My Teen Has a Drug or Alcohol Problem: Is She An Addict?

Confronting Teens, Dealing with an Addicted Child, Finding Treatment, Treatment, Warning Signs:

Do You Think She’s an Addict?

Friday, August 28th, 2009

“I found Lisa* sitting on the couch, asleep I guess or maybe passed out, with a half-eaten apple in her hand. She looked awful. I saw her purse on the floor and rummaged through it to see if I could figure out what she was using. That’s when I found these little baggies labeled ‘Friends of the Night.’ I woke Lisa up and asked her what they were. She told me they were vitamins and I sort of believed her, but I flushed them down the toilet anyway,” Marcie* explained, her voice marked with raw pain as she concluded her long and tortured story about her daughter Lisa’s drug-related adventures.

Marcie had called me at the direction of our pastor who was familiar with our own journey in through this nightmare.

“Do you think she’s an addict?” Marcie asked me anxiously. I knew this question so well as it was one that I wrestled with as we began to peel back the layers of our son’s drug use. Is it really possible that the child you raised with so much love and self-sacrifice could actually be an addict?

Personally I dislike the term “addict” — for me it conjures up the picture of an anorexic-like figure slumped in a garbage-strewn gutter with a needle plunged into a vein, escaping into the euphoria of heroin. That certainly was not the picture of our son, who, when using was occasionally glassy-eyed, but to the uninformed, was the picture of health.

When used in conjunction with dessert or a sports team, the word addiction takes on more passionate overtones, as people gush about their chocolate cravings or the Yankees-Red Sox rivalry. In contrast, addiction paired with substance abuse evokes so many negative images and emotions. Although a convenient label, the term addict does not begin to describe the level of use, its impact on the user and his or her family, and underlying issues that may have contributed to the problem.

Early in my son’s recovery I attended an AA meeting with him where one of the speakers joked, “I love to drink but every time I have a beer I have an allergic reaction – I break out in handcuffs.” I think he was on to something – some can tolerate substance use (like the occasional glass of wine or a beer), while even the smallest amounts can be toxic for others, as with any other kind of allergy.

I told Marcie that I was not in a position to label her daughter— it was up to Lisa to make that determination. Instead I asked her to focus on Lisa’s behaviors – the loss of interest in her favorite activities, failing her college classes, her erratic sleep patterns, the missing money and checks, her new friends, the many car accidents, unexplained absences from home, not wanting to be with family, etc. All of Lisa’s behaviors added up to a level of substance use that required treatment. Given what Marcie had disclosed, I suggested that she explore various levels of intervention with a professional substance abuse counselor or interventionist. Getting help was paramount – not the label.

*not her real name

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Posted by Pat Aussem | Filed under Confronting Teens, Dealing with an Addicted Child, Finding Treatment, Treatment, Warning Signs

Great blog post. I like your direction of moving away from the labels and dealing instead with the behaviors. Scary scenario indeed. Thanks for this. I think it would also be great if you could address what to do if your child refuses to get treatment/go to counseling.

I agree moving away from yet another label is great. What do you do when your 16 yo refuses to quit and refuses to go to the help available? He says he has no problem.

Hi Jean,
I can empathize with your situation when a teen thinks that there is no problem. I tend to go focus on the behaviors, e.g., lying, stealing, using illegal drugs, drinking underage, skipping classes, avoiding family members, sneaking out to parties, etc., and confront those with appropriate consequences. So for example, if your child is smoking pot and refuses to acknowledge that it’s a problem, I would impose various consequences starting small and escalating as appropriate — no allowance, imposing a curfew,grounding if he comes home stoned, taking away the ability to get a permit,etc. As a last resort you can turn over drug paraphernalia to the police and have them have a “chat” with him before imposing more severe consequences that would include probation.

I also think that it is important to get him involved and or reward more positive actions. Encourage sports, music, camps, youth groups and other fun activities that hopefully are drug-free.

Some parents mandate going to an out patient program where even if he’s using, he will get educated on the problems drug use can/is causing. This is sometimes a double-edged sword for kids who are in denial. They often will sit there with selective listening turned on and then hang with the other kids who are just going through the motions. You might ask your school counselor SAC their opinion.

How do you know when it’s time to seek treatment, and whether it should be inpatient or outpatient? Our son does not drink or smoke pot every day — but he has some warning signs: he has been drinking alone, at night, sometimes getting pretty drunk, then brags about it. He says he doesn’t really like to drink, but started when we began testing him for marijuana use. Switching from one substance in the absence of another, continuing to use (but not every day, maybe weekly, sometimes more, sometimes less) in the face of consequences, and drinking alone (even breaking into his grandmother’s cabinet, shearing off the top of a wine bottle and drinking the whole thing at midnight, when everyone was asleep). Grades haven’t dropped, he claims “he can handle it” and “wont’ do anything stupid.” he is ADHD which of course raises his risk. I would appreciate any comments or thoughts.

You mentioned that there are warning signs but that your son says he can handle it. Often it is helpful to ask what would be a problem and see how he responds. Grades dropping, getting caught at school, getting picked up by the police, having chronic sleep problems, etc,may be some of the comments. This hopefully opens a dialog to understand at what point your son would agree that it is a problem to gain some insight on his thinking.

I have also asked for support from the school’s substance abuse counselor to see what teachers are seeing in the classroom and have reported suspected use. The counselor, in turn, has required a drug evaluation which is sometimes an easier way to get a teen to an evaluation as he/she cannot return to school until it is completed.

Drug evaluations can be helpful to the extent that they try to assess a person’s using history, consequences, insights, etc., and they do a urine screen to see what’s been consumed. The person doing the drug evaluation can give you advice as to which way to go for help – an early intervention program, outpatient or inpatient.

Inpatient vs. outpatient is driven by a number of factors not the least of which is often insurance. Most insurance companies will cover the least restrictive level of care – meaning that they generally prefer outpatient over inpatient. In an outpatient setting, the client goes for treatment (usually group therapy and a drug screen) 3-4 days per week for 3 hours per session. Most programs require that the participants also attend AA or NA meetings.

In an inpatient setting, the therapy is more intense and includes more individual therapy as well as group therapy, recreation, educational classes to try to keep up with school, and AA/NA meetings, and life skills. Often people who opt for inpatient have failed in an outpatient program necessitating a higher level of care.

In either case, good programs offer family education, which is so important in order to understand addiction and to know how to support sobriety. I also recommend Alanon or Naranon for family members – these are self-help support groups that focus on taking care of yourself.

Thank you very much, Pat! the “classic” signs such as grades dropping, trouble at school, etc. are not there — yet the substance abuse professionals say he has a problem, a serious problem. Drinking alone at night, late — til he passes out or throws up; breaking into a bottle of wine at his grandmother’s house, at night, alone, and drinking all of it; smoking pot after repeatedly being told of serious consequences. He is able to juggle the balls and keep up appearances — but I can tell that he is not happy that we have such a “no tolerance” policy. He seems to be biding his time until he can move out at age 18 — and drink and smoke all he likes — that’s what worries me. We will have no legal authority to make him seek treatment. If residential treatment has a greater chance of success, we’ll take our hits with the insurance.

I fully appreciate the legal authority aspect. The one thing you should know is that most inpatient treatment facilities require that your son agree to treatment (unless it’s a lock-down facility available in certain states). You will need to spell out consequences for him if he refuses to go. Hopefully he will agree and when he gets there, at least be open to examining his behavior. I wish you all the best!
Pat

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