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Substance Abuse
Mon At the End of My Rope
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<blockquote data-quote="Rumpole" data-source="post: 552068" data-attributes="member: 15255"><p>I saw your post and I was really keen to respond, particularly as I've seen a lot of posts on here advocating a tough love approach. I have a fair bit of familiarity with addiction, and addiction medicine, and I wanted to throw in my 2 cents.</p><p></p><p>A quick disclaimer; I'm not actually a parent, I'm a difficult child. I hope it's not against house rules to make a contribution. I've also had addiction problems and with heroin in particular, and have used Subuxone to treat that. I also overdosed when I was around that age, brought around with Narcan (Naltrexone/Naloxone). I'm a diagnosd ADHD-PI (amongst other things... childhood asthma, anxiety, bouts of depression). I'm currently at law school (in London, UK), and I have a part-time job in higher education that I love. At the same time, I still struggle with all the issues that I have since I was 15; anxiety, relapses of heroin use every few years, depression, disorganisation etc. </p><p></p><p>I first tried heroin when I was 15, after having been prescribed Ritalin for the ADHD, and then withdrawn from it as I was taking more than was prescribed. I left school at 15, but went back when I was 17 and graduated when I was 18. I'm at law school now, and I've had some great jobs in the intervening periods when I wasn't studying, but there was no revelation and things suddenly got better. It's more about managing them than conquering them. But... if properly managed, a difficult child can navigate their way through these problems and find themselves on the other side with good prospects and a future they value.</p><p></p><p>I thought I'd say upfront.... if at all possible, don't throw him out of the house. If your personal safety, or that of your family, is ever in jeopardy then of course you should, but otherwise I couldn't encourage you strongly enough to keep him at home. Being homeless would probably be the least helpful thing for resolving his addiction problems. There's a lot of "tough love" rhetoric, talk about "enabling" and so on, and I can tell you with 100% certainty that these concepts are not just fallacious, they're harmful. Addiction is a mental illness (though not a "disease" in the AA sense, and certainly not an issue of morality or uprightness), it is a medical disorder. You don't punish people for being ill, and doing so isn't going to make them better.</p><p></p><p>It's entirely reasonable to say to him that if he is to live in your house then he does have to seek treatment, and try to work through these issues. And obviously it's in his best interests but I think it really behooves parents not to draw the kind of line in the sand which would be, say, you find out he has used heroin again you throw him out. He's not a bad kid, he's unwell medically and he's only 19. Addiction is absolutely devastating when it hits 40 year olds; imagine how confusing and awful it must be for someone who is barely out of adolescence, who hasn't yet built up the coping mechanisms that you get with age, and who doesn't have a bank of other experiences through which he knows life can be a lot better without drugs. </p><p></p><p>The issues with drugs, this is a symptom of the inner turmoil and chaos. It's not him deciding to be naughty and go out and enjoy himself. People tend to use heroin to block things out, rather than to stimulate themselves, and I know from my own experience that it's a very attractive drug to people like myself and your son because it is so efficacious in "making everything okay". When you're 19, and you struggle with this kind of stuff, you don't have that inner resource which allows you to deal with that stuff.</p><p></p><p>Two things I'd bring up are the issue of treatment. I'm quite surprised that your son was thrown off the Suboxone programme for testing positive to drugs; one would think that if he's testing positive that is exactly the time he needs to be receiving that treatment. Suboxone has what's called a "high affinity" for the opioid receptors in your brain, the brain cells that process heroin. Because of this high affinity, they're very difficult to "dislodge", and so heroin does not have much effect when you are taking suboxone. Suboxone is also extremely safe comparatively, there's next to no euphoria or high, it's pretty much impossible to overdose on it. If you believe he should be back on it, you can find a local doctor / General Practitioner who prescribes, at this website</p><p></p><p>As I understand, in the US, GPs can provide a prescription for a month's supply, in which case it might be a good idea if you were to hold onto it and dispense it (means you know that he's actually taking it). The downside of going ahead with Suboxone is that if he's using heroin less than four times a week, it's highly unlikely that he is actually physically dependent. Suboxone is an opioid and so if he takes it as prescribed, he will become physically dependent. Speaking from experience, it is hard to get off Suboxone (that is mitigated by the fact that it is quite a benign drug to be on). </p><p></p><p>Equally, it seems close to unconscionable that psychiatrists refuse to treat him whilst he has a drug problem, which is when he would need their help most. It sounds as though he would benefit from some specialist addiction psychiatry or something along those lines; seeing a physician who is aware of, and takes into account, all the issues, ADHD, addiction, anxiety etc. But... it can be difficult to find; if you're located on the East or West Coast, you can probably find one, if you're in the Midwest, certainly more difficult.</p><p></p><p>In terms of the other things you said about downward spirals, I really want to extend my sympathy. From what I've read of your post above and below, I think you're doing the right thing in terms of blocking numbers, occasionally following him out, listening at the door. I would encourage you to do what you can / have to to keep him safe.</p><p></p><p>I'd just comment on what you said about "wanting to get help". I think you can make these kinds of comments about a 40 year old, about someone who is, for example, a binge drinker. But a 19 year old with diagnosed anxiety and mental health issues? They do not have the coping mechanisms, the judgement, the perceptiveness, to be able to make these decisions. He's in an incredibly vulnerable position, he is not well-placed to cope in the world if he did have to move out, and frankly this is not his fault. I know it's incredibly difficult for you and your husband, and it seems like he's being churlish and disobedient.... it's not like that. In the same way that it's a parent's responsibility to care for their children, navigate them through their primary and secondary education, teach them life skills and so on, I think the ball is in the parents court to do what it takes to make treatment happen, and it might be very hard work, and stressful, </p><p></p><p>I just don't think that telling him to find a treatment or move out is right; I think when you hear people saying that, it appeals to the part of you that is hurt and disappointed and frustrated, but I just want to emphasise again.... he's 19, he's not well, you wouldn't throw him out if he had diabetes or schizophrenia. He doesn't have the skills to cope out there in the world, and he doesn't have the social perceptiveness to really understand it. </p><p></p><p> So.... I'm not a medical practitioner, but I can tell you what got me past my addiction phase. It was my Mum methodically (and irritating as it felt to me at the time) forcing me to get out of the house to get some exercise with her, getting me involved in things (as I wasn't working or studying), whatever she was doing, but essentially not allowing me to hide away in my bedroom. It was her making sure I took suboxone and Omega-3 and multivitamins, and perhaps most importantly, talking to me about my education and career and making sure I knew where I was going. Having a future tends to make it worthwhile to take a rain check on the drugs.</p><p></p><p>Long post, I hope it wasn't TLDR. I just felt you should have another perspective on this.</p></blockquote><p></p>
[QUOTE="Rumpole, post: 552068, member: 15255"] I saw your post and I was really keen to respond, particularly as I've seen a lot of posts on here advocating a tough love approach. I have a fair bit of familiarity with addiction, and addiction medicine, and I wanted to throw in my 2 cents. A quick disclaimer; I'm not actually a parent, I'm a difficult child. I hope it's not against house rules to make a contribution. I've also had addiction problems and with heroin in particular, and have used Subuxone to treat that. I also overdosed when I was around that age, brought around with Narcan (Naltrexone/Naloxone). I'm a diagnosd ADHD-PI (amongst other things... childhood asthma, anxiety, bouts of depression). I'm currently at law school (in London, UK), and I have a part-time job in higher education that I love. At the same time, I still struggle with all the issues that I have since I was 15; anxiety, relapses of heroin use every few years, depression, disorganisation etc. I first tried heroin when I was 15, after having been prescribed Ritalin for the ADHD, and then withdrawn from it as I was taking more than was prescribed. I left school at 15, but went back when I was 17 and graduated when I was 18. I'm at law school now, and I've had some great jobs in the intervening periods when I wasn't studying, but there was no revelation and things suddenly got better. It's more about managing them than conquering them. But... if properly managed, a difficult child can navigate their way through these problems and find themselves on the other side with good prospects and a future they value. I thought I'd say upfront.... if at all possible, don't throw him out of the house. If your personal safety, or that of your family, is ever in jeopardy then of course you should, but otherwise I couldn't encourage you strongly enough to keep him at home. Being homeless would probably be the least helpful thing for resolving his addiction problems. There's a lot of "tough love" rhetoric, talk about "enabling" and so on, and I can tell you with 100% certainty that these concepts are not just fallacious, they're harmful. Addiction is a mental illness (though not a "disease" in the AA sense, and certainly not an issue of morality or uprightness), it is a medical disorder. You don't punish people for being ill, and doing so isn't going to make them better. It's entirely reasonable to say to him that if he is to live in your house then he does have to seek treatment, and try to work through these issues. And obviously it's in his best interests but I think it really behooves parents not to draw the kind of line in the sand which would be, say, you find out he has used heroin again you throw him out. He's not a bad kid, he's unwell medically and he's only 19. Addiction is absolutely devastating when it hits 40 year olds; imagine how confusing and awful it must be for someone who is barely out of adolescence, who hasn't yet built up the coping mechanisms that you get with age, and who doesn't have a bank of other experiences through which he knows life can be a lot better without drugs. The issues with drugs, this is a symptom of the inner turmoil and chaos. It's not him deciding to be naughty and go out and enjoy himself. People tend to use heroin to block things out, rather than to stimulate themselves, and I know from my own experience that it's a very attractive drug to people like myself and your son because it is so efficacious in "making everything okay". When you're 19, and you struggle with this kind of stuff, you don't have that inner resource which allows you to deal with that stuff. Two things I'd bring up are the issue of treatment. I'm quite surprised that your son was thrown off the Suboxone programme for testing positive to drugs; one would think that if he's testing positive that is exactly the time he needs to be receiving that treatment. Suboxone has what's called a "high affinity" for the opioid receptors in your brain, the brain cells that process heroin. Because of this high affinity, they're very difficult to "dislodge", and so heroin does not have much effect when you are taking suboxone. Suboxone is also extremely safe comparatively, there's next to no euphoria or high, it's pretty much impossible to overdose on it. If you believe he should be back on it, you can find a local doctor / General Practitioner who prescribes, at this website As I understand, in the US, GPs can provide a prescription for a month's supply, in which case it might be a good idea if you were to hold onto it and dispense it (means you know that he's actually taking it). The downside of going ahead with Suboxone is that if he's using heroin less than four times a week, it's highly unlikely that he is actually physically dependent. Suboxone is an opioid and so if he takes it as prescribed, he will become physically dependent. Speaking from experience, it is hard to get off Suboxone (that is mitigated by the fact that it is quite a benign drug to be on). Equally, it seems close to unconscionable that psychiatrists refuse to treat him whilst he has a drug problem, which is when he would need their help most. It sounds as though he would benefit from some specialist addiction psychiatry or something along those lines; seeing a physician who is aware of, and takes into account, all the issues, ADHD, addiction, anxiety etc. But... it can be difficult to find; if you're located on the East or West Coast, you can probably find one, if you're in the Midwest, certainly more difficult. In terms of the other things you said about downward spirals, I really want to extend my sympathy. From what I've read of your post above and below, I think you're doing the right thing in terms of blocking numbers, occasionally following him out, listening at the door. I would encourage you to do what you can / have to to keep him safe. I'd just comment on what you said about "wanting to get help". I think you can make these kinds of comments about a 40 year old, about someone who is, for example, a binge drinker. But a 19 year old with diagnosed anxiety and mental health issues? They do not have the coping mechanisms, the judgement, the perceptiveness, to be able to make these decisions. He's in an incredibly vulnerable position, he is not well-placed to cope in the world if he did have to move out, and frankly this is not his fault. I know it's incredibly difficult for you and your husband, and it seems like he's being churlish and disobedient.... it's not like that. In the same way that it's a parent's responsibility to care for their children, navigate them through their primary and secondary education, teach them life skills and so on, I think the ball is in the parents court to do what it takes to make treatment happen, and it might be very hard work, and stressful, I just don't think that telling him to find a treatment or move out is right; I think when you hear people saying that, it appeals to the part of you that is hurt and disappointed and frustrated, but I just want to emphasise again.... he's 19, he's not well, you wouldn't throw him out if he had diabetes or schizophrenia. He doesn't have the skills to cope out there in the world, and he doesn't have the social perceptiveness to really understand it. So.... I'm not a medical practitioner, but I can tell you what got me past my addiction phase. It was my Mum methodically (and irritating as it felt to me at the time) forcing me to get out of the house to get some exercise with her, getting me involved in things (as I wasn't working or studying), whatever she was doing, but essentially not allowing me to hide away in my bedroom. It was her making sure I took suboxone and Omega-3 and multivitamins, and perhaps most importantly, talking to me about my education and career and making sure I knew where I was going. Having a future tends to make it worthwhile to take a rain check on the drugs. Long post, I hope it wasn't TLDR. I just felt you should have another perspective on this. [/QUOTE]
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