Teen Substance Abuse

This past weekend my husband and I attended a Family Program presented by our son’s treatment facility. We entered the room with trepidation. Not knowing what to expect. This is a room full of strangers and although we are all here for our loved ones, initially you hold back. This is a protective shield that we have all learned to wear.

We looked around the room and immediately recognized an individual who we saw in the dining room earlier. Okay, a little relief, we introduced ourselves. The common bond begins. The first evening was brief, a little education and somewhat of an icebreaker. The next morning the real learning begins.

Friday morning the therapists presenting the seminar, introduce themselves and give a brief personal history. They then have us all do the same. This is the moment we all learn that we share the same burdens. We are parents, spouses, siblings and partners. Addiction has invaded all our lives, we release, tears are shed as we state our names and who our loved one is. There is immediate empathy and compassion for all.

The facilitators have seen this before. They conduct these groups every two weeks and know better than all of us that we need healing too. The facilitators are great. They make us laugh and cry all at the same time. They introduce material that allows us to grasp what is happening with our loved one. They teach us that grieving is okay. It is all a part of the process.

By Sunday morning we are greeting each other with big smiles. We have moved forward. This is a difficult journey, but we are not alone. The treatment facilitators have us each take a golden coin and talk about what the group has meant. Many of us cry. A weekend that many in the group dreaded and entered with trepidation has become a very symbolic event for all of us. We bonded, we laughed, we are hopeful for each other, we are thankful for the treatment facilities family program, we understand…The Power of the Group.

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Late September 2008, our son has been in wilderness therapy for about a week and a half. The updates we receive say that he is cooperative with the group as well as beginning to open up yet still guarded. His counselor has already coined a phrase to describe him, flying under the radar.

Amazing, that in this short period of time they have already pinned him as flying under the radar. He had used right under our own eyes and home, yet we the parents were clueless most of the time. We did not recognize it, nor see it.

A week and a half into the program, the camp has a 2-day parent seminar. We looked forward to going, knowing we would not see our son, but hopefully feel his presence since we would not be far from him. The beginning of the seminar explained the program, as well as participating in several therapeutic exercises. What stands out in my mind, was one of the first things the instructor told us.

She said that “this camp was just a beginning and that it took a long time for things to breakdown to the point of sending your child here.” Wow, I had not thought of it that way at all. My thinking was that things had just recently spiraled out of control with our family. She went on to say that the majority of children in their program would go on to residential treatment or therapeutic boarding schools. Once again, I was not even considering those possibilities.

The parent seminar was just the beginning of what would become years of…learning through denial & pain.

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My husband and I are attending a family education program at my son’s treatment facility this coming weekend. In preparation for this program, his therapist recommended we watch a DVD titled The Neurobiology of Addiction presented by Susan Holman, MD. This was one of the best presented lectures on addiction that I had seen in a while.

She presented a very complicated topic of the neurobiology of the brain in simplified terms that any layperson could understand. Simply put addiction is a genetic brain disease. My son has Reward Deficit Syndrome, RDS. In other words he was not born with enough dopamine, just like a diabetic with an insulin deficit. His has a dopamine deficit. Dopamine is the neurotransmitter that makes us feel pleasure. When he used cocaine and/or bath salts, dopamine was released. Too much dopamine will kill you. So the brain automatically releases less dopamine when it is signaled by the cocaine or bath salt use. The more you use, the less dopamine is released. This same neurotransmitter works the same for alcohol as well. There are other neurotransmitters such as serotonin that work with different drugs but all the neurotransmitters work with alcohol. Also note, dopamine release in an individual with RDS makes them feel normal.

The reward pathway where the dopamine is released is in the primitive part of the brain. This is a critical point. The primitive part of the brain uses automatic reflexes, cognitive thinking does not take place in this part of the brain. That is why it is so hard for an individual to fight addiction, it becomes an automatic action.

The good news, education and treatment. This is a manageable disease just like diabetes. It has to be taken care of daily. If you do not follow daily protocol with diabetes, there is loss of limbs, blindness kidney failure, etc. The same goes for addiction, 12-Step meetings which are cognitive behavioral therapy, diet, exercise, etc. Many only follow part of the necessary therapy to stay well and when they do not, relapse occurs which can lead to death.

If you take anything away from all this information, remember this is a genetic brain disease, called Reward Deficit Syndrome, RDS. Bad parenting, divorce, anger issues did not cause the disease, they may exasperate it, but this is an inherited genetic brain disease….college lecture.

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My son is at the mid-way point in his treatment. He is looking at after care options. Currently he has indicated that he wants to come home after treatment and begin an intensive outpatient program. As well as find a summer job.

I agree that this is a good plan. He will have obstacles in his path. He recognizes that there will be triggers with coming home. Whether that is triggers in the community or stress that he may feel at times in our home. The concern I have with this plan, is that he wants to return to college in the fall. This includes living in an apartment complex off-campus with individuals he partied with this past year.

His father and I are supportive of college but not his living arrangements. The following year will be early recovery for our son. He will be vulnerable to relapse. Also this next year is a time to solidify change in his life, not just attending meetings but learning to live a full life in sobriety. As many in recovery know, it is difficult if not impossible to go back to your old life and obtain abstinence.

Keeping in mind that he has to make the decision about his future, we have told him what we support. We will help him financially with college if he lives in a halfway house. Otherwise the financial responsibilities of college will be his. We have drawn a line in the sand…

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While my son is in treatment, we have an opportunity to have a conference call with him and his therapist once a week. Plus we get the added bonus of being able to visit him weekly. Today is our conference call.

I always anticipate these calls, going over in my mind about what to say and how to say it. Truly, too much thinking on my part.

We are at a point in his treatment where the treatment team is helping our son look at his past and visualize how the past will effect his future. In other words, understanding that the past environment, people, places and things, plays an important role in sustaining or undermining recovery.

My role at this point in treatment is to be supportive, first and foremost. Many things need to change in my son’s life, helping him accept this will help him continue…moving forward.

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It is Wednesday morning, 8am, mid-September 2008. Our son ran away two days ago and returned yesterday afternoon. This morning we are taking him to a wilderness therapy program. We can no longer provide him a safe environment. This is breaking our hearts to have to do this.

The wilderness program is 2 hours from our home and we have agreed to check him in by 10am. Our son is quiet this morning. He is not fighting us. He seems resigned to go. The drive is somewhat surreal, we seem to be having normal conversations and even stopping at McDonald’s along the way.

When we arrive it is a very quick goodbye. The program knows that families are in distress and they do not prolong the goodbye in any way. I am not ready for this and break down crying. Our son leaves, we then sign some paperwork and are told that his therapist will give us an update this afternoon. We drive home in shock, not believing that the situation has come to this.

My son’s therapist calls that afternoon and we are briefed about his take-in assessment and what the next few weeks will look like. Our son stated to the staff member that he has been huffing since 7th grade, white out, expo pens, whipping cream and paint. He uses marijuana 4x’s a day. Drinks alcohol. Abused over-the-counter medications such as Benadryl and has been snorting his prescribed medicine, Buspar. He states that he sees nothing wrong with what he is doing. That there is no problem with this behavior. We are shocked to learn the extent of his drug abuse. We knew something was terribly wrong for the past several months but we had no idea how bad it was.

The wilderness program is therapeutic. Our son will hike into the Appalachian Mountains for the next several weeks, not returning to base camp unless there is an emergency or dangerous weather. The field staff are trained in therapeutic techniques. They work daily on our son’s issues. The lead therapist visits weekly, hiking in and speaking with our son. The therapist is also briefed by the field instructors. The only communication we have with our son is weekly letters. We are are also given weekly family therapy and briefing with our son’s therapist.

At this point, although we are emotional wrecks, we know our son is where he needs to be, yet this is going to be a…long & winding road.

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Honestly, a 42 day treatment program is not nearly enough for sustained, life-long change. Aftercare has to be an important part of a good treatment program. The options are numerous, halfway house, sober living, intensive outpatient,addiction psychiatrist, counseling, 90 meetings in 90 days, etc…

The key element is my son. Is he willing to make serious changes in his life? Which aftercare treatment will he benefit from the most? Which treatment is he willing to do? The treatment team is working with him to make the best choice.

I have been thinking about these aftercare options and speaking with colleagues in the field. I will encourage him to keep an open mind, look at all his options. He made the decision to seek treatment. I have to believe he can and will make the best choice for…aftercare.

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It is mid-September 2008. My son has recently been charged with possession. He is depressed about this.

A day or two after he received the charges, he became uncommunicative. Sitting in a chair, staring off, not answering any questions. I was concerned and called his therapist. The therapist was eating dinner and did not want to talk with me. This was a red flag in regards to this counselor. I knew it at the time, but with my sons emotions spiraling I did not address it. I was able to convince the therapist to talk with my son on the phone. My son became engaged and this incident passed.

Days later, my husband and I would learn that my son had opened a PO Box and was communicating with some pharmaceutical companies in Canada to purchase Xanax. He was in the process of setting up a drug dealing operation. It was a Tuesday night when we learned of all this. We asked him about it that evening. He became very agitated and angry with us. He stormed out of the house, left, ran away. We chose not to call the police that night. We thought he would come home.

Morning came, we had not slept and our son had not returned. My husband went into work for a couple of hours. My sister arrived to lend emotional support. I spent the morning calling our family physician and therapist. They all agreed that we could no longer provide a safe environment for our son. The thinking was that he needed some type of 24/7 supervised care. Soon my husband came home and we began the process of calling facilities and trying to figure out what we were going to do.

At 11am my son’s school called. He had gone to school. We were very surprised by this news. The school was actually calling to let us know that our son was behaving very erratically and had walked off the campus. The school then had to notify the police. At 2pm my son came walking into the house, very disheveled, stated he was coming to get his things and was going to live in a shed at his school. We talked him into staying for awhile and he fell asleep.

While he was sleeping we made arrangements for him to go to a wilderness therapy program. A neighbor had sent their son there a year ago and recommended it. It is an 8 week wilderness program with a strong counseling component. At the time, with our son’s hiking and camping background, we thought it would be a good fit. We made arrangements to take him there the next morning.

This was the hardest decision we have ever had to make for our son. It broke our hearts to send him away. We both wept uncontrollably for weeks. We were all out of control…

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Yesterday we visited our son for the second time. He looks good and has put on weight. He is able to carry on meaningful conversations. His short term memory is improving. Recovery is a struggle. Some days are better than others. The drug cravings are still there but he is thankful that he is in treatment.

What stood out to me was my son stating that he is 19 days sober and that his sobriety date is March 27th. He displayed a self-assurance about his sobriety that he we had not seen from him. These numbers are significant milestones. The fact that he states, knows and recognizes the number of days sober and his sobriety date, means that he is taking ownership in his recovery.

These are big steps for our son. He has never spoken in these terms before…19 days.

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My husband and I discuss all the time what our son’s next step will be after treatment. Halfway house, intensive outpatient or sober living? By thinking about the next step, we are preparing ourselves for that conversation.

We also recognize that our son must decide what is best for him. This is a decision that he will make with the help of his treatment team and our support.

It is important to remind ourselves to live in the moment and take it one day at a time…next step.

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