MAT – Opiate Nation

Recovery Options for Teens

Statue by Gustav Vigeland, Vigeland Park in Oslo, Norway.

(Translation into most languages at tab to the right.)

Understanding the teenage brain was the topic of my last post: Is Teenage Turmoil Inevitable? It is important to digest before parents consider a recovery program for their teen. Knowing that adolescents and teens feel and process information differently than adults is why they require a different approach to addiction and recovery.

Regardless of the type of program considered, the one absolute necessity is that the family be involved in the process – because family dynamics are an integral part of a young persons’ sober and addicted life. And the best place to start this discussion is to focus on the CRAFT model.

The American Psychological Association has an informative article, below. (1) In it they point to studies discussing how programs like Al-Anon for family members with an addicted loved one “may improve the well-being of friends and family members, they are not effective in getting the addicted person into treatment.”

Intervention programs, designed to help “family and friends work with a counselor to confront a substance user and urge him or her to get treatment” is only used by 30 percent of families due to discomfort with confrontation. And treatment is only the first step on the long road to recovery. After that, the family still needs other tools.

CRAFT (Community Reinforcement Approach to Family Training) originated at the University of New Mexico and was developed by Robert Meyers, Ph.D. and colleagues. Research on CRAFT shows that approximately 70% of families who receive CRAFT are able to help their loved ones start treatment within a year (Miller, Meyers, & Tonigan, 1999). CRAFT also helps family members improve their own lives, whether their loved one ends up seeking treatment or not.

CRAFT teaches real life skills to use connection to encourage positive change, because CRAFT is rooted in the belief that connection is the opposite of addiction. It teaches positive communications skills to foster the connection that is desired by the person who is struggling with addiction and their loved ones.

Helping Families Help is a great non-profit website resource for CRAFT information. (2)

SMART Recovery was established in 1994, here in the USA, to meet the increasing demand of those seeking a secular and evidence-informed alternative to the widespread 12-Step addiction recovery program. It is intended for adults over 18 and those seeking flexibility and independence, while AA offers structure and strong community support. It may be best for young adults in their 20’s, as most 18- to 25-year-olds who struggle with addiction are not yet “adult” in their thinking and coping skills. Smart Recovery is now in 23 countries. See info below. (3)

Basically, the steps in helping your teen who is addicted are this:

Getting them into treatment
Choose a program – inpatient or outpatient
Detox
Individual Therapy
Family Therapy
Contingency Management

Getting your loved one into treatment: sign up for CRAFT 10-week email training course through Helping Families Help or investigate other options.
Choose a program: based on the drugs involved and length of time used.
Detox: Most drugs will still be in your child’s system. Detox flushes them out. Detoxing under the care of professionals ensures that it’s done safely out of reach from harmful substances. Your teen will likely experience withdrawal symptoms as well.
Individual Therapy: To understand a teen’s problem and to address it comprehensively. The first course of action in rehab is one or more types of therapy, both one-on-one and group settings. Motivational Interviewing uses a person-centered, non-confrontational style where the teen is encouraged to examine the pros and cons of their use and to create goals to help them achieve a healthier lifestyle. This helps them gradually realize the consequences of their actions. Cognitive Behavioral Therapy (CBT) is goal-oriented therapy that helps teens express and understand their feelings and cope with difficult emotions. They learn to replace negative behaviors (such as using substances) with positive ones (like sports or art or service endeavors).
Family Therapy: Based on the premise that family carries the most profound and long-lasting influence on development, and in modeling both good and bad behaviors and beliefs. These sessions bring together those closest to an addicted teen and address issues such as poor family communication, cohesiveness and problem solving. Again, CRAFT is crucial here.
Contingency Management: This form of therapy tracks each patient’s progress in rehab, including each day they succeed in staying sober, and rewards them with a prize. The more teens feel satisfied with their rewards, not only will they continue striving to stay sober, but their brain will relearn how to appreciate rewards that aren’t drugs or alcohol. Following rehab, a teenager is thrust back into the world. Temptations lie around every corner and their problem stays with them for years after treatment. After you’ve helped your child kick their habit you must help prepare them with a plan to prevent relapse – or for all of you to know what to do when relapse occurs, which is likely especially for certain drugs like opioids. MAT (Medication Assisted Treatment) is vital for opioid addiction and the long-lasting changes in the brain that will continue to undermine all the best plans and determination to stay clean and sober. Our son and many of the hundreds of thousands of young people who died from opioids are the sad evidence of this truth.

I do not offer these steps and advice as a medical or addiction professional. I can only offer my opinion based on our personal experience and the stories from others, along with the research I’ve done over the past 20 years since my husband and I first discovered that our 15 year old son was using heroin. What we wish we had known I share with you in the hope that your story will end differently than ours.

1. An underappreciated intervention

The CRAFT model is giving family and friends the skills they need to help get loved one’s treatment for substance use problems By Katherine Lee – December 2017, Vol 48, No. 11

https://www.apa.org/monitor/2017/12/underappreciated-intervention

2. Helping Families Help – CRAFT Information

https://helpingfamilieshelp.com/about-craft

https://www.npr.org/sections/health-shots/2018/08/10/636556573/families-choose-empathy-over-tough-love-to-rescue-loved-ones-from-opioids

3. SMART Recovery

https://smartrecovery.org/what-is-smart-recovery

4. The Different Types of Adolescent Treatment Programs

New Horizons Recovery Centers (USA)

https://www.newhorizonscenters.com/blog/the-different-types-of-adolescent-addiction-treatment-programs

Celebrating Freedom and New Life

April 4, 2021

(I am taking a break from the chapter by chapter topics from Opiate Nation to focus on the significance of this holy week. Translations into most languages available at tab to the right.)

Spring is the season of regeneration, freedom, new life. The time of year when the whole earth seems excited to be alive after being dormant all winter. For the northern hemisphere, March and April are Spring – for our friends and family in Australia, right now it is Autumn. Regardless of what season it is where you live on this planet, it is Easter Sunday and the end of Passover week. Both the Christian and Jewish traditions celebrate the freedom from bondage and the beginning of a new life, although from differing perspectives and beliefs. Both begin the time with reflection and prayer. (I don’t understand Islamic tradition well enough to comment on it except to say that Ramadan is observed around this same time of year with introspection and fasting in remembrance of Muhammad receiving the Quran.)

For Christians, the freedom is from the bondage to sin in one’s life; for Jews, it is the freedom from bondage that the Israelites suffered under in Egypt. Both faiths look to an historical event in the past. They also remind us that while bondage was dealt with symbolically once – whether personally or communally – it is an ongoing problem in this imperfect world.

The Freedom of Habits

(Twenty-fifth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)

I’ve heard a saying: “The chains of habit are too weak to be felt until they are too strong to be broken.” And just like chains, some habits are stronger and deadlier than others. Conversely, healthy habits can be just as strong and powerful – but instead of bondage, they bring freedom to live our lives to the fullest.

In The Power of Habit, Charles Duhigg says, “Habits are a three-step loop: The cue, the routine, the reward. They become automatic beginning with a cue that triggers a routine and a craving for a clear reward. Craving is an essential part of the formula for creating new habits…You can never truly extinguish bad habits. So in order to change a habit, you must keep the old cue and deliver the old reward (that you are craving), BUT insert a new routine.”

Avoiding Pain

(Thirteenth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)

We are living in particularly precarious times – for people born since WWII, unprecedented problems the world over – seemingly beyond our ability to control or to deal with effectively. With the Coronavirus pandemic, complex problems have arisen for our global society to attempt to solve, from the manufacturing and transport of medical supplies and personal protective equipment to the best medical treatments and the development of a vaccine – which is viewed by many as the magic potion but only if the majority of people could be convinced to ‘get the jab.’

During this extraordinary year pain has come into most of our lives in ways we have not experienced previously: physical pain from contracting Covid19, emotional pain from being isolated or from watching those we know or care for becoming sick and dying, and mental pain from the anxiety caused by all the unknowns surrounding the pandemic. For people living in poverty, these problems are compounded.

OPIATE NATION WINS NATIONAL INDIE EXCELLENCE® AWARD

With so much distress in the world with the Covid-19 Pandemic, especially the effects it is having on the weakest and vulnerable members of our societies, I have hesitated to announce a personal accomplishment. Yet, my hope is that as Opiate Nation gains more visibility, it will get into the hands of people who could be most encouraged and benefit from our story.

I am a member of a group of 35,000 women called “The Addict’s Mom” on Facebook. I confess, I rarely read the posts because it is so depressing: Story after story of mom’s who have been holding out for years to see their daughter or son released from the hell-hold of addiction to drugs, only to then post that “…today I lost my daughter/son…can someone tell me how I will survive this?” It is for these mom’s and dad’s and siblings and friends that we wrote Opiate Nation, but one of the stipulations of being a member of the group is no self-promotion. So I hope that, with more visibility and more reviews and re-posts on social media, our book will get to these most desperate of people.

OPIUM: UBIQUITOUS THEN AND NOW

When I was in Melbourne, Australia recently with our family, I was starkly reminded of the ubiquitous presence of opium in the past as well as the present. Not that I can ever really forget it’s demon-like presence. But when I am asked what I do and I respond that I am a new author, the next question is what my book is about. After I give a short description, I am always surprised at how many people have stories of their own involving this ancient plant – a plant that truly offers humankind a double-edged sword. It can so wondrously relieve pain when our bodies have been injured or undergone surgery. Yet it has a mysterious way of latching on to a large percentage of we mortals who, having once legitimately used this soothing balm, then find the memory of that bliss like an oasis in the desert that we chase after at all cost.

Within a week, I heard three stories. One seems like something out of another era. A 60-yr old man, after hearing about our son and Opiate Nation, began to tell me about his years growing up in Singapore. He explained that both his mother and his father were addicted to opium and would regularly go to the opium dens to smoke. He remembers the intoxicating smell when he would go to find them to use the opportunity of their being in a blissful state to get money from them. He never wanted to use that drug or any other. Melbourne, Australia

Continue reading “OPIUM: UBIQUITOUS THEN AND NOW”

POWER-less or POWER-ful?

Last week I wrote about regrets that John and I deal with – wishing that we had known about some type of long-lasting recovery option for our son, JL – and the SMART recovery approach and how it differs from traditional 12-Step programs such as AA. Continuing on with the concepts about individuals who struggle with life-threatening addictions of any variety, I have a few more thoughts.

With the genetic / disease model of addiction that scientific research has brought to the table, there are many in the recovery world who feel this mindset gives those living with addiction a green light to excuse their responsibility, their power of choice. But I disagree. It is clear that we had nothing to do with our family tree, our genetic inheritance (1). We were “powerless” as far as choosing to be born into our family. Yet, this doesn’t mean we are powerless to overcome the negative Continue reading “POWER-less or POWER-ful?”

Offering Recovery Options

One of the most recurring regrets John and I deal with is wishing that we had known about some type of long-lasting recovery option for our son, JL. He was becoming recovery resistant after so many cycles of detox and recovery programs and relapse. As the opioid epidemic sped up with mounting deaths by overdose, we now have statistics that make it clear that it usually takes many recovery/relapse cycles before a person can maintain long-term sobriety – especially for the main victims of this epidemic – those who started using opioids at a young age. Like our son. It’s not that he didn’t want to be clean and sober. He did, with all his heart. But opioids don’t let go easily or quickly. Continue reading “Offering Recovery Options”

What We Wish We Had Known…

August 2nd was the 5th anniversary of our son, John Leif’s, death by overdose from heroin. As we look back over the years, there is so much information available now than there was for the families of young people addicted to opioids in the early years of this century. So much we wish we had done differently with this son of our hearts – if we had only known.

In the early years of his addiction and recovery programs, we learned how co-dependency and enabling went part and parcel with alcoholism and addiction in family systems. We read all we could about it and worked hard to change from enabling and need-based love to detaching and loving with “tough love.” Sadly, as we now understand, tough love does not work for opioid addiction, because as Dr. Nora Volkow, director of the National Institute on Drug Abuse, says: “The concept of letting children hit bottom with opioids is not the best strategy, because in hitting bottom they may die.” Continue reading “What We Wish We Had Known…”

ANXIETY, Part 1

In the summer of 2005, we discovered our 16 year old son was smoking “BT” ––Black Tar Heroin. A few weeks later, while we were in the midst of his withdrawal and simply putting one foot in front of the other as we searched everywhere trying to find the next step, I was rushed to the ER. After going to bed one night, my heart began racing and pounding out of my chest. After an hour, John called 911. At the hospital, I was given tests to see if I was having a heart attack. No. The diagnosis: extreme anxiety––deep, un-verbalized, foreboding. I was given IV morphine and as my heart rate slowed down, I slept. Who else but our children can affect our hearts at such a fundamental and unconscious level? Continue reading “ANXIETY, Part 1”