Dealing With Your Teen’s Drug and Alcohol Relapse

This is a two-part blog post by Michael V. Pantalon, PhD, Yale Psychologist, Addiction & Motivation Expert, Speaker, Coach and author of INSTANT INFLUENCE: How to Get Anyone to Do Anything—Fast! (Little, Brown & Co., May, 2011)

A “Relapse” Scenario

Imagine your 17-year-old son has been doing really well — staying away from alcohol and pot for the past 6 months following a 28-day stay in rehab.  He’s back at school, his grades are good, and he’s playing soccer again.  On top of that, his new friends seem supportive of his recovery.  As his parent, you feel you can finally breathe a small sigh of relief.

However, when your son comes home early from school one day without his backpack, you’re worried.  You confront him and his explanation makes sense. He explains that his last class was cancelled because a teacher became sick and there was no one available to sub. He didn’t need his backpack because he did his homework earlier in the day and during part of the last period. There was no soccer practice that day, so he came home.  The next day, everything seems back to normal.

Several days later, however, he comes to you and says that he would like to leave school early on Friday to go to a concert in the city.  When asked about how sensible that might be given that it might be a trigger for using and about the group of kids that he’s going to the show with, he becomes defensive and irritable.  A few minutes later, he confesses that the day he came home early, he had slipped out of school right after first period to hang out with some old friends.  He ran into these old friends (the very crowd he used to use and drink with) on the way to school that day and instead of staying in school, he spent the day with them. He played Call of Duty (a popular shooter video game), smoked, drank, and is now struggling with strong urges to continue using.

While he’s saying he doesn’t want to go back to the way he was, he also says, “I’m almost 17! Why can’t I have a drink now and then?!  I want to have fun.  Being sober is not fun.  I’m supposed to be having fun at this point in my life!”  Later, he confesses that he’d made plans to go to the concert with the old friends, but he’s still defending his ability to go with them and not use, stating that his new friends are “nice, but no fun at all.”

How do you feel?

What do you do?

How do you keep this relapse from blowing up in you and your son’s face?  Meaning — is there a way to help without making it worse?

You’re probably feeling a lot of different and feelings are conflicted.  You’re angry, surprised and hurt, but you’re also worried, understanding and sympathetic.  We might all have the strong urge to immediately vent this barrage of emotions toward our child and, in the moment, we would feel justified in doing so.

However, many of us might instinctively know that to do so, would not be helpful.  It might make your son more defensive and irritable.  He might then storm out of the house and go to the concert and resume drinking and using pot NOT simply because of the situation and the people he is with, but because he now feels justified in doing so because he’s angry at his parents (whether or not it is actually justifiable in this manner).

The other thing is that your son IS actually feeling stressed and distressed about his recovery and the conflict he just had with his parents.  And since he’s learned in the past that alcohol and drugs immediately take this feeling away, we’ve just helped him create a new trigger for drug and alcohol use.

Not that you are to blame, but there are certain ways to handle relapses so that this does not happen again.  While we as parents are not to blame when the sort of situation described above occurs, I strongly believe that we have a responsibility to learn ways to prevent it and even to use it as an opportunity to further strengthen our child’s recovery.

In my next blog post An Overview of Relapse, I describe a few ways to do just that.

 

5 Things You Need To Know About Relapse

People in recovery and their families are often terrified of relapse. Understanding the following 5 points may help.

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    Patti Herndon

    July 21, 2012 at 3:59 PM

    Hi Shawna,

    I hope you come back to visit. I regret that I didn’t know your comment was here.

    I’m glad your son is in longer term treatment. That is a real positive in your circumstances. His aftercare, when he gets out of the treatment program he is is now is an important support to him in helping to lesson his risk for relapse. Make sure you discuss an aftercare program with his current treatment staff/counselor to ensure that it is appropriate for his/your family’s needs. You’re doing everything you can. And you will continue to do that. And that spirit of approach will serve recovery. You’re a great mom.

    Your comment:”I keep hearing that they have never seen a kid this addicted this young.”…is something I heard, too, when my, now, 30 year old son-who is in long term recovery-was admitted into inpatient treatment at 15, right after we discovered he was using. What I heard from the initial counselor/staff at the first long term treatment center was “we can’t even measure the severity of his addiction. The numbers are ‘off the chart'”. That is a moment forever burned into my memory -Very scary, at the time. The level of grief I experienced, in the early years of the journey, especially initially, is inexpressible and very easily recalled. But, that sense of grief, shock, and loss lessened, little by little, as I moved through the journey engaging intense learning about the biological psychological sociological aspects of addiction, and seeking out (and vetting) effective support resources that were appropriate for our particular circumstances. I share that with you because it’s important for you to believe that it gets better.

    I can relate to much of what your share. My son was not adopted, but a great deal of the aspects of your circumstances, including the use of cough/pain syrup medication at early age, and your other descriptions, as well are similar to what we experienced… from onset of using substances, to treatment/relapse, multiple clinicians/psychiatrists/psychologists utilized, and your frame of his temperament as not being violent/disruptive etc.. My son was diagnosed with ADD Attention Deficit Disorder at around 10. He was not diagnosed as hyperactive. He was a well behaved kiddo. We didn’t observe any concerning behavioral issues. We did follow the doctors advisement and put him on the medication Ritalin to help him focus on his school work -which my son, several years later, reported as having triggered his desired to use mood altering substances. I liken this to what you mentioned about the opiate oxycodone liquid that your son used, in excess, at a very early age…though these two medications are different classifications in terms of their effect on the brain. One is a stimulant, the other is a depressant. I can tell you the my son has favored stimulants in terms of drugs of choice. It could be that your sons use of an opiate derived pain medication at early ‘could be’ an indication that he favors depressants/or opiates as a general preference. But please know that that is only speculation on my part. Sometimes when people with substance use disorder show a preference toward stimulants, or depressant it ‘can’ give clues/insights to the neurobiological functioning/or lack of normal functioning regarding neuro-based biochemicals. The more we can add to the scope/picture regarding our loved ones challenge, the more information we have to use for determing a ‘best practices’ approach to their/our challenge. It’s a process. It takes time.

    The counselors/treatment center staff comments about the severity of your sons addiction ‘could be’ based on psychological diagnostics testing that has been administered, such as the ASI (Addiction Severity Index).And/or the treatment staff(s)/therapist(s) comments to you about your sons level of addiction could be the result of combination of diagnostics and observation based on their work with him in therapy.

    It’s only speculation on my part at this point, based on what you share above….but your son could have a particularly intense biological/genetic vulnerability to substance use disorder/addiction. It happens.

    I believe a genetic predisposition was a huge contributor to the severity of my son’s addiction disorder, and consequently the length of time it has taken for my son to achieve long term recovery. There have been multiple lapses/relapses. But, it helped me to learn and understand that around 7 ‘relapses’ is average for a person with a substance use disorder working through the journey to sustainable recovery. It’s a long process for so very many.

    My son’s biological father developed serious, escalating alcohol and drug issues in his 20’s. Though I was married to my son’s father for only a few years, it was long enough to recognize his family tree as having many branches where alcoholism was present. His was a very dysfunctional family system. With hindsight, my own experience with my son’s journey through addiction, and 15 years of intense research on the biopsychosocial aspects of addiction, I am better clear on what I believe to be the major contributing factors to my sons vulnerability to coping with substances.

    Your son, very possibly, has a co-occurring mental health disorder such as depression complicating an already complex pathology. My son was diagnosed with Major Depressive Disorder and ‘Poly substance use disorder’ at 15.
    It’s been hard…beyond hard. But, it’s critical for you to believe that your son can begin to make healthier and healthier choices, over time, and achieve long term recovery. It happens all the time.

    It’s also very critical for you to learn, from multiple sources, about the biological, psychological and sociological aspects of addiction.

    “Where can I go for support?”: It so important for you to become familiar with a VARIETY of EVIDENCE-based treatment frames and support/peer support resources.

    Remember “One size treatment approach and support will NEVER fit all”. I’m encouraging you to steer clear of advisements and resources that seem to only espouse a single source/or philosophy for support in dealing with the challenges that come with addiction.

    Shawna, research them all. Try several support resources. If you try one support methodology/ approach and do not observe/experience progress/forward momentum, in a reasonable amount of time, that’s an indication that the philosophy/methodology does not match yours/yours sons individual needs. Be aware of statements such as, “If our/this program is not working for you, it’s because you are not working the program” -Or something similar. That is a huge red flag that you’re in the wrong place.

    When one support resource is not producing the results you hope for in a reasonable amount of time and with reasonable expectation…try ‘something else’. That recognition of, and ability to choose ‘something else’, when what we are doing isn’t producing positive results for our addicted family member, as well as ourselves/our family system is all-important to the development of building good coping skills for the long haul.

    It’s so important to our sense of self efficacy- (the belief we have that we can effectively cope with our challenges no matter what they may be), thus build upon our coping skill set for the journey through addiction- to recognize and take advantage of the reality that there are multiple evidence-based resources for support that we can choose from.

    Steer clear of supports and support groups whereby the structure is framed around gathering and ‘venting’ about all the hardships, to the exclusion of dialoguing about creative problem solving and skill set building regarding coping with and through the individual challenges that we face in the journey.

    When you ‘tune in’ to the ‘energy of the room’, in terms of a group/or peer support, ensure that support does not hedge on very specific advisements…like those that would suggest you ‘cut off all contact and support in the name of ‘tough love’. That or some other ‘very specific’ advising would be another red flag. Also, in general, approaches/philosophies that lean on/use lots of ‘clichés’ or ‘sayings’ to educate are probably not ones that will offer you much in the way of teaching you/your son how to problem solve for your own circumstances. And, problem solving/increased coping really should be the goal: Self efficacy.

    Please don’t hesitate to contact me is I can be of support to you. I would be glad to put together a list of all the support resources in your area, as well as familiarize you with online choices for support.

    It took several attempts before i found the support resource(s) that helped me to fully engage my own strengths for problem solving, coping, and increasing my sense of hope (hope is a clinical component and must be present in order to achieve momentum/progress) for the road ahead and for helping me to help my son engage his own strengths for his journey through addiction. The journey has been an insight-providing and life-enhancing experience for me/my son/my family. I could not have imagined feeling that way about the journey years ago. I’ve learned that I wouldn’t want to trade the experience (with all its massive hardships) for an easier road-even if I could. That’s reason for you to hope, too.

    Please don’t hesitate to make contact if I can support/encourage you in any way.

    I’ve been where you are. It gets better. It takes time. Never lose faith in your son’s ability to make positive change. His believing that you believe in his ability is critical. That belief helps you interact with him in a way that is conducive to his recovery.

    Addiction is the journey. Recovery is the destination.

    patti.herndon@gmail.com

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    shawna

    June 6, 2012 at 4:36 PM

    My son is 16. He started smoking pot at 13 and was immediately addicted. We started testing so he went on to taking massive amounts of cold medication which he either stole or got from school. WE have done everything. He has been to a four month program. Came home. relapsed. He is now in a 15 month program. He has been gone for 6 months. WE get to visit every 2 months. We have been through a dozen different counselors, psychiatarists, eveything. He is not violent, disruptive, rebellious, in any other way. I keep hearing that they have never seen a kid this addicted this young. We are grieving. I He made the connection that drugs made him feel better at the age of 9 following a surgery. I found the bottle of liquid oxycondone empty. He had been sneaking in to drink its there anyone out there who have a similar experience. My son was adopted at birth and has been through no traumatic that I know of. We are an intact, otherwise happy home. What happened? I still do not understand. Where can I go for support?

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    margo

    March 18, 2012 at 6:35 PM

    I am 16 and I have watched many peers go down the wrong path, all because of the affect drugs can have on someone’s life. I write for a blog (RadicalParenting.com) where teen interns can give advice to parents on different issues of challenges their teenage children might be facing. We have an article called Warning Signs Your Teen is Doing Pot that might be helpful to read. Here is is below:
    http://www.radicalparenting.com/2007/12/23/warning-signs-your-teen-is-doing-pot/
    Thanks,
    Margo

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    Steve Castleman

    November 2, 2011 at 6:05 PM

    Addiction is a chronic brain disease. Relapses, no matter how terrifying and destructive they may be, go with the territory. Many relapsers learn from them. I sure did. I learned there are no vacations from sobriety and that I couldn’t have “just one or two” no matter how much my rational mind told me I could. So even though relapse feels like a complete failure, there can be some positive lessons learned.

    Families struggling with a relapsing loved one can learn a lot about appropriate responses at Al-Anon and Nar-Anon. Members there have practical experience dealing with the irrationality of addiction and can provide the emotional support when facing tough decisions. For more, check out http://www.addictscience.com.

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