My 16 year old daughter has just completed a Juvenile Drug Court
program and has been clean and sober for almost 6 months. We have
completed an intense program of family groups, one-on-one therapy and
weekly teen support group meetings. What are the odds of her
relapsing? - Concerned Mom

EXPERT CHRISTY CRANDELL:

While relapse is often times a part of recovery it is not ALWAYS a part of it. Research tells us that one year is the "optimal dose" of treatment so continue with her individual therapy and support groups.
If, indeed, there is a relapse I think the best thing is to remain calm and
remember it doesn't mean she is going to go back to that lifestyle permanently.
She needs to be held accountable for her poor decision but more importantly she
will need to process what happened with her counselor in order to make sure she
has all the tools she needs to stay sober.  – Christy Crandell, Administrative Director
and Founder of Full Circle Treatment Center.

EXPERT RICKI TOWNSEND:

Relapse is a complicated issue based on several things, for you and for your daughter.For you, make your recovery first and your daughter benefits greatly. If you don't then
you could relapse into old thoughts and behaviors. Those behaviors can be unhealthy
communication with your daughter. Your daughter has hopefully made recovery one
of her top priorities also, for the same reasons as I have explained to you. Relapse
statistics are high. And........ I encourage my families to not get caught up
in this. It is just facts and they can only cause you to stress and lose focus
on your program. You are all doing wonderful work it sounds like. Keep it up
and only keep the focus on your individual recovery program. I wish you all
well and I know you can all stay healthy if you keep the focus there. Blessings,
Ricki, Board Certified Interventionist, Drug/Alcohol Counselor, NCAC1,
CAS, RAS, Bri-1

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

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.

My sister has been a substance abuser for well over 18 years. Ironically, she has managed to have and raise four sons (albeit through two failed marriages) and now finds herself unemployed, living with a stranger (that based on her history and addictions, not to mention both of their gaunt appearances) that's involved with methamphetamine's and exposing her four children to very substandard conditions. As a result, my family started the CPS process, contacted the older boys' schools and logged a police report. Needless to say this has generated a reaction from my sister blaming my parents for all of this and ruining her life.  Question: How can you explain to a parent couple that what they have done is right (CPS process, etc?) When they are so distraught over the fact that their grand kids are in limbo and are being used as pawns in my sister's charade? Any thoughts here would be great. –Frustrated Brother

ANSWER: EXPERT CHRISTY CRANDELL

I have two suggestions - that the parents get educated and get support.  The best way to do this would be to go to a local Al-Anon meeting.  In fact, this is recommended for the whole family.  In addition, if the family can afford it, they should seek counseling for the grandkids with a counselor experienced in family systems and addiction. - Christy Crandell, Administrative Director and Founder of Full Circle Treatment Center.

ANSWER: EXPERT RICKI TOWNSEND

This is a hard time for you as well, I would think, seeing your family go through this public piece. While watching your parents’ sadness and your sister’s anger, what often happens is that families forget the grieving piece.

It is very hard for fathers and mothers to let go of their children. Then add grandchildren and the pain can be unbearable.  This time of year is especially difficult. The holiday commercials are all depicting happy families.

So when I say families forget the grief piece, what does this mean?  In my experience with addiction,  I see grief show up in the family. As with your sister, your parents may be feeling grief for what "was supposed to be."  They had dreams and visions at some point about the life she would live. Well, that life (for now) died when her addiction became her priority. The family may not even realize any of this. So what you may say to your parents is this:

"Mom/Dad this must be really hard for you as parents. I understand the hurt you may be feeling, and it is OK to express it. I know this is painful, but I believe you have done the right thing for her and for the grandchildren.”

I believe that Al-Anon is a great place to show our grief and get support for it.  The Al-Anon family groups provide support by members who share their experience, strength and hope, having gone through what you are experiencing now.  They learn how to overcome the grief and shame. Also, don’t rule out resources about grief or the physical nature of your sister's brain disease.

I hope this helps, and if your family chooses not to take advantage of these resources, I hope that you might consider it for yourself.  If they choose not to go to an Al-Anon meeting, I hope that you will.  To find an Al-Anon meeting in your area, internet searches using “Al-Anon Meeting” as key words usually populates with local information. Blessings, Ricki, Board Certified Interventionist, Drug/Alcohol Counselor, NCAC1, CAS, RAS, Bri-1

Listed below are some great books:

Healing the Addicted Brain, by Harold C. Urschel, III, MD

For children and Adults

Your are Special, by Max Lucado

Tear Soup, by Pat Schwiebert/ Chuck Deklyen (For children and Grandparents)

A Voice Came To Me, by Kathleen Johnson

Sad Isn't Bad: A Good-Grief Guidebook for Kids Dealing with Loss

For Grief

The Grief Recovery Handbook : The Action Program for Moving Beyond Death Divorce, and Other Losses, by Russell Friedman

Our 28 year old daughter who is a meth addict (2 yrs abuse) was arrested and basically forced into a 90 day drug treatment program or else go to jail. She completed a 90 day in house rehab, moved into transitional living and has since remained clean and sober. She is now 5.5 months clean and although she has not been looking for a job she has been working her program. We pay for transitional living and give her money for gas, etc. and will continue to do so as long as she remains sober with the idea that she will eventually regain employment.

Yesterday, she told us that her roommate is leaving transitional living at the end of the month, moving into a home owned by her grandmother and has asked our daughter to be her roommate. Our daughter wants to move and states that she can work her program anywhere, remain sober anywhere or relapse anywhere. This move would allow her to have her dog back and take her things out of storage. My first reaction was NO! My husband states we need to think it over and discuss it further. What do you think?

ANSWER: EXPERT BRADLEY DEHAVEN

First off, congrats on your daughter getting professional treatment & sticking to your guns on supporting her as long as she is clean. It is very difficult for people in a sober living home to get and maintain a good job while they comply with the stringent rules enforced in order to live there.

Your daughter is correct: she can get drugs anywhere & any time if she wants. Life outside the boundaries that have helped keep her clean are scary to us parents for obvious reasons. We have seen our children at their worst & now that they are getting better we are hesitant to change anything.

When my son moved out of sober living we ask him to write us a commitment letter as to what he was willing to do to help us be comfortable with his new freedom. We specifically noted all of the restrictions he was currently under at sober living including random drug testing. To our surprise his list was more strict on himself than we would have. He has a job, exercises almost every day, looks great & is growing as a person. We do drug test him randomly & I am always pleased at the results. As long as you are paying the bills you have control but some day you will need to let go and see if your child can become a productive working member of this society. I wish you the best of everything. Hopefully your daughter has decided that she doesn't want to return to the Hell she once lived and she has learned to love and respect herself. Providing for herself financially will go a long way with the self-respect aspect. -Sincerely, Bradley DeHaven

ANSWER: EXPERT CHRISTY CRANDELL

Well said, Brad. The only thing I would add is to talk to the staff at the transitional living home or her sponsor to get their opinion on the move and her roommate. -Christy

BRADLEY DEHAVEN REPLY

Good call, Christy! The two young ladies could be great for each other in their quest to remain clean but the people who have seen them together the most are the sober living home staff & sponsors.

QUESTION: First and foremost, a sincere thanks to all the experts (and everyone on this site) for a terrific job in helping us parents. I don't know what I would do without my 15 minutes each morning.

My son was denied rehab from every facility we went to this year; our insurance company basically said if he is not suicidal, we can't accept him. Insane! So, we self-paid over $30,000 and almost lost our house. The good news: he was clean for 6 months…the bad news: he is no longer sober. After a very good friend recently passed away, he spiraled downward and turned to drugs to cope. We can no longer afford health insurance and really, what would be the reason to purchase again as every door was closed with it?! I spoke to someone who indicated that some rehabs offer grants or pro-bono type cases, etc. Are any of you familiar with this?

Should I call every rehab and just ask or do you think this is just a waste of my time? It is so sad that we live in United States and we can't help our children and young adults (ours just turned 20). It’s even sadder when this person wants the help which is such a huge step. Any insight on where I can go... where maybe a door would open would be most appreciated. In the meantime, we will continue to hold him prisoner the best we can and watch out the window for a possible car pulling up to the house. Again thank you all for your time. -mom in gratitude and desperation

EXPERT KENT MORRISON: To offer some help and insight. Yes there are programs out there that do help find scholarship monies to send people to rehab. Some places like Hazelden, actually Hazelden Center for youth and Families (HCYF), have patient aid money awarded depending on need. Making a phone call to their intake department would be the best way to start. A financial case manager would contact the family and do a needs-assessment and award money depending on the assessment. The intake number for Hazelden is 1-800-257-7810.

Also, I know that Interventionist Ricki Townsend is also very instrumental in helping families find scholarships to other programs as well. Working with Ricki may be a very helpful avenue to take as well. Ricki's contact number is 916-539-4535.

Finally, there is an organization which is designed to help addicts get to rehab. H.E.A.R.T (Helping Every Alcohol/Addict Receive Treatment) and their website is www.heartinc.org. H.E.A.R.T. has been doing this sort of thing for a long time and they have established many relationships with treatment facilities. I would suggest looking more into their website and making contact with one of their representatives. I hope this helps, Kent Morrison, MA, LAADC-r, CADC II

EXPERT RICKI TOWNSEND: The best way I could possibly answer this question is to first say, "I so agree with you” regarding the way those of us in addiction are treated by Insurance companies. I would have to say also my vision for the future; that we are treated with dignity and deep concern. This is a DISEASE of the brain.

Yes, some treatment centers offer scholarships. I travel and am involved with many around the United States and a lot of treatment centers bring Interventionists out, at their cost, to see these treatment centers. They too are having financial troubles as the economy changes. Some will do a scholarship a year, some a month.

Yes, you can call centers and ask if they offer a scholarship, or if they have any ideas for you. They can be extremely helpful, and kind. What about in your county? Are there programs he can do free, or at a small cost? What about Salvation Army? Be prepared to hear they have a waiting list.

What I would respectfully like to ask though, "What is he doing at this moment for himself?"

What are you doing to care for you? We have a difficult time self-soothing and giving ourselves time. Are you putting more work into this then your son is? One question we ask in Al-Anon as well as in my field of intervention…."Are you wanting this treatment more than he is?” I know this is hard, believe me, I too am a parent with someone still active in addiction.

A task I would give you, if you were to accept it: Write a journal every day for one week. This will be a time journal to actually record where your time is going in every hour from your waking moment and until you go to bed. Put it in your purse, take it out when you get home and have it with you every moment for a week. This is one way of seeing where you are putting your priorities.  your time. If your journal reveals that you are spending much more time on your son than on yourself, then possibly this is a time to make some changes. - Ricki

I have three children, ages 22, 17 and 9. My oldest has so many issues, drug abuse being one among many. Although my others are excelling and have healthy approaches to life, I now live in a constant paranoid dread that they too will fall into destructive patterns, and it keeps me from enjoying them and their accomplishments as I should. I struggle with comprehending how my oldest could choose this path when she was so loved. I keep going over it and obsessing how it could be our fault, how it must be our fault somehow.

Even though the other two are doing great, my confidence in my own abilities to parent and mother well has been shattered because of the one, and I can't seem to shake it. My own despondence is beginning to affect the rest of my family. How do I break free? How do I do I get past the hurt, anger and horror at what our beloved daughter has become? I don't even know how to relate in even the smallest way with her.   Thank you.

EXPERT CHRISTY CRANDELL:

I can so relate to your feelings of fear and guilt! I think some personal counseling and education about addiction will be of great help for you. I would recommend a therapist that specializes in addiction and family systems as eventually it will be important that everyone in the family be able to process and have some healing around this. If the oldest daughter is still living at home, this therapist should also be able to advise you on some strategies to get your daughter into treatment. – Christy  

EXPERT RICKI TOWNSEND: 

First of all, my heart goes out to you and the pain and confusion you are going through, so thank you for reaching out to us. Your question touches on different parts of addiction, ourselves, our family and, of course, the addict.

What I will always ask with regard to a question of this type, would be two things.

1. Are you going to any of the free Al-Anon Family Group meetings?

When I go to Al-Anon or my clients go, we go to seek support. Not to be told what to do, but to receive love and support from those who are going through what we are going through and can relate to our pain on a deep level. This is so very important. We finally feel understood.

2. Are you seeing a therapist or family therapist?

I always recommend a therapist who also does addiction therapy. I personally feel this type of therapy can educate a client into the nature of this “dis-ease” and at the same time, support you in your own personal journey of healing.

What we professionals see, unfortunately, in this dis-ease is that the "good children" are left behind. This “being left behind" can happen in different ways: Parents either spend most of the time keeping an "addiction" eye on the children, or they ignore the non-addicts. The latter results in them being left to make it on their own. It is very common for the addicted loved one to get all of your time and attention. Through support and education, you can learn to shift your attention to a healthier place.

Something I have a deep passion about is helping the families deal with addiction. I believe if I educate, listen to, and talk about the options with them, I can bring out the power they have as a unit. With education, the family can become one supportive “family unit". When I say families, I include in this group the aunts, uncles, grandparents and even close friends of the family. Knowledge is power! I see this profoundly in my families after our conference call or meeting. They take a stand together towards the addiction. My families start the journey of seeing they are not the cause, the cure and DO NOT have control over any one person. We then learn that we do have control over ourselves and our environment, and we learn to exercise that power in a healthy way.

Feel free to contact me to request one of my educational conference calls, or I would be glad to refer you to someone close to you,  if you live outside my area. -Ricki Townsend

How do I fix my broken family?

How do I fix teenage addiction?

How do I fix emotional problem me and my children suffer from?

How do I deal with verbal abuse from my teenagers?

My name is Karen and I have 19 year old twins (boy/girl) who are in deep trouble. We have a broken family and I need professional help to fix it. I can't seem to find the right help and I have looked everywhere. I refuse to give up on my children but one of my counselors seem to think the best help I can give my son is to NOT help him and let him hit rock bottom. Then he will figure out how to help himself. It breaks my heart when he calls or text me saying "I wish I had a mom", I'm cold can I spend the night?, I'm hungry, can I borrow your car, do you have any money? I don't have a home or a place to stay". My daughter is in love with a drug addict who is in jail and I believe she is addicted to Oxy (heroin) and or Ice (meth). She's still in my home but things are getting worse day by day. On one hand I want her to stay here so I can help her when she is ready or should I kick her to the curb? If I kick her out I think she'll just get deeper involved with drug dealers and I don't want that to happen.

However I don't want to enable her to continue this downward spiral. I want my daughter to live. I had a aha moment a couple of weeks ago when I got a phone call saying my daughter was in the hospital from a seizure. I know one day it's going to be the call that she overdosed and she's dead. I don't know how to prevent this from happening. Can you help me? I'm desperate! I want to be a normal family again.

EXPERT RICKI TOWNSEND:

Dear Karen,

I am so sorry there are never any easy answers or quick fixes. In most families this has been going on for a while. So the task at hand takes a while.

Think about as an example, someone who has put on 30 lbs. in a year - It will take a while before those 30 lbs. come off. Not in a couple of weeks. First a person must start looking at how they will start? Will I walk a few minutes a day? Will I join a gym? Will I join a weight group? Which one if I do? Well this is how it is for addiction.

We make the decision where to "start". This is what you have done. Your first step was to contact us!

Below are some other pieces you could start looking at. Once you have done this, you could also make the 2nd or 3rd piece on your list be a call to me.

• First, please join a support group such as Al-Anon (some have a parent focus group).  This website may help you: www.afghawaii.org

If you belong to a church you might call and ask if they have any meetings within the church for families struggling with addiction. Some medical organizations offer support or referrals.

• See a therapist familiar and trained in addiction

What I saw in your message was a desperate mom, wanting to fix children, a broken family and the entire emotional problems the family endures from addiction. My experience in my own life has shown me I can only change myself and how I handle situations.

You mentioned you have not found the right help. I would want to know more about where you have looked. And what the answers were that you were not comfortable with.  I am confused about your son - it sounded like he was out of the house when you said he calls that he is cold, hungry, looking for a place to stay, or to borrow your car. When I talk to you about your children please bear in mind as you see my words. I am not talking about your sweet loving children. I am talking about the addiction - The disease.

The disease will manipulate, lie and steal to get what it wants. The most loving thing you can do is respectfully only state the truth to them. “My home is a peaceful loving place for me to come home to. A home that is clean of drugs and alcohol. You have the choice 1. Live here in this way, clean and sober (and I will drug test). 2. Move out and live your life the way you want to. But you are not welcome here, if you choose addiction over this life.”

This is not kicking out; this is delivering a truth (if it is, for you). Sometimes their choice is to not live up to the boundaries you set. This same information could be delivered to your daughter in a similar way. If she will not go, you call the police, and ask for help. I will say this. In California, you must give them a 30 day notice. So please check your city rules.

I know it hurts; I personally had to do this many years ago with my own son. He chose the streets and drugs, over a warm bed. My heart was just breaking. I knew that if I did not do this, he would die. Today he is doing well.

Oxy on the streets here in California can run (a pill) up to $80.00 - Meth can be $25 per bag! Where are they getting the money for this and not food? These are just questions for you to consider and not one that you would take to them and argue. Your children are only coming to you from one crisis to another. The loan of a car could be to get the next hit. They could wreck your car, hurt themselves or another. This is a difficult place to be put in. Please be kind to yourself also, and let go of guilt and shame. There are some good treatment centers in Hawaii. If we talk in the future, I can share some with you.

Remember this saying: We can be part of the solution or part of the problem. My heart goes out to you and from one mom to another; you are in my thoughts.... -Ricki Townsend

It seems like the more time that passes the harder it is for me to cope. Our son is an addict. He went to rehab last Sept and was gone for a month and when he returned he was the son I had before K2! He has been clean up until last week and he has relapsed. I'm not sure what to do and the strange thing is he is currently on probation for the K2 and he started using again like it does not matter. I must say I am shocked and just cannot believe he is taking this attitude. He appears to not care about things again and has no self-esteem what so ever. He says his life sucks and why bother anymore. I am the perfect example of co -dependency. He is 22 and still lives at home. He has struggled his whole life with other issues and the drug addiction just happened to add to the list. I do almost anything he needs done.

Laundry, dinner...lunches for work... etc... I'm not sure what my next step should be since this is his first relapse and I really do not know what to do as far as breaking this cycle I am in. It's hard for me as we lost our oldest son in a car accident and I do not want to lose another.  I know deep down what I need to do but could use some advice on how to handle this.

Hello and thank you for reaching out.  Since K2 is as deadly as other drugs, I appreciate your fear and concern.

There is much I could answer here, but would be extremely lengthy so I will touch on a couple of comments that I felt concern about with regard to your son.

These are a couple of areas I invite you to look into more:

• His remark to you about "Life sucks and why bother? -  I would suggest you bring him to a therapist if he is not already seeing one (if he is, please let her know of his comments) I have deep concerns about depression.  I would encourage an assessment.  (a therapist, not a counselor).  I would always recommend a therapist that also has an addiction back ground.  A therapist can delve deeper into his issues.
• For each one of us, Self-esteem is based on the failures and success we experience from a young age to even old age.  It is a constant journey.  I personally receive my pat on the back from "me" when I achieve something.  Not when something is given to me.

When I was using drugs the shame and guilt of my actions brought depression and low self-esteem.  When I had months in recovery and years, my love of “self” grew from the work I put into "me".  Self Esteem grew with each success and each failure.  Failures when looked at in a healthy way with support (sponsors or mentors) can show us where are strengths and weakness are.  This is how we grow.  This cannot be given to us.

There would be more I could share with you and below is my phone number and web address, if you would like to contact me personally.

Thank you so much.

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

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.

EXPERT 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

I have received so much helpful information on this website. I am truly grateful. However, I don't believe I have seen any advice to parents of troubled/addicted children who have children. I am willing to let go of my daughter and allow her to find her own way. She is 20 years old, and is making her way along slowly... she is not doing terribly... but is not always prone to making the best decisions or choosing the best people to hang around with. I have allowed her to live with me because of my grandchildren. When they live with me I tend to become consumed with helping my daughter at my own expense. I worry about what will happen to my grandchildren if I do not. I truly believe that my daughter does best and learns the most when she is forced to find her own way, and I believe that she should experience the consequences of her choices, but I don't feel that my grandkids, ages 2 and 7 months, deserve to be taken along for the ride. My daughter and I recently had a falling out about her sense of entitlement and what I do for her... she left, taking her kids with her. But now I feel worried and guilty... Because of the kids I'm not sure how and where to draw the line with my daughter.

EXPERT CHRISTY CRANDELL: That's a tough one. If your daughter is putting your grandchildren at risk with her drug use, then that is a reportable CPS offense and one which could ultimately give you an opportunity to be the legal guardian of your grand kids. However if your daughter is not putting them in harm's way and you just don't like some of the decisions she is making that's another thing entirely.  Weighing all that on top of how respectful (or not) of your house rules she is and if you can live with that is the bottom line. -Christy

EXPERT RICKI TOWNSEND: Thank you so much for your question.  I have 6 grandchildren myself with one on the way.  Yes you are right it is a hard situation to watch.

Unfortunately, having the grandchildren with their mother may not always be what is best for them.  Just because we are called Mom, doesn't mean we act the way a true mother should.  When you throw in addiction?  Well, now you are dealing with the addict’s brain.  Mom's addict-brain says “I want what I want, and I want it now!”  So it may mean the children get in the way.  It may mean Mom, with her addict-brain, does not have a lot of empathy, patience and organizational skills, and this is the Mom they have most of the time.  This is why we have CPS -- to look out for the best interests of the child.  Possibly the fear of losing her children will help her want more for herself and for the children.

Something else you may look at with your daughter is all that you provide  for her.  No more money, no more car, no more doing the laundry, no more fixing her dinner! I don't know exactly what you are doing for her that she can do for herself,  although you did mention you did a lot at your own expense.

If you believe your daughter feels entitled, then please ask yourself with an open heart and mind:  Are you doing--and have been doing things for her that have only kept her in entitlement?

I wish you well, and ask that you be kind to yourself.  This is not a time for self-doubt, self-blame and worry – all the things that wear us down. -Ricki Townsend 

I am a stepparent of a 21 year old heroin addict living in our home. She doesn't want rehab and my husband won't stop paying for her car, gas, phone, clothes, spending money etc. We've been married a year and his daughter hasn't gone to school, worked, or helped around the house. I think she was clean for a few months, but now she is taking again...she pawned stolen jewelry in her name to get drug money. I've said we have to stop paying for these comforts unless she goes to rehab. He says forced rehab won't work. He is angry at me and is verbally attacking me and my kids and won't face the heroin issue of his daughter....he even wants to believe she's been clean for 3 weeks because she said so. I don't know what to do. As a stepparent, do I just step back? I don't want my 2 high school daughters to be around someone on drugs. I want to help his daughter, and I want him to stop blaming and getting angry at me. Please advise :)

Expert Christy Crandell - Administrative Director and Founder of Full Circle Treatment Center, Author of Lost and Found: A Mother and Son Find Victory Over Teen Drug Addiction

It's so difficult to see clearly when a loved one is suffering from addiction. My recommendation is for you and your husband to get to an Al-Anon meeting where you will find support for exactly what you are going through. You are right to be concerned about your other daughters. Ultimately, you will need to make some very difficult decisions about what you can and cannot live with. I wish you the best. - Christy

Expert 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

Thank you so much for your question. Many families are going through this exact same issue and challenge. Relationships are put in the middle of addicted children. It is so important you and your husband to come together on some form of middle ground. Not for your selves, but for the whole of your family.

I come into homes and work with families just like yours and bring them into some kind of semblance of balance. When there are fights, there seems to be no resolution to the disease and instead resentment shows up. Remember this is a disease, a brain disease. It is not will power. They are dealing with the brain being changed.

Symptoms are many, but with opiates, they do all of the things you have described and more. When my families pay for the phones, cars, car insurance, clothes etc., they take away the consequences - from them. Without consequences for any of us, in life, we do not learn what we can and cannot do. If we experience the consequences of our actions we also build self esteem.

What we can do, as the parent, is give them back self respect. We do this by giving them back their own choices and consequences. We do this with respect, patience and time.

As far as the statement that" forced rehab won't work,” there is not a treatment center in the U.S., that I know of that you can force an adult to enter. What you can do, is make statements similar to this:

“We will no longer pay for anything in your life but a treatment center. We know you are ill with a disease, and want you to have the chance to become healthy.”

Paying for all of the things you have mentioned will only prolong everything you are going through. Remember this is a disease and like any disease untreated, will only get worse. One cannot get better without support. Support from professionals. The same thing applies for you. I would like to recommend you and your husband find a good therapist to help mediate what is going on.

I know this is very hard for him also. Seeing his daughter not living to her full potential is hard to see. Most likely if he cares enough, pleads enough and yells loud enough he feels she will get better. But this is a disease, and like cancer, one must get help in order to find remission.

Al-Anon Family Groups is a support group that helps families. I would ask you and your husband find a meeting in your local area. If your husband does not want to go, then please go alone. I would also hope of the possibility of taking your children with you. This must be taking a toll on them. You will find that you too begin to see you have choices. You have the choice to stay, work through this, or remove yourself and your children for health reasons. I am sorry; honestly, sometimes really hard decisions have to be made. Please don't hesitate to call me. - Ricki

I am not sure what to do with my feelings of hurt, betrayal and disappointment. My daughter is in treatment right now. She has been in treatment for 5 months and I don't want to do anything to jeopardize her treatment. She has thrown out randomly in conversations the many types of drugs she has used and I am supposed to be okay with it. Last weekend when we had a visit I said to her that I can't believe I was so stupid and saw none of it and she laughed and said "yeah, but I had fun." I was somewhat shocked at her telling response. I have not been able to tell her how I feel about her behavior using. Am I supposed to? Do I let it go? I was a single mom, I thought we were close and thought I was on it. I was so wrong. There was so much manipulation, lying, stealing, putting our home and life at risk....all of the drugs she took. LSD, Ecstacy, Ketermine, Cocaine, to name a few. But her drug of choice was Marijuana. Funny, she told me one day months ago she was working on Steps 8 and 9 and she would need to work with me to get through Step 9 and she has yet to bring it up again. I guess she told my husband that she didn't feel like doing the program and felt like relaxing that weekend.

Expert 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

 My message to mom: 

Accepting this is a disease is very hard, when so much hurt and pain and betrayal comes with it. I encourage my parent clients to allow themselves time to go through a grief period. Work with someone who can counsel you in this area. I also ask them to immerse themselves in Al-Anon meetings. Working the 12 steps helps facilitate the grief process.  With all of this work, we then realize this is about ourselves and not them.  We can feel our anger at our children and release it. We then can be more available to other family members.

 My message about your daughter:

This is a disease, unfortunately with addiction, comes the following:

1. Lying,
2. Stealing,
3. Taking family heirlooms and pawning them,
4. Manipulation, and
5. Not caring what happens to their own family members: children, moms, dads, grandparents and siblings.

If I was your family doctor and you came to me and said "I think I have a cold", I would ask you if you had the following symptoms, and read them off.  The same things go with you and your daughter – The disease of addiction; with lots of symptoms, which I just read off.  As with the common cold, you have to do things to take care of yourself.  The same applies to addiction.   You stay away in whatever form you can by washing your hands and maybe not getting so close.

I hope this helps you in some way. It can be difficult to answer a question like yours in just a few sentences.  You are welcome to email me for any other support. Please remember the most important thing is to get support for YOU.

How do I handle the stresses of my own parents continual quizzing me of how my 18-year old son is doing in treatment?  Their common question, "When will Jeffrey get his act together?" They have pushed the blame onto my husband and myself for allowing him many opportunities in life that neither of our parents could afford, basically their feelings are we raised a "spoiled brat." I am finding it difficult to help them understand that his addiction is a disease and often find ways to avoid their phone calls so I don't have to deal with these relentless comments. Does this topic dealing with teen Grandparents come up often?  - Frustrated Mother, Daughter and Wife

EXPERT CHRISTY CRANDELL:  I believe if you include your parents in any family education sessions that your son's treatment program provides this will help educate them on the disease of addiction. If this is not possible, perhaps go on to the internet and print out some articles for them about this topic.  Al-Anon meetings would be beneficial as well.  Christy Crandell, Administrative Director and Founder of Full Circle Treatment Center.

EXPERT RICKI TOWNSEND:  We call this a family disease. This means it affects every one of the family members - including Grandparents.

In my profession I hear this often. Usually it is because the grandparents don't have much education around this disease. Sometimes, there is so much fear of losing the grandchild they must throw out blame. What other reason could there be? This is a typical blame strategy to justify the unthinkable and so they believe it is the parents who should be doing this and that so that the grandchild will be ok.

Here are a couple of ideas:

1. Invite an interventionist, drug and alcohol counselor, or someone experienced about addiction into your home for “informal education.” I often do this myself in my line of work. I will come over for coffee, sit around the table with power points and explain the disease and answer questions. We talk about boundaries, and what can be done, moving forward. The grandparents can express what they are feeling and I can answer questions. Parents can also express what they are feeling and questions get answered. I then offer my availability for them to mediate situations that might come up.

2. You and your husband might have a family meeting; express your feelings in a calm way. Let the parents know how you understand how hard this is on them also. Invite them to go with you to a parents meeting such as Al-Anon or Nar-Anon. Some support group, such like these, will put you with like minded families. There everyone can learn that you didn't cause this, and you cannot control or cure this disease.

I hope this helps in some way. Please contact me for any further questions or support. Maybe I can refer you to someone in your area. - Ricki, Board Certified Interventionist, Drug/Alcohol Counselor, NCAC1, CAS, RAS, Bri-1

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?

EXPERT 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!"

My son is deep in his addiction, and is not even coming out of his apartment. He calls and says he is coming over and then doesn't. Do I just wait this out and see what happens? I know getting help is his choice but is there anything I can do? He lost his job, he is separated from his wife and kids, and his finances are a wreck. I'm trying not to worry but no one is checking on him and it can be a week and no one has heard from him. Do we go to his apartment and see if we can talk to him? I just want to do what is "right" so that he will get help for himself. But I don't want interfere in his progress to reach that point when he wants help.

EXPERT BRADLEY DEHAVEN: Unfortunately there is no "right" answer. Sometimes an addict is like an animal trapped in a cage; no matter how much we reach for them and try to free them from the trap they are in, they retreat, bite, scratch and kick to stay where they are. Addiction is everything to them and they know no better as the disease has a firm hold. Your son needs professional help and one option would be to find an interventionist. He also needs you but addiction doesn't want you involved unless you are a bridge to more drugs. I know it hurts but he can't see that so forgive him. Do everything in your power to help him choose recovery. If you are fearful for his safety, call the authorities. I wish you the best!

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.

 EXPERT 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

EXPERT 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.

EXPERT 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.

I always had difficulty with the concept of letting go - that the addict has to make the decision to change and be sober. How can an addict's brain make any rational decisions, when it has been altered by their drug use? Are they even capable of making decisions? Even after a sustained rehab or abstinence, the brain needs a long recovery time to get back to a normal state. The doctors would tell me a least nine months of sobriety before we can deal with the mental health issues. I feel we are asking the addicts to make a decision to quit that they are incapable of doing. Recovery rates are very low. There has to be something else or another way.

Why is it that I am bewildered that drug related deaths are continuing? Why aren't these young people terrified to use heroin? My son would express shock when someone he knew died of a heroin overdose. He said he would never use it. It later killed him. He died two weeks after I had to force him to leave because of his continued drug use in our home. It had been an eight year battle. He would not let me talk to him about the need to get sober, though he tried rehab two times. When I did get a chance to talk about recovery, he would say, "there you go again." He didn't want to hear it and he would walk away.  He would say, "you just don't understand." He was right, I didn't and still don't today. -Michael

EXPERT CHRISTY CRANDELL:

Michael- I am so sorry for the loss of your son. You have good questions that are not easily answered. Addiction is a brain disease which left untreated can lead to death. Sobriety is a very difficult journey for most people afflicted with this and can often take years and multiple treatment sojourns.

The hallmark of the disease is denial which is very powerful. The addict's thinking is distorted and like you stated can take quite some time before balance and clear thinking is restored.

For those of us who are not addicts, I'm not sure we can fully understand the powerful pull that drugs can have on a person with addiction. The only way I know of is to continue to find support with other parents who have gone through what you are going through, either through a grief support group or your local Al-Anon. If you are able to afford individual counseling that would also be helpful in processing your heartbreaking loss. -Christy

EXPERT RICKI TOWNSEND:

Dear Michael, the saddest reality is help and treatment doesn't always work.  The sobering truth is that our children can die. I don't know you, but I do want to say, my heart just cried when I came to the sentence your son had died. I have a dear friend who lost her beloved child to this disease.  I am so sorry. The pain can be unbearable at times.

One of the hardest things I share with Families is to Detach with love. I think the words "Letting go" is so harsh. Even "Detaching" is harsh, but I find it a little easier to roll off the tongue. I am also guilty of saying it and wishing I had not.  Whoever taught us that as parents we would have to let go or detach from our children?  Thank goodness for www.pathwaytoprevention.org, and other prevention programs, for young ones and their families.

During the addiction process, we usually are manipulated by the disease and cleaning up the messes.  We want to believe in them and stand up for them.  At some point in this process we also come to terms: it is all a lie. They are addicts. We then learn from the front line of this battle that everything we thought we were to do for our healthy child is no longer true.

When I speak from a former addict perspective I understand that addiction alters normal brain functioning.  An addict’s decision is usually based on "I will die if I don't use, it is my survival."  Like your son, I too was in this battle.  While we are in addiction, most of us are not capable of making healthy decisions, so my family’s boundaries indirectly forced me to make different choices but this took a long time.

Some of my addict friends on the streets had mental health issues so deep that the only choice they made was self medication. This is a complicated disease. Like all diseases, it’s so hard to understand.  When we are using we don't believe that we will die. We believe this will happen to others. This is the reason we die from not wearing seat belts, or get into accidents while texting, or cancer from cigarettes. It will happen to others not me.

I suggest the following:

1. Attend groups that will help you understand fully what addiction is
2. Learn how to communicate differently.
3. Learn how to take care of yourself.
4. Get family therapy.
5. Use a Family Recovery Coach.

Your questions are so important and difficult for me to answer in a couple of paragraphs. I welcome you to call and have a chat with me. Alternatively, Email me and we can continue this dialogue – Blessings – Ricki (916)539-4535 ccrtowns@aol.com

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.

 

EXPERT 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

YOUR QUESTION: My daughter is 24 years old college student. She recently finished a four week rehab program for drugs & alcohol. Now she is attending AA meetings for support. She has a 19 year old sister and is inviting her to the AA meetings for company. Is that appropriate?

EXPERT RICKI TOWNSEND: First of all, I so glad your daughter is attending meetings.  Meetings are our link to hope and recovery. What I always recommend to clients is to attend at least six meetings with your loved one coming out of treatment if they agree to it. If they are not welcoming your attendance then please attend them on your own. I also recommend families and the loved one coming into recovery go to at least six Ala Non meetings together.  If it is a young person, then I recommend the family to go to the parents groups together. My reasoning for this?  Each member is able to see what other families and loved ones coming out of treatment are experiencing. I believe it brings a sigh of relief to us as human beings.  We see hurt, and laughter in its many forms.  We see we are not alone. So, I say yes to your daughter's request. Also, it could be a very good bonding experience for them. Your daughter may want a person she feels safe with next to her while attending her first meetings. I believe for a 19 year old, this could be an excellent way to see what alcohol and drugs can do to all families when it falls into addiction. There is much more to this, and I am available by email anytime.

YOUR QUESTION: I just learned that my 37-year-old niece has been caught using drugs. I would like to know how I can support my sister-in-law, who is
devastated. I don't want to intrude, but I want her to know I am here for her. I don't want to say the wrong things. Any suggestions for
what I should or shouldn't do or say?

EXPERT RICKI TOWNSEND: Your question reminds me of my own life when my own niece was on drugs a few years ago. I went to my sister and respectfully said, I am here to support you. How can I support you? Use the I messages, such as I am concerned about you and want to support you in whatever way you need, rather than you should be doing this or doing that. Be a good listener.  Really try to hear how she is doing, and then respect and honor whatever she says. Maybe she wants phone support a few times a week, or maybe she wants some company at an Al-Anon meeting.  Or maybe she just wants to be alone with her feelings.  I know it is really tough to just stand by, but sometimes our family and friends need their space. If she says she wants no support, then I would encourage you to respect this, and find some Al-Anon meetings you can attend to learn about the disease of addiction.  That way, when she is ready for help, you will have the tools and knowledge to support her. The best way to be a loving sister-in-law is to be with her wherever she is and to be empathetic to the feelings she has, no matter what they might be.

 EXPERT CHRISTY CRANDEL: "How fortunate for your sister in law to have such a loving and concerned family member. My best advice would be to just walk beside her without judgment and let her know you are there for her whether she wants to talk or just go to a movie and forget about it. It could be just the beginning of a long journey. You can also offer to attend an Al-Anon meeting with her if she feels like that would be something that would help her. She is lucky to have you in her life!"

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.

EXPERT 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!

EXPERT 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.

Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use despite harmful consequences to the individual who is addicted and to those around them. Drug addiction is a brain disease because the abuse of drugs leads to changes in the structure and function of the brain. Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can affect a person’s self control and ability to make sound decisions, and at the same time send intense impulses to take drugs. For more information, go to http://www.nida.nih.gov/Infofacts/understand.html

Drugs are chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs are able to do this: (1) by imitating the brain’s natural chemical messengers, and/or (2) by over stimulating the “reward circuit” of the brain.  For more information, go to http://www.nida.nih.gov/Infofacts/understand.html

Nearly all addicted individuals believe at the outset that they can stop using drugs on their own, and most try to stop without treatment. Although some people are successful, many attempts result in failure to achieve long-term abstinence. Research has shown that long-term drug abuse results in changes in the brain that persist long after a person stops using drugs. These drug-induced changes in brain function can have many behavioral consequences, including an inability to exert control over the impulse to use drugs despite adverse consequences—the defining characteristic of addiction. http://www.nida.nih.gov/podat/faqs.html#faq3

I am not sure what to do with my feelings of hurt, betrayal and disappointment. My daughter is in treatment right now. She has been in treatment for 5 months and I don't want to do anything to jeopardize her treatment. She has thrown out randomly in conversations the many types of drugs she has used and I am supposed to be okay with it. Last weekend when we had a visit I said to her that I can't believe I was so stupid and saw none of it and she laughed and said "yeah, but I had fun." I was somewhat shocked at her telling response. I have not been able to tell her how I feel about her behavior using. Am I supposed to? Do I let it go? I was a single mom, I thought we were close and thought I was on it. I was so wrong. There was so much manipulation, lying, stealing, putting our home and life at risk....all of the drugs she took. LSD, Ecstacy, Ketermine, Cocaine, to name a few. But her drug of choice was Marijuana. Funny, she told me one day months ago she was working on Steps 8 and 9 and she would need to work with me to get through Step 9 and she has yet to bring it up again. I guess she told my husband that she didn't feel like doing the program and felt like relaxing that weekend.

Expert 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

 My message to mom: 

Accepting this is a disease is very hard, when so much hurt and pain and betrayal comes with it. I encourage my parent clients to allow themselves time to go through a grief period. Work with someone who can counsel you in this area. I also ask them to immerse themselves in Al-Anon meetings. Working the 12 steps helps facilitate the grief process.  With all of this work, we then realize this is about ourselves and not them.  We can feel our anger at our children and release it. We then can be more available to other family members.

 My message about your daughter:

This is a disease, unfortunately with addiction, comes the following:

1. Lying,
2. Stealing,
3. Taking family heirlooms and pawning them,
4. Manipulation, and
5. Not caring what happens to their own family members: children, moms, dads, grandparents and siblings.

If I was your family doctor and you came to me and said "I think I have a cold", I would ask you if you had the following symptoms, and read them off.  The same things go with you and your daughter – The disease of addiction; with lots of symptoms, which I just read off.  As with the common cold, you have to do things to take care of yourself.  The same applies to addiction.   You stay away in whatever form you can by washing your hands and maybe not getting so close.

I hope this helps you in some way. It can be difficult to answer a question like yours in just a few sentences.  You are welcome to email me for any other support. Please remember the most important thing is to get support for YOU.

Communicate. Talk to your children about the risks of drug use and abuse.

Listen. Be a good listener when your children talk about peer pressure, and be supportive of their efforts to resist it.

Set a good example. Don't abuse alcohol or addictive drugs. Children of parents who abuse drugs are at greater risk of drug addiction.

Strengthen the bond. Work on your relationship with your children. A strong, stable bond between you and your child will reduce your child's risk of using or abusing drugs.

http://www.mayoclinic.com/health/drug-addiction/DS00183/DSECTION=prevention

There is an excellent handbook called “Navigating the Teen Years: a Parent’s Handbook for Raising Healthy Teens.”  Download your copy now.

Look for:

Problems at school: Frequently missing classes or missing school, a sudden disinterest in school or school activities, and a drop in grades may be indicators of drug use.

Physical health issues: Lack of energy and motivation may indicate your child is using certain drugs.

Neglected appearance: Adolescents are generally concerned about how they look. A lack of interest in clothing, grooming or looks may be a warning sign of drug use.

Changes in behavior: Teenagers enjoy privacy, but exaggerated efforts to bar family members from entering their rooms or knowing where they go with their friends might indicate drug use. Also, drastic changes in behavior and in relationships with family and friends may be linked to drug use.

Spending money: Sudden requests for money without a reasonable explanation for its use may be a sign of drug use. You may also discover money stolen from previously safe places at home. Items may disappear from your home because they're being sold to support a drug habit. http://www.mayoclinic.com/health/drug-addiction/ds00183/dsection=symptoms

The particular signs and symptoms of drug use and dependence vary depending on the type of drug. You might be able to tell that a family member or a friend is using or abusing a drug based on the physical and behavioral signs and symptoms associated with the drug.  Go here to learn the symptoms of particular drugs:  http://www.mayoclinic.com/health/drug-addiction/ds00183/dsection=symptoms

Drug paraphernalia is often marketed specifically to youth—with colorful logos, celebrity pictures, and designs like smiley faces on the products—the items are meant to look harmless and belie the dangers of taking controlled substances. Other paraphernalia like magic markers can conceal pipes, and small, hand-painted blown glass items look more like pretty trinkets than pipes or stash containers. Parents need to be aware that these kinds of products often conceal drug use.  http://www.justice.gov/dea/concern/paraphernaliafact.html

Think like a teen, and be creative.  Look:

• Behind the dryer in the vent that takes the lint outside
• In TVs, radios and any electronic device that has batteries. The battery compartment is a common hiding place for drugs
• Behind the electrical outlet cover in the wall
• Under the bed to see if the bottom of the box springs has been slit to create a hiding place
• Any device or furniture that has a possible hollow portion is an ideal hiding spot. For example, look at any lamp or desk fan with a hollow neck that can be unscrewed.
• Real looking soda, soap, shaving cream cans, etc., in which the bottom comes off provide a hollow bottom where drugs can be found.
• Behind books on bookshelves.
• Inside coat pockets and sneakers

Drug use can run the range from casual use to abuse to addiction.  About one out of ten kids who “experiments” will go on to become addicted. When a person becomes addicted to a drug or alcohol, they need increasing amounts merely to feel “normal” or to avoid the illness caused by withdrawal.  Addiction is characterized by an intense preoccupation with the drug that becomes an inescapable obsession.

Drug addiction is widely recognized as a brain disease that impacts the most primitive “reptilian” part of the brain.   When casual use becomes addiction, it is possible to view the organic, structural changes in the brain on a SPECT scan.

Teens start experimenting with drugs or alcohol for various reasons—to be popular, to fit in, to numb themselves to pain or fear, or to have fun.  Teens that have a physiological vulnerability to addiction can go from casual use to abuse to addiction within a short time period.  As their addiction progresses, they become dependent upon drugs to feel “normal” or to avoid becoming sick from withdrawal.

Addiction is an equal opportunity disease that strikes approximately one out of ten teens who “experiment” with drugs or alcohol.  People from every walk of life are vulnerable to addiction.

The best predictor of a child’s recovery is their willingness to change.  We cannot change our children; only they can change themselves.

Alcoholism and drug addiction are diseases that can be treated with medical, psychological and behavioral help.  Treatment needs to be tailored to individual needs in order to be effective; there is no “one size fits all.” To learn more about possible treatment alternatives, go to http://phpchapelhill.org/AddictionFinances101.aspx

An intervention is the process in which the family and friends of addicted individuals convince them to seek the help they need. Interventionists are the professionals that make such interventions possible each day as they facilitate the process drawing heavily on their mental health training and understanding of addiction.

The first place to go is the Association of Intervention Specialists. They have a code of ethics and a respected route to credentialing through their AIS Certification Board. Those who earn this certification will put the BRI-I or BRI-II credentials after their name. Confirm through AIS that the interventionist has indeed earned the right to use these credentials.

Substance abusers of any age commit crimes. They sell drugs. They steal. They rob. They shoplift. They run merchandise return scams. They drive under the influence. They break into homes. They vandalize. They will do anything to get money for drugs or alcohol. If your child has a substance abuse problem, I can assure you that they have committed crimes, no matter how much you want to believe that your son or daughter wouldn’t do those things. Until your child reaches the age of majority, you as a parent are liable for their actions. If they damage property, you will be held responsible for reparations. If they injure or kill someone, you may have criminal or civil liability. http://phpchapelhill.org/AddictionFinances101.aspx

If person is 18 or over, he/she cannot be compelled to get treatment unless it is court-ordered, usually as part of a sentence.

Absolutely not! Remember, the earlier children begin drinking, the higher their risk of becoming alcohol dependent. You are also assuming a high risk. All states in the United States have social host liability laws wherein adults can be prosecuted for serving alcohol to anyone under the age of 21. Liability can include medical bills and property damage. Parents who are not home can even be held accountable for underage drinking. Social host liability laws can apply to parents who don’t take adequate steps to prevent teenage drinking in their homes. www.fullcircletreatmentcenter.com Advice from local Author and Anti-Drug Advocate Christy  Crandell excerpted from her book: Lost & Found: A Mother and Son Find Victory over Teen Drug Addiction.

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.

EXPERT 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?

EXPERT 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.

 EXPERT 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

EXPERT 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.

EXPERT 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.

 

EXPERT 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

EXPERT 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.

EXPERT 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!

EXPERT 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.

EXPERT 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!

EXPERT 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.

Like other chronic diseases, addiction can be managed successfully. Treatment enables people to counteract addiction's powerful disruptive effects on the brain and behavior and to regain control of their lives. The chronic nature of the disease means that relapsing to drug abuse is not only possible but also likely, with relapse rates similar to those for other well-characterized chronic medical illnesses—such as diabetes, hypertension, and asthma that also have both physiological and behavioral components.

Unfortunately, when relapse occurs many deem treatment a failure. This is not the case: successful treatment for addiction typically requires continual evaluation and modification as appropriate, similar to the approach taken for other chronic diseases. For example, when a patient is receiving active treatment for hypertension and symptoms decrease, treatment is deemed successful, even though symptoms may recur when treatment is discontinued. For the addicted patient, lapses to drug abuse do not indicate failure—rather, they signify that treatment needs to be reinstated or adjusted, or that alternate treatment is needed.  http://www.nida.nih.gov/podat/faqs.html#faq3

Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And, as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal failure—rather, it indicates that treatment should be reinstated, adjusted, or that alternate treatment is needed to help the individual regain control and recover.   http://www.drugabuse.gov/infofacts/understand.html

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!

EXPERT 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

While addiction is a chronic, often relapsing brain disease, there exists tremendous hope for recovery.  There are May treatments that help people achieve sobriety and return to a productive life and successful relationships. The many sober members of our communities are a testament to the strength of recovery.  A treatment program that is tailored to meet your child’s medical, psychiatric, and social problems can lead to sustained recovery and a life without drug abuse. NEVER give up hope.

I have three children, ages 22, 17 and 9. My oldest has so many issues, drug abuse being one among many. Although my others are excelling and have healthy approaches to life, I now live in a constant paranoid dread that they too will fall into destructive patterns, and it keeps me from enjoying them and their accomplishments as I should. I struggle with comprehending how my oldest could choose this path when she was so loved. I keep going over it and obsessing how it could be our fault, how it must be our fault somehow.

Even though the other two are doing great, my confidence in my own abilities to parent and mother well has been shattered because of the one, and I can't seem to shake it. My own despondence is beginning to affect the rest of my family. How do I break free? How do I do I get past the hurt, anger and horror at what our beloved daughter has become? I don't even know how to relate in even the smallest way with her.   Thank you.

EXPERT CHRISTY CRANDELL:

I can so relate to your feelings of fear and guilt! I think some personal counseling and education about addiction will be of great help for you. I would recommend a therapist that specializes in addiction and family systems as eventually it will be important that everyone in the family be able to process and have some healing around this. If the oldest daughter is still living at home, this therapist should also be able to advise you on some strategies to get your daughter into treatment. – Christy  

EXPERT RICKI TOWNSEND: 

First of all, my heart goes out to you and the pain and confusion you are going through, so thank you for reaching out to us. Your question touches on different parts of addiction, ourselves, our family and, of course, the addict.

What I will always ask with regard to a question of this type, would be two things.

1. Are you going to any of the free Al-Anon Family Group meetings?

When I go to Al-Anon or my clients go, we go to seek support. Not to be told what to do, but to receive love and support from those who are going through what we are going through and can relate to our pain on a deep level. This is so very important. We finally feel understood.

2. Are you seeing a therapist or family therapist?

I always recommend a therapist who also does addiction therapy. I personally feel this type of therapy can educate a client into the nature of this “dis-ease” and at the same time, support you in your own personal journey of healing.

What we professionals see, unfortunately, in this dis-ease is that the "good children" are left behind. This “being left behind" can happen in different ways: Parents either spend most of the time keeping an "addiction" eye on the children, or they ignore the non-addicts. The latter results in them being left to make it on their own. It is very common for the addicted loved one to get all of your time and attention. Through support and education, you can learn to shift your attention to a healthier place.

Something I have a deep passion about is helping the families deal with addiction. I believe if I educate, listen to, and talk about the options with them, I can bring out the power they have as a unit. With education, the family can become one supportive “family unit". When I say families, I include in this group the aunts, uncles, grandparents and even close friends of the family. Knowledge is power! I see this profoundly in my families after our conference call or meeting. They take a stand together towards the addiction. My families start the journey of seeing they are not the cause, the cure and DO NOT have control over any one person. We then learn that we do have control over ourselves and our environment, and we learn to exercise that power in a healthy way.

Feel free to contact me to request one of my educational conference calls, or I would be glad to refer you to someone close to you,  if you live outside my area. -Ricki Townsend

It seems like the more time that passes the harder it is for me to cope. Our son is an addict. He went to rehab last Sept and was gone for a month and when he returned he was the son I had before K2! He has been clean up until last week and he has relapsed. I'm not sure what to do and the strange thing is he is currently on probation for the K2 and he started using again like it does not matter. I must say I am shocked and just cannot believe he is taking this attitude. He appears to not care about things again and has no self-esteem what so ever. He says his life sucks and why bother anymore. I am the perfect example of co -dependency. He is 22 and still lives at home. He has struggled his whole life with other issues and the drug addiction just happened to add to the list. I do almost anything he needs done.

Laundry, dinner...lunches for work... etc... I'm not sure what my next step should be since this is his first relapse and I really do not know what to do as far as breaking this cycle I am in. It's hard for me as we lost our oldest son in a car accident and I do not want to lose another.  I know deep down what I need to do but could use some advice on how to handle this.

Hello and thank you for reaching out.  Since K2 is as deadly as other drugs, I appreciate your fear and concern.

There is much I could answer here, but would be extremely lengthy so I will touch on a couple of comments that I felt concern about with regard to your son.

These are a couple of areas I invite you to look into more:

• His remark to you about "Life sucks and why bother? -  I would suggest you bring him to a therapist if he is not already seeing one (if he is, please let her know of his comments) I have deep concerns about depression.  I would encourage an assessment.  (a therapist, not a counselor).  I would always recommend a therapist that also has an addiction back ground.  A therapist can delve deeper into his issues.
• For each one of us, Self-esteem is based on the failures and success we experience from a young age to even old age.  It is a constant journey.  I personally receive my pat on the back from "me" when I achieve something.  Not when something is given to me.

When I was using drugs the shame and guilt of my actions brought depression and low self-esteem.  When I had months in recovery and years, my love of “self” grew from the work I put into "me".  Self Esteem grew with each success and each failure.  Failures when looked at in a healthy way with support (sponsors or mentors) can show us where are strengths and weakness are.  This is how we grow.  This cannot be given to us.

There would be more I could share with you and below is my phone number and web address, if you would like to contact me personally.

Thank you so much.

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

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?

EXPERT 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!"

I have a son who is 19. Our family has dealt with the hell of his addiction for 6 years. He started smoking pot at 13 and got into to ice at 16. We sent him to Outward Bound for at Risk Teens for a month, he spent 2 months in a lock down psyche ward to get off ice followed by 2 months in a rehab in California and finally to another rehab where he earned his GED, started and finished college courses and stayed sober for a year. We had our son back! The day of his return home he was already using again. The past year has been a sad decent back into his using and the loss of our son again to drugs. I finally told him to leave 4 months ago. He left with the clothes on his back into the waiting truck of a drug buddy and never looked back. He hasn't been in contact with anyone from our family. He somehow has kept a job at a restaurant. I reached out to him after 2 months and learned his so called friends have had enough of him, his girlfriend broke up with him for obvious reasons, his laptop was stolen and he admits to being homeless which has led to being demoted at work and written up for his appearance. He was just suspended from his job because he gave drugs to a co-workers younger brother and the guy pulled a gun and threatened to kill him! He called me only to ask for copies of his birth certificate and social security card so he could apply for food stamps. I had a talk with him and he asked what he had to do to come home. I told him he had to give me a clean drug test for a start. He eagerly agreed he wanted that. I said I had found a rehab on the island that we would be willing to pay for. He said he wanted to go for the appointment but today blew me off when it came time for me to pick him up. It didn't surprise me but I just want my son back and I'm so sad he thinks the answer to his problems is getting public assistance. I have read books, gone to countless meetings over the years but the pain that greets me each morning when I open my eyes won't go away. Does a mother ever give up on her child? This life he has chosen leaves me so sad and I worry the longer he's out on the streets, the longer that becomes his normal. I've established my boundaries and will not let him come home, give him money etc, but I'm so tired of him only contacting me on his terms and just giving lip service to getting help. Would it be better to not have any contact with him? When I don't have contact with him I'm unhappy and when I do have contact with him I'm unhappy. I want to feel better but how is that ever going to be possible under the circumstances? - Nancy

EXPERT CHRISTY CRANDELL:

Nancy-
You have perfectly described the heartbreak that happens when you love someone with addiction.  You are doing all the right things. It sounds like you could use some more emotional support, however.  I would recommend seeking counseling for you in addition to attending Al-Anon meetings. Don't ever give up hope but do try to stay healthy in spite of his sickness.  I wish you the best. -Christy

EXPERT RICKI TOWNSEND:

One pertinent question you asked that moved me is, "Does a mother ever give up on her child?”

I would say most of us just could not. We never give up on his/her possibilities. We never give up on the "knowing" Life is his journey. We have nothing we can no to empower him with the want to live up to his potential. Most families I sit with, the first thing the always say, my child is so smart, so loving.

Yes they are. What they are also, is in the depth of this horrific disease.

From the heart of a mom to your heart as a mom, I am so sorry for the pain your are living with. So is this how we live? We learn how to live life with this truth in the back of our heart. This was the secret for me. Live with it in the back not the constant forefront of my heart and daily living.

I knew my child had an addiction problem, living out on the streets, going from couch to couch, but I made the decision, for me, that I wanted to laugh again.

I sent prayers and I created a vision board for his future by taking his pictures, and pictures of what his life could be like if he chose it to be and affixed them on a small board. I kissed it and put it in the back of my closet.

I know this sounds silly to some, but to me it meant that I was not forgetting him, and more importantly I was not partnering up with his belief about himself. I knew he could be and do anything he wanted to, if he made this decision. Some nights before going to sleep, I took it out. I wished my son love and recovery, and put it away. Yes many times I would cry, and I would say to myself, ok. You have given time to cry and hurt. Now let’s give this day to joy, and peace.

I went to therapists, and felt renewed when I left. I went to Al-Anon meetings, and I felt empowered that I was the only one in my life I could control. I took on hobbies I had never tried before. I went to dinners more often. I shopped and laughed and had coffee with friends, more often. Those times I never discussed my child. This was my time.

So coming from a professional and a mother of perspective, no, we never forget, we just move on. We know those three "C's" well:

1. I can't cure this
2. I can't control this
3. I didn't cause this.

Remembering only they can change themselves. What we do is continue to take care of ourselves and our environment. Blessings, Ricki

Question: My daughter is an addict. She is 25 years old. She has been in detoxes twice for heroin addiction. The last one was 3 years ago. She was clean and sober for 9 months and doing very well living in a half way house for women, attending meetings and seeing her professional.

While in rehab she met a man 11 years her senior. She announced to me that after knowing him for 6 weeks that they were going to move in together. I did not agree with this for obvious reasons but there was no big argument....She totally cut me out of her life which is totally uncharacteristic for her.

Around two years ago, she slowly started to reconnect with me and told me that she started to drink again. I was not allowed in her apartment, and her boyfriend did not want to see me or speak to me. Summer of 2011 she became pregnant with the same man she met in rehab. She visited me on my birthday this August. We had a nice visit until her boyfriend demanded she come home immediately, and she fell to pieces. They fought on the phone... she left the next morning and I never saw or heard from her again. She has cut all of her family and friends out of her life. I am not sure if this is her doing because of her addiction and mental illness or if this is his taking control of her.

I have tried everything in my power to connect to her and she refuses. Out of desperation I have called the police the house they live in looks very unkempt on the outside and has all the shades drawn ...with no baby furniture or sign of a baby.. (I have been by 3 times in a year; she lives 30 minutes from me) so this freaked me out. The police did a wellness check and all seemed to be fine. I called child protective services because I am worried that they may be doing drugs and that the baby maybe neglected..... There is not much they can do without evidence. I have no facts... I have no evidence.... and this is killing me... to the point of a nervous breakdown a few months ago....

I have a daughter and a granddaughter (whom I have never seen) and they are out there out there. I have never been an abusive parent and am not an addict myself. I just do not know what to do anymore.... the anxiety is terrible.... I do say the serenity prayer and have excellent professional help.... I used to go to Al-Anon but I found that it made me more depressed and that I cried even more....

I just feel so stuck in this horrible place...... I just want to reach out and grab the two of them but I can not... I feel just terrible.... the anxiety and the sadness is always there although I do have really good friends and am a lover of life.... a teacher, a student and a musician.... but some days I cannot love life cause what I love the most is cut off... out there somewhere...

How can I weather this? I am currently a unemployed teacher who is working on my doctorate... it is hard to get the energy to do this work... when some days I just cry......and miss her sooo much.

EXPERT RICKI TOWNSEND:  What I saw in your email was largely a mom who is driven by grief. When we live with loved ones in addiction, it is so important for us to feel grief in a healthy way.  I suggest you think about doing some work around your sorrow and the loss of dreams that you had for your daughter. The weddings, the grandchildren…whoever prepared us for this? Each day it seems as though our hearts are being rubbed with sandpaper. A grief counselor can help you deal with your deep pain.

You mentioned Al-Anon made you cry even more; possibly again this is a sign of deep grief. Did you have a sponsor? I hope you will try this again for at least 6 months, really going deep within the steps with a sponsor. We must honor those 3 c's, they talk about in Al-Anon: You didn't cause her behavior; you can't control her life and decisions; you can't cure her. Only she can make herself better, and only you can make yourself better.

In your email, again, all I see is a mom wanting the best for her daughter and herself. From your email, it sounds like you have done everything a mom could possibly do. Honestly, every one of my clients is simply doing what they feel will help the children and grandchildren. They say the just want the "best" for them. Sometimes, the "best" can just be sitting back and letting things unfold.

You mentioned you are seeing a therapist. Please continue this and possibly consider working with a grief counselor. I have some very good referrals I could email to you. I also work with families on a monthly basis over the phone. If you would like to email me, I would be glad to share how this is done. In your email, you stated your love of life. You now have some new steps to take in order to live every day with some joy and peace, and deepen your love of life.  Work the twelve steps, work with a therapist or sponsor or a grief counselor like me…Just keep moving forward, one day at a time. You are welcome to email or call me to discuss this further at ccrtowns@aol.com, 916 539 4535.

Ricki Townsend, Board Certified Interventionist, Grief Counselor, Drug/Alcohol Counselor NCAC1, CAS, RAS, Bri-1

EXPERT CHRISTY CRANDELL:  I am so very sorry for your loss. What you are experiencing is deep grief. I am so glad to hear you have already reached out to a counselor, but based on the intensity of your emotions, I would advise that you contact him/her immediately for an evaluation. You may need medication to help you through this ongoing traumatic event. Please don't wait.

Best regards,

Christi Crandell, Founder of Full Circle Treatment Center
Christy

Your Question:

My son is using pot and steroids. He will be 24 years old soon. He choose to leave my home instead of stopping the drugs and seeking help. I have not seen him in 4 months. Heard from old friends only a few times. My son only liked 2 college classes having a double major. He is very handsome, smart, funny and grew up loving the Lord - he even helped start a Church. My heart is so heavy my joy is all gone. I pray for him but I can't seem to let go and let God. It hurts so bad all the time. People seem to grieve with you when a child dies but not when you grieve over a child still alive that you can not see, touch or help. I feel as though I am grieving deeply and people want me just to go on and let this be his problem. How do I deal with this? How do I find joy? It is Christmas and I miss my son. I love him so much!

Thanks for any help in advance

Carol

EXPERT RICKI TOWNSEND: I have children also, I know what it is like to be so concerned for them; we can some times lose ourselves. My daughter had an unexpected illness hit her, and we had to stand by powerless while we watched all of the tubes keep her alive and heard doctors tell us she may not make it. Really, there is no difference in this disease. We stand by helpless. So from one Mom to another, I am sorry for your pain.

First I want to ask you to please attend a parents Al-Anon meeting. I am not sure what city you are in. If you go online, you will be able to find one close to you. http://www.al-anon.alateen.org/meetings/meeting.html  It is about being with like minded parents. They understand how you feel. They will not tell you what to do, but will share what they have done to at least feel some joy and peace in their life, during this Holiday season.

One of the hardest questions I am asked is the one you have asked: "How do I let Go and Let God?" I am so sorry that there are no magical answers. It is so different for everyone of us. This is how I, and so many others have done it-- I went to Al-Anonrst, as many times as I needed. For me. this was 4 nights a week. I also worked with a  therapist who helped me walk through the grief. I sought out a sponsor and worked with her on a constant basis. I made my health Number  One in my life.

We are not the Cause or the Cure of his illness. My prayers to you as you work through this pain. You my also call me or email personally, for any other questions, or if you feel you need more of an explanation to your questions.

Blessings

Ricki

 EXPERT KENT MORRISON: Hi Carol, first your grief is real and your lose is understandable.  Addiction is a serious disease that steals away the people we love.  I would like to comment on two aspects of what you wrote.  First, you expressed a faith in the Lord.  Trust in Him that He will help guide your son away from active addiction  and into recovery.  God has plans for all of us, we just don't always see them nor do they always make sense to us in the moment.  Second, reach out to your son and tell him you love him and that when he is ready to seek help, you will be there to help him.  You were right in asking him to make a choice, get well or leave.  It is his recovery, no matter how much you try it is his responsibility to help himself.  Just letting him know that when he is ready, he has an avenue towards help can offer him the hope he may need to reach out and seek recovery.  Last, as tough as it is, letting him experience the consequences of his choices during this Holiday Season is the best thing to help him realize the gravity of his problems.