Posted on November 4, 2009

If you are the parents of a teen addicted to alcohol or drugs or a combination of substances, most likely you experience conflicting emotions. You want to get help for your child, but you may feel ashamed, guilty, overwhelmed, helpless and confused about exactly what you should do and when. Where do you find treatment? What type of treatment is appropriate? How can you pay for it? How long will treatment take? Will it work? You want and need answers to these questions and many more when it comes to treating teen addiction.

The Scope of the Teen Addiction Problem

Teen addiction is a serious problem, since age at first use is often a predictor of lifelong difficulties with alcohol and drugs. The good news is that overall current usage of alcohol and drugs is remaining stable among youths aged 12 to 17 as evidenced by numerous reports and surveys, including the annual National Survey on Drug Use and Health (NSDUH). The 2008 annual report, prepared by the Office of Applied Studies (OAS), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), shows current (past year) use among youths aged 12 to 17 declined for illicit drugs overall from 2002 to 2008. Specific drugs mentioned include marijuana, cocaine, and prescription drugs used for nonmedical purposes, pain relievers, stimulants and methamphetamine. An exception is the increase in past month use of hallucinogens, driven partly by an increase in Ecstasy use.

Similarly, the 2008 report shows a decrease in rates of current (past year) alcohol use among two age groups, those aged 14 to 15 (13.1 percent, down from 14.7 percent in 2007), and aged 16 to 17 (26.2 percent, down from 29.0 percent the previous year). Among youths aged 12 to 13, the 2008 rate is 3.4 percent.

Age at First Use

In 2008, an estimated 2.9 million persons aged 12 and older used illicit drugs for the first time in the past year, according to the NSDUH report. That’s about 8,000 initiates per day. Three fifths of this population (56.7 percent) was under the age of 18 when they first used, and 54.9 percent were female. New users’ average age was 18.8 years overall. Among individuals aged 12 to 49, average age of first use of inhalants was 15.9 years, while it was 17.8 years for marijuana, and 19.8 years for cocaine.
The HSDUH report showed that 84.6 percent of the 4.5 million recent (past year) initiates to alcohol were under the age of 21 at first usage. The average age was 17.0 years, while the mean age was 15.9 years.

Number of Youths Needing Treatment for Alcohol/Drug Abuse

Although overall current usage of drugs and alcohol by teens is not on the increase (except for hallucinogens like Ecstasy), the need for treatment for alcohol and illicit drug use is troubling. The numbers of youths needing treatment remained virtually unchanged from 2007 to 2008, with 2.0 million (7.9 percent of the population) needing treatment in 2007 to 1.9 million (7.8 percent of the population) in 2008. According to the NSDUH annual report, of 1.9 million who needed treatment for drug or alcohol use in 2008, only 143,000 received it at a specialty facility (7.4 percent). This leaves 1.8 million youths who needed treatment but did not receive it at a specialty facility.

At Issue: Family in Crisis

There’s no question that teen addiction affects the entire family. When you discover that your teen has a problem with alcohol or drugs, no doubt everything is in turmoil in the family environment. In the midst of the crisis – arrest for DUI, suspension or expulsion from school, health problems, etc. – it’s hard for parents to think clearly. Independent of the emotional state of all involved, practical solutions are often difficult to ascertain.

Experts in teen addiction counsel that treatment for teens is not just a scaled-down version of adult treatment. It’s simply not effective to treat teen and adult addicts the same way, since their life experiences, emotions and family circumstances are different. Teens may have more difficult family circumstances, may have attempted or thought about committing suicide, and have more psychological problems. In addition, while it takes an adult hitting the bottom to seek help, with teens, it is the parents often who have to search for the signs of teen addiction and get the necessary help.

The first signs are usually trouble at school, difficulties in relationships with friends and family, possibly a legal issue involving drugs. Mood swings, paranoia, secrecy, stealing and physical changes are also signs of potential drug and/or alcohol abuse. Once you notice the problem and decide to get treatment for your teen, you’ll probably meet with tremendous resistance on the part of your child. Unless you, or the judicial system, insist upon treatment, most teens will strenuously object and won’t go. There is an upside to this, however, in that once teens enter treatment and stay with it, they seem to respond well – especially when the family is involved in the treatment.

Specific Problems Teens Face During Treatment

In the course of treatment for drug and/or alcohol abuse, teens – just like any other addict – first have to detox from the substance (if appropriate). During detoxification, or elimination of the drug from the body, teens may be more susceptible to depression, anxiety, doubt and fear than their adult counterparts. Withdrawal symptoms may be intense and painful, or mild and quickly overcome, depending on the particular drug. Teens need special attention during this time so that they can successfully come through detox and proceed with their treatment.

Drug and/or alcohol treatment must be specifically tailored both for teens and personalized for the individual. What works for one patient may not work for another. Similarly, the teen’s treatment program needs to be monitored and evaluated, with changes made based on progress toward goals and individual needs.

When in treatment, teens may lose their identity as they struggle with various issues. They will then regain their identity or form a new one based on building self-esteem through problem solving and developing social skills, learning to identify feelings, how to ask someone for help, as well as developing coping mechanisms and dealing with anxiety, depression, and other emotional roadblocks. Without addressing these issues, the teen addict may relapse.

Family involvement in the teen’s treatment for drug and/or alcohol abuse is a critical element in the teen’s overall recovery. Certain family dynamics and circumstances may need to be changed upon the return of the teen to the household. For the health and recovery of the teen, therefore, early and continued family involvement in teen treatment, as directed by the treating professionals, is necessary.

Following treatment, the teen should have a network of new peers to provide support. Considering the fact that much teen involvement in drugs and/or alcohol is with others who similarly abuse the substances, the teen needs new friends who are clean and sober. This is best accomplished through aftercare programs as part of the overall treatment program. Such aftercare most likely includes continued peer group discussions and meetings, in conjunction with ongoing one-on-one counseling.

Abstinence and Relapse

During the first 90 days of abstinence following the treatment program is when most teens will relapse. The best way to ward off relapse is continuing aftercare and attendance at adolescent-oriented self-help groups, recovery-oriented schools or programs, and substance-free structured activities. Unfortunately, according to statistics, only about 10 percent of teens who complete treatment goes on to continuing care outpatient treatment – even if it is readily available to them.

Many teen substance abusers also have co-occurring mental health issues such as depression, anxiety, self-mutilation, traumatic memories or suicidal thoughts, or behavioral problems such as hyperactivity, inattention, conduct disorder, multiple sexual partners, HIV/AIDS, or problems with crime or violence. Some have only one co-occurring disorder, while others have five or more. The more issues or conditions occurring simultaneously in the teen, the more likely relapse becomes.

Successful treatment for these teens involves addressing the problems at the same time. Standardized assessment, on-site services, case management, close involvement with family, and coordination among services and service providers can help prevent relapse.

Type of Treatment Programs Available for Teens

Several types of treatment programs for teens with drug and/or alcohol use problems are available.

• Early Intervention Groups – Also called school or student assistance programs, early intervention groups attempt to help teens either before they develop the problems or during the first 1 to 2 years of substance use. Most of these programs offer outpatient or intensive outpatient treatment, often combining individual, family and group therapy. Such treatment may be an hour of therapy once a week, or more intensive therapy lasting several hours a week, while some programs may extend into the homes of the teen.

• Residential Treatment – Generally, this type of treatment program is designed more for teens with protracted abuse problems, multiple addictions, or co-occurring disorders (substance abuse coupled with mental health issues). Teens at particularly high risk include those who are homeless, abused, or who are in family or peer group situations where drug and alcohol use is prevalent. Residential treatment is also advised for teens who have kept on using despite prior attendance at other types of treatment programs. Residency may last 30 to 45 days, or up to a year in cases that require long-term treatment. According to teen addiction experts, long-term residency treatment is usually for those who have been involved in the criminal justice system (and are likely to commit crimes if they are released), those in very unstable homes (such as multiple foster care home stays), or who have not responded to treatment of shorter duration.

• Individual Counseling – Private psychiatric counseling may be an avenue that works for some teens, especially in conjunction with group counseling as facilitated by the therapist and part of the overall treatment plan for the teen.
 

Important Questions to Ask About Teen Treatment Programs

Before you take your teen to a drug and/or alcohol treatment program, be sure you get satisfactory answers to the following questions:

• Is the treatment program at your facility specifically designed for teens?
• Do you personalize the treatment program to my teenager?
• What is the effective rate of your teen treatment program?
• What type of aftercare does your teen treatment program provide?
• What types of psychiatric services does your facility have available on-site?
• How much, and how, specifically does your teen treatment program involve the family?
• How much does the program cost? Do you have a sliding scale or ability-to-pay program or any available grants?

Teen Addiction Treatment – Act Now

Don’t be discouraged by the situation as it currently stands. If your teen is addicted to or has a problem with alcohol or drugs, seek help now. Do the necessary legwork and find a treatment facility or program that meets your needs, and that of your teen. Ask all the questions you need to be satisfied that this is the right program with the best overall success rate for your child. Then get your teen into treatment.

Most of all, as parents, you should be sure that your teen knows that you are fully supportive of his or her recovery. You will be there for your child at all stages, and will do what it takes to help their recovery succeed