As the parent of an addicted child, feelings of helplessness, blame, and fear can drown out any sense of hope. If your child uses alcohol or drugs, you know firsthand how it affects your family. You may be carrying your child’s addiction on your shoulders. You’ve cried and felt scared, wondering if today the drug would take your child forever. You might have been angry and asked, “How did I miss the warnings?” or wondered, “what did I do wrong?”
You love your child but, like one patient’s mother told me, you may feel overcome with fear. She sat across from me and through her tears, she cried, “I didn’t know what to do. I thought I was going to lose her.”
If addiction has plagued your family, you see up-close how alcohol and drugs invade our child’s brain and create abnormal behaviors. Angry outbursts. Defensiveness. Rebellion. When you try to control these behaviors, you set in motion a conflict that escalates the problem. So, you establish strict rules, and when your child violates them, you punish the behavior. Soon you find yourself stuck in a cycle of control and out-of-control. It’s easy to become overwhelmed with the battle.
The majority of teens I treated used marijuana, usually multiple times a day. When asked why they used it, most said, “It helps my anxiety.” Their answer points to an important clue hidden below the surface of substance abuse. There could be an underlying reason why your child uses alcohol or drugs. It might be to relieve anxiety or depression. Perhaps it’s to avoid unwelcome memories like bullying. It might be to cope with a psychological issue, such as post-traumatic stress disorder, attention deficit disorder, or a personality disorder. While not every child using substances has an underlying psychological issue, for those that do, treating the alcohol or drug problem without treating the mental health issue behind it can be a treatment plan doomed to fail.
When you look beyond your child’s drinking or drug use, you may discover their struggle to manage intolerable thoughts, feelings, or memories is a core issue that requires treatment. However, you’re probably not equipped with the resources, training or education to adequately do so. Therefore, it’s important that you insist on a comprehensive assessment before starting any treatment.
If you’ve been down this road, you might have already taken this step. Hearing the results of your child’s psychological assessment and diagnosis can be more difficult than hearing the details of their substance use. No parent wants to hear that their child is “broken”. You probably knew something about their alcohol or drug use, but the psychological findings can be shocking. Shattering. Confusing. Frightening.
I have sat in hundreds of diagnostic conferences when parents heard for the first time that their child has severe anxiety, major depression, or suffers from an emerging personality disorder. Hearing these diagnoses is heartbreaking because parents usually see the substance abuse while completely unaware of the underlying mental health issues.
Your child may be creative at flying under the radar and discreetly hiding their substance use. The most frequent comment I heard from parents was, “I had no idea this was going on!” Or if they suspected their child was using a substance, they were shocked at how extensive it was. Sometimes it was weekly use. Often it was daily.
There are important differences between adult and adolescent substance abuse. Unlike the adult brain, your child’s brain is a work in process and reaches maturity in their mid-twenties. Thus, introducing an illicit substance into their maturing brain puts your child at risk of developing a substance use disorder.
The consequences of substance use are another difference. Adults abusing substances often experience catastrophic consequences, such as losing a job or relationship. Many have been incarcerated. Adolescents, on the other hand, experience few consequences other than the threat of punishment from their parents, which often reinforces their substance use as a form of rebellion.
Discovering your child has a substance abuse problem is not a death sentence. It can be an opportunity to have a meaningful discussion with your child about their substance use. While not every child will respond positively to a discussion, for those that do it can lead to a better understanding behind their substance use. For example, you may learn that their use of a drug like marijuana has been their attempt to control anxiety. Or you may discover that they have used alcohol to manage depression. You may also learn they have been subjected to peer pressure.
If your child refuses to talk about their substance use or denies it you may need to insist on a comprehensive and professional assessment. Your child will likely oppose any assesment but it’s important for an accurate diagnosis that it be completed.
It’s not enough to obtain just a substance use assessment. While such an assessment is important for a diagnosis, you will need a much more comprehensive assesment to obtain a true picture of what is going on behind your child’s substance abuse. Here some of the assessments that will be helpful:
- A comprehensive physical examination. This involves blood work, EKGs, and a drug screen along with other routine examinations recommended by a physician. You want to rule out any physical problems that may be contributing to substance use.
- An addictions assessment. This will examine the extent of your child’s use, what substances have been used, the frequency of use and whether there is a probability of a substance use disorder that could be mild, moderate or severe.
- A psychological assessment. This is usually done by a psychologist and will examine multiple psychological factors including those that might have contributed to your child’s substance use.
Once the assessments and tests are completed, diagnoses and a treatment plan can be recommended. There is no “one size fits all” approach to substance abuse treatment. The results of the comprehensive assesment will guide treatment recommendations. Many adolescents do well with outpatient treatment; others may do well with an intensive more frequent outpatient program. Some, with severe substance use and mental health issues may require longer term residential treatment.
You can read more about adolescent substance abuse in The Addicted Child: A Parent’s Guide to Adolescent Substance Abuse. You will learn how drugs impact the adolescent brain, how to recognize street drugs being used by adolescents, more information on assessments, warning signs every parent should know about, and what types of treatments are available and where families can turn for help.