Reaching for a New High: The Salad Bowl Syndrome

Dr. Niru Prasad

Have you ever heard of the "salad bowl" syndrome? If you are the parent of a teenager, and you notice your salad bowls missing from the kitchen, please check your teenagers bedroom closets. You may find these bowls stacked up with stolen medication pills that have been taken from parents or grandparents. These may even be color-coded. In the past year, there has been an increasing trend of prescription drug abuse among our adolescents. As more prescription drugs fill our medicine cabinets, our kids have more of a chance to abuse them. Last February, I had the opportunity to visit Cancún, Mexico. On the day I arrived at the resort, I was sitting in the lobby and observed an airport shuttle drop off a group of about 20 teenagers.

They appeared to range in age from 16-18. Later that afternoon, while I was relaxing at the beach, I saw the same group of teenagers. I noticed that most of them were carrying their own "salad bowls" filled with what I thought was different colored candy. They were tossing the bowls around and passing them back and forth to one another. A few of them were also popping the "candy" in their beer bottles.

My curiosity grew more and more since these kids were loud, laughing, giggling, and appeared to be getting very high. When I got closer to the kids, I was shocked to see that what I thought was candy was actually medication - all color-coded in their salad bowls. Sadly, experimentation with drugs and alcohol among teenagers is very common due to their growing curiosity, peer pressure, and the availability of drugs.

After having researched the topic, and visited correctional facilities for drug rehabilitation, I have arrived at certain conclusions regarding adolescent drug abuse that I would like to share with you.

Teenagers at risk for developing serious alcohol and drug problems include:
• Children with a family history of substance abuse
• Children who are depressed or have low self-esteem
• Children facing extreme peer pressure

Commonly abused drugs include:
• Alcohol
• Tobacco
• Marijuana

Non-prescription drugs such as ephedrine, over the counter sleeping pills, Benamonly prescribed medications for them or their members such as Ritalin, Adderall, Oxycontin, Codeine, Vicodin.                                                                                                                                                                                   

Inhalant abuse among children is also gaining popularity due to its ease of use through the nose. Inhalants are known by such street names as huffing and sniffing. The dangerous habit of getting high by inhaling fumes of common household detergents such as, ethanol, methanol, helium balloons, etc. has been responsible for the immediate deaths of thousands of these children every year due to lung and brain damage.                                                                                                                 

Crack is a powerful addictive stimulant that is an inhalant form of cocaine. Although crack is used to get a quick high, prolonged use leads to drug dependence, aggressive behavior, and malnutrition.                                                                                                                                                                                               

Club drugs: this term refers to drugs being used by teens and young adults during all night parties known as "raves" and "trances". Methamphetamines, LSD, and ecstasy are some of the party drugs that are gaining popularity since most of them are colorless and tasteless and can easily be added to beverages to increase euphoria. There has also been a significant increase in anabolic steroid use among our athletes.                                                                                                                         

Recently, there have been many reported deaths due to an overdose from a deadly mix of heroin and a potent painkiller called fentanyl. The heroin/fentanyl cocktail has alarmed law enforcement officials in major cities where authorities claim the cocktail mixture is being used to initially make users euphoric. The use and abuse of heroin laced with fentanyl is getting very serious. Fentanyl is a synthetically manufactured pain medication 50 to 100 times more potent than morphine.

Signs of early regular use include:

1. Heavy use of perfume or aftershave to mask the smell of smoke
2. Alcohol on breath or use of breath freshener or gum
3. Diminished interest in social activities held at school, church, or with family
4. Morning-after fatigue
5. Unusual thirst
6. Midnight vomiting

Signs of regular use or beginning drug dependency:
1. Loss of appetite, craving for sweets
2. Possession of drug paraphernalia such as rolling papers, pot pipe, or cellophane "baggies" (usually indicative of marijuana use)
3. Loss of eye contact during conversations
4. Red eyes, frequent use of eye drops, dilation of pupils
5. Burning incense and heavy use of perfume in the room
6. Finding reasons not to be home after school
7. Strange phone calls, vagueness about activities
8. Major drop in school performance

What are the treatment plans?
1. Parents can help through early education about drugs, keeping their own medication controlled, open communication, good role modeling, and early recognition of the problem
2. Since the decision to get treatment is serious, parents should seek help from mental health professional and act accordingly
3. There are a few important factors to remember:

a. It is very important to match the treatment setting, intervention, and services to each individual's particular problems and needs
b. Effective treatment should focus on multiple needs of the individual, not just drug abuse
c. The treatment duration should be prolonged until recovery
d. Counseling individuals and group therapy are critical components of effective treatment
e. The person should have a strong motivation and positive attitude towards life, and lastly, it is important to know that an addicted individual may require prolonged and multiple episodes of treatment to achieve long-term abstinence and fully restored functioning