Drug, Alcohol Use Increase Risk of Unsafe Sex by Teens
By Leslie Davis

When talking to your teens about the dangers of drug and alcohol use, it is important to discuss the perils of drunk driving, overdosing, impaired behavior and addiction to substances. And, though it may not be a topic you are necessarily comfortable talking about, you also need to talk to them about the increased risk of engaging in unsafe sex.

About one quarter of high school students reported using drugs or alcohol during their most recent sexual encounter, according to the Kaiser Family Foundation. And teens who use drugs and alcohol are more at risk for having unprotected sex, unwanted pregnancies, multiple sexual partners and sexually transmitted diseases.

Because of the increased chance of unsafe sex by teens who engage in drug or alcohol use, talking to your teens about this should be high on your list of topics to address with them. The following are some ways to broach the topic, which is likely to be as uncomfortable for your teens as it is for you.

Discussing Sex with Your Teen
Start with the basics. A discussion about unsafe sex needs to start with a discussion about sex itself. If you have not yet had “the talk” with your teens, it is likely too late – between friends, movies, television shows and the Internet, your teens have probably figured out what they need to know about sex. But, to be on the safe side, have the talk anyway.

Schedule a time. If you’re a teenager, no time is a good time to sit down with your parents to talk about sex. Schedule a time to talk with your teenager about the topic so you both know what’s coming. It gives both of you time to mentally prepare, and to go into the conversation more focused than if the topic is brought up out of the blue. It also gives your teens time to come up with any questions they may have.
Honesty is the best policy. Your teenagers’ questions may include questions about your own sexual experiences. Use your discretion when answering, but remember that honesty is generally the best policy and that your teens look to you as role models (even if they are initially embarrassed by your answers). If you waited until college until you became sexually active, tell your teens so they won’t feel insecure themselves about wanting to wait. If you were 13 when you had your first sexual encounter, maybe your teens won’t feel so guilty that they started at an early age.

Come prepared. While some parents may be more comfortable talking about their own experiences and answering questions, others may feel more prepared walking into the conversation with an outline, research or talking points. Writing down what you want to discuss with your teen increases the risk of you not forgetting what you wanted to talk about or stopping out of embarrassment.

Cover all your bases. Just talking to your teens about sex is not enough to keep them safe. Be sure to cover the importance of having safe sex (including methods of birth control), how drugs and alcohol can impair their judgment and lead to potentially unsafe sexual situations, and the dangers of STDs.

Keep an open dialogue. Talking to your teens about sex may not be a one-time thing. It is likely that more questions will come up the older your teens get, or the more involved they become with a partner. Keep an open door policy with your teens and let them know that nothing is off topic. This lessens the chance that they will feel embarrassed talking to you about a potentially serious issue (such as being at risk for an STD).

Test Predicts Risky Sexual Behaviors
If you feel that uncomfortable talking to your teen about sex, you may want to engage the help of your teen’s physician. A diagnostic test currently in use at Children’s Hospital Boston can screen teenagers for high-risk drug and alcohol use that may result in risky sexual behavior. The test, developed by the Children’s Center for Adolescent Substance Abuse Research, asks teens a series of questions to determine if they are at high risk for drug and alcohol use.

Teens who screen positive for substance abuse are at greater risk for having sexual contact after using, according to a recent study in the Journal of Adolescent Health. More than 40 percent of surveyed teens reported having sex without a condom, about 26 percent after drinking alcohol, 15.6 percent after using drugs and 21.7 percent with a partner who had been drinking.

“Clinicians should be prepared to discuss high-risk sexual behaviors with their patients along with the dangers of engaging in sexual activity while intoxicated,” Sharon Levy, MD, co-author of the study, said in an Oct. 19 article on PsychCentral.com. “Something as simple as asking an adolescent a few questions during a clinical appointment might make the difference.”

Teens who are administered the diagnostic test at Children’s Hospital receive advice on drug and alcohol use, and teens who screen positive for substance abuse are advised to get a further assessment for substance abuse disorders.

“Primary care physicians are on the front line of identifying adolescents who are at-risk and all should be screened with questions like these at every routine medical visit,” Levy said. Levy and the other authors also recommend that adolescents receive counseling on high-risk sexual behaviors and sexual activity after drug or alcohol use.