Teen substance abuse: Lots of questions, no easy answers

With a Propel bottle full of Malibu rum in her bag, Leticia sat through high school programs that warned her about the dangers of drinking.

But her spiral into alcoholism, then drug addiction, began years earlier.

She was 8. She walked in on her dad having sex with her nanny on the family room floor. He begged Leticia not tell her mom, but she did. The nanny was fired, and her parents stayed together.

Leticia, now 22, started her story there. She didn't exactly know why. It just felt connected to her alcoholism and marked when she started feeling "yucky."

Her childhood wasn't bad.

"My mom is very loving. My dad is very loving," said the Alcoholics Anonymous member, who asked that her last name be withheld.

For Leticia and others like her, the roots of her substance abuse are more complicated than having a troubled childhood.

For parents of teen substance abusers, the question of why their children crossed into addiction is haunting.

Mike placed his son, Allen, into substance abuse treatment when he was 18. Five years later, Allen still struggles with drinking and taking pills. He attends AA for his dad. They're both regulars at weekly AA meetings for youths held at a small downtown commercial space. It's always on Friday nights.

As a father, Mike didn't set a zero-tolerance alcohol policy for Allen. He reluctantly accepted what he thought was unavoidable: Las Vegas Valley teens confronted with temptation will drink.

Then his son "got in trouble with the law."

"Before that, I did what 99 percent of parents probably do: chalked it up to 'That's what they do at that age,' " Mike said.

Teens and their parents aren't the only ones who struggle with the ramifications of underage drinking.

Clark County trauma surgeons see the damage done while mending juvenile drinkers mangled in car accidents. Emergency room personnel work to minimize the impact of binge drinking as they treat alcohol-poisoned teens. Police called to break up house parties force juveniles to face the legal consequences of imbibing. And psychologists keep working to identify what makes certain teens more susceptible to substance abuse than others.

CONSEQUENCES CAN BE FATAL

Critical care surgeon Jay Coates doesn't go a week without seeing a bleeding teen on his table because of an alcohol-related car crash.

"It's incredibly common," said the 11-year University Medical Center trauma surgeon. "More so than people think."

The Clark County coroner's office tracks underage deaths related to alcohol, but only when it's the direct cause, as in cases of alcohol poisoning. Fatalities resulting from drunken car wrecks don't fall in that category.

Four underage alcohol-poisoning deaths occurred in 2011. Between zero to three deaths for those under 20 happened in previous years dating back to 2006.

The lucky ones are dragged into UMC's emergency room and laid before doctors like Dale Carrison, head of ER services. He can't do much. Pumping their stomachs often has little effect. If their friends are worried enough to bring them to the ER, the alcohol has already impaired their systems.

His patients - sometimes as young as 13 - either come back or not. All Carrison's staff can do is insert an IV and hope the alcohol isn't too much for their body to metabolize, which may take 20 hours. They're also at risk of choking on their own vomit. A tube down their throat ensures safe breathing.

"Near fatal levels of alcohol" led to the death of 17-year-old Bishop Gorman High School student Brady Caipa on Oct. 30, but it didn't kill him, according to Clark County Coroner Michael Murphy. He said Caipa's ability to breathe was compromised. Murphy would not specify how, but gave the example of breathing being blocked when the head rests on the rim of a sink or a trash can.

Scenarios like this weigh heavily on Carrison, who tells each recovering patient how he blacked out after binge drinking at age 16 and almost died.

"Don't tell me I don't know," he tells them. "But they don't listen to an old man."

In his 24 years of experience, only two came back, shook his hand and said thank you.

"Better than zero."

Others have returned on gurneys. He understands the pressures, remembers wanting to be one of the guys and setting priorities that seem silly in retrospect. "It's not easy growing up. Nothing makes sense."

The most recent High School Youth Risk Behavior Survey of the Centers for Disease Control and Prevention found in 2009 that one in four Nevada high school students admitted catching a ride with a driver who'd been drinking in the month before the survey. One in four also reported drinking more than a few sips before age 13 and binge drinking. These figures aren't much different nationwide. Binge drinking was defined as having five or more drinks in a row within a couple hours, which is the main culprit of alcohol poisoning.

CONFRONTING THE PROBLEM

A student's death over summer break changed the rules at Faith Lutheran Junior/Senior High School.

According to parents with knowledge of the summer 2010 incident, a student rented a party bus and drinking ensued. On board, an incident occurred that embarrassed a male student into later killing himself.

"We had a defining moment where we had to make a decision," said Steve Buuck , who was principal at the time and is now CEO of the private school.

He didn't want to talk about the 2010 incident but did recount the school's reaction. Beginning with the 2010-11 school year, Faith Lutheran prohibited students from taking party buses or limos to school functions. Party buses, unique to cities like Las Vegas, can be as large as charter buses. They can come equipped with couches, stripper poles, mirrored ceilings and blacked-out windows.

"You and I both know nothing good happens there," Buuck said.

Faith Lutheran's new rule had an immediate impact. Before 2010-11, only a dozen students would stay at dances, Buuck said. The rest came to have their pictures taken and left.

"The bus became the dance," he said. But now the school holds packed, chaperoned dances. Once students leave the event, they can't return, he said.

But Faith Lutheran has just a fraction of the area's high school students, 88,000 of whom attend class in the Clark County School District, the country's fifth-largest school system. The district has no rules against the use of party buses or limos, spokeswoman Amanda Fulkerson said. It has alcohol education programs, but no universal requirement for alcohol education.

Also in 2010, Las Vegas police organized a unit to crash house parties. The goal wasn't just to stop underage drinking, but also to reduce the violence that can unfold at such events.

The unit's creation was a response to two 17-year-old girls who were shot and killed at separate parties that year, Metropolitan Police Department spokesman Bill Cassell said.

The patrol was disbanded because of budget woes. However, Cassell said, it was successful and the tactics that the unit developed for locating parties have been taught to all officers.

Those skills come in handy this time of year. Summer break is the peak of underage partying, he said.

HITTING THE WALL

By the time Leticia was in middle school, she was skipping class with friends to smoke marijuana and drink alcohol stolen from their parents.

"The feeling of losing yourself in something was amazing to me. My feeling of uneasiness went away," said Leticia as she cracked her knuckles. She's fidgety, and as she tears up a sticky note, a tattoo on her inner wrist becomes visible. It reads "Yolanda" in sweeping, script letters.

It's the name of her 15-year-old sister who she said was murdered. By who, her family still doesn't know. She admits to using Yolanda's death as an excuse to experiment with stronger drugs. If others questioned her odd behavior, she played it off as mourning.

Stressful events early in life may place juveniles at risk for substance abuse later in life, according to University of Nevada, Las Vegas psychologist Laurel Pritchard.

Her research, and that of others in the field, have shown that traumatic events during childhood make people more susceptible to the effects of drugs later in life. They often transition faster from casual use to dependence, she said. Why is unclear, Pritchard said. Traumatic childhood experiences connect many AA members.

"It's how we feel inside that we share," said Michael, 20, a recovering alcoholic. "Everyone either didn't fit in, or something changed their lives and they picked up a bottle to deal with it."

Michael, who also abused drugs, has been clean since he overdosed in his father's kitchen at breakfast more than a year ago.

"I was falling all over the place," Michael said. His father couldn't see his problem. He asked Michael if he was eating enough.

"I always told him I was tired," Michael said. "He'd be sleeping on the couch and I'd have a needle in my arm in the bathroom."

Michael used to live with his mother and drank on weekends. After she died within a month of being diagnosed with cancer, Michael, then 17, moved in with his dad, who didn't condone partying, weekends or not.

He rebelled.

"Pot, then pills, heroin, putting needles in my arm. I wanted to try everything. I didn't care what happened to me," said the thin, baby-faced man.

The fall into drugs can be effortless for some teens, said Jack, manager of Las Vegas AA and a member for 43 years. A lot of kids don't make it in AA "because they're kids," he said. But, "Every once in a while, you get one who runs against a brick wall and says, 'That's it.' "

It took years for Leticia to hit that wall. She didn't reach it until she moved from drinking and pot to pills, left her parents' home and turned to exotic dancing after high school to pay for heroin and crack.

"My mom didn't know what to do, so she didn't do anything," Leticia said.

Several people told her about AA, but she didn't listen.

"They went in to save me from a burning house, but I didn't want to be saved," she said.

But pleas from her family got to her. "I thought, I can either change my life or end up another dead sister."

That led to three days in a detox center and a month in a rehab house, where she relearned the simple tasks of living. "I don't know who I am yet. I'm new to this sober thing," Leticia said.

She started to remember things, horrible things, like overdosing at her best friend's house party.

"She gave me mouth to mouth," Leticia said.

She's recovered dozens of memories like that, moments where she teetered on the edge. A slight change in events, a faint flick of the finger would've pushed her over.

When Leticia received her one-year-sober chip in December, she was astounded by her accomplishment.

"One year!" she marveled. "Like all those days in a row. In a row!"

Six months later, she's still clean and attending AA. She works as a karate instructor. She said in June, "I've learned how to get in touch with that good voice."

Contact reporter Trevon Milliard at
tmilliard@reviewjournal.com or 702-383-0279.