The headlights of the SUV swept  across the face of the gray contemporary home just before dawn. Ever so quietly, the doors of the SUV opened as two beefy men emerged and glided like practiced dancers across the walkway to the back of the house where Diane was waiting.  Heart pounding, Diane* slid the doors open, greeted them with a curt nod, and escorted them down the dark hallway to Jake’s room.

Vaguely sensing someone’s presence, Jake awoke shielding his eyes from the harsh overhead light his mother had just switched on.  As his eyes focused, he took in the sight of the men standing behind Diane, and knew in an instant that they were here for him.  Although unsure of whether the nightmare of his drug life was over or just beginning, Jake knew with certainty that there was no escaping these men, handcuffs and leash in hand.   Ready or not, the escorts would ensure his safe, if not reticent, delivery to a treatment program in Utah.

While this probably sounds like a scene from a made-for-TV melodrama, it actually played out at our neighbor’s house several years ago as they desperately struggled to get their son, Jake, into treatment.  He had adamantly refused any help and was on a path to jail or a premature death.   As a last resort, Jake’s parents turned to escorts to get him into treatment.

Unlike Jake, there are some adolescents who recognize that their drug use is causing their lives to spiral out of control, and ask to go to treatment.  My experience is that  having this kind of insight is unusual, leaving parents wondering what to do, short of escorts, to get their son or daughter help.

In our case, we told our son, Alex, that he had to go to intensive outpatient treatment and he did not put up a fight.  The reason was that he figured he could scam the drug screens at the program (and he did) and bide his time until completion.  When his life continued to plunge into the abyss, we told him that he needed a higher level of care.  We patiently explained that he could either choose to go to inpatient treatment for a month or we would send him to a lockdown therapeutic boarding school where the only way he could come home was to graduate or age out.  Weighing his “sentences” of 18 months or more versus one month in treatment, Alex agreed to go to the inpatient program.

A few days later, he tried to renegotiate, suggesting that he really didn’t need inpatient treatment – he would recommit to the outpatient program and go to AA meetings.  My husband and I briefly discussed this privately, trying to assess whether we thought it was a viable proposal or not, especially in light of the financial burden of inpatient treatment.  In the end, we presented a unified front to Alex, and adamantly refused his request.

When we arrived at the treatment facility and began the intake process, the counselor asked Alex if he was agreeing to treatment.  Despite the fact that he was a minor at the time, if he had said no, he would not be admitted.  My entire body tensed as I waited for his reply.  Looking glumly at the floor, Alex said “yes”.

Other parents I know have tried different approaches to getting teens to treatment including taking away key privileges, using the school as leverage, or arranging an intervention.  As a last resort, some parents have engaged the judicial system.  Some strategies work better than others depending upon the teen, the urgency of the situation, available financial resources and having both parents/guardians on the same page.

Parents can choose to take away privileges like the use of the car, paying for insurance, cell phones, Internet access, and other forms of financial support such as paying for college tuition or participation in sports.  Generally they frame it so that if the teen agrees to treatment and is compliant, the privileges are gradually restored.  Counselors at treatment facilities can tell parents if their adolescent is just going through the motions or if he or she is committed to the program.

If the teen is over 18 years of age, parents have the additional option of offering the teen the choice of going to treatment or moving out of the home until he or she agrees to go to treatment.  This option is not without risk, however.  Most teens who are using are cognitively immature and will have a difficult time supporting themselves without turning to connections they have with using friends and/or dealing.  Assuming the teens begin to recognize the value of family life and home as opposed to what is ahead of them on the street, they will often agree to treatment.

Other parents have used the school as leverage to get a son or daughter into treatment.  The parents work with the Substance Abuse Counselors (SAC) at the school, to identify when their teen is going to school high or likely getting high during or between classes.  The SAC pulls the teen from class and informs him or her that there is suspicion of drug use.  The parents are called and are required to take the teen for a drug evaluation at a treatment facility where the teen must also provide a urine screen.  If the recommendation is for treatment, the teen must comply or he/she will not be readmitted to school.

Some families opt to try an intervention where family members, close friends, clergy, etc., confront a teen about the impact of his or her drug use.   The help of an interventionist or counselor trained in addiction treatment can be very useful either to provide guidance or as an active participant.  Under these circumstances, it is ideal to have a treatment facility on standby to accept the teen if he/she agrees to go so that there is not time to rethink the decision.

As a last resort, some parents engage the police in the hope that the judicial system will mandate treatment.  This potentially carries the additional burden of an arrest record, drug fines and time in juvenile detention or jail.  Most parents shudder at such a thought, but if it is a choice between drug use that will result in death and the possibility that it can be thwarted in some way using the judicial system, many will choose the latter to save their child’s life.

One final observation – if  one or both of the parents are abusing substances, whether alcohol or drugs, it is often difficult to get a teen into treatment.   Many adolescents view this as hypocritical – a classic case of do as I say, not as I do. Under these circumstances, if parents really want to help their teen, they need to address their own issues with substances.
*Not her real name