have a bad feeling that drugs might be involved?
I don't like beating around the bush, so I told my teenagers straight up that their behaviour worried me or raised questions – and that it was my responsibility to address these issues. Whether it was smoking weed, drinking too much alcohol recently or pills being passed around at parties. These issues are relevant to their development.
For some, consuming it ten times is enough to become addicted, while others are not dependent even after a hundred times.
Wolfgang Sommer, addiction researcher
I used to want to know whether they had brushed their teeth or worn their bike helmets. Parents often think that they will be rewarded if they approach such conversations in the right way. Unfortunately, the child is unlikely to thank us for asking; there will probably be trouble. But we have a duty to persevere. So we go back and ask again. The message is clear: we need a solution so that you can enjoy your freedom and I can fulfil my responsibility to protect you. To achieve this, we need to talk to each other.
Simone Munsch, Professor of Clinical Psychology and Head of the Psychotherapy Practice at the University of Freiburg
10. It is said that certain substances can be addictive even after the first try. Is that true?
No. There is no addiction switch in the brain that can be flipped. It is possible that even the first time a substance is consumed, it causes changes in the reward system, i.e. at the molecular and structural level. But these changes are reversed if consumption is not continued. Addiction is a learned behaviour that is reinforced through repetition. How many repetitions it takes for brain structures to change permanently and cause a compulsive craving depends on the individual, their genetics and environmental factors. For some, ten times is enough to become addicted, while others are not dependent even after a hundred times.
Wolfgang Sommer, addiction researcher at the Central Institute for Mental Health, Mannheim, professor of psychiatry at Heidelberg University and senior physician at Bethanien Protestant Hospital, Greifswald (Germany)
Alcohol is the most dangerous drug, simply because of its prevalence. Alcohol is so socially acceptable that those who do not drink have to justify themselves.
Wolfgang Sommer, addiction researcher
11. Which drug poses the highest risk of addiction?
There is no blanket answer to this question. We know that people with ADHD are more susceptible to substances in general and stimulants such as cocaine in particular due to their neurobiology. But basically, we all react very differently to substances. When it comes to the risk of addiction, the extent to which a substance is available or socially accepted also plays a role. Therefore, I would personally say that alcohol is the most dangerous drug, simply because of its prevalence. In our society, alcohol is so socially acceptable that those who do not drink have to justify themselves. It also opens the door to harmful behaviours, whether it be senseless dares or risky drug experiments.
Wolfgang Sommer
12. What does it mean to be a good role model when it comes to addictive substances?
It certainly requires us to ensure that we ourselves consume alcohol in moderation and set an example by showing that alcohol can be a luxury item, for example, to accompany a fine meal, but certainly not the means of choice for unwinding after a hard day. Children observe closely the coping strategies we use to deal with stress, conflicts and difficult emotions. I advise families to discuss this topic regularly, to talk about what helps us to switch off, when we are worried, anxious or dissatisfied – and to ask the children what tips or strategies they have in this regard.
Julia Rüdiger, specialist at Samowar Prevention and Youth Counselling, Horgen district, Zurich
Smoking in secret is not advisable. The child will find out. And realise: in our family, we cover things up to avoid difficult conversations.
Kinga Gloor, psychotherapist
13. As a smoker, am I not credible when I advise my child against addictive substances? Would it therefore be better to hide my addiction?
Everyone has behaviours that are not suitable as role models. Being a smoker is one facet of a person who is much more than that and can therefore contribute to the healthy development of a child, even with regard to addictive substances. The child will want to know why you smoke when it is harmful. Then I explain the problem transparently and in an age-appropriate manner: that nicotine changes my reward system in the brain and has made it impossible for me to quit. That this loss of control is restrictive and the best reason not to start smoking.
And that, if that is the case, I want to manage to give up smoking. Smoking in secret, whether out of addiction or for pleasure, is not advisable. The child will find out. And realise: in our family, we cover things up to avoid difficult conversations. That is not a good basis for the openness we hope for from teenagers.
Kinga Gloor
14. What should we think about parents who allow teenagers to smoke weed or grow cannabis at home, arguing that this way their children will at least consume «clean» products and not buy them on the street?
This approach is particularly unfavourable if parents allow themselves to be persuaded by the argument that their children will simply smoke cannabis at home. This demonstrates a lack of clear stance, which is crucial. The situation is different if parents take a firm stance and link it to agreements that clearly define the conditions under which smoking cannabis or growing cannabis at home is permitted.
There is a difference between a crash occurring twice a year and the third time within a few months.
Nina Kalman, specialist at Samowar Prevention and Youth Counselling, Horgen district, Zurich
However, parents must be aware that they are committing a criminal offence. Personally, I would therefore advise against this approach and instead recommend discussing the safer use rules for cannabis, which have been compiled by specialist agencies, with young people. It is also helpful to have the option of having cannabis analysed free of charge at a drug testing centre.
Nina Kalman
15. What warning signs indicate that your child is going too far with substance use?
A decline in school performance, unusual physical changes or behavioural changes can be an indication: when socially integrated young people isolate themselves, neglect their hobbies and hardly participate in family life anymore. However, withdrawal is also normal during adolescence. It is certainly important to take notice if teachers or other caregivers are concerned. The time factor also plays a role: how long have we been observing behavioural changes that concern us? How intense are they? There is a difference between a slump occurring twice a year and the third time within a few months.
Nina Kalman
