Search Results for: outpatient

Does outpatient rehab work?

Some people do find success in outpatient drug rehab, but the odds are lower than if they had checked into a residential program. Research shows that the “gold standard” for sustained recovery is 90 days in an inpatient facility.

Ask the Expert: How do I help or learn how to trust my son?

teenage alchoholismMy son is 17 years old. He started smoking marijuana at 13. This just got worse and worse. In March of this year he was arrested. He was seen snorting suboxone up his nose and taking a hit of synthetic marijuana. He went to juvenile detention center for 6 days and then to inpatient rehab for 45 days. He came home in May and finished school, got his diploma. He was taking masonry in a vo-tech school, he graduated from there and got a job right out of school. He was going to outpatient sessions, and NA meetings. A few weeks ago he broke his arm and was out of work. This is when the suspicious behavior started again. I found marijuana and suboxone in his wallet last weekend and I turned him in to his probation officer. We are all at a loss of what to do for him.. So now he is going to be on strict house arrest for up to 6 months, and he will no longer be allowed to drive to work or his meetings. He also has to attend a meeting every day. Please help me with some advice on what to do. He will be 18 in August, but that isn’t going to matter since probation has now placed him on house arrest. I just want my son back, but I don’t know how else to help him or how to trust him.

Photo of Christy CrandellEXPERT CHRISTY CRANDELL: “It sounds like your son  needs a more intensive outpatient program to help him with his ongoing recovery. Does his probation officer work with any local treatment programs in the area that they can recommend or even perhaps help pay for? The recovery process is oftentimes a bumpy road and a very frustrating and scary time for a parent. Find a local Al-Anon program in your area which will give you support as you try to love your son through this but at the same time allowing you to stay healthy yourself. Sometimes you have to try multiple meeting locations to find one that meets your needs. Remember, he has been smoking marijuana for four years and it is going to take him awhile to figure out how to live his life without it. People beat this every day – don’t lose hope!”

Christy Crandell, Co-Founder of Full Circle Treatment Center

Ask the Expert: My son’s relapses and legal issues make me lose hope. How do I get my son back?

QUESTION: My son is 17 years old. He started smoking marijuana at 13. This just got worse and worse. In March of this year he was arrested. He was seen snorting suboxone up his nose and taking a hit of synthetic marijuana. He went to juvenile detention center for 6 days and then to inpatient rehab for 45 days. He came home in May and finished school, got his diploma. He was taking masonry in a vo-tech school, he graduated from there and got a job right out of school. He was going to outpatient sessions, and NA meetings. A few weeks ago he broke his arm and was out of work. This is when the suspicious behavior started again. I found marijuana and suboxone in his wallet last weekend and I turned him in to his probation officer. We are all at a loss of what to do for him. I have read everything about recovery and relapse and what to do, but this is frustrating. So now he is going to be on strict house arrest for up to 6 months, and he will no longer be allowed to drive to work or his meetings. He also has to attend a meeting every day. Please help me with some advice on what to do. He will be 18 in August, but that isn’t going to matter since probation has now placed him on house arrest. I just want my son back, but I don’t know how else to help him or how to trust him.

Photo of Christy CrandellEXPERT CHRISTY CRANDELL: “It sounds like your son just needs a more intensive outpatient program to help him with his ongoing recovery.  Does his probation officer work with any local treatment programs in the area that they can recommend or even perhaps help pay for?  The recovery process is oftentimes a bumpy road and a very frustrating and scary time for a parent. Find a local Al-Anon program in your area which will give you support as you try to love your son through this but at the same time allowing you to stay healthy yourself. Sometimes you have to try multiple meeting locations to find one that meets your needs.  Remember, he has been smoking marijuana for four years and it is going to take him awhile to figure out how to live his life without it.  People beat this every day – don’t lose hope!”

Treatment Options to Addiction

The devastating path to addiction begins when an individual tries an addictive substance for the first time. Over time, after continuous intake of the addictive substance, the individual looses the ability to choose whether or not to abuse the substance; this is known as substance addiction. Substance addiction is a traumatizing, complex brain illness characterized by an uncontrollable drug craving and a compulsive need to use drugs to function normally every day, despite the consequences. With more than 22 million people in the U.S. abusing addictive substances, only 2.6 million people actually receive the addiction treatments they need. That leaves 19.4 million people vulnerable for the catastrophic results of substance addiction.

No single addiction treatment works for everyone, but various effective treatment options are available that attend to an individual’s substance addiction, as well as other needs of the individual. Such treatments include:

1. Standard treatment programs:
• provide educational and therapy sessions generally focused on getting/staying sober and preventing relapse
• may include family and group sessions
• depending on the individual’s level of addiction, these programs may include residential or outpatient settings
2. Self-help groups:
• Patients can meet other individuals with the same or similar problems which often helps increase motivation
3. Counseling/Psychotherapy:
• One-on-one therapy sessions with a specialist
• Family therapy sessions with a specialist: provide higher chances of a positive outcome by having a strong support system
• Discussing topics such as coping with cravings, avoiding the substance and relapse, and dealing with possible relapses
• Counseling may also incorporate discussions about legal problems, relationships with family and/or friends, work, school and more
4. Withdrawal therapy:
• Detoxification: stop taking the addictive substance as quickly as possible
• Withdrawal therapy may involve gradually reducing the dose of the drug or temporarily substituting the substance with other substances that have less serious side effects
• May include inpatient or outpatient residential settings
5. Behavioral therapy:
• Gives patients the opportunity to change their attitudes and behaviors that relate to their substance abuse
• Helps patients further engage in their treatment process by recognizing situations in which they are most likely to abuse the addictive substance, and how to avoid and cope with those situations
• Addresses the variety of influences on their substance abuse
• Motivational incentives are used for positive reinforcement to promote abstinence from addictive substances
6. Medications:
• used to help restore normal brain function, prevent relapse and eliminate cravings for an addictive substance
• For example, methadone and buprenorphine are used to act on the same part of the brain that opiates such as heroin and morphine effect, in order to minimize withdrawal symptoms and relieve cravings
• Other medications such as Naltrexone are also used to relieve cravings as well as the effects of the addictive substance

A Place of Hope’s Center for Counseling and Health Resources provides help for those who seek addiction treatments for alcohol addiction, illicit substance abuse addiction, prescription drug addiction or issues relating to gambling, sedatives, steroids and more. Dr. Gregory Jantz and his team of addiction medical professionals, psychologists, nutritionists and fitness trainers help to address the physical, psychological and spiritual problems that are behind the symptoms. Please visit us online at A Place Of Hope For Addiction or call us on 1-888-379-3372.

Ask the Expert: My son’s trouble with relapse and the law has me losing hope. How do I get my son back?

Question:  My son is 17 years old. He started smoking marijuana at 13. This just got worse and worse. In March of this year he was arrested. He was seen snorting suboxone up his nose and taking a hit of synthetic marijuana. He went to juvenile detention center for 6 days and then to inpatient rehab for 45 days. He came home in May and finished school, got his diploma. He was taking masonry in a vo-tech school, he graduated from there and got a job right out of school. He was going to outpatient sessions, and NA meetings. A few weeks ago he broke his arm and was out of work. This is when the suspicious behavior started again. I found marijuana and suboxone in his wallet last weekend and I turned him in to his probation officer. We are all at a loss of what to do for him. I have read everything about recovery and relapse and what to do, but this is frustrating. So now he is going to be on strict house arrest for up to 6 months, and he will no longer be allowed to drive to work or his meetings. He also has to attend a meeting every day. Please help me with some advice on what to do. He will be 18 in August, but that isn’t going to matter since probation has now placed him on house arrest. I just want my son back, but I don’t know how else to help him or how to trust him.

Photo of Christy CrandellEXPERT CHRISTY CRANDELL: “It sounds like your son just needs a more intensive outpatient program to help him with his ongoing recovery.  Does his probation officer work with any local treatment programs in the area that they can recommend or even perhaps help pay for?  The recovery process is oftentimes a bumpy road and a very frustrating and scary time for a parent. Find a local Al-Anon program in your area which will give you support as you try to love your son through this but at the same time allowing you to stay healthy yourself. Sometimes you have to try multiple meeting locations to find one that meets your needs.  Remember, he has been smoking marijuana for four years and it is going to take him awhile to figure out how to live his life without it.  People beat this every day – don’t lose hope!”

 

Check out other questions from our readers and ideas from our experts here.

My son’s trouble with relapse and the law has me loosing hope. How do I get my son back?

My son is 17 years old. He started smoking marijuana at 13. This just got worse and worse. In March of this year he was arrested. He was seen snorting suboxone up his nose and taking a hit of synthetic marijuana. He went to juvenile detention center for 6 days and then to inpatient rehab for 45 days. He came home in May and finished school, got his diploma. He was taking masonry in a vo-tech school, he graduated from there and got a job right out of school. He was going to outpatient sessions, and NA meetings. A few weeks ago he broke his arm and was out of work. This is when the suspicious behavior started again. I found marijuana and suboxone in his wallet last weekend and I turned him in to his probation officer. We are all at a loss of what to do for him. I have read everything about recovery and relapse and what to do, but this is frustrating. So now he is going to be on strict house arrest for up to 6 months, and he will no longer be allowed to drive to work or his meetings. He also has to attend a meeting every day. Please help me with some advice on what to do. He will be 18 in August, but that isn’t going to matter since probation has now placed him on house arrest. I just want my son back, but I don’t know how else to help him or how to trust him.

Photo of Christy CrandellEXPERT CHRISTY CRANDELL: “It sounds like your son just needs a more intensive outpatient program to help him with his ongoing recovery.  Does his probation officer work with any local treatment programs in the area that they can recommend or even perhaps help pay for?  The recovery process is oftentimes a bumpy road and a very frustrating and scary time for a parent. Find a local Al-Anon program in your area which will give you support as you try to love your son through this but at the same time allowing you to stay healthy yourself. Sometimes you have to try multiple meeting locations to find one that meets your needs.  Remember, he has been smoking marijuana for four years and it is going to take him awhile to figure out how to live his life without it.  People beat this every day – don’t lose hope!”

Ask the Expert: How do I Trust My Daughter After Detox?

My 21-year old daughter is a heroin addict. She just finished her detox at an inpatient facility. I find it very hard to trust her and let her go places alone in fear she will use. She says and has said she has no desire to start again. She is going to be starting an intensive outpatient program soon. How do I trust her and how do I support her? I believe she should have stayed in rehab at the inpatient facility or perhaps another one. She didn’t like the one she was at, and I don’t think this was handled the way it could have been in some circumstances.

Thank you,

Mom that is scared and a co-dependent

EXPERT KENT MORRISON:

There are several questions that need to be asked. First, why is she still not in an inpatient program? Did she leave against staff advice? Reason being is that it is always ideal to transfer from one program to the next, door to door, to keep continuity and motivation strong.

Second, rebuilding trust is a long process. As your daughter is 21, it is even more on her to earn back trust. With this there are several suggestions which are important. First, as she transitions into an outpatient program, there must be a family component to it to help educate and inform the entire family about addiction and recovery/sobriety. Helping the entire family will certainly be a positive step in healing the trust/relationship. Also, it will be important that your daughter seeks long term help. Heroin addiction (or any opiate/opioid addiction) is a difficult addiction to fight. There are compounding issues that contribute to why the addict’s use this type of drug and there are several critical components to recovery (such as diet, exercise, and mindfulness). It is even truer that we as professionals must treat the body, mind, and spirit of the addict. Finally, boundaries are going to be a helpful tool in rebuilding trust. Setting clear simple boundaries will help you see how your daughter is doing and seeing healthy behavior will provide visible signs of improvement.

- Kent Morrison, Substance Abuse Counselor, MA, LAADC-R, CADC II, ADCR

Photo of Christy CrandellEXPERT CHRISTY CRANDELL:

It is wonderful she has taken this first important step in her recovery but recovery takes time. When she begins her outpatient program, make sure to inquire about family involvement. This is where you will learn about addiction and steps to take to rebuild your relationship. I would also recommend you attend Al-Anon or Nar-Anon meetings to find additional support for yourself.

– Christy Crandell, Administrative Director and Founder of Full Circle Treatment Center.

 

For resources to help you with the issue of trust, check out the “Trust Meeting in a Box.”

Finding the Right Rehab for your Addicted or Alcoholic Child

As a responsible parent, I sought out the right school for my kids, researched the right food for our healthy table, and found the right physicians for our family. But the right rehab?  Dr. Spock clearly omitted that critical chapter from his parenting books.  Where do I even begin with that due diligence under the pressure of an imploding family?

In shock, I was ill equipped to tackle the task at hand and didn’t even know what to look for.  Should I look for something local, or would it be better for my son to leave his local triggers behind? Did I even want him nearby or would it be better for all of us if he was far, far away? Should I seek a religious program or a 12-step program…and what is a 12-step program, anyway?  Residential or outpatient treatment?  Co-ed or not?  And how do I even know if a rehab is safe and good? And, by the way, how do we pay for rehab, and how long is it supposed to last, anyway?

Even if I could figure out what I was looking for, I didn’t know where to find it. After searching the internet and coming up dry, in desperation I called a spiritual store I had wandered into several months earlier.  The proprietor pointed me towards a rehab where my son began to build the foundation for his recovery.  I still think of that referral as a divine intervention.

With chemical dependency, there are more questions than answers.  I know that other parents continue to struggle with the fundamental question:  which rehab is right for my child?  I hope that readers of today’s blog will comment and share your insight about the rehab that you selected for your child.

How do I trust my daughter after detox?

My 21 yr. old daughter is a heroin addict. She just finished her detox at an inpatient facility. I find it very hard to trust her and let her go places alone in fear she will use. She says and has said she has no desire to start again. She is going to be starting an intensive outpatient program on the 16th of Nov. How do I trust her and how do I support her? I believe she should have stayed in rehab at the inpatient facility or perhaps another one. She didn’t like the one she was at, and I don’t think this was handled the way it could have been in some circumstances. Thank you, Mom that is scared and a co-de

EXPERT KENT MORRISON:

There are several questions that need to be asked. First, why is she still not in an inpatient program? Did she leave against staff advice? Reason being is that it is always ideal to transfer from one program to the next, door to door, to keep continuity and motivation strong.

Second, rebuilding trust is a long process. As your daughter is 21, it is even more on her to earn back trust. With this there are several suggestions which are important. First, as she transitions into an outpatient program, there must be a family component to it to help educate and inform the entire family about addiction and recovery/sobriety. Helping the entire family will certainly be a positive step in healing the trust/relationship. Also, it will be important that your daughter seeks long term help. Heroin addiction (or any opiate/opioid addiction) is a difficult addiction to fight. There are compounding issues that contribute to why the addict’s use this type of drug and there are several critical components to recovery (such as diet, exercise, and mindfulness). It is even truer that we as professionals must treat the body, mind, and spirit of the addict. Finally, boundaries are going to be a helpful tool in rebuilding trust. Setting clear simple boundaries will help you see how your daughter is doing and seeing healthy behavior will provide visible signs of improvement. - Kent Morrison, Substance Abuse Counselor, MA, LAADC-R, CADC II, ADCR

EXPERT CHRISTY CRANDELL:

It is wonderful she has taken this first important step in her recovery but recovery takes time. When she begins her outpatient program make sure to inquire about family involvement. This is where you will learn about addiction and steps to take to rebuild your relationship. I would also recommend you attend Al-Anon meetings to find additional support for yourself. – Christy Crandell, Administrative Director and Founder of Full Circle Treatment Center.

 

 

 

 

 

 

Need-a-Rehab

ParentPathway is honored to feature some of the rehabs we consider to be the best in the nation.  While the success of recovery ultimately lies in the hands of the client, we have found that these rehabs offer strong programs.  Also, please make sure you are familiar with our terms of use regarding information offered on the ParentPathway web site. Here’s one of our favorites:

Clean & Sober Recovery Services (CSRS) is a small, co-ed 12-step based residential rehab near Sacramento, California.  We like it because:

  • It’s high-caliber yet reasonably priced.
  • The program offers a strong focus on relapse prevention.
  • The treatment program integrates residents into the local recovery community where they will find support for sobriety after their formal program ends.
  • The program includes three months of aftercare.
  • CSRS is a family business, with the owners on site.
  • The recovery program offers family education to help the resident’s family understand the disease of addiction and make the changes necessary to support sobriety.
  • CSRS will soon offer outpatient treatment.
  • CSRS now accepts insurance. Call them for details.

Opened in 2008, Clean and Sober has served over 1,000 clients. CSRS’s recovery model is based on the “bio psycho social” system of care.  “The biological element is the physical healing of brain and body through detox and nutrition,“  explains co-owner John Perry.  “The psychological element focuses on understanding the self—what drives one to use and abuse. The social element of recovery involves developing the skills to maintain sobriety while returning to the outside world.” Learn more about CSRS, or call them at 916 990-0190.

Check out the Substance Abuse and Mental Health Services Administration (SAHMSA’s) searchable Substance Abuse Treatment Facility Locator that includes more than 11,000 addiction treatment programs.; You can search on type of rehab (inpatient or outpatient) and area of emphasis (LGBTQ or vegan, for example). What kind of substance use disorder are you tackling?  The locator lists programs for drug addiction and alcoholism. Listings include treatment programs for marijuana, cocaine, and heroin addiction, as well as drug and alcohol treatment programs for adolescents and adults.

While Parent Pathway does not sanction or endorse any of these referrals, we are making this information available for your convenience. CLICK HERE to enter the drug abuse and alcoholism Treatment Facility Locator.

 

Treatment Questions

Drug treatment is intended to help addicted individuals stop compulsive drug seeking and use. Treatment can occur in a variety of settings, in many different forms, and for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring. http://www.nida.nih.gov/podat/faqs.html#faq3

Individuals progress through drug addiction treatment at various rates, so there is no pre-determined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes. For methadone maintenance, 12 months is considered the minimum, and some opioid-addicted individuals continue to benefit from methadone maintenance for many years. http://www.nida.nih.gov/podat/faqs.html#faq3

It is important to know that no single treatment approach is appropriate for all individuals. Finding the right treatment program involves careful consideration of such things as the setting, length of care, philosophical approach and your loved one's needs.

Here are some questions to consider when selecting a treatment program:

  • Does the program accept minors?
  • Does the program accept your insurance? If not, will they work with you on a payment plan or find other means of support for you?
  • Is the program run by state-accredited, licensed and/or trained professionals?
  • Is the facility clean, organized and well-run?
  • Does the program encompass the full range of needs of the individual (medical: including infectious diseases; psychological: including co-occurring mental illness; social; vocational; legal; etc.)?
  • Does the treatment program also address sexual orientation and physical disabilities as well as provide age, gender and culturally appropriate treatment services?
  • Is long-term aftercare support and/or guidance encouraged, provided and maintained?
  • Is there ongoing assessment of an individual's treatment plan to ensure it meets changing needs?
  • Does the program employ strategies to engage and keep individuals in longer-term treatment, increasing the likelihood of success?
  • Does the program offer counseling (individual or group) and other behavioral therapies to enhance the individual's ability to function in the family/community?
  • Does the program offer medication as part of the treatment regimen, if appropriate?
  • Is there ongoing monitoring of possible relapse to help guide patients back to abstinence?
  • Are services or referrals offered to family members to ensure they understand addiction and the recovery process to help them support the recovering individual? http://csat.samhsa.gov/faqs.aspx

Some people do find success in outpatient drug rehab, but the odds are lower than if they had checked into a residential program. Research shows that the “gold standard” for sustained recovery is 90 days in an inpatient facility.

Sober living homes are homes in the community that offer a safe and structured environment for long-term recovery.  Usually, sober living residents move into these homes directly from rehab.  The homes offer a more loosely structured environment where residents can return to school or work as they continue to strengthen their recovery.

My child has been addicted to Suboxone (prescribed by a Physician) for 2 years. What started out as a treatment plan to assist with helping by child "get off" of addiction to Opiates has turned into it's own beast. I believe it has kept my child in addiction mode. Does anyone have any thoughts on this drug?

ANSWER 1 OF 2: EXPERT PATTY INGRAM

The goal of Suboxone treatment is to reduce illegal opiate use and to help ease individuals off their opioid of choice. Suboxone is a partial opioid agonist, and produces a milder effect, reducing cravings without generating extreme highs and lows. Suboxone detox is difficult because the drug is still an opioid, though weak, and can cause long term mental and physical addiction.  Traditional drug rehab treatments many times are unsuccessful for Suboxone. The Waismann method (detoxing while under anesthesia) has had some success. The larger question here is this: What does "addiction mode" in your child look like? In general, if a patient's life is getting larger (increased activity, better nutrition, more socialization, improved ability to work/perform at school), rather than smaller (isolating, depressive symptoms, lack of interest in daily life) then continued therapy could be a good route. If the patient is returning to behaviors much like their original addiction, then a medically monitored detox may be the best choice. Physicians are divided on this and I believe it truly has to be patient specific. - Patty Ingram, Drug and Alcohol Counselor (RAS) Intern and Educator

ANSWER 2 OF 2: EXPERT MEL POHL, M.D. 

Because relapse rates with opioid addiction are so high, many clients and treatment professionals have turned to medication assisted treatment (formerly called maintenance) programs that provide long-lasting opioids such as methadone (Dolophine) or buprenorphine (Suboxone and Subutex).  I am not a fan of buprenorphine for maintenance for the reasons stated below, but there are many addiction specialists who believe that it is the best available treatment for opioid dependence. I am not among them.

Buprenorphine’s unique pharmacology causes less of the same negative side effects commonly seen with morphine and methadone (e.g., respiratory depression, cognitive impairment, and euphoria more likely to be associated with craving and abuse) and has opened the way for treatment of opioid dependence in new settings. This allows treatment options to reach those who may not have previously had access or don’t feel comfortable with other treatment settings such as a methadone clinic. Buprenorphine has been touted as a safe, low risk option for treatment of opioid dependence because of its mild effects and a ceiling effect at high doses. Yet, despite the apparent advantages of buprenorphine over other opioid maintenance medications, an abuse potential remains.

Here are several key questions to consider regarding the use of buprenorphine for the treatment of opioid addiction:

  • Is the brain of the opioid addict more normal with buprenorphine than without, as many medication assistance proponents assert? At least with methadone dependent addicts, it has been shown that
    brain dopamine transport system is impaired compared to abstinent opioid addicts.
  • Is there a reasonable hope of achieving a buprenorphine-free state once it has been started? If so, when is the logical time to attempt withdrawal? After six weeks, six months, two years? If withdrawal fails, is that because of dependence on buprenorphine, which is extremely difficult to discontinue, or is relapse inevitable in the absence of some opioids? We all know that discontinuing maintenance doses of opioids is extremely difficult; but is that because of withdrawal (protracted with buprenorphine) or is it because the brain requires a medication like buprenorphine to function and feel normal.
  •  There are clinics that have sprung up in some cities that include buprenorphine treatment among a vast “service line” menu, including Botox, Restalyne, liposuction, and teeth whitening. Do we truly expect an addict to find recovery in such a setting?
  • How are you to manage these clients as an addiction professional? It is your task to help clients find quality in their lives.  Can you steer them to buprenorphine-friendly meetings? Should the      maintained addict go to mainstream meetings and hide the fact that they are on buprenorphine. It is not uncommon for addicts who disclose their status to be ostracized or encouraged to discontinue medications by nonprofessional peers. Can you help clients navigate these difficult waters and develop a supportive community to help them as they live life on life’s terms?
  • Some feel that opioid-free is simply not an achievable state; the data appears to suggest low percentages of successful abstinence. Where are all the addicts who are successful? There are     thousands of opioid addicts in recovery who have abstained through the help of the twelve-step fellowships for decades. We know it can be done, but how can we tell who is likely to be successful?
  • Do we commit everyone to maintenance for life? Is this “harm reduction” or are we actually doing harm by using mediations for all without attempting to help clients achieve a drug-free state? Do we try abstinence a time or two or ten? Do we eventually accept buprenorphine-maintained recovery as a reasonable alternative? Do we try again for abstinence after a time?  If so, when? -Mel Pohl, M.D., Medical Director, Las Vegas Recovery Center

Do you have a recommendation for treatment facilities that offer detox and subsequent rehab from Suboxone and Xanax?  Many of the centers will not accept clients that are taking this "medication" until they have stopped taking it. Other centers offer a 14 day detox and then off you go. My child says he wants to "feel normal." He has been to multiple therapists, psychiatrist, addiction specialist, EMDR therapy and is resistant as he continues drug seeking to "feel normal."  Thank you.

ANSWER: EXPERT MEL POHL, M.D.
Well, it appears that there are two questions. First, who will facilitate withdrawal from Suboxone and Xanax - both are tough to come off of without medical assistance. The Las Vegas Recovery Center does offer medically managed withdrawal from these drugs as do many other centers including Betty Ford Center and Hazelden to name a few.

As for your son's desire to feel normal, unfortunately, the level of "normal" that he feels on drugs is modified by the drugs. In other words, while he remains physically dependent on these drugs which alter his perceptions about what is "normal".  Any treatment center he would work with would have to help him accept the plan to come off those drugs and assist him to adjust to a new sense of normal without the drugs (this might take longer than anyone would like - several months, depending on the dose of each medication that he is using).

On a basic level, he will have to come to the conclusion that he needs to come off the drug and hang in there for a while until he begins to accommodate to recovery. -Mel Pohl, M.D., Medical Director, Las Vegas Recovery Center

 

FATHER 'S QUESTION:  I have two daughters who have been back and forth with a heroin addiction problem, among other emotional problems. They are both young adults (nearly 20 and 23). They refuse to go to rehab. My ex-wife and I support them both financially, one of them in her own apartment. We don't know what to do, and want to know if there are professionals who can tell us the best approach to dealing with the problem.

Photo of Ricki TownsendEXPERT RICKI TOWNSEND:  Your situation with your daughters will only get worse, if not paid attention to.  I am sorry, there is not an easy answer, but there is help for parents and it will require you to step up to the plate.

I don't know if you have ever played baseball. I did, and when I stepped up to the plate,

I had to concentrate on pitcher, and the ball in her hand.

I concentrated on it from the time it left her hand until it reached me.

As it came to me, I was already solid in my place and my feet planted.

When I swung, I did it with the intention that I was going to hit it out of the park.

With your daughters it is similar; you focus on what it is you want for them. What hasn't worked? (Like when I struck out at the plate. So the next time I step up to the plate, I remember what didn't work and change the stance).

Are you changing your stance? You mentioned they refuse to go to rehab, and the next sentence, you mention you support them financially.

If every time I stepped up to the batters plate, someone pushed me out of the way, and said, "Ricki, I'll hit for you"  - would I want to go to the batting cages and practice?  Your daughters don't have to learn how to swing at life.  Addiction robs people of self worth and motivation to change.  If someone swings and hits a home run for them each time, this feeds the addiction's stronghold and takes the desire away to be all they can be in life.  It's a tricky situation for parents.

Personally I would want to know more information, but I hope at least some of this has sparked you to focus on making some small moves.

I am an interventionist. I work all over the country. My main focus is "Family" Because this is a Family disease. You have a lot of loving power when used in a healthy way, to move your daughters in a healthier direction. I hope you will consider working with myself, or an interventionist you are familiar with. This is a serious problem. Your daughters could loose their life.

I am available by email if you want a more concentrated support. I also would ask you check into a parent focused Al-Anon or Nar-Anon meeting in your area.  This gives you support and ideas from other families experiencing similar situations with their children.

Ricki Townsend
Board Certified Interventionist, Drug/Alcohol Counselor
NAADAC Certification Commissioner
Ncac1, CAS, RAS, Bri-1
Member of AIS, NII, NAADAC
Chaplain
Grief Recovery Specialist
916-539-4535
www.apathtorecovery.com

Expert Mel Pohl:  To be blunt, why would your daughters stop using drugs and go to rehab if they are supported financially?  The term is enabling - done out of love and lack of understanding what can be done.  What can be done is to set out clear boundaries including that you will not support them UNLESS each goes to rehab by date certain.  This is probably the toughest thing for a parent to do, so get help - go to Alanon or Naranon - so that you can get support for yourselves!  -Mel Pohl, M.D. Medical Director

 

My son just got out of jail last week in Las Vegas. We live in another State. He has no money no clothes nothing, he keeps calling for help to get back here but he has no home to go to. He is 29 years old and has been in and out of prison and jail. He is drunk or on drugs every day. I have been in AL-ANON for 5 months and it has been very helpful, but I still struggle with guilt for not helping him out ,he calls constantly - up to 10 times a day and says he will have to resort to stealing to eat. I am pretty sure there is some mental illness going on,can you help me?

Photo of Christy CrandellEXPERT CHRISTY CRANDELL: "It is so wonderful that you are attending Al-Anon.  This is where you will find the strength to do what is best for your son.  Call the county mental health department and find out what services are available for your son.  When he calls, give him this information and tell him you love him.  The rest is up to him.  Tell him you will be available for more support only when he seeks help for himself.  Stay strong!"

QUESTION:  My son was on pain pills for 5 years and Suboxone for two. He got off Suboxone recently for a month and decided to go back to the daily clinic and now is on Methadone. Since he is working and on Methadone, he thinks he is good and doesn't need to ever change and be drug free. Is it safe to be on Methadone for years? Or is this the drug talking?

EXPERT PATTY INGRAM: Methadone can be a safe and stable solution long term if dosed by a pain specialist or addiction medicine expert, at a very low dose. It can prevent the cravings and impulses to use - much as Suboxone does. It should be monitored and used only to create stability and not provide a "high" or "secondary benefit". All methods possible ought to be employed to prevent overuse and diversion.

Ideally, with time, one could wean off the drug completely: but if such a goal leads to complete relapse then the decision lies with which option causes the least harm. If someone in recovery achieves a long and solid return to health and activity while on a low, controlled dose of Methadone for maintenance, then that is a wonderful outcome.   As a diabetic may always need Insulin to maintain a healthy life, so some individuals may need other medicinal options to maintain balance and live a productive life.  Blessings, Patty Ingram

EXPERT KENT MORRISON: There are 2 different things that need to be addressed here. First, is your son seeing a counselor/therapist? I believe this would be a great topic of discussion for a therapy session between your son and a counselor/therapist. There are different views on recovery and what recovery means. To share my view, recovery is ultimately total abstinence from all mood altering substances, this means Methadone too. Any time a recovering addict is still using, even a prescribed medicine, there should be some check in with a counselor/therapist. Second, there is a difference between Suboxone and Methadone. There is emerging research that is now suggesting long-term or even lifelong use of Suboxone to help manage recovery for recovering opiate addicts.

Methadone does not have the same research results. There is a new and needed emergence in the field of substance abuse, Medically Assisted Treatment, which is incorporating the use of prescription drugs to help addicts with recovery. Methadone is not part of this movement. Methadone presents several obstacles for the recovering addict. First, methadone is only given out through clinics, which requires the addict to be there at a certain hour/day, this is not always convenient for the addict. Second, the addict is still getting an opiate, Methadone, which if a dose is not gotten the addict could go into withdrawal, prompting a relapse to street drug use. And, Methadone can be taken in excess to get high. (Suboxone can be used in the same manner, used in excess to get high, but what I have heard addicts say is that they do not like the Suboxone high). Second, the way Methadone works within the body is different than the way Suboxone works within the body. To be simple and general, Suboxone works in a manner that allows the body to start to regenerate its own endorphine/opioid system. Whereas Methadone is a complete take over and does not allow the body to regenerate its system. In my experience, Methadone can be used for withdrawal purposes effectively; however I do not see it as an effective management tool like Suboxone is. I hope this helps.

Last, even with the new research about long-term or lifelong use of Suboxone, I still think the addict needs to look into total abstinence and alternative, more specifically "natural", remedies to help repair the body's deficiencies. This can be done through diet, exercise, and supplementation. I would be more than happy to talk further if it would help.  Please feel free to reach me at 916-966-4523 ext 2. Kent Morrison, MA, LAADC-R, CADCII

 

Question:  Our son is not using on the street and goes to a methadone clinic every day for his dose. For years we have spent all our money trying to get him to completely stop and are broke. Are we wrong to stop helping him with money? He works but doesn’t make enough. It’s at least $11.00 a day at the clinic. He feels he is not an addict because he goes to a clinic. I am so messed up on when to help or not to help.

 Photo of Christy CrandellEXPERT CHRISTY CRANDELL:  Is he getting counseling at the clinic? If so, ask to attend his next session with him so you can get some of your questions answered. Methadone can be a successful replacement therapy when used with counseling and tapered over time. Does your son seem to be moving forward with his life? Do you feel like you are working harder on his recovery than he is? The answers to those questions are a good indicator if you should continue to offer your support. In addition, I would recommend you find an Al-Anon meeting in your area where you can find additional support for yourself. Best regards – Christy Crandell, Administrative Director and Founder of Full Circle Treatment Center

Photo of Ricki TownsendEXPERT RICKI TOWNSEND:  Your question is one I get asked often by clients, and my response is usually very simple: this is about you. How do you feel about paying out of your own pocket for Methadone? Have you googled what professionals think about Methadone, what it does and how it works? This information may help you make your own decisions about spending any more money on an addiction.

You may decide that you no longer want to spend your hard-earned money on his Methadone.  If so, please communicate to him in a very short letter why you will be discontinuing this payment. Remind him in a respectful way that you have supported this approach so far, but now you are finished paying for it. If your son wants to continue relying on Methadone, then allow him his free will, and he can figure how to get it, such as with another part-time job.  Otherwise, he will have to find a way to detox from it.  I personally would want to give him two weeks to 30 days to take action and be free of your Methadone support.

Remember, in Al-Anon we learn that we didn't cause, can't control and can’t cure this disease. It is up to him.  Blessings – Ricki Townsend, Board Certified Interventionist, Drug/Alcohol Counselor, NCAC1, CAS, RAS, BRI-1

 

QUESTION:  I am not a parent. I am a sibling. My brother has gone to a treatment center already and stayed clean for a few months. My parents let him live in the house. He got a job after treatment and then went back using a few months ago (oxycontin, pills etc).

I am so scared for my parents and my brother. I have provided them with home drug tests so they can randomly test him--- although I think it’s unfair they should be burdened with the responsibility, I feel if they are housing him they have to have a way to test him, right?  My dad?

My dad is looking for a psychiatrist for my brother who has expertise in addiction. I am not sure that is the answer. I do know my brother is depressed so that doesn't help. His girlfriend is clueless and never realizes when he is on drugs again. Do we clue her in?

I guess my main question is what do we do in this situation? Sorry for bringing up so many different issues on one email. I am eternally grateful for your site. It is helping so much.

Photo of Ricki TownsendEXPERT RICKI TOWNSEND:  Addiction is hard on our hearts, no matter if we are parent, brother, sister or close friend.

Being a sibling, through, can create additional frustrations. First, coming from a protective mode, we can become frustrated, that our parents are being hurt. Or we can become frustrated with our parents because they won't do what we think would be healthier for them and for our siblings.  We can also become frustrated because we see them being manipulated and we are powerless to change the circumstances.  Understanding the source of your frustration can help you feel more in power.

As far as relapse, it is often part of this disease.  When I counsel families like yours, I ask that parents do not allow children return to their home. Instead, I ask that the son or daughter move into transitional living, such as a sober living house where they will be randomly drug tested and can live with like-minded roommates. They are usually required to also attend meetings, and have sponsors. The rules vary depending on each transitional living home. Your parents also have the right to set rules about having their own home be a sober home, and passing a drug test may be one thing they require of your brother, were he to remain in their home.

Regarding the psychiatrist, I personally would ask that my client first see a primary care doctor. The primary care doctor may or may not refer your brother to a psychiatrist; if he did, you would know that is someone the doctor trusts. Yes, your brother may need anti- depressants, which a primary care doctor may prescribe. Sometimes we as addicts want a psychiatrist to obtain things like, Suboxone, Xanax, and klonapin. With my clients, I have seen them start abusing those. Again, I don't know your family member; I am only sharing what I experience.

There are also addiction primary care doctors. They will put requirements on the client like requiring that they attend AA or NA meetings or see an addiction counselor, etc. These are important elements of a strong foundation for recovery.

Those around you might look like they are "clueless,", yet I believe that they intuitively suspect that something is amiss. You could break the silence and:

1. Have a conversation with your brother

2. Have a conversation with your parents or

3. Have a conversation with all, including girlfriend.

I know it can be scary to face the proverbial “elephant in the room: which is creating havoc, yet everyone looks the other way.  It is healthy for you to face the elephant before it can cause more damage.

Thank you for asking these important questions, which so many siblings are confronting.  I would be glad to talk with you further about my thoughts at Ccrtowns@aol.com  or 916 539-4535.

 

Your Question-

my son has been thru 3 rehabs. the last one he finished the 90 day treatment and went into SLE. He moved back home during his SLE stay and it has been back and forth with the drugs again. He is still at home, 23 yrs old, and is like poison in our home. I have a 14 yr old daughter who sees it all. My husband is done with paying for more rehabs. He does not want to take him to a therapist or psychologist or psychiatrist, not that it would help either. He says it is all just a money-making business and what if after more of our money goes on any therapists our son still doesnt get well? I dont blame my husband, I know that could happen. I dont know where to turn or what to do now. I dont want to throw him out because I am very afraid of what would happen to him. I dont know if thats the answer or not, but i don’t think i could live with myself if something did happen. i love him so much but he is tearing our family apart. i am in despair. i am glad I came across your blog, i wish i would have found this a year ago. I really feel like i have nowhere to turn. Any suggestions?

Thanks for listening.

 

Photo of Christy CrandellEXPERT CHRISTY CRANDELL:

Karen-I'm so sorry to hear about your son. You are one of many families that struggle with the serious issue of addiction. You have given your son every opportunity for recovery. Unfortunately, it can sometimes take many attempts at sobriety before it "sticks" so to speak. This is not to say I think you should pay for any more rehab. There are places your son can check himself into on his own with limited or no financial resources when he is serious about wanting to stop using drugs.  Salvation Army is one of these places.  In the meantime, your son needs to find another place to live other than your home since he continues to use. While this is a very hard thing to do, it is the most loving thing you can do for him. You and your husband should find a local Al Anon meeting where you can find support for yourselves among others who are in your same situation. Take care of yourself,

Christy

 

 

Photo of Ricki TownsendEXPERT RICKI TOWNSEND: In our country, we have the right to make our own decisions, and no one has the right to lock us up unless we are going to hurt ourselves or others. Yes, you may feel he is harming himself, but not in the eyes our law. So the question you could ask yourself is, Why do I want to force him to do something he has said he does not and will not do? He is old enough to make this decision.

 

There really are no easy answers. My heart goes out to you. Even if your son had cancer, you could not force him into a treatment you believe would help him. Yes, his poor choices may lead to jail, prison or even death. So this is when I ask you to please seek support for you. We must move forward as parents, no matter what our children are doing. Seek support from a good addiction therapist, go to Al-Anon, work with a sponsor, read the mothers’ blogs on this web site

 

I believe letting go of others means grasping on to ourselves. Loving ourselves enough to say, “I have done everything a mother could do. I say to my child, ‘This is your life, I love you and now must let you go and live yours. I don't have to like your poor choices or even have you around me while you live them. But, I can love you and respect that you are your own person.’” That is all we can do.

 

I am not comfortable telling you what to do about his parole officer. What I would ask is that you go to the person you trust the most and ask their advice. You might also ask his counselors at the treatment center what they think.

 

These are the “Three Cs” I love from Al-Anon:

  • I did not cause this
  • I can't control this
  • Nor can I cure this.

 

Our loved ones must do it for themselves. I promise you --I know of many cases worse than your scenario, and they are now in long-term recovery, doing well. They made this decision to seek recovery for themselves, though.

 

I offer Family Phone Coaching if this ever seems like something you would want. I could even direct you to someone in your area that might offer this as well. Peace be with you.

 

 

Photo of Christy CrandellEXPERT CHRISTY CRANDELL"I think your last statement answered your question - you would feel guilty if you didn't try.  You can only ask your son's probation officer to mandate it based on what you have witnessed with his behavior.  Ultimately, the probation officer will make the final decision and you will need to rest in the knowledge that you did all that was in your control and then let it go.  Please find yourself a good support group through Al-Anon so you can stay healthy through this very difficult journey."

 

 

YOUR QUESTION: My 22 yr. old son lives with us and has been addicted to opiates for the past 2-3 yrs. Since early HS was chronic pot smoker, drinker and did other numerous drugs. He has been to 30 day rehab 2 times...May 2012 and Jan 2013. Has relapsed several times and was using suboxone too. He is or was participating in an IOP support group locally. Soon he will have acourt appearance for possession of heroin...has a long record of traffic violations, pot possession and 2 DUIs. Last night we found evidence that he is once again using and possibly selling. He has been sleeping most of day, up all night, and barely working in family office to pay off fines, not grooming, eating little....yet has been very pleasant and loving. I put a suitcase on the front porch as he stayed out all night. He had been using the drugs in our home and obviously that is unacceptable. Yesterday before we confronted him, he expressed to me that he thought his life was a "hell hole". He doesn't want to do this but it really has a hold on him. Should we go ahead with "kicking him out" or try to discuss parameters for him living here and continuing with his recovery????????? Thanks so much!

Photo of Christy CrandellEXPERT CHRISTY CRANDELL:"While it may appear harsh to kick him out, it is really the most loving thing you can do for him as it may help him get to the point where he is ready to check back into a treatment program. The latest research tells us that one year is the optimal dose of treatment. While your son has been able to get clean in the 30 days of rehab, he needs to continue in an ongoing program for much longer. A transitional living home would be best for him so he can focus on his recovery. Please find support for yourself in a local Al Anon meeting to help you stay strong and healthy during this difficult journey with your son."

 

EXPERT BRAD DEHAVEN: Your son has all of the classic signs and symptoms of Opiate drug abuse as you now know all too well. Ask yourself if everything you are doing for him is too much and not enough at the same time. I think I know the answer will be "yes". Addiction doesn't get better without professional help and just like other diseases, sometimes it doesn't get better with help. You hit your bottom long ago and in my opinion, it is time for the addict to hit their bottom. I don't believe it is fair to treat any disease with a specified period of time for treatment. All addicts are different just like all people who have cancer. Imagine how outraged you would be to discover that your insurance only covers 30 days treatment for cancer. I have spoken to hundreds of addicts and most told me that 30 day treatment centers were just a temporary fix to a permanent problem. Most addicts see 15 days left in a 30 day treatment and know that is how much longer they need to wait to abuse drugs again. Based on hundreds of interviews of families and addicts who are afflicted by addiction, I find that those who send their addict away to a long term treatment program which is over when it is over get much better results on recovery. I also see that those who send them away for treatment and let them grow up surrounded by people with the goal of sobriety do much better. We parents are ill prepared to treat addiction at home and we are fooling ourselves if we think this will work. Your son has learned over his whole life how to manipulate you and now that he is an addict and a liar out of necessity, you are not equipped to curtail his drug abuse. Hand your addict to a professional, step away as mom & dad and allow someone trained in the field to attempt to recover your son. My second book "The Addict Among Us" has many suggestions on how to live with and treat addiction and this information was shared with me by these families. I hope you get the help you need because as you know all too well, addiction doesn't get better over time, no disease does. All the best, Brad

My son is 20 years old and is in his sophomore year in college and I have come to learn today that he is an addict. He is a study in contradictions...graduated with honors from high school and arrested for felony drug charges. Starting quarterback of the high school football team the in jail for probation violations. When he went off to college 2 years ago he had an academic scholarship, a spot on the college football team, a car, a driver' license and now he has lost it all. He got 2 DUI's and is back in jail for smoking marijuana while on probation. As far as I know he does not do any other "hard" drugs but his treatment counselor and his probation officer are recommending long-term residential (12 months!) treatment. My heart would break to have to send him off and be able to see him for months. Do you think this kind of treatment would be best? He has a 3.0 GPA in college and I would hate to see him get off track with his education.

Photo of Christy CrandellEXPERT CHRISTY CRANDELL:

Sounds like a great kid with a very serious problem.  My own son was given the same recommendation for inpatient treatment when I had him assessed at age 17 for a drug problem.  Unfortunately, I didn't take the advice and he ended up in prison for 13 years for crimes committed while trying to get more money to get more drugs - something I could never imagine he would do.

I know you are worried about his college completion but he is already off track with the choices he has been making in the last two years.  The fact that he continued to use marijuana after having the DUI's and being on probation is indicative of level of his addiction.  Please listen to his treatment counselor as his life could depend on it.

Learn all you can about the disease of addiction and find some support for yourself as you begin this very difficult journey.  A local Al-Anon group is a good place to start.  Above all, do not despair - many people live an abundant life in recovery!

Photo of Ricki TownsendEXPERT RICKI TOWNSEND:

Thank you for submitting your questions.  I know this is a difficult time and the decision you are asked to make seems impossible.

After reading over your question, I agree with exactly what has been recommended for him, and nothing less. He has already shown you he cannot continue in school. Failing more will only be a negative experience for him. His self esteem is already low, with all that he is going through. His whole life is ahead of him. Give him a chance to heal and get back on track, joining so many others who have gone back to school later in life and found great success.

Most importantly, taking a critical year off to get healthy will not derail his academics, but addiction will.

Your son’s accomplishments muddy the water and make it hard to see that he is already in deep trouble. First of all, you mentioned "hard drugs."  With two DUIs, he is already on the drug that is most likely –statistically- to kill him.  And he may be on other drugs besides pot and alcohol:  as one father said in a meeting, “If you think your child is on one drug, think again, and throw everything else in the mix. If f you think it’s only been a couple of years of substance abuse, then add about four more to that." I could not have stated this better.

Two DUI by the age of 20?  And then you add that he is willing to risk jail for pot? Your son sounds like he is in the throes of addiction. Please remember addiction is a brain disease, a disease that is chemically driven by mood-altering substances including drugs and alcohol. He needs serious help.

For your son to change, you need to change, too.  I encourage you to do two things.

1. See an addiction counselor or other therapist to help you work through our own fear, grief and pain.

2. Start going to a "parents" Al-Anon meeting to get ongoing support. There you will learn what other families are doing to help them through this difficult time.

Again, thank you for submitting your question, which will help other families who find themselves in a similar situation.

My son is 17 years old. He started smoking marijuana at 13. This just got worse and worse. In March of this year he was arrested. He was seen snorting suboxone up his nose and taking a hit of synthetic marijuana. He went to juvenile detention center for 6 days and then to inpatient rehab for 45 days. He came home in May and finished school, got his diploma. He was taking masonry in a vo-tech school, he graduated from there and got a job right out of school. He was going to outpatient sessions, and NA meetings. A few weeks ago he broke his arm and was out of work. This is when the suspicious behavior started again. I found marijuana and suboxone in his wallet last weekend and I turned him in to his probation officer. We are all at a loss of what to do for him. I have read everything about recovery and relapse and what to do, but this is frustrating. So now he is going to be on strict house arrest for up to 6 months, and he will no longer be allowed to drive to work or his meetings. He also has to attend a meeting every day. Please help me with some advice on what to do. He will be 18 in August, but that isn't going to matter since probation has now placed him on house arrest. I just want my son back, but I don't know how else to help him or how to trust him.

Photo of Christy CrandellEXPERT CHRISTY CRANDELL: "It sounds like your son just needs a more intensive outpatient program to help him with his ongoing recovery.  Does his probation officer work with any local treatment programs in the area that they can recommend or even perhaps help pay for?  The recovery process is oftentimes a bumpy road and a very frustrating and scary time for a parent. Find a local Al-Anon program in your area which will give you support as you try to love your son through this but at the same time allowing you to stay healthy yourself. Sometimes you have to try multiple meeting locations to find one that meets your needs.  Remember, he has been smoking marijuana for four years and it is going to take him awhile to figure out how to live his life without it.  People beat this every day - don't lose hope!"