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Advice doctors give their own kids before they head off to college

Sex, drugs and alcohol topped the list of essential topics to discuss with a college-bound teen.

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Over the next few weeks, bittersweet goodbyes will be taking place all across the country as parents send their children off to college for the first time. If you’re one of those moms or dads, you may be wondering if you gave your kid all the pearls of parental wisdom he or she needs to survive life out there on their own.

Who better than a doctor would know the answer to that question? So CBS News asked some top physicians what advice they doled out to their own college-bound kids before they flew the nest.

The sex talk

Talk about it. Every doctor interviewed for this story told CBS News that this topic is a must. Even if you’ve had conversations with your kid about sex over the years, have a pre-college talk, because for some, it may be the first time they become sexually active, said Dr. Denise Sur, professor and vice chair in the department of family medicine at UCLA’s David Geffen School of Medicine.

Sur, a mother of four whose last child is finishing up college this year, told CBS News, “I got even more comfortable talking about it when I realized my older kids didn’t give me grief when I gave them advice, and they did call me when stuff came up. Whether the younger ones liked it or not, I was way more open about sex and condoms with them.”

Sur said parents can adapt the discussion to their personal belief system and their child’s personality. She framed the discussion with her kids like this: “My wish is that you will not be sexually active and that you’ll wait until you’re older, but if that changes while you’re at college, you can easily access birth control and protection.” 

If a situation comes up at school and they don’t want to call and talk about it on the phone, they can email or text her, she said. College health centers or her kids’ physicians at home or a doctor up near school could help, too.

“My relationships are completely different with all four kids. Some I’m totally comfortable talking with and others it didn’t seem as comfortable to go into it so I brought them to their family doctor, so that they had someone else to talk to,” Sur said.

She said either way, college-age students need to know that two forms of protection are necessary – one to prevent pregnancy and one to prevent the spread of infections, including herpes, HPV (genital warts), HIV, gonorrhea and chlamydia. She recommends long-acting reversible contraceptives, such as IUDs or implants, for young women to help prevent pregnancy and condoms for women and men to help prevent STDs.

Father of five, Dr. Steven Lamm, clinical professor and medical director of the Tisch Center for Men’s Health at NYU Langone Medical Center, stressed that that sexually active gay and bisexual young men should also know they’re at higher risk for HIV. They should talk with their doctors before going to college about pre-exposure prophylaxis, called PrEP, which involves taking a pill every day to help reduce the risk of infection if exposed.

Dr. Ellen Rome, who heads up the Center for Adolescent Medicine at Cleveland Clinic Children’s, is taking her son to college next week where he’ll be a freshman at the University of Michigan. Her daughter is only a few years behind.

“He’ll be the first one to tell you the sex/drugs conversations with mom are most unwelcome but it doesn’t mean we avoid them,” said Rome.

Her approach is to be honest, with a dash of humor: “We say, we would prefer you not to have sex until you’re older – until you get out of the convent, the monastery, until you’re 29, until you’re married.”

She said it helps to be clear about your hopes for them. But she also says to her kids, and to her patients, “If you choose to have sex, we want it to be a choice, not an ‘Oops,’ not an ‘I didn’t mean to do that’ moment. And not a drunken or high choice either. It should be a conscious choice, not an opportunistic choice.”

Both partners should be comfortable enough to ask questions about protection and STDs, such as whether or not they’ve both had the HPV vaccine, which protects against cervical cancer in women, Rome said.

“Make sure you are comfortable enough in the relationship to ask those questions, because if you’re not, then that’s not someone you should be having sex with,” she said.

And you can’t assume your kid is necessarily going to believe what you believe. “If they don’t agree, then actively listen. Then it’s fair game to share your ideas,” she said, telling them you’ll do your best not to be judgmental, but instead to have a dialogue.

Alcohol and drugs

Dr. Peter Galier, internal medicine specialist and vice-chief of staff at UCLA Medical Center in Santa Monica, California, has a daughter and a son.

“My daughter just finished [college]. She graduated from UC Davis and my son went to California Lutheran. The advice was different at times, as double-standard as it sounds,” said Galier.

But he did say to both before they left for college, “We raised you right. We know you’re going do the right thing. But if anything ever happens, where you get in trouble, we’re here to help you.”

He reminded them both that their parents worked hard to send them to college, as did they, and that they needed to continue their hard work and stay focused on their goals and behavior. That includes being responsible when it comes to alcohol.

“We said, your behavior matters. Treat everyone with respect. Do not stand by if you see anything happening that is not right. If you go to parties and see things you don’t like, see someone in danger, see someone slip something into a drink, do something about it,” said Galier.

“I gave the pros and cons of alcohol use and drug use. I told my kids alcohol is legal if you’re 21, but just because it’s legal doesn’t mean it doesn’t have its own risks. Drinking and driving is unacceptable. Using drugs and doing anything like that is unacceptable. If you get caught doing something illegal, there are a lot of ramifications, not to mention the damage you can do to someone else’s life,” he said.

Cleveland Clinic’s Rome said she tells her children and her patients, “Don’t drink out of anyone else’s glass, so you don’t get strep or mono and so nobody gives you a date rape drug. It’s happening on campuses every semester. Acquaintance rape​ is very common. Date rape drugs are a real thing. It is common on college campuses and in bars. And it’s still happening to nice kids at nice schools across the country.”

“We know there’s going to be a lot of exposure to alcohol at school,” said Dr. Felice Adler, a pediatric infectious disease expert at Children’s Hospital of Orange County and UC Irvine. “I tell my two kids, while it’s best not to drink, if you feel that’s something you have to do, then do it responsibly. Never take an open drink from someone. Never have a drink mixed elsewhere by someone else – so no one’s spiking your drink or putting drugs in your drink. And I talk about how alcohol can impair your decision-making and things can happen that you might not normally do. It can make you more vulnerable in situations involving sex that you don’t want to be in and it may make you more likely to try drugs.”

Adler added, “With my son, I remind him that no means no, and you can’t initiate any sexual activity with someone you think has been drinking.”

No sexting​, and no posting pictures and video if you’ve been drinking or posting of people without consent, the doctors advise their kids.

NYU’s Lamm said if alcoholism, addiction or depression​ run in your family, it’s really important that a child knows the family history before they move to a college campus.

“If there’s a genetic predisposition to alcoholism or depression, have a discussion about it,” said Lamm, because the risks are much higher for those kids. Drunkorexia – an alcohol-related eating disorder​ – is an issue on campuses now, too, he added.

Personal safety

Safety at night is key, said Adler. “Make sure you walk in pairs or groups. Even just this morning, I sent my daughter the emergency phone for the police at Berkeley and for the campus escort at night. And my son a lot of times when it was two in the morning, he’d call Uber. Even using car-sharing services. But if you’re a young woman, I wouldn’t recommend that.”

UCLA’s Galier said it this way to his kids: “When they go to a party with three friends, leave with three friends – watch out for each other.”

Galier also asks his kids to keep their phone locater app on, and he made sure they gave him the phone number of a good friend, just in case.

“I say, ‘I’m never going to use it unless I have to.’ I only had to use it one time,” he said. “I just want to know if we ever needed to reach you, can we have someone’s cell, just to know that you’re OK.”

And he says he and his wife usually checked in with their kids at least once a week – by phone or text or FaceTime – usually on Sunday afternoon, just to touch base. 

“It’s good to stay in contact. When patterns change, it’s when we worry,” Galier said.

Personal safety doesn’t just mean being safe at night, some of the physicians noted. They said if parents have children with allergies or chronic illnesses, make sure their student health center knows about it, check in with your kid regularly and ask if they have enough of their medication such as diabetes and asthma prescriptions, as well as EpiPens​ for food and other allergies that can cause anaphylactic shock. Roommates also need to know about each other’s health issues and know when to call for help or, for example, how to use an EpiPen​ in an emergency.

Mental health

NYU’s Lamm said he listened and watched his children carefully that first year, especially. He said if they look well – a healthy weight​, not overly tired – at their first visit home for Thanksgiving, that’s a good sign.

“It’s a transition period and you want to be aware of that,” he said. If they had an eating disorder or depression in the past, for example, college may make them more vulnerable to those issues again. Student health centers can provide support services if a child seems to need help.

Lamm said if you call regularly to check in and they answer the phone groggy or don’t sound like themselves, if their grades are slipping, or they’re having personal problems, it’s time for a parent to visit. Even if it’s under the guise of, “I just wanted to come up and take you to dinner.”

Sur said shy or less social children may struggle a little more when they hit a college campus, and it’s important for them to seek out like-minded people so they don’t find themselves pulled by peer pressure into the wrong groups and situations.

“So much of peer pressure is being with the wrong people at the wrong time. If you like soccer join a soccer club, or if you like theater join the theater club. Find that group because I think that’s what can help you survive the pitfalls,” Sur said.

Health basics

Adler, who is sending her two children to college this fall – one’s a freshman at Berkeley and the other is an upper-classman at the University of Michigan – focuses on the positive, proactive things her kids can do, too, not just what to avoid. Kids can get overwhelmed and zone out if everything’s a warning.

“I wanted to talk to them both about nutrition​, exercise, and sleep habits,” said Adler, whose husband is also a physician. She said all three of these factors will help them fight infection, feel physically good day-to-day, and stay mentally healthy, but it can be challenging to maintain good habits in campus life.

“All of a sudden they may not get meals cooked by parents and they may not be getting all the nutrition they got before. I tell them it’s important not to make potato chips your only meal of the day. A healthy diet will make you more resistant to getting sick. And it’s important that kids exercise​​ every day – even joining a club sport or going to the gym a few days a week. They need 45 to 60 minutes of exercise a day that gets their heart rate up,” Adler tells her kids.

She reminds them not to pull all-nighters, to plan in advance so that they don’t have to stay up all night to write a paper or study for an exam.

Sleep​ is super-important. It helps you resist getting infected with germs. People need 7 to 9 hours of sleep​ a night. Certainly getting less can start causing issues. It might be more difficult to focus in class, affect your performance in school and make you more likely to get sick,” Adler said.

Her son was diagnosed with cancer last year and took some time off from school, so that adds to her concern for his health. “I feel like I worry a lot,” she said.

Both Adler and Galier said they send their kids off to college with a homemade emergency health kit, too.

“I packed them a college first aid kit. It has the basics, like Tylenol, ibuprofen, Band-Aids, some Pepto-Bismol, Zantac. Basic stuff you’d need going off to school. Hydrocortisone cream – anti-itch cream – first aid ointment, antibacterial ointment. A cold pack, heat pack, gauze and tape and scissors. Tweezers for splinters,” said Adler.

Every year before his children headed off for college, Galier said he’d slip them a card.

“I reiterated all these things. I put a card in their car. I picked out a mushy card for my daughter and a cute card for my son and I’d stick it under their backpack so they’d find it when they got to school.”

“All parents wish for is that their children are safe,” said NYU’s Lamm.

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