This is a two-part blog post by Michael V. Pantalon, PhD, Yale Psychologist, Addiction & Motivation Expert, Speaker, Coach and author of INSTANT INFLUENCE: How to Get Anyone to Do Anything—Fast! (Little, Brown & Co., May, 2011)

A “Relapse” Scenario

Imagine your 17-year-old son has been doing really well — staying away from alcohol and pot for the past 6 months following a 28-day stay in rehab.  He’s back at school, his grades are good and he’s playing soccer again.  On top of that, his new friends seem supportive of his recovery.  As his parent, you feel you can finally breathe a small sigh of relief.

However, when your son comes home early from school one day without his backpack, you’re worried.  You confront him and his explanation makes sense: his last class was cancelled because a teacher became sick and there was no one available to sub; he did his homework earlier in the day and during part of the last period, so he didn’t need his backpack; and you already knew there was no soccer practice that day.  The next day everything seems back to normal.

Several days later, however, he comes to you and says that he would like to leave school early on Friday to go to a concert in the city.  When asked about how sensible that might be given that it might be a trigger for using and about the group of kids that he’s going to the show with, he becomes defensive and irritable.  A few minutes later he confesses that the day he came home early, he had slipped out of school right after first period to hang out with some old friends.  He ran into these old friends (the very crowd he used to use and drink with) on the way to school that day and instead of staying in school, he spent the day with them, playing Call of Duty (a popular shooter video game), and smoking and drinking, and that now he’s struggling with strong urges to continue using.

While he’s saying he doesn’t want to go back to the way he was, he also says, “I’m almost 17! Why can’t I have a drink now and then?!  I want to have fun.  Being sober is not fun.  I’m supposed to be having fun at this point in my life!”  Later, he confesses that he’d made plans to go to the concert with the old friends, but he’s still defending his ability to go with them and not use, stating that his new friends are “nice, but no fun at all.”

How do you feel?

What do you do?

How do you keep this relapse from blowing up in your and your son’s face?  Meaning, is there a way to help without making it worse?

You’re probably feeling a lot of different and conflicting feelings.  You’re angry, surprised and hurt, but you’re also worried, understanding and sympathetic.  We might all have the strong urge to immediately vent this barrage of emotions toward our child and, in the moment, we would feel justified in doing so.

However, many of us might instinctively know that to do so would not be helpful.  It might make your son more defensive and irritable.  He might then storm out of the house and go to the concert and resume drinking and pot use NOT simply because of the situation and the people he is with, but also because he now feels justified in doing so because he’s angry at his parents (whether or not it is actually justifiable in this manner).

The other thing is that your son IS actually feeling stressed and distressed about his recovery and the conflict he just had with his parents.  And since he’s learned in the past that alcohol and drugs immediately take this feeling away, we’ve just helped him create a new trigger for drug and alcohol use.

Not that you are to blame, but there are certain ways to handle relapses so that this does not happen.  While we as parents are not to blame when the sort of situation described above occurs, I strongly believe that we have a responsibility to learn ways to prevent it and even to use relapse as an opportunity to further strengthen our child’s recovery.

In my next blog post “An Overview of Relapse,” I describe a few ways to do just that.

Related Links:

Teens Only Listen to One Person…

Adjusting to Recovery: When Your Addicted Child Begins to Get Well

A Light at the End of the Tunnel

For teens in recovery, going back to their home schools and old friends can mean returning to old habits.  If your teen has made a firm commitment to recovery, you might consider the option of sending your child to a sober high school like I did.

Sober high schools are academic institutions that have a state approved academic curriculum and recovery support services for teenagers in recovery from alcohol and other drug abuse or dependence.  These schools typically combine academics with a recovery culture that includes counseling for students and families.

Finding the right one can be challenging though.  Here are 10 important questions every parent should ask a sober high school before enrolling:

1.)    What kind of training has the staff had regarding adolescent addiction?

When my son was in a sober high school, the principal was a kind and knowledgeable educator, but he did not have a background in adolescent addiction and was easily manipulated into thinking the kids would voluntarily admit if they or fellow students were using. That didn’t happen. Like teenagers everywhere, not to mention teenage addicts, the kids lied about their own use and covered up for their friends. Staff needs to be educated and trained in adolescent addiction.

2.)   Does staff include specialists like therapists and substance abuse counselors?

Many students in recovery deal with co-occurring disorders like ADHD, depression, OCD or mood disorders. They may need some “mental health time” during the week, either individually or in groups. They also need substance abuse counselors who can reinforce recovery. The school should have a licensed counselor on staff.

3.)   What is the curriculum like? How is it different or similar to mainstream high school curriculum?

One of the things I liked about my son’s sober high school was how the teachers incorporated the kids’ experiences and interests into curriculum. Another neat aspect was encouraging artistic and creative expression as both part of healing and recovery and an opportunity to explore various mediums using new technology or traditional craft approaches. Self-expression, creativity and the chance to discuss how recovery relates to the real world are desirable curriculum components.

4.) Does the sober high school meet state requirements for awarding a high school degree?

Students in recovery are often behind in credits. It is important that they receive valid credits for transferring to either another high school, for graduating with a degree, or for entrance into college. Check out the school’s certification by the state.

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Blogger Carole Bennett, MA is author of the book “Reclaim Your Life – You and the Alcohol/Addict” (www.reclaimyourlifebook.com) and the founder of Family Recovery Solutions, a counseling center for family and friends of loved ones with a drug or alcohol problem.

Substance abuse within a family is a devastating, gut-wrenching problem.  It can tear at the very fiber of even the strongest family 24 hours a day, 7 days a week.

How do responsible parents communicate with their other healthy, children about the disease that has infected their other sibling?  Confusion, uncertainty and insecurity abounds for children who don’t understand why their brother or sister is sleeping all day, acting crazy, looking funny and no longer participate with the family.

I believe that being honest and open to your child/children about their sibling’s substance abuse issues is respectful and fair.  Don’t forget that children are very intuitive and if they see their parents speaking in hushed tones when it comes to their sibling or witness an emotional and/or physical change they will realize something is up.

Here are seven tips for parents on how to begin a conversation about substance abuse in the family:

1.) Pick an easy, comfortable time to chat with your kids.  Maybe a picnic in the park or a meal at their favorite restaurant is a good backdrop.

2.) Though it is a big deal, don’t make it so in the conversation.   Parents should be able to tell the truth in a way that children are able to understand and prepare themselves for the changes that will happen in the family. For many kids, routine helps them feel safe. So if life becomes unpredictable, they will need help adjusting to the changes.

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It is easy to have high expectations for a teen coming home from some kind of treatment, but what they need to know, is how important they are to their recovery — that failure is not the end and success is up to them.  Substance use disorder creates stress for a family and there is no guarantee of the outcome of recovery without diligence. You know who your teen is.  What comes after treatment is more work.  Finding ways to deal with it are critical.  There are resources everywhere and the web is a good place to start, even to find a meeting.  There are also, ways for the whole family to just work together that enhances the success of a teen’s recovery.  Here are a few:

1.    Willingly, engage in the process of recovery. Recovery takes the whole family. You’ve survived together through major crises. You now have the chance to repair family bonds.

2.    See this in a new light. You know that your teen’s substance abuse was not a passing fad, so “accept” your teen’s addiction.  Try on addiction as a disease, not a moral problem. Look at recovery as an enduring process not a single event.  Don’t view relapse as a failure, but accept sobriety, at any time as a success; usually, the biggest success in an addict’s life.

3.    View your teen as an important. They have a huge burden and deserve to know the freedom of sobriety.  We forget that each of us, are the most important person in our own lives.  Knowing that, gives us the strength to make it.  No one can do what we do for ourselves.  A recovering addict needs to accept who they are to stay sober.  Drugs were a way of hiding and eventually became a way of life.  Sobriety depends on facing ourselves, head on, while staying sober one day at a time.

4.    Respect your teen’s return home by expecting what you would of a house guest. Encourage courtesy, gratitude and other human graces.  These attributes will heal dysfunction in the family.  Living with a recovering teen is still a challenge, but kindness and mutuality will help everyone.

5.    Put expectations aside. Parents usually have big plans for their teens!  Right now, staying sober is as big an accomplishment as any.  Placing more importance on anything else is stress that your teen might not need for a while.  Encourage your teen to resume education and work activities at his or her own pace.  Recommend physical exercise, lots of water, sleep and healthy food.

6.    Don’t underestimate addiction. Without diligence, sobriety can crumble.  Have a plan for relapse.  Encourage daily 12 step meetings to create bonds with other sober teens. Treatment plans should cover these things.  Al-anon is a good counter-plan for a parent.  If a teen relapses, you can maintain your emotional sobriety.  A teen getting back on track can happen just as quickly as they relapse.  Remember, failure is just another step closer to success.

7.    Be resilient and be prepared. Living with an addict who relapsed can necessitate outside help and tough consequences.  Do this rationally and discuss consequences with your teen.   If relapse persists, consider co-occurring disorders which might negate your teen’s ability to engage recovery without counseling and/or psychiatric evaluation.  It gets harder to deal with this once your child turns 18.

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Why is it so hard to give up on our dreams for our children?  We stare reality in the face every day and yet we still hold on to those hopes and dreams.

The day our kids are born we start making plans. We start squirreling away money into college accounts. We dream of smiling proudly as our child graciously strides across the stage at graduation. Nice, neat little homes in the suburbs with our grandchildren playing in the yard. Some of us even have the audacity to picture ourselves in the front row during a presidential inauguration on a cold January day in Washington.

It’s all possible for anyone.

Then we snap out of our dream and see our child addicted to a drug and wonder if the future is even possible. We mourn the loss of our dream. We experience suffering for our child because in our life and wisdom we know the hardship of life even without being saddled with addiction. We cry, become depressed and grieve this fading picture. Never really giving up the hope that all of the past will go away and we all get a “do over”.

Finally, after months or years we realize that today is all we get and tomorrow can be just as fearful as it can be hopeful.

The next phase of our realization begins to become clear. These dreams were ours. That is why the pain is so great. We feel our dream slipping away. It’s such a shame we have imposed our dream upon our child and we see their addiction as a failure to achieve our dream. Oh, I’m sorry, I mean “reach their potential” is the way we say it as parents.

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One of the biggest barriers to patients getting help is the stigma of addiction. The stigma is so pervasive that many family members also resist seeking help for a loved one and for themselves out of fear of discrimination, shame from feeling like a failure or embarrassment from being judged by others.  This happens too often resulting in too many families destroyed.

Addiction affects many individuals and families.  But, it doesn’t have to be this way.  And it begins with sharing our stories, better public education and a broader sense of acceptance of addiction as a treatable disease (similar to diabetes, heart disease, etc.).

Read what these five parents had to say about the stigma of addiction:

Susan: I have felt shame about having a child who is an addict. It’s one of the toughest emotions I’ve had to deal with. The ignorance of others; neighbors, friends, family, etc., is frustrating and can make you feel bad about yourself. I’ve found that reading the Intervene blog and going to Alanon meetings have been a big help.

Colleen: Family members and friends do not understand. They try, but society and media have them convinced that there is something amoral or weak about addicts. I get asked,”Why would he do this to you?” “Why do you allow him to live this way?” I am perceived as a bad parent by many, and I have been completely torn apart by some neighbors on a very public social network. My son is considered by many to just be a problem that society doesn’t need. I tell my friends and family, “It was his choice to try heroin the first time. That was his very bad choice. After that, he had no choice.” No one would choose death or jail if it wasn’t a disease. Anyone who can’t see that, well, they are the problem.

Ron: We spent years hiding from our son’s addiction. We denied it, we were ashamed of it, we tried protecting him from it, if we could have disappeared we would have. That strategy served no one well.

When we were able to overcome our shame we were finally able to take the first steps forward in helping ourselves and being in a place to help him when the time comes. We also began to realize that when people ask about our son it was because they cared about us and they cared about him. It isn’t fair to shut out these people that care for us because we are ashamed and embarrassed. I actually wrote a posting for The Partnership about overcoming your shame.

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Certain parenting memoirs help us feel less alone and provide hope that our child’s drug use problem can get better.  If you’re a parent of a child struggling with drugs or alcohol, here are 6 noteworthy books that offer information and advice, and might even give you comfort and strength during this difficult time.

Stay Close: A Mother’s Story of Her Son’s Addiction (2010)
By Libby Cataldi
Stay Close is one mother’s tough, honest, and intimate tale that chronicles her son’s severe drug addiction, as it corroded all relationships from the inside out. It is a story of deep trauma and deep despair, but also of deep hope-and healing.
This River (2010)
By James Brown
Award-winning author James Brown gained a cult following after chronicling his turbulent childhood and spiraling drug addiction in The Los Angeles Diaries. This River picks up where Brown left off in his first memoir, describing his tenuous relationship with sobriety, telling of agonizing relapses, and tracking his attempts to become a better father.

We All Fall Down (2010)
By Nic Sheff
In his bestselling memoir Tweak, Nic Sheff took readers on an emotionally gripping roller-coaster ride through his days as a crystal meth and heroin addict. Now in this powerful follow-up about his continued efforts to stay clean, Nic writes candidly about eye-opening stays at rehab centers, devastating relapses, and hard-won realizations about what it means to be a young person living with addiction.

My Daughter’s Addiction: A Thief in the Family - Hardwired for Heroin (2009)
By Marie Minnich
A captivating story of one mother’s journey raising her heroin-addicted daughter. The autobiographical story also chronicles the murder of the author’s mother in 1968; the Youth Culture of the 60s, the author’s experience as a battered wife and the devastating effects on her adult daughter who is a drug addict.

Beautiful Boy: A Father’s Journey Through His Son’s Addiction (2009)
By David Sheff
With haunting candor, David Sheff traces his oldest son’s Methamphetamine addiction from the first subtle warning signs, the denial, the attempts at rehab and at last, the way past addiction. He shows his readers that whatever an addicts fate, the rest of the family must care for one another too, lest they become addicted to the addiction.  He shows his readers that whatever an addicts fate, the rest of the family must care for one another too, lest they become addicted to the addiction.

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“Be all you can be.” That’s The U.S. Army’s recruiting slogan.  It also happens to be a necessary motto for every parent of an addict.

So what’s it really like raising a child with a drug problem?

It starts with letting go of the idea of having a “normal” life. Truthfully, it’s a far cry from the storybook life we all fantasized about once upon a time. Being a parent of an addict is about being more than you ever dreamed you could be. And most days it feels like you’re at war.

You quickly learn survival skills.  Not just physical survival. Yes, those are necessary at times, but also emotional survival skills.

You learn to love someone that, by all accounts, is un-loveable. Being close to an addict is toxic, even for a parent. We are not immune to the symptoms of the disease. We just learn how to absorb the poisonous relationship and deal with the behaviors in a way that allows us to protect ourselves and do our best to protect our suffering child.

A parent finds a way to hold on to hope when your heart is being torn apart and all seems hopeless.  But you never give up on hope — not for your child or yourself.

You find a way to survive in situations that you never dreamed you would encounter, such as visiting with your child through a glass wall surrounded by steel bars and cages. Or standing beside him as he lay in an emergency room bed while a very somber doctor explains the situation.

Miraculously, you find a way to detach yourself from your child’s actions that run counter to every value you hold dear and have taught him since he was a baby. You learn to manage your emotions when you know that your child is dealing in areas that you would not venture into without a police escort.

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During a very dark time a friend told me, “Where there is life, there is hope.” I don’t know if he knew how profound those words were to me.  In fact, I didn’t even know at the time.  I just heard the words and applied them to my son’s situation.

At face value, the statement is so simple.  Just seven words strung together telling me that as long as my son is alive there is hope he will see the light – that he can give up his life of drugs.

Then I began to think what does this really mean to me; what is the real meaning to that statement? After a lot of deliberation, I was able to feel the true meaning of those simple words.

Life is not just about our addicted child. Where there is life, there is hope applies to the parent’s life, too. We can hope for our child to see the light and we can also hope for our own acceptance, peace and happiness. This statement applies to all of us and all of those we love.

When I look around I see life all around me. A wife, daughters, mother, brother, sister, caring relatives and friends are in every direction I turn. That’s when it dawned on me: Where there is life, there really is hope!

Yes, there is! Where there is life, there is hope.

What does that statement mean to you?

When I first discovered that my daughter was using marijuana and alcohol, I was blindsided. At first I tried approaching her as a concerned parent and when that didn’t work, I resorted to yelling, threatening, punishing and even having the police at the house to lecture her when she broke curfew.  No matter what I did, things kept getting worse. I finally realized that I was having about as much success as someone standing on a train track trying to stop a fast moving train.  That was the point when I became desperate enough to seek help from adolescent addiction professionals and also joined a support group for parents who were dealing with their children’s addiction. I thought I would feel shame when I reached out, but instead found understanding, support and a sense of renewed hope. Once I began to apply my newfound knowledge by communicating with my daughter differently, things began to change for the better.  Below are some valuable lessons that I learned. 

1)  Arguing with an addicted teen doesn’t work

Reacting to your teen only fuels the fire.  Addicts can be manipulative and they have an uncanny way of turning an issue back on you.  When you react and blow up, you take the focus off of them, and put it right back onto you.  Now it is all about your anger and you are the bad guy.  This gives them even more reason to use.  Reasoning with them doesn’t work either.  A teenage addict has a chemically altered mind that will rarely respond to reason. 

2)  Set Clear Boundaries and stick to them

Your teen should understand that using drugs and alcohol comes with specific consequences. But don’t make hollow threats or set rules that you cannot enforce. It is also important that your spouse agrees with the rules and is prepared to enforce them.  Standing as a united front as parents is crucial when you are fighting against a foreign substance that has taken over your child’s brain.  

3)  Arm Yourself with Support and Information

Learning to talk to my addict daughter was like learning a new language. My greatest teachers were my parent support group and the substance abuse counselors that partnered with me to intervene in my daughter’s addiction.  The internet is also a great tool.  I never would have been able to navigate my way though those difficult times without learning some new ways of communicating and applying them with the help of others.   

4)  Timing is everything

Perhaps your teen has been arrested or expelled from school or has been caught driving under the influence. You can use this as an opportunity to approach your child and convince them to enter treatment.  Don’t blow a good chance.  A crisis event can be an opportunity for parents to confront their child.  Facing real consequences can wake some teens up.  Any intervention, either formal or informal, is an attempt to convince an addict that they are at their bottom, and it is time to make a change.  The goal is to get your child to the place that they stop fighting for their addiction.  Going it alone however can be difficult.  Enlisting the intervention assistance of Adolescent Substance Abuse Professionals can dramatically increase the odds that your teen will become willing to accept help.

When the disease of addiction hit my family, it was like a tornado hitting our home from the inside out.  There were days when I felt like I was losing the battle.  Towards the end, my daughter had a full blown addiction to crystal meth. It was important for me to keep moving forward to keep building my arsenal of knowledge and expanding my circle of support.  Nothing changes if no one changes.  It had to start with me.