Help Me Help My Teen, Run Aways, Substance Abuse, Legal Issues, Education Problems

The following link will take you to an organization called Cornerstone Recovery – an excellent resource for teens and families in recovery.

http://www.cornerstonerecovery.org/knowledge/

When you find out your child has been using drugs or alcohol it’s common to feel angry. You blame yourself. You blame your child’s friends. You blame the school. Take a deep breath, try to stay calm and focus. If your teen has decided to start using drugs and alcohol whether he likes it or not, you must do all that you can to protect him.
The following are deliberate steps that you must take.

Define the problem
Many parents get stuck here. We are far from the days of Nancy Reagan’s “Just Say No,” campaign; however, society sends mixed messages about drug and alcohol use. Parents wonder if it’s okay to set a boundary when they themselves have a drug or alcohol problem. Perhaps they’ve heard from their friends or a therapist that a little experimentation is okay. And of course, there is the hope that it was only this ‘one time’ and your child does not have a problem. Here is what the experts say (from the Diagnostic and Statistical Manual, 4th edition):

Substance Abuse
Substance dependence is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one (or more) of the following, occurring within a 12-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (such as repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; or neglect of children or household).
2. Recurrent substance use in situations in which it is physically hazardous (such as driving an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (such as arrests for substance related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (for example, arguments with spouse about consequences of intoxication and physical fights).

Alternatively, the symptoms have never met the criteria for substance dependence for this class of substance.

Substance Dependence
Addiction (termed substance dependence by the American Psychiatric Association) is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring any time in the same 12-month period:

1. Tolerance, as defined by either of the following:
   (a) A need for markedly increased amounts of the substance to achieve intoxication or the desired effect
   or
   (b) Markedly diminished effect with continued use of the same amount of the substance.
2. Withdrawal, as manifested by either of the following:
   (a) The characteristic withdrawal syndrome for the substance
   or
   (b) The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
3. The substance is often taken in larger amounts or over a longer period than intended.
4. There is a persistent desire or unsuccessful efforts to cut down or control substance use.
5. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
6. Important social, occupational, or recreational activities are given up or reduced because of substance use.
7. The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance (for example, current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).

You know that drugs and alcohol are bad for your teen physically, and you’ve read the definitions, but you still aren’t sure your teen’s drinking or drug use is a problem. This may help:
Teenage drinking and drug use is illegal
Allowing a teen to drink or use drugs is also illegal.

Dr. Kate Walker, Ph.D., LPC, LMFT
AchieveBalance.org

There are deliberate steps you must take if you find your teen is using drugs or alcohol. Part 1 talked about defining the problem. The next step:

Get Help
By drinking or taking drugs, your teen is committing a crime so you must get her help immediately. Teens who are angry may deny they have a problem or offer any number of excuses and justifications for their use. It is important that you get help from a specialist who deals with drug and alcohol abuse or find a program that is designed for teens who use. You must contact your child’s friends’ parents and let them know you have caught your child using. This is important not only so you can be a good neighbor and give them a heads up that drugs and alcohol have entered the picture; it is also a way for you to judge their reactions and their philosophy about drinking and drug use. If you don’t have contact information for your teen’s friends’ parents then Download My Teen’s Friend List from ‘Worksheets and Forms’ and this will help you organize your thoughts.
Some special programs you should consider are:

Licensed Chemical Dependency Counselor
Addictions counseling is a form of mental health counseling that specializes in understanding the addictive process as well as the impact of addiction on the client, family and society. The requirements to become a chemical dependency specialist differ according to state but all counselors who hold this endorsement must be able to recognize the potential for substance use disorders and behavioral addictions to mimic a variety of medical and psychological disorders. In addition, the addictions counselor recognizes the potential for medical and psychological disorders to co-exist with addiction (called a dual diagnosis). In many states counselors and therapists who are not chemical dependency certified/licensed are able to treat individuals who are using drugs and alcohol; however they cannot display the chemical dependency credential without the special training. These services may or may not be covered by insurance. Go to ‘Worksheets and Forms’ to download a sample Letter of Medical Necessity (LOMN) you can send to your insurance company if they try to deny coverage.

Alternative Peer Group (APG)
This little known treatment modality may be highly effective in not only helping your child, but also helping you and your entire family. The groups vary from region to region but the basic philosophy is the same: Immerse the teen in a peer group of healthy teens in recovery. The most effective groups we know of also immerse the parents in a group of healthy parents in recovery. This dual support helps parents stick to rules and consequences that aid the teen in his recovery as well as provide the teen with daily therapeutic intervention and social activities that are drug and alcohol free. Some good ones we know of are:

Cornerstone Recovery www.cornerstonerecovery.org
Palmer Drug and Alcohol Program

Intensive Outpatient (IOP) and Residential Treatment (RTC).
When Counseling and APG groups are not working to stop your teen from using, you may need the help of an IOP or residential treatment center.
An IOP is considered to be an intermediate level of intervention. Teens attend a group 2 to 5 times a week (depending on the structure of the program) for 2 to 3 hours at a time. Teens may receive one on one counseling, group counseling, as well as participate in community activities. A licensed clinician generally leads the groups. An IOP can also be a step-down treatment from a residential treatment program and can help with the transition back into the home.
Residential treatment (RTC) refers to the extended stay facilities with intensive services but that are less intensive that inpatient facilities such as hospitals. Teens stay at residential facilities that treat their addiction and promote their movement towards independence. Residential treatment stays can range from a few weeks to several months.

A Word About Insurance
Insurance will generally cover more intense services if you have exhausted ‘lower levels of care.’ What this means is, many insurance companies don’t want residential treatment to be your first intervention and may deny your claim (Go to Worksheets and Forms to download a sample letter you can send to your insurance company if they try to deny coverage). If at all possible, seek help from a counselor or APG first, then move to the IOP and residential treatment options. Of course if your teen is in crisis, go to your nearest emergency room and let the insurance company sort it out later.

Dr. Kate Walker, Ph.D., LPC, LMFT
AchieveBalance.org