known as Angel’s Trumpet or Thorn apple. This plant
It is amazing how accomplished some
behaves very much like Jimsonweed, which is also
known as “loco weed” because of the effect it has on
cattle, who accidentally ingest it. The flowers, leaves
and stems of Angel’s Trumpet contain atropine and
atropine-like substances. The most common symptoms
produced by its ingestion include agitation, spasmodic
movement, coma, drowsiness, hallucinations and el-
evated temperature. In other words, the classic symp-
toms of atropine or anticholinergic intoxication.
We later discovered that Jason’s friend also added a
little Benadryl to the mixture, further accentuating the
Sleep Problems In Early Childhood May Predict
Substance Use During Adolescence
By Maria M. Wong, Ph.D., Kirk J. Brower, M.D.,
Hiram E. Fitzgerald, Ph.D., & Robert A. Zucker, Ph.D.
Researchers know that there is a connection between
insomnia and the subsequent onset of alcohol abuse,
nicotine dependence, and drug abuse/dependence in
some adults. Recently, a long-term study has found
an association between sleep problems in children’s
toddler years and the chance that they’ll use alcohol,
cigarettes and drugs early in their teen years.
The study is a part of a family health study that fol-
lowed 257 boys and their parents for ten years. The
relationship between early childhood sleep problems
and onset of adolescent substance use held true even
after other plausible explanations for the connection,
such as depression, aggression, attention problems and
parental alcoholism, were taken into account. Long-
term data on girls are currently being examined.
Taken together with other studies in this area, these
findings help make up a chain of evidence linking sleep
disturbances to alcohol problems across a large seg-
ment of the life span. The findings suggest that early
childhood sleep disturbances is a marker, or a predic-
tor, for early use of drugs and alcohol in adolescence,
but not a predetermined path. Nonetheless, parents
should take children’s sleep problems seriously. If
necessary, they should consult with their child’s pe-
diatrician or family doctor for help in addressing the
problem.
There was no connection between parental alcoholism
and children’s sleep problems or behavior issues. But
children of alcoholics were, as expected, more likely
effects of the tea.
of these kid are at pharmacology!
Thankfully, Jason did quite fine, and once the effects
of all the chemicals wore off, he was a pleasant and
polite young man. His mother was thankful, of course,
but also realistic. “He won’t do this again,” she said
confidently, and then added, “But he’ll find something
else.”
John E. Monaco, M.D., is board certified in both Pediat-
rics and Pediatric Critical Care. He lives and works in
Tampa, Florida. He welcomes your comments, sugges-
tions, and thoughts on his observations.
to have started using alcohol and drugs early in ado-
lescence. This kind of family-associated risk is well
known to exist.
The link between sleep problems and substance use
was clear, even after controlling for parental alcohol-
ism. Boys with early-childhood sleep problems were
2.3 times more likely to have started using alcohol by
age 14, and 2.3 times more likely to smoke cigarettes
occasionally or regularly, than boys whose mothers
hadn’t observed sleep problems.
They were also 2.6 times more likely to have used
marijuana, and 2.2 times more likely to have used il-
licit drugs. The only drug related issue to which sleep
problems weren’t significantly linked was how early
the boys had gotten drunk.
The researchers re-analyzed the data to examine
whether the relationship between sleep problems and
the early onset of substance use was in part due to
the presence of attention problems, aggression and
anxiety/depression. Although early childhood sleep
problems predicted attention problems and anxiety/
depression in late childhood, these problems did not
predict the onset of substance abuse independent of
sleep problems.
It is still unclear why there is a long term relationship
between childhood sleep problems and early onset of
Continued on page 9
Page 7
Volume 21, Number 6
instance, everybody is getting ready for Uncle Harry’s
funeral. You walk past your teenager’s room and hear
her sobbing uncontrollably. You open the door and
remark comfortingly, “I know, Sweetheart, we all loved
Uncle Harry and will miss him terribly.” Your teenager
lifts her head and wails in reply, “Look at this zit on
my face! I can’t believe I have to walk around with the
world’s biggest zit in the middle of my forehead!”
That egocentrism is exacerbated by another irritating
side effect referred to as “imaginary audience.” Ado-
lescents become extremely self-conscious and spend
a lot of time primping because they are thoroughly
convinced that everyone is looking at them all the
time. Anyone who has had the misfortune of sharing a
bathroom with a teenager knows she will be in there for
hours making sure every article of clothing is properly
adjusted, every accessory is correctly selected, and
every hair on her head is perfectly in place. After all, as
soon as she walks out the door, you can forget about
Uncle Harry and the rest of the population living or
dead – she will be the center of attention for all family,
friends, and strangers. A comment that “Nobody will
notice” – with either a tone of comfort or aggravation
– will fall on profoundly deaf ears.
Perhaps the most difficult side effect to deal with
is referred to as the “personal fable.” Teenagers are
thoroughly convinced that they are the only ones to
ever think and feel the way they do and that their
experiences are unique in the annals of mankind. So,
for example, your adolescent has a falling out with
her boyfriend of a few months and again is sobbing
uncontrollably. Your attempt to console her by saying,
“Everybody goes through this kind of heartache with
their first love” is met by the furious response, “No! Our
love was the purest, deepest love there has ever been!”
And incredible as it may seem, she truly believes that.
Offering “been there – done that” comments such as
“I know what you’re going through” or “I went through
the same thing at your age” is like trying to throw a
raw egg through a brick wall.
And then there is the immensely irritating “idealism/
hypocrisy” combination which comes from the blending
of abstract thinking and lack of “real world” experience.
Your teenager will rail against you and other members
of your generation for spending billions of dollars on
bullets and bombs when a small fraction of that money
could be spent on food to save all the starving children
in Africa. Remarkably, before you can respond, she will
insist that you give her $200 so she can go to the mall
and buy that cashmere sweater that she absolutely
must have to wear to school on Monday.
I wish I could offer parents some pithy advice for deal-
ing with all of this. But if I had the answers for deal-
ing easily and effectively with the adolescent mind, I’d
be on a private island counting up my vast financial
fortune instead of sitting at my keyboard. All I can
recommend is that you give your teenager as much
room as possible, exercise a little empathy, pick your
battles wisely, and be patient. Constant condemnation
makes the situation a lot worse, and time does tend to
solve those problems that often are impervious to the
strongest and most well-meaning parental efforts.
It’s helpful to remember that although your teenager’s
seemingly irrational behavior and attitudes may be
aggravating and even alarming on occasion, at least
she is acting and thinking “normally” for an individual
going through this particularly difficult yet mercifully
temporary period of life. And it also helps to recall the
anecdote often told by the famous American author
and humorist, Mark Twain: “When I left home at the
age of 18, I thought my father was the stupidest man
on earth. When I returned home at the age of 21, I was
amazed at how much my father had learned in those
three short years.”
Michael K. Meyerhoff, Ed.D., is executive director of The
Epicenter Inc., “The Education for Parenthood Informa-
tion Center,” a family advisory and advocacy agency
located in Lindenhurst, Illinois. He may be contacted
via email at epicntrinc@aol.com.
Sleep Problems – continue from page 7
substance use. There are at least three possibilities.
First, sleep problems and substance problems may
share some neurobiological dysfunction whose details
are not yet known. Second, sleep problems may lead
to poor choices and judgment in peer relationships
and activities, which in turn results in a poor choice of
friends and early substance use. Third, teens who have
sleep problems may use these drugs to self-medicate to
relieve their physical distress. The researchers plan to
conduct further studies on all of these issues.
It is important for parents to pay attention to their
children’s complaints about insomnia and overtired-
ness. If necessary, they should discuss these problems
with their child’s health care provider. They should also
set a regular sleep schedule for their children, ensure
they get adequate amounts of sleep, and encourage
their children to engage in relaxing, not stimulating,
activities before bed.
The study was funded by the National Institutes of
Health, National Institute on Alcohol Abuse and Alcohol-
ism. The Principal Investigator of the study is Dr. Robert
A. Zucker.
Page 9
Volume 21, Number 6