When teens get involved in drug abuse, it alters their behavior in ways that are usually fairly obvious.

"There may be changes in friends, attitudes, appearance, grades, sleeping patterns," said Dr. Jeff Black, a psychiatrist at Laurelwood, Northeast Georgia Medical Center’s inpatient mental health unit.

"It’s easy to see the signs. But often only in hindsight."

Parents are often shocked to discover their child’s drug use and wonder how they could have been so blind. But since even teens who don’t use drugs tend to be moody, rebellious and unpredictable, parents assume their child is displaying normal adolescent behavior.

"I hear that all the time," Black said.

What disturbs him, however, is the number of parents who think that substance abuse is also part of "normal adolescent behavior."

"I’ve heard parents say, ‘Well, yeah, my child drinks some alcohol, but most teens drink,’" he said.

Some parents even allow booze-filled parties in their home, rationalizing that if their child is going to abuse drugs or alcohol, it’s better to do it when adults are there.

"Often they aren’t being parents. They want to be their kid’s friend," Black said.

They also may think they have no authority to judge their child’s choices, since they have a past history of drug use themselves.

"They use the justification of, ‘Well, I did this when I was young, so who am I to say?’" Black said. "But parents shouldn’t be afraid to say, ‘This is not OK.’"

Yet even when parents do everything right, sometimes a child still ends up using drugs, and this can be hard to accept. People find it difficult to believe that a student who gets good grades and is involved in extracurricular activities could ever succumb to substance abuse.

"A lot of parents think, ‘Oh, my child wouldn’t do that,’" said Black. "They tend to put their heads in the sand, even though the warning signs are there."

They may think that drugs are only a problem in poor, inner-city neighborhoods. Yet living in an affluent community and attending a private school does not inoculate a child against drug use.

"Alcohol and drug abuse isn’t about socioeconomic levels," Black said. "It happens even to the ‘good’ kids."

Unfortunately, it’s not always possible to pinpoint which children are likely to become drug users.

"It’s natural for kids to be curious. Some people see (experimenting with drugs) as a rite of passage," said Betty Guilfoile, area services director for Avita Community Partners, a state-subsidized mental health treatment center in Gainesville.

"Not every kid who abuses substances will become an addict. But we don’t know which ones will. And you’re more likely to become an adult addict if you start at a young age."

Guilfoile said some parents take a hands-off approach, believing if their child chose to take drugs, he should deal with the consequences.

"A lot of times, parents don’t want to participate (in family therapy)," she said. "They think it’s the kid’s problem. Or they don’t want to be blamed. But we (therapists) don’t point fingers. And if parents won’t get involved, it makes it harder for the kid to recover."

But parents aren’t the only ones who are in denial. Many teens refuse to admit they have a problem.

"When adults come to treatment, it’s usually because they have decided for themselves that their life is unmanageable," said Guilfoile. "With kids, usually it’s because some adult has decided their life is unmanageable. But the nature of adolescence is, ‘You can’t tell me what to do.’"

If a teen is uncooperative, she said, treatment almost always fails.

"Some kids are just going through the motions because someone is making them," she said.

Guilfoile said denial can be so strong that the teen thinks he is somehow immune to the effects of drugs.

"Kids know drugs are bad. They’ve had health classes since kindergarten," she said. "But they don’t internalize it. They say, ‘Yeah, drugs are bad for other people, but not for me.’"

That illusion of invincibility makes some teens unable to empathize with those whose lives have been destroyed by drugs. Guilfoile said when they see a billboard depicting someone whose appearance has been ruined by methamphetamine abuse, most teens don’t worry that the same thing will happen to them.

"Scare tactics usually don’t work," she said. "Kids think, ‘That’s somebody else. That’s not me.’"

Guilfoile said teens tend to live in the moment and do not imagine themselves at an older age. So it does no good to warn them that if they keep using drugs, they could damage their minds and bodies.

"Kids use drugs because it’s pleasurable for them," she said. "If you just tell them, ‘All drugs are bad,’ they’ll shut down. So we come at it a different way. We look at what is it about drugs that is so pleasurable? Then we try to find something to replace that, something positive."

But that can be tough to do when a person is already in the grip of an addiction.

"We create selective memories for ourselves," Black said. "People who use crack cocaine remember the experience of that first high, and they spend years ‘chasing the high.’

"When a kid is highly depressed or angry and they use (drugs), something clicks with them. They see it as pleasurable and want to re-create that."

Black said people who already have a mental illness, such as depression or bipolar disorder, are at higher risk for substance abuse.

"They’re ‘self-medicating,’" he said.

So getting proper treatment for a child’s mental illness could help prevent future substance abuse. But Black said there is "no way to 100 percent drug-proof your child."

"Do the best you can," he said. "Stay engaged. Kids with support from family and friends are less vulnerable."

Guilfoile agrees that parental involvement can help a child stay on the straight and narrow path.

"It’s so important for parents to really know their kids and know their kids’ friends," she said. "If they’re going over to a friend’s house, call the parents and find out if they’re going to be supervised. Parents have the biggest influence on their kids’ lives, either positively or negatively."