It's the DOPAMINE, stupid! Posted by:Max--Wednesday, June 15, 2011

New York Times - Health

"A General in the Drug War"

The following is an article I just read in the "Health" section of the New York Times. Much of the information may not be new to PSST regulars, or the professionals we work with...NEVERTHELESS..it is very interesting from a medical and political perspective. I made minute edits to keep the article focused on our subject of choice, the world of addiction. For the full article, click on A General in the Drug War.

From heroin and cocaine to sex and lies, Tetris and the ponies, the spectrum of human addictions is vast. But for Dr. Nora D. Volkow, the neuroscientist in charge of the National Institute on Drug Abuse, they all boil down to pretty much the same thing.

A driven worker with a colorful family history and a bad chocolate problem of her own, Dr. Volkow (pronounced VOHL-kuv), 55, has devoted her career to studying this chemical tide. And now, eight years into her tenure at the institute, the pace of addiction research is accelerating, propelled by a nationwide emergency that has sent her agency, with a $1.09 billion budget, into crisis mode.

The toll from soaring rates of prescription drug abuse, including both psychiatric medications and drugs for pain, has begun to dwarf that of the usual illegal culprits. Hospitalizations related to prescription drugs are up fivefold in the last decade, and overdose deaths up fourfold. More high school seniors report recreational use of tranquilizers or prescription narcotics, like OxyContin and Vicodin, than heroin and cocaine combined.

The numbers have alarmed drug policy experts, their foreboding heightened by the realization that the usual regulatory tools may be relatively unhelpful in this new crisis.

As Dr. Volkow said to a group of drug experts convened by the surgeon general last month to discuss the problem, “In the past, when we have addressed the issue of controlled substances, illicit or licit, we have been addressing drugs that we could remove from the earth and no one would suffer.”

But prescription drugs, she continued, have a double life: They are lifesaving yet every bit as dangerous as banned substances. “The challenges we face are much more complex,” Dr. Volkow said, “because we need to address the needs of patients in pain, while protecting those at risk for substance use disorders.”

In other words, these drugs must be somehow legal and illegal, encouraged yet discouraged, tightly regulated yet easily available.

The experts are looking to the institute for scientific tools that might help by loosening the tight bonds between pain relief and addiction in the brain.

And that, Dr. Volkow told her audience with a small smile, is all about the dopamine. She knows a little about dopamine firsthand: She is a dedicated runner and a helpless pawn in face of dark chocolate. Her most significant long-term addiction, though, has been to the science of scanning the brain with techniques that expose its workings like a map, a passion she has pursued like a guided missile since medical school.

Dr. Volkow’s research career, still based at Brookhaven, has been notable for its “brilliant science,” said Don C. Des Jarlais, an expert in drug addiction who directs the Baron Edmond de Rothschild Chemical Dependency Institute at Beth Israel Medical Center in New York. Dr. Des Jarlais cited her recent widely reported study showing that cellphones alter brain metabolism as a typical example of her unusually creative scientific thinking.

A Merging of Missions

Her days now veer from reviewing raw laboratory data with her research colleagues to leading the back-to-back meetings of a government functionary, but the two roles are joined by the mantra of her time at the institute: Policy should be grounded in valid science.One recent decision in the upper echelons of the National Institutes of Health reflects a similar conclusion: The drug abuse institute and the National Institute on Alcohol Abuse and Alcoholism are on track to be merged into a joint institute on addiction still in the planning stages.

National Institutes of Health watchers have already started a body count. “It will be a big loss that Nora Volkow, current N.I.D.A. director, cannot possibly be selected to head a new institute,” wrote one anonymous blogger on the Scientopia Web site. “This would be too much like N.I.D.A. ‘winning.’ ”

But Dr. Volkow says she is all for the merger, calling the current structure “an artificial division with many missed opportunities,” like having an institute for every particular variety of cancer. Addictions tend to move together, she said, sharing many triggers and a great deal of biology.

Again, it is all about the dopamine.

All addictive substances send dopamine levels surging in the small central zone of the brain called the nucleus accumbens, which is thought to be the main reward center.

Amphetamines induce cells to release it directly; cocaine blocks its reuptake; alcohol and narcotics like morphine, heroin and many prescription pain relievers suppress nerve cells that inhibit its release.

Addicts and first-time users alike get the high that correlates with the dopamine wave. Only a minority of novices, however, will develop the compulsion to keep taking the drug at great personal cost, a behavior that defines addiction.

Researchers now postulate that addiction requires two things.

- First is a genetic vulnerability, whose variables may include the quantity of dopamine receptors in the brain: Too few receptors and taking the drug is not particularly memorable, too many and it is actually unpleasant.

- Second, repeated assaults to the spectrum of circuits regulated by dopamine, involving motivation, expectation, memory and learning, among many others, appear to fundamentally alter the brain’s workings.

For instance, Dr. Volkow’s group showed several years ago that when cocaine addicts watched videos of people taking drugs, dopamine levels surged in the part of their brains associated with habit and learning, correlating with the intense drug cravings the subjects began to experience. Her research and that of others has also shown that even after addicts are successfully detoxed and long clean, their dopamine circuits remain abnormally blunted. Substances that elevate dopamine levels in normal subjects had notably muted responses in ex-addicts.

This observation, experts say, may explain the intense difficulty addicts have staying clean, as the ordinary rewards of daily life may have little effect on the recovering brain. Only the drug of choice will send dopamine levels high enough for any kind of pleasure.

“Nora is as responsible as anyone,” Dr. Des Jarlais said, “for showing that addiction really does cause changes in brain function. Her work is a primary basis for considering it a disease, rather than poor choices or immoral behavior.”

Arming Doctors With Tools

Dr. Volkow has watched the microscopic events of addiction play out in fluorescent rainbow colors on brain scans for decades now. But those scans are used entirely for research, not for patient care. To the average doctor, she knows, the addict’s brain is impenetrable. All that is visible is irrational, illegal and sometimes threatening behavior. Surveys show most doctors prefer to keep their distance from addiction and addicted patients.

“My obsession is to engage the health care system in addiction,” Dr. Volkow said, to medicalize what is often considered mainly a criminal problem by arming doctors with their accustomed tools: effective treatments, even a vaccine.

“She’s been a champion of bringing addiction science into mainstream medicine,” said A. Thomas McLellan, director of the Penn Center for Substance Abuse Solutions at the University of Pennsylvania. Medicine is finally beginning to understand, Dr. McLellan said, that if you pay no attention to the behavioral factors leading to a chronic illness, be it diabetes or substance addiction, you can never catch up.

“That’s been one of Nora’s big contributions.” In a study published in 2000, Dr. McLellan pointed out that while the overall success rate for curing drug addiction with medications, therapy or both is not high (about half of treated individuals return to active substance use within a year), it is quite similar to overall successful treatment rates for other chronic medical conditions like asthma, diabetes and high blood pressure. Failure to take prescribed medications and backsliding to old bad habits is endemic, no matter what the condition.

The success of treatment for addiction is particularly dependent on the social milieu of the addicted individual, Dr. Volkow said. “So, for example, the best successes in treatment generally are physicians, for they are also the ones with the strongest support.”

But treating people with the prescription drug problems is particularly challenging, because, of course, for these particular drugs, physicians are the nation’s pushers.

The number of prescriptions written for potentially addictive pain medications has soared in the last decade, reaching more than 200 million in 2010, Dr. Volkow said. Surveys asking teenagers where they get pills find that relatively few buy from strangers. Many have their own prescriptions, often from dental work. Even more are given pills by friends and relatives, presumably out of other legitimate prescriptions.

Doctors may be flooding the country with narcotics, but most have never learned much about pain control. Dr. Volkow said that some data suggests that medical schools devote considerably less time to the subject than veterinary schools do. The Obama administration addressed exactly this deficiency in April with a call for doctors to undergo special training before being allowed to prescribe some of the most addictive painkillers.

“Students and residents have gotten the message that pain is undertreated,” said Dr. Mitchell H. Katz, an internist who directs the Los Angeles County Department of Health Services. “So they just prescribe higher and higher doses.” Meanwhile, he said, there is no evidence that treatment with opioids for more than four months actually helps chronic pain, or that higher doses work where lower ones fail.

There is good evidence, however, that higher doses raise the risk of overdose and death.

“The dichotomy between good drugs prescribed by doctors and bad drugs sold on the street is just bad science,” Dr. Des Jarlais said. “N.I.D.A. is now having to address the fact that there are real problems with prescription drugs.”

The institute is starting a multipronged effort to teach and to learn more about pain control as it relates to addiction. The teaching part includes sponsoring performances of excerpts from Eugene O’Neill’s “Long Day’s Journey into Night” at medical conferences, in order to humanize for doctors the problem of addiction.
The learning part is continuing: New science for pain control may take some time to devise, Dr. Volkow said.

New Approaches

One promising way to lessen the addictive properties of pain relievers, she said, is to slow the speed with which they reach the brain: A dribble of dopamine is far less addictive than a surge. New formulations to deliver pain relief slowly should minimize older drugs’ addictive potential. Skin patches are one example of this effort (although they can still cause fatal overdoses) and research is under way into others.

Another technique is combining drugs to deter abuse.

The drug suboxone, an alternative to methadone, is constructed with this intent. It combines a methadonelike drug for maintaining addicts on an even keel with another drug that counteracts overdoses and opiate-associated highs. If the suboxone is taken orally, as intended, the methadone effect predominates.

But all hard-core addicts know that if an oral drug is injected into the bloodstream, it will rush into the brain and create a far more dramatic high. If suboxone is injected, the second substance kicks in immediately and prevents the high.

Dr. Volkow generally forswears any interest in politics per se, but midway through a long day of meetings last month she sighed and acknowledged, “science and politics are intertwined.”

We think we have free will, she continued, but we are foiled at every turn. First our biology conspires against us with brains that are hard-wired to increase pleasure and decrease pain. Meanwhile, we are so gregarious that social systems — whether you call them peer pressure or politics — reliably dwarf us as individuals.

“There is no way you can escape.”

Profiles in Science | Nora D. Volkow
"A General in the Drug War"
By ABIGAIL ZUGER
Published: June 13, 2011

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TWO TIRED TRAVELERS TAKE TIME TO REST UP Posted by:Rocco--Wednesday, June 15, 2011

CISCO'S SAGA CONTINUES

When we left off the other night Sally and I did not know where Cisco was, who he was with or what his plans were. We knew there was not much else we could do. We had texted him several times with no response. We let him know that we would be at our regular Tuesday meeting and we hoped he would be there.

"The P.O." did not quit.


"The P.O." called us early Tuesday morning to let us know that he had made contact with Cisco and that Cisco would see us later in the morning. Cisco was good to his word and returned home somewhat embarrassed and feeling stupid [his words]. He asked if he could go back to Second Run for our meeting. As we promised him we didn't lecture him [too much] on the way. We also did not buy him cigarettes or stop at McDonald's when he asked.

When we got back to Second Run, Cisco was surprised to see the concern and the feelings of relief expressed by his housemates. They gave him the 'talking to' that we usually gave: "Why didn't you talk to us first?" "Don't you trust us?" "Why didn't you answer our texts? We wanted you to come back." "Don't go doing something stupid." "You know we got your back."

Sally, Cisco and I had our meeting with his counselors Tom and Clair. Tom is very good at reaching Cisco. Most of the meeting was about Cisco receiving more freedom and trust from his program and his parents; getting more chances to develop his life skills and opportunities to return the trust. Tom told him that nobody expected perfection but that we were looking for good choices, openness and honesty. Tom made the observation that the main reason that he drug tested Cisco was what he perceived as a recent trend of Cisco's lack of honesty and openness as well as some bad choices.

In a brief summary, Tom explained how using is just the climax of the relapse process. That overconfidence, deception, cheating and lying are the building blocks of the relapse process. He added that Cisco had already laid the foundations of his relapse in the last few weeks; that his using was just the capping off of his relapse.

He asked Cisco how he felt after using again?

Cisco replied "It felt like sh*t."

Tom said quietly "That's good, that's good. Now how does feeling like sh*t help you?"

Cisco wasn't sure.

Tom and Clair explained how his honesty about his relapse now gave Cisco a small window of opportunity to become completely honest; how he had just a brief time, before the window closed, to tell us what happened. Not just the night before but for the last few weeks. Where he was, what he was doing and who he was with.

Cisco opened up a little and explained some of what he had been up to. Tom challenged Cisco again. He explained that this was not the time to give us little bits of qualified details of what was going on. The window was now open but he needed to tell as much as he could before it shut. Cisco opened up one more time and Tom challenged him again and reminded him that omitting information was a form of dishonesty also. Cisco told a little more and Tom asked Sally what she thought about her son's honesty. Sally looked Cisco in the eye and told him that she had heard it all before and [asking him to look her in the eye] told him that quite frankly he was not telling the whole truth. Tom told Cisco that if nothing else; the least he could tell us is that he is "not ready to be completely honest" at this time.

He assured Cisco that he wanted to keep working with him but that he would need to go back into a rehab facility for a few weeks and that then he would need to reapply for Second Run. Then his housemates would need to interview him, be assured that he was serious about his recovery, and vote him back into the house. Tom said, if they voted him in, that Cisco would be starting at square one again and that he would not rush the program. He would need to do it step by step. Cisco agreed that this was a good plan.

At this time Cisco is to be evaluated for voluntary admission to an inpatient facility [his housemates voted to let him stay at Second Run until then. ]

As Sally noted; Cisco has a large tool box with a lot of shiny tools that he has worked for for the last two years; now he needs to get serious and use them. Or as Tom noted Cisco is a big boy and is much too large for anyone to carry anymore.

Sally and I see real progress in this latest episode:

- Cisco ran, not so much to get away from his program but because he was drug tested and knew he would show positive. He admitted that he felt shame for using and "it made him feel like sh*t."
As Tom said "That's good..." It has been a long time since Cisco has felt shame for using.

- Cisco came back quickly and faced his housemates and owned up to what he did.

- Cisco is voluntarily going into an inpatient rehab.

- Cisco wants to stay with his recovery program.

Sally and I are feeling good on how we handled this together. We are going back to our remodeling projects, our yard work, our classes and our Summer of 2011 [and our PSST Meetings].

We, once again, extend our thanks to the Allegheny County Juvenile Probation Program, PSST, Wesley Spectrum and Cisco's Halfway House, his housemates and especially his counselors, Tom and Clair.

This story will be continued, I am sure.

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A Proud Parent Promises to Work Her Own Program Posted by:Sally--Tuesday, June 14, 2011

Front of shirt: Click 'read more' to see back.

It is necessary for me to start off each and every new day with the following promise to myself: I will remind myself that I am powerless over my sons addiction and promise to work at staying in control of my own life. I will pray each morning that I do not enable or act in a co-dependent manner.

Even though Rocco and I were weary yesterday and things looked bleak since Cisco walked away from his program and we did not know where he was, I felt a calmness from within. I know the source of that calmness came from God.

Cisco is now safe. Lloyd spoke with Cisco last night and Cisco told him he would meet us at our bi-weekly meeting at Second Run. I was not 100% certain that he would show up, however, Rocco and I got a good nights sleep. We stayed in our regular routine this morning and around 10 o'clock, Cisco called to ask if he could stop home and if we would drive him to Second Run.

I had a hard time facing the previous relapse that Cisco had. I think this one was harder on Cisco. He seemed embarrassed to face the men at Second Run who are diligently working their own programs.

The meeting went better than expected. Tom has a way of dealing with Cisco that is so effective. He is by far the best 'counselor' on addiction that Cisco ever had.

Cisco is going to a rehabilitation facility for a few weeks until he is detoxed.

Then he will have a chance of getting back into Second Run; the men who live there will have to vote on it. There will be a meeting and they will talk with Cisco and then make their decision. I got a first-hand glimpse at how AA and NA truly work. These men hold each other accountable. Some of them may be rough around the edges but they have hearts of gold and they care about each other.

I am proud of Cisco. Addiction is a very tough disease to handle and he is handling it well.
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Two Tiresome Travelers Tell Their Troublesome Tale Posted by:Sally--Monday, June 13, 2011

Rocco and I are the weary travelers on this treacherous road of recovery. We have been at it now at continuously persistent speed for at least four years. Even before we met all the wonderful people at PSST and his recovery facility we will call Second Run we tried many avenues to aid our son in his recovery.

Cisco left Second Run tonight. He walked away from the facility after taking a drug test that he knew would come out positive.

I cringed when I saw the number of Tom, the director of the facility, show up on my phone. After a few years, you develop a sixth sense about a phone call and you realize when you are about to hear bad news.

We sent Cisco a text and explained that he should make a good choice and go back to New Beginnings so that Tom could work with him on this. He texted back that he was interested and we told him we would transport him back (with no lecture) if he would tell us where he was. We did not hear anything else from him. We do not know where he is or what he is doing. We let him know that we would be at our regular Tuesday meeting and we hoped he would be there.

I am simply hoping that we do not get a phone call tonight from the police or worse.

As for Rocco and I, we are seeing this in a very similar manner. I am thankful for this because it is so easy for an addict to drive a wedge between his parents. It is difficult to agree on some of the decisions that need to be made at a time like this.

Maybe it did not fully sink in yet or maybe I have finally mastered the art of detachment but I am in control of my emotions on this one. Rocco said that Cisco needs to 'hit bottom' and even though the weather is nice at this time of year, (he will not freeze his a$$ off - this became a controversy between Rocco and I last winter when Cisco walked away from a different program) he can hit bottom when he gets hungry and tired and has nowhere to rest.

I agree with Rocco on this one.

We have done all that we could to help our son. We are running short of tools in our tool box. There are just some loose screws and nuts rattling around in there at this point.

On the other hand Cisco is carrying around a lot of good tools with him. He better put his Tools for Recovery to good use.

He is the only one who can build a strong structure called recovery.

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The Prodigal Son is Given a Choice - by Joy Y, a PSST Mom Posted by:Sally--Monday, June 06, 2011

The Prodicgal Son is Given a Choice ~ by Joy Y

The Prodigal came in at 9 a.m. after being out all night, not sleeping and got ready to go to work. As he was eating what I prepared for him, I asked him to please send me the drug test results (still hasn't) and he agreed.

I asked if he blazed last night, to which he responded "a bit". I said "You know if you stop blazing now that you will be able to remain at home after your final exam on June 24th".

P.S. said "If you stop giving me drug tests I can live at home".

I replied "To live at home we will continue to give you drug tests AND they need to be negative".

"As long as I follow the rules I should be allowed to live at home" he answered.

I told him, "Your right, and the rules are to live at home you need to be off drugs and to remain in drug counselling".

There was a silence for a bit then I noted "So I guess you are planning to move out?".


He looked up and asked "what do you mean?".

I said "Well, You know that you can't remain at home if you keep getting positive drug tests. So you must have plans of where you plan to live. It would be good to know if you are moving out".

He replied "Okay then, I will move out".

I told him "That's good to know, it will help with my plans".

He paused again "What plans?".

"Well", I informed him, "This house costs me $2000 a month. If we are only going to be the four of us, we can downsize to a smaller place and live in a place that works for all of us".

He exclaimed "WTF, why would you do that?".

I explained to him that we had been discussing for a while now about moving once you guys are out of high school to a place that is less expensive since we don't need to remain in this area. So knowing that you are planning to move out helps me plan better".

I went into the other room and asked one of the Prodigal's brothers if we moved to a smaller, less expensive place, where would he want to live. His other brother wants to live south of where we are, because it is near the university he wants to attend. But I asked where would he want to live. We discussed it for a bit, all the while, with the Prodigal is muttering from the other room "shut about about that".

We kept talking.

As I drove him to work, I asked if he started to get negative drug tests and remained at home, where would he want to live, if we moved.

He told me "I don't know".

I said "Well think about it, because we will definitely take your input into the decision".

He said "Well me and a bunch of friends are thinking about moving out for the summer".

I told him that was good to know".

He asked "Why?".

"Well, if you are moving out, then we will make the choice of where to live and how big a place we need, accordingly" I explained

"Well, what if I want to move back later?" he asked.

I told him "If you got off and stayed off drugs you'd be welcome to live with us wherever we were living. Hopefully there would be enough room for five of us and it would be in a location that would work for you".

He replied "I am not on drugs! I smoke weed".

I let him know that he is entitled to look it that way, neverthe less, for him to live at home he needs to have negative drug tests, which he doesn't.

He asked "Well nothing is carved in stone yet about moving out?"

"Well, we only need to give a month's notice on the house so if you move out we will take it from there" I explained.

He retorted "I don't see why I can't blaze and not do drug tests!"

I replied "If you live on your own, you can do whatever you see fit. However that is what it will take for you to live at home. We would like you to live at home, but you need to make a choice".

Then the Prodigal said something about "I bet you wish I was like my brothers".

I replied "No, I like you just the way your are, you are you and they are them".

He told me "That's not true! You wish I was like them!"

I said "I'm sorry you feel that way, but its not true".

By then, we had arrived at work. He just opened the door and left, saying nothing.

He is now finally in that place where he actually has to choose what he wants to do.

If the discomfort of remaining the same is greater than the discomfort of changing, then, who knows, maybe the Prodigal is ready to make some choices.

Stay tuned.

~Joy Y.

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Wilma Does Not Waver Posted by:Sally--Monday, June 06, 2011

Today is Bam Bam's 17th birthday and he spent it at Bedrock manor. I remember 17 years ago getting the phone call from his birthgrandmother (he is adopted) that he was born. I spent the next few days back and forth to Latrobe hospital to get to know my new son. His grandmother and great-grandmother were wonderful very focused on what was best for the baby. His birthmom had many problems and was not allowed to be alone with the baby or allowed to bring him home. She had to have a plan for him. Her family already had custody of Bam Bam's sister(one year older than Bam Bam) and had their hands full with her and all of the drama surounding their mom. They wanted him to have a chance for a normal life with a mother and father. Birthmom Kandy had chosen us over two other couples and we felt so lucky and blessed.

I bonded with Grandma and Great-Grandma so on the day we went to pick him up from the hospital I walked hand in hand in with them down the hall to Kandy's room. Fortunately, she had a c-section and the lawyer had her sign the papers 72 hours after the birth. The nurses were wonderful, very thankful Bam Bam was going home with us. Kandy had been raising all kinds of he@@!! during her stay at the hospital and there was concern about the baby's safety. We had the new-baby crash course in bathing and feeding and went home with tons of formula, diapers for our new precious baby. After 7 years we were parents!!!

Fast forward 17 years and here we are at Bedrock Manor. We have a standing 5:30 appt with the counselor, get there and she isn't there. She was in court all day in another county several hours away and didn't make it back to the facility and forgot to call us. So now we have an hour to kill. Left for an hour and came back at 6:30 for family programming.

First the parents meet with Miss Lacey and she goes over what we will be working on. It is an aftercare plan for when the kids are discharged-what treatment they will have, going to NA/AA, getting a sponser, school. Then it is tougher; the kid has to name which using friends they won't hang out with, which non-using friends they will hang out with, and on and on. A couple of us mention our kids only have friends that use. In fact, my son is friends with the Olsen twins who were recently arrested at school. I think they should be on the friends not to hang out with. Then the staff brings the kids in and we are to go over the plan with them.

BamBam comes in not looking too happy but of course it's his birthday. I did wish him happy birthday. We start on the plan and he writes a couple things like SHORES for D & A in Home treatment, then when it's the meeting part of the plan he talks about how they want them to do 90 and 90 which is 90 meetings in 90 days and says he isn't doing it , its stupid he would do it in 180 days. Fred doesn't know what this is. I suggest Bam Bam explain it to his dad but he refuses. I told him he could spread it out a little if he wants to but it is important. Then we get to the school part of the plan and he asks if what he is doing there counts, and what he did in cyber should count and he might as well just get his ged if he has to do school work in the summer, and on and on. We tell him AGAIN that it all counts, he might as well do school work as he wouldn't get his ged until June 2012 when he would graduate from high school which he already knows. We weren't getting mad or anything then he says something like "this is shit" and calls me a psycho.

From here I could see it escalating into him calling me an F&&&ng B!!*%%$ch. I said I don't have to listen to that and leave the room and wait in the lobby area. He is upset, Miss Lacey comes out to talk to me. Bam Bam wants me to come back and I refused. I can hear him telling them he needs to talk to me but they won't let him out in the lobby thank goodness. I told her that if we were at home Bam Bam would be stalking me through the house . Thank goodness we were at Bedrock and not at home so he couldn't do that. I told her that I am not putting up with his disrespect. She came out a couple times to try and get me to come back but again. I refused. It's freezing in the lobby so i went outside. Lacey comes out again and asks if i could come tomorrow for a session with Miss Margarock and I told her no, i came today and its not my fault the counselor wasn't there. I am very busy at my work right now (I do have a lot of flexibility but I am not jumping through hoops to reward Bam Bam's disrespect). and was not planning on traveling back and forth to the facility on Wednesday. Bam Bam has a 9 hour pass tomorrow and the plan was for Fred to pick him up and they would do a few things together. I would go early to work but then I would leave early to spend time with Bam Bam and Fred and then we would all go to dinner for his birthday. Lacey tells me that he is crying but I am not budging.

She asks if I would do a phone session in the morning with Bam Bam and his counselor and I said I would do that. While I was outside another staff person I had met before told me that I did the right thing so I felt somewhat vindicated. She told me they tell parents they do not have to take abuse from the clients. Bam Bam never went back into the cafeteria to participate in the programming with his dad. So I don't know if he will get his 9 hour pass which he did earn. And if he does right now I don't know If I will go out with him.

So much drama. I do feel bad for him that he is not home for his birthday, however, his plan was probably to hang out and get high/drunk with his friends. And that did not happen.!

Editor: The original image of the Bam Bam birthday cake, which does not appear to be copy writed, was found at http://imageshack.us/photo/my-images/692/bambambirthdaycake.jpg/

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Intervention Posted by:Lloyd Woodward--Sunday, June 05, 2011

Recently my 36-year old son’s mother, his older brother and I intervened in his world of addiction.  We surprised him with this move, and his mother and I presented him with letters. A recent addiction-driven, tragic experience within the family of a good friend of mine enabled my older son and me to finally convince my younger son’s reluctant mother that this needed to be done sooner rather than later. It was a somber and difficult, but necessary, meeting. Below is the letter that I gave to my addicted son. In order to maintain confidentially, I have substituted (Son) in the parts of the letter where I used his name. Perhaps some of you who read this will find something in it that will be helpful to you. 
 

Dear (Son):

We are all saddened, disappointed, angered, frustrated and frightened as a result of the position you have put us and yourself into, (Son). And, those are only a few of the intense feelings that we have at this time.





It has all become, seemingly, very complex after all of these 20 plus years. So much so, in fact, that we all find it necessary now to bring some simplicity and order into all of our lives, most especially concerning the matters relating to your ongoing addiction and addictive behaviors.

So, we have decided together, out of our love for you, to detach ourselves from your struggles. We have not come to these decisions lightly. This is all very painful for all of us.

Your decision to leave treatment early in 2009 left us baffled, but we were hopeful as well, hopeful that you had progressed to the point that you would take responsibility for your life. That has not happened. We have seen precious little effort on your part. In short, (Son), our hope for change has not been fulfilled, and we are left with an empty feeling after all of the love, time, effort and money that we have put into this dilemma.

We all have come to know over the course of the years that change, big change, is an absolute necessity for any addict who expects to experience success in their recovery. But, we cannot change you, we can only change ourselves. And so we will.

We wish you well.

Love,

Dad
5-11-11

Author's Note: Of course, there are risks that we must face with nearly every decision that we make, and this is certainly no exception. But my thoughts with regard to the risks involved in this decision are that without intervention, my son is on the road to a slow and painful death, albeit most likely an early one.

My son is laden with guilt and regrets of lost years and wasted opportunities, and I firmly believe that this is the best that we can do for him. Please do not wait until your loved one is so low. Take it from one who has been there, you do not want, nor do you or anyone else deserve 20 years of this, especially your addict or addict to be.


Other posts by the same author can be found here:

HELLO! MY NAME IS ED: THE DISEASE OF CO-DEPENDENCY (PART 1 OF 2)

My name is Ed- Part II: The Plan

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Violet Stands Up to the Challenge ~ Supported By Her PSST Skills - by Violet Posted by:Sally--Sunday, June 05, 2011

...I am now in mama bear mode protecting her cub. ~ Violet

As I reflect on the events of the past week I find the tools I have learned from our meetings has changed not only the way I interact with my son but the way I interact on his behalf and in the life of the addicts family, where there is limited positive reinforcement, this has shown to be beneficial. So back to the story...

Court for Sal for Consent Decree Review – via probation violation – was Tuesday. His PO is not there so I have a replacement. As I sat waiting for our turn I am confident in what I will say to his judge. Filled with this confidence Sal’s PD [who I might add looks 18 or is it just that I have aged so much through this ordeal] approaches me. She proceeds to interrogate me but she is unaware that I am armed with PSST tools that prevent this from occurring and I am able to turn the tables.

Since we have hours, I utilize this time informing her of my ultimate intent, to save my son’s life. She tries to persuade me towards her position, or as she claims my son’s but I am not budging. She is no match for the mother of an addict. I explain that my son, being a teen and an addict has no idea what is best for him and that I feel it is irresponsible for her to not try and discuss with my son options to save his life. She tries to scare me with a suppression motion. But again as the mother of an addict that is small in comparison to what I have been scared with. Since I have unfortunately been in this position more than once I inform her the judge will be notified of my concerns and recommendations based on my observations which she cannot suppress.

As I puff out my chest she moves away. The line in the sand is drawn.

Then unexpectedly the Tip staff informs us that the case will probably have to be continued because Sal was taken to the hospital because he was throwing up.

I am ashamed to admit I immediately wondered what he took. Since he is technically a prisoner no one was allowed to know where he was taken. Well as the mother of an addict I had to utilize the detective skills I had acquired, which I might add have become quite astute. I found out which hospital he was in and after several tries found a nurse to talk to me. Evidently Sal had bloody urine and it was determined via CAT scan he has kidney stones and one was trying to pass.

At this point we had to ask the judge for a court order so I could see Sal and the case was continued until Thursday. I might add the texts were flying to Val who was such an asset.

As I arrive at the hospital Sal is handcuffed to the cart with the Sheriff by his side. I tell the sheriff I have a court order to see my son but he says he hasn’t received it so I can’t.

Well I am now in mamma bear mode protecting her cub. I speak to Sal over the Sheriff so I can get a handle on his status. The Sheriff tells me to leave the area and I inform him that the hospital is the only one that can remove me from the general emergency area. Hence the arrival of a woman police officer. I am at this point wondering if juvenile probation can help out me should I end up arrested.

Since I am also a nurse I decided to go into the medical mode and found Sal’s physician who was quite willing to tell me whatever I wanted to know probably wanting the disruption to stop. I was told Sal had passed one stone but still has another in the kidney. They were releasing him on medication which included, get ready, Vicodan.

Well at this point I went from medical mode to just raving lunatic. Informing the Doctor that it was negligent of him not to know Sal was an addict. After all that’s what we were in court for. Didn't he notice Sal was handcuffed to the cart? Maybe he missed the sheriff standing next to him? I suggested alternate medications which he was more than happy to write after he ran over to the sheriff to grab the script of Vicodan. OMG!!!

So Sal was sent to Auberle to await court. I now scramble to once again change my work schedule for Court Thursday. I am wondering how many of us get no vacations because all our days are spent for counseling, court etc. Anyways I go see Sal, he is not looking to good but is better than he was. I again inform him of my intent to tell his judge what I have observed and what I feel is needed. He did try some manipulation of that conversation but I had learned the best response and told him no one was permitted to sensor my speech and that court was my chance to work my program. Conversation over.

It is now Wednesday. I see the number for Auberle on my phone. Again that sinking feeling returns. A call from placement is never to tell you how good your child is doing. It seems Sal had another attack from his kidney stone and was once again in the hospital. This time they keep him and consult a urologist and a surgeon. OK, now the texts are flying again. I must mention that although his P.O. was off she was in contact with Val regarding the events and called me to check on Sal’s condition. It is P.O.’s like her that make a difference in saving our children. I am very grateful.

In the meantime I receive a call from Sal’s PD who asks me to have Sal released to my custody so the Sheriffs do not have to stay with him in the hospital. Obviously she has no clue what she is asking. Her lack of concern for the best interest of my son and me is again apparent. I informed her that I was NOT COMFORTABLE with that decision and it was not going to occur. The fact a sheriff must stay is not a rule I made THEREFORE it was not my responsibility. OMG!!

So more tests for Sal. Surgeon says no surgery. The other stone has not passed yet but Sal is OK. Court is now rescheduled for Tuesday, so once again I rearrange my schedule and take another vacation day.

At this point Sal is realizing he will go to another placement. He has tried some manipulation to dictate where he will go but I am holding firm. If I say he should go to A he wants to go to B,C or D.

He has begun to ask about where I want him to go, which is the Youth Forestry Program a 12 week program. Perfect. They have agreed to let him out a few days early so he can go back to college which for him I believe is a positive thing. He now seems settling in to the idea. His behavior is good and he looks healthy which is a lot easier for him when he is in placement.

I am confident his judge will go along with our recommendations but if I see his PD trying to steer it in another direction I will not hesitate to speak up. For you see, I am stronger even if I feel like I am falling apart, I will stand up for what I believe. I have the strength for this never ending fight because of you who have taught me, you who have stood beside me in my darkest hours, you who have picked my son up from the abyss of addiction and given him guidance, accountability and most important life.

Because of you today and maybe just for today I have hope.

Violet

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Every moment NOT a "teachable" moment Posted by:Lloyd Woodward--Sunday, June 05, 2011

There was great discussions yesterday at our Eastern District meeting. One of the questions being batted around was how do you just listen to your teenager and not give in to the old habbit of giving him advice, preaching, or lecturing. We were reminded of a quote although the source escapes me at the moment, "We give no lack of solutions to our children but we never give them enough problems to solve." The message we imply is that they aren't competent to figure anything out for themselves.



I wish to offer a simple recipe to at least stave off the lecture for a bit. In some cases following this outline might even set the table for leaking a bit of a lecture in the back door.

Son: You know, I was trying to get a gun once. Someone I knew told me that they could get one for me. I knew it was wrong, but I just figured I wouldn't get caught. Later, I was glad that they couldn't get one for me but from time to time I still want one. Sometimes, I think about it a lot- like how much fun it would be to own one, take care of it, learn to use it, and basically just feel safer. You know what I mean?


Mom: Well, let me pull myself together here- [strong eye contact good body language and she says the next sentence slowly} You know you really surprise me sometimes.

Son: How? You mean because I want a gun?

Mom: I didn't know that either, but no, I mean i'm surprised that you shared all that with me.

Son: Well, they say it's an honest program. {meaning his 12-step program}

Mom: Well, yeah, but still, that's a lot to share with your mother.

Son: I know- I just thought you should know. What do you think?

Mom: I think you expect me to lecture, preach, warn you, and tell you that would be the stupidest thing you could do.

Son: Yeah.

Mom: I dunno. Maybe that's why you don't tell me anything.

Son: Can you understand why I want one so badly?

Mom: Probably it's not easy for me to understand that. Maybe it's a guy thing. I never wanted a gun so I'm not going to pretend that I understand. [No one wants to be understood to easily anyway}

Son: Yeah.

Mom: I think you want it so bad sometimes that you sort of have yourself convinced that it's worth the risk or maybe you think you can manage the risk. I dunno. Like I said I don't think I understand. {but she just showed that she did understand something- not the whole thing- but something about it she just showed that she understood}.

Son: Well yeah, I can manage the risk, but I don't know sometimes.

Mom: [patiently waiting]

Son: I just don't even want to think of the risk.

Mom: How'd you do it then? [note: How'd you do it? is what they ask in 12-step, when somebody gets a new key tag for staying clean. How'd you do it is a great way to ask for information.}

Son: Do what?

Mom: Stop yourself from getting a gun.

Son: I don't know, I mean he didn't have it when I was trying to get it.

Mom: Yeah, but it sounds like you made a decision to stop looking for one?

Son: I did.

Mom: How'd you do that especially seeing how bad you wanted one?

Son: I guess I thought it was too risky.

Mom: Oh. {Said as though she was SURPRISED even though she was just saying the very same thing to him a minute ago and he was saying he could manage the risk.

Son: I mean, I don't want to get sent away again and you know I would get sent away in a heartbeat if I got caught with that.

Mom: I'm sure.

Son: Another thing I thought of, is that someday I can own one legally you know?

Mom: Yeah.

Son: And if I get too much of a criminal record maybe I could mess that up.

Mom: You're surprising me again.

Son: Why? [smiling}

Mom: I'm surprised at how well you thought that through. I'm not sure I would have thought of that.

Son: Yeah, I thought it through pretty much like for example, I don't think this would happen, but what if I was carrying it and I used it to protect myself?

Mom: Oh! {the hint of surprise again}

Son: Yeah, I could go to jail, not a Detention Center for kids, but to a real jail for a long long time.

Mom: Hmmm.

Son: Hmmm what?

Mom: Well, I thought of that one too and that's pretty scary. {Notice she doesn't have be surprised at every darn thing! That's over doing it and it can become fake real easy. This is more of an agreeing- bonding statement}

Son: How bout this one? What if there was a body attached to the gun I bought?

Mom: What's that mean?

Son: You know, if someone had killed someone with that gun that would be lots of trouble for me.

Mom: OK, I see what you mean.

Son: You kind of surprised me too. {expect to be imitated- it's the sincerest form of flattery}

Mom: How's that?

Son: I thought you'd flip out when I told you all this stuff about me wanting a gun!

Mom: Oh I am.

Son: Really?

Mom: Yes, I'm flipping out inside.

Son: Don't worry. I'm not gonna get one, you know. I'm moving on.

Mom: Well,sometimes it's better to not flip out. I'm trying to learn how to do that. It's hard for me actually. Of course, I'm afraid that you will end up dead or in jail for something stupid ANYWAY so when I hear you tell me stuff like this- it's hard for me not to react. You know, it kind of pushes my buttons.

Son: So, you'd rather I didn't tell you stuff like this?

Mom: I don't know. You decide. I'll go with what you decide. If you want to share- I'll do my best to handle it- if you don't want to, then I'll try not to pry to much.

Son: Really? {sounding surprised}

Mom: Well, sure. You know, except for the part where I search your room with a drug dog, a cop, and a really fine tooth comb. Except for that part I'll try not to flip out!

Son: [laughs] Well, you're going to do that anyway, I guess.

Mom: You guess right buddy.

Son: What would you do if you found a gun in my room!

Mom: You'd be the first person I'd shoot with it.

Son: [laughts} oh sure, no, I mean really.

Mom: OK, that's a fair question, but I gotta answer it with another question. What do you think I'd do?

Son: Call my PO or dial 911.

Mom: Good. I'm glad you already knew that. Thank you.

Son: For what?

Mom: For saying it so I didn't have to say it, and ALSO for letting me know that I've made it clear that I'm not keeping secrets. {She's thanking him at the same time she's warning him again. This is where she gets to "leak in" a wee bit of lecture!}

Son: Oh yeah you made that clear.

Discussion: OK, I'm sure it might not have gone that smoothly but you never know till you try. Lets review the recipe. In this parenting skill there are only two things to remember.

1. Let your teenager know that he has surprised you. No one likes to be predictable. If, on the other hand, you want to put up a wall between you and your teenager, then tell him you knew exactly what he was going to do. It's a tough one because as parents we pride ourselves on being able to read our kids. That's how we know we are good parents. We can tell when they are lying. We can tell what they are feeling. We know what they are going to do. Even when they screw up, we are not surprised- we saw that one coming!

The other day I was drug testing a kid who had run away for a night. The mother told the Wesley Spectrum therapist that she knew her son would test dirty for drugs. She could "just tell." He was confidant regarding the test and he tested clean. As soon as she found out the test result, she said, "I knew he would be clean!" Was she lying? Maybe not. She might have forgot what she said to the therapist. She wasn't sure from the get-go if he was clean or not. She had mixed feelings. After the test result was in, she remembered having mixed feelings, so part of her thought he was dirty and part of her thought that he was clean. The overriding dynamic is that she believes that she knows her son so well that and that that defines her as a good mom. If she didn't know the result ahead of time that would define her as a not-so-good mom. Because of the way she defines herself as a good or not-so-good mom she can't allow herself to be surprised.

2. Let you teenager know that that last thing he probably wants or needs is a lecture. Start there. Even if you end up lecturing, at least acknowledge that he expects it and that it's not always helpful. You can do this in your own style. This role-play just demonstrated one of many ways to let your teen know that you "get it" that lecturing isn't always helpful. Hopefully, as in this example, it will lead to an exchange of ideas. Probably, if the parent hadn't said something along these lines, this young man would never have never told his mother how he sized up the risks.

Bonus #3: It's not part of the recipe but did you noticed that there was a point where the mom asked "how'd you do that?" This led to an exchange between the two of them. In this case it was "how'd you stop yourself?" We've talked about asking "Why?" and how that puts up a wall. Asking "how" instead of "why" often brings walls down. In Narcotics Anonymous when people pick up Key Tags for one year, 18 months, or multiple years, the crowd yells out "How'd you do that?" It seems to be a type of question that stimulates the flow of information rather than stifling it.

Hopefully, we've just seen an example of where every moment is not a teachable moment. On the other hand, maybe this was a teachable moment for this young man. Maybe it was a teachable moment for both of them.

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SUMMARY OF THE MAY 21 PSST MEETING IN MT LEBANON Posted by:Rocco--Friday, June 03, 2011

Saturday Morning PSST ~ May 21, 2011

We had another great turnout at the Mt Lebanon PSST Meeting on Saturday May 21 – In attendance were 19 PSST parents representing 15 families, a.k.a. Alice & Ralph, Jenn &Brad, Rose, Daisy, Sally & Rocco, Angela, Jessica, Cheryl, Becky, Wilma, Kitty, Jennifer, Candy, Brigitte & Francois and Violet.

Our PSST Pros Kathie T of Wesley Spectrum along with Michelle of Wesley-Spectrum In-Home Services and Val, Lloyd and his former intern/sidekick Rebecca from A.C. Juvenile Probation were here to share their experience and wisdom mixed with a little humor. Rebecca is moving on to an adult program. You have made a positive impact on us and our teens in the short time you have been here Rebecca. All of us at PSST wish you the very best in both your future professional and personal life. Thank you.

Jenn & Brad did a super job running today’s meeting. As usual, with such a large turn-out, we went around the room for short updates and asked those in need to let us know so we could return to them.


LET'S TALK

Alice & Ralph have two sons Norton and Ed. Their older son Norton has been in contact with them about returning home. He has explained that he is saving his money for his trip. Alice & Ralph are letting Norton know that he will still need to comply with the same home rules that he ran away from if and when he comes home. But first he will need to deal with his legal issues that he also ran from.

Their younger son Ed successfully completed his inpatient recovery program and is attending school. Ed has hit a few potholes on his road to recovery but has kept up a positive attitude and continue to move forward. He earned his driver's license, purchased a truck and is running his own landscaping business.

See Ralph's latest post Technology and Your Teen

Alice and Ralph have shown how powerful a home contract can be if used properly and have enforced it with some wisdom. Remember contracts don't need to be carved in granite, there is some wiggle room on consequences, NEVER-THE-LESS, any revisions to the contract need to be approved and made by the parents.

Thanks for being a big part of PSST Alice and Ralph.

Rose has a son Joe who is currently in an inpatient program. Joe's drug of choice is known as "Robo-Tripping". It is very hard to control because it uses legal drugs containing Dextromethorphan. DXM is a cough-suppressing ingredient found in a variety of over-the-counter cold and cough medications like Robitussin.

The abuse of cough medications including DXM can contain other ingredients, such as acetaminophen, which can be very dangerous when taken in large quantities. For example, large quantities of acetaminophen can damage the liver.

DXM is also sometimes abused with other drugs or alcohol, which can increase the dangerous physical effects.

For more information on this and other drugs click on The Partnership at Drugfree.org

Rose took a pass to give some others some time.

Thanks for continuing to attend the PSST Meetings Rose. We are here to assist you in any way we can to help your son and for you to lean on as needed.

Jenn & Brad, this week's leaders have only been with PSST for just about 5 months and they have made really great progress with their son Dylan. Dylan had entered the juvenile system earlier but now Jenn & Brad have their PSST Powers to support them in their struggle to assist Dylan in his recovery. Jenn & Brad were feeling good enough today to pass their time on to others in need.

Jenn & Brad you have come a long way in a short time. PSST will be here to help you in your next steps.

Daisy is one of our PSSTough Moms. She has helped her son Ozzie get his life back on track and continues to show him that she will do whatever it takes to keep him straight [including making Ozzie's P.O. appear out of thin air when he least expects it!] Daisy was also feeling good enough today to pass her time on to others in need.

Daisy, you are one of PSST's best examples at taking back the power in your home and helping your son. Thanks for continuing to be part of PSST

Sally & Rocco's son Cisco is continuing to do well in his recovery. It has been almost two years since Cisco first entered an inpatient recovery program voluntarily following his arrest. He has been in and out of several programs and we have made it clear to him that we will be there to support him but that we will NOT enable him in any way. Cisco is currently in a halfway house and has started to attend CCAC. He has been enjoying his weekend passes and beginning to mature as he gets more and more clean time in.

On this second anniversary of sorts we [Sally & Rocco] once more would like to sincerely thank Val, Lloyd, Kathie and Cathy and everyone else at PSST for their assistance, support and time in helping us to help our son save his life.

Angela’s daughter Samantha has completed her inpatient recovery program and had returned to school. She had a slip up a few weeks ago. Angela and her husband Tony quickly put a stop to her behavior which included a stay at Shuman Juvenile Detention Center. They have worked with the system and have Samantha in an intensive in–home therapeutic recovery program for 15 hours per week. Samantha also attends three meetings per week. It seems as if she is responding well to this in lieu of going back into an inpatient program.

We are all very interested how the in-home treatment works.

Please keep us posted, or maybe write something for the blog, as this may be appropriate for other families.

Angela, you and Tony have shown what caring and concerned parents can accomplish in less than six months if they are willing to practice some new (and sometimes difficult) parenting skills. It's not the easy way but it is the PSST way! Thanks for being part of PSST and continuing to share your story.

Jessica is yet another great example of how, in just about 6 months, parents can turn their lives and their family around and heading in the right direction. She and her husband Roger have shown how you can go from pathologically compliant [thanks Jessica for the great description], confused and powerless to accepting the power and using it to assist their son Herman in his recovery. They have learned to assert their parental authority and work with the system to see that Herman gets the best help that they can provide.

At the same time they have taken some time for themselves and the rest of their family to get back to what "normal" families do. They have also let Herman know that they will not accept his old behaviors and it is up to him to make them comfortable.

This process does not happen over night and mistakes will be made, NEVER-THE-LESS, Jessica is seeing some real progress. She is seeing how with more and more clean time Herman is becoming more transparent and less angry. She even noticed that he is getting his sense of humor back.

I am starting to sound like a broken record, you know vinyl?, no? okay, I am starting to sound like a stuck CD, but Jessica and Roger have shown what caring and concerned parents can accomplish in less than six months if they are able to stick with some new (and sometimes difficult) parenting skills and are not afraid to question authority. Thanks for being part of and contributing so much to PSST.

Cheryl's son Andy is now in an adult half-way house. She and her husband Jim have seen an improvement in his behavior and hope that this placement will help him understand the importance of his recovery.

A while back Cheryl and Jim had to make the decision to let Andy know that they were not comfortable with him coming home. This is tough decision for any parent to make but these are the things we learn how to do at PSST. They sent a very clear message to him that they are serious about his recovery.

Once more, Cheryl, you and Jim, have shown what caring and concerned parents can accomplish in less than six months if they can make the tough decisions and work with the system to get the best care for their teenagers. Thanks to you two for being a big part of PSST.

Becky's 16 year old son Sid is back home from his in-patient recovery program. The downside is that they could not get their school district to assist them in finding an alternate school so Syd is back to his old school. The upside is that Syd is enjoying working after school and it seems to help him to keep busy. The other upside is that Becky and Tom have been working together to help themselves and their son and they are not afraid to call in "The P.O." as needed. This is a result of them doing the “uncomfortable thing” and having their teen placed on juvenile probation. It becomes a major tool in your tool box to help you help your teen stay clean.

Becky, you and Tom, have done a great deal in just a little more than six months and have turned things around. This is not always easy but we appreciate you for being a big part of PSST and we are here to support and encourage you.

Wilma's son Bam-Bam is in an inpatient recovery program Because Wilma cared enough to file Act 53 charges [with no support from her husband Fred]. Bam-Bam is not a happy camper and told Wilma that he is coming home as soon as possible. Wilma has made it clear that she is not comfortable with him coming home. She will take the next step and file charges to have Bam-Bam put on probation to make sure he gets the help that he needs [with or without Fred - maybe he will catch on some time soon].

Hang in there Wilma, you are doing all of the right things to help Bam-Bam get the tools he needs to save his life and his future. We at PSST are here to support and assist you. Thanks so much for all of the input on the blog.

Kitty's is wondering about her son Carlyle. He completed his inpatient recovery program and is back home and is doing okay. She was asking, as many of us at PSST do: "What is 'normal teenage behavior' vs 'ADHD behavior' vs 'recovery behavior?'"

In the meantime her older son let her know that he plans to stick it out in his own recovery program.

Thanks for being part of PSST Kitty. We all have similar questions about our teen's behavior and I am not exactly sure myself sometimes. I do know that we know our children better than anyone else, especially moms. As Sally reinforces with me we need to trust our feelings and feel free to question our teens [not confront them] as long as they continue to live in home. Thanks for sharing your wisdom with us.

Candy’s daughter Tori has been in a halfway house for about 5-12 months. Tori still has an issue about following rules and regulations but she has been clean for 9-1/2 months. Toriis about to be discharged and is planning on getting an apartment in the same town as the halfway house. Candy is "cautiously Optimistic" about Tori's chances at success but knows that she has a much better chance at making a life for herself than last summer when Candy and her husband stood up in court several times to make sure that their daughter received the help she needed to save her life.

Candy, you and Aaron have been on this long strange trip almost as long as Sally and I and we can both see positive improvements and a possibility of a future for our kids. We have worked hard with our PSST Pros at Juvenile Probation and Wesley Spectrum to see that our teens received the best chance that we could provide for them to work their recovery. It is not over but we can both relax a bit more than we did last summer. Thanks for sticking with us and remember we are there for you when needed.

LET'S TALK A LITTLE MORE...

We try to save time at our PSST Meetings for those who need to share a little more about what is happening, good and bad. If you attend a meeting please don't be shy about speaking up here. Remember we are here to help you, not judge you.

Brigitte and Francoise's son Pierre returned home following 3 weeks in an inpatient recovery program. Pierre has recently relapsed and is in Shuman awaiting a hearing. He claims that his younger brother Jacques was using in front of him. Of course Jacques denies it.

Brigitte used her best new parenting skills and took immediate action not just with Pierre but also with Jacques. She contacted the parents of Jacques 5 friends and had the parents agree to testing them. They came up positive and the parents agreed to sanctions on them.

This is great Brigitte. Thank goodness most of the other families seemed ready to cooperate with you on being proactive. Unfortunately this is not always the case with other parents of our teen's friends. Many of them are either in denial, afraid to take action or they just don't seem to care.

In the mean time Brigitte has her hands full dealing with her youngest son who has hit an emotional low.

Pierre was doing pretty well in his recovery he but recently seemed to have gone backwards with people, places and things.

We discussed how our children in recovery not only grieve the loss of their old "friends" but they also grieve the loss of their power in their home and over their family.

This grieving can appear as anger/resentment towards the parents especially when they are visiting their child in an inpatient facility. They see that they are losing their control of their parents and that things are going to be different when they return home. Don't let this worry you, in fact accept the blame/the power.

If they tell you that it is all your fault that they are "in here" do not hesitate to agree with them. "Yes, I did put you in here and I will continue to do whatever it takes to help you with your recovery / to keep you safe / to save your life . Remember, while your child is in a recovery program is the best time to let them know that you are taking back the power and will not be manipulated. Allow them to act out so that their counselors will understand them better and work with them.

Brigitte and Francoise are awarded the PSSTrophey for being proactive and for taking back the power in their home. You two are a great addition to the PSST parents. Thanks for sharing with us.

Violet's son Sal came home from his halfway house in time to begin college in January. He was staying on campus but coming home every weekend to visit his P.O. His P.O. would also pay random visits to Sal at college.
Sal did pretty good and maintained his studies but he has recently relapsed on benzo's and K-2. He has a hearing with a judge on Tuesday and will remain in Shuman Juvenile Center until he is placed in another recovery program.

Sal tried his best to manipulate his mom with "K-2 is not in my contract" and "If you don't speak-up in court I will probably just get some outpatient program" and the standard "You know that I am the only one who can work my program. You can't work my program". Violet was not buying any of Sal's manipulation. She retorted "And you can't work my program! I will speak up in court and I will do whatever it takes to save your life." Violet is frustrated [I know the feeling myself] and has invested too much in the last few years to give up on her son's recovery.

Way to be Violet. You have come a long way since you began PSST. You are one of the best examples of a parent being on board for the long term. See Violet's update; Violet Stands Up to the Challenge

Jennifer's 17 year old son Maxwell began using marijuana around age 14. He has shown all of the usual addictive behaviors but his anger problem became a serious issue. Maxwell has been through a recovery program, was attending meetings and had a job that his dad arranged for him. Like so many of our teens Maxwell has a really hard time staying away from people, place and things that feed his addiction [especially his "friends" a.k.a. "the only people who understand and care about him". Yep most of us at PSST have heard about our teen's "friends" and they do care about him as long as he wants use with them or supply them.

Maxwell is also a master manipulator. A real bad sign for our teens in recovery is when they give you the lecture about how they do not need to attend meetings or have a sponsor and that they can handle their recovery better on their own.

Besides manipulating and returning to his old "friends" Maxwell also managed to lose his job, total his car, miss his curfews, break all the rules and basically escalate the chaos in his home.

Addictive behavior pushes family relations to the maximum limits. It takes some time before parents realize that logic and common sense don't work. Some parents never understand that addictive behavior causes tunnel vision. The ONLY thing an addict can consistently focus on is where can I find my next high. It does not mean that the addict doesn't love their parents, care about their family or even that they don't understand that they are making the wrong choice. Their addiction will tell them they need to do whatever they need to do to feed their addiction, and then they can clear up the rest of that family stuff.

Some parents like Maxwell's dad tend to shrink away from being a parent of an addict and will continue to "walk on eggshells" so they don't "add to the chaos". Some parents take on the "just wait until you are 18 and I throw you out" role and tend to raise the chaos levels. [HINT: Neither of these methods help.]

Other parents like Jennifer look for outside help on how to deal with their out of control teen [this is not always the comfortable thing to do]. They find that working with professionals takes a big burden off of their shoulders.

Jennifer is continuing to look for help and is working with the professionals to have her son placed into a recovery program and is doing everything else that she can to save his life and her family. PSST is here to support and assist you Jennifer. You are now heading the right direction and things will improve.

NOTE TO PARENTS: Relapse happens. It is not the end of the road, it is a big pothole in the road. You may need to stop and change your tire and maybe even replace the wheel. Then you can get back on the road and moving forward in a short time. When relapse happens get professional help. This is why Sally and I have stood up in court to keep our 18 son on juvenile probation. The help has been there for us when we asked.

LET'S PLAY

We had enough time [thanks to Jenn & Brad's leadership] to do a role play.

ROLE PLAY - A son discussing his upcoming hearing with his mom and his burrito eating dad.

Violet played the son, Sally played the mom and Ralph was the burrito eating dad.

Son: (Shouting from his bedroom) MOM! Come here a minute I need to talk to you!

Mom: If you need to talk come down to the kitchen. We can talk there.
[this is a minor but important parental power point - get your teen out of their territory and into your territory to talk]

Son: C'mon, is this going to be another of your rants? I need to talk to you about what my PD [public defender] just talked about.

Mom: I just want to make sure that I hear you clearly and understand you.

Son: Okay, listen, my PD says that this hearing is really simple. It is not a big deal and at the most all I would need to do is some intensive outpatient, stay in school and get a job. I can still live here at home.

Mom: Did he really? That is really encouraging isn't it? How does that work?

Son: Mom, it is no big deal. Relapse happens you know. K-2 is not in our home contract and it is not even illegal. He said if you just be quiet and don't say anything at the hearing that we can be in and out in no time.

Mom: Really? Listen honey I can't...

Son: Don't screw this thing up mom. There is no reason for you to even come to court.

Dad: [looking in the refrigerator] Yea, give him a break. He is doing his best working his program.

Mom: Are you both done? Let me know when it is my turn to talk.

Son: What?

Dad; [still looking in the refrigerator] Hey, I was just looking for my burrito.

Mom: [looking directly at the son and ignoring the dad] Honey you and your PD have some good points, never the less, I...

Son: There you go again with that PSST talk.

Mom: Is it my turn to talk or do you want to go on some more?

Son: I am not comfortable with that PSST cr@p!

Mom: Never the less, when I go into to court I will do whatever it takes to keep you working your program...

Son: I am working my program mom! I am the only one working my program! I am the only one who can work my program! I don't need you to work my program!

Mom: [waiting for the Son to finish - do not attempt to talk over your teen]: You're right. I cannot work your program and you cannot work my program!

When we get to court I will work my program and my program is to do whatever I can do to get you the help you need to help yourself. Then we will let the judge decide who is right.

You let your PD know that you want to work your program and that I will work my program, okay? Do we need to discuss this anymore?

Son: No.

Mom: Good, now help your dad find his burrito.

REMEMBER: Bing your teen into your territory for discussions, listen carefully to what they are saying, do not talk over your teen, if they interrupt you - stop talking and wait until they are done - ask them if they have anything else to add and then continue with your original point [do not let them manipulate you off of your subject], try to find an agreement point with something they are saying; never the less; stick to your point, never belittle your teen and do not be distracted by dads looking for burritos.

FINAL COMMENTS

We try to save enough time for everyone who wants to make a final comment. This is the only place where we ask for no discussion due to time constraint.

Rose: "My son Joe is near the end of his recovery program. I need to prepare my house and myself for his return. I do not think that a halfway house is the right idea for Joe. I want him home with a contract, attending an outpatient program and on juvenile probation. Probation is my safety net. Now his dad has come back into the picture. He wants Joe off of probation so that he can move to North Carolina with him and start a job he has lined up for him. That makes me feel uncomfortable. After all that I have been through with Joe for almost two years - to just let him off of probation and let him leave makes me fear for him."

Wilma: "Writing my story on the blog is great therapy. Thanks to everyone for their comments and advice."

Editor's Note: Wilma is right; writing is great therapy and it is a help to other parents out there with similar issues. Thanks for contributing Wilma.

If anyone has anything to share please forward it to sallyservives@gmail.com


Jessica: "I get my 6 month chip for attending PSST. In the 6 months I have been coming to PSST meetings I have learned not to put the horse before the cart. I felt we needed PSST to push Herman into his recovery program but PSST is for Parental Survival. We need to be a big part of our teen's recovery but we also need to sometimes sit back and let the system work for us."

Sally: "Like the quote on the PSST Home Page said 'Superman is not a hero, he is indestructible. Regular people doing extraordinary things are my heroes.' All of you PSST Parents are my heroes - you are destructible but you are doing extraordinary things!"

Alice & Ralph's son Ed had a glitch with his home contract but he handled well. He accepted his punishment and he dealt with it.
"He has started his landscaping business, earned his drivers license and has a pick-up truck. We created a driving contract including a tracking device on his truck. It also includes a clause concerning no driving while intoxicated or high. If for some reason he finds himself drunk or high he is to call us to pick him up with no immediate questions or consequences. The next morning we will deal with his relapse.

Ed's best recovery aid is keeping busy."

A VERY CLASSY MOVE: Ed's recovery facility know about Ed's lawn-care business and presented him with a refurbished lawn tractor. They wanted him to know how proud they are of him and really wanted to wish him the best in his clean life. [We are hoping that Ralph will do a post on the details of this]"

Jenn "Violet, You say you are confused and you don't know what you want for Sal. But you really do know what you want, you want Sal to have a chance for a clean life and you will continue to help him achieve that. You just need a little time to gather you thoughts together and to vocalize them."

Violet "I would like to thank everyone in the juvenile probation system and PSST. I want to remember the good things that Sal has accomplished so far. So many time we forget to tell our kids we understand what they are going through and about the good things they have done. Sal is getting better but he is not done yet. It will take a little bit longer, but he is alive because what we have done so far. Thank you."

Wilma "I attended a presentation at Ambridge High School this week. They showed the parents actual drugs and drug paraphernalia to watch for. They explained to them what is happening with drugs in all of our neighborhoods and schools. It was very informative but they really had no advice on what the parents could do to get help for themselves and their children. The parents had no idea on where to go for this help. I feel extremely lucky to live in Allegheny County and appreciate the juvenile probation program and PSST."

Candy: "Parents need to realize that teens using drugs are playing a deadly game. Addiction can kill. We need to work with our kids in recovery but we need to learn to accept progression and not perfection from them."

Editor's Note: Thanks Candy for the new PSST Bumper Sticker:

--EXPECT PROGRESSION NOT PERFECTION--

Jennifer: "I am really having a hard time handling the pressure of my son's addiction. It has ruined our home. I need help"

Editor's Note: That what PSST is here for Jennifer, we are here to help you and your family - please keep coming to our meetings.

Kitty: "Don't put extra pressure on yourselves about recovery, don't worry about even one day at a time, do it one minute at a time."

Michelle (Wesley Spectrum): "Parents: hold your service providers accountable."

JUST THANKS

Thanks to everyone for sharing their stories and their thoughts and their advice and just thanks for being here. You are helping not just yourselves - you are reaching out and helping a lot of other people. Thanks to Lloyd and Val for creating PSST and to Allegheny County Juvenile Probation for supporting it - you are saving lives. Thanks to Kathy T and Justin and Jocelyn and Cathy and Michelle and all of the other at Wesley Spectrum for supporting us.

If I missed anything, or misinterpreted anything, or misspelled anything, that is par for the course - please let me know and I will do my best to correct it.

Please feel free to give us some feed-back either in the comment section below this article or by e-mailing to sallyservives@gmail.com

COME AND TRY PSST - ITS FREE - NO COST - NO COMMITMENT - WE ARE NOT HERE TO JUDGE YOU - WE ARE HERE TO HELP YOU

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WILMA WONDERS about WEEK 2 OF BAM BAM’S ACT 53 PLACEMENT AT BEDROCK MANOR Posted by:Sally--Friday, June 03, 2011

What a week! Bam Bam has been doing everything he can to get kicked out of Bedrock Manor. He told us on Sunday that someone told him that we could get him out even though he is court ordered to be there. I did confirm with Betty that yes I do have legal custody but if Bam Bam’s behavior got him to the point where he was asked to leave Bedrock Manor we would go to Plan b, c or d and he would not come home. As I’ve said before he cannot come home, not yet when he would not be able to cope with the triggers at home and in our community. And his behavior is not acceptable and of course he can be threatening. On Tuesday the fearless Act 53 coordinator, Betty, met with Bam Bam and his counselor, Ann Margrock.

Tuesday night Fred and I went for our family meeting. Bam Bam was calm even pleasant. Prior to the meeting his counselor told us that he was told in no uncertain terms when he met with Betty and her that his behavior would not get him home but would in fact result in other less pleasant (for him) consequences. She said his behavior was much better that day and he even smiled a genuine smile. What a miracle! He also was saying he’s just going to get his GED but they told him he should just work on school work towards his diploma as he couldn’t get his GED until June 2012 when he would graduate. I already knew this from his Guidance Counselor at his home school but he obviously didn’t remember this. However, he still has to do school work at Bedrock Manor. He was being non-compliant so he wasn’t earning any brownie points. I also had a call on Tuesday from cyberschool about his work not being done and that they were going to be sending out a truancy letter. He had some classes where he hadn’t done any work since March. He would pick and choose what to work on even though we all were telling him “this is not what you are supposed to be doing.” I brought this up to Ann Margrock as Bedrock Manor was supposed to have informed cyber school but we agreed that the information hadn’t gotten to his cyber teacher yet that he was in placement. Cyberschool is withdrawing him and we already got the labels to send everything back. Just a note here that this isn’t always the best option even though at the time it seemed to be our ONLY OPTION.
When Bam Bam joined us we talked a little about when he comes home (why do we have to talk about that now all the time??!!) and his friends. He can’t understand why we don’t like his friend Eddie Haskell who I have been finding out has in own little drug empire running out of his basement. On our A,B, C peer list Eddie is on the D list. (We were working on this in MST which is closing this Friday.) The counselor suggested that Eddie would have to prove himself to us the parents before any contact between the two. I have to say I am not on board with this idea yet. We discovered that Eddie was at our house when we weren’t home a few weeks ago. Bam Bam said he wasn’t but we told him we have undisputed evidence that he was in our home so Bam Bam said we must have hidden cameras in the house!!! How Big Brother of us!!! I had also said that I would speak with the parents of any friends he would see on his return home and Bam Bam and Fred thought this was a little harsh. Bam Bam thought it would send red flags and cause trouble for his good friend, Dino’s, parents who may not know he has smoked (supposedly in the past) and drinks. I don’t see a problem with talking to the parents so I’m on my own on this. All four us also talked a little about the school thing. Anyway, we get through the meeting and now its time for family programming. We go into the cafeteria and Fred is on alert because the chairs are arranged in a circle and this can only mean on thing-talking about feelings!! We find out the topic is communication so he leaves to sit in the car. I tell the guest speaker that I’ll just be mad on the way home and she said don’t bother getting upset about it , not worth it so I took her advice on the drive home and kept my blood pressure under control. Parents are brought in and then our wonderful off-spring. The evening counselor tells me that Bam Bam is refusing to come to the program did I want her to try and persuade him but I said no it’s not worth it. That is just what he wants anyway is someone to try and talk him into it and I’m not playing. So I stayed. Initially I was the only single attendee but another boy left the communication circle so then there were two of us on our own.

Wednesday night we get a call from Bam Bam ( I was surprised as I didn’t think he had phone privileges) and of course he’s getting tiers for nothing, everyone is against him, he’ll go to any other rehab, if I don’t get him out he’ll run (which I would like to see as I don’t think he would know how to get home from there.), his medicine isn’t working, they changed his sleep meds now he can’t sleep, etc, etc, etc. He got a lot in in 10 minutes. He did remain calm, though, and didn’t use any profanity with me. I told him I would talk to Ann Margrock on Thursday. So this morning I call and guess what? He has used profanity against one of the staff, earned three tiers yesterday, isn’t happy, not cooperating, wasn’t supposed to be able to call so that is getting looked into and told her I’m getting him into another rehab. Not the same kid from Tuesday. And I’m not surprised. I’m just glad it’s not happening at home.
I do feel better than I did now that I know if he succeeds in his quest to get kicked out of Bedrock Manor he isn’t coming home but will be referred somewhere else. And I’m not bringing him home. We have our alternative plans and I will follow through. For right now this is not the best place for him to be. He will be 17 in a few weeks and that is hard thinking of him spending his birthday in placement but he did put himself there and I have to remember I am trying to save him so I am determined to not be sad he is there but be happy that he is alive.

Wilma

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