1. What defines an addiction?
Criteria for a substance-related addiction include, amongst other things, a strong to compulsive urge to use a substance, as well as a reduced ability to control when to start, how much to use 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 the neglect of other interests or social contacts in favour of substance use – which continues even though it has harmful consequences for the person affected and those around them. Addiction is not a lack of willpower, as is often claimed, but a chronic illness that cannot be cured simply like that.
Philip Bruggmann, Chief Physician at the Arud Centre for Addiction Medicine, Zurich
2. What's the story 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 young people smoking cannabis and their later use of so-called hard drugs. Of course, there are cases where people first smoked cannabis before moving on to cocaine, for example.
Following this logic, tobacco would also have to be described as a gateway drug, or alcohol – which, for most young people, is the first psychoactive substance they come into contact with. That, too, would make no sense, because it would imply that it was alcohol or tobacco that led a person to turn to other drugs later on. As I have said, no such causal link can be demonstrated for any substance.
Philip Bruggmann
3. Which substances do young people in this country use most frequently?
The latest data from 2022 show that one in three 15-year-olds had used at least one tobacco or nicotine product in the 30 days prior to the survey. The sharpest rise was observed in the use of e-cigarettes: compared with 2018 , this increased by just under 5 per cent among boys and 12 per cent among girls. Alcohol consumption remains at a similar level to before the pandemic: 43 per cent of 15-year-old boys and the same proportion of girls of the same age reported having drunk alcohol at least once in the past 30 days.
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 that, during this period, they had consumed five or more alcoholic drinks on a single occasion at least once, which is classified as 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 proportion 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's a current event – such as a commuter newspaper, a radio programme or an online article – that picks up on the topic, for example reporting on the crack scene in cities, this is a good opportunity to strike up a conversation with your child, whether at the dinner table or in the car: What did the local residents who were interviewed say about the drug scene? What problems are they facing?
As a parent, I can share what I've heard and read, or anything that's unclear to me. And I can ask: «What do you know about this?» Perhaps the child has questions too, and I don't have the answer – in which case we can look it up together. I don't need to give a lecture on drugs – there are plenty of everyday situations that provide a natural opportunity to talk about it using specific examples. At the village fair, for example, when there are dozens of different cocktails and just three non-alcoholic options to drink: what's the story behind that?
Julia Rüdiger, specialist at Samowar Prevention and Youth Counselling, Horgen district, ZH
5. How can I talk my child out of using addictive substances?
Addiction prevention services in the Canton of Zurich advise: don't just say «no»; instead, explain to your child why you don't want them to use addictive substances. And do so by relating to their everyday life, rather than warning them about long-term consequences. You could, for example, say: «I have good reasons why you shouldn't use these substances.» A few concrete examples are:
- You're protecting your brain from damage. It develops rapidly during puberty and is much more sensitive to substances than an adult's brain.
- People who regularly use addictive substances die younger and are more likely to become seriously ill. Nicotine, cannabis and alcohol are highly addictive. This leads to problems: when people are under the influence, there are more accidents, arguments, fights and rapes.
- People who drink or smoke cannabis regularly find it harder to concentrate and often run into problems at school or in their apprenticeship.
- Addicts always want more. That costs money, and you don't have that money for other things.
- Tobacco products cause wrinkled skin and brown teeth, and other substances can also make you look older. Without them, you'll stay fitter and look better.
- The tobacco and alcohol industries make money from addicts – do you want to give them your pocket money?
Addiction prevention services in the Canton of Zurich, parents’ leaflet «Alcohol, Cannabis, Nicotine» (quoted here in a slightly abridged form)
6. My child uses addictive substances at least occasionally, even though I don't approve of it. How should I deal with this?
I try to strike up a conversation and tell him that I don't approve of his drug use. At the same time, I listen and take an interest in what ’s motivating him. I insist on rules that are important to me – such as no drug use at home.
If it seems that smoking cannabis is a way of coping with distressing emotions, alternative coping strategies should be discussed.
Nina Kalman, specialist at Samowar Prevention and Youth Counselling, Horgen district, ZH
It is particularly useful to discuss safer-use guidelines with older teenagers – guidelines that specialist organisations have drawn up for various substances: For example, eating properly if a boozy party is coming up later, and drinking water in between; ensuring cannabis is properly mixed and smoked slowly; or making use of the services offered by drug-checking centres, which carry out free pharmacological tests on psychoactive substances to minimise the risks for young users.
Nina Kalman, specialist at Samowar Prevention and Youth Counselling, Horgen district, ZH
7. How should I react if my teenager is hanging over the toilet after the party?
Then, to quote Tom Jones, the first thing called for is «Tender Loving Care»: put the child to bed, set out a basin, offer them some water. Now is not the right time to talk. Anyone who is wringing their hands in frustration should pause for a moment: what does it mean that my child is seeking refuge at home? Or rather: what if they were to go somewhere else in this state?
Of course, the whole thing is no cause for celebration. But it's good that we're the safe haven our child turns to in their time of trouble. Once the hangover has passed, it's time to ask a few questions: What happened? What triggered this experience? How can you make sure the next party goes off without a hitch?
Kinga Gloor, psychotherapist and deputy head of the Counselling and Treatment Department at the Centre for Addiction Disorders (FABB), Bülach, Zurich
8. I've been rummaging through my teenager's things and found some cannabis. What should I do now?
Don't bombard the child with accusations; instead, take a deep breath and observe: what's my impression of them? Do they socialise and have interests? Do they take part in family life? Are things going reasonably well at school or in their apprenticeship? Then it's important to find out their side of the story – at a quiet moment. Be honest: «I had a look around your room and found some cannabis. I'm sorry for invading your privacy. I did it because I was worried.» The child should know: «This isn't an interrogation; I'm interested in how you're getting on.» They'll have their reasons for smoking cannabis.
Sincere, open questions can help you get to the bottom of this: What benefits do they see in it? When and with whom do they use it? If it's about having fun and experimenting, and if my child seems stable and well-integrated socially, that's a good start. If you get the impression that smoking cannabis is a way of coping with stressful feelings, alternative coping strategies should be discussed. A specialist service can also help with this. If teenagers are reluctant to go, parents can seek advice themselves. This helps to make sense of the situation and, if necessary, plan further steps.
Nina Kalman
9. How do I broach the subject with my child if I have a nagging feeling that drugs might be involved?
I don't like beating about the bush, so I've always told my teenagers straight out that their behaviour worries me or raises questions – and that it's my responsibility to address these issues. Whether it's a child smoking cannabis, having recently had too much to drink, or pills being passed around at a party. These are issues that are relevant to their development.
For some people, using it just ten times is enough to become addicted, whilst others are still not addicted even after a hundred times.
Wolfgang Sommer, addiction researcher
I used to want to know whether they'd brushed their teeth or put on their bike helmet, too. Parents often think they'll be rewarded if they handle these conversations the right way. Unfortunately, the child is unlikely to thank us for asking; it'll probably lead to a row. But we have a duty to keep at it. So you just 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 do that, we need to talk to each other.
Simone Munsch, Professor of Clinical Psychology and Head of the Psychotherapy Practice Centre at the University of Freiburg
10. It's said that certain substances can be addictive from the very first time you try them. Is that true?
No. There is no «addiction switch» in the brain that can simply be flicked on. It is possible that even the first-time use of a substance can cause changes in the reward system – that is, at a molecular and structural level. However, these changes are reversed if use is not continued. Addiction is a learnt behaviour that is reinforced through repetition. The number of times a substance needs to be used before brain structures change permanently and a compulsive craving develops depends on the individual, their genetics and environmental factors. For some people, using a substance just ten times is enough to become addicted, whilst others are still not dependent even after a hundred times.
Wolfgang Sommer, addiction researcher at the Central Institute for Mental Health, Mannheim; Professor of Psychiatry at the University of Heidelberg; and senior consultant at the Evangelical Bethanien Hospital, Greifswald (Germany)
Alcohol is the most dangerous drug, simply because of how widespread it is. It is so socially acceptable that anyone who doesn't drink has to justify themselves.
Wolfgang Sommer, addiction researcher
11. Which drug poses the greatest risk of addiction?
There is no one-size-fits-all answer to this. We know that people with ADHD are, due to their neurobiology, more susceptible to substances in general and stimulants such as cocaine in particular. But fundamentally, 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. So personally, I would say: alcohol is the most dangerous drug, simply because of how widespread it is. In our society, alcohol is so socially acceptable that anyone who doesn't drink has to justify themselves. What's more, it opens the door to harmful behaviour, be it senseless dares or risky experiments with drugs.
Wolfgang Sommer
12. What does it mean to set a good example when it comes to substances of abuse?
It certainly requires us to ensure that we ourselves practise moderation in our consumption and set an example by showing that, for example, alcohol can be a luxury item to enjoy with a fine meal, but is certainly not the best way to unwind after a hard day. Children closely observe the coping strategies we use when dealing with stress, conflicts and difficult emotions. I would advise families to discuss this topic regularly, to talk about what helps us to unwind, and to address worries, anxiety or dissatisfaction – 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, ZH
Smoking in secret is not a good idea. 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, do I lack credibility if I advise my child against using addictive substances? Would it therefore be better to hide my addiction?
Everyone has behaviours that aren't exactly role-modelling material. Being a smoker is just one facet of a person who is so much more than that, and can therefore certainly contribute to a child's healthy development, including with regard to addictive substances. The child will want to know why you smoke, given that it is harmful. I then explain the issue clearly and in a way appropriate to their age: that nicotine alters the reward system in my brain and has therefore made it impossible for me to give up. That this loss of control is limiting and is the best reason not to start smoking in the first place.
And that – if that's 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's not a good foundation for the openness we hope to see in teenagers.
Kinga Gloor
14. What are your thoughts on parents allowing their teenage children to smoke cannabis or grow it at home, on the grounds that this at least ensures their children are using «clean» cannabis rather than buying it on the street?
This approach is particularly problematic if parents allow themselves to be persuaded along the lines of: «Well, you can just smoke weed at home then.» In that case, there is a lack of a clear stance, which is crucial. The situation is different if parents take a firm stance on this and link it to agreements that clearly set out the conditions under which smoking weed or growing cannabis at home is permitted.
There is a difference between a crash happening twice a year and it happening for the third time within a few months.
Nina Kalman, specialist at Samowar Prevention and Youth Counselling, Horgen district, ZH
Parents must, however, be aware that they are committing a criminal offence. Personally, I would therefore advise against this approach and instead recommend discussing the safe-use guidelines for cannabis – which have been drawn up by specialist organisations – with young people. It is also helpful to have the cannabis analysed free of charge at a drug-checking centre.
Nina Kalman
15. What warning signs indicate that a young person is taking substance use too far?
A decline in school performance, unusual physical changes or changes in behaviour can be a sign: when young people who are well integrated into society start to withdraw, neglect their hobbies or hardly take part in family life any more. That said, withdrawal is also normal during adolescence. It is certainly worth taking a closer look if teachers or other key adults are also concerned. The time factor also plays a role: how long have we been observing these behavioural changes that are causing us concern? How frequently do they occur? For example, there is a difference between a relapse happening twice a year and it happening for the third time within a few months.
Nina Kalman
