Substance Abuse Incident, What Next?

Substance Abuse Incident, What Next?

i Aug 21st No Comments by

There has been an incident with your loved one involving substance abuse. Quick – what are the first 5 steps you should take immediately?

  1. Make sure the person is out of physical danger
  2. Identify the facts about what exactly happened
  3. Remove any substances or items that could cause additional harm, including an automobile, if necessary
  4. Seek the counsel of an experienced substance abuse counselor
  5. Assess the degree or extent of the problem

The first five steps after a substance abuse incident can save a life and help people think and act more clearly.

If your teen is on your phone plan, then start monitoring their call, text and internet activity. Start a record to track habits and calls. Start exploring the best course of action. Now.

Law enforcement or Student Conduct might dictate the next step, giving you no choice regarding what to do next. Unfortunately, depending on the community or school, some teens will be forced to attend mandatory, often inadequate DUI schools, which in many cases feel so punitive, that they hardly inspire sobriety or improved behaviors. What’s more, law enforcement might also impose community service, which could add fuel to feelings of humiliation, particularly if it is a service that does not necessarily fit the transgression or the behavior.

Intensive out-patient programs (IOP), which combine therapy, group therapy, counseling and medicine dispensation, along with other programs are available. Look for details forthcoming. Here is a start, in the meantime.

  • Weekend outpatient
  • Inpatient recovery programs, which usually involve detox for addicts, alcoholics. Detox needs to be medically supervised, or death could result in severe cases
  • Comprehensive residential addition programs
  • Wilderness programs, 20 to 90 day recovery centers that focus on intensive outdoor forms of therapy, combined with individual/group therapy
  • 12-step programs or communities

Will Ban on College Campuses Curb Alcohol Abuse?

i Aug 17th No Comments by

In January of this year, the New York Times ran a story about Dartmouth banning hard liquor on it’s campus. Since then, I have been meaning to write about this.

So banning hard alcohol at frat parties and on campus will help “arrest bawdy behavior and reduce sexual assault”? Hmmm… who said so? Addiction therapists and experts at many respected facilities advise clients that it is alcohol, more than other substances, that wreaks the worst havoc on young adults and families. Beer, wine, or booze, they pretty much have the same impact. Heroin is an exceptional substance because it kills from overdose and has more addictive characteristics than many other substances. But alcohol, regardless of the form, is often more damaging.


Dartmouth College attempted to curb alcohol abuse by banning booze on campus.

In fact, the most dangerous substance abuse problem on many campuses is allegedly alcohol mixed with Xanax. So what does Dartmouth expect to accomplish with a ban on booze, but not beer and wine? Does the action placate wealthy alums who expect action but don’t understand the real facts surrounding substance abuse? Hard alcohol is easier to conceal than a case or a keg. That doesn’t mean that banning it will help.

How about institutionalizing programs that support prevention and teach and enable students to intervene if a friend is getting into hazy territory? How about mandatory group substance abuse counseling on Sunday night at the Frat house? How about a sober tailgate? Sponsored by the likes of Coke or Pepsi or Ford, and other big brands that want to target young and millennials and be part of a healthy, even a party culture?

Come on Dartmouth, show a little leadership. Show a little resourcefulness. Get real on young adult behaviors and alcohol abuse.

Marijuana Addiction is Real

i Aug 16th No Comments by

What about Weed? For parents who don’t think it is addictive, read this excerpt from an article published on CNN.

pot in the raw

Marijuana bud. Credit: US Library of Congress

We now know that while estimates vary, marijuana leads to dependence in around 9 to 10% of adult users. By comparison, cocaine, a schedule 2 substance “with less abuse potential than schedule 1 drugs” hooks 20% of those who use it. Around 25% of heroin users become addicted.

The worst is tobacco, where the number is closer to 30% of smokers, many of whom go on to die because of their addiction.

There is clear evidence that in some people, marijuana use can lead to withdrawal symptoms, including insomnia, anxiety and nausea. Even considering this, it is hard to make a case that it has a high potential for substance abuse. The article continues, “The physical symptoms of marijuana addiction are nothing like those of the other drugs I’ve mentioned. Withdrawal from alcohol… can be life threatening.

Pot.NIMH. umaLateralWholeBrain1

Brain receptors are vulnerable to marijuana among all users. If a user is among the 10% of adults prone to addiction, he or she is highly vulnerable to marijuana addiction.

I do want to mention a concern that I think about as a father. Young, developing brains are likely more susceptible to harm from marijuana than adult brains. Some recent studies suggest that regular use in teenage years leads to a permanent decrease in IQ. Other research hints at a possible heightened risk of developing psychosis.

Much in the same way I wouldn’t let my own children drink alcohol, I wouldn’t permit marijuana until they are adults. If they are adamant about trying marijuana, I will urge them to wait until they’re in their mid-20s when their brains are fully developed.”

Dr. Herbert Kleber, M.D., professor of Psychiatry, Columbia University, and pioneer in research and treatment of substance abuse, spoke at a National Center on Addiction and Substance Abuse (CASA) seminar on July 7, 2016. He stated that “…14 to 17 year old brains might not recover (from marijuana abuse) until they are 25 or older. “He also noted that edible marijuana can take one hour to kick in and can trigger a psychotic episode. Something to think about if you’re over 21 and consuming it in states where its sale is legal. For details that the professionals read on addiction, here is CASA’s most recent report on addiction.


Drug Abuse Statistics – A Look at the Numbers

i Aug 13th No Comments by

Substance Abuse Statistics are not going away.

The Facts* among the U.S. population for ages 15 to 29 is 64.6 million, over 21 percent of total U.S. population.


6.5% of this group uses marijuana daily. Photo Credit: US Library of Congress.


22.7%   used marijuana in the past month

15.5%   used a prescription drugs non-medically in 2012

 13%      prescription drug use for non-medical reasons is highest among young adults

250%   increase in young adult deaths from Rx overdoses between 1999-2010. That translates to 3000 deaths**

Complicating these facts are co-existing behavioral health disorders: In 2013, about 1 in 10 adolescents (10.7 percent) had a major depressive episode (MDE) in the past year. Among adolescents with MDE, 38.1 percent received treatment or counseling for depression in that past year.

Some research has shown that co-morbidity of addiction and mental illness can be 50%, and an office practice is not the setting of choice for most addicted patients (Clinical Philosophy: The Psychodynamic Approach to Addiction Treatment by Sid Goldman, M.A., for Caron Renaissance.)

An important part of family recovery from teen substance abuse is a willingness to help others in crisis with insight and information, all the while protecting the reputation and the future of the teens, with discretion and respect for privacy. Talk with as many people as you can and as many people as you can trust with regard to your teen’s problem, and protect his or her privacy.

Here is the NIH link to drug facts and trends among youth and teens. You are not alone.

Learn More Here

What is a 12-Step Program for Recovery?

i Aug 11th No Comments by

12-Step Programs are communities whose members come from all walks of life. They share a set of guiding principles outlining a course of action for tackling problems including alcoholism, drug addiction and compulsion. Per Wikipedia, a 12 step program was originally proposed by Alcoholics Anonymous as a method of recovery from alcohol. The original Twelve Steps were first published in 1939; then they were adapted and became the foundation of other 12-step programs.

American Psychological Association summarized following as hallmarks of 12-step programs:

  • admitting that one cannot control one’s alcoholism, addiction or compulsion;
  • recognizing a higher power that can restore sanity;
  • examining past errors with the help of a sponsor (experienced member);
  • making amends for these errors;
  • learning to live a new life with a new code of behavior;
  • helping others who suffer from the same alcoholism, addictions or compulsions.
sowhatis a 12stepprogram

12 step programs offer fellowship, shared experiences, support and hope for recovery in a confidential setting.

Many 12-step and AA meetings will group people by age segment (any by sex, and by newcomers versus longstanding members). A young teen or adult will probably hear about a circumstance much like their own if they get in a group that is more a reflection of them, as opposed to a group with lots of adults.

Here are a few characteristics of the program, which probably need to coincide with other programs or support:

  • No one in the group has to speak up. The point is to listen and have an open mind
  • Anonymity is an important “spiritual foundation”
    of the program. And no one uses last names.
  • Groups tend to be spiritual, but not religious fellowships – People refer to a “higher power” not to Christ, or Alla, or other spiritual entities
  • There is no professional counseling, and no one recommends any. More experienced members lead the meetings. If people want advice off-line, they can stay afterwards to ask questions
  • It is free. Contributions are requested
  • Individuals are encouraged to seek a sponsor
  • Teens and parents can find meeting schedule and find books that are enormously helpful here: for teens for parents

Other helpful organizations:

Alcoholics Anonymous (AA)


Al-Anon / Alateen


Find a Meeting (US & Canada)

Cocaine Anonymous (CA)


Find a Meeting

Narcotics Anonymous


Find a Meeting

Co-Dependents Anonymous (CoDA)


Find a Meeting

Gamblers Anonymous


Substance Abuse and a DUI or MIP

i Aug 9th No Comments by

If you need to pay bail, then arrange to pay, or get a bail bondsman to pay, so you can get your child home and stabilized. If it’s not the first time, let your child figure it what to do this time. Watching that unfold will enlighten you about the extent of the problem – is this a bump in the road, a chronic habit, or a bigger problemiss?

Call the number on the citation and get a copy of the police report, to see what exactly happened and whether other stuff went on. This could take 2-3 days. You will need to go to the jail to get the report. But get it, because you need to know what really happened.


DUI or MIP for substance abuse can help families identify extent of a problem and accelerate a recovery path. Photo: Library of Congress.

Get an attorney for your child or request a court assigned attorney. Everyone has a right to one. If you hire one, get a specialist, a litigator who has handled this sort of issue before, preferably in the county or court system in which it is assigned. Expertise helps save a lot of time.

Comply with a lawyer’s advice. First time offender statutes work in your favor, if you think your kid will abide by the statutes.

Show up in court, and early. The court system can be punishing to anyone who wastes its time. Tell your child to address the judge yes or no, “your honor” and to look presentable. It matters.

If the incident was reported to your child’s school, schedule a meeting with the school counselor and your child immediately. Make the school your friend. Believe it or not, school administrators are potential advocates for your child, unless he has been a repeat offender – in which case, they might feel your problem is beyond their expertise.

J. Tom Morgan wrote an excellent book called Ignorance Is No Defense, about the laws in Georgia impacting teenagers. It is an excellent overview of what every teen and parent needs to know.


Recovery Programs in Atlanta

i Aug 8th No Comments by

Atlanta has a big drug problem. So many programs exist for substance abusers. Where to begin is tricky, because each person’s problem is unique and different from another’s. Let’s start chronologically by age, with programs from young teens to young adults.

Psychology Today Magazine has a website where you can comb through numerous options and get a sense of not only what you might need, but also what might sound like a fit, after you have received an assessment. But on the left column, you can refine your search, quickly.


Wilderness programs can help teens and young adults overcome challenges, regain control over their lives, and get back on a healthy, happy track.

Wilderness programs for teens and young adults tend to jump-start the recovery and results process. For the most part, a teen needs to commit to such a program for at least 30 days, and while these programs are lauded for having quicker outcomes, some teens and young adults might need to stay up to three months. What’s more, insurance rarely pays for them, claiming they are “camps”, which is unfortunate. They carry a heavy cost, but many of the programs have scholarships and payment installments available.

While we are not endorsing Aspen Wilderness programs, their site provides a good explanation of what makes Wilderness popular. Some are located in Georgia and North Carolina. It is a good starting place, Click Here to learn more.

Substance Abuse and Mental Health Services Association (SAMHSA) has a good overview of what you need to be considering and keeping in mind as you get close to a decision.

Metro Atlanta Recovery Residences: gender specific programs and sober living environments that enable young adults to continue school or work. Scholarships are available, as well as male mentoring.

Kennesaw State University Center for Young Adult Addiction and Recovery – Focus is on the college student. Criteria are pretty demanding. Students need to be clean and sober for at least six months, have a certain GPA, and be willing to live in a sober community. Young adults who want to stay in college in a supportive community can find it here. But they must earn the privilege of participation with extended sobriety.

Talbot Recovery Center: 3 locations in Georgia and a free one hour assessment available.

For mental health issues such as depression, bi-polar and borderline personality disorders. Skyland Trail has a new Atlanta campus for young adults, as well. And they offer thorough assessments; but clients need to be 18 or older.



Substance Abuse Treatment Options

i Aug 7th No Comments by

Treatment for substance abuse disorders, like every medical condition, should be tailored to the needs of the client. Basically there are a few distinct treatment paths, and for many people a combination of treatments is necessary. Here is a representative list:

    • 12 step programs-free and confidential with very flexible meeting schedules like AA or Narc-anon. Just Google them with your zip code
    • Detoxification- Short term treatment to get past the medical issues that are associated with withdrawal from some substances (the most worrisome being benzodiazepines (“benzos” and alcohol)
    • Inpatient treatment-residential care, varying from a few days to several months to a year or more
    • Outpatient treatment- combinations of group treatment and individual treatment variable in length and intensity based on patient needs
    • Medication Assisted- Medication prescribed by a physician to assist in maintaining or achieving sobriety. Not intended as a standalone treatment
    • Wilderness therapy programs. These can be 30+days in rural environments. They can be successful jump-starts that certain teens and young adults respond to rapidly, and well.
    • Therapeutic boarding schools. There are many, and many treat co-existing issues such as depression, OCD, anxiety, and learning issues. Their differences demand close attention.

The best recovery programs will include group and individual therapy sessions. Credit: Library of Congress

These are just some substance abuse treatment options. You can consider live-in or drop-in programs that include counseling and some medical treatment. Group counseling offers the support of others who share a similar problem. Often, one-on-one counseling with a therapist or social worker is combined. Twelve-step programs such as Alcoholics Anonymous and Narcotics Anonymous offer free support through the recovery process.

If a problem requires medical care and counseling as a teen withdraws, consider a live-in treatment center for about 30 days. The days-only program might lead to devoting longer than a month toward recovery.

National Institute of Health recommends programs with therapy that promote:

  • Skills development
  • Cognitive or behavioral therapy
  • Support groups
  • Psycho-educational therapy
  • Therapy that focuses on the interpersonal process

Try to find a person who’s been through this situation, or a school, church, or other guidance counselor who can get you started on the right path to a selection. Most people who know that you are in crisis will be discreet and respect your privacy.

Avoid Relapse Now

i Aug 5th No Comments by

Substance abuse relapse doesn’t mean drug rehab was a waste of time or money, or that a teenager is a failure. Rather, experts now view relapse as a valuable learning experience that brings an adolescent one step closer to lasting recovery.

Stress can translate into higher rates of relapse. “When teens feel that life is out of control, they tend to fall back on old behaviors and coping strategies,” says Eric Belsterling, an adolescent therapist at Phoenix Outdoor Wilderness Rehab.

Old habits of substance abuse die hard when stress is manifested. Ironically, relapse is often part of the path to successful recovery.

“Teens are already balancing school and relationship stress, media influences, and pressures to fit in and succeed,” Belsterling notes. “When you add worries about getting jobs and affording college in a difficult economy, a number of teens begin self-medicating their stresses with drugs and alcohol.”

Parents can support their teen in early recovery by taking the following steps:

  • Don’t keep alcohol, tobacco or other drugs in your home.  Safeguard your prescription drugs and over-the-counter medications by locking them in a medicine cabinet and disposing of them properly when you no longer need them.
  • Offer praise and encouragement when your teen attends 12-Step meetings or therapy sessions, follows their relapse prevention plan or gets through a difficult situation without using.
  • Support your teen if they relapse and get them back into treatment rather than blaming, nagging, or judging them. At the same time, avoid enabling their addiction by refusing to make excuses or cover for your child.
  • Encourage your teen to befriend teens who don’t use drugs and to get involved with hobbies, activities or work that appeal to them.
  • Talk openly with your teen about how they are feeling, and if either of you senses the threat of relapse, get help right away.
  • Make sure your teen isn’t overbooked or dealing with excessive stress.
  • Take care of yourself by speaking with a therapist, attending Al-Anon meetings, joining a support group or taking time for the things you enjoy.

Although teens in early recovery may have a vulnerable moment, substance abuse relapse treatment helps them get back on track before they make a full return to their old drug-abusing lifestyle. This non-profit help site, was created by by Dr. Steven Melemis, MD, Phd, and offers additional insight and suggestions to avoid relapse.


10 Things to Know about Relapse

i Aug 3rd No Comments by

I didn’t write this, but I found it a while back and am searching for the author. It has been helpful to a number of friends, with thanks to countless professionals who care so deeply about our teens.

Teens in early recovery are extremely vulnerable to relapse. It can be hard to understand why a teenager would work so hard to achieve sobriety only to fall back into drug use−but that’s the power of addiction.

Studies suggest that between 50 to 90 percent of addicts relapse at least once in the first four years of sobriety, and most relapse many times. Triggers for relapse can be as mundane as hearing a certain song on the radio or as significant as hanging out with friends from the old drug crowd.

Although relapse is considered normal and predictable, knowing the common triggers for relapse and having an action plan can help teens and their families guard against any slip-ups. Here are a few common relapse triggers to watch out for:

Being in social situations or places where drugs are available

Unless teens remain on guard, their thoughts will likely turn back to old behavior patterns when they are around the people or places associated with their past drug use. Old friends who still use drugs will use peer pressure, teasing and subtle manipulation to get a teen in early recovery to return to their “fun” old self. These friends may not be ready to confront their own drug use and will not respond positively to someone who questions their habit or forces them to take a look at their own behavior.

Each adolescent has their own set of high-risk friends, places and situations that they must sacrifice for the sake of their sobriety. In drug rehab, teens can practice ways to cope with those triggers, make new friends who don’t use drugs and find sober activities they can enjoy.

After maintaining their sobriety for a time, many teens want to “test” their willpower by going back to certain places or social situations. This can be risky and seldom makes teens feel more secure in their recovery.


Reverting to old friendships can be a trigger or warning sign of substance abuse relapse. Photo: Shutterstock

Isolation or Old Friendships

While it’s risky to stay in touch with old friends who use drugs, it’s equally risky to be socially isolated. Teens in early recovery need to closely follow the relapse prevention plan they created during drug rehab. This plan likely includes attending 12-Step meetings and therapy sessions to get support from other people in recovery and to have someone they can go to when the urge to use arises. Without this support system, teens start to feel alone in their struggles, which may make them want to start using again.

Being around drugs or using any mood-altering substance

Being around drugs of any kind can trigger a craving to use.  Even the sight, smell or sounds associated with a drug can bring back memories of the way drugs made the teen feel, as well as an overwhelming desire to use again. Most teens in early recovery will need to get rid of all paraphernalia, photos or any other item related to drugs or alcohol in order to avoid temptation.

A common pitfall for teens is thinking they can use drugs, as long as they avoid what used to be their drug of choice. So if they were hooked on painkillers, they figure it’s safe to drink alcohol. The reality is that addiction to one drug easily transfers to another drug (and even other compulsive behaviors like video game addiction, gambling and spending). If a teen has abused drugs before, they will likely need to abstain from all mood-altering substances for the rest of their life.


Many teens first start using drugs to cope with stress brought on by school, relationships or home life. Although adolescents learn new coping skills in drug rehab, it is common to revert back to old methods when life gets tough.

Before drug rehab, when conflicts arose, drugs or alcohol would allow the teen to escape the situation. Now, the teen must practice new ways of coping, such as taking a walk, calling a friend, journaling or some other form of healthy expression.

Establishing a daily routine, including getting up at a certain time or joining a club that meets regularly, may help teens maintain a sense of control in their lives. While predictability can help, teens will eventually have to learn to accept that they cannot control everything.


Self-confidence and an optimistic outlook are protective factors against relapse, but over-confidence is one of the most common reasons for relapse. The 12-Step principles remind teens that humility and an admission of powerlessness over addiction are essential for lasting recovery. But after staying sober for a period of time, some teens are so proud of their accomplishments that they don’t think they need to follow their relapse prevention plan anymore. They stop attending meetings and become less vigilant in monitoring their emotions and cravings.


A close cousin to over-confidence is complacency. Some teens in early recovery start to take their sobriety for granted. They become complacent, assuming if they’ve been able to maintain their sobriety for a certain amount of time, they no longer need to monitor their mental state, attend meetings or follow their relapse prevention plan with the commitment they started with.

In many cases, teens begin to wonder if they can use only occasionally or have just one drink without returning to their addiction. They want to prove to family and friends that they no longer have a problem. Unfortunately, complacency often leads to relapse.

Mental or physical illness or pain

Addiction frequently goes hand in hand with mental illnesses such as depression and anxiety. Something that aggravates an underlying mental illness can also trigger the desire to use drugs or alcohol. Teens with co-occurring disorders require dual diagnosis treatment that addresses both their substance abuse and psychiatric illness. After formal treatment ends, they also need to carefully monitor their state of mind through journaling, therapy and other forms of self-reflection.

Physical illness is also problematic, particularly if a doctor prescribes painkillers or other drugs as a form of pain management. Teens who self-medicate a mental or physical illness may find themselves becoming dependent on drugs of relief. For this reason, self-care is essential. A healthy diet, exercise and adequate sleep will help guard against exhaustion and physical illness.

Though it may seem counter-intuitive, positive life events and emotions can also trigger relapse.  For example, getting straight A’s, falling in love or getting into a good college could be cause for celebration and reignite the desire to use drugs.

Reminiscing about drug use or telling “war stories”

If an adolescent spends time thinking obsessively about how it felt to be high or telling “war stories” to friends about past drug use, this is an indication that relapse is imminent.


Without drugs, many teens in recovery don’t know what to do with their free time. A bored teen is a teen who is asking for trouble. Drugs are exciting; there are other activities and hobbies that are equally thrilling without the high level of risk. Teens can get involved in rock climbing, white water rafting, or some other adventure sport. They can also keep busy with school activities, clubs, sports, exercise or hanging out with sober friends.


We all want life to go out way, but even the most fortunate among us won’t always get what we want.  Many teens fall into the trap of self-pity; feeling impatient that recovery isn’t happening fast enough, wondering why they have to deal with addiction and rehab, and questioning why other people can go out for a drink with friends and they can’t. They begin to feel entitled to have a drink or use drugs because they’ve been sober and worked so hard.

Though it isn’t fair, this is the reality of addiction. It’s better to accept the good and bad life deals rather than feeling like a victim.