Addiction
Why Can’t My Kid Stop Using Opioids?
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What Is
Addiction? The word addiction is used in several different ways. One definition describes physical addiction. This is a biological state in which the body adapts to the presence of a drug so that drug no longer has the same effect, otherwise known as a tolerance. Another form of physical addiction is the phenomenon of overreaction by the brain to drugs (or to cues associated with the drugs). An alcoholic walking into a bar, for instance, will feel an extra pull to have a drink because of these cues. However, most addictive behavior is not related to either physical tolerance or exposure to cues. People commonly use drugs, gamble, or shop compulsively in reaction to being stressed, whether or not they have a physical addiction. Since these psychologically based addictions are not based on drug or brain effects, they can account for why people frequently switch addictive actions from one drug to a completely different kind of drug, or even to a non-drug behavior. The focus of the addiction isn't what matters; it's the need to take action under certain kinds of stress. Treating this kind of addiction requires an understanding of how it works psychologically. When referring to any kind of
addiction, it is important to recognize that its cause is
not simply a search for pleasure and that addiction has
nothing to do with one's morality or strength of character.
Experts debate whether addiction is a "disease" or a true
mental illness, whether drug dependence and addiction mean
the same thing, and many other aspects of addiction. Such
debates are not likely to be resolved soon. But the lack of
resolution does not preclude effective treatment. All About the
Teen Years There’s a reason that teenagers
act the way they do. Understanding the brain science behind
teenage behavior can help parents better prepare their kids
to avoid drugs and alcohol. Why Do Teens Act
The Way They Do? From mood swings to risk taking, “normal teenage behavior” can appear to be anything but normal to parents and other adults. However, research reveals that patterns of brain development during these formative years play a significant role in shaping your teen’s personality and actions. In other words, there’s a biological reason teens act the way they do. Scientists have learned that it takes a brain about 25 years to fully develop. To some degree, you can consider the teen brain still on “training wheels” – it’s not yet able to perform at optimal adult levels. A huge burst of development happens during adolescence, and that burst can explain a lot of unpredictable – and sometimes risky – teen behavior. The Adolescent Brain and the Behavior it Causes From early adolescence through the mid-20s, the brain develops somewhat unevenly, from back to front. This may help explain teens’ endearingly quirky behavior, but it also makes them prone to risk-taking. Parts of the brain drive different behaviors.Brains develop back to front. So what? (Here's what.)And how do we know that? (Brain imaging technology.) Developing brains may be more prone to damage. The parts of the adolescent brain that develop first are those that control physical activity, emotion and motivation, in the back of the brain in the cerebellum, amygdala, and nucleus accumbens respectively. However, the part of the brain that controls reasoning and impulses – known as the prefrontal cortex – is near the front of the brain and, therefore, develops last. This part of the brain does not fully mature until the age of 25. The staggered development of certain parts of the brain can have noticeable effects on adolescent behavior. You may have noticed some of these in your teen:
The development of the adolescent brain and behavior are closely linked. The prefrontal cortex, which could be called the ‘voice of reason’ in the teen brain, isn’t as influential as those parts that place a higher emphasis on emotion, excitement and short-term reward. In an instant, hormones can shift your teen’s emotions into overdrive, leading to unpredictable – and sometimes risky – actions. Unfortunately, developing brains are generally more prone to damage. This means that experimentation with drugs and alcohol can have lasting, harmful effects on your teen’s health. The Effects of Drugs on the Teen Brain Finding ways to satisfy needs and desires is part of life. It’s one of the many skills being fine-tuned during the teen years. When a teen takes drugs in order to feel good, it interferes with the body’s natural ability to do so. Here’s how drugs affect the brain: The brain is made up of billions of nerve cells. Nerves control everything from when the heart beats to what your teen feels, thinks and does. They do this by sending electrical signals throughout the body. The signals get passed from nerve to nerve by chemical messengers called neurotransmitters. For example, some of the signals that neurotransmitters send cause a feeling of satisfaction or pleasure. These natural rewards are the body’s way of making sure we look for more of what makes us feel good. (For instance, when we eat something tasty, neurotransmitters tell us we feel good. Seeking more of this pleasure helps to ensure we don’t starve.) The main neurotransmitter of the “feel-good” message is called dopamine. Drugs overload the body with dopamine — in other words, they cause the reward system to send too many “feel-good” signals. In response, the body’s brain systems try to right the balance by letting fewer of the “feel-good” signals through. As time goes on, the body needs more of the drug to feel the same high as before. This effect is known as tolerance, and it can be especially dangerous in the cases of drugs like heroin and cocaine. The effects of drugs on the brain don’t just end when the drug wears off. When a person stops taking a drug, dopamine levels remain low for some time. He or she may feel down, or flat, and unable to feel regular pleasures in life. The brain will eventually restore the dopamine balance by itself, but it takes time — anywhere from hours, to days, or even months, depending on the drug, the length and amount of use, and the person. Because teenagers have an over-active
impulse to seek pleasure and less ability to consider the
consequences, they are especially vulnerable when it comes
to the temptations of drugs and alcohol. And because the
internal reward systems are still being developed, a
teen’s ability to bounce back to normal after using
drugs may be compromised due to how drugs affect the
brain. Preventing Teen
Drug Use: Risk Factors & Why Teens Use Common Risk Factors Unfortunately, when it comes to kids and alcohol, parents can’t just gaze into a crystal ball to find out whether their kids will face problems with drinking or drug use in their teenage years. But there are biological and environmental factors you can watch out for to help you figure out if your child may be at a greater risk for addiction. It is important to keep in mind that risk factors do not determine a child’s destiny — instead, they provide a general gauge as to the likelihood of drug or alcohol use. But it is safe to say that addressing risk factors early and paying careful attention to children at higher risk can reduce that child’s likelihood of a future problem with drugs or alcohol. Understanding risk factors is also very important when a child with more risk has already experimented with substances or has a problem. Family History Family history of drug or alcohol problems can place a child at increased risk for developing a problem. While there is a stronger biological risk if a child’s parents have addiction problems, he or she is still at an elevated risk if an aunt, uncle, grandparent or cousin has an addiction or is in recovery. Of course, inheriting the gene does not mean the child will automatically become dependent on alcohol — no single risk factor determines a child’s destiny. If there is a history of a dependence or addiction in your family, you should let your child know since he or she is at a higher risk for developing a drug or alcohol problem. These conversations should take place no later than the pre-teen or early teen years. Discuss it in the same way you would if you had a disease like diabetes. Not sure what to say? Try changing the following script to fit the needs of your situation and family: “Your grandfather had a disease called alcoholism. It means he wasn’t able to drink alcohol, and when he did drink and wasn’t watching out for his health, it really hurt me and other people he loved. Yes, drinking is legal but some people can handle it and some people can’t. This disease can run in families so it’s something you need to watch out for — and I’m going to help you do that.” Mental Health or Behavioral Issues If your child has a psychiatric condition like depression, anxiety or Attention Deficit Hyperactivity Disorder (ADHD), he or she is at more risk for a drug or alcohol problem. Although not all teenagers with these disorders will develop a substance abuse problem, the chances are higher when they have difficulty regulating their thoughts and emotions. Therefore, parents with children with psychiatric conditions should be vigilant about the possibility of their teen using drugs or alcohol. It is also a good idea to talk with your health care providers about the connection between psychiatric conditions and substance use. Managing and treating underlying psychiatric conditions, or understanding how emotional and behavioral problems can trigger or escalate a substance use problem, is important for reducing risk and preventing co-occurring disorders. Trauma Children who have had a history of traumatic events (such as witnessing a car accident, experiencing a natural disaster, being a victim of physical or sexual abuse, etc.) have been shown to be more at risk for substance use problems later in life. Therefore, it is important for parents to recognize the possible impact of trauma on their child and get help for their child to address the issue. Impulse Control Problems Children who frequently take risks or have difficulty controlling impulses are more at risk for substance use problems. While most teens understand the dangers of taking risks, some have particular difficulty resisting impulses to engage in risky behavior — especially as teenagers. Why Teens Use Drugs & Alcohol It’s important to try and understand where interest in drug and alcohol use might come from. Beyond risk factors, teens have their own reasons for using drugs or alcohol. Below are some of the key factors that influence their decisions to do so. Other People Teenagers see their parents and other adults drinking alcohol, smoking cigarettes and, sometimes, trying other substances. Sometimes friends urge one another to have a drink or smoke pot, but it’s just as common for teens to start trying a substance because it’s readily available and they see all their friends enjoying it. Popular Culture Forty-five percent of teens agree with the statement “Movies and TV shows make drugs seem like an okay thing to do.” (PATS 2012) So be aware of the media that your son or daughter is consuming and talk to them about it. Escape and Self-Medication When teens are unhappy and can’t find a healthy outlet for their frustration or a trusted confidant, they may turn to chemicals for solace. The often rough teenage years can take an emotional toll on children, sometimes even causing depression, so when teens are given a chance to take something to make them feel better, many can’t resist. Boredom Teens who can’t tolerate being alone, have trouble keeping themselves occupied or crave excitement are prime candidates for substance use. Not only do alcohol and marijuana give them something to do, but those substances help fill the internal void they feel. Rebellion Alcohol is the drug of choice for the angry teenager because it frees him to behave aggressively. Methamphetamine, or meth, also encourages aggressive, violent behavior, and can be far more dangerous and potent than alcohol. Marijuana, on the other hand, often seems to reduce aggression and is more of an avoidance drug. The reasons for teenage drug-use are as complex as teenagers themselves. Instant Gratification Drugs and alcohol work quickly. The initial effects feel really good. Teenagers turn to drug use because they see it as a short-term shortcut to happiness. Lack of Confidence Many shy teenagers who lack confidence report that they’ll do things under the influence of alcohol or drugs that they might not otherwise. Not only do you have something in common with the other people around you, but there’s the mentality that if you do anything or say anything stupid, everyone will just think you had too many drinks or smoked too much weed. Misinformation Perhaps the most avoidable cause of
substance use is inaccurate information about drugs and
alcohol. Nearly every teenager has friends who claim to be
experts on various recreational substances, and they’re
happy to assure her that the risks are minimal. Educate your
teenagers about drug use, so they get the real facts about
the dangers of drug use. Preventing Teen
Drug Use: How to Spot the Early Warning Signs Even if you don’t find direct evidence, it’s important to always trust your gut — take action by talking with your child and seeking help if necessary. How to Find Out if Your Child is Using Drugs or Alcohol Use Your Nose. Have a real, face-to-face conversation when your son or daughter comes home after socializing with friends. If there has been drinking or smoking, the smell will be on their breath, on clothing and in their hair. Look Them in the Eyes. When your child gets home after going out with her friends, take a close look. Pay attention to his or her eyes. Eyes will be red and heavy-lidded, with constricted pupils if they’ve used marijuana. Pupils will be dilated, and he or she may have difficulty focusing if they’ve been drinking. In addition, red, flushed color to the face and cheeks can also be a sign of drinking. Watch for Mood Changes. How does your teen act after a night out with friends? Are they loud and obnoxious, or laughing hysterically at nothing? Unusually clumsy to the point of stumbling into furniture and walls, tripping over their own feet and knocking things over? Sullen, withdrawn, and unusually tired and slack-eyed for the hour of night? Do they look queasy and stumble into the bathroom? These are all signs that they could have been drinking, using marijuana or other drugs. Monitor Driving and the Car. Your teen’s car and driving habits can offer clues as well. Is driving more reckless when he or she’s coming home after being with friends? Are there new, unexplained dents? If you’re suspicious, examine the inside of the car too. Does it smell like smoke or alcohol fumes? Are there any bottles, pipes, bongs, or other drug paraphernalia rolling around on the floor or hidden in the glove box? If you find evidence of drug use, be sure to prepare for the conversation ahead. Keep an eye out for deceit or secretiveness. Are their weekend plans starting to sound fishy? Are they being vague about where they’re going? Can they describe the movie they supposedly just saw? They say parents will be at the party they’re attending, but can’t give you a phone number and come home acting intoxicated? They get in way past curfew or estimated time with an endless string of excuses? When excuses fail, do they respond to your inquiries and concern by telling you that it’s none of your business? If these ring true, something is wrong and it’s time to take action. Should You Search Their Room? The limits you set with your child do not stop at their bedroom door. If you notice concerning changes in behavior, unusual odors wafting from their room (like marijuana or cigarette smoke), smells to mask other smells like incense or air fresheners, or other warning signs, it’s important to find out what’s going on behind that “KEEP OUT” sign. One note of caution, however. Be prepared to explain your reasons for a search, whether or not you decide to tell them about it beforehand. You can let them know it’s out of concern for their health and safety. If you discover that your kid is not drinking or doing drugs, this could be a good time to find out if there’s something else that may need to addressed. Kids come up with some crafty places to conceal alcohol, drugs, and drug paraphernalia. Some possible hiding spots include:
Don’t overlook your teen’s cell phone or other digital devices. Do you recognize their frequent contacts? Do recent messages or social media posts hint at drug use or contradict what they’ve told you? If your search turns up evidence of
drug use, prepare
for the conversation ahead and
do not be deterred by the argument of invaded privacy. Stand
by your decision to search and the limits you’ve
set. Look for
Warning Signs If you’ve noticed any of the described changes or behaviors in your child, don’t be afraid to err on the side of caution. Prepare to take action and have a conversation during which you can ask direct questions like “Have you been drinking or using drugs?” While no parent wants to hear “yes,” being prepared for how you would respond can be the starting point for a more positive outcome. "The signs were vividly present yet camouflaged with aspects of what appeared to be just teenage behaviors. Looking back I realized, with great anguish, how my stepdaughter’s disease of addiction manifested right before our very eyes." - Linda Quirk, mother/stepmother of 3 Of course, not every child is inclined to confess and a “no” could also mean they’re in need of help for other reasons, including a mental health issue. In either case, experts strongly recommend that you consider getting a professional assessment with your child’s primary care doctor or a clinical psychologist to find out what’s going on. Behavioral Changes
Mood & Personality Shifts
Hygiene & Appearance Problems
Health Issues
School and Work Concerns
At Home and in the Car
You can never be too safe or speak up too soon. Even if you think they’re just
“experimenting.” Download our Intervention
eBook (12 page PDF) and begin
taking the first steps toward helping your child with his or
her substance use. Prepare to Take
Action if You Suspect Teen or Young Adult Drug Use Talk With Your Spouse or Partner We’re all familiar with the trick of turning to one parent when the other says no. It’s best if you and your spouse come to a common stance on drug and alcohol use before raising the subject with your child.
Prepare to be Called a Hypocrite You’re likely to be asked whether or not you’ve done drugs, and there are ways to answer honestly that keep the emphasis less on you, and more on what you want for your son or daughter. You could explain that you tried drugs in order to fit in, only to discover that’s never a good reason to do anything. Or you can focus on the fact that drugs affect everyone differently, and just because your life wasn’t harmed by drug use, you’ve seen it happen to too many others. Don’t let your response become a justification for your child’s drug use. Focus on the issue at hand – that you don’t want your son or daughter drinking or using drugs.
How to Talk to Your Kids About Drugs if You Did Drugs You can do this, and we can help. You may even be able to use past experience to your advantage. Gather Any Evidence It’s understandable to have some reservations about snooping in your child’s room or through their belongings, but remember, your primary responsibility is to their well-being. As you gather evidence, try to anticipate different ways they might deny using, like the excuse “I’m holding it for someone else.” Even if you don’t have an airtight case, you’ll be better prepared for the important conversation to come. Common hiding places include:
Expect anger, and resolve to remain calm If you think the conversation will be uncomfortable for you, imagine how uncomfortable it will make your son or daughter. Be prepared for them to say things to shock you, deny even the most convincing evidence, accuse you of distrust, and worse. Think about how you’ll handle an angry or resentful reaction from your child.
Set a Realistic Goal Things will go more smoothly if you have a desired outcome in mind. It’s OK – and probably for the best – to keep expectations low. It may be unrealistic to expect your child to admit to use and pledge to stop. A more reasonable objective, like simply expressing that you don’t want him or her to use, can be a win.
Spell Out Rules and Consequences Before the conversation starts, think through which rules you would like to put in place, and what the consequences of breaking them will be. This can help clarify the goal of your conversation, and help you set a clear next step. For more tips, see advice on setting limits.
Recognize Any Addiction in the Family Don’t deny addiction in your family. Use it as a way to talk to your child and regularly remind him or her of their elevated risk. Drug and alcohol dependence can happen to anyone. But if there is a history of addiction – cocaine, alcohol, nicotine, etc. – in your family, your child has a much greater risk of developing an addiction. Explain that while they may be tempted to try drugs, the odds aren’t in their favor. Their genes make them more vulnerable to developing a dependence or addiction. Download your free guide to speaking up You can never be too safe or speak up too soon – even if you think they’re just “experimenting.” Download the Intervention eBook, our comprehensive guide to taking the first important steps to address your child’s drinking or drug use. Source: drugfree.org/article/prepare-to-take-action/
When You Discover Teen or Young Adult Drug Use: Start Talking
Learn how to have a conversation instead of another confrontation. Set the Stage Take a deep breath and set yourself up for success by creating a safe, open and comfortable space for to start talking with your son or daughter.
Establish a Good Connection As angry or frustrated as you feel, keep reminding yourself to speak and listen from a place of love, support and concern.
How to Have a Conversation not a Confrontation Learn how to best approach your son or daughter about his or her drug use, how to remain calm and make it a productive conversation. Now You’re Talking You’ve collected your thoughts and steeled your nerves, but how do you actually start talking? And more importantly, get your child to talk too?
Break Through Barriers It can be difficult to get past a flat-out denial of drug or alcohol use from your son or daughter. Some kids can’t bear to take responsibility for their behavior and want to look good at all costs.
Keep the Conversation Going Have you succeeded in having a productive conversation? Give yourself a well-deserved pat on the back, but don’t stop there. Keep talking and keep the dialogue open.
Get Expert Advice on Talking with Your Teen or Young Adult Child Therapists and parenting experts share
advice on preparing for and engaging in more productive
conversations with your child. When You
Discover Teen or Young Adult Drug Use: Set Limits &
Monitor Establish Rules & Consequences Rules provide a concrete way to let your child understand what’s expected of him or her and to learn self-control. Don’t just assume they “know” you don’t want them to drink or do drugs. Teens and young adults don’t deal well with gray areas, so when they’re offered alcohol or drugs, you don’t want any confusion in their minds. If you’re a parent who feels bad about setting limits, remember that deep down, your child actually wants them. Rules mean that you care about your child and his or her safety. And consequences actually help – not hurt them. A firm consequence, such as getting grounded or having to give up a fun privilege, will remind your child what not to do in the future. When you lay out rules and consequences, make sure you’re clear – and that your child understands the limits you’ve set before there’s opportunity to do something wrong. One great way to do this is to actually write out the things you expect from one another (being home before curfew, getting a ride home from a party if things get out of hand), and jointly sign off on them, in effect, creating a contract. Write a Contract with Your Child Put it writing with a simple contract establishing clear rules and consequences. Use our template to get started. Write a Contract with Your Kids Monitor How will you know that your son or daughter is following the rules? By keeping a close eye on him or her and communicating regularly about their whereabouts, friends, activities, and more. Ways to keep closer tabs on your child:
Keep Track & Take Notes When drug use is suspected, and even once it’s confirmed, it’s useful to keep records of everything that concerns you over time – the date, time, where it occurred, what was found, and changes over time. Your child will likely work hard to convince you that things didn’t happen the way you remember, or that the things you found are not what you think they are. In addition, all of this information will be invaluable should it become necessary to seek outside help. Helpful Things to Note:
BOTTOM LINE Just because your child agrees to something during an initial intervention, it doesn’t mean their drug use or related behavior will actually stop. You need to set limits and firm consequences. No one wants to be a mean parent, but setting rules is ultimately about keeping kids safe. Download your free guide to speaking up You can never be too safe or speak up
too soon. Download the Intervention eBook, our comprehensive
guide to taking the first important steps to address your
teen or young adult’s substance use. What are the
Treatment Options? Treatment for teens and young adults struggling with substance us or addiction can take place in different forms, settings and for different lengths of time — and the type you don’t know about could end up being the best one for your child. Before you make any decisions, take time to understand the options. Understand What’s Available Approaches to treating addiction are generally similar regardless of substance. However, treatment is typically individualized to some degree based on the characteristics of the patient — treatment programs usually address an individual’s physical, psychological, emotional, and social issues in addition to his or her alcohol or other drug use — as well as the type of substance itself, as in the case of medication-assisted treatment for opioids. Review the overview of different types of programs below. And if you haven’t already done so, be sure to review our information on Navigating the Treatment System. "I've heard from countless young people that the reason they got into recovery was because of a parent who fought for them when they couldn’t figure out how to help themselves." - Pat A. Treatment Program Types OUTPATIENT Low to Medium Intensity Clients typically attend no more than nine hours of treatment a week (slightly less for teens) at a specialty facility while continuing to live at home. Many programs make services available in the evenings and on weekends so individuals can remain in school or continue to work. INTENSIVE OUTPATIENT Medium to High Intensity Clients attend 10-20 hours of treatment a week (slightly less for teens) at a specialty facility while continuing to live at home. Many programs make services available in the evenings and on weekends so individuals can continue to work or stay in school. A better option for individuals who need multiple services, have accompanying medical or psychological illnesses or have not been successful in outpatient treatment. DAY TREATMENT / PARTIAL HOSPITALIZATION Medium to High Intensity Clients attends four to eight hours of treatment a day (20 or more a week) while continuing to live at home. Most families use these types of programs when their child needs an intensive and structured experience. Day treatment can be appropriate for individuals with co-occurring mental illness. RESIDENTIAL Medium to High Intensity These programs provide treatment in a residential settings and can last from one month to a year. Typically, residents go through different phases as they progress through the program. During certain phases, contact with your child may be limited. Ask questions about the program’s policies and procedures, and any additional services like education or vocational training. INPATIENT High Intensity Treatment provided in specialty units of hospitals or medical clinics offering both detox and rehabilitation services. Typically used for people with serious medical conditions or mental disorders. MEDICATION-ASSISTED TREATMENT For individuals with a physical dependency on certain drugs, primarily heroin and other opioids, medication is provided in a specialized outpatient setting in combination with counseling and other treatment services. Learn more about Medication-Assisted Treatment for Opioids >> Services Offered Most treatment programs offer a combination of the services listed below. It’s important for individuals struggling with substance use to receive a comprehensive range of services. If a service is not offered at your child’s program, the staff there should be able to help your family find it elsewhere. INDIVIDUAL COUNSELING One-on-one counseling to explore personal problems that an individual may not be comfortable discussing in a group setting. GROUP COUNSELING Usually consists of six to ten people with one or two counselors facilitating a discussion of their struggles, experiences and problems. HOME BASED SERVICES Substance use and mental health treatment services provided in-home. Examples include Adolescent Portable Therapy (APT) and Multidimensional Family Therapy (MDFT). EDUCATIONAL SERVICES Grade-appropriate classes (or GED classes) for teens still in school, or those who may have dropped out, to help reduce disruptions to their schooling. VOCATIONAL SERVICES Services to help determine an individual’s vocational aptitudes and interests, along with job skills, resume development and other work readiness skills. LIFE SKILLS Focuses on behavioral tools designed to help a teen or young adult cope with the stresses and challenges of daily life and develop greater self-esteem in order to better manage their recovery. TREATMENT FOR MENTAL ILLNESS Individuals diagnosed with co-occurring mental illness need treatment for their substance use in addition to the mental illness, ideally in an integrated fashion. Treating the substance use alone will not help resolve underlying mental illness, and treating a depressive disorder alone will not resolve the substance use or dependence. FAMILY SERVICES In most cases, family involvement is an important element in treating teens and young adults. It helps family members understand addiction as a chronic illness, helps the family have realistic expectations and goals for treatment, and helps improve communication and overall family functioning. CONTINUING CARE Sometimes labeled After Care or Follow-up Care, this includes treatment prescribed after completion of a formal structured program in any type of setting. It is a necessary support plan for ensuring that the tools learned in treatment can be applied successfully in the real world. Learn more about Continuing Care >> Recovery Supports and Services Recovery from addiction or a substance use disorder is more than abstinence. Recovery is about improving one’s quality of life, being emotionally and physically healthy, succeeding in school or work, having healthy relationships, having a healthy social life and living drug-free. For most people, maintaining recovery requires supports and services after formal treatment is completed. Common recovery supports and services include the following; RECOVERY OR SOBER HOUSE These are transitional residences for adults 18 years and older in recovery. Homes usually have a small number residents, a small professional staff, clear and enforced rules about abstinence and a significant level of structure. Potential residents should be able to make a three- to six-month commitment to living in a group situation where a major focus is remaining sober. SOBER DORMS For teens and young adults entering or already in college, you can ask the university if there are any dorms set aside for students in recovery from alcohol or other drug addiction. If not, you can ask about the procedure for establishing a sober dorm on campus; as requests increase, more universities are likely to create them for young people in recovery. RECOVERY HIGH SCHOOLS High schools that combine a state-approved curriculum (make sure the school meets requirements for granting diplomas) with recovery supports and services. For a list of recovery high schools as well as universities with sober dorms, visit www.recoveryschools.org. ALCOHOLICS ANONYMOUS (AA) and NARCOTICS ANONYMOUS (NA) 12-Step groups of men and women that
come together to share their experiences, provide support
and stay sober. It’s important to find a group your
child is comfortable with such as a meeting with other young
people in recovery. How to
Navigate the Addiction Treatment System What is Treatment? For most people, “treatment” for substance use conjures images of detox or a residential rehab facility. In reality, detox (detoxification) is not treatment, and a residential program is just one of a variety of options. Treatment can take place in different forms, settings and for different lengths of time. The approach to treating addiction is generally similar regardless of substance. However, treatment is typically individualized to some degree based on the characteristics of the patient — programs usually address an individual’s physical, psychological, emotional and social issues in addition to his or her alcohol or drug use — as well as the type of substance itself, as in the case of medication-assisted treatment for opioids. Unfortunately, when it comes to addiction and substance use disorders, just as with other health conditions, there are no guarantees for the perfect treatment, and it can be difficult to access quality care. Addiction is a manageable but chronic disease, just like diabetes or asthma. Because it is a chronic, relapsing disease, treatment should not be approached as a way to “cure” your loved one. It is a first step in helping your child learn how to manage his or her addiction. How to Find the Right Treatment Getting the right treatment for your child is a process, and navigating the current systems in place requires due diligence and perseverance. There are services that may offer to find a treatment program for you at no charge; be careful as there are unscrupulous people out there who will pretend to have your best interests at heart, but are more interested in their own financial benefit (see our note on referral services). We are a nonprofit, and our parent services are made available for the sole purpose of helping you find the best solutions for your child and your family. EDUCATE YOURSELF One of the most important things you can do to help your child is to educate yourself about substance use disorders, what quality treatment consists of, and the types of programs available. Using the various resources offered here on this site is a great start. GET A SCREENING ASSESSMENT In order to determine the severity of the issue and an appropriate level of care, you may wish to have a substance use counselor take an assessment. It should include a thorough look at the extent of your child’s drug and alcohol use, your child’s mental and physical health as well as personal, medical and family history. NETWORK Talk to the people around you. You may feel like keeping your child’s drug or alcohol problem a secret, but you shouldn’t. Addiction is a chronic disease, not a moral failing on your part or your child’s part. The people you’re hiding from may be the same people who could connect you to needed help, offer support or a shoulder to cry on. UNDERSTAND THE OPTIONS There are many types of treatment services available, in a variety of settings, including outpatient, inpatient, and residential. And none of it is one-size-fits-all. Before you make any decisions, know the options. CONSIDER LOCATION Family involvement is a critical element of adolescent and young adult treatment, making location an important factor. If you live in an area that doesn’t have the level of care your child needs, and you choose remote care, discuss with the program how your family will be involved (e.g. phone or video calls, emails, family visits, etc.). MAKE CALLS, ASK QUESTIONS You can’t be sure if a program is the best fit for your child unless you get to talk to the people there and ask the right questions. It will be time-consuming — but worth it. Health Insurance and Paying for Treatment Unfortunately, the current reality is that treatment programs can be shockingly expensive. But there are options available that can help your family handle the financial burden of paying for needed treatment. We know it is not easy, but the more information you have the better able you will be to make good decisions for your child and family. There are several options when it comes to paying for substance abuse treatment for your child. One of the most common is through private health insurance, but additional options to explore include Medicaid, Veterans Administration benefits (if you’re a military family), Employee Assistance Programs (EAP), student health services, clinical trials, financial aid, payment plans and a sliding fee scale. Under the Affordable Care Act, many health insurance plans are required to include mental health and substance use disorder coverage; however coverage varies state by state and plan by plan. Earlier legislation also requires that those plans that include mental health coverage provide the same level of coverage as they do for other physical illnesses. It’s important to understand what your insurance will cover. For example, your plan may say that it covers 30 days of residential treatment, but they may decline allowing you to use this benefit if they believe an outpatient program is sufficient. In such instances you can ask for an emergency appeal, which in most cases is done within 24 hours. It may also help to investigate whether they will cover an outpatient program with a boarding component. In the treatment world, this is often referred to as the “Florida Model.” These are facilities that will provide treatment five days a week with activities scheduled for the weekend, coupled with boarding. And of course there’s the issue of how your coverage may be structured. Do you have a deductible (an amount you have to pay before insurance kicks in)? What is your co-pay (usually expressed as a percentage of covered costs)? Is coverage in-network only? You don’t want to be blindsided by hidden or unexpected costs. Getting Your Child Into Treatment Understandably, you may have concerns about actually getting your child to begin treatment. Many good treatment programs know how to engage teens and young adults in treatment and to help them recognize the importance of it. You can always seek help from the program you have selected. This is a good opportunity to talk to your child about your concerns for his or her life, health, and safety, and about how entering treatment may be a little scary but it’s a step toward a healthier life. Depending on the state you live in, your child may have to agree to treatment. Some programs won’t accept children if they don’t agree to attend, even if they are under 18. You may have legal options available to you but it depends on the specific laws in your state. Although the registration process can vary from program to program, the following are few things to look out and be prepared for: MOST PROGRAMS REQUIRE A PRE-SCREENING. You or your child may be interviewed over the phone, but that doesn’t mean your child will (or should) end up in that program. If it isn’t a good fit, the provider should refer you to another program that can better meet your child’s needs. THERE IS A LOT OF PAPERWORK. You may feel overwhelmed by it, but it is important that you read the paperwork carefully and not just sign at the dotted line. Be sure to ask your son or daughter to sign a release allowing you to speak with personnel at the treatment facility. Absent such consent, the facility becomes bound by HIPPA protocol, and they’ll be unable to share information with you. THERE WILL BE A FULL INTAKE PROCESS. This should include questions about your child’s drug use, your family, your child’s medical history, educational history and mental health. YOUR CHILD AND HIS OR HER BELONGINGS MAY BE SEARCHED. It is not uncommon for patients to try to sneak drugs or alcohol into a residential treatment center. So be aware that they may take your son or daughter into a private room and search clothes and belongings. For some this can feel like an invasion of privacy, but it is necessary and important to ensure a substance-free environment. AFTERCARE SHOULD BE A PART OF THE TREATMENT PLAN. Treatment is not over after discharge; rather that is when much of the hard work is really just beginning. Families need a successful discharge plan that can be realistically implemented. Explore the topic of Continuing Care to learn more. WAITLISTS EXIST. In some areas there are extensive waitlists for treatment services. We understand the frustration and added challenges this creates. If you find yourself in this situation, consider calling your state’s Department of Human Services and your state’s Department of Mental Health & Addiction Services (or equivalent agencies) to see if they can direct you to available treatment programs. Recovery centers, Angel Programs connected to law enforcement and word-of-mouth at 12-step and support group meetings are also great resources for learning where or how to get treatment more quickly. In some cases, simply being persistent and calling a facility on a daily basis can help your loved one move up on the list. Taking Care of Yourself Although you are probably not thinking about yourself right now, one of the smartest things you can do for your child in trouble and your family is to take care of yourself so that you remain strong, healthy, and sane. Many parents with a sick child forget about their own emotional and physical health. But remember, just as your child needs to get healthy and learn life without drugs and alcohol, you and your family also need to get healthy and stay healthy. Seeking professional counseling for yourself is just as important as getting help for your addicted child. While your child is battling an alcohol or other drug problem, you’re also likely struggling with some overwhelming feelings of fear, anger, resentment, guilt or shame, among others. Physical symptoms like migraine headaches, insomnia and upset stomach or indigestion are not uncommon. Embracing the notion of self-care at a time when it feels like your world is crumbling will be more of challenge for some than for others. But the need for self-care, and its benefits to not just yourself, but your entire family, can’t be overlooked or overstated. Learn more about taking care of your own needs and why self-care isn’t just for yourself. A NOTE ON REFERRAL SERVICES: If you’ve searched online for
help or treatment for your loved one, you’ve likely
encountered what are advertised as free treatment referral
services. These services are frequently affiliated with
private, for-profit treatment providers. Those providers may
indeed offer reputable treatment, but it’s important to
be well informed before engaging with a service that could
be putting someone else’s bottom line above the best
interests of your family How
to Find an Addiction Treatment Provider Find a Treatment Provider The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains and manages the most comprehensive searchable database of treatment providers across the country. Before using this tool it’s helpful to have already done your homework on the types of treatment available — like intensive outpatient or residential care — so that you can target your search most effectively. The SAMHSA treatment locator is a robust tool with a variety of filtering options such as type of care provided, treatment setting, payment types accepted, languages spoken, etc. in order to focus in on your family’s specific needs. It can be overwhelming, however. There is a great video tutorial available to help walk you through it. Once you have a list of potential treatment or rehab providers, it’s important to call and ask the right questions to determine who can best meet your family’s needs. For example, you may need a rehabilitation program that in addition to substance use also addresses trauma, self-harm behaviors or other mental health needs. There are lots of important questions to ask with regard to insurance and payment options as well. A treatment or rehab facility may state that they take private insurance, but you’ll need to verify that your insurance company will authorize use of your benefits for the type of services selected. You may also find working with a
certified addictions professional helpful to sorting through
the available treatment options and determining the best
rehab programs to consider in light of your child’s
needs and other important factors like location and
financial accessibility. Skills to Help
Your Child and Family Heal But there’s another way. What is CRAFT? 3:47 If your teen or young adult child is experimenting with alcohol and drugs or has a full-blown substance use disorder, you likely feel frustrated, overwhelmed and helpless. Community Reinforcement and Family Training, or CRAFT, is a scientifically proven approach to help parents change their child’s substance use by staying involved in a positive, ongoing way. CRAFT, created by Dr. Robert Meyers and expanded upon by the psychologists at the Center for Motivation & Change, is an approach to help family members change the way they have been interacting with their child to influence choices around substance use. CRAFT provides families like yours with tools to better understand your child’s reasons for substance use, ways to improve communication and to reward non-using behaviors while discouraging substance use. Equally important are the tools around self-care to handle negative emotions like anger, guilt and depression, and to address feelings of isolation. Principles of CRAFT Our CRAFT
video series helps bring these
principles to life via real families that have been there
just like yours, and for whom the skills and practices of
CRAFT were a game changer.
Behaviors Make Sense It’s helpful for family members to ask themselves what is driving their loved one’s behaviors around substance use. It could be anything from boredom and a lack of purpose, to feeling left out and insecure, to curiosity and thrill seeking. Understanding the “why” behind your child’s drug and alcohol use can foster empathy for your child and also help you think about ways to encourage healthier behaviors that compete with his or her substance use. Active Listening When a child is using substances, lecturing, blaming, criticizing, yelling and the silent treatment are common. The response on the child’s part is to get defensive or to deny that there is any problem, as trust within the family evaporates. CRAFT offers numerous communication tools to improve the way families interact and to create opportunities for a more open dialogue. Active listening can help you better understand what your child is experiencing, so that you can respond in a way that will encourage change for the better. Learn how to have a conversation instead of another confrontation > > Positive Reinforcement It’s easy to focus on everything your child is doing wrong when substance use is in the picture, but to motivate behavior change, it’s helpful to look for and reward what a child is doing that is healthy and productive. Helping a sibling, finding work, getting chores done, coming home on time, attending a family function sober and going to the gym are examples of behaviors families typically want to see more of, and positive reinforcement is the key to making that happen. Reinforcers can be as simple as a hug, a compliment, or a loving text message. Or they can be more substantial like a restaurant gift card, a round of miniature golf, a pedicure, a favorite meal or a full tank of gas. The important thing to keep in mind is to link the non-using behavior to the reward and choose rewards that the child likes. Learn more about Positive Reinforcement > > Natural Consequences It’s natural to want to protect your child from the consequences of their behaviors or diminish the impact, but life can be a great teacher if you let your child learn directly from their experiences. For example, a child might be hungover and ask a parent to call in sick at work for them. If the parent does this, the child may be able to keep the job, but it reinforces their drug use. It would be better if the child had to face the consequences of explaining the absence directly to the employer. CRAFT helps parents step back and allow others, like teachers, employers, law enforcement, non-using friends and romantic interests, to provide boundaries around substance use. Self-Care It’s likely that your child’s substance use has taken its toll on you, whether in the form of excessive worry, or not attending to your own needs to be healthy and happy. CRAFT offers the opportunity to examine your own emotional triggers to develop a more effective response. Taking time to nurture and renew yourself, and remembering that your worry for your child is not a proxy for your love, are at the heart of self-care. It’s also a way to model behaviors for your child so that they see how a healthy adult manages life’s ups and downs. Learn more about Self-Care > > Research studies show that CRAFT has helped two-thirds of people with a substance use problem elect to engage in formal treatment. 1 The studies also show an improvement in the caregivers’ well-being, feeling less depressed and anxious. It takes time and practice, but relationships can get better and loved ones can get healthy. For more information on CRAFT, please call our free Parent Helpline at 1-855-DRUGFREE to speak to a trained and caring parent specialist. Learn More About Using CRAFT to Stay Involved in Positive, Loving Ways CRAFT principles come to life in this short series of videos focused on positive reinforcement, natural consequences, active listening and behaviors making sense. Source: drugfree.org/article/skills-to-help-your-child-and-family-heal/
Teen or Young
Adult Drug Use: Using Positive Reinforcement to Help Change
Behavior Positive Reinforcement: A Powerful Tool to Change Your Child’s Behavior Positive reinforcement is a motivating factor in all our lives, from a toddler who feels encouraged by her parents’ cheering to take her first steps, to an adult who collects a bonus or a tip for a job well done. We are more likely to repeat a behavior when it makes us feel good. Substance use can also be reinforcing. For example, drugs or alcohol may help a person feel less anxious, alleviate boredom, encourage social interactions, help with insomnia, provide energy or help with weight management. In other words, because they “solve a problem” – although in an unhealthy way – the person is more likely to repeat the behavior of using drugs and alcohol. As a parent or caregiver, you can use the same strategy to reinforce healthy, pro-social behaviors you want to see more of in your child. The following are some examples of positive behaviors you can reinforce or praise in your child.
You may be thinking, “Wait — these are things my child should do anyway, without any kind of reward.” But by rewarding your child’s good behavior, you are helping to link a behavior you want to encourage with a positive outcome. Doing this repeatedly will help your child recognize that there is value in acting this way. Over time, he or she will learn that there are other ways to “feel good” besides using substances, which can lead to less substance use or even abstinence. Your kindness and compassion will inspire a positive and warm feeling within your child and reinforce their belief that they are capable of feeling good from means other than using substances. Examples of rewards or reinforcers that are free:
Examples of rewards or reinforcers that cost money:
Watch our skills video on Positive Reinforcement Positive Reinforcement is wonderful skill to use to help your family heal. Click the button below to watch a video about it, created for our CRAFT skill video series. Four tips for using positive reinforcement: 1. Think about your child and what motivates him or her. Often parents will come up with a reward that they personally find reinforcing, but their child could care less. It helps to take the time to develop a list of reinforcers that you think would be appealing, and if you are unsure, ask your child. 2. Consider what a replacement behavior might be. For example, you may want your child to complete homework or look for a job instead of playing video games and getting high. What would be an incentive for them to do so, even if it was just for one day? Alternatively, you may tell your child that if he completes a certain number of assignments or applies for X number of jobs, he or she will get a tangible reward (e.g. a giftcard to Starbucks, two movie tickets, a small clothing item, etc.). 3. Reward the small steps along the way. Eventually they will add up to positive behavior change. So, if your child hasn’t done homework for weeks, but completes one assignment, reinforce it with a tangible reward or a kind comment. If your child hasn’t looked for a job in the past month, but looks on Craigslist and applies to two jobs, notice and praise the action. 4. Try a reinforcing a comment. Instead of saying, “It’s about time!”, try saying: “I know how hard it’s been for you to complete your homework and it’s really great that you were able to complete the assignment.” or “I’m really glad to see that you applied for a job.” BOTTOM LINE: Your child has probably heard a lot of complaints and negative feedback about his or her substance use. But the truth is, you don’t get someone to change by nagging. When people feel unacceptable as they are, they are often stuck and unable to change. Think about your own self. You are probably more encouraged by praise, not criticism. Kind words, compassion and rewards can go a long way in inspiring your child to work toward healthy behaviors – and away from negative ones. Give it a try – it may be a game
changer for both of you. Get One-on-One
Help to Address Your Child’s Substance Use Our specialists will listen to your story — the challenges, setbacks, obstacles and myriad emotions that often go along with a child’s substance use. Given that there is no one-size-fits-all approach and each family is unique, they’ll propose a personalized course of action, offering the best tools and resources to help you help your child, yourself and your family. In case our specialists are busy helping another family, please use the email contact form below to describe your situation and schedule a call back.
Learn more about what separates our services from others you may see advertised >> Connect via Live Chat Live chat with one of our specialists to receive the same help and support with an additional level of privacy for anyone uncomfortable or not able to speak on the phone. In case our specialists are busy helping another family, you will be redirected to an email contact form which you can use to describe your situation and schedule a call back. Expect a response within 48 hours.
Email Us In case you’re unable to call or chat at this time, or you simply prefer email, complete our contact form to receive a personal response from one of our specialists. If you’d like to schedule a call back, please include times during which you are available. telephone-support helpline parent "You were a safety net when I felt like I was drowning. You had resources to suggest and knew just what to say. Thank you for being there." - Helpline caller Parent Coaching Depending on individual circumstances, you may be referred to Parent Coaching during your call to our Helpline 855-378-4373. This program pairs those seeking additional guidance and support with a trained parent volunteer who has also traveled the path of dealing with a child’s substance use. Coaching takes place on the phone – over the course of about five calls – during approximately a six-week period. Coaches are versed in the techniques of Community Reinforcement and Family Training (CRAFT), an evidence-based approach shown to set the stage for positive outcomes. Parent coaches are there to listen, offer ideas and reaffirm that you aren’t alone in this struggle. Parent Coaching relies on volunteers who generously lend their time and emotional energy, so availability is limited. If you’re interested in receiving parent coaching, begin by calling our Helpline 855-378-4373. You can also browse questions most frequently encountered by parents like you, and read what our Parent Coaches have advised, or submit your own question to be answered. Get started under Ask a Parent Who’s Been There. "The experience was so great. I don't know if I could have made it without my parent coach. It's so different to hear from someone who's gone through it. Just an amazing relationship and an incredible experience." - Parent Coaching Participant If you’ve searched online for help or treatment for your loved one, you’ve likely encountered what are advertised as free treatment referral services. These services are frequently affiliated with private, for-profit treatment providers. Those providers may indeed offer reputable treatment, but it’s important to be well informed before engaging with a service that could be putting someone else’s bottom line above the best interests of your family. We are a nonprofit, and our services are made available for the sole purpose of helping you find the best solutions for your child and your family. Our Helpline is not a crisis hotline.
If you are in need of immediate or emergency services,
please call 911 or a 24-hour crisis hotline such as the
National Suicide Prevention Lifeline 1-800-273-TALK (8255)
or the National Domestic Violence hotline 1-800-799-SAFE
(7233). Suggesting
Treatment to a Loved One If your loved one expresses even a little willingness to engage with treatment — whether it’s a consultation, attending an AA or NA meeting, or going to more intensive programs — it can be all the invitation you need to begin the conversation. While the hope is that your loved one will readily and quickly agree to treatment, don’t despair if he or she says no or wants to think about it. There will inevitably be other opportunities to raise the subject again. Managing your expectations around engaging and staying in treatment are a part of good self-care. Note: It’s important to do your homework before suggesting treatment so that you know what programs are suitable, have openings and what means of payment will be accepted. Listen for “Change Talk” So, how does a willingness to get help reveal itself? It usually comes in the form of “change talk.” Change talk is any time your loved one voices a concern over the way things are, or expresses a desire to improve his or her life in some way. Do any of these examples of change talk sound familiar? “I think I really upset Jack [a friend] last night when he thought I had one too many.” “I want to move out and have my own place.” “I wonder if I should go back to school.” When a loved one expresses change talk, take notice and help him or her connect the dots. Compassionately explain how their substance use is related to their concerns in the present and their hopes for a better future. Consider the following contrasting dialogues between a parent (P) and young adult (YA) who is struggling with substance use, can’t get a job and wants to be independent. YA: I really want to move out and have my own place. P: How many times have I heard that? You need to get a decent job. YA: Yeah, I know, but no one’s hiring. P: You mean no one is hiring that doesn’t want a drug screen. When are you going to figure out that employers don’t want stoners? If you’d only get your act together and stop smoking, your life would be so much better. You know, you really ought to go to rehab. YA: That’s ridiculous! It’s not that bad. P: Not that bad? You’re stoned right now. You’d better figure it out pretty soon because your father isn’t going to put up with you not contributing and you’re going to find yourself out on your ear. YA: I have to go. There’s no point in talking to you about anything. Now consider the following exchange which begins with very similar change talk. YA: I really want to move out and have my own place. P: I know you’ve wanted your own place for quite some time. What do you think is holding you back? YA: I can’t get a decent job that pays enough. P: What have employers told you when you’ve applied? YA: They all want drug screens. That’s BS in my opinion. I mean why should they care that I smoke some weed and do a little cocaine now and then. P: So, you want a good job and your goal is to move out, but your drug use is getting in the way. YA: Yeah, that about sums it up. P: What are your thoughts about getting a consultation to see what kind of help might be available to cut back, or quit for at least a while so that you can get a better job? YA: I don’t know… maybe. P: Why don’t you think about it and let’s talk about it again in a day or so. YA: Ok. What can we take away from these conversations? There are several key differences to note. The second exchange remains a respectful conversation without becoming confrontational by using techniques like open-ended questions that lead the young adult to reach his or her own conclusions. The parent likely knows that drug use is at the root of their child’s unemployment, but draws it out of him or her without belittling or judgment. And the timing of this kind of conversation is important. While it’s useful to let a loved one’s change talk open the door to this type of conversation, it’s counterproductive to do so when they’re under the influence, racing out the door, overly tired or might otherwise feel interrupted. Note that in the second conversation, the parent suggests “getting a consultation” rather than demanding, “You have to get treatment” or “You have to go to rehab.” Treatment comes in a range of options and it’s helpful for your loved one to have some degree of input and choice. This could be at the level of treatment (for example, your loved one may agree to attend an intensive outpatient program, but won’t agree to residential treatment) or within a treatment level (for example offering that a loved one could make a choice to attend ABC outpatient program or XYZ outpatient program.) In addition, even though abstinence may be the ultimate goal, it can also be effective to suggest that a loved one consider treatment in order to “cut back” on substance use. Once in treatment, they’ll have an opportunity to examine whether they can moderate and still meet personal goals. Incentives and Leverage Some parents choose to use incentives or leverage to get their teen or young adult into treatment. An incentive ties treatment to something a loved one wants. For instance, “If you complete treatment and remain abstinent, we will help you with a deposit for a halfway house or apartment.” Leverage usually involves taking something of value away. For example: “If you don’t go to treatment, we won’t cover any more of your expenses like tuition or rent.” Sometimes leverage takes the form of disclosing substance use to someone of significance including a probation officer, coach or significant other. Choosing to use leverage in this way should be done as a last resort and with caution, as often loved ones will react defiantly, and the situation could get worse. It helps to present any leverage in a loving way and to give your teen or young adult a week or two to think about it before going through with whatever you’ve decided. A conversation using leverage might begin as follows: “I continue to be concerned about your substance use and would like you to seek a consultation on how to manage your substance use (or go to counseling, an intensive outpatient program, residential treatment, etc…) I know this is something you’ve been opposed to in the past, but the current situation is difficult for all of us and I’d like you to reconsider. If you choose not to seek treatment, I will not pay for college this upcoming semester (or you will have to find alternate housing, lose privileges for the car, etc…) I’d like you to think about it and let me know what you decide by the end of next week.” This is in contrast to “I’m sick and tired of your substance use so either go to treatment or you won’t not see a nickel from me for college. What’s it going to be?” Interventions Intervening — that is, stepping in and speaking up — is a vital first step in taking action to address a loved one’s substance use. However, media and pop culture have popularized the notion of an intervention as a scenario in which family and friends gather around a loved one to share the impact of the loved one’s substance misuse, usually followed by an ultimatum: go to treatment or else. The “or else” can include cutting the loved one off financially, asking him or her to leave the home and cutting off all communication unless the loved one agrees to treatment. The success rate of this style of intervention is lower than using other evidence-based approaches like Community Reinforcement and Family Training (CRAFT), and claims to the contrary are generally limited to getting someone into treatment, with no measures related to the successful completion of treatment. MANDATED TREATMENT If there is a danger to self or others as defined by the courts, civil commitment laws can be invoked to mandate treatment. In the U.S., 38 states have laws that permit civil commitment to inpatient or outpatient substance-abuse treatment programs. An additional eight states have a form of involuntary treatment, such as emergency hospitalization due to substance-related concerns. The commitment process varies from state to state, so it’s important to look into what specifically is required for mandated treatment. Navigating the Treatment System Helping a loved one reach the point of
being willing and ready to engage in treatment is an
important milestone. Keep in mind there is no
one-size-fits-all approach. Getting the right treatment for
your child is a process, and navigating the current systems
in place requires due diligence and perseverance. Medication-Assisted
Treatment for Opioid Addiction Is your child addicted to opioids? Opioids include prescription painkillers like OxyContin, Percocet and Vicodin as well as the illicit drug heroin and synthetics like Fentanyl, and are a group of drugs known for high risks of dependence and addiction. Medication-assisted treatment is the use of anti-craving medicine such as naltrexone (Vivitrol), buprenorphine (Suboxone) or methadone — along with comprehensive therapy and support — to help address issues related to opioid dependence, including withdrawal, cravings and relapse prevention. Evidenced-based treatment approaches like this are often needed to successfully overcome addiction and maintain long-term recovery. “With a strong motivated family, a treatment system that sees to medication and psychiatric care and social supports, there is tremendous hope — no child has to be lost.” - Dr. John Knight, Director of the Center for Adolescent Substance Abuse Research at Boston Children’s Hospital Understanding Opioid Addiction Many teens and young adults first use opioids when they are prescribed them following an injury or routine procedure like the removal of wisdom teeth. Common prescription opioids include:
For a variety of reasons — to party and get high, or to cope with stress — some teens and young adults intentionally misuse opioids. The vast majority of those misusing prescription drugs are getting them from the medicine cabinets of friends, family and acquaintances. Some young people start misusing prescription opioids and then switch to heroin as it becomes cheaper or easier to acquire. Visit our interactive infographic to further explore the Rx to heroin journey. Opioid use and misuse can create brain changes that lead to addiction. A person who is addicted develops an overpowering urge, or craving, for the drug. The person also experiences a loss of control, making it more difficult to refuse the drug, even when use becomes harmful. Most people who are addicted to opioids cannot taper off (use less of the drug over time) without help. How Medication-Assisted Treatment Can Help Opioid Addiction When people become dependent on opioids, they feel sick when there are no opioids in the body. This sickness is known as withdrawal. Along with intense cravings, withdrawal is a hallmark of opioid addiction, and the two combined can make recovery especially difficult. By helping to reduce cravings and withdrawal, medication-assisted treatment can help a person stop thinking constantly about the problem drug. This allows the person to focus on returning to a healthy lifestyle. In addition to tailoring medications to address cravings and withdrawal, a comprehensive treatment approach will also include therapy or counseling to address behavioral issues, support recovery and prevent relapse. Family therapy is especially effective for teens and young adults to address substance use along with other issues. Misunderstandings About Medication-Assisted Treatment Some people in treatment programs for addiction, or who are seeking help through a 12-step program, may be told that medication-assisted treatment is simply substituting one addictive drug for another. This is not true. Taking medication for opioid addiction is like taking medication for any other chronic disease, such as diabetes or asthma. When it is used according to the doctor’s instructions, the medication will not create a new addiction. As a parent, you are responsible for helping your child be healthy and safe, no matter what others think or say. You are your child’s biggest advocate, so never let embarrassment stand in the way of getting your teen or young adult the help they need and deserve. Listen to Physicians and Patients Discuss Treatment Options We sat down with a variety of medical professionals and those in recovery to learn more about medication-assisted treatment options including naltrexone (Vivitrol), buprenorphine (Suboxone) and methadone. Source: drugfree.org/article/medication-assisted-treatment/
Staying on
the Road to Recovery Following Treatment Keeping Your Child Healthy Following Treatment Many parents expect their child to be “fixed” following treatment, but addiction and substance use disorders can be a lifelong, relapsing disease that requires ongoing management. The initial completion of treatment is just the beginning of what may be a longer road to recovery. Your child will need help to manage his or recovery over time. "How many times have some of us tried to diet, exercise or quit smoking? It isn’t always one and done. Seldom is there one straight path out of the woods." - Paul Kusiak, parent Please visit our complete site on Continuing Care to discover all the ways you can support and encourage your child’s recovery. Learn ways to reinforce a message of drug-free and healthy living, and discover how to monitor and support your child so he or she can continue to progress. Substance use and addiction treatment
isn’t over once your child is discharged from
treatment; rather, that’s when much of the hard work is
really just beginning. We’re here to guide you this
portion of the journey, too. Self-Care
Isn’t Just for Yourself So what can you do? Remember to take care of yourself. The Benefits of Self-Care The idea of self-care may make you roll your eyes and ask, “You want me to do something enjoyable for myself when my world is crumbling around me?!?” Yes. And we aren’t the only ones. According to Dr. Barbara Fredrickson, principal investigator of the Positive Emotions and Psychophysiology Laboratory at the University of North Carolina, self-care increases positive emotions like joy, gratitude, hope and serenity: “When people increase their daily diets of positive emotions, they find more meaning and purpose in life. They also find that they receive more social support — or perhaps they just notice it more, because they’re more attuned to the give-and-take between people. They report fewer aches and pains, headaches, and other physical symptoms. They show mindful awareness of the present moment and increased positive relations with others. They feel more effective at what they do. They’re better able to savor the good things in life and can see more possible solutions to problems. And they sleep better.” When you feel better and more optimistic, you’re better able to handle things. You can think, plan and act more effectively. You’re able to use your best judgment and problem solve better — which is so important, because when you feel depleted from your child’s struggle, it’s easy to react and make snap decisions instead of taking time to think things through. In addition, self-care can make you more resilient, meaning you can adapt and roll with life’s ups and downs better, without falling into despair or getting angry when your child has a setback. "You need to take care of yourself too because you’ve got to stay strong; you’ve got to be stronger than your kid through this. Because if you don’t, how are you going to help your child?” - Carol Allen, parent Self-care allows you to model healthy behavior and coping skills for your son or daughter. For example, if you come home from work, tell your child that it was a really stressful day and then go for a walk or take a hot shower to relax, you are modeling a healthy way to deal with life’s challenges. Give it a try. Take a break from worrying. Try infusing your life with something positive on a daily basis for the next week. Treat yourself to a cup of coffee with a friend, buy some fresh flowers, light a candle, take a walk in nature, spend 10 minutes doing a puzzle, take a yoga class, listen to a podcast, get a haircut, read a book. Go for a run, cook your favorite meal, watch a funny movie or take a long, hot bath. BOTTOM LINE: Self-care can look different to everyone. Seek out whatever it is that you enjoy doing that will fortify your mind, body and soul. Living in panic mode isn’t healthy or helpful. You can’t afford not to take care of yourself. Take some time to nourish yourself and
see how you feel. It will be a gift not only to yourself,
but also for your loved ones around you. Find a Support
Group The Treatment Research Institute launched the Support Group Project to make it easier to find available in-person or online support groups. Use their site to quickly search support groups in your community, or register an existing group to help others in their own search for support. The Support Group Project You don’t need to deal with your child’s substance use issues all by yourself. Find a support group in your area today. Source: drugfree.org/article/find-a-support-group/
Addiction and
Substance Use Disorders People can develop an addiction to:
People with a substance use disorder have distorted thinking, behavior and body functions. Changes in the brain’s wiring are what cause people to have intense cravings for the drug and make it hard to stop using the drug. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory and behavior control. These substances can cause harmful changes in how the brain functions. These changes can last long after the immediate effects of the drug — the intoxication. Intoxication is the intense pleasure, calm, increased senses or a high caused by the drug. Intoxication symptoms are different for each substance. Over time people with addiction build up a tolerance, meaning they need larger amounts to feel the effects. According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:
People with addictive disorders may be aware of their problem, but be unable to stop it even if they want to. The addiction may cause health problems as well as problems at work and with family members and friends. The misuse of drugs and alcohol is the leading cause of preventable illnesses and premature death. Symptoms of substance use disorder are grouped into four categories:
Many people experience both mental
illness and addiction. The mental illness may be present
before the addiction. Or the addiction may trigger or make a
mental disorder worse. Treatment Effective treatments for addiction are available. The first step on the road to recovery is recognition of the problem. The recovery process can be hindered when a person denies having a problem and lacks understanding about substance misuse and addiction. The intervention of concerned friends and family often prompts treatment. A health professional can conduct a formal assessment of symptoms to see if a substance use disorder exists. Even if the problem seems severe, most people with a substance use disorder can benefit from treatment. Unfortunately, many people who could benefit from treatment don’t receive help. Because addiction affects many aspects of a person’s life, multiple types of treatment are often required. For most, a combination of medication and individual or group therapy is most effective. Treatment approaches that address an individual’s situation and any co-occurring medical, psychiatric and social problems can lead to sustained recovery. Medications are used to control drug cravings and relieve severe symptoms of withdrawal. Therapy can help addicted individuals understand their behavior and motivations, develop higher self-esteem, cope with stress and address other mental health problems. Treatment may also include:
Many people find self-help groups for
individuals (Alcoholics Anonymous, Narcotics Anonymous) as
well as their family members (Al-Anon or Nar-Anon Family
Groups) useful. Prevention
These 13 principles of effective drug addiction treatment were developed based on three decades of scientific research. Research shows that treatment can help drug-addicted individuals stop drug use, avoid relapse and successfully recover their lives. 1. Addiction is a complex, but treatable, disease that affects brain function and behavior. 2. No single treatment is appropriate for everyone. 3. Treatment needs to be readily available. 4. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. 5. Remaining in treatment for an adequate period of time is critical. 6. Counseling— individual and/or group —and other behavioral therapies are the most commonly used forms of drug abuse treatment. 7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. 8. An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure it meets his or her changing needs. 9. Many drug-addicted individuals also have other mental disorders. 10. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse. 11.Treatment does not need to be voluntary to be effective. 12. Drug use during treatment must be monitored continuously, as lapses during treatment do occur. 13. Treatment programs should assess
patients for the presence of HIV/AIDS, hepatitis B and C,
tuberculosis and other infectious diseases, as well as
provide targeted risk-reduction counseling to help patients
modify or change behaviors that place them at risk of
contracting or spreading infectious diseases. How to Help a
Friend or Family Member Learn all you can about alcohol and drug misuse and addiction.
Some things you don’t want to do:
Adapted from: National Council on
Alcoholism and Drug Dependence Related
Conditions
9 Facts About
Addiction People Usually Get Wrong #1 Fact: Substance use changes the brain, which can make drug use compulsive An adolescent may start out doing drugs occasionally or may be prescribed medicine by a doctor. Over time, continued use rewires the brain to compulsively seek substances, despite negative consequences. With opioids, a person may initially like the euphoria, but soon, the drug is needed just to feel normal and not get sick from withdrawal. LEARN MORE: Addiction is a chronic medical disease of the brain. #2 Fact: Expect your child to "just quit" cold turkey is unrealistic Changing substance use behavior is a process. In the beginning your child may not think there is a problem. Next, she may realize it is a problem, but feel conflicted about addressing it. Then she needs to figure out how to deal with it and take steps in a healthier direction, including getting professional help, changing friends, learning drug refusal skills and more. LEARN MORE: Find out how you can best suggest treatment to your child. #3 Fact: Intervening early is more effective than waiting for "rock bottom". Because behavior change is a process, instead of letting your son or daughter hit their lowest point, it's important to help right away. And it is much easier to help when they are still engaged in school or work, have social supports and interested in sports or hobbies. In other words, they have structure, purpose and social connections—scaffolding needed for a good outcome. LEARN MORE: Get one-on-one help and support from our trained and caring master’s-level counselors. #4 Fact: Your child can be ambivalent about treatment and it can still be effective. While some welcome the opportunity for treatment, most will be conflicted about stopping their substance use. Studies show those who enter drug treatment programs as a result of loving pressure do comparatively better in treatment, regardless of the reason they sought treatment in the first place. LEARN MORE: Learn how you can address your child’s drug use. #5 Fact: Relapse is common and represents a learning opportunity. Relapse doesn't mean that treatment hasn't worked. As with all chronic diseases, many people have one or more relapses before achieving long-lasting recovery. Relapses happen both when the person is doing well or when struggling, and can serve as a learning opportunity to identify what triggered the relapse -- and to find ways to address it for the future. LEARN MORE: Read 5 Things You Need to Know About Relapse. #6 Fact: Positive behavior and communication skills are more effective than punishment. Addiction is a brain disease and needs family support as with any other chronic illness. Shaming, detaching or punishing often backfires, with kids spiraling further into risky substance use or isolation. What does work is reinforcing positive behaviors, finding healthy activities that compete with your child's use and letting him or her experience natural consequences. Coupled with empathy and compassion, this approach (known as CRAFT) is a scientifically-proven way to help parents change their child's substance use. LEARN MORE: Use CRAFT skills to help your family heal. #7 Fact: Finding an effective approach for treatment can mean investigating different doctors or programs before finding a good "match." The best programs give a screening and in-depth assessment of your child by a qualified professional versed in addiction and mental health. They will develop an individual treatment plan and combine methods tailored to address your child's specific needs. But don't be discouraged if the first program you investigate is not a good fit -- keep exploring other options. LEARN MORE: Find out more in our Treatment eBook. #8 Fact: Medication-assisted treatment, coupled with counseling, is the preferred treatment for heroin and other opioids Taking medication for an opioid addiction is like taking medication for any other chronic disease, like diabetes or asthma. Numerous studies have shown that medications can reduce cravings, relapses and overdoses when taken as prescribed. LEARN MORE: Medication-Assisted Treatment can help aid recovery. #9 Fact: Many people struggling with substance use require longer-term and/or repeated treatment. Because a drug problem can include
relapses, going through treatment once may not be sufficient
to keep your child drug free. Each treatment episode allows
them to be abstinent for a period of time while learning new
coping skills -- but it may take time. Know the treatment
options available so that you can make the best choice for
your child's path to recovery. LEARN MORE: Get
help navigating the treatment system. Substance
Abuse and Mental Health Services Administration
(SAMHSA)
5 Types of
Alcoholics Alcohol Abuse and Dependence The designation of mild, moderate, or severe alcohol use disorders is the terminology used in official medical diagnoses. The three main types of alcohol problems are commonly described as:
The National Institute on Alcohol Abuse and Alcoholism has further defined different types of alcohol problems by categorizing five different types of alcoholics. These include:
The effort was made to categorize different types of alcoholics, in part, to dispel the myth that there is a typical alcoholic. Identifying the category into which a person with a drinking problem falls also makes it easier to understand the root of the problem and choose rehab and treatment options that will be most effective. The categories acknowledge a person’s:
In the past, any effort made to categorize alcoholics focused primarily on hospitalized individuals or those receiving treatment. But since only about one-fourth of people with alcoholism received treatment, the previous information did not represent many with alcoholism. How Were the Categories of Different Types of Alcoholics Determined? A study by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which is part of the National Institutes of Health (NIH), analyzed 1,484 survey respondents who met certain diagnostic criteria for alcohol dependence. The study included people both in treatment and not seeking treatment. The results revealed five different types of alcoholics, which are as follows: Different Types of Alcoholics The five different types of alcoholics include young adult, young antisocial, functional, intermediate familial, and chronic severe alcoholics: 1. Young Adult Alcoholics Young adult alcoholics make up about a third of the alcohol use disorders in the United States. Age 24 is around the time they develop alcohol dependence. Young adult alcoholics tend to drink less frequently than older alcoholics, but they binge drink – sometimes more than a dozen drinks in one situation. Any young person can have a drinking problem, but the majority of young adult alcoholics tend to be male and single. Many are still in school. In most cases, they have low rates of COD, moderate rates of other SUD and family members with AUD, and rarely seek treatment. Some young-adult alcoholics outgrow their problem drinking while others develop an addiction to alcohol as they get older. 2. Young Antisocial Alcoholics The next category of alcoholics also includes young people. This group starts drinking around 15 and develops alcohol dependency around 18. But they are different in that young antisocial alcoholics do not drink as a social activity with peers. Instead, antisocial alcoholics drink alone and typically struggle with other issues. Unlike regular young adult alcoholics, antisocial alcoholics tend to have family members with alcohol addiction. They also typically suffer from co-occurring mental health problems, such as bipolar disorder, depression, antisocial personality disorder, or social anxiety disorder. Many of them also abuse other substances, including cigarettes, marijuana, and opiates. On average, this type of alcoholic will consume 17 drinks at a time. Three-quarters of this group are males. 3. Functional Alcoholics Functional alcoholics account for about a fifth of all alcohol addictions. This means despite their addiction to alcohol, they hold steady jobs, are in relationships, have decent family incomes, and tend to have a higher level of education. Most are middle-aged (around 41) and started drinking around age 18. They consume alcohol daily or at least several times per week. While they might not binge drink, they do drink more alcohol than someone without a problem would consume. This group suffers moderate depression, but low rates of other COD. Sixty percent of this group are males. 4. Intermediate Familial Alcoholics Intermediate familial alcoholics are similar to functional alcoholics, but the former is more likely to be born with a genetic predisposition to alcohol. This started drinking around 17 and developed dependency around 32. About half of them come from families where there are other people with alcohol problems. They have a high probability of suffering from an antisocial personality disorder, depressing, generalized anxiety disorder, and bipolar disorder. Also, high rates of cigarette, marijuana, and cocaine addiction. 5. Chronic Severe Alcoholics This group accounts for the fewest number of alcoholics. It is one of the most devastating types of alcoholism and includes people struggling with the highest percentage of antisocial personality disorder of any group, divorce, co-occurring mental health disorders, and other substance abuse issues. This group experiences the highest rate of alcohol-related emergency room visits, problems at work, and in their personal lives, and withdrawal experiences. The majority of people in this group are men in their late 20s, around 29, who started drinking around age 15. The good news is people in this group seek treatment at a higher rate than other groups and are most likely to participate in detox programs, inpatient treatment, and rehabilitation programs. Alcohol Addition Resources
Source: www.addictiongroup.org/alcohol/addiction/types-of-alcoholics/
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