To wrap up the month on addiction, I thought it would be good to look at warning signs and current stats on teen chemical use.
First, the waring signs
Warning signs that your teen could be using drugs or alcohol:
- Sudden change in friends and appearance
- Changes in appetite or sleep patterns
- Sudden weight loss or gain
- Deterioration in personal grooming or physical appearance
- Unusual smell on their breath, clothing or body
- Sudden decline in grades
- Drop sudden loss in interests
- Complaints from teachers, classmates, friends
- Missing money, valuable, prescription drugs
- Preoccupations with alcohol and drug-related lifestyle in music, clothing and posters
- Using incense, perfume, and air freshener to hide smell of smoke or drugs
- Using eye drops to mask bloodshot eyes and dilated pupils
- Laughing at nothing
- Periods of unusual hyperactivity or agitation
- Appears fearful, withdrawn, anxious, or paranoid with no apparent reason
It is good to note that one or two of these things on their own could easily be explained by typical adolescent behavior but they are all signs that something stressful is likely going on in your child’s world so it is time to take note. I think it is also worth mentioning that the ‘perfect child’ the one who is ‘never a problem’ could be hiding behind perfect grades and school attendance in order to fly under the radar.
Recent facts on use
Because there can be a lot of confusing and misleading data about kids available, I went to the Center for Disease Control (CDC) for some info. The stats listed below are from articles published on the CDC website in May of 2017.
- Percent of adolescents 12-17 years of ago who smoked cigarettes in the past month: 4.2%
- Percent of adolescents 12-17 years of age who used alcohol in the past month: 9.6%
- Percent of persons 12 years of age and over with any illicit drugs in the past month: 10.1%
- Percent of persons 12 years of age and over with any nonmedical use of a psychotherapeutic drug in the past month: 2.4%
It is good to note that each stat is only looking at the previous 30 days. Also, a lot of this data is based on self-report so I tend to think that a lot of it is a little lower than the actual number. Of the stats listed, I thin it is of particular note that illicit drug use is higher than alcohol use. While this number does include marijuana, it also includes things like cocaine, meth and heroine.
Like their homework and chores, we should be talking to kids regularly about sex, social media, drugs and alcohol. I think about it this way, you tell them more than once to take out the trash and to study, why wouldn’t you talk to them more than once about all the other issues?
As always, I would love to hear from you. What makes it difficult to start conventions about drugs and alcohol? Keep in mind that while this topic is uncomfortable for both of you, it is absolutely critical to have it.
As someone who works with addicts and their families, I get asked with some regularity for help finding a treatment center. So I thought I would put together a list of questions to ask in the process so that you can find the right treatment facility for yourself or your loved one.
First, I think it's important to note that there are no perfect treatment centers just like there are no perfect people. However, I think you can find something that is a 'more right' or better fit than another treatment facility.
Are you (or they) ready?
Have you come to a realization that you cannot live this way anymore? By the way, the evidence does not support that treatment outcome is dependent on a person hitting rock bottom. Outcome is far more impacted by willingness to admit that you do not have the answers and your life cannot continue as you are currently living. If you or your loved one isn't ready/able to say that life cannot go on as is then now may not be the right time for treatment.
What level of care do they need?
Detox
A medical detox is necessary in many (not all) cases with alcohol and heroine because withdrawl from both can cause seizures, vomiting, fever, tremors, etc. In addiction, there are always withdrawals when you are going cold turkey (even from sugar and caffeine) but not all addicts are in need of a medical detox for safety but trying to detox from heroine and/or alcohol on your own can be dangerous.
Inpatient treatment
Inpatient is pretty self explanatory but there are different lengths of stay ranging from one week to six months. Most insurance companies will reimburse for about 30 days of impatient treatment (depending on your policy) but you or your loved one may need to be in treatment longer. Most facilities can offer you a payment plan so that you can get the treatment needed. It is pretty standard to have at least one psychiatric evaluation during a 30 day treatment stay and to have several hours of group and individual treatment daily. There is typically a family component to treatment as well.
PHP
Partial hospitalization program (PHP) is typically Monday through Friday from about 8am to 5pm. In those programs, it is common to see a psychiatrist a couple of times per week and to spend much of the day in groups and regular check ins individually with a treatment provider. This level of care is probably most common for minors and most PHP programs allow for students to do at least a little school each day.
IOP
Intensive outpatient programs (IOP) are a really popular option for adults as well as minors. It allows you to continue to go to school or work but feels most of your free time with focused group treatment. I often think this can be a good first half step when someone doesn't have a total buy in with treatment but agrees there is a problem.
Sober living
Sober living is a great option for anyone who is trying to learn new habits but is probably most common as a step down from inpatient. There are typically a lot of rules, house meetings and there can even be drug/alcohol testing done in order stay there. It can be a really good way to learn how to deal with the world/life while coming home to a place with were drugs and alcohol are not tolerated or allowed so there is an element of safety and accountabilty.
Have they been in treatment before?
For a lot of people, treatment is necessary a few times before they are in remission. It may be helpful to search out different treatment styles or modalities if they are already tried treatment.
Does the facility cater to age?
There are families that cater to creatives, young people, the GLBTQIA community, veterans, dual diagnoses, etc. For some people, it can be easier to embrace sobriety if they feel as though they can related to the treatment providers and the people in treatment with them.
Do they need a facility that can handle dual diagnoses?
For many people who struggle with chemical dependence there is a mental health disorder that contributes to or complicates to use. If he person in need of treatment has been diagnosed with a mental health disorder it is important to ensure that the treatment program is equipped to treat both their disorder as well as their addiction. They are a package deal and should be treated as such.
How are you paying for it?
If you are relying on your insurance, it is important to call both the treatment family and your insurance company to know what if any additional costs you could encur.
What about aftercare?
Keep in mind that addiction and unhealthy lifestyles rarely form in 30-90 days and to get sober and stay sober will take longer than that too. Aftercare is critical in order to set yourself up for success. Aftercare can look like a lot of different things including but not limited to sober living, AA/NA/CA meetings, individual therapy, group therapy, support groups, church groups, etc. Think of it like being in remission from cancer. Your doctor will likely recommend some lifestyle changes and you will have to get follow up tests/scans in order to ensure that the cancer doesn't come back.
This is not a complete list but this is a good place to start. As much as possible, it is good to customize the treatment to your needs. The more it speaks to where you or your loved one is, the more likely the necessary shifts will come.
Good luck in your search! I would love to hear from you. If you feel like I missed a question, please let me know. If you would like some local suggests I will do my best to help you.
I often hear people trying to explain that even though they are struggling with something, they are sure they aren't an addict. I think people struggle with the label or word "addiction", in part, because there is a social stigma. Somehow calling yourself an addict feels too scary. Perhaps because if seems like the solution is too hard to it means that you would have to give up something that you may not be ready to give up.
What is addiction anyway?
I think it is important to mention that there are "addictions" that can be good for us. In Glasser's, "Positive Addiction" he points out that things like running and meditating can be addictive but that they can also bring good things to your life. It's a short read but I think it's a really good one. It reminds me a little too of some things I read in the 'big book' about starting to crave things that are better for you like community and spirituality.
Just between you and I, one of the not awesome changes that took place between the DSM IV TR and the DSM V (the gigantic book that we base all diagnoses on) is that they combined substance abuse and dependence. I liked the distinction because I felt like it could speak to and escalation and/or a de-escalation of symptoms. It could be something you could track and look at over time and know if you were improving or if you needed more support. In the new DSM the only difference is mild, moderate or severe. In my experience people have been able to more easily accept that they are abusing and there for in danger of becoming addicted that to just be labeled an addict.
Who cares?
In my mind, anything that impedes your goals or social connections is a problem. Weather that is a chemical, a habit, another person, etc. And you can call it addiction or dependence or an unhealthy relationship but the result is the same no matter what you choose to call it... You aren't living the life you want.
I challenge you to ask yourself if there is a thing/habit that is holding you back from what you want. Are you allowing something to sabotage you from having the life you want? If so, does it matter what you call it (addiction, dependence, etc) or is the solution more important? I would love to hear from you.
