Denying a Problem

Ignorance is bliss, according to some people. Many parents take a hands off -”what we don’t know won’t hurt us” – approach to parenting, especially when it comes to teens and drugs. They feel that it is best if they don’t make a big deal of things. They believe all kids are going to experiment with drugs at least once, so the best thing to do is let kids be kids and get it out of their system.

Talk To Your Teen

Studies show, however, that parents who do not talk to their kids about drugs or who are accepting of their child’s drug experimentation end up with kids who do drugs – often in a dangerous way. Parents who talk to their kids, however, about the dangers of drugs are the voice that often influences the child so that they do say no to drugs. Parents need to be the first step in drug prevention for their child, and then continue to be aware and on the lookout for their teen to try drugs so they can get help if necessary.

Be Aware

It is important, therefore, for parents to have some knowledge of the current drug scene. This scares many parents, but it doesn’t have to be intimidating. Just do a little research. Many parents know about age-old drugs like marijuana, heroin, cocaine, and LSD. They are aware that club drugs like Ecstasy and meth are out there, and that prescription drugs like OxyContin are becoming a huge problem. Parents may need to investigate further, however, to find out about the new synthetic drugs making their way around the country, such as bath salts and synthetic marijuana. These substances are trickier because they can be very misleading and sometimes even legal, yet just as harmful as illicit drugs. “It’s chemistry. They’re able to change the chemical structure just by small amounts to avert the law, even though it would have some of the same common properties and same psychoactive effects”, said Bruce Reeve, of the Division of Criminal Investigations Crime Lab. (1)

Investigate the Topic

Parents can gather a lot of information by doing some quick Internet searches. The Internet provides a host of how-to sites on ways to make drugs, get drugs, and pass drug tests. If parents can access this kind of information, so can their teen, so it is important for parents to look for details about drug abuse in this way.

Parents can talk to local law enforcement or hospitals, or attend seminars that are designed to inform about drug trends. By doing a little investigating and talking to their teens, parents can feel confident in their knowledge of drug dangers that their child faces, in the hopes that they can help their child stay drug-free. Knowledge is power.

Sources

(1) Special Report: Synthetic Drug Use Spreading Fast

Guard Against Synthetic Drugs

Synthetic drug use hard to track

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Defining Depression

Depression can be hard to diagnose. Physicians traditionally use a reference book such as Diagnostic and Statistical Manual of Mental Disorders (DSM) which is widely accepted in the mental health field as the most comprehensive and most accurate. But even this book is subject to debate. In the newest version, the American Psychiatric Association (APA) is once again planning to exclude bereavement or grief as part of the depression definition. Many people don’t agree with this decision. “Depression can and does occur in the wake of bereavement, it can be severe and debilitating, and calling it by any other name is doing a disservice to people who may require more careful attention,” Sidney Zisook, a psychiatrist at the University of California, San Diego, said. (1)

Blood Test for Depression

It is possible that a simple blood test, developed by Ridge Diagnostics, could tell doctors very quickly if a person does indeed have depression. The test analyzes 9 biomarkers – such as inflammation, the development and maintenance of neurons, and the interaction between brain structures involved with stress response – that distinguish patients with depression. “These results are already providing us with intriguing new hints on how powerfully factors such as inflammation – which we are learning has a major role in many serious medical issues – contribute to depression.” says lead author George Papakostas, MD, director of depression research at Mass General and a professor at Harvard Medical School. (2)

Helping Depression Patients

Many people are hopeful that because of this test, more people with depression will get the treatment they need. Co-author John Bilello, PhD, chief scientific officer of Ridge Diagnostics, which sponsored the study, said, “It can be difficult to convince patients of the need for treatment based on the sort of questionnaire now used to rank their reported symptoms. We expect that the biological basis of this test may provide patients with insight into their depression as a treatable disease rather than a source of self-doubt and stigma. As we accumulate additional data on the MDDScore and perform further studies, we hope it will be useful for predicting treatment response and helping to select the best therapies.” (2)

The traditional ways of diagnosing depression are subjective, and many patients and even doctors question the accuracy of the diagnosis. “Traditionally, diagnosis of major depression and other mental disorders has been made based on patients’ reported symptoms, but the accuracy of that process varies a great deal, often depending on the experience and resources of the clinician conducting the assessment,” Dr. Papakostas states. (2)

Sources

(1) Can You Be Diagnosed With Grief?

(2) Promising Blood Test for Depression Reported by Massachusetts Research Collaborative

Blood test accurately distinguishes depressed patients from healthy controls

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Prescription drug abuse

Adolescents abuse prescription drugs more than just about any other substance. “For adolescents, prescription drugs are second only to marijuana as the most popular form of illegal drug use,” says Steven Ungerleider, PhD., founding editor of The Prevention Researcher. “With 22% of high school seniors reporting that they have used nonmedical prescription drugs sometime in their lives, abuse of these drugs is a growing concern for parents and many professionals who work with youth.” (1)

Entertainment

There are different reasons why teens abuse different prescription drugs. Some are taken purely for entertainment or to help them enjoy a party more. These prescription pills float around from student to student, sometimes without the user even knowing what they are taking. Pill parties are get-togethers where adolescents bring whatever drugs they could get from home or a relative’s house, and take turns popping the pills and exploring the effects.

Performance Enhancement

Other teens have begun taking prescription drugs to enhance their performance at school. Medications that help people focus or increase energy so a student can stay up all night to study are the most commonly abused. Often with these kinds of drugs, students don’t even see that it is wrong, because they see it helping out for a good purpose.

Meeting a Need

Still other teens take antidepressants, sleep aids, or anti-anxiety medication without a prescription to help with these kinds of mental health issues. While these teens may be in need of a real prescription because they do have a condition that warrants it, taking the drugs without a prescription is illegal and it can be harmful.

Dangerous and Illegal

Prescription drug abuse is a serious problem. Drugs can have fatal side effects, especially if taken in combination with other drugs or alcohol. Other drugs are so addicting that by abusing them when they are young, adolescents are setting themselves up for a life of addiction.

Because prescription medications come from a doctor, many adolescents still do not believe that taking them is wrong. Prescription drugs seem like a harmless way to have fun or to solve a little problem, and because of the great number of teens abusing these drugs and the ease with which the pills can be acquired, many don’t see it as wrong or dangerous. We need to get the message out to our young people that prescription drug abuse is dangerous. The researchers at The Prevention Researcher conclude that “it is imperative that service professionals who work with adolescent populations be aware of this emerging and serious issue. Clearly, any substance use prevention programs that target adolescents must include information on nonmedical prescription drug use.” (1)

Sources

(1) New Resources for Prevention of Adolescent Prescription Drug Abuse

The Partnership at Drugfree.org Collaborates With Award-Winning TV Personality and Celebrity Chef Andrew Zimmern

The Prevention Researcher

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Health Benefits to Exercising

We know there are health benefits to exercising. Working out will help with things like obesity, high blood pressure, diabetes, and arthritis. It also helps improve mood and decreases depression and anxiety. Exercising helps a person gain confidence, it refocuses their mind, gets them out and about with others, and increases body temperature, which is thought to have a calming effect.

Mental Health Benefits to Exercising

People have called exercise a magic drug for people with depression. Getting the blood pumping actually releases endorphins which are the feel-good chemicals of the brain, and decreases the amount of immune system chemicals in the body that make depression worse. “Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger,” says Jasper Smits, director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas. “Exercise appears to affect, like an antidepressant, particular neurotransmitter systems in the brain, and it helps patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing.” (1)

Some people even suggest that with the benefits of a good exercise program, certain mental health patients can be weaned down on their medication or be treated without medication altogether. “Exercise can fill the gap for people who can’t receive traditional therapies because of cost or lack of access, or who don’t want to because of the perceived social stigma associated with these treatments,” Smits says. “Exercise also can supplement traditional treatments, helping patients become more focused and engaged.” (1)

Be Active in Things You Enjoy

Exercise can be a daunting undertaking. Most people are so overwhelmed by the thought of getting in shape that they avoid starting any kind of program altogether. The good news is that exercise does not have to occur only at a gym or on a treadmill, or while training for a marathon. Taking a walk is the easiest form of exercise, and it can be very enjoyable – walking along a lake path, walking the dog, or taking a hike through a beautifully wooded area in the fall. Bike rides may take a little more coordination and energy, but can be just as relaxing. Other people may choose to play volleyball with their kids in the yard, or get on a softball league, or even use household activities like gardening or cleaning to get moving. The important thing is to find ways to be active, and to continue to do them. Experts suggest exercising 30 minutes or more three to five days a week to improve depression symptoms.

If depression or mental health problems are disrupting your life, seek the help of a professional. They will come up with a treatment plan that will best serve you. In addition to this treatment, however, it would be beneficial to incorporate an exercise routine to your daily schedule.

Sources

(1) Mental Health Providers Should Prescribe Exercise More Often for Depression, Anxiety, Research Suggests

Exercise may boost mood for some chronically ill

Depression and anxiety: Exercise eases symptoms

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Prevention Talks

Parents today are learning how important it is for them to talk to their teen about substance abuse. Adolescents whose parents have ongoing conversations with them about not trying drugs or alcohol are up to 50% less likely to try these substances. Prevention definitely starts at home, and parents can make a conscious decision to be the first and most important step in prevention.

Role Models

The example parents set also affects an adolescent. Kids who grow up watching their parents abuse alcohol are more likely to abuse alcohol themselves at a younger age. Adolescents learn behaviors from their parents and, good or bad, will start following the example set for them.

The latest study, which is published in the journal Alcoholism: Clinical and Experimental Research, looked at the brain chemistry of teens in order to further understand the impact of parental influence. The small study out of Oregon performed MRI scans on adolescents who had no previous experience with drinking, but who were children of alcoholics. They found differences in the areas of the brain that control decision-making compared to teens with no family history of alcoholism. These young people showed weaker development in the decision-making areas of the brain, possibly putting them at risk for making poor choices with regards to drinking in the future.

Bonnie J. Nagel, assistant professor of psychiatry and behavioral neuroscience at Oregon Health & Science University concluded, “Therefore, differences in brain activity may impact the ability of individuals family history of alcoholism to make good decisions in many contexts, and in particular may facilitate poor decision-making in regards to alcohol use. Taken together with other studies on youth family history of alcoholism, these results suggest that atypical brain structure and function exist prior to any substance use, and may contribute to an increased vulnerability for alcoholism in these individuals.” (1)

This study only helps reiterate the important role parents play in keeping their children away from drugs and alcohol. Parents should first of all talk to their children regularly about the dangers of alcohol abuse. Secondly, parents need to set a good example for their teen by drinking responsibly. If a parent’s drinking is out of control, they should seek help right away in order to provide their child with the best chance at living a sober life.

Sources

(1) Familial alcoholism affects teen brains

Teenagers with alcoholic parents more likely to have impulsive and addictive personalities

Parental Alcoholism Linked to Brain Changes in Kids

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The Beast We Call Progression

Within the self-help network, the treatment delivery system, and prevention world, addiction is known as a “life-threatening progressive condition” that worsens if it goes untreated. We hear about it, and read about it all the time. However, when it looks you in the eye it becomes so much more real. I attended a function last night, and while there, saw a former client of mine who had “dropped out” of treatment somewhat abruptly about a year ago. When I met him he was employed at a long-held job, had a very charming young wife, and a newborn baby son.

I’ll call this client “Nick,” although not his real name. So Nick came to see me because he was struggling with a Percodan habit that he just couldn’t manage any longer. It was starting to cause real problems for him at his job, at home, financially, and internally. He was caught up in the obsessive aspect of addiction, and couldn’t seem to break free from it.

It clouded and tainted everything good in his life, and he wanted to stop. Ironically, he was one of those individuals that didn’t present with a long history of drug use that grew into a dependence on prescription pain meds. He had injured his back and was prescribed Percodan to alleviate his pain. It doesn’t take long to become addicted to a drug as strong as Percodan, and he was no exception. It soon consumed him and every waking moment of his life was spent thinking about getting more. He was addicted. So I saw him for about six months, and tried to help him to stop using the drug, which he could never seem to do. He could “white-knuckle” out a day or possibly two, but he always relapsed, until he finally disappeared.

Seeing him last night was a total surprise, but felt good. During our conversation he laid out his “progression,” which sounded almost textbook to me. We went right down the line as I asked him about work, he lost the job; wife, she had thrown him out; newborn, he sees him as his former wife allows; living arrangement, he’s back living with Mom and broke. So, that sums up the “progression” of addiction for anyone wondering what that term means.

Basically, it means that a person’s drug or alcohol use will wipe out anything good or positive in that person’s life if their condition goes untreated. Interestingly enough though, Nick had never told me about alcohol being a problem for him while I was seeing him, but last night he told me that he had pretty much stopped using the Percodan but couldn’t stop drinking and relapsing with alcohol. He also said that alcohol had pretty much always been a problem for him, but he never realized it until he quit the prescription drugs and went “crazy” with the drinking.

Nick’s story emphasizes the importance of us being aware that addiction is addiction, and whether it’s addiction to alcohol or Percodan or Cocaine, it is still a “life-threatening, progressive condition” that, if goes untreated, will worsen and take everything a person is willing to give, including their life.

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Seriousness of Mental Illness

SAMHSA administrators acknowledge the seriousness of mental health disorders. Administrator Pamela S. Hyde said, “Mental illnesses can be managed successfully, and people do recover. Mental illness is not an isolated public health problem. Cardiovascular disease, diabetes, and obesity often co-exist with mental illness and treatment of the mental illness can reduce the effects of these disorders. The Obama Administration is working to promote the use of mental health services through health reform. People, families, and communities will benefit from increased access to mental health services.” (1)

The CDC agrees. “Mental illness is a significant public health problem in itself, but also because it is associated with chronic medical diseases,” said Ileana Arias, Ph.D., Principal Deputy Director of CDC. “[The] report issued by SAMHSA provides further evidence that we need to continue efforts to monitor levels of mental illness in the United States in order to effectively prevent this important public health problem and its negative impact on total health.” (1)

The Forgotten Mentally Ill

However, accusations have arisen that say SAMHSA did not accurately present information for their report because they failed to count people in jails, prisons, and hospitals, and the homeless who have mental health issues. The accusation states that SAMHSA underestimated the incidence of serious mental illness and overstated the percentage of those receiving treatment.

This raises some concerns, particularly about the number of mentally ill inmates in our country. Studies suggest that 10 percent of prisoners, or 218,000 individuals in the system at any given time, have severe psychiatric disorders. (2)

Jailing the Mentally Ill

Mentally ill individuals find themselves behind bars for a variety of reasons. Some are arrested because local businesses do not want them seen on their streets. Police in some areas arrest people with serious mental illness to keep them from causing a disruption or hurting themselves or others. Mercy bookings are done by police who are trying to protect mentally ill citizens from being victimized. Some family members reportedly go through the justice system to get their loved ones into treatment, because they believe the process is faster that way.

Not Equipped to Treat

The problem with the practice of arresting mentally ill citizens is that the justice system is not equipped to treat these individuals. Corrections officers in 84 percent of jails receive either no training or less than three hours training in the special problems of people with severe mental illness. (2) Jails and prisons are becoming crowded with patients they cannot help. A prison psychiatrist in California states, “We are literally drowning in patients, running around trying to put our fingers in the bursting dikes, while hundreds of men continue to deteriorate psychiatrically before our eyes into serious psychoses… The crisis stems from recent changes in the mental health laws allowing more mentally sick patients to be shifted away from the mental health department into the department of corrections.” (2)

Sources

(1) Mental Illness Affects 1 In 5 Americans

(2) Criminalization of individuals with severe psychiatric disorders

SAMHSA Statistics Ignore 500,000 Mentally Ill

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Let me start by saying that I love my line of work, but if I hadn’t lost my own brother to addiction, I’m not positive that I would have been this passionate about not only helping addicts, but also helping their families. I currently work for Treatment Solutions Network, who in my opinion has the absolute best approach to working with addiction in the workplace and addiction period. I feel confident saying this because I’ve worked in this field for many years and seen firsthand how to lead addicts along a better path and unfortunately, I’ve also seen companies lead addicts right out the door without even a chance. Treatment Solutions Network fights for every individual to get well, which is why I wanted to become part of their team.

Now, I wouldn’t talk the talk if I personally hadn’t walked the walk. For the past 22 years I was posted up at the Massachusetts Department of Corrections, where I was fortunate enough to be the Director of their Employee Assistance Program (EAP). While in that position, my team serviced over 5,200 employees, family members and retirees so I learned a thing or two about addiction along the way. In fact, I dealt head-on with virtually every setback scenario you could imagine like drugs, alcohol, financial, post trauma, marital, and so on.

I am proud to say that our team was very successful at what we did and the simple reason our EAP resources were so effective was because we made it as simple as possible for the employee and their families. We did our best to be a one-stop shop, which in essence meant that when you came to us with a situation, we weren’t going to send you out the door with a bunch of homework, we were going to assess your particular situation and find a solution for you and your family. This obviously made the situation a great deal more bearable for the individual and their family, but also, the employer saved time, stress and money. An EAP is generally a peer-elected post for just that reason, you need to be a conduit between the problem and the solution for both the employer and employee. It is a fine line but one that must be done with pride and respect.

It was during this time when I had the good fortune to work with Treatment Solutions Network and see that their organization had the same goal as my EAP team, just on a much grander scale. Treatment Solutions Network is the ultimate one stop shop and has saved countless lives as a result. One of the most difficult situations for an EAP to face is working with Public Safety Officers struggling with addiction. These officers have a career built on public perception and are far less likely to ask for help than your average employee. Treatment Solutions Network is comprised of former officials and Public Safety Officers who have been humbled by personal hurdles in the past and are now in a position to apply their unique wisdom and experience to people in need of help. When I saw how members of the Treatment Solutions team were able to take the one stop shop notion to a level I never imagined and apply multiple services beyond drug and alcohol treatment, but stress, counseling, family therapy, and mental health to name a few, I knew I wanted to be part of their team.

The Treatment Solutions team is built with the finest union and business leadership from the workforce and a network of the absolute best resources available in the addiction and recovery industry. It only takes one call and not only will you have a solution, but also you’ll have the best possible solution for your specific need and equally important, the needs of your family. This is the finest team I’ve had the good fortune to be a part of and while I personally lost a family member to the disease of addiction, along with Treatment Solutions, I have been able to keep countless families alive and together.

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Kids, Drugs, and Parents: What to do?

I recently received a call from a former client saying, “My 15 year old son is out of control, and I don’t know what to do. He’s drinking alcohol and smoking a lot of pot, he’s disrespecting his brother and me, he’s breaking all rules and ignoring any curfews I try to impose, and I’m afraid he could get physically violent because he’s so angry and enraged.” So we spoke about her situation and what was happening, not just with her son but with her family. We spoke about how to address the issues (alcohol/drug abuse, anger, unhealthy family relationships) they were struggling with, and how to change some of the dynamics that were allowing the “out of control” behavior to continue. I sensed my suggestions were not what she was hoping to hear. She was looking for an answer, the solution to fix her son and stop his behavior. It’s a parents’ nightmare when situations with their children are out of control. It can be scary, threatening, and extremely stressful, especially when parents aren’t really sure what their child is using. So, what do we (professionals, experts) tell them? Often it’s not what they hope or expect to hear.

I can’t count the number of calls I have received from parents, loved ones, friends, and even employers regarding someone they know who is in trouble and struggling, but they don’t know what to say or do to help. It’s a difficult position to be in, to watch someone you care about spin out of control and there doesn’t seem to be anything you can do to stop or change it. This position really can make a person feel powerless and helpless; but are we? That depends. There are times and instances where you simply cannot protect or save a person from themselves and their self-destructive actions no matter what you do. That is a very bitter pill to swallow, and often the only option is to keep stay healthy yourself and set clear boundaries in the relationship. There are other times though, which you can do something effective in bringing about change and help get things back under control. This usually entails examining our role in the family drama that is taking place and making changes in places that we do have some ability to control.

Educating parents about alcohol and drug use is good information to have, and very useful in helping them recognize and label the condition. It helps them see warning signs, identify suspicious behavior, and know the differences among various drugs and their effects. It’s a good start, but it isn’t enough. Remember, if nothing changes, nothing changes. So what will help? What do we tell them? It’s more than what we tell them to do; it’s a change in thinking and behaving on the part of the parent or loved one. It’s a different mind-set in looking at or trying to manage an out of control situation. I’ll share something that I learned from a Family Therapist I worked with early on in my career about working with individuals and families struggling with alcoholism, drug abuse, and dependence. It’s affectionately known as the “3-C’s,” and they were pasted on his office walls to share. He would simply explain to parents and loved ones that 1. You didn’t cause this condition. 2. You can’t control it, and 3. You can’t cure it. This might seem like strange advice in some ways, especially after reading my comments saying you (parents/loved ones) do have some control in this. It probably seems confusing, and it can be. But, using rational and logical thought processes when dealing with irrational and illogical behavior (alcoholics, substance abusers) and out of control situations doesn’t usually work very well. So here’s a different way of looking at it, thinking about it, and managing it.

A common scenario in working with individuals and families around alcohol/drug abuse and dependence looks something like this: The person abusing substances, regardless of which ones, usually ends up in trouble at school, work, legally, in relationships within the family and outside the family. Due to their drinking and drug use, and their out of control behavior they become the focus of attention and labeled as the “problem” or “troublemaker.” In the treatment world they are called the identified patient. To the family and loved ones these individuals need fixing so the family can get back to being “normal.” Much of the energy and attention (and blame) is put on those individuals to change their “crazy” behavior. The problem is that often times they aren’t able to at that point, so you’re asking someone who is out of control to take control. It usually doesn’t work, and continues to worsen until finally the court, police, families have to take control. So if the 3-C’s say “you can’t control it,” what do you control? Well, if enough pressure is exerted upon an individual (jail, job loss, divorce, eviction) they might agree to go into treatment which will, hopefully, begin the process of change. However, entering treatment can be used as an escape from the current situation and once it ends the individual quickly returns to their prior behaviors and lifestyle. Treatment is useful, even vital, but it is limited; it’s a beginning. If all the pre-existing conditions (stressors, relationships, etc) in a persons’ life remain unchanged, returning from treatment and maintaining change can be very difficult. Many families I’ve worked with believe that by sending someone to treatment “cures” them and they should never want to use again. That has not been my experience over the past twenty two years working in this field. What I have seen is that families get sick together, and families recover together; if they change.

In speaking with my former client about her son I couldn’t help but think about the entire family and also ask her, how did he become so “out of control?” It’s unusual that one particular family member would be out of control for no reason. As we spoke, she told me about what had been going on in their family since I saw her last. After hearing her story, it was not surprising that he was acting out, what surprised me (again) is that all the emphasis and focus is on him and his behavior, not the family. Understanding families and family dynamics is difficult enough, but adding alcohol and drugs takes it to an entirely different level. Many families have little or no understanding of alcohol and drug abuse or addiction, and are scared and confused by it. It’s difficult to figure out without help. What do I do? What do I say? And, how do I say it? These are the questions I get asked by parents, spouses, and concerned others who are at their wits end, struggling to make sense of their situation and in fear that a tragic ending is on the horizon.

I find myself returning to the 3-C’s time and again when trying to offer advice, or guide others in this situation. I start by validating for them that they are not the cause of this condition, nor can they control it, or cure it. But, that doesn’t mean they have to sit around and wait until their loved one decides to change, which could be a long wait or something that might never happen. The choice is a hard one to make, but it can be very effective in jump-starting the change process with those who are out of control, or not interested in changing their behavior. I also help them identify and label what changes within their power and control they can make. I emphasize that any changing has to begin with them, and that will vary depending on their relationship with the IP or out of control individual. Often times when we change, those around us change as well if they want to continue in the relationship.  Seeking treatment is often the beginning of this change process which, hopefully, leads the individual and the family into lifelong Recovery.

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