The epitome of the OYA Community is having parents and professionals come together to share experiences, offer resources and provide hope. This is what that looks like in my home-town community. What’s happening in your community? Let’s collaborate and share content to address the issue of substance use among young people.
This is the third of a three-part series by @DrewHorowitz, a recovery coach and interventionist who specializes in working with young adults and their families to work through addiction, treatment and recovery. Thank you, Drew, for sharing your professional insights to help families confronting substance use.
A young adult is a hybrid of an adolescent and an adult. I consider most young adults that I work with to be professional adolescents since they have not yet taken on the responsibilities of an adult and have been in graduate studies in adolescent behavior. The oppositional-defiant behavior coupled with the feeling that they are entitled to free room and board eventually causes parents to feel disrespected, resulting in anger. This cycle creates chaos between the young adult and parents, and the untreated addiction coupled with immaturity continues to dominate all parties involved.
A new study shows that nearly 7 million American’s aged 18-25 (more than one in five young adults) needed treatment for drug or alcohol use in the last year. The study, conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) also shows that 95 percent of these young adults did not receive the help they needed at a treatment facility. These levels have remained fairly stable since 2002. In addition, 96 percent of the young adults needing help did not believe they needed the help. Even among the 4 percent who thought they needed treatment in the last year but did not receive it, less than on third made any attempt to get treatment.
Why is it so hard?
Deemed the most challenging age group to treat, the young adult population has flooded drug and alcohol treatment centers throughout the country. Many treatment centers have developed specific tracks, while others have devoted their entire program to this population.
Why? Because young adults do not easily fit into an adolescent group or an adult addiction group. Usually the young adult is the only 24-year old in a group of adults with the average age of 38. The young adult will quickly use this fact as a reason why an addiction program is not what they really need. This patient cannot relate to the adult stressors of childcare, marriage nor the pressure and responsibility of paying bills (which he has never experienced).
Further, this same population cannot identify with the adolescent group either. Adolescents face different stressors and challenges with sobriety when compared to the young adult. Part of this confusion stems from the young adult believing that they are grown men, mature and no longer need “babysitting,” which sometimes occurs in adolescent treatment programming.
For this reason, the combination of young adults with adolescents can be extremely counterproductive, causing patients to leave against medical advice or “checking out” for most of treatment.
How to Treat Young Adults with Addiction
Recognizing the unique needs of this population is imperative for successful recovery. Any addiction treatment program that treats this age group must have the experience, the ability and the interest to deal with this population.
The onset of chemical dependency in the adolescent or young adult stage of human development can result in arrested development preventing the sufferer from maturing into healthy adulthood. For this reason, many young adults arrive at treatment with many childish like tendencies.
For example, the young adult may become argumentative with his or her counselor, push the rules of the program and potentially get them removed from the program for breaking rules. It is common for addiction counselors to create behavioral plans, threaten to involve law enforcement and family, while confronting the young person on their acting out.
This is one of the greatest mistakes that a counselor can make. Confrontation generally makes the situation much worse. Young adults are naturally oppositional and respond poorly to demands and threats. Therefore, when counselors become agitated and frustrated with their client, it amplifies the situation.
The young adult is accustomed to being spoken down to and told that they are out of line or misbehaving. By re-enforcing this pattern, it essentially tells the patient that they are “bad” or “misunderstood”, which pushes them further away and leaving them to cope by using substances.
Changing Our Approach to Treatment for Young Adults
The solution lies in taking a more empathetic, compassionate and caring role to validate frustrations and provide support. Taking a client-centered position and changing the cycle will ultimately create greater outcomes.
The key: to not become part of the dangerous downward cycle that this population creates. By engaging in arguments it fuels the addiction and leads to poor outcomes and early discharges from treatment. However, when validated, recognized and heard, the young person is almost left speechless and in awe by the counselors attitude. It is this understanding and rapport that sets the young adult up for success.
In my experience, this population suffers tremendously from low self-esteem and self-worth. At the basis of their illness rests strong feelings of inadequacy and failure. It is these emotions that fuel the addiction and keeps the young person caught in a cycle of anger and helplessness. For that reason, the foundation of treatment must be built on trust, empathy, support and unconditional positive regard. Additionally, it is crucial that they play a strong role in their recovery. Asking them to assist in writing their treatment plans, allowing involvement in aftercare planning and validating frustrations and concerns goes a very long way with this group.
I recently asked one of my clients, “How can I help you in your recovery?” His response, “Just treat me like a person.” This young man has been through several rigorous treatment programs and all have failed him. The treatment center is not entirely at fault, however many have not set the stage for their recovery.
It is imperative that prior to treating young-adult clients that counselors must first build a strong alliance where the patient and his or her counselor can walk with them through their recovery as opposed to dictating their recovery.
About Drew Horowitz, MA, LADC, RAS, CIP
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.
This week’s guest blogger has a familiar online presence: Substance For You. A substance user as a young adult, he offers personal experience, resources and hopes for the #OYACommunity. Today he writes about steps families can take to ensure success in early recovery.
Every parent wants to know two things when they have a child or loved one just getting clean for the first time. They want to know, “What could I have done different?” and the next most asked question is “Where do I go next to help prevent this from happening again?” It is important to know the issues surrounding key aspects of early recovery as you may have someone you love just now getting clean for the first time and not know where to go.
Below is a list of safety precautions one may implement in early recovery for their loved one to help guide the situations surrounding going back to addiction or relapsing. None of us want that to happen to someone we love, but we might be stuck in this very situation and not know where to go. With this comprehensive list of precautions to take in early recovery you can now easily set guidelines, rules, and stipulations that both the loved one and lover(s) can be held accountable for in guiding them to a new found wonderful path of recovery. With this list it will make it easier to understand the dangers surrounding things like money, responsibilities, and making relapse completely inaccessible to the addict, to the very best of your ability.
How do I know these tips will work? Well, this is almost word for word the conversation that my parents and I had when I first decided to come home from rehab after a year long stint with heroin and a previous year long stint with opiate pills like Vicodin and Oxycontin along with benzodiazapem and muscle relaxant abuse. Not to mention I was a chronic alcoholic I had always been spending my money illegally in all of these aspects, considering I got clean by the time I was twenty years of age.
This list is one of the key factors into how I kept my triggers and opportunities extremely low for relapse. With this list of precautions to take in early recovery I could guide myself in reteaching myself the rights and wrongs, the social contract we all live and abide by, and the social norms that were considered to be good instead of my deviant life I was living. This was a pivotal turning point in my recovery and I have one thing to say to the people that implanted it.
“Thank you mom and dad for NOT being easy on me. Thank you for doing the right thing no matter the lines we had to cross to get there. Without this and your love I don’t know where I’d be. I’m forever grateful and humbled by your poise to implant these tools into my life, and I know now that I couldn’t have done it without you, my support system. Mom: I love you for your emotion and compassion that made me realize it’s time to listen and make a change. Dad: I love you for always butting heads with me but being able to control the impulses yourself, God knows I had enough of them. You were both strong and held your ground. You didn’t enable. You are what guided my recovery, and these tools work if ever you needed affirmation to that! Thank you! I love you momma and pops!”
1. Give Access to Your Money to Someone Trusted- In the first thirty or ninety days or even my first six months I always had a rule: “No Cash.” This meant that I wouldn’t carry any cash on me or have any credit or debit cards that could act as cash for me. If I was going somewhere I knew I would take the specific amounted needed to get the job done, say filling up the gas tank. The reason being for all of this precaution was my urge to splurge. I always wanted to find some new fixation to spend my money on, and it always ended up being something so negative or not appropriate for a clean and healthy lifestyle. If my urge to splurge wasn’t fixated on something negative that you could buy at any convenient shop, I might go to the extreme. If there was nothing to satisfy my urge to splurge with any legal means—although still feeding my reward center in my brain—I would tell myself: “Well you have the money, it’s here and it’s now or never.” My thinking mind would always say to itself that if you have the money and it’s not gone when you get home, and you really don’t want what you intended, why not get some dope? This was a constant battle because in early recovery I always wanted dope more than I wanted something of material possession from say a “JC Penny” or gas from a “Speedway.” This is just something my brain was so accustomed to spending my own money on. It is safer to be on no money and have the urge not there at all than it is to have “Extra spending cash.” Then, if I didn’t come home with all the money spent that was given to me my parents would ask, “Where did the money really go? Show me proof?” And this brings me to my next point: “Receipts.”
2. Parents: Require Receipts from Your Children in Early Recovery- In my early recovery, I know I said only take what you know you will spend. So, what if you do spend all of the money you are given, but you still spend it on dope? How are you held accountable? Well here is how it worked in my family. My parents would give me a certain amount of money—say $20 for gas—and would write down the amount in a “little black book” they kept handy. Then when I got home from getting the gas I would always be required to immediately hand my father the receipt that said $20 on it, and sometimes check my pockets and gas tank (not always for the second two but you can). If the receipt did not say $20 on it and it said $16.84, I would be required to produce $3.16 to them, write it down for reference, and the reason there was change. I know this seems tedious, but it most certainly worked. For starters there was no fooling anyone. Secondly keeping me accountable in my daily actions showed me the way the world really worked, and it wasn’t the way I thought it did when living in my addiction. Everyone is held accountable for his or her actions, good or bad. And thirdly, if I broke the rules and couldn’t produce a receipt, whether it was accidental or not, there were always consequences that were written out in an agreement signed by my parents and me. As my dad always said, “You sign this, it is legally binding. You break my rules then you break the law. You do dope, you won’t have me to answer to this time.” This didn’t just keep me accountable with my parents for my actions, but it put things into perspective if I was to get dope with the money and that is, I’d be going to jail for a felony case. Why would my own parent do this? “Well, son I do this because this is my house and if anyone brings felony drugs and paraphernalia into my house who do you think they will be taking to prison? Me or you? The house owner or tenant?” Now you understand what this written contract does, it doesn’t only protect me from screwing up, it protects my family if I was to actually go and screw up. I would never purposefully hurt my family, but addiction can play crazy tricks on your mind. So for the safety of the household, my mom, dad, and little brother I signed the contract willingly and was on my way to the next part of acceptance.
3. Keep a contract/written rules signed by both parties of actions versus consequences- This is the ultimate ending to parts one and two. With keeping this you know that the money that is being trusted by someone else is being respected. Then, you also know the money they do give you to do responsible things with is being spent within your and their—well thought out—boundaries. Without having an actions versus consequence list, guideline, or rulebook there would be no reason to abide by these rules and this would increase the chance of relapse in early recovery ten fold. We as the addicts have not been able to keep good inventory of ourselves in our addiction and our behavior in early recovery isn’t going to be too much changed to where we would know the differences of our actions. So in consequence of this we trust someone like a parent or mentor with our funds and give them a peace of mind and our own habits safety to their enforced contract. Parents/mentors you must be willing to enforce this contract, and leave enabling to the drugs themselves. Playing into the disease will do no one any good so make sure when you both sign this you are both ready for the consequences. Without keeping that little black book you may lose track and get confused and then make assumptions that could cause the addict to use just because you miscalculated totals, also. So when doing this be tedious and be careful, as it is well deserved and earned at this point once both parties are wanting to help to better not just one person but each other. Be cautious, be safe, but don’t forget it is the love that binds us together in all of these. We don’t do it because we have to; we do it because we don’t want to see the other fail. Simply, we do it because we love them! It’s not a contract of “What ifs” and “Well he/she said.” It’s a contract bonded by love and care for the betterment of each other in early recovery, positive lifestyle living, and beating addictions.
About the Author:
The owner of www.SubstanceForYou.com wrote and published this post. Substance For You is lifestyle brand providing hope for addictions and recoveries. We share personal stories, scientific and philosophical debates, and stories for betterment encouraging a positive and sober lifestyle. It is a place for someone who has either found recovery or is either looking for recovery and has an array of subjects covered with nearly 200 articles. Substance For You also offers 20+ sobriety and addiction recovery clothing and apparel items in their widely known sobriety shop on the website, that is meant to inspire and create social change in this world that proves, recovery is truly possible. We hope to provide a friendly reminder to anyone who is out there that we are there for them in any part of their journey and encourage sharing on our site with submissions going directly to the owner at SubstanceForYou@gmail.com
We are growing fast on Twitter (@SubstanceForyou) with 21,000 followers, and expanding fast on Facebook.com/SubstanceForYou with 3,000+ followers, and have 8,000+ followers on our Instagram.com/SubstanceForYouIG . Please join us in our movement as the owner will be nearing his 5 years clean of his demons (Alcohol and Heroin/Opiates) on December 25th, yes Christmas! On the blog we are expanding the series The Substance For You Saga into a 20 part series (Yes the size of an addiction recovery book!). Come find out what we are all about and what the owner and www.SubstanceForYou.com stands for! Remember it is possible as long as you stay clean and do the right thing. You can do it! I believe in you!
When Midwestern Mama’s son first went to treatment in 2011, she found online news articles about a young man who had attended the same program and had recently published a memoir about his experience. She emailed him and was pleasantly surprised to get a response. In the long years ahead, Midwestern Mama and Chad Hepler stayed in contact – ever grateful for his insights, support and encouragement all from a young man’s perspective. Today, Chad Hepler is a certified addiction counselor serving adolescents and their parents. Read what he has to say about the process of recovery.
Addiction and recovery is a process. A person does not become a rock bottom drug user overnight. It takes time. Just like the process of recovery.
This “process” is best explained by Prochaska & DiClemente’s five stages of change. In this article, I will examine the first two stages, precontemplation and contemplation, and how they relate to the teenage drug user. I will also discuss how parents survive this “process” of recovery.
The precontemplation stage is essentially denial. During this stage, the user does not believe there is a problem.
They are not considering change and generally do not care what you have to say in regards to their substance use.
A large percentage of users fall into this stage even when their life seems to be crumbling around them. This is the reason, insanity, is paired with addiction.
From an outsider’s perspective, it is painfully obvious the drug use is the problem, but the user just keeps on pushing.
There is no logical answer as to why a person continues to use, it’s simply insane. It’s doing the same thing over and over but expecting different results. Or as one of my patients said, “It’s doing the same thing over and over, knowing damn well, nothing will change.”
As an adolescent addiction counselor, I am faced everyday with the teenage drug user in the precontemplation stage. My goal is to move them from precontemplation to contemplation.
If I can help the teen reconsider their drug use, then I have succeeded. Nothing will mess up a good buzz more than a mindset of ambivalence.
Like they say in the rooms of AA, there’s nothing worse than a stomach full of booze and a mind full of AA. Sure, I would love to say my goal is long term recovery without a relapse, but quite frankly, that would be insane.
So how do the non-users maintain their sanity, while the drug user goes through this “process?” They work on themselves. They attend a self-help group, such as Alanon, Alateen, Naranon, and Families Anonymous. They get a sponsor, they work the steps, and they love and support their user’s recovery, not their addiction.
Chad Hepler is a Certified Addiction Counselor, working with adolescents for the last five years in a psychiatric hospital setting. He is also the author of two memoirs of his own addiction and recovery, Intervention: Anything But My Own Skin and Beyond Intervention: A Memoir of Addiction and Recovery.
Sunday night reflection. Our Young Addicts all started with a single word: Addiction. It has grown into a word that means many, together: #OYACommunity
In what seems like eons, but in reality spans 2009 – 2015, I’ve penned at least 1,000,000 words; as of today, nearly 7,000 tweets; well over 1,000 pages of draft copy, 100-plus blog posts. Additionally, for a few years, I wrote a bi-weekly newspaper column that ran in the St. Paul Pioneer Press and I continue to write for a feature article here and there for magazines.
How did it all start? It started with concerns about my teen-age son. Thing were happening so quickly that it was hard to keep track of everything, so I began taking notes in simple, black-and-white composition books. From there, I would type up the notes to maintain a chronology of professionals we consulted, of my son’s behavior, words and actions, and of the maze of solutions we pursued. Later, the notebooks became my journal that I took to Ala-non meetings and to sessions with a therapist to work through feelings, concerns and hopes.
All together, these hand-written pages were the foundation for Our Young Addicts, a concept that is evolving from addiction to community, and I could not be prouder or more excited about the future.
The stats are startling. Each one that I read is riveting on its own. Together, it’s downright overwhelming. But stats don’t tell the story, and stats don’t solve the problem. That’s why I’m glad you’re part of the #OYACommunity – we need you, and we need your stories to personalize the stats, and hopefully to see these diminish.
A recent survey revealed that parents are more concerned about teens mental health than substance use: http://www.drugfree.org/join-together/mental-health-greater-worry-substance-abuse-parents-teens-survey-finds/?utm_source=Stay+Informed+-+latest+tips%2C+resources+and+news&utm_campaign=35bd1152ce-_JT_Daily_News_Controversial_Bud_Light&utm_medium=email&utm_term=0_34168a2307-35bd1152ce-223036473
Another source offers 20 stats about teen substance use:
I’m not anti stats, and I don’t want to stop reading these – I just want to do more. I want our #OYACommunity to share experiences, resources and hopes, and the best way to begin by being informed. So, I’ll keep seeking and sharing the stats … as if any of us need convincing that there are way too many young people becoming addicted to drugs and alcohol.
Midwestern Mama is convinced that the signs of drug and alcohol use are right before us. You can see it, smell it, feel it, taste it and hear it. Let the “Mom (or Dad) Radar” guide you in identifying use before it gets out of hand.
It was April 2010 that we first confirmed our son’s drug use. He was a senior in high school and we had suspected drug use but he denied it and we hadn’t found actual evidence. He later confirmed he started with marijuana in summer 2009.
For a full year prior, his behavior and attitude started to change and although we addressed these head on with a visit to the doctor to rule out anything physical followed by family counseling and individual sessions to identify the emotional and mental needs. He always flat-out denied drug use, and stupid as it sounds, we didn’t know how to drug test him.
We later learned that you can get inexpensive marijuana and other drug tests at places like Wal-greens; while not the most thorough, these can be a starting place. There are also a variety of other places to purchase Urine Analysis drug tests. We thought you had to go to a hospital or doctor’s office – we just didn’t know and it was nearly impossible to find answers even among professionals or online. Crazy, I know. Live and learn.)
Some of our observations included changes in sleep patterns, changes in friends, lying, poor attitude toward family activities, not turning in homework, skipping class, and more. Our first thought was some kind of depression and because bi-polar runs in the family, it was a natural concern. However, it was more than mood, it was agitated, angst and other exhibits that really concerned us and gave us reason to suspect drugs.
The timing of our realizations is key here. April. Spring. Spring fever. Kids being kids? Right of passage? NO WAY. Yet, kids get tired of school and sports routines. They feel their oats, as it were. It’s spring break, it’s prom season, it’s graduation coming soon, it’s all kinds of feelings and situations where we trust them because we’ve had all the right conversations, and yet, they make choices that sometimes lead places they never imaging – like experimentation, recreational use, substance abuse, addiction, consequence, and worse.
So what’s a parent to do? I’m big on trust and communication. However, because of our experience with our son, I’m also big on the five senses.
- Eyes: Keep an eye out. Become an observer. Take notes. Watch for patterns and changes. Open your eyes to the possibilities – even the unthinkable ones. Drug and alcohol use is often right in front of us, yet we miss it.
- Ears: Listen. You know the expression, God gave us two ears and one mouth. Resist the urge to lecture, yell, tell, etc., even though it’s OK and important for our kids to know how strongly we feel about the negative impact of drug and alcohol use among young adults. Listen in your conversations – hear their tone and think about its meaning (intended or just teenage-ease). Without being an overt eavesdropper, pay attention to their interactions with other people – on the phone, in person, etc. Are they talking in code?
- Mouth: Above, I addressed talking, so here I want to talk about taste. No, not actual tasting – that could be nasty and dangerous! However, there’s taste as in does this interaction, observation, etc. leave a bad taste in my mouth? There’s also a sense of is their action, behavior and communication in good taste? For example, my son stopped wanting to receive gifts from family members – even Grandma! – and definitively didn’t believe he should have to say thank you for gifts he didn’t ask for or want. Whoa! This was not the polite son we had known. This was a bitter, negative person and it left a really bad taste in our mouths.
- Touch: Sometimes there’s a point when our kids don’t want to be touched, even hugged. I get that and as they mature, they become loving again. But let’s think about touch – if they recoil, they may be hiding something. Also, you never know what you might feel. I would feel my son’s jacket and backpack – sort of like a pat down at the airport – and from there, I started to find all kinds of things: lighters, matches, Visine, hollow tubes used to snort, empty baggies with oregano-looking flecks (marijuana), and more. One day, his backpack was particularly heavy and I gave it a gentle kick with my foot. Ouch! There was something large and hard inside – an expensive, gigantic glass bong.
- Nose: That same backpack smelled horrible. There was a wet towel drenched with filthy bong water. Yuck. Also pay attention to smells to mask drug use – body spray to cover up smoking and other chemical smells that are related to drugs; strong mints to cover up alcohol use or smoking; Febreze or Lysol sprayed in the car. The smell of marijuana itself. And more.
There are so many clues that may indicate drug and alcohol use, and as parents we have to rely on our five senses and our gut – what I fondly refer to as Mom (or Dad) Radar. Without a doubt, we know what is going on and we must address it before it’s too late.