When a relapse occurs Posted by:Lloyd Woodward--Wednesday, August 13, 2008

What do we say? For example, you have just given your teen a urine screen and he fails it. What strategy to employ?


There are two primary tasks to accomplish. First, give your teen a chance to admit that he has relapsed. If he admits it- give him credit for being honest about it. If not, give a second test on the same urine sample. If the second test comes back positive, express confusion and express confidence that the test instruments are reliable. Don't expect an immediate confession but continue to express confusion and let your teen know that it is his responsibility to account for why his urine is testing positive.

At the point where the teen has still not admitted to a relapse, I like to ask him if he has been around anybody who has been abusing drugs. This question often provides me with more information. For example, if he reports that he has been inside a vehicle with others who were smoking marijuana and he thinks that he got an indirect dirty urine as a result, well now i know that he has been associating with drug abusers while they are getting high and that he is in some danger if he is riding in automobiles and smoking marijuana. This is important information but it does not necessarily account for why the THC is at a level for which it tests positive in his urine.

Keep in mind, that while an admission from your teenager is important, it is not necessary. Even without an admission you can move to the second task. Try to refrain from calling your teen a liar. Name calling can be counter-productive. Saying things like, "I am struggling to belive your story - it doesn't account for why this test is positive" is different from saying "I don't believe you- I know you are lying." Remember, we don't "know" anything, unless we were there when he got high. But he has to tell us something that makes sense, something that is credible, and if he tests positive on the second test as well as the first, then he has some explaining to do."

One question that comes up repeatedly is this: can a person test positive if he is just around others who are smoking marijuna? The textbook answer to this, which is provided by the drug testing companies is no. There is generally not enough of the substance second hand to provide enough THC to test positive. However, common sense will tell us that there can be exceptions to this. In the above mentioned example, you have teens smoking marijuna in a car with the windows up. If this goes on long enough, then of course a person who is not smoking it can get a "contact high." Or, at a party in a smaller room the marijuana smoke can become really thick so that your might hear people joke that all you have to do is go into that room and you will get high. Unlikely? Yes. Impossible? No.

A good question to ask the teen who refuses to admitt it is this: "did you feel high?" If the answer to this question is a yes, then you have your admission because he certainly has relapsed, as he allowed enough marijuana into his body to feel intoxicated. Of course, he may still be lying. Still, an admission is an admission. If on the other hand, he denies that he felt anything, then that that denial constitutes an unacceptable explanation.

Task number two: holding your teen accountable. Whether or not your teen admits to a relapse, you can move to the second task. While it is important to give your teenager a chance to account for why his urine is dirty, a chance to come clean so to speak, it does not change much in the way of the second task, which is to hold him acccountable for the relapse. State the accountablitly in simple business-like terms. Most of the accountability will involve restricting him from contact with peers, grounding, loosing cell phones, and perhaps an assessment from a local drug treatment program. If he has had outpatient treatment already, he may need inpatient treatment now. If your child is on probation or if you have filed an ACT 53 petition, then there may be legal consequences as well. Keep the second part short. Going on and on about a relapse is usually counter-productive.

Things to avoid doing:
1. Asking why they did it is usually counterproductive. Probably they like the feeling of being high. That's the real reason. This may feel like the perfect time to hit home a point about how bad of a decision it was to get high but it really is not the right time to make any points, except the two mentioned above. The problem with asking why is also this: there is no good reason and so you your question is a trap of sorts. Any reason they give you will not suffice. Mostly the reasons will be excuses, e.g., "I was depressed," "I was around my old friends," "you shouldn't have let me go over Sam's house," etc. We really don't want to hear the excuses, just skip that part and cover the consequences. However, there is nothing wrong with saying, "teel me what happened." Just don't expect much and don't make it the driving goal. He relapsed. Now, no matter what happened, you have to deal with it.

2. Asking how could they do this to you? Try not to take it personally. Probably it was not something they did to you- they just like the feeling of getting high. Creating a lot of drama over how horrible of a thing this was to do to you might feel like you are setting up a deterrant for the next time but we need to remember that we are powerless really to stop our teens from using drugs. We can only do our best to provide responsible pararent supervision and pick up the pieces in the best way that we can after it happens.

3. Don't keep this relapse a secret. Not from the other parent, the siblings, the counselor, or from the Probation Officer. This has to be exposed for what it is.

4. Don't try to "rip them a new one." That just doesn't help. Hold them accountable by restrictions, more clinical evaluations, or following through with Probation or Act business as you probably already told them that you would do. Let them feel the heat via consequences, not via your verbal tirade.

5. Your teen may lie about his relapse even after you see the result on the urine test. Be careful not to fall into the trap of making the primary issue his lying. The primary issue is continued abuse of drugs. They lying about it is secondary. So, lets assume that you go on and on about how important it is not to lie about these things. Finally, after a long session with you he admits that he relapsed. Now you move to the seond phase where you hold him accountable. Now he screems that he told the truth! But he is still being punished! See, he says, he knew he shouldn't trust you by telling the truth and he'll never tell the truth again now that he sees what it gets him. Just remember that the primary issue is his drug abuse and whether or not he admits to it- you can hold him accountable. If he admits to it- good for him- he told the truth- but he is still to be held accountable but now he can feel a small bit better because he got that off his chest.

6. It is natural to want to make your teen feel quilty about this. Stop it. They probably feel bad that they got caught. Maybe they do feel bad they they relapsed, but trying to heap on the guilt as a way of providing a deterrant against future drug abuse is not effective. We don't have the power to make them feel bad, except that they may feel bad for the consequences that they must now experience. Fine, lets go with that. Sometimes, we might hope that if our teen feels bad enough about what he has done, that we don't have to hold them accountable. "Oh, we talked about that- its' ok now." If you have not held your teen accountable, then the issue has not been delt with just because you talked about it and you might better now that you know how badly he feels. It's a trap. The primary issue is not his guilt- it's his relapse.

5. Remember that people learn from failure. Sometimes we have to fail and experience the consequences for that failure in order to learn. The old saying is: people change because they feel the heat- not because they see the light. Just remember that the most effective "heat" is consequences, not a verbal thrashing.

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