By Sarah Finney, MS, LMFT
One of the most common calls I receive is from the family of a young person who, among other things, is struggling with substance abuse and/or dependency. These calls vary greatly, from reports of initial experimentation with pot or alcohol all the way to an addiction that is life threatening. Regardless of where their loved one is on this continuum, family members feel ill-equipped to successfully navigate the path they find themselves on. Often they have more questions than answers. What is addiction? How do I know whether my child’s drug abuse is just a stage they’ll grow out of or something more serious? At what point does my child require intervention and treatment? What sort of help is available given all the nuances of my child’s particular situation? Does treatment work? While my advice to each family is specific to their situation, I hope my general answers to these questions will provide a helpful starting point.
What is drug addiction?
A growing body of research suggests that addiction is a brain disease which develops over time as a result of initial, voluntary drug use followed by a progression to more uncontrollable compulsive drug craving, seeking and use. This behavior can interfere with and/or destroy a person’s functioning in one or more key areas of their life i.e. health, family, school. It is viewed as a medical condition that requires treatment.
How do I know whether my child’s drug abuse is just a stage or something more serious?
Drug use becomes drug abuse and drug abuse becomes addiction. That’s the path. Research has conclusively shown that drugs and alcohol alter mood, perception, memory and emotional state. Pervasive use of these substances changes the brain’s structure and function, and the impact can persist long after usage stops. This brain-altering effect is particularly important for young people whose brains continue to develop well into their twenties. There are of course other possible consequences associated with drug abuse (particularly as usage increases over time), such as exposure to dangerous situations, family/relationship problems, school problems, behavioral problems, mood changes, arrested emotional development, legal issues, etc. Because of these consequences, I believe any level of drug abuse by a young person (or anyone else for that matter) is problematic. That being said, there is a clear difference between drug experimentation and drug addiction. So how do we determine if my child’s drug abuse is serious? My general rule of thumb is this: If drug use is negatively impacting one or more significant aspects of someone’s life (health, school, work, family, legal status, relationships), there is a serious problem. If your child fails to stop using after repeated promises or attempts to do so, there is a serious problem. If drug use has endangered the life of your child, whether once or many times, there is a serious problem. How serious? I need to learn much more about each unique situation to answer that question. And then there’s what to do about it.
At what point does my child require intervention and treatment?
Prevention is best. However, since 75% of people under 18 in this country will try drugs, I’d suggest that intervention and perhaps some form of treatment is indicated, wherever you might find your child on the “use to abuse to addiction” continuum. However, the intervention and treatment (if indicated) must be appropriate for your child and his or her particular situation. For example, if you’ve caught your 13-year-old daughter smoking pot with some of her friends, intervention may look like taking away her cell phone for a month, random drug testing, grounding her from spending time with those ‘friends,’ and then, perhaps, doing some research together on the harmful effects of drug use. If your 20-year-old son overdoses on heroin for the second time in three months after having dropped out of college due to depression, anxiety and drug addiction, intervention may look like admitting him to a dual-diagnosis (addiction and mental health) treatment program for 90 days and then going to a sober living program for the next six months. I wouldn’t recommend placing that 13 year old who gets caught smoking pot for the first time into treatment for 9 months, nor would I recommend allowing your 20-year-old son who is addicted to heroin to move home so you can “keep a closer eye on him.” The goal is to match the treatment to the problem, creating a plan that offers young people the best opportunity to stop using drugs or alcohol and effectively address their challenges, so that they can more successfully navigate their way through adolescence and adulthood.
What sort of help is available given all the nuances involved in my child’s particular situation?
The short answer to this question is that there is an overwhelming amount of help available; charting the right course for your child and family is the tricky part. But before we go further, it is critical to acknowledge and understand that you as parents or family members need guidance and support as much as your child does. Effective intervention and treatment rarely occurs if a parent doesn’t recognize that there is a problem and take the right steps to address it. In most cases, families are not in great shape when they make that first call to me. I wouldn’t be either. They are emotional –worried, sad, perhaps angry or feeling helpless. They may feel alone, depleted or overwhelmed with decisions. They desire to do the very best thing for their child but don’t know exactly what that is or where to find it. At this point, professional advice and support to navigate this path can be extremely helpful. Fortunately, this country offers a wide array of experts who are well versed in addiction/ mental health and can provide invaluable advice, support and guidance to families during difficult times. Like any other profession, there are great ones, terrible ones and everything in between. Do your research, ask around and find someone who is knowledgeable, reputable and seems like a good fit for your child and family. Let them educate you, advise you, and help you chart the course.
There are hundreds, even thousands of treatment options for young people in this country who struggle with addiction. Some of the more common resources include therapists, doctors, interventionists, treatment consultants, outpatient clinics, hospitals, detox centers, residential treatment programs, wilderness treatment programs, therapeutic boarding schools, independent living programs, sober living houses, sober coaches and other recovery management professionals. The options and quality of resources vary greatly even within the same category. Seek the help of an expert who can assess your situation and help you select the most appropriate state-of-the art treatment plan for your child and family. These experts should be knowledgeable about addiction and mental health as well as have in-depth experience with a wide array of top quality resources. Their approach must be holistic and long term. Ideally, they should be willing and able to partner with you, so that the plan includes the right primary treatment, aftercare plan and long-term relapse prevention support. This plan should be highly individualized, and decisions regarding each step should be formulated in response to your child’s current progress and needs along the treatment continuum.
One last point which I cannot emphasize enough: There is no quick fix for addiction. Just as addiction develops along a continuum, so does recovery. Be wary of any person or place that promises a quick fix or any kind of “cure”. Recovery from addiction takes time and effort.
Does Treatment Work?
Contrary to popular views, research shows that most addicts are not able just to stop on their own. It is not simply about willpower. The right treatment offers an opportunity to change your brain state and provides a better chance of managing symptoms of addiction (cravings, triggers, etc.). It also offers an opportunity to address underlying mental health issues, trauma and other factors that contribute to relapse. Moreover, quality treatment helps individuals learn vital skills that can improve their overall ability to thrive, such as learning healthier ways to cope with stress, build communication and relationship skills, improve areas of executive functioning and learn important life skills. Effective treatment will also provide a space for relationships to heal and shift in a healthier direction for everyone involved, not just the addict.
Since addiction develops along a continuum, arresting the abuse of drugs or alcohol anywhere along that continuum has a huge impact on the brain and body. This is no small accomplishment, because it stops the progression of the disease in its tracks. Sober time helps build more sober time. All the research confirms this fact. So while there is no cure for addiction, treatment can stop or slow its progression and provide important tools to help manage the disease over a lifetime. Essentially, treatment may prevent a young person from getting worse, or interrupt the progression of the disease, so that the addict has a fighting chance.