Dear Dr. Garner,
I am writing in the hope that my experience can serve as a wake-up call for other parents.
We have a beautiful daughter who was badly injured in a car accident. She was driving while intoxicated, and now faces months of rehabilitation.
There were warning signs that we should have picked up on, but my husband and I attributed it to normal teenage behavior.
What can we do about alcohol and drug addiction in our teenagers?  Why is it so prevalent? I hope your answer helps to prevent other parents from going through what we are going through.
Heartbroken in Hollis

Dear Heartbroken,
The fastest growing group of substance abusers are teenage girls. The teenage years are a tough time, and girls and boys go through them differently. Girls tend to have low self-esteem, high stress, and a higher risk of depression than teen boys.

When teen girls turn to drugs and alcohol, it is usually for relief of these issues. Boys, on the other hand, tend to experience an adrenaline rush when abusing illegal substances. Girls who have been abused, or whose parents abuse alcohol or drugs are also more likely to abuse drugs themselves.
Unfortunately, the teenager herself will be the last to realize she is addicted. She will most times be in denial.

There are signs that parents can use to help identify if there is a problem. Some of these include:

• Teenager is totally exhausted all the time.

• Negative change in schoolwork.

• The teenager starts to hang out with different friends.

• Bottles of eye drops around the house to cover up bloodshot eyes and dilated pupils.

• Mouthwash bottles to hide the smell of alcohol.

• Use of room deodorant or perfume.

• Wearing sunglasses in the house.

Addiction in teen girls happens much quicker than in boys because of the physical make-up of girls. They have more fat and less water, making the effects of the drugs and alcohol more severe at lower levels. The female hormone fluctuations also cause decreased metabolism, making the drugs and alcohol effects more severe.

A major problem is that serious medical conditions associated with drug and alcohol abuse occur more frequently in teen girls. Some of these are:

• Liver problems.

• Associated promiscuous behavior.

• More likely to be involved in a DWI.
• Stunting of growth.

• Delayed puberty and abnormal menstruation.

• IV drug abuse with increased AIDS and HIV.

• 70% of addicted women report a history of physical and sexual abuse. They allow themselves to be exposed to more dangerous situations.

It is important to help the teen realize she has a problem. Some of the behavior patterns she might be undergoing include taking drugs to relax before certain situations, taking alcohol or drugs to cure a hangover, and feeling depressed. They usually become very secretive and hide the drugs or alcohol around the house.
It is important to take the child to a drug and alcohol treatment facility that is geared to problems of women. While using “shame” might work for boys, in girls, it has precipitated episodes of depression, overdose and suicide. Teen girls need particular attention to multiple associated issues, such as depression, low self-esteem and social issues. An “all women” group works best, and they respond well to group counseling.

This problem affects all religious and socio-economic groups. No family is immune.
I urge parents to be vigilant in looking for signs of abuse, and to intervene at the earliest possible time. Delay will result in another tragedy, such as the one described by Heartbroken.

Thank you for your letter and I hope this serves as a tool to prevent other young girls from going down the path your daughter did.

As you know, I like to report on important medical advances that have occurred since the last column. A major advance in the treatment of breast cancer was described this past week.

The FDA approved a new drug for breast cancer this week. This drug, known as Tykerb, works differently from most used to treat cancer. Unlike traditional chemotherapy, which kills cancer cells and healthy cells alike, the actions of Tykerb are targeted. This means that the medication specifically seeks out the cancer cells and gets inside of them and stops them from growing. Another advantage is that unlike most chemotherapy, it can be taken as an oral pill once a day. The side effects are also much less severe.

This drug is used in conjunction with other breast cancer medicine. Early studies have shown that advanced breast cancer that has spread to other parts of the body like the brain or liver can be stopped from growing for about 8.5 months. It is quite possible that with the right combination of medications that this time can be expanded much further.

The drug is used for about 25% of cancers and I urge any of our readers who know someone with breast cancer to consult their physician to see if Tykerb might be useful for them.

I hope to see you on the next live telecast of “Ask the Doctor” on the Prayer Channel at 8 p.m. on Tuesday, April 17.

Dr. Steven Garner is affiliated with New York Methodist Hospital, Park Slope. He is a Fidelis Care provider. He also hosts the popular call-in cable TV show “Ask the Doctor” seen locally on The Prayer Channel.