You don’t get a Get Out of Jail Free card just because addiction is a disease

1254880_shiny_brain_[1]I understand that addiction/alcoholism is a brain disease, but that doesn’t let my beloved addict off the hook or give him excuses like, “I can’t help it!  I’ve got a disease.”  And it doesn’t give me an out either.  If I think, “He can’t help it!  He’s got a disease,” then I am giving him a Get Out of Jail Free card.  I am giving him a reason to keep abusing drugs or alcohol.  I am enabling his  self-destruction, pure and simple.

Yes, my child has a disease, one that he needs to manage as he would diabetes or cancer or heart disease. Here are the rules of the game for those with impaired hearts or bad pancreases or chemically-dependent brains: keep away from the things that are bad for you.  Avoid sugar or fatty meat or – for the chemically dependent – any mood altering substance.  Pot, crack, alcohol, pain pills; these are all the same to the diseased addict/alcoholic brain.  Addicted to one means addicted to all.

As an aside:  I know many parents think, “It’s just pot!  How bad can that be?”  I was one of those naïve parents.  I didn’t know that pot had eight times the THC as in years gone by, or that it was causing psychosis among some users. I didn’t know there were more kids in rehab for pot than for all other drugs combined.  And today’s national landscape makes the picture even murkier: if pot is so dangerous, why is it being legally sold around the country?  That’s a mixed and confusing message for teens and adults alike.

My personal mantra for parental recovery is, “Give your beloved addicts a reason to change.”  The flip side to that is, “Don’t give them an excuse to use.” Don’t let them play the disease card.  Hold them accountable for the choices they make.  We can’t stop them from putting their hand to their mouth or a needle in their arm.  But we can stop making up excuses for them.

Losing the ACA means losing access to addiction and mental health treatment

swing setThe advocacy organization Shatterproof reports that “If the ACA is repealed, Harvard-NYU researchers estimate that more than four million Americans will lose access to addiction and mental illness treatment.

And millions more would be at risk of missing out on future insurance coverage because addiction is considered a pre-existing condition.

We can’t let this happen. According to the CDC, we’re in the midst of the worst drug epidemic in U.S. history, and drug overdose is now the #1 cause of accidental death in our country. Repealing the ACA without a replacement would make things worse for communities trying to fight back against the epidemic. It’s irresponsible and unacceptable to lose lives in the name of politics.”

Together, our voices carry weight. Tell your representative that repealing ObamaCare will make the opioid epidemic even moire deadly.

“She had so many hopes and dreams. Being an addict wasn’t one of them.”

The  Christmas post every year is dedicated to Tiffany Noel Chapman, a Christmas baby born in December, 1976.  She became addicted to the pain pills that were prescribed when she broke her neck in a high school car accident.  She died when she was 27, her liver destroyed by the pain pills that she had come to depend on.

Many people believe that people “choose” to become drug addicts or alcoholics when they party with drugs or alcohol, but addiction often develops under less voluntary circumstances.   Tiffany’s genetic predisposition for addiction was triggered by the pain meds that she needed to take for intractable pain. Her story, while not uncommon, is an eye-opener to those who had no clue that even doctor-prescribed and doctor-monitored medications can become addictive.

Tiffany’s parents took her home from various ERs after repeated overdoses.  Not once did they receive discharge instructions that shed any light on the brain disease they were fighting.  Not once did they receive counsel about rehab or information about resources.  They didn’t understand the phantom they were fighting in the dark, without tools or weapons.    And they aren’t alone in their not-knowingness:  teen addiction and alcoholism aren’t commonly discussed in today’s parenting books.  In fact, most physicians have little or no training about addiction or alcoholism, especially as a teen issue, and little information to share with struggling parents.

Tiffany’s mother Linda opens her heart when she shares their story in the Collision Course-Teen Addiction Epidemic documentary, reminding all of us to be aware and vigilant because anyone—even the most golden child—can be vulnerable to this deadly disease.

The opioid tsunami is just ramping up….

The CDC’s most recent Morbidity and Mortality Weekly Report paints a bleak picture of skyrocketing opioid overdose rates. The new 2015 data indicates that, in 2015, the five states with the highest rates of death due to drug overdose were West Virginia (41.5 per 100,000), New Hampshire (34.3 per 100,000), Kentucky (29.9 per 100,000), Ohio (29.9 per 100,000), and Rhode Island (28.2 per 100,000).

A picture speaks a thousand words, and the CDC’s map reveals that the opioid tsunami has barely nicked the western US, with the exception of Washington State.  Note to states west of the Mississippi – you ain’t seen nothing yet.

The report also suggests four ways to prevent overdose deaths and reduce the drivers of this epidemic:

1) Improve opioid prescribing to reduce exposure to opioids and prevent opioid use disorder by training providers and implementing the CDC Guideline for Prescribing Opioids for Chronic Pain.

2) Improve access to and use of prescription drug monitoring programs (PDMPs).

3) Protect those suffering from opioid use disorder (OUD) by expanding OUD treatment capacity and enhancing linkage to treatment.

4) Implement harm reduction approaches including naloxone distribution and syringe services programs.

I would add: Raise your voice if your child struggles with opioid use disorder. Join the other advocates saying “Enough of this shame and stigma while our children suffer from a preventable and treatable disease.” Admittedly, it takes a lot of courage to speak up, but there are ways to advocate from the privacy of your home. For example, support the anti-stigma work of groups like Shatterproof. Loudly or quietly, claim your power as a parent to change the course of this disease that is killing our kids.

The best holiday gift of all from parents of addicts and alcoholics

Reflections on Motherhood and a child with AddictionDecember marks the official kick-off of the non-profit fundraising season, and I’d like to ask ParentPathway readers to support a non-profit that is focused on PREVENTING substance use and abuse.  Your support won’t cost you a penny when you shop on Amazon (any time, from any device!) because of an affiliate marketing program that will give PathwayToPrevention a small commission on every sale that originates through a Pathway to Prevention link.

How does this work?  If you plan to make any purchases at Amazon, simply enter the Amazon site through one of Pathway to Prevention’s links, and then shop away for anything and everything you want. Consider entering Amazon through one of our recommended books, below. You don’t have to buy either book: just enter the world of Amazon through this portal, and shop away.

  • Saving Jake – When Addiction Hits Home by D’Anne Burwell.  This articulate chronicle of a young man’s chemical dependency could be written by so many of us:  a loving family, a talented child, the search for answers, the hope of recovery. The book is sprinkled with resources and evidence-based information about the epidemic of chemical dependency that is gripping our nation.
  • The Joey Song: A Mother’s Story of her Son’s Addiction by Sandy Swenson. One Amazon reader commented, “It took years for (author) Sandra to realize that she could not save her son. That loving him meant letting go. She concludes the book without knowing what lies ahead for her son. This is not a happy story, but it carries a powerful message. While our children might move into a place where we can no longer follow, we must not blame ourselves for our failure to save them. Our children, much as they might blame us, must assume responsibility for their choices. Their lives depend on it.”

Prevention work takes time, money, dedication and expertise.  Learn how Pathway to Prevention turns evidence-based information into free, downloadable, sharable resources for parents and educators, and please keep this worthwhile organization going strong with your Amazon purchases.

I can run, but I can’t hide from substance abuse in the Family

Trying to manage addiction is like willing a train to stop. No matter how hard I concentrate on it, the train is moving with or without me. Depending on my location, I either get run over, passed by, moved or left behind.  Ultimately, addiction moved on but I lost who I was and what was really important to me. I remember my job’s demands were accelerating parallel to the addiction progression in my family. I was traveling several weeks a year away from home and I looked forward to leaving. I fantasized that if I could move far, far, away, the problems would go away. But the worry never left, nor did the problems when I returned home. I could engulf myself in long term projects to avoid feelings of failure as a mother. I heard a speaker at a 12-Step meeting say “everywhere I go, there I am!” and another said “nothing like Arkansas in the rear view mirror!” It made sense, intuitively; running away would not solve my problem because I was somehow connected to it.

At some point I had to face the reality. This was not going away or going to get better unless I decided to do something different. I had to make some changes, but how? Joining a support group with similar circumstances and seeking professional help was a good start. When I started to put the focus on myself and stop waiting for others to change, my life started to get better. My decision to change my behavior versus running away from the problems in my life was frightening at first. But overcoming this fear of unknown was worth the risk of continuing as is. Get on! Get off! Move out of the way…Do something within your control.

Recognizing Substance Abuse in Teens

One of the biggest concerns for parents with teens is the experimentation and abuse of addictive substances. During adolescence, teens face many social and emotional obstacles as they grow and learn how to face the challenges that walk hand in hand with growing up. As they face these challenges, it is normal for teens to become more emotional and independent, but for parents it can sometimes be hard to differentiate teenage moodiness from signs of substance abuse. If left unrecognized for too long, substance abuse can worsen and the results can be deadly. It is crucial that parents and guardians quickly identify and respond to the specific factors that could be the result of drug or alcohol misuse.

 General signs to look out for:

 Evidence of drug or alcohol paraphernalia, such as empty alcohol bottles, pipes, syringes, rolling papers, lighters, etc

  • Problems at school such as: skipping school, missing classes, severe drop in grades, violent or disruptive behavior
  • Extreme efforts to restrain family members from entering their rooms
  • Amplified efforts to hide their whereabouts, new friends, activities or where they go with their friends
  • Drastic changes in behavior: lack of energy, motivation, or concentration, avoidance and distancing, uncooperative
  • Excessive use of room deodorizers or incense to hide smoke or odors
  • Increase in borrowing money without reasonable explanations, missing money or other items, or stealing
  • The signs and symptoms of substance abuse vary depending on the type of substance; you may be able to determine if a teen is abusing a specific drug by identifying the physical and behavioral symptoms associated with the specific drug

Signs of Use

Marijuana

  • Red eyes
  • Slowed reaction time
  • Paranoia
  • Increased heart rate and blood pressure
  • Increased appetite
  • Reduced coordination
  • Lack of concentration

Cocaine, Methamphetamine (Meth), Ritalin, and Other Amphetamines

  • Irritability
  • Euphoria
  • Paranoia
  • Rapid speech
  • Lack of sleep
  • Severe weight loss
  • Decreased appetite
  • Damage to the mucous membrane of the nose

Opiates (pain pills, heroin)

  • Severe weight loss, loss of appetite
  • Pinpoint pupils
  • Aggression and anger
  • “Nodding off” or falling asleep in the middle of a conversation
  • Mood swings
  • Depression
  • Suppression of breathing, followed by death

Ecstasy (MDMA), Rohypnol (Roofies), GHB

  • Amplified feelings of happiness
  • Amphetamine-like symptoms
  • Poor judgment
  • Heightened senses
  • Rohypnol and GHB
    • Drowsiness
    • Loss of consciousness
    • Can result in seizures, coma and death

 Early acknowledgment and response are necessary for parents and guardians to save teens from engaging in substance abuse. Substance abuse can lead to more severe drugs, addiction, and even death if action is not taken.

A Place of Hope’s Center for Counseling and Health Resources provides help for those who seek addiction treatments for drug and alcohol dependency, depression, or issues relating to gambling, food, pornography and more. Dr. Gregory Jantz and his team of addiction medical professionals, psychologists, nutritionists and fitness trainers help  address the physical, psychological and spiritual problems that are behind the symptoms. Please visit online at A Place of Hope.

Which planet reigns — Mars or Venus — when you are parenting an addict?

Moms and Dads tend to deal with a child’s chemical dependency in different ways. Dads often want to fix the problem, dammit, to make the kid better, to clean up the mess he or she created along the way.  For fixers, all this hard work gives rise to some serious resentment and tests even the best anger management skills.  In contrast, Moms want to soothe the hurt, protect the baby, kiss the problem away, even if that requires them to bear their pain. For us enablers, speed dialing grief counselors or Jack Kevorkian can be the order of the day.

This disconnect in parenting styles didn’t arise with addiction or alcoholism.  It probably lay dormant all along, but a child’s substance use disorder throws kerosene on the flames of parental disconnect and discontent.  Mars to Venus, we’ve got a problem, illuminated by the flame-out of our struggling children.

In order for the family to get healthy, it is essential to “circle” the wagons, which requires all parties to agree to take the same approach towards chemical dependency.  It requires a common understanding of the disease of addiction and a shared commitment to not enabling, not fixing….simply getting out of the way of our children as they try to right their own ships. It requires us to talk with our spouses/partners when we would rather retreat or cast blame or yell or cry. Being the parent of an addict is not for sissies, but it gives us a chance to hone our resiliency, character, and commitment, which are silver linings in an otherwise dark cloud.

Is Suboxone a solution or simply another addiction?

What role can Suboxone play in recovery from opioids?  It’s a controversial subject. Here is the perspective of Mel Pohl, M.D., Medical Director, Las Vegas Recovery Center
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 medications 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

 

 

Ten life-saving tips for parents of addicts and alcoholics

kindness of others along the journeyDid that title make you think you’d found the magic wand to saving your child?  Guess what?  You did.  If you get healthier, chances are that your child will reclaim his or her health, too. And most importantly, you’ll be healthier if you follow some or all of these suggestions. So please consider these important steps to take on your own road to recovery:

  • Find an Al-Anon meeting or Nar-Anon meeting near you (or online).  You’ll find support, perspective and camaraderie there.
  • Read Co-Dependent No More to learn how to sever the ties of co-dependency, which often plays a part in the family disease of substance abuse.
  • Develop a support system of friends, spiritual advisors, doctors, counselors, or anyone else who can help you stay afloat.
  • Learn everything you can about the brain disease of substance use disorder. It’s a disease, like cancer or diabetes. You didn’t cause it, you can’t cure it and you can’t control it.
  • Surround yourself with positive people and things.  Nourish your soul.
  • It’s triage time. Put the oxygen mask on yourself first. Take care of your physical, financial and spiritual needs first.
  • Develop tools to “turn off” the obsessions about your child.  Whenever you begin to worry or dwell on your child (which does nothing but torture you), switch gears to a mantra like the Serenity Prayer or a simple affirmation of peace and hope.
  • Read the Open Letter from an Alcoholic.
  • Forgive yourself. What parent doesn’t want to be the best parent possible?  We all do the best with what we have, and we need to learn to forgive ourselves for not being perfect. Our imperfections did not make our children addicts or alcoholics. Parents – even imperfect ones – are not powerful enough to create a brain disease. So forgive yourself for being human and concentrate instead on creating a healthier future for yourself and your family.
  • Keep a gratitude journal, if only in your mind.  Start every morning by looking for something to be grateful for, and close each day with an acknowledgement of thanks for the goodness in that day. It’s there, somewhere; and if you look for it, you’ll find it. When the things we focus on change, we change.