Category Archives: Adolescent and Young Adult Substance Use

A teenager with the brain and brain stem highlighted.

How Drugs Affect The Brain of a Teenager

By on June 2nd, 2021 in Adolescent and Young Adult Substance Use

Learning to respond to teenagers with drug problems has always been a challenge in the drug addiction and mental health world. The differences between the effects of drugs on teens and adults on drugs is enough that SAMHSA and the National Institute on Drug Abuse have both separately built resources centered on teen drug use. When it comes to teens drinking or using drugs, it’s tempting to ask drug-specific questions, like “how does alcohol affect the teenage brain?” or “what are the effects of marijuana on the teenage brain?” While it’s true that each drug is different, we would submit that the broad strokes are largely the same from drug to drug. Teenagers who use drugs largely all have the same outcome, whether they are drinking alcohol, smoking pot, or using other illicit drugs.

In order to better understand how drugs affect the brain of a teenager, we’re taking a look at some of the work done by Dr. Steven Jaffe, MD – a pioneer in the development of substance use treatment programs for teens and young adults. Jaffe is a professor emeritus of psychiatry at Emory University and a clinical professor of psychiatry at Morehouse School of Medicine. He is also a consultant for multiple teen-focused alcohol and drug treatment programs around the country.

What follows is a discussion of the neurobiological information presented by Dr. Jaffe in his 2017 book, Sacred Connections: Studies of Spirituality in Recovery Adolescent and Young Adult Substance Abusers. His work has been invaluable to us in the field of teen drug use treatment.

What Motivates the Teen Brain, and Why Teen Drug Treatment Often Doesn’t Work

Teenagers operate under an entirely different set of motivations than adults who are entering addiction recovery. In general, adults enter recovery from drug and alcohol addictions as a response to the consequences they have faced – many times they’ve lost homes, businesses, or respect in their communities. Often their families won’t talk to them, or they are on the verge of divorce. For adults, these consequences spark a powerful motivation to change. Addicted teenagers, on the other hand, often enter a drug abuse treatment center because they’ve been caught by parents, their school, or the police – leading to the belief that the parents or school are the problem, not the drugs. Almost every parent of a teenage drug user has heard some variation of these words:

“If everyone would just leave me alone, I’d be fine.”

Anonymous surveys on teen drug use show that high school age teens essentially use drugs to feel good and have fun. Teens often haven’t been exposed to the long-term effects of drugs and alcohol. Dr. Jaffe spends some time in his book addressing the factors that lend to the success of the enthusiastic sobriety model in particular. Specifically, he provides a clinical approach to what is happening in the adolescent brain on drugs to shed light on how to best help young people recover from the effects of alcohol, marijuana, or other drugs.

Alcohol, Marijuana, and the Teenage Brain

In the book, Dr. Jaffe discusses two important parts of the brain: the prefrontal cortex and the nucleus accumbens.

The prefrontal cortex:

  • Helps to regulate impulses and make informed and smart decisions.
  • It is well documented that this portion of the brain is not developed until a person is in their mid-twenties.

The nucleus accumbens:

  • Is a vital part of the brain’s reward circuit and is responsible for regulating motor functions relating to seeking things we “like” and avoiding things we “don’t like.”
  • Unlike the prefrontal cortex, the nucleus accumbens develops much earlier and is fully developed in children.

Teenagers differ from adults in that their “reward-seeking” system is working properly whereas their “inhibitory” system (prefrontal cortex) isn’t developed. The result is that teenagers are naturally predisposed to impulsive or risky behavior, such as binge drinking, partying late, or driving drunk. For instance, an adult may think, “doing cocaine would be really fun,” but then immediately think, “I could lose my job,” and decide not to use drugs. The second inhibitory thought never occurs to the teenager.

To understand how recovery occurs, it is paramount to address what happens when a teenage brain is affected by drugs and alcohol. In Jaffe’s own words:

“Heavy drug use in adolescence is diminishing a not yet fully developed inhibitory prefrontal cortex.”

Therefore, in addition to the prefrontal cortex being under-developed in teenagers, its development is further stunted by substance use.

Reversing the Effects of Marijuana, Alcohol, and Other Drugs on the Teenage Brain

From a biological standpoint, there are two neurological brain function “problems” to address when a young person enters our program with a substance use disorder:

  1. There is an underdeveloped prefrontal cortex.
  2. Drug use results in a numbing of the response of the pleasure center (nucleus accumbens) that leads to a diminished response to normal everyday pleasures.

The result is a teenager having a need to seek extreme risks to enjoy their life, even if those decisions are dangerous or even life threatening. For a parent, this is quite a predicament. They often ask, “How do I help my son or daughter get off drugs?”

Jaffe provides the following solutions:

First, sobriety needs to be something that is fun and attractive to the teenager, in order to stimulate the nucleus accumbens. Since the nucleus accumbens has a lessened response to life’s pleasures, teenagers need to take fun, safe risks while being sober! Dr. Jaffe refers to these as “high stimulus experiences.” These high stimulus experiences create an opening for the brain to heal and create positive neural pathways related to being sober and seeking joy in a more positive way. Over time, the teenager’s brain becomes resensitized to normal dopamine levels and the brain resumes normal production of neurotransmitters.

The next step is to include a spiritual component, to help the prefrontal cortex recover from the damage done. Enthusiastic sobriety (and 12-step recovery in general) includes a spiritual component. Dr. Jaffe includes information saying, “some brain scan studies have shown increased activity in the prefrontal cortex while a person is engaged in prayer.” He goes on to describe increased brain response from meditation and prayer. In other words, the prefrontal cortex is allowed to function normally and its development is resumed.

Last, the positive peer support group plays a large factor in recovery for a young person. Dr. Jaffe coined the term “borrowing another’s prefrontal cortex.” Seeking the opinion and suggestion of another young person who has experienced recovery from a substance use disorder can be someone’s greatest ally against using substances or engaging in negative behavior. One of the primary ways for this to happen is when a positive peer support group helps guide the young person’s decision making processes for a time. It is because of the strong relationships based on love and healthy attachment that recovery begins.

Dr. Jaffe states, “The biochemical systems that are impacted by drugs and alcohol are the same systems that are regulated by relationships and love.” The prefrontal cortex responds strongly to attachment, fun, hope, faith, trust, and love. The enthusiastic sobriety model and 12-step approach help to target the prefrontal cortex and resume its development and healing.

Simply, by stimulating the nucleus accumbens and reawakening the prefrontal cortex, we can begin to reverse the effects of alcohol, drugs, or marijuana on the teenage brain.

Why Punishment and Fear of Consequences Is Not The Answer

One common traditional approach to getting kids off drugs is to educate them as to the dangers of substance misuse. While we are certainly not against anti-drug education (it can be very helpful in substance abuse prevention), we’ve never seen it work very well in teenagers who already have drug problems.

This is because foresight, predicting the future, and planning complex behaviors are tasks handled by the prefrontal cortex. In short, the teenage brain is not equipped with the tools to be able to identify the long-term consequences of their actions following extended substance abuse.

In Conclusion

By knowing how drugs affect the brain of a teenager, we can better formulate some basic strategies that will help. A teenager can experience success in sobriety through a combination of:

  • High stimulus experiences
  • Positive peer relationships focused around trust and love
  • A spiritual component to have hope and faith in the future

In this way, a teenager can recover from a substance use disorder that is appropriate to their age range and adequately adapts to their social and emotional needs.

Rather than a focus on consequences, enthusiastic sobriety focuses on providing a safe, fun environment with a positive peer support group. Applying that foundation, sobriety is transformed into something that can be fun and attractive to a young person. Once this precedent is set, providing tools to help stay sober long-term can be provided. In short, a young person can stay sober and gain tools to build positive relationships.

Teenagers in substance abuse recovery getting out of themselves.

Getting Out of Yourself in Adolescent Substance Abuse and Addiction Recovery

By on April 9th, 2021 in Adolescent and Young Adult Substance Use, Articles, Substance Abuse Recovery Tools

An often-repeated piece of advice in recovery is to “get out of yourself.” Usually, this piece of direction is given with the understanding that to get out of ourselves, we need to “get into others.” What our sponsors typically mean when they give this piece of direction is that we should go out of our way to be of service to someone or something. This can come in the form of reaching out to a newcomer, setting up a meeting, helping clean, or just holding the door for someone and asking how their day is going.

What we typically mean when we say “get out of yourself” is: do something that causes you to think of yourself less. This can be achieved by being of service to someone else, or by simply linking up with our positive peer group and having fun for an afternoon or evening. Whether in a traditional 12-step program like Alcoholics Anonymous (AA) or an enthusiastic sobriety support group, we normally have an abundance of opportunities to do both of these things, provided we are paying attention and looking for opportunities.

But does this piece of advice hold any water in the grand scheme of recovery from drug or alcohol use? Academics have produced a lot of literature on the merits of many addiction recovery tools – mindfulness, meditation, group therapy, family counseling, and support group participation, to name a few. However, the literature is relatively sparse on the benefits of “getting out of ourselves” in recovery – slightly ironic given the fact that helping others is one of the cornerstones of 12-step recovery. One of the most iconic recovery stories is the classic story of AA’s two co-founders, Bill W. and Doctor Bob staying sober by being of service to each other.

There is one source of literature on the topic – numerous studies by Maria Pegano et al have shown the benefits of service and “helping behavior” in adolescent drug and alcohol treatment. While detailing these studies may be the topic of another post, this 2016 article entitled Can Helping Others Keep You Sober? would be a great place to start if you’re interested in learning more.

Why the Emphasis on Helping Others?

Those of us in recovery know the value of “getting out of ourselves and into others,” especially where staying sober and emotionally on track are concerned. We know that when someone is “out of self and serving others,” there are massive positive reward outcomes. People in long term recovery know just what this does for the process of getting and staying sober and what it essentially does in terms of substance addiction relapse outcome studies. These simple “acts” can most assuredly improve quality of life and overall level of happiness.

One of the greatest tools we instinctively know that we have internally is to shift our focus from thinking about ourselves and onto other people when all else fails as a sort of “master key” to humanity.  It seems no matter how far down on their luck someone is, human beings just seem to want to render aid and support to someone who needs it even if they are suffering themselves.

Those in 12-Step recovery have known about this for years. It is a recurring theme in 12-step fellowships and literature and recovery circles. In the opening line of Chapter Seven, Alcoholics Anonymous (the Big Book) itself declares, “practical experience shows that nothing will so much insure immunity from drinking as intensive work with other alcoholics. It works when all other activities fail.” This book, authored in 1939, had the right idea even 80 years ago when providing strategies to help with our human condition and addictive issues.

What about Taking Care of Ourselves?

We’d like to emphasize the following caveat to everything above – getting out of ourselves is not a replacement for taking care of ourselves. It is simply a piece of the puzzle. There is a reason that the 12-steps also include principles such as self-examination, making amends, and meditation. Additionally, we wouldn’t suggest that someone blow off their IOP program or other counseling / therapy in order to simply serve others or have fun. What we’d simply like to state is that when all of the work on ourselves is done for the day, there’s only one thing left to do: turn the lens away from focusing on ourselves and get some relief. This habit goes a long way towards the healing process.

Why Getting Out of Ourselves Works

When someone has a behavioral or emotional issue, it is something within themselves that they are struggling with. Add to this the fact that when most of us are in pain, we have a tendency to metally laser-focus on the problems in our lives. Most of the time, even the traumas of our past which are still affecting us day-to-day are simply internal emotional hurdles by the time we hit recovery. When we turn our focus away from focusing on ourselves, these emotional hurdles get turned on their head for a little while. This effect is easy to observe even in early recovery from drugs and alcohol. The act of “getting out of self” can add tremendous staying power to our recovery and emotional state as we heal.

How to Get Out of Yourself

As stated above, those of us around enthusiastic sobriety or other forms of 12-step recovery tend to be surrounded by opportunities to get out of ourselves, as long as we’re willing to look for them. Here are some ideas:

  • Take a walk
  • Call a newcomer and ask how their day is going
  • Think of someone in your sober network that you haven’t talked with in a while and call them
  • Go to an AA event or sober social activity
  • Link up with some sober friends and get an activity started!

Benefits of Getting out of Yourself

Some of the possible positive benefits of getting out of self include:

  • Deepening the experience of getting out of the way of problems
  • Getting focus off of negative events
  • Breaking out of obsessive thinking (or at times completely forgetting whatever it was that was initially occurring)
  • Helping us let go of being connected with any problem
  • Developing the ability to return to a problem with a clearer perspective

As stated above, getting out of yourself isn’t a catch all tool – we still need to work through our problems and address any behaviors and thoughts that may be impeding our progress. However, some of the best stories about finding joy and connection have started with someone deciding to serve someone else. When you’re done working through whatever issue is eating your proverbial lunch, don’t forget to get out of yourself!

Teens dealing drugs to one another.

Arizona Youth Survey | Young Adult and Teen Drug Use Statistics in AZ

By on December 8th, 2020 in Adolescent and Young Adult Substance Use, Arizona Substance Abuse, Articles

Finding out that your teen has begun to experiment with drugs can be a scary reality. Many times parents we have worked with already had a sneaking suspicion, but often the discovery leads to more questions than answers. If you live in Arizona, hopefully we can answer a few of those questions about middle school, high school, and teen substance abuse in Arizona for you today. Note: if you’re not sure, check this resource about warning signs of teen drug use for some helpful tips to determine whether you should be concerned or not.

Whether you are a professional who works with teens and young people, a parent looking to determine information pertaining to the potential risks your loved ones face, or a concerned citizen, we would like to present the teen drug abuse statistical data available to us in as straightforward a manner as possible. The data below has been compiled from the 2018 Arizona Youth Survey, which covers topics ranging from risk factors such as dangerous behaviors and teen drug use to environmental factors such as gang involvement and family attitudes. For the purpose of this article we will focus solely on drug use among Arizona teens statistics.

What is the Arizona Youth Survey (AYS)?

The AYS is an anonymous survey given every two years to youth all across the state of Arizona in middle schools and high schools that decide to participate. The report is reported on state-wide, as well as broken down by county. Due to the anonymity involved in the testing tool (see the tool used in the survey), students are far more likely to tell the truth than in other settings. We believe this is the most reliable glimpse into the reality of drug, alcohol, and tobacco / vape use among teens and youth in the state of Arizona. The teen drug abuse statistical information is also particularly helpful in monitoring the future of prevention efforts in our state.

This teen substance abuse statistical information is, of course, specific to Arizona, but we find it mirrors what we see in other parts of the United States. For instance, here’s a resource on statistical information about teen drug use in California.

Will there be a 2020 AYS?

The AZCJC reports that “Due to school closures in response to the coronavirus (COVID-19) pandemic, the 2020 Arizona Youth Survey (AYS) has been postponed until Fall 2020.” We eagerly await the results of this newest installment of the AYS, and we will update this post accordingly once the results come out.

What grade levels take the Arizona Youth Survey?

The Arizona Youth Survey is taken by 8th graders, 10th graders, and 12th graders throughout Arizona. This allows for an accurate picture of age of onset and progression of use as teens get older.

Key Statistics: Why do Arizona teens use drugs?

One of the most common questions we get revolves around the motivation for substance abuse, especially for first time drug use. When we meet parents they are often bewildered that their kids have made the decision to turn to drugs. While it is natural to start questioning our parenting skills, as well as wondering if our kids have other mental health problems, we find that the real reasons kids use drugs are often extremely simple. Here at Pathway, we have an expression – we lovingly call teenagers “fun machines”. This is because so much of what they do has such a pure and simple motivation: to have as much fun as possible, today. The other commonly cited reason is to deal with stress. The results from the Arizona Youth Survey speak for themselves:

When asked about the reasons for using alcohol and other drugs in the past 30 days:

  • 50.8% of teenagers replied that they used drugs “to have fun”. 
  • 38.6% stated that they used drugs “to get high or feel good.”
  • 36.0% cited school-related stress as a reason for using substances.
  • 31.5% cited family-related stress as a reason for substance use.
  • 28% cited feeling sad or down.

Other common answers were “to stay focused or think better” (20.1%), and to deal with peers and friends (23.0%). For a full breakdown, see page 64 of the AYS.

Key Statistics: Where are Arizona teens getting drugs and alcohol?

Below we have listed the common sources of various drugs of abuse. It is important to note that not all the numbers add up to 100%. This is because a teen obtaining drugs could technically qualify for two or more categories. An example would be a student who acquires a drug at school from a friend. This student would have checked the boxes for “at school” and “from a friend” for the same drug. Here are the numbers:

Sources of marijuana

67.4% of students who used marijuana reported that they obtained it from friends, and 27.2% reported that they obtained it at a party. One particular statistic of note is that 25% of students reported obtaining the marijuana from someone who had a medical marijuana card, and 15.4% reported that they obtained it at a dispensary either within or outside of Arizona. Other sources included over the internet (5.7%), from school (17%), and from home (9.6%), among others.

Sources of alcohol

47.1% of students reported obtaining alcohol at a party, and 22.8% reported that it was given to them by a relative over the age of 21. 20% reported that alcohol was given to them by a non-relative over 21. Other common sources included stealing it from home (18.0%) and stealing from a store or someone else’s home (6.8%).

Sources of prescription drugs

Unlike other drugs, the most common source of prescription drugs was from friends at 29.0% and from home at 23.6%. As these drugs are particularly dangerous, this goes to show the importance of keeping your prescription drugs locked up and disposing of them once you are done using them. Other common sources were from a doctor or pharmacy inside or outside of he US (21.8%), at a party (11.9%), and at school (10.5%).

Key Statistics: How prevalent is teen drug use in Arizona?

Marijuana

29.7% of all students across all grades reported using Marijuana one or more times in their lifetime. 23.4% reported using marijuana concentrates (such as wax or hash oil). We can extrapolate that 79% of those who used marijuana were using some form of concentrate. The number did not significantly decrease or increased across the 2014, 2016, and 2018 surveys. This makes sense, as  our own data shows that marijuana is firmly the number one drug used by teens.

15.7% of students reported using marijuana in the past 30 days, and 12.3% reported using marijuana concentrates in the last 30 days, confirming the statistic above that about 80% of marijuana use is through concentrates. It should be noted that, like the relationship between cigarettes and vaping, marijuana concentrates are significantly stronger than even modern plant marijuana.

Alcohol

44.9% of students across all grades reported having drunk alcohol for “more than just a few sips” in their lifetime. This number dropped slightly across 2014, 2016, and 2018 surveys. The number of students reporting using alcohol in the last 30 days was 20.2%, about one in five. In surveys of our own clients, we’ve found that alcohol is still second on the list of the top drugs used by teens.

Tobacco and E-cigarettes / Vaping

37.1% of students across all grades reported having used electronic cigarettes in their lifetime, and 16.9% reported smoking traditional cigarettes in their lifetime. While the number of students using traditional cigarettes has dropped significantly (by as much as 77%, depending on the grade), the number of students who have vaped has increased by as much as 74%. This shows that while traditional cigarettes have fallen out of vogue with teenagers, nicotine use levels among students remains about the same.

This trend continues when students were asked about use over the last 30 days – 19.0% reported having used e-cigarettes in the last 30 days, whereas only 4.7% reported using traditional cigarettes in the last 30 days. As noted above in the marijuana section, vaping nicotine tends to be significantly stronger than traditional cigarettes.

Prescription Drugs

Multiple prescription drugs were reported on, with the most commonly used being prescription pain relievers (9%), followed by prescription sedatives (4.8%) and prescription stimulants (4.6%).

While these numbers may seem less significant than the higher numbers reported for marijuana and alcohol, it should be noted that 3% of students reported using prescription pain relievers in the past 30 days, followed by 1.4% for prescription sedatives and 1.3% for prescription stimulants. These drugs are known to be very dangerous and addictive, and they are present in schools.

Poly Substance Use

A particularly alarming statistic is that 11.7% of teenagers report using more than one illicit drug at once during their lifetime, with the highest number being 12th graders at 18.1% (almost one in five). 3% report that they have utilized the specifically dangerous combination of alcohol and prescription pain relievers at the same time.

This number drops to 4.7% when students were asked about poly substance use in the last 30 days. 1% of students also reported combining alcohol with prescription pain relievers in the past 30 days.

Other Drugs

Other drugs were reported on in the survey, with levels of lifetime use being between 1-3%. These drugs include cocaine / crack, ecstasy, methamphetamines, heroin, and steroids, among others. View pages 49-50 of the survey for complete data on these substances.

Are there teens who do not use drugs?

Absolutely! While the teen drug abuse statistics above can paint a bleak picture, there is evidence that prevention works. The survey even details (on page 63) reasons students chose NOT to use alcohol or other drugs. This information is particularly useful for prevention efforts, but can also be helpful to parents.

Among teens who reported that they have turned down drugs in the past 30 days, the most common reasons were:

  • 87.9% stated that they turned down drugs because they are not interested in drugs.
  • 74.2% stated that they turned down drugs because they knew their parents would be disappointed.
  • 56.5% reported that they avoid drugs because their parents would take away privileges.
  • 48.2% avoided substances because would get a bad reputation and 31.1% cited that their friends would stop hanging out with them. This is known as positive peer pressure.
  • Other common reasons were because drugs are illegal (61.4%) and because they are aware of the damage drugs can do to the body (73%).

This goes to show the importance of a family making it clear that they do not approve of drug use, the importance of drug abuse / drug addiction related education and positive peer relationships.

If you have any questions or would like to speak with one of our professional counselors further regarding your specific situation, please call (877) 921-4050. We will gladly discuss your situation or recommend a course of action based on your circumstances.

Teens dealing drugs to each other.

2020 Teen Drug Abuse Statistics in California | Prevalence of Adolescent Substance Use in CA

By on November 16th, 2020 in Adolescent and Young Adult Substance Use, Articles, California Substance Abuse

Is substance abuse among teens and young adults a major problem in California? We believe that it is. This is especially true considering that in the United States, 90% of adults who meet the criteria for Substance Use Disorder began using substances (including tobacco) prior to the age of 18.

Drug abuse can be a scary topic. As of this writing towards the end of 2020, we are in the middle of a global pandemic, but there is another, often forgotten epidemic going on: the widespread use of drugs, alcohol, and vaping among youth and teenagers. Whether you are a parent dealing with the realization that your young one is experimenting, a representative from a school or community organization, or simply a concerned citizen, we would like to present the information to you in as straightforward a manner as possible. As a drug abuse program specializing in working with teenagers, we wanted to present some of the teen drug abuse facts and statistics.

Though this topic can be hard to make sense of, luckily there are a number of sources that compile teen statistics on the top drugs used by teens:

Sources of statistical information on teen and young adult drug abuse

The substance abuse in adolescence and teen statistics below are compiled from three primary sources:

Though all of these resources include data on other topics (such as instances of mental health issues), for the purpose of this article we will keep the discussion on their insights in to youth and young adult substance use in California. If you would like to see a complete list of references contained in this article, click here.

Defining the terms of Substance Use and Substance Use Disorder

We would like to start by defining a few commonly used terms in the substance abuse and drug abuse / addiction world.

Substance Abuse – This term refers to using a substance in a way that is problematic to the user. For instance, an individual may use substances and it may cause them to miss a school assignment, miss a family gathering, or affect their work performance. The presence of these “consequences” is one of the first symptoms we look for in determining whether someone has a substance use disorder.

Substance Use Disorder – This term was first introduced in 2013 in the Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition by the American Psychiatric Association. It is a diagnosable disorder characterized by the user reporting any of 11 criteria. These criteria range from reporting a desire to cut down on use, experiencing tolerance, experiencing withdrawal, and a number of others.

Alcohol, Marijuana, and Tobacco use among California adolescents aged 12-17 Statistics

The following three tables outline the statistics of substance abuse among secondary school students between the ages of 12-17. If you would like to skip ahead to specifically see data regarding young adults (aged 18-25), click here.

The California Health Care Foundation reported in their 2018 PDF that:

Lifetime use of substances for various grades
  Grade 7 Grade 9 Grade 11
Alcohol 13.3% 32.3% 51.7%
Cough/Cold Medicine – 43.6% 43.5%
Marijuana 7.9% 23.1% 37.9%
Cocaine – 3.7% 6.4%
Prescription Pain Medications – 16.8% 21.8%
Percentage of 11th grade public school students that used a specific substance at least four times to get high
Alcohol 33.0%
Cold/Cough Medicines 31.2%
Marijuana 25.1%
Prescription Pain Medications 8.2%
Ecstasy 3.4%
Inhalants 3.6%
Cocaine 3.0%

The table below details statistics from the Behavioral Health Barometer, Volume 5 in regards to substance use in teens aged 12-17.

Additional statistics on youth aged 12-17 (According to the Behavioral Health Barometer)
  Initiation of use in the past year Used in the past month
  California National Average California National Average
Marijuana 5.2% 4.8% 7.5% 6.8%
Cigarettes 2.9% 3.9% 2.9% 3.9%
Alcohol 8.5% 9.4% 9.8% 10.1%

Other statistics on adolescent drug use

Kidsdata.org reports in their PDF that:

Percentage of students who have used alcohol or other drugs in the previous month.
  Female Male
7th Grade 7.3% 7.1%
9th Grade 22.7% 16.6%
11th Grade 30.0% 27.7%

Key takeaways regarding adolescent / teen substance abuse in California

The above three substance abuse categories represent the most commonly used substances among adolescents. The report notes that while tobacco and alcohol use among teens age 12-17 were down in 2017 from their levels in 2005, marijuana use has not dropped. The report also does not detail use of other drugs, such as opioids, stimulants, or prescription drugs. In our professional experience, we have seen that many teens are using other drugs, especially prescription drugs, more often and we would like to see these numbers included in the next survey.

Additionally, it should be noted that as the older the kids get, it appears the more likely they are to experiment with drugs or alcohol. While this is not surprising, it is very revealing to see statistics approaching 1 in 3 students using substances as they approach the 11th grade level.

Young adult (ages 18-25) drug use in California Statistics

There is significantly less data compiled on this topic, since “young adult” generally means that the subjects are over the age of 18. This age group tends to get lumped together in the “over 18” category, which typically includes any adult over the age of 18. However, the SAMHSA’s 2017 data does provide some insight on the topic: 

Young Adults aged 18-25 who reported (in the past year)
  California National Average
Tobacco Use 33.4% 42.6%
Marijuana Use 34.7% 33.0%
Marijuana Use Disorder 5.8% 5.1%
Heroin Use 0.9% 1.3%
Illicit Drug Use Disorder 7.5% 7.2%
Binge Alcohol Use 35.2% 38.1%
Alcohol Use Disorder 10.9% 11.0%
Substance Use Disorder 14.4% 15.1%

Key takeaways on young adult substance use and substance use disorder in California

As with the reported numbers on youth, key numbers have dropped since 2005 – alcohol and tobacco use are down. However, there is one notable exception. Marijuana use among young adults has risen from 28% to almost 35%.

Young adults are far more likely to have experimented with drugs in their lifetime, and they are far more likely to have experimented with “harder” drugs such as cocaine or heroin. The key point to remember with this age range is that many of them used for the first time before the age of 18, and the ones that didn’t are still at much higher risk of developing dependency than 25+ year olds who have fully developed frontal cortexes.

What to do about a young person’s drug use

This is often the question that parents, guardians, and loved ones have for us when we first meet them. For many of us, the day we realize that our loved one is using drugs can be described as the worst day of our lives. It’s common to experience guilt, shame, fear, anger, distrust, feelings of betrayal, or a combination of these emotions upon first discovering that a family member is using drugs.

We’d like to start by saying that – there is hope, and you are not alone in this realization.

We often say that there are no guarantees in the drug and alcohol treatment world, but what we do know is that as a program, we see the results of young people and teenagers changing their lives and mending their broken family relationships every day of the week.

Our first recommendation is that you connect with a professional in the field of youth and young adult substance abuse. Many programs offer free assessments, or will talk with you on the phone. It is especially valuable to receive an assessment from a professional because it can be incredibly difficult to assess the severity of an individual’s substance use without a proper assessment. Sometimes this process makes you realize that perhaps the problem wasn’t as bad as you thought, and other times you realize that it’s time to seek real help and/or treatment.

Though our offices are located in California and Arizona, we are more than happy to spend time with you on the phone discussing options. Please reach out to us if you have concerns, questions, or would like a free assessment.

References:

Alcohol/Drug Use in Past Month, by Grade Level

Beharioral Health Barometer, Calofornia, Volume 5

California Student Mental Health Scorecard, 2015-2017

Mental Health and Substance Use: A Crisis for California’s Youth

Substance use among adolescents in California: A latent class analysis

Youth Alcohol, Tobacco, and Other Drug Use in California

Matt Klein, DO is the psychiatric consultant for The Pathway Program

A Psychiatrist’s Perspective on Adolescent Drug Use and Addiction

By on April 17th, 2020 in Adolescent and Young Adult Substance Use, Videos

Watch this video about adolescent drug use and addiction with Dr. Matt Klein, DO, the psychiatric consultant for The Pathway Program, and is board certified in psychiatry and adolescent psychiatry.

If you would prefer to read, rather than watch the video, scroll down to find a transcript of the interview. Also, timestamps are provided directly below the video if you would like to skip to a specific question.

Timestamps

  • 0:20 – Can you give us a brief overview of who you are and what your role is at the pathway program?
  • 2:25 – What type of patients do you typically work with at the pathway program?
  • 3:19 – What do you think the young people you meet with drug problems typically struggle with the most?
  • 5:57 – Many parents struggle to determine which came first, the drug use or the mental health symptoms. What would you say to parents in this sort of “chicken and egg” debate?
  • 9:04 – What trends have you noticed among the young people you have seen over the past few years?
  • 10:58 – If you could give a single piece of advice to a parent who finds themself trying to help their drug or alcohol abusing son or daughter, what would it be?

Q: Can you give us a brief overview of who you are and what your role is at the pathway program?

A: I’m Dr. Matt Klein; I’m a psychiatrist here in Arizona. I am a DO, and I’m board certified in psychiatry, as well as child and adolescent psychiatry. I’m also a psychiatric consultant for Pathway. My role at Pathway includes providing input in a general sense for certain situations, or if someone needs more specific psychiatric help, they will see me for evaluation and further management. What that has often incorporated is young people who were abusing drugs, they weren’t telling their family, and they look like they have all kinds of disorders as a result of that. The family did what was reasonable and took them to a professional. Because this young person doesn’t want to stop using drugs, they lie about that, and end up with diagnoses and prescriptions and oftentimes that may not be the case because of the drug use causing a lot of emotional lability and depression and anxiety, especially anxiety, when they are not on drugs. Many of these things can resolve and we’ve seen many cases where they just resolve naturally through the treatment at Pathway. My role is often to take a reevaluation, especially when the person in treatment has become more honest about what has been going on, and really reevaluating what is appropriate or needed and working with someone through that process.

Q: What type of patients do you typically work with at the pathway program?

A: The people I usually see at Pathway are people who are in the Pathway program – adolescents and young adults with drug problems. Most typically I’m just reevaluating the patient because they have become honest about their drug use and prior to that may have appeared to have other problems because they weren’t honest about drug use and showing a lot of emotional lability or depression or anxiety or all these other things which could be a part of their drug abuse. Reevaluating that, and reevaluating their medications and helping support them through that process, especially while they are in outpatient [treatment for drugs].

Q: What do you think the young people you meet with drug problems typically struggle with the most?

A: A common problem when people are abusing drugs, especially young people, is that adolescents are at a time in life where they are getting out in the world, socializing, and learning how to navigate these situations, and often don’t have a lot of skills. It’s a time in life where they are developing these skills. The natural thing would be, if you make a mistake, to feel bad about it, go back, and amend the situation or learn to not do that again. Whatever the situation is, the consequences of life will help guide someone through that process and learn how to form and maintain relationships. If you say something that hurts someone’s feelings, you should probably feel some guilt; that’s a natural consequence of that. When people start using drugs, they abort that process. If a mistake is made, well, it’s OK because tonight, I’m getting high. That’s the process they begin to develop, and as a result, that whole natural developmental process of socializing and learning how to have emotions and respond to emotions really gets arrested because there’s a quick fix. That’s probably the most common theme I see among people I work with at Pathway. They have a reason to come off drugs, but then they feel totally inadequate because they don’t have any skills, and it’s really intimidating. It creates some extra anxiety because I’m losing the one thing that helped me through all this, and on top of that don’t have any other options, and so it leaves people really anxious. That, across the board, really does resolve throughout treatment at Pathway as people begin to go back and go through that process of developing skills and things that they are missing.

Q: Many parents struggle to determine which came first, the drug use or the mental health symptoms. What would you say to parents in this sort of “chicken and egg” debate?

A: In the substance use treatment world, or mental health world, there has been a lot of talk about this term “dual-diagnosis”. That typically has meant that someone has a drug problem, and another psychiatric problem. These can be viewed in a lot of different ways. Some people see that someone was depressed or anxious and they used drugs to deal with it, and really the problem is that they are depressed and anxious. Through our experience here, that we’ve seen, when the drug problem isn’t addressed, those other problems don’t get addressed anyway. So, regardless of if it’s dual-diagnosis or not, if the drug problem is not addressed, the underlying issues or the other problems, even if those other problems didn’t contribute to the drug problem, they still won’t get addressed very well, if at all, while using drugs. On the flip side, sometimes people start using drugs first, especially young people. They love to start using drugs because it’s fun and their friends are doing it. Throughout that process, they become dependent and it becomes their coping tool. These patients will often develop depression as a result of their drug use, or become anxious because a lot of drugs, when you’re not using them, create anxiety as more of a withdrawal effect or prolonged withdrawal effect. If someone’s dependent on drugs, and they don’t have drugs coming in or they’re not sure where they’re coming from, those people get very anxious at that time. It can be sometimes very difficult to tell, especially at the very beginning of treatment if someone had an underlying issue that contributed to the drug use or if their drug use created other issues that then become their own separate issues. The bottom line is you’ve got to take care of the drug use before you can proceed successfully in any other of those areas, at least from our experience and what we’ve seen. You’ll often find that when you address the drug problem to help someone keep from returning to the drug problem, they will have to begin working out how to cope with these other things.

Q: What trends have you noticed among the young people you have seen over the past few years?

A: Some of the trends I’ve seen… One that’s particularly interesting to me is that in the past few years people’s first drug use, at least that we’re seeing at Pathway has not been alcohol. Years ago, almost everyone’s first experience of drug abuse was alcohol, because it was so accessible. A common situation was being at a big wedding and there was alcohol easily accessible and that would be someone’s first experience using – alcohol or getting drunk before any other drug use. Today it’s much different. Very commonly the first use we are seeing is marijuana, which makes me wonder if marijuana is more accessible than alcohol to young people. That’s unfortunate, because there’s a lot of negative effects of marijuana on adolescent brain development, and that’s pretty well researched. The other trend I see is pill abuse starting really young. Sometimes that’s someone’s first introduction to drug use, even before alcohol, is getting Xanax from a friend. Benzodiazepines are a huge issue. There’s a lot of talk about the opioid epidemic and that’s a big issue as well, but we’re seeing a lot of people using benzodiazepines early or before other substances that they are abusing. These are dangerous substances. People can become addicted and have very serious consequences from withdrawal from them.

Q: If you could give a single piece of advice to a parent who finds themself trying to help their drug or alcohol abusing son or daughter, what would it be?

A: If I had some brief advice to parents in general, if you find out your child is using drugs, seek professional help or get a professional opinion, especially from people in the substance use field. A lot of people think, maybe this is just a phase, or it was just a phase for me and I’m OK now, but what if it’s not? Do you want to take that risk? If you find that your child is using drugs or alcohol, I’d say take it seriously. Get an evaluation or help from someone – a professional in the field of addiction and don’t take that risk.

Marijuana or weed is one of the most popular drugs used by teens and young adults today

My Teenage Experience Using Marijuana

By on April 10th, 2020 in Addiction, Adolescent and Young Adult Substance Use, Articles

As a substance abuse counselor for young adults and adolescents, the use of marijuana by young people is a topic that comes up daily. On one side of the discussion, there are those who speak of the multitude of health benefits from marijuana. On the other side of the discuss, there are those who argue that a drug is a drug and that it is never acceptable to use drugs. In this article I hope to provide a personal testimony of my own experience with marijuana and my opinion on marijuana’s effects on teenagers specifically.

My Story with Teenage Marijuana Use

I remember being in elementary school, learning about various drugs and sitting in the classroom making a personal vow to never to use drugs. Especially hearing these various stories of people overdosing from drugs, getting caught by the police, or losing everything they love. It was easy as a child to determine that drugs were bad and that I wanted to avoid them. As I grew, however, that perspective began to shift. I began to see TV shows and movies where kids sneak out and smoke weed or get drunk at a party. They made it look like a lot of fun! By middle school I had friends who were cool to me that used marijuana, and they were the rebels. My personal vow was losing it’s appeal. My idea condemning marijuana lost the foundation of its argument.

I tried marijuana for the first time when I was 14 years old. I didn’t get high, but another thing stood out about that experience – I got in no trouble whatsoever! I didn’t get caught by the police, my family had no idea, and I didn’t experience any adverse health effects. This immediately changed my perspective on marijuana and I decided to try it again.

The next time I smoked marijuana, I actually experienced its effects. At that point I felt I had every reason to continue smoking marijuana! At the age of 14, I was concerned with one thing more than anything else: having fun. Despite the fact that I had a basic understanding that drugs were bad, I did not care. I had a host of new friends that I thought were cool and getting high felt extremely positive to me. Like many teenagers who begin abusing drugs, I wouldn’t start to experience real consequences until much later in life.

Consequences of Marijuana Use and Recovery

The first time I got caught doing drugs was spring break when I was 15. My friends and I stole a little alcohol from the top of every bottle from a friend’s parents’ liquor cabinet. We drank the liquor in my room, and a few hours later one of my best friends was puking all over himself and barely conscious. Worried, I woke up my mom. She was upset at the scene she found, but I was careful to insist that “it was the first time and I won’t do it again.” I took my month’s grounding and moved on.

Gradually, using drugs and alcohol took over my life. I continued to drink, but primarily used marijuana. By the time I was a senior in high school, there were a few distinct changes in my life. I constantly argued with both of my parents. I had manipulated my mom to the point where she was okay with me using marijuana because she believed I was limiting my use to once a week. Little did she know that I was using drugs every day! At this point, my life centered around my marijuana use. I viewed it as essential to be able to use marijuana. It had become more important to me than sports, extracurricular activities, or my schoolwork. I had changed groups of friends multiple times to people who used drugs the same way I did. I tried other drugs, including LSD, prescription stimulants, and prescription benzodiazepines (Xanax). I believed that I was having fun, and looking back, the insane part is that I didn’t see anything wrong with it.

Not unsurprisingly, I began experiencing more significant consequences. I found myself in the hospital. I was nearly expelled from high school. By this time, I was completely dependent on drug use to get through the day.

Something had to change.

Thankfully, it was during this time that I was introduced to sobriety. At my family’s urging, I begrudgingly agreed to have an appointment with a professional. I got into a good treatment program that specializes in adolescent drug use in my area. Though I fought it every step of the way, I began to abstain from drug use.

During my first six months of recovery, I began to understand and accept the consequences of using other drugs besides marijuana. I gained new tools to cope with life and rebuild my broken relationships. However, I could not part or wrap my head around the negative consequences of marijuana. I didn’t realize it at the time, but I had become everything I had sworn not to be when I was younger. I talked loftily about how marijuana was actually good for the brain and led to better decision making, rather than worse.

However, around the six month point, some things finally clicked. After months of staying clean, I began to clearly see some of the real consequences from marijuana specifically.

The Turning Point in My Recovery

The counseling staff and my peers in my recovery group used to use the term “three degrees off” to describe marijuana users and pot smokers. This is not intended as an insult, it’s simply a description of the effect of marijuana on our brains.

It’s important to remember that in marijuana users, cognitive functions are affected until 28 days of abstinence. Click here to read one of the many clinical studies on the topic. What this meant for me was that my decisions were not only affected for the few hours that I felt intoxicated, they were also affected, on some level, for up to 28 days after using marijuana. Compound this with daily marijuana use, and we end up with somebody who makes chronically bad decisions and doesn’t experience the true emotional repercussions of their actions.

For the first time, I took stock of the real effects of marijuana use on my life:

I didn’t become a drug using teenager overnight. However, with my slightly altered, “three degree off” decision-making, the end result was same. Over time, I had gone from a respectable, athletic, smart teenager to someone who lied to family and friends, cheated those around him, and stole from those he loved to be able to use marijuana and obtain drugs. I was willing to manipulate and argue to get high. While my brain was in the its peak of cognitive and emotional development, I was using a substance that blocked its normal functioning.

Manipulative and dishonest behaviors became easier and easier to justify. It wasn’t a bad kid, but I was willing to do anything to protect getting high. Over time, I even moved on to using other drugs, answering the age old question of if marijuana is a gateway drug. One national study by Secades et al shows that for people who were life-time marijuana users, 44.7% moved on to other illicit drugs. Comparatively, this is significantly higher than someone who never tries marijuana in the first place. In my professional experience counseling drug using teenagers, young adults, and their families, nearly every young person who receives counseling services started with marijuana.

Why Teenage Marijuana Use is So Damaging

I especially take notice of teenagers who use marijuana. The results are in: this 2014 evidence based study showed that marijuana users who began before age 17 experienced long-term issues with executive functioning. This includes problems with abstract reasoning, verbal fluency, verbal learning, and memory. This differed from users who began using after 17.

Another study showed that users who began using marijuana before 18 were 4-7 times more likely to develop some sort of substance use disorder.

From personal experience, I see that my marijuana use held me back from gaining the real tools to succeed long-term. Rather than coping with the problems in my life, I resorted to using marijuana. Marijuana created such a strong instant gratification that I had no need to develop real friendships. Rather, I made a decision to choose friends based on whether or not they used marijuana. As my tolerance for marijuana developed, I had nothing to fall back on to create lasting self-esteem and happiness.

Giving Back

Today, I want to help prevent young people from moving backwards because they didn’t give their brains time to develop. It is not surprising to me that marijuana is the number one drug used by teens. My goal is for teenagers and young adults to find long-term happiness. In my life, I ended up finding and utilizing real self esteem building tools. I utilize the 12-steps, a sponsor/mentor, and positive relationships to help accomplish this. The result of this has been a life that is more fruitful than anything I attained when I was using marijuana or other drugs. Even if it is “only marijuana” I hope to encourage any young person to seek sobriety to support long-term success.

References

Crean, R. D. Crane, N. A. Mason, J. M. (2011, March 1) An Evidence Based Review of Acute and Long-Term Effects of Cannabis Use on Executive Cognitive Functions. Journal of Addiction Medicine, 5(1). Retrieved From https://journals.lww.com/journaladdictionmedicine/Abstract/2011/03000/An_Evidence_Based_Review_of_Acute_and_Long_Term.1.aspx

Pope, HG Jr., Gruber, A. J. Hudson, J. I. Huestis, M. A. Yurgelun-Todd, D. Neuropsychological performance in long-term cannabis users. Archives of General Psychiatry                (2001, October) Retrieved from ncbi.nlm.nih.gov/pubmed/11576028/

Secades-Villa, R. Garcia-Rodriguez,O. Chelse, J. Jin. Wang, S. Blanco, C. (2014, August 2). Probability and predictors of the cannabis gateway effect: A national study. International Journal of Drug Policy, 28(2). Retrieved from https://doi.org/10.1016/j.drugpo.2014.07.011

Winters, K. C. Lee, C. S. (2008, Jan 1) Likelihood of developing an alcohol and cannabis use disorder during youth: Association with recent use and age. Drug and Alcohol Dependence, 92(1-3). Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0376871607002979?via%3Dihub

Kim Miller answers 11 frequently asked questions about substance use in young people.

11 Questions About Adolescent and Young Adult Drug Use with Kim Miller, LCSW, LISAC

By on March 31st, 2020 in Adolescent and Young Adult Substance Use, Videos

The following is an interview with Kim Miller, LCSW, LISAC, and Pathway’s Chief Clinical Officer. We asked her 11 questions about the recovery process, the family’s role in the recovery process, the Aftercare process, and her thoughts on clients seeking outside therapy.

If you would prefer to read, rather than watch, just scroll down past the video. The entire transcript will be provided there. If you would like to skip to a certain question, timestamps will be included below the embedded video and above the transcript.

Timestamps

  • 0:21 – Can you briefly discuss who you are? What are your credentials?
  • 1:09 – What type of people do you typically work with at the Pathway Program?
  • 2:23 – What do you think young people you meet typically struggle with the most?
  • 3:55 – What do you find the parents struggling with the most?
  • 5:36 – At what point should someone in drug or alcohol treatment seek outside therapy or help?
  • 7:02 – Do you think it’s important to set up aftercare before leaving treatment? How do you think families should go about this?
  • 8:31 – You’ve said you believe that connecting young people into a community is important for their recovery. Why do you think it’s such a big deal?
  • 10:34 – I just found out my son or daughter is using drugs or alcohol. Where should I start?
  • 12:15 – Drug and alcohol addiction can be devastating on a family. What do you think are the best ways for a family to begin healing?
  • 14:14 – You mentioned the family having their own recovery plan. What would be some key components of a family member’s recovery plan?
  • 15:45 – In closing, is there anything in particular you would like parents who are going through these tough decisions to know?

Interview Transcript

Q: Can you briefly discuss who you are and tell us your credentials?

A: My name is Kim Miller, and I’m a licensed clinical social worker, a licensed independent substance abuse counselor, and a certified somatic experiencing practitioner. [I am] an EMDR clinician, and I do brain spotting, and I’m also a certified sex addiction therapist candidate. My role at the Pathway program is Chief Clinical Officer, and what I bring to Pathway is I have a lot of specialty in mental health, addiction, and trauma, as well as the interplay between all three. Also, I have the ability to really take a look at what’s going on for someone from all those different angles, really bringing in a three-dimensional approach.

Q: What type of people do you typically work with at The Pathway Program?

A: The clients that I work with at Pathway are adolescents age 13-17 or young adults age 18-25. I really enjoy spending time with young people and just watching them come from, maybe, a “failure to launch” kind of scenario or difficulty finding their way and then watching them become very joyful and full of life. It’s just one of my absolute passions. I love working with young people for that reason. I also really feel like, you know, the piece that I can bring is if you have young people coming in for substance issues, and then other things are arising, there’s an opportunity there to see what we can do to create a plan and that’s frequently the type of people that I end up being able to really work with on a deeper level. So if there’s trauma, or if they have some other outside issues or addictions that arise in their process, it’s an opportunity for me to be able to assess them or help create a plan for them to be successful.

Q: What do you think the young people you meet with drug problems typically struggle with the most?

A: I think young people with drug problems typically struggle the most with how to just grow up. I would say they are coming in and just struggling with … some of their failure to launch, they are struggling with, “How do I respond now to life? … for a long time now I’ve been using substances, or I’ve been very distracted by a substance-using type of lifestyle.” Sometimes the very basic things that they’re trying to do, they don’t know how to them, or they’ve never had the opportunity to do things that might be … age appropriate. I would say they are primarily struggling with, “How do I live on the planet? How do I get a job? How do I do a resume? How do I have interactions with other people? How do I have fun?”

The biggest thing that we are really working on with them is to have an enjoyable life, and have a life that’s fun and full of friendship and community. I really think that’s a piece that’s missing: if we just give people skills for progressing in life. But I think if we can give people the opportunity to also have fun and have a group of friends around them, I think that’s really valuable. 

Q: What do you find the parents struggling with the most?

A: I would say that parents who are struggling with young people that have drug problems are primarily struggling with how to parent their loved one according to the age that they actually are, knowing that they have a drug problem and their emotional growth is delayed. Watching them navigate … “How do we expect him or her to be an adult, or young adult, or adolescent,” while also keeping in mind that maybe some of their skills have been compromised. At the same time, “How do we hold them up to a high bar? How do we get them to be closer to where we’re hoping they can be at a certain age to be functional?”

I also notice for a lot of parents, what can really hold them back is just different fears, shame, or things that they feel like they’ve done wrong. Maybe sometimes they blame themselves. They think, “This is all my fault that my loved one has turned out this way.” That actually ends up being a really critical point in all of our sessions that we’re doing together – really working with the parents on how to take a look at their fear. How to take a look at things like resentments or anything that they have that they need to let go of emotionally – to just be able to dive into the present moment and see their young person for where they really are, and to get a really accurate picture of the reality of the situation, and then be able to respond to their young person from that standpoint.

Q: At what point would you recommend that someone in drug or alcohol treatment seek outside therapy or help from a professional such as yourself?

A: I would recommend, if a young person came in and we were trying to evaluate the situation, first and foremost, if somebody asks for help with some outside services or they are asking about some specifics around a certain situation, I’m all ears. That’s when I start really diving in and listening and seeing what we can do. There’s quite a few young people that will actually say, “I want to work a little deeper on this issue.” Then we get to evaluate. Is that something we would want to bring somebody into the treatment team to help with, or is this something where we can help them come up with more of a plan?

I also think that sometimes, if you see somebody in treatment and they’re getting stuck, and you’re also noticing in their assessment a significant history of grief, trauma, or mental health symptoms, you do want to catch those right away up front and be really mindful. I think it’s good to continue to evaluate people, and if you do notice that there’s different issues coming up or different situations coming up that do need further addressing, that’s a really good opportunity to take that to the treatment team and come up with a plan.

Q: A lot has been said about the lack of aftercare programs and resources available to drug and alcohol treatment patients and their families. Do you think it’s important to set up aftercare before leaving treatment? How do you think families should go about this?

A: Aftercare planning or discharge planning should happen from the moment your client hits the door. They are going to be at your facility with a really well guided staff – but what happens when they leave? This is … a really important thing to address. We know that a lot of steps back or relapses happen within just weeks of leaving a treatment center. Studies have shown over and over again the absolute importance of having plans from the moment they hit the door all the way through treatment and having those very solid and stable and in place so that the minute that they leave, they are literally walking right into the next phase of their treatment, which is part of their aftercare plan. Any program that you’re looking at that doesn’t have really strong aftercare planning, which might include social, spiritual, physical, meetings, opportunities for people to continue to grow in their trajectory. There should be opportunities for them to attend outside meetings, for them to come up and do alumni meetings, for them to hopefully be able to reach back somewhat sometimes to the staff for further support. I think all these things are really key in the process. 

Q: You’ve talked in the past about how you believe that connecting young people into a positive community is important for them to recover. Could you discuss that a little? Why do you think it’s such a big deal?

A: It’s so important that we have a community around us. Especially in a recovery community if you’re going in for help for substances or even mental health or trauma. It’s really important that we have those people around us for a sense of connection. I think a lot of people feel that the opposite of drug addiction is connection. I think that having a community is such an important part of … finding our way back to relationships. Maybe we’ve never had relationships before. I think if we don’t have a plan to include that as part of someone’s treatment or even part of them leaving treatment, I think we are missing out on a really big piece of the puzzle.

Having a community to laugh with, to share with, and to talk to is just so vital to who and what we are as human beings. We absolutely need that to help us [find] our way. I think it should be a big part of the recovery process and I think it absolutely has to be a part of the aftercare process for people to really build themselves into a support system and build themselves into a greater community and learn how to be back in with social engagement with other people. Being able to connect and be in connection and relationship with other people is so important. In my opinion, what drug use does is it separates us and it isolates us. So much of that recovery process is if we can come back into connecting with one another. It is such a big part of the healing process.

Q: I just found out my son or daughter is using drugs or alcohol. Where should I start?

A: I think one of the best ways for a family to start healing is for a young person to … get evaluated [and] for the family to treat it as if it is an issue. I think one of the biggest things we can’t do is underplay things. I think the sooner that we say to a loved one, family member, or young person in our life that’s struggling with substances, “We need to just go somewhere and talk to someone who’s a professional.” I think it’s OK to have someone come in and evaluate the situation other than a family member. I feel it’s very difficult with our own family members to get a read on if something is out of the norm or if there’s an issue. I think it’s better to not underdo something. I would rather have someone overdo it a little bit – maybe bring someone in to get an evaluation for them to decide it wasn’t as bad as they thought. One of my fears with substance use is sometimes we’re just seeing the tip of the iceberg. If we’re catching somebody in a pattern that we didn’t know was happening or we’re catching them using, there’s usually more than meets the eye. That’s why I usually tell people, one of your biggest moves is to take somebody in and get them evaluated, have them work with a professional, and ask a professional some questions.

Q: Drug and alcohol addiction can be devastating on a family. What do you think are the best ways for a family to begin healing?

As far as the family recovering, I have seen families do the best when the family members themselves are actually involved in the treatment process. I cannot reiterate enough how much having family there is probably the most critical part of the entire process. If I have a young person come in, I’m immediately looking – even if they’re over 18 – at what their family system looks like. Who can we bring into the process? [I start] getting the family members introduced to Al-Anon or other support meetings or support groups. [I start] getting a community for the family members. When I see a whole family all pulling on the same rope as best as possible, I have always seen the best outcomes. Having the whole family get involved in the process as much as possible is one of my primary goals in working with people.

I will say, just briefly, sometimes you don’t have that opportunity. You may have someone who can only bring in one family member. Then, I’m working with that person to say “bring in that one family member, bring in your sponsor, bring in a neighbor, [or] bring in somebody who’s supportive.” Bring more people into your community that we can really help be a part of the process with you. There’s something about building that sense of relationship and community … that comes into play with family members, too, whoever that young person deems as their family, like good supportive friends. I would say just bringing in the whole family as much as possible into the process, and having them have their own recovery plan, too. 

Q: You mentioned the family having their own recovery plan. Could you touch on that a little bit? What would be some of the key components of a family member’s recovery plan?

A: Oftentimes, if you have a young person who’s coming in for help, what I typically find is I have a family coming in with them who’s hurt. They’re scared. I even have family members who say, “I feel like I have symptoms of somebody who’s just lived through something that’s a really big tragedy or a big trauma. I feel so afraid or I feel so stressed out.” These are the kinds of reactions sometimes that I experience when family members come in. Sometimes [I work to help] family members get their own counselor, or help them be connected with their own support system or their own support group. I have family members who might get their own sponsors and work their own program in a 12 step program or other platform. To me, I think it’s evaluating a recovery plan for a family member to get their own support and their own services. I have them reading books. There’s a bunch of books out there that I think are a really helpful part of the plan for them. Sometimes they are doing their own writing and their own writing assignments, or doing work to let go of any fears or shame, resentments, or different things that are holding them back from responding as well as they would like to respond.

Q: In closing, is there anything in particular you would like parents who are going through the tough decisions of putting their loved one in treatment to know?

A: If you are considering putting your young person in treatment, and you’re like many parents or family members who’ve come and walked this road, just know that it’s hard, it’s difficult, there’s a lot of questions, but that more than likely if you’ve come to this point, there’s something going on that you’re concerned about. It’s not … easy to be validated throughout this process. A lot of people feel like they’re turned upside down, or they’re confused or they’re not sure which direction to take. I would absolutely encourage you just to come in and get some information. Get a little information about how to set up an evaluation to have somebody else take a look at the person that you’re concerned about. Especially if you’re not sure. It’s OK not to be the treatment center, or not to be their treatment counselor. A lot of families say that one of the most valuable things they’ve learned in a session is that they don’t have to have all the answers. They don’t have to be the ones creating a treatment center at home to try to help their young person. They can reach out to people who have experience on this to get input and help and resources, so that they can hopefully find that path back to relationship again with their family or their family member.