Top 10 Addiction Myths — and Myth Busters Posted by:Ken Sutton--Friday, April 20, 2007

(From the Robert Wood Johnson Foundation's "Silent Treatment: Addiction in America" project, produced by Public Access Journalism LLC.)

Think you know about addiction? Then these common myths may sound familiar:




Myth 1: Drug addiction is voluntary behavior. You start out occasionally using alcohol or other drugs, and that is a voluntary decision. But as times passes, something happens, and you become a compulsive drug user. Why? Because over time, continued use of addictive drugs changes your brain — in dramatic, toxic ways at times, more subtly at others, but virtually always in ways that result in compulsive and even uncontrollable drug use.

Myth 2: Drug addiction is a character flaw. Drug addiction is a brain disease. Every type of drug — from alcohol to heroin — has its own mechanism for changing how the brain functions. But regardless of the addiction, the effects on the brain are similar, ranging from changes in the molecules and cells that make up the brain to mood and memory processes — even on motor skills such as walking and talking. The drug becomes the single most powerful motivator in your life.

Myth 3: You can't force someone into treatment. Treatment does not have to be voluntary. Those coerced into treatment by the legal system can be just as successful as those who enter treatment voluntarily. Sometimes they do better, as they are more likely to remain in treatment longer and to complete the program. In 1999, over half of adolescents admitted into treatment were directed to do so by the criminal justice system.

Myth 4: Treatment for drug addiction should be a one-shot deal. Like many other illnesses, drug addiction typically is a chronic disorder. Some people can quit drug use “cold turkey,” or they can stop after receiving treatment just one time at a rehabilitation facility. But most people who abuse drugs require longer-term treatment and, in many instances, repeated treatments.

Myth 5: We should strive to find a "magic bullet" to treat all forms of drug abuse. There is no “one size fits all” form of drug treatment, much less a magic bullet that suddenly will cure addiction. Different people have different drug abuse-related problems. And they respond very differently to similar forms of treatment, even when they're abusing the same drug. As a result, drug addicts need an array of treatments and services tailored to address their unique needs. Finding an approach that is personally effective can mean trying out several different doctors or treatment centers before a “match” is found between patient and program.

Myth 6: People don't need treatment. They can stop using drugs if they really want to. It is extremely hard for people addicted to drugs to achieve and maintain long-term abstinence. Research shows that when long-term drug use actually changes a person's brain function, it causes them to crave the drug even more, making it increasingly difficult to quit without effective treatment. Intervening and stopping substance abuse early is important, as children become addicted to drugs much faster than adults and risk greater physical, mental and psychological harm.

Myth 7: Treatment just doesn't work. Studies show drug treatment reduces drug use by 40 to 60 percent and can significantly decrease criminal activity during and after treatment. There is also evidence that drug addiction treatment reduces the risk of infectious disease, Hepatitis C and HIV infection — intravenous-drug users who enter and stay in treatment are up to six times less likely to become infected with HIV — and improves the prospects for getting and keeping a job up to 40 percent.

Myth 8: No one voluntarily seeks treatment until they hit rock bottom. There are many things that can motivate a person to enter and complete treatment before that happens. Pressure from family members and employers, as well as personal recognition that they have a problem, can be powerful motivators. For teens, parents and school administrators are often driving forces in getting them into treatment before situations become dire.

Myth 9: People can successfully finish drug abuse treatment in a couple of weeks if they're truly motivated. For treatment to have an effect, research indicates a minimum of 90 days of treatment for outpatient drug-free programs, and 21 days for short-term inpatient programs. Follow-up supervision and support are essential. In all recovery programs, the best predictor of success is the length of treatment. Patients who are treated for at least a year are more than twice as likely to remain drug free, and a recent study showed adolescents who met or exceeded the minimum treatment time were over one and a half times more likely to stay away from drugs and alcohol.

Myth 10: People who continue to abuse drugs after treatment are hopeless. Completing a treatment program is merely the first step in the struggle for recovery that can last a lifetime. Drug addiction is a chronic disorder; occasional relapses do not mean failure. Psychological stress from work or family problems, social cues — meeting some from the drug-using past — or the environment — encountering streets, objects or even smells associated with drug use — can easily trigger a relapse. Addicts are most vulnerable to drug use during the few months immediately following their release from treatment. Recovery is a long process and frequently requires multiple treatment attempts before complete and consistent sobriety can be achieved.

(Sources: National Institute on Drug Abuse, National Institute of Health; Dr. Alan I. Leshner, former director of the National Institute on Drug Abuse; “The Principles of Drug Addiction Treatment: A Research-Based Guide” (October 1999); The Partnership for a Drug-Free America)

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Summary of 4-14-07 Alliance Office PSST Posted by:Lloyd Woodward--Saturday, April 14, 2007

Nine parents attended this meeting at the Alliance Office in the North Hills. Powerlessness was a huge topic. Our role-play can best be entitled "Let's all blame Mom." Most participated in some aspect of the role-play. I was not needed in this role-play, not even as a coach! The parents all did a terrific job. Each parent who played the Mom put the drama in a new light! Fantastic job. Special thanks to the parent who contributed this role-play and was willing to act it out with us. The following written role-play is inspired by what you all did...

Role-play: Ganging up on Mom.


Mom: Honey, the weed smoking and the alcohol abuse that you are doing is unacceptable. I hope with what happened at school, with the marijuana that they found in your school locker- I hope you can see that now.

Son: It's your fault! You are the one who got me busted.

Dad: Did you really do that? Did you call the school about our son and get him in trouble?

Mom: Yes.

Son: See, I told you Dad! She is a witch! There is no way you could do that to me- ooooooo- I am so pizzed at you for that you evil witch!

Dad: Son, just calm down now.

Son: I told you she did that! You said "no she wouldn't do that!"

Dad: C'mon now Son, I have to put up with her too you know. [winks at mother as though this joke is an inside one.]

Son: She's your wife, "DAD," and she wont' even listen to what YOU tell her.

Dad: [Looking at Mom] Why didn't you tell me you were thinking of calling the school?

Mom: Didn't think I needed to!

Dad: Well, you should have told me- I would have told you if I was thinking of doing something like that. I don't think we should ever call the school about stuff like that- now look at this mess!

Mom: You think this is my fault?

Dad: No, it's his fault for having the marijuana at school. But I just don't think you handled it right. I wish you wouldn't go off making phone calls like that!

Mom: OK, OK, OK, Let me get this straight- hold on now. [Looking back and forth from the Son to the Father. ] So, I called the school and told them that I thought that you were using drugs because I've been worried about that. You know we have talked about this. I asked them if they could advise me about where to go to get help for you. They decided to check your locker, and they found the Marijuana that you had put there?

Son: Yes, I PUT it there! OK Mom, does that float your boat? I PUT it there- you got me busted- I just hope your're happy! Dad and I both know you shouldn't have done that.

Dad: Settle down Son, lets don't all start yelling. I know you have a hard time getting along with you mother- sometimes it's hard for me too.

Dad: [Looking at Mom]- Can you see where you've screwed everything up now?

Mom: Do you think he put the marijuana in his locker because of me then?

Dad: Oh you're just too hard on the kid- You've always been too hard on him. I think that's probably why he feels that he has to smoke marijuana.

Son: It is why; I have to figure out a way to cope with you, don't I, you vicious witch.

Dad: Now now son...

Son: It's true. Hey Mom, want me to get your broomstick out of the closet so you can ride to a PTA meeting and tell em some more shyt about me?

Dad: Son, I don't appreciate how you're treating your mother.

Son: You don't?

Dad: No I do not! I have to deal with her all the time, dont' I, and you don't see me calling her names.

Mom: [Moving in closer to Dad] You often undermine me in front of our Son. I am trying to help him stop using drugs and you don't help at all; in fact, you pull the rug out from under me all the time with him. Never undermine me in front of our Son. If you want to tell me that you disagree with me, talk to me in private.

Dad: Oh my God, it must be great to be you! You just get to look down on everyone else don't you? It must be lonely way up on the white horse of yours. Well just ride off on it then, leave us alone. And bring me my bottle of whiskey over there before you ride off- this meeting is making me thirsty...

Son: Yep, that's what I been telling you Dad, you got to take something just to be able to handle the evil witch.

Pause

Mom: [Looking at Dad] I need to talk to you in private!

Dad: No! You can talk in front of our Son, because he needs to hear what you've got to say for your self, you know, for the rotten trick you pulled on him.

Mom: Ok, good point- maybe he does need to hear some of this.

Mom: [Looking at Son and moving closer] [Lowing her voice and speaking lower] Do not take drugs. Do not use alcohol. Never bring drugs home and never take drugs to school. Be ADVISED, that this witch will always get right off her broomstick and go to the phone to call school officials and police. I will not tolerate you smoking marijuana or abusing any other subtance and I will stop you by whatever means necessary...

Dad: [interrupting] You don't mean that you would pull that on him again do you? I told you - I don't think that is too good an idea!

Mom: [focusing on Son, not on Dad but she answers Dad's comment more effectively this way] Oh, for your information. HE [points at dad], can NOT protect you from me. This witch is going to patrol the home daily, and if you persist in bringing drugs into this house- I will see that you get help for this problem if you have to be marched off in handcuffs.

Dad: You can't say that!

Mom: [Still looking at Son] Nevertheless, never bring drugs into this house. Never bring drugs to school. Never take drugs! Yesterday, I contacted ACT 53. If you continue to refuse to see a therapist or participate in outpatient, then there will be a court date. I am filing a petition that will force you to have an assessment and treatment for your drug problem.

Son: Dad, stop her- she's crazy!

Dad: You're not going to keep making phone calls like that one, are you?

Mom: [Still looking at Son] Regardless, I will go through your room. I will go though your cell phone, and if you do not allow me to go through your cell phone, I will cancel the phone. I might just cancel it anyway...

Dad: What! that's not your phone- you can't cancel that!

Mom: [Still looking at Son even though it was Dad who spoke the last complaint.] Regardless, I will cancel the your phone if you continue to refuse to participate in outpatient. I will call outside this house for help in a New York Minute. For one thing, I understand that I will get no help from anyone else in this family.

Son: This is all your fault you witch! [rasing voice.]

Mom: Oh, yes, this IS something that I will take a little bit of credit for- but you have no idea how far I am willing to go to see that you do not do drugs.

Dad: Please stop this. [Wincing].

Mom: [Now looking at Dad, finally] Until you sit down with me alone and in private to discuss our Son's drug problem, I have nothing else to say to you about this.

Dad: You are not the boss of me!

Mom: Regardless, I have NOTHING to say to you. [Moving in closer as she says this, which seems to suggest that she has volumes to tell him, but just not right now!]

Dad: You haven't heard the last of this!

Mom: Nevertheless, I have nothing more for you until you are ready to sit down in private with me.

Mom: [Looking back at Son, who is starting to look worried, like he is afraid that she will go get that broomstick; he really did not expect mom to be this bold in front of Dad!] You won't believe this now but I will tell you anyway! I love you.

Son: Yeah right, you NEVER loved me! You don't love me now, not like Dad does; you just want to get me put away!

Mom: Nevertheless, it is because I love you that I will stop at nothing to see that you quit doing drugs and drinking alcohol.

Son: Dad drinks, why can't I smoke weed? Weed is better for you than alcohol. If I stop drinking, can I still smoke weed? Everyone knows weed isn't bad for you.

Mom: [Mom does not bite on that hook!] Regardless, it is illegal. Never smoke weed, never bring it into this house and never bring it to school. It is illegal and I will call for help again if I have to. Is that clear?

Son: YES! Leave me alone. I hate you! No one else's mother is as evil as you are! Why can't you be cool like other parents?

Mom: Nevertheless, never use drugs or alcohol.

Son: "Nevertheless- nevertheless, I HATE that word!

Mom: Regardless, never use drugs. Never have them at home or at school. [Mother gets up to leave, and walk away but she turns towards Dad when she hears him speak...]

Dad: Wait, I've got something else to say to you!

Mom: Really? I'd say you better make an appointment for that private meeting then! [Mom walks off, gets on her broom, revs the engine, and flys away into the sunset...]

Also, for estranged or divorced Parents visit this role-play http://nevertheless-psst.blogspot.com/2006/12/parent-vs-parent.html.

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Idea: Manny the Manipulator Posted by:Lloyd Woodward--Wednesday, April 11, 2007

Ken and I have been talking about having one place where you can go to see all the manipulative techniques that our kids use. This could be ongoing, and we can start now by collecting comments from readers. What great diversions and power-plays do your teens throw at you? We thought about calling this one Manny the Manipulator...

We thought that we can divide these into types or categories (like power plays or pushing limits) under which there will be many variations. Ken's thinking is we can end up with something like "If your teen says this ____; you can reply with ______. "
Of course, a lot of the time, we are just recommending that the reply is a power word such as "nevertheless" or "regardless," but not all the time. Rather than just becoming robot responders, we can throw in an empathic statement along with the power word, or if the manipulation opens the door to one of our talking points, then we can respond with something like, "that is a really good question" OR "I'm so glad you brought that up. "

Also, some particular things that teens say might call for very specific responses, such as a suicidal threat. We never want to treat a suicidal threat as a mere manipulation, because we know that teens who threaten suicide, and who do not really seem to be trying very hard to carry out that threat, actually do kill themselves. Therefore, all threats to hurt themselves or to hurt others should be taken seriously and the teen should be taken to an ER at a local hospital or at WPIC for evaluation. In an emergency, 911 should be called. Oddly enough, once the teen knows that this is your standard response, they are less likely to use this threat as a manipulative ploy.

The first category of manipulations that I am thinking of is when the teen tries to turn things back on the parent. For example:

Manny: You always let (insert name of older sibling) stay out till one, why can't I stay out that late?
Manny: You lie all the time! I could never trust you!
Manny: You have a drink or two every night, why can't i smoke weed?
Manny: You only want me to stay home because you have no life, and no friends! You want me to be a looser like you are!
Manny: You are so uncool. You don't know anything about kids today Mom. I have to tell you everything.
Manny: You need to wear better clothes. Throw those rags away! I'll tell you what to wear, gee you don't know anything- do you!
Manny: You don't know anything about recovery or about drug addiction, do you? Don't tell me I need to call my sponsor when you never had a sponsor and you don't know squat.
Manny: You always need to call my Probation Officer. You can't just be a parent and handle me. Why can't you just be my mom and we can handle it instead of always calling my PO and whining about me. You need to grow up and be a mom! That PO ain't my Daddy!
Manny: You're just jealous because I HAVE friends!
Manny: You're trying to work my program for me!
Manny: You are so negative! All you do is bytch at me! Can't you say anything good? What about all those days that I didn't get high? All I hear about is the stuff I do wrong!
Manny: You put me in this place. It's cause you don't want me at home! Now you can just be with your boyfriend; that's why you got rid of me!

This is just a few of the one's where the "Teen Turns Things Back On The Parent." This is just to start us off. There are so many of these both in this category and in other categories. Other categories might include, "Turning Parent against Parent, PO, Teacher, Counselor, or Rehab," "Getting loud and having a tantrum," "Threatening (such as 'I am going out anyway')," "Badgering (where any thing is thown out until the parent just caves in), and other categories as well. I realize that some of these overlap. We want this to end up being comprehensive, so we really need help to gather them all up- so please leave some comments here. Eventually, we think we might devote a dedicated space on the web site to these so that parents can see the manipulations and possible answers to them.

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Eastern Probation Office Meeting 4-7-07 Posted by:Lloyd Woodward--Sunday, April 08, 2007

Nine parents attended this meeting. Topics that we discussed: the incurable yet treatable disease of addiction, what to do with anger and resentment, parent letters to the disease, breaking a few eggs, teen manipulative strategies, using your child's Probation Officer effectively, what to do about pre-relapse anxiety a parent can feel, and how to engage ACT 53. We made time for two role-plays at the end. The role-play printed here is only inspired by the two that we did in group and not an actual representation.



Role-play: preparing for a six hour pass home from the rehab.

Mom: Honey, we need to talk about this home pass, you know, get expectations out in the open.

Son: What are you talking about? You act like I'm a criminal or something. I'm not going to be getting high anymore now- so we can cut the shyt. I'm done with all that. Don't worry- I'll be fine- I learned my lesson!

Dad: Son, we are here to tell you that things are going to be different at home from now on.

Son: I know that Dad! Do yo think I'm stupid. Whatever. Make your silly rules up- it's not going to matter because I'm done with the marijuana. Crap! You'd think I was doing Heroin! That's what kids in here do DAD, they do Heroin! You guys think you have problems- you should feel lucky! These kids on Heroin are a mess. THEY have problems. I'm not even on that shyt!

Mom: Look, Honey all we want to talk about right now is the six hour home pass. We need to know that you are going to follow expectations and the rules.

Dad: Right, we can cross the other bridges later.

Son: OK, OK, OK,- tell me the rules! [Rolling eyes- exasperated-clearly these parents are trying his nerves and if they don't watch out he might have to blow up just to get them back in line- a manipulative technique that may have worked for him in the past.]

Dad: OK, first: the home pass is to spend with us- not your friends.

Son: Duh!

Mom: OK, "duh," well said son- it IS a nobrainer- glad you see that. Here is the deal: no use of the telephone AT ALL unless we know who and why you are calling, and unless one of us says that it's OK. Two: no use of computer AT ALL. Three: no going out in the yard or hanging on the porch unless one of us is with you...

Son: [Not able to restrain himself anymore.] That's fu&^#d up! You can't do that! Are you crazy? You CAN'T DO THAT! THAT'S ILLEGAL [raising voice now].

Dad: Nevertheless, son, that's the deal- I'm sorry to say this but take it or leave it. [Dad ignores the "bait" on the whole illegality ploy because he sees it for the distraction that it is.]

Mom: And there's more. But I'll let you talk for a minute because you seem upset- when you're ready I'll tell you the rest of the rules.

Son: There's no "rest of the rules." Listen you guys are going to get in trouble. I'll call the police if I have to. There are laws against taking hostages! You just can't do that to me. Who the hell do you think you are anyway? You can't stop me from using the phone. THAT is ridiculous!

Mom: Regardless, maybe you should just think it over.

Son: NO- I'm not a piece of shyt and if you and Dad think that you can treat me like that just because I'm in a drug rehab- you're nuts! And that's wrong. I won't let you get away with it.

Long pause- [Everyone looks uncomfortable- no one speaking. These parents have learned that they don't get their point across by getting in the last word- they are patient. At least for right now they know they know they are holding all the cards- they have prepared for this meeting, in fact, they have insisted that the drug rehab allow them time to structure expectations for the home pass- they demanded it and told the rehab that if they don't clarify expectations, there will be no home pass. These parents have decided before hand that their son needs this pass home more than they need him to be home. They know that there are two big reasons to get these expectations resolved before the home pass starts. One: to help to avoid any problems such as their son getting high on a home pass. Two: to send a message to their son that he is no longer in charge, i.e., there is a new sheriff in town! They are tired of walking on egg shells around their son and they are ready to begin to take back control.]

Son: What? [Looking at them, uncomfortable with the silence.]

Dad: I'm not ready for a home pass unless we can come to an understanding.

Son: Fine! I'll stay here! Is that what you want? Hey, even the Heroin addicts get to go home for Easter! But not me! No, no, no-a "big bad marijuana fein" like me, isn't safe to go home- that is such a crock of shyt- are you going to tell them you don't want me home? Huh? They are going to laugh at you! This one counselor said I shouldn't even be here! And another one said that they hope I don't "overstay" cause that could be bad for me to be stuck in here with all the junkies, but no- thanks to you now I got to go tell them that my parents don't want me home.

Dad: OK, OK, OK, [Holding up hand in the universal traffic signal.] You bring up a good point. Hold on a minute. I need to say a few things about this- but I don't want to be interrupted once I start talking, so you tell me when you're done, so I can talk. OK? I'll wait.

Son: [Glares- clearly he does not want to agree not to interrupt- but he wants to hear what Dad has to say.] Just you remember this- how you're treating me now when I'm in here - I'm going to remember that when I'm home! OK- you both got that? I want to be treated decent, like a f&$@*ng human being- not like I'm somebody's dog-and if you give me trouble now- I'm not going to forget that once I get home. OK?

Mom: Just let us know when you are finished.

Son: Go ahead!

Mom: [Looking at Dad, she is not sure how far he is ready to go with this whole thing now-they were trying to keep this meeting relevant to the six-hour home pass, which would usually make sense- but they are getting a lot of resistance and may have to pull out a big gun issue. Mom chooses to let Dad deal with the bigger issue if he wants to go there, i.e., should Son even come home if he is going to be so resistant, and she takes a different course].

OK, well before your Dad starts- I want you to know that you sound like Tony Soprano with the threats you're making. [It is a good idea to pay attention to what is happening. Mom pays attention by labeling behavior as a threat. Notice that she does not threaten back at him, or make this THE ISSUE all of a sudden, but neither can she fail to pay attention. Many, but not all negative behaviors disappear if parents correctly label them.]

Son: I did not threaten you. You're twisting what I said.

Mom: Nevertheless, I feel threatened.

Dad: So do I- but Son, this is a good time- I want to share some things with you. [Dad also labels the threat- but then moves on to the larger issue.]

Son: Yes, I SAID "Yes." You are both so up my butt with this crap- you know it's this kind of shyt that makes me want to use weed! It's assholes like you that make people like me need weed!

Dad: Are you OK? [Ignoring the last effort at distraction-this distraction is actually a good thing to talk about at some point, and both parents make a mental note that Son is threatening to use, and therefore is hardly out-of-the-woods on the substance abuse issue. However, they are two people on a mission and must now return to the home pass issue.]

Son: YES [Obviously mad now.] Just get it over with! I hate this meeting. Can we just get this over with please!

Dad: OK. I didn't want to tell you this right now. I just wanted to deal with the home pass issue, but I think that I need to tell you this now. No interruptions, OK?

Son: OK, OK, OK, I told you OK- just tell me!

Dad: Your mother and I, we want you to be happy, and of course we want you to be drug-free too, but it's important to us that you are not miserable. Maybe happy is too strong a word.

pause

Dad: We think you are very unhappy at home! And the way this meeting has gone so far- I feel horrible, but I'm afraid that maybe you are not going to find happiness at home. Now I know you are only 15, and probably living in a group home or something that Probation finds for you is not a pleasant idea, but just think for a minute- if you didn't have to deal with us on an everyday basis, do you think you would be happier?

Son: Are you for real? I'm not going into a group home. Shut up. That's stupid. I got a home. I'm coming home.

Mom: Not so fast.

Son: What?

Mom: Not so fast. I'm not agreeing to even take you for a home pass- let alone take you home when you get out of here- and if and when I do agree to either a home pass or to actually take you home after discharge, it's because I think you can be successful at home. Frankly, nothing I've seen in this meeting leads me to believe that you are ready to come home and be successful.

Son: I told you- I'm done with the weed! I'm done with the drugs!

Dad: Ahhhhh, but are you done with the friends that you did drugs with?

Son: Hey, those are my friends; you can't pick my friends for me!

Dad: OK we are going no where. We can talk for ever about this- and you will believe what you want and we will believe what we want. Nothing will change on either side. So, lets do this. Lets assume after you think it over - that you agree with the rules for the home pass. You don't even know what they all are yet! And this is the only meeting we can have before we come to pick you up. So, lets cover them and if you think we are too unreasonable, then don't come on the home pass. We will respect your choice to stay in the rehab instead of coming home.

Mom: Right, so we only have a couple more rules to tell you anyway. You will go to a 12-step meeting. We will drive you there and pick you up. And one of us may sit in on the meeting. Oh, And doorknobs have been removed from a lot of the doors in our house. We have even taken them off the bathroom for right now. You are not to be behind any locked doors on the home pass.

Son: What? [Incredulous look on face.]

Dad: Yes, and another thing. Don't give us too hard a time. We know you are going to be angry. That's OK, but don't take it out on us. You don't have to talk to us if you don't want too, but no swearing at us- yelling at us, or going off on your own without supervision.

Mom: Oh yeah, and no smoking!

Son: What? you always let me smoke, just as long as I'm in the basement or outside?!!!!

Dad: Yes, but we have decided not to allow that now.

Son: And why not?

Dad: We enforce all rules that this rehab has while you are with us for a home pass.

Son: They all smoke on home pass- the rehab knows that- THEY aren't nuts like you guys! They expect us to smoke.

Dad: [Dad gets closer to his son- makes DEAD ON eye contact and lowers his voice to a slow whisper- picture Clint Eastwood in Dirty Harry in the "go ahead, make my day" scene. ] Nevertheless- smoking on your home pass is unacceptable.

Son: Why not? Give me one good reason!

Mom: [Moving up closer and slowing down her speech too.] Because we said so!

Son: That's not a good enough reason.

Dad: Regardless, that's the reason.

Son: I can't accept that.

Dad: Whether or not to come on the home pass is up to you Son; think it over. [Putting the ball back in his court is better than having the last word- let him have the last word.]

PAUSE

Dad: One more thing. If you don't think you can handle these rules, I think it's better that you don't come home on the pass. It might be easier for you just to stay here rather than try to cope with the rules we have set down. For one thing, if at any point in the home pass, it appears that you do not intend to follow these rules, we will return you directly to this facility. [Reverse psychology, which might motivate an the oppositionally defiant.]

Mom: Oh yes- and let me tell you young man [moving even closer] we love you- we want you home with us for Easter- but if you decide to come home, and we see that you are making no effort to meet these expectations- I don't care if we are only in the parking lot outside this building- we are marching you right back inside! So, think it over very carefully.

Son: No way. Forget the home pass. Don't come visit me anymore. You don't want me home, I can see that; just go ahead with your lives because I can see that you don't want me home.

Dad: I'm sorry it looks that way to you. Regardless, these are the rules. You think it over Son, we'll respect whatever you decide on this one. [Dad ignores the bait of the whole "you don't want me home," except to say that he is sorry that son sees it that way. This is another distraction, a good one that many parents fall for.]

Son: You know, you tricked me. I can't trust you anymore.

Dad: Really? How so? [This is another distraction- but Dad allows just a bit of a distraction here, because Dad and Mom have considered the whole "trust" issue, they are ready for it, and it suits their purposes to allow this one distraction because it allows them to cover one of their talking points.]

Son: Before I decided to come in here- I didn't know that you guys were going to go all postal on me- nutso with changes before I got out! You lied and said, "Oh we'll work it out- you'll be home in no time."

Mom: Good point Son. I see it looks to you like we've been deceptive. [Mom agrees with him that it "looks to him" like they have been deceptive. This is Counter-manipulative strategy; she will put her TWIST in it before it's done. By sort of agreeing with his accusation, she stops this issue from becoming a huge distraction.]

Son: Right- I would have never told my PO that I was coming in here if I knew all this was going to happen. You keep changing things, that's why I can't trust you now! When am I coming home? That will be the next thing you try to change on me!

Dad: I don't think it will matter to you, if we tell you we didn't exactly see all these changes coming either. [Still going with the reverse psychology.]

Son: Yeah, right! [rolls eyes] You knew! [He doesnt bite on the reverse psychology. However, even when it doesn't seem to work- the reverse psychology does work. Dad called this one. It didn't matter to Son, just like Dad said. So, Dad looks like he knows what he's talking about :) ].

Mom: I'm glad you pointed this out, really.

Son: [Looking encouraged, as if he thinks that he has scored a big one now- the look of triumph in his eyes.]

Son: So, yeah this is really going to be hard for us to get through now that I realize that I can't trust you. You shouldn't make all these changes while I'm in here- it's not fair. It's like the coward's way to work things and now I can't trust you. [He continues to beat the "I can't trust you drum" believing that his parents have a strong NEED to be trusted, just like he mistakenly thought that his parents had a strong NEED to have him home on the home pass- as if THEY will be the ones suffering if does not come home.]

Son: From what I can see- you're being mislead by this crazy dude at those meetings you go to. I heard about that guy- NO ONE up here can stand that guy. As long as you're going to those meetings, I think it's going to be hard for me to trust you.

Dad: Wow. You said a lot there. Phew. Let me try to take that all in for a moment.

Mom: Right - me too. Gee whiz son, you are good! You really should study Law- with reasoning like that - you could win a lot of court cases. [Simple flatery. We forget that it is one of the basic tools of effective communication. And really, this kid IS quite good at debate and at throwing up distractions. Aren't they all?]

Son: [Looking pleased with himself now.] It's true. You can ask anybody up here! Everyone says it.

Mom: OK, Well this what I hear you saying. Number One: we are changing things and that makes you think you can't trust us.

Son: Right- cause you are.

Mom: And two: you think the problem that we are having is partly becasue we attend PSST meetings? [Basic active listening skills.]

Son: Yep. That's the way I feel about it. You don't want me to lie do you? I really am feeling some kinda way about this- like this is going to be hard for us to work though and that's what we are supposed to be doing up here- working through our issues!

Mom: Well, honey I'm glad you said all this- and yes, I'm very glad that you are being honest with us. For you to say that, means that you believe that we are making changes at home. You are so right. We are making a lot of changes and I see that you are starting to believe that now. Good for you. [Enter the TWIST.]

Dad: Yes, I agree. Nice going Son. And I can hear you that you feel you can't trust us now. [Moving closer.] I think the way you are looking at it, you are right. You definitely CAN'T trust us. You can only TRUST that we will do EVERYTHING in our power to try to help you save your own life from drugs and alcohol. [Another TWIST- in group this line in role-plays draws applause!] You can trust that we will search your room; trust that we will take off the doorknobs; trust that we will use the Probation Officer, the Counselors, the School people to help. Trust that we will do everything we can to see that you get ALL the treatment there is for this life-threatening disease. If this rehab isn't long enough- we know there are other places. And you so are right to point this out: TRUST that your mother and I will CHANGE things as we go along. Lot's of things.

Mom: Right, you can trust that we are going to change a LOT of things whenever we feel that it might help you stay away from drugs. And I know that you are no Heroin Addict, at least not yet, but the large amounts of money you stole from us, the continued drug abuse of marijuana and pills, the school problems, and the fact that we have become completely POWERLESS to control you- that is now unacceptable to us. WE WILL CHANGE EVERYTHING IF NECESSARY TO SEE THAT THIS DOES NOT CONTINUE. [Said sternly, with strong eye contact- but in a quiet voice, not a yelling voice. This is embracing First Step for parents.]

Dad: And Son, I'm glad you brought up the meetings that we go to. I didn't think you noticed that or cared about where we go. You may not know this but we are also going to Bridge To Hope meetings, and Naranon meetings now. We are not going as often as we'd like to, but we will go to anyplace we can if we think it might help. That includes PSST meetings. But that is our business- you can have feelings about it- that's OK, but that's our business and we will make those decisions. [Good boundaries- Son's problem with the meetings is that he can sense a shift in power from the strength and motivation that the parents get from the meetings. What a shift- usually it's the parents who are concerned about where the teen is going, now the teen is concerned about where parents are going! Full of irony at the least. ]

Son: I can't believe this!

Dad: Thanks for letting us explain all this- I know it was a lot to handle, but really we needed to get that off our chest. [Expressing gratitude for son listening is not a sign of weakness but to the contrary- we can all still be civil and not forget to let loved ones know that we appreciate the little things they do. And think about it: this was a LOT for the kid to sit through. He is not used to this kind of confrontation.]

Mom: Yes, and I know this was not an easy meeting for you. You did fine. You didn't interrupt us much after we asked you not to do that- and you didn't start a tantrum. You did just fine. Now, if I were you I'd think carefully about my next step. If you decide not to visit or not to return home to live with us at all- then talk to the people up here about what your options are. [Putting the ball back in Son's court. Once again, this is much more effective than getting in the last word.]


Son: I'm not going to live in a stupid group home, if that's what you're thinking!

Dad: Good for you, then. So you've got a lot to think over I'd say.

Son: Maybe. [At this point, Son is not about to agree with anything that THEY say.]

pause

Son: We'll let me ask you something.

Mom: Sure thing.

Son: If I come home for the pass and I do all this STUFF, can I at least have a cigarette- just one- or maybe two- before I come back here. It's so hard to go without them. Hey, if you want, you can even just give me one if I follow all the rules you have, you know, as a reward or something. Nobody here will know.

Dad: OOOOOOOO- now you tempt me Son- [Smiling.] [It is tempting- now if you agree to his cigarette request, he will or might agree to your conditions. Just pay him off. Of course that actually puts Son back in control and makes co-conspirators out of all three of you. This is a trap, a back door effort to sneak in the control he feels he is loosing.]

Mom: Yes, me too, but you know, we have a problem with that too- but it is a really good question you are asking. [A good question is one that opens up one of the parents talking points :)]

Dad: Yes, it is a good question and it deserves a good answer. Son, we can no longer keep secrets like that for you. Period.

Mom: Yes, you see we have learned that our secrets keep us sick- and honey we don't want to loose you to this terrible disease- so we have made a committment not to keep secrets about your behavior- not from the rehab staff- not from your Probation Officer. So, you see they would find out. We would tell them.

Son: Who are you people and what have you done with my real parents?

Mom and Dad: [Laughing].

Dad: So glad you can keep a sense of humor about this Son. Oh, and one more thing that I don't think you will believe- but I got to tell you. We miss you. I miss you. You should know that.

Son: Doesn't sound like it.

Mom: No I don't suppose it does sound like that to you. [More active listening- this Mom is skillful :)] Well, sorry it looks that way to you- regardless, we love you very much. You let us know what you want to do about the six hour home pass, OK?

Son: Ok, [Son tries to walk away- but parents grab him- hug him anyway- he tries to resist- they let him go- he walks back acting upset, but without the same angry conviction he displayed earlier in the meeting.]

Mom: [Watching Son walk away she turns to Dad.] That was hard- my heart is breaking.

Dad: Me too. But, hey, we did the right thing- he will be ok, he is learning that he has to deal with us- and he hasn't had to deal with us like this for a long time. It will take some time for him to get used to us.

Mom: I guess so, [Starting to cry a little], but we did good didn't we?

Dad: Yes, honey, we did good.

[Parent's hugging.]


Final point: If you are a single parent and you read this you might say to your self, "they are lucky - there is two of them," and you would be right. However, you can combine Mom and Dad's comments: one parent could say all that. It is often more difficult to pull off, but it can be done. After the role-play, if you are single parent, make sure to go somewhere else for a hug. You need one too.

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Reaching Out To Young People Before They Reach Out To Alcohol And Drugs Posted by:Ken Sutton--Saturday, April 07, 2007

Reaching Out To Young People Before They Reach Out To Alcohol And Drugs
By Mike Manko

The numbers are frightening; children as young as nine and ten taking their first drink, five thousand young people trying marijuana for the first time each day, more than one hundred thousand young people dying from drug overdoses in the last five years. It is clear that more so than ever before, the lives of young people are being impacted and in many cases ended by alcohol and drugs.



Three years ago, school district officials and members of law enforcement from throughout Allegheny County approached the Allegheny County District Attorney’s Office asking if a program existed that could help to educate parents, teachers and students about the trends and the dangers of mixing drugs and alcohol. Although the DARE (Drug Abuse Resistance Education) program has been available to elementary age children for several years, there was no specific program to tackle the issue of middle school and high school students having to deal with decisions involving alcohol and drugs. District Attorney Stephen A. Zappala Jr. recognized an opportunity to begin a dialogue with these groups and to engage those same groups in their communities and on their schedule. “Historically, the District Attorney’s Office has been a reactive entity, taking care of problems after they occur,” said D.A. Zappala. “For the past decade, I’ve welcomed the opportunity to get involved on the front end of situations, before problems begin to manifest themselves.” Having such a dialogue and line of communication is crucial because the overwhelming majority of young people have yet to make important and life altering decisions about substance abuse.

In addition to the overall threat of substance abuse involving teens and pre-teens, the request for assistance from District Attorney Zappala on this issue was prompted in part by a significant increase in heroin use in our area that began in the mid 1990’s and continues today. What has made the current popularity especially worrisome is the fact that the price of this drug has made it attractive and the potency of the drug is ten to fifteen times what it was when heroin was popular thirty years ago. “Part of the reason heroin was confined to a relatively small group of people in the 1970’s was because the purity of the drug was between five and seven percent and you had to use a needle to get high,” said Zappala. “People always have an aversion to injecting themselves, more so today because of the risk of HIV and Hepatitis. Now, we have heroin that is seventy to ninety percent pure and users who aren’t thrilled with the idea of sticking a needle in their arm can initially get high by snorting or smoking the drug.”

The initial version of the presentation was titled “Heroin is in Your Neighborhood” reflecting the increased popularity of the opiate based drug. Since then, it has been regularly modified to keep up with substance abuse trends, such as the presence of methamphetamine in our communities and the fact that one of the main avenues to drug abuse for young people is through prescription painkillers and anti-depressants. The constant changes in the way that young people become involved in substance abuse and the products and drugs being abused makes it extremely difficult to stay ahead of the curve on this issue, but one thing has remained constant; almost all addicts will start off with nicotine and alcohol.

“There is no doubt that the longer a child stays away from alcohol and tobacco, the better the chance of that child being able to enter young adulthood without the impact of substance abuse,” says D.A. Zappala. “And the more successful we are at preventing substance abuse now, the better our communities will be for the next generation.”

Communication and information remain the two most valuable resources when dealing with the threat of substance abuse. Being able to accept the fact that no matter the situation, every child in our community is a potential victim of substance abuse is vitally important. A recent New York Times article indicated that when communication in a family is lacking, problems that occur tend to be magnified. Even the simple act of setting aside time for a sit down meal can make a significant difference in how a family handles adversity and the pressures and problems that children experience as they age. The fine line involves being able to communicate with children while respecting who they are. The earlier that parents begin to ask questions and set up guidelines for behavior, the easier it will be to carry on that line of communication as children get older.

“We adults need to be better at everything we do,” says Zappala, “we need to be better parents, better leaders and better role models, not just for our own children but for the entire community.”

Mike Manko has served as communications director for District Attorney Stephen Zappala for more than six years and has given the presentation nearly 100 times. If you would like to schedule your group any time during the day or evening, Call Mike at (412) 350-3123.

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North Hills Town Hall Meeting 4/10/2007 Posted by:Ken Sutton--Saturday, March 31, 2007

The North Hills School District, in cooperation with the Alliance Against Drugs, will host a town hall meeting to discuss drug use and its effects on adolescents and their families from 7 – 9 p.m. on Tuesday, April 10, 2007, at the North Hills Senior High auditorium.



“No community is immune to teenage drinking and other drug use,” Dr. Joe Goodnack, superintendent, said. “If we are to truly make a difference, we as an educational community must stand united against teenage drinking and other drug-use.”

The evening will focus on current drug issues facing teens, how the drug culture has changed, the importance of early detection, and what the community can do to make a difference. Parents as well as students are encouraged to attend.

KDKA reporter Marty Griffin will moderate a panel discussion. Panelists include school administrators, the local magistrate and law enforcement officers, district attorney’s office representative, a juvenile probation officer, student assistance specialists, drug and alcohol counselors, and a member of the Alliance Against Drugs.

For more information, contact Debbie Kehoe, executive director of the Alliance Against Drugs at 724-612-5554.

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Lost Posted by:Ken Sutton--Thursday, March 29, 2007

Every member in the group lost someone this week. The loss wasn't the result of a lack of trying, a lack of caring or a lack of loving. Take some time this week to recover, count your blessings and work on your resolve and tenacity to help our children beat this terrible disease.

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Live Drug Forum on KDKA radio Posted by:Ken Sutton--Thursday, March 22, 2007

The Alliance hosted the second annual Drug Forum with Marty Griffin today. This event was live on KDKA radio from 9:00 to Noon broadcasting from the Orchard Hill Church, Wexford. Juvenile Probation and Coffeehouse Nation were there to share their stories of hope and success.

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Role-play: Parent helps to prevent relapse. Posted by:Lloyd Woodward--Tuesday, March 20, 2007

We have all learned a great deal about the signs of relapse. As Mary pointed out, overconfidence and anger can be signs. Home Alone hit on a lot of them, including the fact that a relapse happens in the teenager's mind before he actually takes "the first one." Hanging out with old friends and attending fewer meetings can be signs. But what is a parent to do to help?

Preparation can often be the most helpful thing. For example, what was the plan that your teenager came up with while he was in the rehab? Or what plan did he come up with before the "stinkin thinkin" set in? Stick to that plan, even if your teen no longer believes that he needs to do that. Don't be distracted from the recovery plan by the attitude of your teenager. Yes, we wish that he always kept that "recovery high" that he had when he first came home from the rehab, but since addiction is "cunning, baffling, and powerful," it is often the case that we don't get our parent-wishes. In general, don't be distracted. Insist that your teen follows the plan.

Dad: Hey, can we talk a minute?

Son: What's up, Yo?

Dad: Well, I've noticed that you only went to a few meetings last week.

Son: Dad- [making a face of disgust] I know when I need to go to a meeting!

Dad: Yeah, but we agreed on a meeting a day for the first 90 days. Then we said we'd talk.

Son: You know you really kill me. You really do. You think cause you went to a few of Lloyd's meetings, and a couple of Gateway family meetings that you're some kind of expert on addiction! You probably think you're going to write a book about your experiences, don't ya?

Dad: Well, I don't know about that...

Son: [cutting off his father] Well, don't quit your day job! I think after what I've been though, I know how to stay clean. You never even been addicted you said. So, you don't really know, do ya?

Dad: Well, no but...

Son: [cutting off his father] Listen Dad, I know you worry, but my sponsor said something that's important. And HE knows about recovery, cause he's in it- you know what I mean? Well, he says that you and Mom are trying to work my recovery for me. And that just makes me angry. In fact, if anything THAT makes me want to shoot dope! So, you should back off, Yo!

[Pause]

Son: Anyway, you think I would ever do anything to make me go back into rehab? You think I want to get sent away? You're crazy! I hated that place! I will NEVER do dope again! I'm to smart for that shyt now man- no way! You think I'm stupid?

Dad: Ok, ok, ok, let's back up here can we? Just hold your horses [dad puts up the traffic sign for stopping traffic].

Dad: First of all, no I do not think that you are stupid. Far from it. Second, you are right, I am not an addict and I don't know a lot of stuff about it- [laughing] AND I’m not starting my book yet so YOU back off, Yo!

Son: O.K.- that's good! [struggles to put up a smile- but it's not working as he is too upset to relax].

Dad: Son, do you know who taught me the most important stuff about addicitions?

Son: Abe Twerski, when he gave that lecture at Gateway?

Dad: Ooh- that was a good lecture- but no not him. Not at all.

Son: Who then? I know you're gonna tell me anyway! [Rolling eyes].

Dad: You did. When you were in rehab.

Son: [Looks surprised]

Dad: Yes, son in rehab you taught me that you need to go to a meeting a day for at least the first 90 days. And you taught me that you need to go to those meetings regardless of whether you feel like going.

[pause]

Dad: And you taught me that you need to cut yourself off from all the people that you used with. Remember that list that you came up with? That list of people that you need to stay away from? Well I learned a lot from you coming up with that list- you really gave that list a lot of thought. And I was surprised at how many names were on it! I was proud of how much work you put into that. Well, I see that you have started to hang with Denny. [pause] and Son, we both know he is on that list.

Son: Ahhh Dad! He don't use no more. He's goes to meetins now!

Dad: Nevertheless, he is on the list- and he is someone you shot dope with.

Son: You think I'm stupid- I will never do that junk again, man, you make me mad talking like this - [getting louder] you trying to work my program for me!

Dad: Regardless, we are sticking with the plan that you came up with in the rehab. We are not changing plans now. Son, trust me on this one; we ARE NOT changing plans now.

Son: But, even my sponsor says...

Dad: Regardless, we are following the plan we came up with in treatment. It's non-negotiable.

Son: I'm not going to all those meetings anymore, Dad. I mean- I'll go when I need to go that's all. And Denny's not a bad guy like you think- he's my friend - and you can't pick my friends for me neither!

Dad: [moving closer with strong eye contact the father says slowly and softly] That is unacceptable, Son.

Son: You can't make me do that stuff!

Dad: Son, we can do a lot- and if you want, your mother and I will discuss with you what we are prepared to do. But maybe it's enough for now if you just trust me- trust that I am prepared to do whatever I need to do to see that you follow the plan that you came up with in rehab. That's all.

Son: [walks off in anger, muttering obsenities]

Dad: [ Lets him go.]

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Relapse Posted by:Ken Sutton--Sunday, March 18, 2007

In a previous meeting we talked about how easy it was to see the signs of a relapse when looking backward in time and how difficult it was to see them as they are occurring. Looking back on a relapse in your family, please leave a comment on some of the signs you saw before the relapse occurred. Also, you may want to check out the relapse information on the HBO site.


There is a lot of information on the HBO site. I plan on spending some time there.

The cartoon is from this months Readers Digest.

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Suboxone Posted by:Ken Sutton--Friday, March 16, 2007

I met Melanie Donati ( RN, BSN melanie.donati@reckittbenckiser.com)at an Alliance meeting. Melanie is a Clinical Liaison for Reckitt Benckiser Pharmaceuticals who manufactures Suboxone a treatment for opiate addiction. Attached to this article is a complete patients guide to the drug. There still seems to be a lot of mystery surrounding the use of Suboxone and I have heard all kind of rumors (like it is very expensive compared to Methadone and your insurance won’t cover it - I checked and my insurance covers it for 90 days). I had the chance to ask Melanie a few questions and she was gracious enough to reply and allow me publish them here.

Question: When can you / should you start Suboxone?




Answer: Suboxone therapy can be initiated at any point in recovery. Now that Suboxone awareness is growing it is becoming the first-line treatment of opioid dependence. A patient can certainly be switched from Methadone to Suboxone but they have to be weaned down to about 30 mg of Methadone before the transition can be a smooth one. The biggest factor to this point in deciding when or how to utilize Suboxone has been the number of available providers. Fortunately this number is increasing everyday so the difficulty of finding a provider is becoming much less. Also, many Methadone clinics detox centers, and behavioral health facilities are incorporating Suboxone into their treatment protocols so the availability is much higher now. There is no set rule for when Suboxone is appropriate in opioid dependent patients. It basically boils down to awareness that it is available, finding a provider to initiate treatment, and the patient be willing to try the therapy. It most certainly can be the first course of action. It is indicated for 16 years and older as opposed to Methadone, which is approved for 18 years and older.

Question: I have heard that Suboxone is sold on the street and abused?

Answer: Regarding the street value. This topic comes up a lot and I can tell you that the street value is minimal. With Suboxone there is no high or euphoria as opposed to opioids and Methadone. So, people do not take Suboxone and get high. The street value, which exists, is somewhat unique. If someone is high and they are soon to be in-between fixes and are concerned about becoming “dope sick”, they will buy a Suboxone to prevent that sickness until they find their next drug. Suboxone fills the opioid receptors and prevents withdrawal from occurring until they find their drug of choice. Also, this can be the case whether or not they are trying to get well. If someone is trying to find a treatment provider or a program to accept them the will have to keep taking their drug until that time to prevent withdrawal so Suboxone plays a role until they find their own provider. There is also the person who does not want to get better yet and also does not want to be “dope sick” so they will substitute Suboxone in between fixes. The only way to prevent street sales is for physicians to be very, very cautious on their prescribing habits. If the patients are only getting exactly what they need pills won’t end up on the street. Because the patients need the pills they will not sell what they need themselves. However, if a person received too many pills there is always the possibility for street sales.

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First North Hills PSST: Thanks for your support! Posted by:Lloyd Woodward--Saturday, March 10, 2007

Valerie and I wish to thank all ten parents who helped make this meeting a success. Half of the Parents had already attended our Eastern Probation Office Meetings, and the other half were first-time members.

Candid exchanges between group members set a tone for supportive confrontation in this meeting. Especially, Parent after parent affirmed the need to focus on the drug problem if your teenager is still using. Other issues such as education, legal problems, health, MUST take a secondary role if the teenager is still abusing drugs. It is only natural that we allow ourselves to become distracted by these other important issues, because if there was no drug problem that High School Diploma, upcoming Court case, Hepatitis-C, or psychiatric problem WOULD of course be the main issue. Nevertheless, your teen cannot get that Diploma if he is dead. What can a parent do if their teenager is still abusing drugs?

The first step is to admit that your teenager is still abusing drugs and THAT none of the other problems can successfully be addressed as long as is active in his addiction.

The second step is to TAKE AN ACTION. Do not just wait it out. Chances are good that the longer you wait the more difficult the situation will become. Also, let us remember that this is a life-threatening disease.

Teens cannot hear what we are saying. This goes double when they are still active in the addiction. Therefore, the only way to SEND MESSAGES to them is by taking an action. For example, putting a teenager back in inpatient if possible is taking an action. Yes, we may have doubts that it will do any good, but we must take what actions are available to us. Putting a teen that has relapsed back into inpatient is not perhaps the only option, and may not be an option in some cases, but it does fit the bill in terms of SENDING A MESSAGE and TAKING AN ACTION. Figure out what actions are appropriate, along with your partner if you have one, confront your teen, and take an ACTION.

The Third Step is not to become sidetracked by other issues. Even the fact that you cannot insure that any ACTION you take will help can become a distraction. "Why am I going to put him back in inpatient, he already has been there and it didn't work." Yes, that may true although that is difficult to know. However, once again, SOME ACTION is required. Some parents have contracted with their teenager, that if he uses he must leave the home. If that is your contract with your teenager, then you must follow though. It depends on the age of your child, what drugs he uses, whether or not you have a Probation Officer or ACT 53 case, as to whether that might be a good contract to make.

The Fourth Step is to fine-tune the plan. If your child has gone into rehab, placement, or jail, then you have an ideal opportunity to get a strong commitment from your teen to do the following.

1. Attend 12-step meetings daily.

2. Develop a "we" of the program that includes sponsor, home group, and calling recovering peers each day. Chapters can and have been written about developing the “we” of the program.

3. Divorce old friends that represent ties back to the substance. Keep in mind that most relapses can be reduced to two forces at play. Backing off from recovering people ("those meetings don't help") and moving closer to people who use drugs ("he is my friend- he isn't a bad person, he doesn't even smoke Crack anymore.") We are NOT saying that anyone is a bad person. We are saying that your teenager's old friends are bad for your teenager and your teenager is bad for his old friends. They will want to use drugs again if they spend time together.

4. Agree to being drug tested WHENEVER parents choose to drug test.

5. Attend outpatient treatment and follow the therapist's recommendations.

6. Do not become distracted by the accusation of "You're trying to work my program for me." This is not the case here. You are negotiating a plan for recovery. If you do not come in with high expectations, then you are missing the big opportunity. This is mere negotiation.

7. However, it may be that your teenager is going to feel like you are working his recovery for him. Ok, agree with that premise if it makes it easier to move the discussion forward. “Yes, I am working your recovery somewhat. When you can work it yourself, I will be glad to take a vacation from working it for you. Until then, if you want to live here in this home, you will allow me to guide your recovery. Or you can work your own program somewhere else.” If he does not want to live with you, what are his other options? Perhaps he can work his own recovery somewhere else, like a group home, or a halfway house for recovering addicts. Guess what? Those places are going to have expectations about working a program too, and they won't be swayed by charges of "working their program for them." It is possible to be too involved in your teenager’s recovery, however that is the stuff of another post, or perhaps readers can leave comments on that issue.

8. This is an opportunity because if your teenager refuses or is reluctant to commit to conditions such as these, you should reconsider allowing him back home, or if he is at home you should consider what other options besides living at home that he may have. If we allow our teens to be active in their addiction and continue to live at home with no consequences or accountability, then we ENABLE them. We provide them with a base-of-operations from which they can easily seek the ways and means to abuse drugs. What are your other options? If he knows that you are serious about this plan, he may realize that he wants to live at home and he must comply.

The Role-play: check back later this week, time permitting, I will try to recap the role-play.

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Breaking a few eggs: (Summary of 3-3-07 Meeting.) Posted by:Lloyd Woodward--Wednesday, March 07, 2007

Our meeting at the Eastern District Probation Office this last Saturday featured a lively discussion, a spirited role-play, and some homemade Lady Fingers brought by one of our members that ARE TO DIE FOR. About 10 parents attended. There was much optimism laced with caution. One parent put it something like this: “Things have been going great this year, but I could go home from this meeting and find that my son has relapsed again.”

The Role-play: We all know the experience of being around someone who may react badly if we say the “wrong” things. We walk on eggshells. We constantly measure the effect that our words may have before we utter them. Like an overly cautious carpenter we measure twice, three or four times the impact that our words may have- so that we only have to cut once.

The Scenario:

For some time now, this young man has been struggling with Heroin Addiction. He has been at Abraxas for about three months. At first, he hated it; he ranted and raved about how his mother and this Probation Officer placed him there. Now, he appears to be well adjusted and is maintaining the top behavioral level in the program. He has apologized to his Mom for the things he has done during his love affair with Heroin. He no longer seems to be blaming others. He says that he takes responsibility for the things he has done that has resulted in his placement at Abraxas.

Up until now, Mom has not brought up some of the things that have been bothering her. This role-play takes place during an imaginary visit to her son at Abraxas…


Mom: Hi Sonny. You look SO good. Oh my goodness, you have really gained weight up here! Oh my, it’s good to see you! [Mom moves chair up closer and makes warm friendly eye contact.]

Sonny: [grunts], Ok mom, Ok its good to see you too. [As if to say-c’mon don’t embarrass me- someone might hear.]

Mom: I mean it! Even your brothers, who sometimes act as if they hate you, said they miss you.

Sonny: I should be home soon on a home pass.

Mom: I know. [Pause]. I hear great things about what you are doing up here. You mentor other teenagers now!!! I am very proud of you! And I know that you are back to playing guitar and I keep hearing about how talented you are!

Sonny: Yeah, well that home pass gives me something to look forward to. You want me to come home, right?

Mom: Oh honey I want you home in the worst way- we all do. Of course, I don’t want you home if you’re going to kill yourself with Heroin; nobody wants that.

Sonny: Mom! I quit that! I’m never going to do that stuff again. I learned a lot up here! [Scowl on his face shows displeasure that she would have to bring THAT up.]

[Pause.]

Mom: You know what? I really need to talk to you about some difficult things. I guess you could say that I need to get some things off my chest.

Sonny: What? Mom, don’t mess things up for me, OK? [Obviously feeling fearful of what might come up.]

Mom: What do you mean?

Sonny: Well, I’m finally getting the hang of things up here- you know its real hard for me up here, and I try so hard, so please don’t start bringing me down, OK?

Mom: OK, I’m listening, what could bring you down?

Sonny: I don’t know- anything. I have a lot on my mind right now. Let’s wait till we get home to talk about anything important- I don’t want my therapist to get the wrong idea. I might loose my home pass.

Mom: Well honey, I’m not sure if it will mess up your home pass or not- I hear you – that you are afraid, but Sonny, I NEED TO TELL YOU SOME THINGS. [Slowing down her words.] I mean, some things have been really bothering me.

[Pause.]

Mom: You know, I think you brought up a really good point.

Sonny: What?

Mom: About your counselor getting involved in this. Let’s ask her to come over here and sit in on this, so that she can support you and help you process our talk after I leave. That is a much better idea than her trying to figure it all out later.

Sonny: Are you nuts? I’ll get a level drop for sure. Ok, go ahead [Looking exasperated.] You’re going to do it anyway- I know you’re going to try to make me mad so that I don’t get my home pass. You don’t want me to come home do you? That’s what this is all about. You know I’m doing good, and you don’t want me to come home. Right?

Mom: Listen to me first – judge what I say second. Look, if you don’t want your therapist to sit in on this that’s OK. But I am going to tell her what we talked about. Nothing that I say is going to be kept secret. So, it’s up to you, but staff will be included now or included later.

Sonny: Why?

Mom: Because things that we agree to keep secret-keep us sick. And listen to this part honey- I WILL NEVER STAND BY AND HELP YOU TO STAY SICK! And that means, I won’t be keeping your secrets for you when you come home either. I will be honest with your probation officer, and I won’t cover or lie for you anymore.

Sonny: Ok call him over [Scowling again.] I don’t care, do what you want. I don’t care what you do. You’re going to do what you want anyway.

Mom: [Raising her voice.] Rose, do you have time to sit in on our visit?

Rose: Sure thing, you told me you might need me today- so I have someone here to help me cover.

Sonny: [Rolls his eyes.]

Sonny: Ok, what is it?

Mom: Son, I am troubled by some things that lay heavy on my heart. One is that I know from actual evidence, as well as from the core of my instincts as a mother, that you are the one that wiped out our bank accounts.

Sonny: Oh I TOLD you I never did that! You ain’t sticking me with that one. You better ask my brothers about that one cause I never took any of your money. [Delivered unemotionally, in a monotone.]

Mom: I’m glad we can talk about this. The second thing that troubles my heart, is that you have never taken responsibility for stealing from us.

Sonny: Cause I didn’t do it! [Looking mildly exasperated!]

Mom: Look son, [moving even closer and holding out a black book] I found this book out in the garage with your Heroin and your drug paraphernalia. It is definitely in your hand writing and it has every one of our bank account numbers listed.

Sonny: That is so wrong- you coming up here and accusing me of this. You calling me a liar Mom? Are you? Cause that’s what I think you’re doing, you’re calling me a liar, aren’t you?

Mom: It hurt a lot to lose the money. It hurts me even more that you have never admitted it. It’s like a knife in my chest! [Makes a motion of stabbing herself in the chest with imaginary knife.]

Sonny: You’re doing this just so that I won’t get to come home. You waited till I was doing good, didn’t you? Why did you wait till now to bring this up? Huh? I keep asking you that – you’re the liar – you won’t admit that you don’t want me home!!!!! That’s what this is all about!

Mom: You are right about part of that.

Sonny: Yeah, I know I’m right!

Rose: Wait a minute you guys. Sonny, why did you write these account numbers down in a book and keep it hidden in your Heroin stash?

Sonny: [Looking at his Mom- not his counselor.] See mom. You happy? I’m going to loose my level now. I told you-[looking at counselor now] I told her- that is not my writing. I never wrote down anything like that. Did she ask my brothers about it?

Mom: [Keeping eye contact with Sonny, not the counselor.] Oh I’ve checked. It’s not your brother’s hand writing. It’s yours. And they don’t do Heroin, so why would it be hidden in a Heroin stash in the garage?

Sonny: [Looking at his counselor, not his Mom.] She’s just turning things around on me- cause I’m doing so good up here.

Mom: I’m so glad you brought that up. [Moving chair closer to Sonny.]- I AM TURNING MYSELF AROUND. You see, I WILL NEVER STAND BY AND WATCH WHILE YOU KILL YOURSELF WITH HEROIN. I DID DO THAT. DO YOU HEAR ME SONNY? I DID THAT AND I AM TURNING MYSELF AROUND. I’M NOT THE SAME PERSON that used to be so afraid that I might upset you. AND I W I LL NEVER stand by and do nothing while you kill yourself with drugs. And I will not stand by now while you say you want to change your life, but you still can’t find the courage to take responsibility for what you have done.

Sonny: [Seething Quietly.]

Mom: And let me tell you one other thing. I DON’T want you home until you’re ready to recover from this Disease. And until then, I will do EVERYTHING in my power to see that you stay up here where you are safe- where you can’t hurt yourself.

Sonny: I can come home now for a visit and not get high mom. I will never get high again. I gave all that up- but you just don’t trust me!

Mom: No- you are so right! I can not begin to trust you as long as you persist in these lies. Maybe you can stay clean on a home pass; maybe you can’t. But as long as you persist in these lies, I want you to stay up here where you are safe.

Sonny: You just want me to fail up here.

Mom: I want whatever is going to help you save your own life. If that means a level drop- so be it. You deal with it!

Sonny: You don’t care about me. I work so hard up here. You’re turning it all around on me.

Mom: Sonny, I’m proud of you and the hard work you did up here. But it’s going to take more than that to stay off Heroin. I’m so afraid you’re going to kill yourself.

[Pause.]

Mom: You know what?

Sonny: What?

Mom: I would feel a whole lot better if you were more worried about your life-threatening disease – than about your level drop!

Follow up note: I made up that role-play. The role-play we did at PSST inspired me to write it- but it is not the exact same one. I want to thank the parent who provided the scenario and who acted the part of her son.

Discussion:
As parents, we learn early how to figure out what is wrong with our children. We start when they are infants. We know which cries mean that something is really really wrong, which ones mean that something is really wrong, and which ones just mean something is wrong. Then, as they grow we continue to “read” our children, constantly assessing what emotions, they feel and how things look from their perspective. When we gain that place of understanding, we feel better. Because now that we know what is wrong so we can help.

Most of what we do to help we do to help we do to mitigate or ease the pain of our child. If he is upset that he is not able to have a toy that another child is playing with, we find him a similar toy. If he is jealous that another child has been successful when he has failed, we point out to him that he is successful at many things too. If he wants to watch his show on TV (and he might be very disappointed or angry if he does not get to watch) - we gladly sacrifice our own TV show so that he can watch HIS show.

This is part of how we judge our success as parents. If our child is upset, we have failed. If he is happy, then we have succeeded. This is natural. But what happens when our teenager gets involved with drugs?

NEXT: Enter the ADDICTION. Now everything we have done to manage, “read,” and intervene in our children’s life sort of backfires. For example, our teenager wants money or he wants to go out without making good acceptable plans. If we do not give in- he will be unhappy, at best. If we do give in, he will be temporarily pacified. Moreover, if he is unhappy and throwing a tantrum, then it is we the parents that he blames. Are we good parents? If we are so good, why is he so unhappy?

At some point we start to walk on eggshells. We do not want to rock the boat. God forbid we make our teenager angry now. Many of our teens with drug problems have really mastered the anger thing. Many times, we are also dealing with psychiatric problems in our teens. It is difficult to know what to do. Who wants to upset a teenager by saying NO to something that he wants so badly, and end up hearing something like, “You know what? YOU’RE the reason that I need to f___ing get high, so that I can get away from you.”

NEXT: Enter the RECOVERY. Ok, now we are finally where we need to be. Maybe our teen is in an inpatient treatment program and he is planning to work a 12-step program. However, now we are REALLY walking on eggshells. We not only fear that he is going to be angry with us, but now we also fear that WE will cause THE RELAPSE. After all, if he gets angry he will be at a higher risk of going back to the drugs. Now darn it, it is all our fault because we made him angry.

NEXT: Enter FAMILY COUNSELING. The therapists and counselors tell us that it is important that our teenager be able to get to the bottom of some of his problems, no doubt some of which are rooted in his relationship with us! Then, when the family sessions start- we feel like we are targets for his frustrations.

Perhaps he is full of resentments. These resentments can range from “you liked my sister better than me,” to “you should have stopped me from using the Heroin before I got hooked.” What has not changed now that he is in Recovery, is that he is still trying to control us with the threat that he might become upset. His power in the family may still be incredible. Even in inpatient treatment, or in court placement, our teens attempt to control us by the threat that they will be absolutely livid with us.

And maybe we feel that many things WERE our fault, because darn it, we are human beings, and therefore we are not perfect. So we apologize, and we look for ways to let our teenager know that we still care and we still love him; as if love can cure anything.

Meanwhile, all our apologies, statements of love, and our determination to “understand” are often seen as a sign of weakness by our teenager. He will play along of course. He understands this game well. The name of the game is “How Many Ways Can We Make This MOM and Dad’s FAULT?”

Therefore, we walk on eggshells. How else can we make it though the day? Well, there is another way. We can break a few eggs. In fact, we can break a few on purpose. Why? Because we come to understand that our child’s well being is no long further by the whole “tiptoe around the eggs thing.” Furthermore, our teenager is not the only one that needs to express a few resentments! As parents, we need to express some things too! What is good for the goose...

And secondly, we come to accept that if he is going to believe that we have changed once he comes home from the rehab, then we better show him some changes while he is still in the rehab. Our hope is that it produces therapeutic grist for the treatment mill.

We need to take risks in order to have any chance of helping our teenager make good decisions. We need to be strong, take-the-bull-by-the-horns parents, who do not shy from confrontation. We need to break a few eggs.

I hope that you see from this role-play that we can break a few eggs without being unseemly or mean-spirited. Our love and our warm caring feeling can be expressed at the same time that we are taking our bull by the horns.

Closing Note: I do not mean to imply that by pacifying our children, we parents have caused their addiction. We all pacify our children to one degree or another. That is not what causes the addiction and most children will not develop addictions just because a little spoiling has happened. However, when addiction strikes, it becomes counter-productive to pacify or enable them out of the consequences of their addiction. Our only hope lies in combining warm expressions of love and concern with toughness. We can see the manipulations. We must not be manipulated any longer. So, let’s break a few eggs.

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