We here at Addiction Blog strive to help parents raise healthy young people. In this interview, we hope to help you define and recognize problems with drugs or alcohol early. So, if you’re a worried parent, know first that you are not alone. However, we encourage you to learn about addiction treatment for teens and to react quickly.
Is my teenager using drugs?
If you think there is a problem, there probably is.
It’s a fact that teenagers are more inclined to take risks and show impulsive behavior. Drug use can sometimes be a part of that behavior, and the struggle of every parent is to notice problems on time and to react. So, what can a parent do after the first hint of drug use in their teen? How can parents start to recognize the influence of drugs in the first place? And what can they do about it?
Today we talk with Daren Casagrande, Associate Director of Outpatient Services for Advent Group Ministries, and have put your questions to the experts. The goal? To provide you with as much information as possible in the battle with teen addiction. However, if you have more questions or want to share your experience, please address them in the comments section below. We will try to answer all of your questions quickly and personally.
ADDICTION BLOG: What is the #1 most important sign of adolescent drug abuse in teens?
ADVENT GROUP: The obvious sign of drug use in teens is of them coming home looking high or drunk, or even finding paraphernalia.
Still, this is a relatively complex thing to answer, but truthfully the greatest and earliest indicator would be a noticeable and significant shift in the behavior of your youth. Truthfully, the only trick to this is to really invest in your relationship with your child. With interest, you would be able to do detect this to begin with. This is by far the clearest indicator that there may be something wrong, but when I say investing in the relationship – I truly mean being interested in their life and the things that interest them.
What I do NOT mean is trying to squeeze every bit of information out of them you can to alleviate your own anxiety as a parent that they are not doing things you don’t agree with. This only causes the teen to turn inward to preserve their own sense of growing autonomy (which is developmentally appropriate). That, in turn, means they aren’t involving you in their decision making-processes.
When a parent is not invited into a teen’s decision-making process, the result is that they rely on peer input, society’s input on the topic, or (if you’re lucky) another trustworthy adult. By the time they are teenagers, much of their internalizing of the values a parent has taught them is done or in process. What they are really doing is practicing living out those values or “trying on” other values if they determine that they disagree. By the time a child becomes a teenager the parent’s primary job is to maintain basic, maturity-appropriate boundaries, but to also teach them how to recover from their mistakes and think things through.
Statistically if you want indicators of what kids are likely to use drugs, it would be kids with:
- struggling GPA’s
- poor school attendance
- numerous friends who use drugs
- single parent families
- a socioeconomic environment that is near or below the poverty line
Those are all things we would typically think of anyway, but the strongest correlation is between how many hours a youth is home alone after school before a parent or guardian arrives home from work. The more hours between when school gets out and when the parent comes home, the more likely they are to do drugs.
An additional interesting factor is that having a family dinner where everyone gathers around a table to eat dinner together is one of the greatest preventative factors for the reasons I spoke of above. Kids that have an adult they are connected to that cares about their life and is interested in them are much less likely to use drugs. And family dinner is a daily accomplishment of this feat that is non-threatening and less socially pressured than “let’s sit down and talk.”
Consider that most teens that we treat in our programs who have significant substance abuse problems in adolescence started using between 8 and 13 years old. So, spending this quality time with your child and showing interest in their lives starts long before their teenage years.
ADDICTION BLOG: What about some other major signals that a teenager has a problem with drugs or alcohol?
ADVENT GROUP: When I describe this it will sound like I am describing every teenager that ever existed, but again, please only pay attention to what is different for your child’s “normal range of behavior.” Social indicators would be:
- a shift in friend groups
- a chance in activities with friends
- a withdrawal from family relationships
- staying out much later than normal
- sneaking out
- decline in school attendance or grades
- guardedness or deceptiveness in sharing about themselves
Emotionally you will notice that they may increase in:
- more extreme emotional highs and lows “depression-like” symptoms particularly after a time when you suspect they may have been high or if they were out exceptionally late with friends
Physically, you will notice:
- bloodshot/glassy eyes
- pupils that are much larger or smaller than everyone else in the room
- sometimes loss of weight
- significantly oversleeping or under-sleeping (10 hours a night is normal for an adolescent)
- a new and unexplained chronic cough
- frequently looking pale or ashy
Again, these are the very early signs. So, what you are really looking for are deviations in their normal behavior. If you do see some of these signs, the best solutions would be to talk to your kid about drug addiction and just directly ask them about drug use. Or, you can take them to a substance use professional for an assessment or interview. You can also talk to people that interact with your child a lot (such as teachers, parent’s friends, tutors, or coaches) to see if they have seen any concerning behaviors. Problematic use will eventually start to show up across multiple domains of their life.
ADDICTION BLOG: What are three steps I can take immediately if I think my kid is using drugs?
ADVENT GROUP: As a precursor, if you have no direct evidence I would not accuse them. Instead, I would ask them if they are using drug because you are interested in helping them with whatever they are facing. I know it is upsetting as a parent to suspect your child is using drugs, but condemning it will assure they will not feel safe to continue to talk to you about it.
ADDICTION BLOG: So, what are your three steps if Addiction Blog hopes to contribute to the fight against addiction.
ADVENT GROUP:We strive to help parents raise healthy young people. In this interview, we hope to reach concerned parents and help them define and recognize possible problems with drugs or alcohol,and to encourage you to react on time and in the best possible way.
Suspect your child is using drugs?
1) Process your concerns and develop a game plan depending on how your child might respond. Do this as a parent first. Talk through the topic with your spouse, family, or close friends. Journal if you need to. Seek counseling yourself. Process it until you’re ready to have a calm conversation with your child.
2) Ask them. Tell them you’ve been concerned by their behavior lately and that you care about them so you are concerned for their well-being. Regardless of their answer use this as a starting point for the conversation.
3) Get help. If they tell you they haven’t been doing it, then offer (or ask them) to enroll them in regular counseling. Then, make a concerted effort to spend more quality time with them with interest in their life and interests. Consider this an opportunity to get them extra support and “gather more data.”
If you have no proof, it could be very damaging to trust to falsely accuse them. If they say yes, then thank them for the honesty and remind that you love them. Then follow that up by getting an assessment done by someone with specific training in drug and alcohol issues (a normal mental health counselor does not have specific training – MFT or MSW). This professional can offer recommendations for what type of care would best suit the needs of your child as well as yourself.
Most families also need support to figure out how to best support their child. Whether your child says yes or no, consider getting support for yourself in the form of a counselor or support groups such as CoDA of Al-Anon.
ADDICTION BLOG: Who should I tell if I suspect my teen is using drugs? Who can I share this information with and who should I avoid telling?
ADVENT GROUP: If you suspect your teen is using drugs I would recommend only talking to your closest support people (spouse, family, or close friends). You need support, but you don’t need to shame your child. They feel enough shame about their choices already whether they express it or not.
I would also seek support for yourself as a parent, either through counseling, spiritual counsel, or public support groups such as CoDA or AL-Anon. As always, safety trumps all, so if you need to tell another adult for safety purposes that is appropriate as well. This generally includes adults that are helping to raise the child whether they are in the home or not.
As a general rule, I would avoid telling people that are untrained in matters of substance abuse as they tend to overreact and create more problems. For instance, unless their school already knows this, I would not share it with the schools. School personnel are not trained in these issues, and tend to operate out of their personal fears and ideas about what substance abuse or addiction is. This generally results in them turning a suspicious eye toward your child, or falsely accusing them, or generally treating them differently than they would have before (not in a good way). This can only make the problem worse as the youth feels more socially isolated and stigmatized. This then causes them to use their “go-to” coping method for stress, which for most youth we treat becomes their drug of choice. So, I would avoid telling school staff, but you can ask teachers how your child is doing behaviorally or if they see anything concerning.
Telling the authorities is a personal decision, but there are several things to consider:
- Is your child creating a safety issue in the home?
- Is your child out of control and becoming a safety issue for themselves?
- Is your child out of control and in need of accountability?
- Is preventing them from legal consequences enabling their behavior and increasing the likelihood that they won’t change their behavior before adulthood?
- Is their behavior creating a financial/legal risk for you (under 18 you are legally responsible for their actions)?
Sometimes, avoiding legal consequences is more helpful to a child that is not in a severe situation yet, but other times it can be vitally important to helping them see that their actions have real life consequence. The truth of the matter is that legal involvement before age 18 is preferable in the sense that it allows them to see where they are heading before their record becomes permanent (in most cases kids can get their record sealed or expunged once 18). Once they are 18, this is very difficult to do and severely impacts opportunities for employment – perpetuating their challenges. Additionally, once they are 18 there is a lot less graciousness from the legal system.
The juvenile court system is designed for juveniles, and is more likely to work with a child and their families to rehabilitate rather than purely punish. One important consideration as well is that being involved in the legal system does cost the parent money: for being incarcerated, house arrest, and potentially restitution (at present in Santa Clara County it depends on what you earn). Lastly, the reality is that depending on the judge and probation officer, your child successfully completing probation can range from quite difficult to overly easy. Legal involvement can also further reduce a child’s self-confidence further, so it should always be a thoughtful decision unless they acquire charges on their own.
In the state of California there is unfortunately little recourse that parents have at a certain point beside legal involvement because minors cannot be enrolled in something against their will (like military school, or residential treatment) even if the parent orders it in the best interest of the child. The only mandated detention would be due to breaking the law or safety to self or others (hospitalization).
ADDICTION BLOG: Will my teen go to jail for using drugs?
ADVENT GROUP: They certainly can, and in some cases they probably should (see my answer the above question). In some states (like California), there are now amounts of certain drugs that will result in a misdemeanor citation rather than a felony. This means they will get a ticket rather than a court date.
If your child is a first time offender in Santa Clara County, you should see if they qualify for a program called Deferred Entry into Justice (DEJ). This gives the child an opportunity to get the charges dropped if they obey certain court requirements and they are put on informal probation which comes with less restriction. Most other counties undoubtedly have an equivalent program. If your child gets in trouble with the law, but has mental health issues in Santa Clara County, I would definitely look into either a Mental Health Court (for more severe issues) or Juvenile Treatment Court (JTC) for less severe cases. These courts try to address the underlying mental health issue in addition to any legal accountability, and are more collaborative between the legal system, health care providers, and the family.
ADDICTION BLOG: How do I know if my teen needs treatment for drug problems, or not?
ADVENT GROUP: This is extremely difficult to evaluate as a parents or guardian as you are too close to the situation to generally be objective in evaluating your child. This is why the inclusion of a drug and alcohol professional for assessment is critical. Again, I would seek out an agency or person who has specific training in drug and alcohol issues.
You should be able to use the Santa Clara County Gateway to get resources (800-488-9919 ) or find a private provider of your liking on your own. Possible physical symptoms that are signs of addiction and need immediate medical supervision would be: hand or limb tremors (the “shakes”), noticeable withdrawal symptoms, or tolerance (where they need more drug to get high).
ADDICTION BLOG: If my teen needs treatment, does s/he still go to school?
ADVENT GROUP: Yes. Under 18 years old, children are required to be in school and receive education – whether they are in treatment or not. As such, any licensed treatment facility will offer this.
That being said, check with each provider to assess whether they are put on independent study, placed in a normal high school, or offered classes that are separate from the general school population. Also, assure that they are able to accommodate any unique educational needs your child may have. If anything, it is preferable to have them in a facility in which they are not educated with the general school population and thus given access to drugs and alcohol at school. That being said, your child will face that when they come home so it is something they will have to learn to cope with while in treatment.
ADDICTION BLOG: Can I visit my teen in an treatment center? What are the main benefits of treatment?
ADVENT GROUP: In most cases you can, but sometimes not initially. It is at the treatment providers discretion based on what would be of most benefit for your child. Sometimes it is more effective to have a separation period from the family and reincorporating them in the middle or end of treatment. Other times, it is more helpful to incorporate the family from the beginning. It must be understood that substance abuse and addiction is generally a family issue in that it affects everybody. Sometimes the best way to repair the situation is for everyone to separate, learn new skills, and then come back together to create new family patterns that incorporate those new skills. This is not a judgement on your parenting, this is simply acknowledging that things weren’t working before, and to make them work better we have to make some changes as a family.
The main benefit of treatment is that the child can learn to identify why they are using, and then developing healthier ways of dealing with that issue. One has to understand that substance abuse or addiction is method of coping with life – at its core it is pain avoidance (emotional, physical, or spiritual). Consider that if there was not a benefit of great value to the user, they would stop because it comes with a lot of consequences financially, physically, socially, emotionally, legally, etc. So whatever benefit they are receiving far outweighs the negative to them.
Understanding that, consider what must be so painful to them that it is worth all the other difficulties it causes. It may not have started out due to an immensely painful issue, but their substance use has most likely thrust them into much more painful circumstances that perpetuate it. Is it a destructive and ineffective way of coping with their pain? Yes. Does it kill the pain well? Yes. So it will continue to be appealing until we work with them to develop other effective ways for them to deal with this pain.
Lastly, once their use arrives at addiction or dependence it is not only the pain relief, but it becomes a drive (not just a thought!). At that point their body is telling them the drug is necessary for survival. A small and less intense parallel would how you feel when extremely thirsty or hungry. When you are extremely hungry or thirsty and food or water is placed in front of you but you are told you will be arrested if you eat or drink it, you are much more impulsive in that moment and likely to eat it no matter the consequence because your body is driving you toward something it has deemed necessary for survival.
Things that are addictive are addictive because they trick those systems in your body into believing that it is necessary for survival. Thus, you seek them out in the same way. Think of an overdose the same way you would an emaciated person who is given food and then eats so much and so fast that they actually harm themselves from overeating. It is the same bodily system, but it takes time for your body to assign a drug that level of priority – which is why someone is not addicted after the first time, but over the course of weeks or years (depending on age and individual physiology)
ADDICTION BLOG: What about transitional living? Does every teen need it?
ADVENT GROUP: Transitional living is something in between residential services and traditional outpatient. In a transitional living environment, the youth is allowed to go about their normal day but must return to a treatment center for the night for counseling and support. They live in the facility, but it is voluntary so they can come and go as they please as long as they follow house rules. Not every teen needs it, but it can be beneficial for youth that have been to residential and have difficulty transitioning back into “normal life” in their neighborhood, school, and family with all of their normal stressors. I generally recommend it for kids that are on their second (or more) round of residential treatment, or who have a particularly difficult home environment (for whatever reason).
ADDICTION BLOG: What are some things I should look for in a teen treatment center or aftercare living environment?
ADVENT GROUP: For a treatment center or aftercare living environment, you generally want to look for places that specialize in substance abuse and addiction. You also want to look for places that are more holistic in that they evaluate for underlying medical conditions or mental health conditions that may be driving the substance use (sometimes substance use is about self-medicating symptoms). I always think it is preferable that they include family counseling as a component of treatment. Generally, the more the treatment facility is in an urban place the higher the likelihood the youth may run from treatment, the more rural the less this it is likely because it becomes impractical (I wouldn’t NOT choose a facility for this reason, but it is a reality).
Ask them what their protocols are for kids that run, and ask whether they screen the kids in the program for violent tendencies or assess for safety to others before enrollment. I would also ask for an overview of their treatment model and focus to see if you are comfortable with it. Also ask if you can do a walk through of the facility when the other kids are at school to assure that it is clean and orderly. Explore all of your options. See what your private insurance offers, see what other organizations there are in the state, and see what publicly funded options there are through the county and state.
ADDICTION BLOG: How long does sober living usually last?
ADVENT GROUP: This can vary wildly from 45 days to 1 year. Generally the average is 3-6 months. This seems like a long time, but in reality longer is generally better as the teen has more time to establish deeply engrained patterns and to stabilize. Frankly, the first month or two can often be withdrawing from the drug, stabilizing, and then developing enough rapport with the staff to talk about the real issues. After that, it then takes about 90 days to establish long-lasting patterns (according to research). So it seems long, but a 6 month program is ideal if its available or you can afford it.
ADDICTION BLOG: What are the chances that my teen can overcome a problem with drugs or alcohol?
ADVENT GROUP: This is entirely dependent on one very important factor: do they want to change? If they do not, it is NOT very likely to be effective. This is why accusing them of using and forcing them into programs generally does not work. Generally the way that people move from not wanting to change, to wanting to change is through seeing the fallout of their decision making and taking time to reflect in a non-judgmental and caring environment. This is why withholding consequence can be enabling – they never get to see what their actions are causing in their life and the lives of those they love. This is also why constantly punishing them without showing them genuine love and concern for them will not help as it is trying to take the choice to change out of their hand.
So to help them get there, show them that you love them by continuing to offer help and expressing your concern for them, but also allow them to experience the natural consequences of their choices, let them know how they affect your life (in an appropriate way), and set personal boundaries around your life as you need to. Don’t punish while you’re angry or out of anger, punish out of compassion and genuine love for them. If you can’t, get help for you so that you can appropriately help them. Statistically speaking, the odds are very poor that they will overcome the problem unless they see it as a problem and want to change. Your part and treatment’s part, is trying to get them there so that treatment can help them arrive.
ADDICTION BLOG: What else should parents know about teenage drug use and its treatment?
ADVENT GROUP: Again, it is a family issue. So if your teen won’t get help or listen, then get help for everyone else in the family to create an environment that is healthy and therefore helping your teen to be more likely to seek and utilize help. If they want and get help, the likelihood of long-term damage is less likely. Many of the faculties impaired by drugs and alcohol can be restored with sober time, and the extent of the longer term damage is dependent on how hard the drug was, how long they used it, and their particular body chemistry. Knowing this and wanting them to change sooner is a beautiful sentiment, but you cannot make your child change – you can only change you. So sweep your side of the street and they will be more likely to sweep theirs.