Podcast Episode Summary

Podcast: We're Out of Time

Episode: Teen Drug Crisis Explained with Dr. Katie Held & John Lieberman: Fentanyl, Vaping & Recovery

Host: Richard Taite

Date: December 23, 2025

Episode Overview

This episode pulls back the curtain on the escalating teen drug crisis in America, focusing on real-world insights from the front lines. Host Richard Taite speaks with Dr. Katie Held (Chief Clinical Officer) and John Lieberman (CEO) from Visions Teen Center, delving into the dangers of fentanyl, high-potency THC, vaping, mental health, and the crucial role of family involvement in recovery. The conversation is raw, practical, and driven by the urgency to save young lives.

Key Discussion Points & Insights

1. Current Trends in Teen Substance Use

• Substances in Treatment: Teens are using a wider and more potent array of substances than previous generations, including high-potency marijuana, vape products, alcohol, cocaine, counterfeit pills, and sometimes unknowingly ingesting dangerous substances.
  “Anything and everything we’re seeing today...” (Dr. Held, 01:46)

• Rise in THC Potency:

  • Street-level cannabis and vape concentrates now contain up to 50–90% THC; kids as young as 13 are experiencing psychosis (03:15).
  • Teens are not getting marijuana from dispensaries but from social media and friends, increasing their exposure to contamination and higher risks (05:10).

2. Access and Normalization

• Accessibility & Glamorization:
  “With legalization, with more access, with glamorization, we’re seeing a lot of increase.” (Dr. Held, 02:03)
• Vaping Epidemic:
  Vaping has become nearly ubiquitous, starting in preteens, with risks made worse by easy concealment, round-the-clock use, and the danger of contaminated cartridges (07:36–09:15).
• Counterfeit Pills:
  Kids buying substances via TikTok/Instagram face added risks of fentanyl contamination and sexual exploitation (09:22).

3. The Dangers Beyond Drugs

• Sexual Exploitation & Trafficking:
  Multiple stories of girls from affluent backgrounds getting trafficked during attempts to obtain drugs.

  • “We’ve had…about five teenage girls…who got involved and were trafficked.” (Dr. Held, 10:07)
  • “...this is just the way it is. Which is sad.” (John Lieberman, 10:40)

• Parent Perspective:
  Many parents are blindsided, calling for help in moments of crisis, often for the first time, their voices wracked with both pain and mistrust (11:51).

4. Mental Health & Co-occurring Disorders

• Almost All Cases Co-Occur with Mental Health Issues:
  • “Every single time.” (Dr. Held, 41:30)
• Severe Anxiety & Depression:
  Almost universal among teens entering treatment; substance use often starts as self-medication for underlying anxiety (06:33, 22:21).
• Failure to Address Underlying Issues:
  If families and providers don’t address mental health and trauma, relapse is nearly inevitable (36:20).

5. Parental Responsibility & Family Involvement

• Responsibility & Accountability:
  • “If you don’t accept responsibility, you’re in a victim position. If you accept responsibility, you’re in a powerful position. And now you can change it.” (Richard Taite, 23:50)
• Family Participation as Rule-Out:
  Visions does not accept clients if parents won’t participate (20:26–20:41).
• Therapy & Repair:
  Building healthy repair processes in the family is key.
  • “Repair goes back to…when they can repair with a parent, a coach…that’s the foundation for their lives.” (John Lieberman, 40:49)

6. Changing Teen Psychology

• After COVID:
  • Increased social awkwardness, emotional withdrawal, “the stare”—difficulty interacting without technology, masks, or social media as a buffer (27:34–28:49).
  • Kids’ resilience is decreasing, parents are more protective, and physical play (the “benefit of a skin knee”) is declining (31:34).
  • “Parents don’t want kids to feel discomfort anymore... it’s helpful for kids to feel discomfort.” (Dr. Held, 31:07)

7. Challenges with Setting Boundaries

• Parental Boundaries:
  Parents struggle to say “no” or hold boundaries.
  • “They set a boundary, but they don’t hold the boundary…setting the boundary and not holding…is actually worse.” (Dr. Held, 45:51)
• Taking Back Authority:
  Help parents rediscover their “spine” (44:19), essential for successful family treatment.

8. Notable Successes & Heartbreaking Losses

• Stories of Death and Survival:
  • “It’s probably about twice a year that we get the call [about alumni who have died]...” (Lieberman, 15:15)
  • Story of a direct hospital transfer saving a boy’s life (17:01–17:57).
  • Importance of small victories—seeing a “sparkle” return to a child’s eyes after treatment (19:52–20:22).

9. Treating Adolescents vs Adults

• Adolescents as Hostage:
  • “They’re a hostage…because they don’t have a choice.” (Richard Taite, 41:56)
  • Faster, more significant visible changes in teens than adults (46:10).

Notable Quotes & Memorable Moments

• On Parent-Child Repair:
  “Repair…with a parent, a coach, a teacher, we’re setting the foundation for how they work out their lives.”
  —John Lieberman, 40:49

• On Modern Marijuana:
  “What THC is today is street drugs… 50%, 90%… 12, 13 year olds… psychosis as a result of THC.”
  —John Lieberman, 03:15

• Parent Responsibility:
  “If you don’t accept responsibility, you’re in a victim position. If you accept responsibility, you’re in a powerful position.”
  —Richard Taite, 23:54

• Family Involvement:
  “Our requirement is family involvement. It is family, family, family, family.”
  —John Lieberman, 20:42

• Hope Amid Crisis:
  “There’s absolutely hope.”
  —John Lieberman, 48:32

• The “Stare” Post-COVID:
  “Today you talk to kids, and…they’ll just do this [stares]…what is that?”
  —Richard Taite, 28:17

Timestamps for Key Segments

• [01:46] – What substances are most common now?
• [03:15] – THC potency and adolescent psychosis
• [05:10] – Teens buy from social media, not dispensaries
• [09:22] – Social dangers (vape dealers, sexual assault)
• [10:07] – Sex trafficking cases among teens
• [11:51] – Parental crisis and initial outreach
• [15:00] – Overdose deaths and fatal delays to treatment
• [17:01] – Harrowing hospital overdose story
• [20:26] – Family engagement as a requirement for treatment
• [22:14] – Parental presence, connection, and early intervention
• [23:50] – Responsibility as empowerment for parents
• [27:34] – Where is the mental health of teens today?
• [31:34] – The “benefit of a skin knee” and growing resilience
• [36:20] – The importance of aftercare and early intervention
• [41:30] – Co-occurring disorders: “Every single time.”
• [41:56] – Adolescents in treatment: “They’re a hostage.”
• [44:19] – Helping parents find their "spine"
• [46:10] – Visible, rapid change in adolescent recovery
• [48:32] – Final words: “There’s absolutely hope.”

Tone & Style

• The conversation is frank, urgent, and deeply compassionate.
• The hosts and guests blend clinical expertise, personal lived experience, and no-nonsense truth-telling.
• Humor used to break tension (“I have extra spines and testicles. We can do implants here”—John Lieberman, 44:07).

Conclusion

This episode is an unflinching yet hopeful look at the realities facing families and teens in a country overwhelmed by modern drugs, mental health crises, and shifting cultural norms. The importance of early intervention, family engagement, honest conversation, and ongoing repair is stressed repeatedly. The takeaway is clear: parents must engage, take responsibility, and seek help early—because in this crisis, “We’re out of time.”