Two years ago my child lost two very close friends two weeks apart from each other. Prior to losing his friends my child was a star student and athlete. A little under a year after the death of his friends, my son dropped out of school and started having problems which anger. We then found out he was using pot and alcohol. We have tried talking with him on numerous occasions to no avail. We thought counseling would help, but he refuses to go. I am concerned that the drug use is becoming a daily ritual; he says it is the only way he can get through his day. My heart breaks because although I try to help, I don’t know how you can help a child that doesn’t want help. I feel as though my son died the day his buddies died two years ago, I just get to still see the shell of mine. We love him with all of our heart, do you have any suggestions on how to talk to him or what to do? Thank you for your help.

-- Anonymous  

Make no mistake about it -- this sounds like full-blown addiction. In my experience in cases like this, the patient’s future and possibly life depends upon getting into treatment. Depression is clearly a prominent feature of his syndrome so there should be physicians available at whatever facility you choose who are skilled at treating depression and addiction. I would recommend considering hiring an interventionist to get him in to treatment. If you do not have resources available then my experience has been that the identified patient has the highest probability of getting in to treatment when important relationships attend a co dependency 12 step program like Alanon. This is not a casual recommendation. If someone you love will not get help, often your only option is to disrupt the dance in which you engage with the patient. A genuine detachment with love will often catch their attention and begin to motivate them to get help. This will only happen when these important relationships attends meetings, obtains a sponsor and works steps. What you need to do in situations like this will run counter to every fiber in your being. You will need support from someone who has been there to handle this situation effectively.

 

I am so scared. My daughter is in the beginning of her second year at college. I noticed last year when she would call me that her speech was slurred. She said she was just tired so I let it go. This summer she drank an entire bottle of Robitussin, passed out and had to be taken to the emergency room. She then went to brief counseling. Once she returned to school, she did it again and again. School has been in session three weeks and she has already been to the emergency room again. She is going to start counseling at the University twice a week, but they only offer twelve sessions. We are then planning on having her undergo counseling off campus. I am worried that she uses DXM because she is under the impression that it is less harmful than other drugs. She doesn’t want to leave school and wants to get help while she’s there. Because she is 20, I feel it is ultimately her decision. Should we have insisted that she return home? Should we not pay for school? Or, do you think it is possible for her to get help while still in school? Please help.

-- Anonymous  

It has been my experience that in cases like this you have every reason to be frightened. This is a very serious situation. First of all your daughter needs to see a psychiatrist or psychologist with experience treating young people with drug abuse and addiction. I cannot tell what is going on here, but I can tell you that she needs a thorough diagnostic work up. I had a very fine professor in medical school who pounded into my head, “no diagnosis, no treatment.” This is to say unless you have an accurate diagnosis you cannot expect to be able to successfully apply the appropriate treatment because you literally you don’t know what you are treating. Your daughter is at least abusing dangerous substances. It sounds like there may be a mood disorder as well. If there is a family history of addiction of alcoholism then you should strongly suspect that this in fact is likely to be addiction. Whether or not she can be treated without leaving school depends upon the final diagnostic impressions. It sounds to me like she would be best served by taking some time off school and having a thorough assessment in a drug treatment center.

 

 

My 15-year old daughter is a good girl. We have a very open relationship and I believe her when she tells me that she does not use drugs. She hangs out with a very tight group of girls – mostly just like her. A few, however, have definitely started to experiment with drugs, alcohol and boys. These girls have been her best friends since they were seven years old – I’m practically a second mother to all of them. I know the right thing to do here would be to tell my daughter not to spend her time with these bad influences, but I don’t know how to do that when she has such rooted friendships with these kids. What should I do? Should I talk to their parents? Should I make my daughter stay away, even though it would break her heart? My biggest fear is that she starts to get curious and want to start participating. Please help!

-- Anonymous  

Based on my experience in situation like this I would have some concerns. I am not insisting that your child is necessarily in trouble, but I must tell you that the scariest words that I hear from parents’ mouths are, “not my kid.” I am delighted that you and your daughter share an open and communicative relationship, but I have yet to meet a 15-year old that can be completely and totally honest with his or her parents. It is simply not something that they can muster at that age. Think of yourself at that age. Could you have been completely forthcoming with everything that was coursing through your mind at that time? Trust but verify.

 

I am scared I might develop a drinking problem. I am 18 years old and probably drink three times a week. Alcoholism runs in my family, so I am aware that the chance that I become an alcoholic is high. I drink frequently, I drink when I am alone and it’s definitely something I like to do and look forward to doing. I don’t want to stop drinking totally – I’m in college and like it or not, it’s a big part of my social life, but I feel like I should cut down. Is it possible for me to drink socially, but not become an alcoholic? Am I already past this point? How can I watch out for myself?

-- Anonymous  

Unfortunately the reality is that if you are an alcoholic there is no way to reliably moderate your drinking.  As you say, your risk for this condition is considerable given that it is in your family genetic heritage.  Alcoholism is progressive disorder, marked by progressive consequences from the relationship with alcohol.  There will be more trouble ahead -- I have no doubt.  I understand your ambivalence about giving up alcohol.  This is one of the more challenging problems I encounter in my treatment center; trying to get young people to give up drugs and alcohol.  They believe that they will miss out on something that they are entitled to.  I assure you that the benefits of stopping far outweigh any potential for “missing out.”

 

Self-Medicating
I first started using drugs when my best friend died, I thought it was the only way of taking away my pain. Well it did but I lost more friends because I was doing drugs. I thought that my friends were joking about not being friends with me anymore, but they weren't. Now I hang out with the people who do the kind of drugs I do but whenever I see my old friends I know if I quit they'll be my friends again. That's if they forgive me. But it's so hard and my parents fight with each other and yell at me all the time So I don't know what to do....So I think I'll just do some coke and I'll feel better. It's so hard to quit I don't know if I can. Can you help me please?

-- Anonymous  

It is hard to give up drugs and alcohol. You use them because they work. Sounds like they’ve been the old friend you could always count on to make you feel better. The problem is that your new friends, drugs and alcohol, have a dark side. They set up changes in brain that disrupt the system that normally establishes motivational priorities. How we prioritize things in our lives is set up in a deep brain system. It involves very powerful drives such as survival, obviously an important priority. But when addiction gets going, this system is broken. People with addiction progressively suffer a series of losses because drugs and alcohol assume a greater priority in their life.

Ultimately addicts lose their health and often even their lives as the drugs and alcohol become a more priority than even survival itself. Other drives break away and the drive to use usurps all others. Friends are only the first of the losses to be suffered as addiction progresses. Family, work and ultimately health are lost. At your stage you can always find other friends as you lose your non-using friends. You will especially discover it’s easy to find those who will go along with you on your path to addiction. Stop the process now before it becomes worse. Find someone who has experienced treating addiction or just get out to a 12-step meeting.

 

My Dad Used Drugs
My dad used to be into some pretty heavy drugs – cocaine, heroin, pretty much anything. The worst part was that my little sister and I would always see him stoned but we never realized what was going on. Now I've started doing pot with some of my friends and I just can't seem to find a way to say no. It's just always there. I always said I would never do stuff like this, but I'm doing it anyway. And my "friends" are starting to produce stronger drugs and I'm running out of excuses to leave. I need someone to talk to.

-- Anonymous  

You sure do need someone to talk to – that is a terrific instinct. You should reach out for help from a professional if you have the opportunity. Having an intoxicated, addicted parent is very traumatic for children. As you’ve discovered, when you were not sure what the problem was – you knew something was wrong and you didn’t feel safe. An intoxicated parent is an abandoning parent – we need our parents in order to develop a capacity for flexible and emotional regulation. When the parent is not available or is intoxicated, the basic mechanism for building our emotional wires breaks down.

If you have suffered trauma such as this, then when you enter adolescence, the challenges of development can be overwhelming. Emotions cannot be regulated – particularly negative emotional states or when an experience is excessively prolonged and intense. When you are presented with substances, particularly those that your friends find harmless it is inevitable that you would use them in a bend for regulation. If you have a family history of addiction there’s roughly a 50% probability that you will have inherited that potential for addiction.

As you can see, situations like yours are really a recipe for addiction. Please follow that instinct and talk to someone. Either find a mental health professional with experience treating addiction or get out to a 12-step meeting. You will find many people with stories very much like yours. Please take care of this before the consequences begin to accumulate.

 

Trying To Stay Sober
For eight months I was clean and sober. (I was incarcerated for the eight months.) But now that I’m out, it seems like the problem still haunts me. It doesn’t feel good to wake up and feel like crap, worried that when I go to work my co-workers will know something. I like drinking, but enough is enough! I want to stop but I can’t seem to. I only drink on weekends and by myself. I want and need the help to stop the evil in alcohol. I pray that it will. I just need that friendship in other people to push me to stop. Please, will someone help me? I don’t want to die from liver cancer or overdosing on alcohol. I’m really scared.

-- Anonymous  

The reality is you are not clean and sober. You are clean, but not sober. You were merely incarcerated. And, of course, as Carl Jung pointed out, you could treat any addict by merely putting him in a room and locking the key, unfortunately that is not a reasonable solution to your problem.

The treatment for your problem is the Twelve-Step recovery program, Alcoholics Anonymous. You need to go, and as they say, "take the cotton out of your ears and put it in your mouth." Listen to the process, be open to the fellowship, obtain your own sponsor, and actually work the steps. With that, your chances of recovery are quite good, if you're ready.
 

Daughter's Meth Use
My daughter turned 19 a few days ago and I just found out she has been using meth. I don’t know if she is using now, but she had been in the last six months. She tells me it’s not a problem, she was doing it with – and because of – a guy, but he is no longer in the picture and she is not using it anymore. It sounds too addictive to be able to just stop like that. I came home a few weeks ago, and caught her and a friend smoking weed. At that point, I was glad it was “just” weed. My husband and I have been a wreck the last month with worry. How do we help her if she won’t admit to us she is using? I want to enforce her 1 a.m. curfew, but at 19 can I do that? We have told her we want her to do drug testing, but she refuses to be “humiliated” that way. She quit college, isn’t working, and we have cut her money down. We are at the point to cut her off completely financially, but we have told her she will always have a place to stay and food to eat. She is our only child, and everyone tells me not worry, she’ll be back. She’s a good girl, but I do worry because I don’t want her ruining her life. I never did drugs of any kind, and am having a hard time dealing with this.

-- Anonymous  

You are right to assume that someone who is doing methamphetamine with any regularity, meaning three times a week for more than a month, has a very serious drug problem and will require treatment at some point. Remember that addiction is a progressive problem. You perceive marijuana as "just weed" but this is probably her primary drug of choice. Do not feel relieved that it is only marijuana. Most marijuana addicts eventually become depressed from the side effects of chronic marijuana exposure. They try to compensate for that by smoking more and more powerful marijuana; eventually they find their way to speed which corrects that depression.

I am concerned that in addition to addiction, your daughter may be having some more serious mental health issues. She doesn't work, she's quit college, these are signs of profound problems, perhaps depression. She needs help and she needs help now, you're absolutely right — before the trajectory of her life is so far off course that she really heads into chronic problems.

You are not going to be able to withstand the limits you're going to have to place on this young woman on your own. You're going to need a Twelve-Step codependence recovery program such as Al-Anon — you're going to need your own sponsor and have to work steps with that sponsor. Your daughter needs an evaluation by a psychiatrist who has experience dealing with addiction. You will come to understand that in the course of your Al-Anon recovery that cutting down on her support and money will probably have a very limited effect on her drug addiction. Unfortunately, you're going to have to cut her off completely. I'm not saying leave her angrily. I'm saying lovingly support her if she is willing to struggle with her condition, but you must not support the disease in any way.
 

Our Daughter is Addicted
My husband and I recently got a tip from a friend that our 16-year-old daughter was using drugs. We had her tested and before the results came back she admitted that she had smoked marijuana. Her test was positive. My question is, do we limit her friends? She has been very vocal about not being able to see two of her friends. One has done drugs but doesn’t do them anymore. The other, we don’t know. Can you suggest what we can do? We are considering moving her to another school. Just how do we control her exposure to these other kids? Help!

-- JJ  

I would urge you strongly not to look at your daughter's problem as somehow more her friend's problem than her hers. One of the greatest mistakes that parents make is to believe that somehow by merely changing friends or changing the environment they're going to improve their child's behavior. While keeping her among healthier influences of course is useful, the fact is that the problem is your daughter's. If she is smoking so much pot that she is unable to pass a random drug screen this is a very serious problem and requires professional intervention.

Let me commend you for having tested your daughter, that's the only objective screen we have for use of substances. If you think that perhaps the test might have been a fluke, I would encourage you to continue testing randomly, but you must understand that the child who is unable to pass a drug screen is more than an occasional user and requires professional intervention immediately. With the help of a trained professional you may be able to evaluate and more carefully structure her environment and decide exactly where to fight your battles and set limits, but merely extracting her from her environment will not likely have a significant influence.

I'm sure there are those reading this answer who would say to themselves that they know someone or they themselves have experience where change in the environment had a significant influence, and absolutely it will influence, but the problems which have surfaced now will reemerge. I would encourage you to intervene fully on your daughter's behalf.
 

Help For My Parents
I don't need help, my parents do. They have had a problem with drugs since I was little and I've tried to help them. I don't what else I can do. Do you have any information that will help?

-- Jennifer S.  

Although I know you feel as though no one else on earth is struggling with the stresses that you have, approximately 1 in 4 children in the US is exposed to alcohol abuse or dependence through the family and many other children are living in families with illicit drug abuse. You are not alone.

You need to know that it's not in any way your fault. This is a disease. You did not cause it and you cannot make it stop. But you need and deserve help for yourself. Since children of alcohol- and drug-addicted parents are about 4 times more likely to become addicted if they drink or use drugs, you need to be alert to your own potential risk, and along those same lines, really all you can do is take care of yourself. Talk to an adult about this, maybe a teacher, a school counselor, a friend's parent, a doctor or another family member or a neighbor — someone who will help you.

I also recommend an organization called Alateen, or if you're over the age of 18, Al-Anon. There you'll meet other people who are going through the same thing and find a sponsor who will personally work with you. While Alateen and Al-Anon are about taking care of yourself, the most important intervention I've seen for an unmotivated alcoholic is to have their family members actively engaged in program such as Al-Anon. These are free services — you can find them at www.al-anon.alateen.org or 1-888-4AL-ANON. And finally if you feel like you need more individual help then a therapist can be very useful.
 

Daughter is Self-Destructive
Our nightmare is just beginning. My daughter is 13 and has been involved in a number of drug, alcohol, self-mutilation, writes suicidal poems, and possibly has already had sex. I don’t know where to turn. It seems as if no one has any advice on what to do. I’m sure what works for one may not work for another. My daughter is a beautiful, blonde-hair, blue-eyed beauty. She’s excellent with kids. She has been in dance for five years, but last year she wasn’t in it due to the fact that she had failing grades. All her life people have commented on how beautiful she is. I had divorced my daughter’s dad four years ago and there have been a lot of adjustments that come with the divorce that I feel are the reason she’s turned to this life. It’s taken a toll on me and the people who care about her. I pray to God that she’ll get through this and that I can give her all the help she needs. Our children’s suffering – and what they’re going through – has a more powerful effect on us than anything. The thought that I could have caused my daughter any pain that would have caused her to feel like I wasn’t there for her is hard to deal with. Before the drugs took over her life she had a sparkling twinkle in her eye, and was always smiling. I want to help her get that back.

-- Anonymous  

I cannot stress strongly enough how serious the circumstances are for your daughter. As always, drug abuse and suicide — as well as self-mutilation — in a young adolescent are very, very serious problems. While the divorce from her dad certainly has been difficult on her, it would not explain the profound psychiatric symptomatology she is manifesting at this time.

She needs at minimum, a long-term relationship with a therapist and probably a psychiatric evaluation. If indeed it turns out that she is an addict, she will also require comprehensive chemical dependency treatment.

The symptoms that are beginning to manifest in your daughter suggests that she is a trauma survivor. In my world, essentially all patients who require inpatient treatment for chemical dependencies have a trauma history. And by trauma, I mean inter-personal trauma, experiences of powerlessness, and so those people are more dependent on nurturance, love and safety. This would include sexual abuse, physical abuse, abandonment and neglect. Trauma tends to interrupt the normal progression of psychological and self-development. As a result, young people enter adolescence with deficiencies in the inability to regulate their feeling states — something in my world we call "affect regulation." It's not so much that they feel more depression or anxiety than other 13 year olds do, what is important is that the intensity and duration of all feeling states cannot be regulated. The feelings are too intense, too long, too protracted and overwhelming. And if so, the individual who does not have adequate capacity to regulate tends to feel deficient and unworthy from the trauma itself and this makes the individual feel unworthy of the love and nurturing that children so desperately need, resulting in profound low self-esteem.

All of your child's acting out is an indicator of affect dysregulation — drugs and alcohol then become an attempt to try to feel better, sex to try to feel better, self-mutilation to try to escape the painful feelings that she's unable to regulate. Hopefully through working with a skilled therapist she will rebuild those regulatory mechanisms, sometimes with help from some medication. And if she is indeed an addict, she will learn to develop relationships with a female peer called a sponsor and through a guided experience we call the Twelve Steps, she will gain an increasing ability to tolerate and regulate a broad range of feeling states without feeling overwhelmed.

Again, let me reiterate, these are terribly, terribly serious matters that should be addressed progressively just like any other life-threatening condition.
 

Brother on Meth
My brother is abusing Meth. I don’t know how to help my mom. She lives in the San Jose, CA area and I am in San Diego so there is a distance problem. I need help and I am attending Al-Anon meetings (for only two weeks). My problem is I don’t know how to be supportive without hurting her. She is so sad and knows she has to make a decision about what she is going to do with him. He will not go to rehab. She thinks she needs to kick him out but feels so horribly about it. It is taking over her life and she is afraid to leave her house (he still lives at home.) Please, any advice would help. Thank you for your time.

-- Stephanie  

Stephanie, your mom's situation is an all-too-frequent story. Unfortunately, your brother's Methamphetamine addiction is taking over your mother's life and is doing nothing to help him. I promise you, remaining at home and watching him and policing him will not prevent him from doing the amphetamine. He is doing it right under her nose. Many mothers I have treated harbor a fantasy that if they don't cling tightly to the addict the addict will die of this disease, when in fact quite the opposite of this is true. The mother's loving embrace is in fact killing them.

You will learn from ongoing participation in your Al-Anon meetings that the only alternative is to set very firm limits with him, and the only way that you will be able to stand up to his disease without being overcome by the fear of his demise is with her own participation in Al-Anon. Both of you will need an Al-Anon sponsor and actually yourself participate in the Twelve-Step process. Without this I'm afraid your brother's prognosis is very poor. It's unclear that she will need to kick him out; it is clear though that he will have to go to treatment. She needs to be prepared to deploy whatever leverage she has to get him to do that.

I have a basic aphorism that I use to coach families, which is "reject the disease and support the recovery." Withdraw every inch of support you provide for him, rely on your support and Al-Anon to be able to do this. Let them know that you love them and as soon as they're prepared to be involved in the treatment of their disease, you're one hundred percent there for them.

 

My Son's Smoking Marijuana
My son has been smoking marijuana now for the past six months. Well, that is when we first found out he was using it. We have grounded him and taken away his car and his phone. We now randomly drug test him and he still comes up positive. He denies using it anymore and says the tests are positive from him hanging around his friends who do use it. I have called the drug company and they said it would be rare for this to be true. I just don’t know what else to do for him. We have a terrible drug problem in this town and everyone knows it and just turns the other way and acts like if they ignore it, it will go away. Any advice you have would be appreciated. Thank you.

-- Anonymous  

Well first of all, let me commend you for stepping up on behalf of your son, and realizing that there really is a serious problem. Marijuana can be a profoundly addictive drug for some people. While we all understand it to be a common drug of abuse, particularly for younger people, many people are in denial that it can be difficult to stop using marijuana. In fact, one in seven people admitted to treatment centers in this country today say marijuana is their primary drug of abuse.

Based on my experience with patients, marijuana addiction syndrome is often not a slowly progressive process as some people believe it to be. Usually, the first one or two exposures to marijuana are not particularly notable. Somewhere around the third or fourth try, however, the individual will have a profound euphoria. When I ask marijuana addicts about the first time they smoked marijuana they usually say that it was no big deal. Then when I ask, how about the first time you got high from the drug, they usually say, "Oh, my God, I loved it!"

Well, when you've had one of the most amazing experiences of your life, particularly when you're a young adolescent, guess what you wake up the next day thinking about doing? And the next and the next and the next. A marijuana addict will commonly use from that day forward for somewhere between one and twenty years. Then the syndrome predictably plays out as follows: the marijuana becomes less effective, the individual begins feeling more depressed, in response to that, they use more or stronger marijuana to try to get the old euphoric effect. As they do this, however, the depression usually accelerates. It's at this point we either see them in treatment or they switch to another drug.

So with this understanding, it sounds like your son may well be addicted to marijuana. Remember, addiction is inspired by the ongoing use in spite of consequences. Here you are, drug-screening your child appropriately, but he continues to have evidence of this drug in his test. His excuse that it's from hanging around friends who smoke marijuana is simply ridiculous. Most marijuana addicts I've treated use that excuse at one time or another. Remember, drug screens are the only objective tests we have for addiction. A persistently positive test is a sure sign of a problem.

If this were casual drug use, grounding him and taking away reinforcers, such as his car, would be effective in getting him to stop using the drug. If he's an addict, that will do nothing. (As I previously stated, addiction is about not being able to stop in spite of consequences.) I suggest you get professional help from someone with experience treating addiction. If this is, as I suspect, an addiction, getting help is going to take a long and concerted effort probably by a chemical dependency team. In addition to Twelve Step, and potentially Al-Anon for you and your spouse, family therapy will be necessary and possibly a psychiatric evaluation for him. Be prepared for a long haul. Adolescents don't typically embrace recovery rapidly and wholeheartedly, but it is critical for you to get going in the process as he is on the launch pad of his life. Spending this period encumbered by addiction will alter his trajectory into adulthood.