Addiction Science: The Teenage Brain and a New Online Drug and Alcohol Prevention Program

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Guest Blogger, Kim Bemis, founder of Gobi.

Every human culture has its intoxicating substances—and in each culture there is a subset of users who become addicted.

In the U.S., 21st century addiction problems are appearing earlier in life[1], according to the latest scientific data revealed in May by the nation’s foremost addiction experts at a New York conference I attended.

Addiction science reveals that abuse and addiction occurring in the biologically sensitive period of adolescence can harm a vulnerable brain—so much so that abusers’ and addicts’ brains may not reach their full potential or function normally. This is because repeated and chronic use of substances targets the paired system governing behavior: the brain’s reward center (nucleus accumbens) and the impulse-control center (prefrontal cortex). As the keynote speaker, National Institute on Drug Abuse (NIDA) Director Dr. Nora D. Volkow, put it: “Addiction and drugs attack the reward centers we need to survive. They hijack that system” by radically disrupting the neurochemical signals to produce constant reward-seeking behavior with no checks or balances from the impulse control center. “When executive function is decreased you are at risk of seeking rewards without sound judgment.”

Dr. Volkow also emphasized that the prefrontal cortex—that brain capacity so critical to making executive decisions in the person’s and society’s best interests—is not fully developed until age 25. Yet in our society, we have 15-year-olds—and younger—at risk of jeopardizing their developing brains with excessive use of drugs and alcohol. Not only do these chemicals have the power, over time, to change the circuitry of the developing adolescent brain, but extensive or continued use robs adolescents of normal and necessary growth experiences central to identity formation, positive affiliation, family/community connection and a sense of purpose.

This concerns me because I am an entrepreneur who has spent the last 11 years working in the drug and alcohol recovery field—and the scientific insights my background gives me suggest we are, as a society, at risk of creating a culture that promotes access to substances in a way that leads to easy use, frequent overuse and, too often, to abuse.

Of course, addiction doesn’t happen overnight; one drink won’t hurt. But the science suggests it is essential to educate the public to understand that teen substance use is a public health problem and that addiction is a complex brain disease that, in most cases, originates in adolescence. Our health systems must work to prevent or delay the onset of substance use through effective public health measures.[2] I want to do all I can to help prevent teens from abuse and addiction, to help them make better decisions. Here’s who I am and what I do:

  • A gratefully sober man for over 27 years, able to enjoy the blessings of family and friends because of my recovery from drug and alcohol addiction
  • A former executive of an internationally renowned treatment center helping people get sober, stay sober and reconnect with life
  • Now, the CEO of Gobi, a new, accessible and affordable approach to intervening to help teens who might be in trouble because of their substance use. Gobi (gobi.support) is a novel online tool for teens and their family members. It is science-based and developed by expert clinicians in addiction science, parents and teens, Gobi is intended to reach digital natives in their own space—online, with social media follow-up and support. At the same time, Gobi also supports parents, with research on adolescent substance use and tips on communicating effectively with teenagers. Figures 1, 2, and 3 convey sample findings from our recent user survey during the 60-day course of Gobi online programing.

Figure 1: Fig1_Gobi connects

Figure 2:Fig2_Gobi offers keys to change

Figure 3: Fig3_Gobi results

In May 2016 I had breakthrough experiences at two tremendous addiction conferences: “From Statistics to Solutions Prevention Summit: Addressing Underlying Issues of Youth Substance Abuse,” in the Twin Cities, with sponsors and partners including Know the Truth, Our Young Addicts, Minnesota Teen Challenge, and more, and “The Addicted Brain and New Treatment Frontiers: Sixth Annual Aspen Brain Forum,” sponsored by the New York Academy of Sciences and the Aspen Brain Forum in New York City.

Below, I share several key messages from the New York summit. In my next post, I’ll elaborate on my Minnesota conference aha moments, and the tremendously encouraging things happening.

  • Over time and frequent use, substance-induced changes to the brain impair a person’s self-control and ability to make sound decisions, while sending intense impulses to continue to use—just to feel “normal.”
  • Our brains develop from the bottom to the top and from the back to the front until approximately age 25. Brain circuitry during this developmental stage is particularly vulnerable to substances of abuse.
  • Data show that teenagers are more likely than adults to experiment with alcohol, cigarettes, and illegal/prescription drugs, and also have a higher rate of addiction: Among addicted Americans, 1 in 4 began using before age 18, which compares to 1 in 25 who started using at age 21 or later[3].
  • Underlying youth addiction is a complex network and interplay of neurobiology, psychology, social and family dynamics and genetics.
  • Brains do recover! Never lose sight of this.

Early detection and intervention in teen substance use, with the explicit goal of preventing the progression to abuse and addiction, is really where we need innovative approaches and programs to help youth and families.

My goal with Gobi is to foster better communication in families and to help teens make better decisions around using drugs and alcohol before the “brain hijacking” occurs. I look forward to sharing some preliminary user data that suggests despite worrisome trends in adolescent drug and alcohol use, there is also encouraging news, hope and help.

[1] In my next post, I will share demographics from our early research with teens participating in the program we designed to prevent early experimentation from leading to abuse and addiction.

[2] This is a stance I share with the National Center on Addiction and Substance Abuse. http://www.centeronaddiction.org/

[3] Data from a national survey of use patterns, Adolescent Substance Use: America’s #1 Public Health Problem.

http://www.centeronaddiction.org/newsroom/press-releases/national-study-reveals-teen-substance-use-americas-1-public-health-problem

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.

©2016 Our Young Addicts   All Rights Reserved.

#TBT – Denial – No Way!

Back in 2011, our son hit another bottom but still wasn’t ready or willing to go to treatment. The drugs had a grip on him. We sought guidance from an intervention specialist but our gut told us this was not the right person, not the right time, not the right approach. The meetings we had were such a disappointment and ended when the intervention specialist told me I was in denial about our son’s problem. Yep, me. Right. Not so. What follows is a quick vent that I typed up that afternoon … but never sent. Sometimes it’s just good to pound it out on the keyboard. Today, I thought other parents and professionals might benefit from this perspective.

Contrary to what (the intervention specialist we met with in 2011) believes, it is based on limited knowledge of me compounded by poor listening skills. Perhaps it was a “test” of my emotional stamina, open mindedness and ability to accept feedback or how explosive I might be during an intervention if I felt attacked, but back in May I was not at 11 on a scale of 1 to 10 for my own recovery; today I am not at a 9.  My therapist, Al-Anon and the online parenting forum that I participate in — all groups who know me far more authentically — would say otherwise.

I will let go of (my son), but I will not abandon nor alienate him — he already feels these to a certain degree. I will not enable him, but I will continue to let him know the family life continues and that our home is a place of comfort and joy, which he may visit but not live as an active addict. I am modeling real love.

I am not in denial nor am I marginalizing his problem.

Midwestern Mama

 

©2016 Our Young Addicts            All Rights Reserved

At Wits End with Your Teen’s Substance Use? The T.E.A.M. Approach is a Better Fit ThanTraditional Intervention for Young Adults

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Today’s guest blog post is by Drew Horowitz, MA, LADC, RAS, CIP, a Twin Cities-based substance use and mental health professional. Welcome to the #OYACommunity, and thank you for sharing part 2 of a 3-part series with our readers.

Recently I had a conversation with a mom from North Dakota, and truthfully, it’s a typical conversation I have with parents all over the country.

The mom asked, “Would you be able to come pick up my 22-year-old son and bring him to treatment in Minnesota?”

“Sure.” I replied. “I would be happy to help your son get the treatment he needs. What day are you thinking?”

Her reply: “Well that’s the thing, he doesn’t exactly want to go nor does he think he has a problem”

“Oooookay,” I said with an extended tone. “Well how exactly do you want this to happen?”

The parent went on to explain her utter exhaustion with her son’s addiction and reported that she and her husband were simply “done.” She wanted her son out ASAP and in a treatment center by the end of the week.

I asked the mother, “Have you tried to encourage your son to seek treatment, and if so what did he say?”

Her words: “I have told him over and over again that he has a serious drug problem and he is not the son we raised”.

Enough said, I understood.

The Traditional Approach to Intervention Doesn’t Work Well with Teens

In previous years, my common response entailed an immediate plan of action to quickly intervene and remove the young adult from the environment. The plan would have been simple, either he would come with me to Minnesota or exit the home and live independently (potentially with police involvement). Additionally, I would have placed the element of fear inside his head, by letting him believe that he either came with me or he positioned himself near death.

Using this traditional approach, I have conducted countless interventions nationwide. Repeatedly, I showed up at homes around the country and informed young adults that they had two choices: A. Go into treatment TODAY or B. live independently on the streets without the support of family or friends.

Addicted or not, almost 80% made the choice to reluctantly enter treatment. Leveraged into a corner, the young adult considers living independently on the streets, however, generally sees that treatment may be a better option.

That being said, it’s almost never a fairy-tale ending.

An extremely high percent of those admissions did not stay sober or even remain in treatment.

Families would call me a few weeks later and ask for help – in complete despair with the rebellious nature of their son or daughter.

A Realization in the Making

Continually, I was saddened by what I was seeing and it personally effected me. I realized that I was not actually providing a beneficial service to families as THEY, the families, were essentially dictating the course of action.

I posed the question to myself, “Shouldn’t it be I, the professional, to provide the family with the best option to support their son or daughter?” I pondered on that thought and knew that there must be a better way to do this!

Launching a New, Improved Approach to Helping Young Adults with Addiction

In August 2014, when I founded Drew Horowitz & Associates, I decided that my method of intervention would change. My objective would be to incorporate a strength-based, empowering approach to intervention.

The new approach is called the “Teen Environmental Advancement Model” (T.E.A.M) and it’s designed to help teenagers and young adults seek treatment for their existing substance use disorder.

It does not use leverage or force to move them into a recovery setting. Instead, this model works to educate people on themselves, identify values and aspirations, draw discrepancy between existing behavior and goals and learn about steps that best position them to be successful in life.

In my professional opinion, it made much more sense to “meet the client where they are at” and guide them through a process to begin understanding the detriment of their behavior. Not only does this model help the individual make their own decision to enter treatment, but also it increases the odds of long-term sobriety.

T.E.A.M. Work (Teen Environmental Advancement Model) 

Let me share the approach with you in with the counselor applies empathy, genuineness, self-disclosure and compassion and in which we continually work to strengthen rapport and alliance with the young person.

  • Preparation: This consists of the counselor gathering information from family and friends regarding the condition of the identified young person. This process helps the counselor come to understand the person of concern.
  • Introducing the idea: The counselor provides a suggested script for families to use when they introduce their loved one with the idea of meeting a counselor. The counselor then coaches parents and other family members on how to answer the person’s questions and address their objections, thereafter helping families overcome those barriers and create a segue for the counselor to meet with the person.
  • Meeting the Young Person: Next, we schedule a first meeting between the person of concern and the counselor. The counselor begins building rapport and establishing trust, taking an empathetic and person-centered approach that differentiates between the people being “sick” versus “bad.”
  • Building Discrepancy: At this point, the counselor meets with the person of concern to help identify goals, aspirations and personal values, continuing throughout to build rapport and validate the person’s thoughts, feelings and frustrations. While encouraging the person to attain their vision, the counselor begins the process of building discrepancy between the ways the person is living versus their values. The counselor methodically works to help the person see that their current behavior isn’t allowing them to be the person they want to be. In most cases, the person of concern starts to become self-aware of their destructive behaviors and agrees with some need for change.
  • Making a Recommendation: Now the counselor recommends a course of action. This involves remaining non-confrontational and compassionate while informing the person that the next step in moving forward and accomplishing their goals entails entering a treatment program of some type. Opposition and frustration are typical responses, to which the counselor reminds the person that by seeking treatment they best position themselves to be successful in life and attain goals. However, the person is never forced into treatment, but instead is encouraged to keep an open mind about the process. It is not uncommon for the person to start at a lower level of care and work up to an in-patient setting.
  • Entering Treatment: The counselor arranges transport to the treatment facility and, in the interim, prepares the person for their treatment experience, investing considerable time in articulating to the person how much courage and strength they’re demonstrating by taking this life-changing step.
  • Moving Forward: At this point, the person of concern is under the care of the treatment provider and it’s critical that they remain on track. Toward that end, the counselor’s role changes to that of a clinical case manager for the person and a family educator for their loved ones. Ideally, the counselor visits the person in treatment weekly or biweekly, depending on the facility’s location.
  • Providing After Care: As primary treatment concludes, the person of concern receives a recommendation for continuing care. The counselor supports the treatment program’s recommendation and encourages the person to follow through, applying intervention tactics and working with the family as needed to ensure that they take the appropriate aftercare steps.
  • Turning it Over: The counselor’s involvement isn’t intended to be long-term. The hope is, after a period of time, the person of concern will no longer be a concern. The counselor defers to the recovery community and encourages the person to lean on their new found community—their sponsor and peers—for ongoing support. That said, the counselor never declines a phone call or meeting request.

Using the T.E.A.M. model, I have seen a massive increase in positive outcomes among young adults: Pleasant goodbyes from home, motivation in treatment to get healthy, abiding by aftercare recommendations and active participation in the recovery process.

In order to be effective with today’s vulnerable young adult population, we must promote autonomy, strength and mutuality. I now leave interventions with a sense of inner peace and hopefulness that I had never experienced in the past. More importantly, our young loved ones and their families are finding a similar inner peace and hopefulness, too.

Drew Horowitz, MA, LADC, RAS, has a vast range of experiences working with addiction and mental health. He gained a wealth of knowledge through his own recovery coupled with extensive training: a master’s level education from the Hazelden Graduate School of Addiction and an undergraduate degree in psychology and human development from Hofstra University. Following a career with several substance abuse and mental health organizations, he formed Drew Horowitz & Associates, LLC, an organization designed to assist young men who struggle to overcome addiction and mental health.

Drew Horowitz, MA, LADC, RAS, CIP
Drew Horowitz, MA, LADC, RAS, CIP
Contact Drew:

http://drewhorowitzassociates.com/

horowitzassociates@gmail.com

651-698-7358

©2015 Our Young Addicts         All Rights Reserved

A Heartwarming Phone Call on a Cold November Evening

11-17-14

Midwestern Mama gets an unexpected phone call that warms her heart on a cold November evening; her son is making amends, recovery is in progress!

It may only be November, but winter is already upon us in Minnesota. The snow and freezing cold temps started about a week ago, an earlier and more frigid start than usual even for this part of the country. We’re craving comfort food to warm our souls. We’ve donned down jackets and mittens, and yes, we’ve already had to shovel the driveway – several times. And, yes, we know that this is only the beginning.

At a time when the seasons are in transition and one year begins to wrap up, it seems my son’s addiction and recovery are also in transition. This time, it feels like a new beginning even though it means trudging through snow and navigating slippery roads.

The hard work underway is welcome. The challenging conditions are welcome. This is indeed the time to express gratitude, to celebrate the season upon us. An unexpected phone call last night reinforced that the hard work and challenging conditions are just the right events at the right time.

Usually when the parent of a young addict mentions a phone call, it conjures up scary and unpleasant things. Even for the parent of a son in recovery, a phone call can trigger all kinds of emotions. This phone call, however, was the best kind of surprise – unexpected and heartwarming.

My son had spent the day with one of his childhood, sober friends. This friend has stuck by him all these years and was part of a family intervention about six months ago. They hung out, played video games, had lunch together, talked about their jobs, you know, just regular stuff that’s popular with 22 year olds.

The phone call I received that evening, however, was from the friend’s mother. (She’s been privy to my son’s addiction and has been a supportive family friend. ) That afternoon on her kitchen counter, she found three twenty-dollar bills and a handwritten note of apology from my son. He said he was sorry for stealing from her and was grateful for how wonderful their family had always been to him.   The mom told me the incident had happened a few years ago and she never knew until now that it had been my son, although she’d had her suspicions. In tears, she said she was so proud of him. By this time, I was teary-eyed, too.

My heart was warm. It remains warm. This was such a big step forward. This was such a sign that recovery is taking hold.

Midwestern Mama

Never Say Never

Midwestern Mama and her family have been modeling for us what it means to be the loving support system for a family member with a substance use disorder. They keep him close and include him in family activities without enabling or condoning his use. They treat him with dignity and respect, while encouraging him to get the help he needs. This is a very difficult line to walk and it’s easy to step outside the path, but I believe it’s better to make mistakes and keep our loved ones close.

I have always said to both my sons that I am glad God gave them to me. Someday I believe Midwestern Mama’s son will tell his family that he is glad God gave him to them.

Recently Midwestern Mama tweeted “I keep praying that a guardian angel will show up and that my son will trust and have faith in the help this angel offers.” It looks to me that that angel has shown up and it’s guiding this family.

“Never, never, never give up.” Winston Churchill

Mid Atlantic Mom

Where’s the reset button? It’s time to reboot.

Techie or not, most of us know that when something electronic is not working that hitting the reset button – rebooting – is often the best thing to do.  Amateurs and professionals alike suggest it as a first course of action.  Sometimes it works and sometimes it doesn’t.

It got me thinking that we have hit the reset button and attempted to reboot many times since addiction started messing with our son’s wiring.  Research on drugs and alcohol continues to show substantial, detrimental impact on the brain – a complex network of wiring and chemicals – even when used recreationally.  So, it seems like the computer analogy applies when a loved one is affected by chronic substance use and its various repercussions.

Within a few days of leaving his recovery program – early, against their recommendations and without a solid plan in place — my son reverted to his previous coping mechanisms and behavior patterns.  It’s now been about five weeks and what I’m observing is not very encouraging.  It’s downright sad.

When a loved one has gone haywire, it feels like it’s time to  is an attempt to do just that: to push the reset button, to reboot. However, the only buttons to which we have access are our own.  Hard as it is, the only reboot button that I can push is my own.

Midwestern Mama