Substance Use and Recovery
In 2021, it was estimated that over 46 million Americans aged 12 and older had at least one substance use disorder. Marijuana remains the leading cause of adolescents entering substance use/abuse treatment, accounting for 63 percent of admissions for those aged 12 to 14 and nearly 70 percent of individuals aged 15 to 17 in 2011. In addition to being illegal, it is dangerous for youth to use substances. Drinking can impair teens’ judgment; affect their lives at school, preventing them from playing sports or participating in other activities; and impact college applications. Drugs and alcohol also can interfere with treatment for mental health disorders and worsen the long-term prognosis for those who experience them.
If you have used drugs in the past, it should not prevent you from having discussions with your children about the dangers of their using substances. Be specific and explain your reasoning when talking about family rules regarding substance use and the consequences for breaking them. During the discussion try to keep an open mind and remain calm and objective. Youth should be able to express their concerns and feelings.
If you are concerned that someone may be an alcoholic, talk to him/her when he/she is sober and not hungover. Having the conversation remain factual and neutral (i.e., unemotional) also is helpful since addicts often experience guilt and shame. Quitting drinking can be frightening. Consuming alcohol may be a significant part of an individual’s daily routine and/or social life and serve as a coping mechanism for difficult emotions or stress.
Teens have a much higher risk of alcohol poisoning than adults because they metabolize alcohol less efficiently, get drunk faster, and stay intoxicated longer on less alcohol. In addition, drinking after using any kind of drug, whether prescribed or illegal, can increase the risk of alcohol poisoning. Warning signs include: being unresponsive to physical contact (such as pinching, poking or shaking), shouting or talking; an inability to stand up or remain standing without assistance; skin that is clammy, cool, or appears bluish to purplish and/or very flushed; slow irregular breathing and a pulse that is uneven or less than 40 beats per minute; unconsciousness; and vomiting while being passed out and not waking up.
Calling 911 and remaining with the individual until medical assistance has arrived is the only solution to alcohol poisoning; and waiting until someone is unresponsive or unconscious may be too late. Parents should tell children that while they are expected not to drink, everyone’s safety is the most important thing. Adolescents should always call when they are in a risky situation and, if someone needs help, they should dial 911 or phone a trusted adult rather than worrying about possible punishment. To avoid using substances, youth can volunteer to be the designated driver or tell friends that they are allergic to alcohol or their parents test them for drugs. If there is a history of substance abuse in their family, they also can share that, saying they prefer not to drink as a result.
Participating in and saying something at self-help group meetings, even if it is only one or two sentences, reinforces the likelihood of continuing recovery and makes it easier to connect with other participants. Dual Diagnosis Anonymous (DDA) is a self-help group intended for individuals who have been diagnosed with both a chemical addiction and a psychiatric disorder. Unlike some traditional self-help groups, DDA can provide a safe forum to discuss prescribed medications. In addition to adapting Alcoholics Anonymous’ (AA) 12-steps, DDA has 5 additional ones that address mental illness and its treatment. Another alternative is Self-Management and Recovery Training (SMART Recovery) , which focuses on clinical evidence and science; incorporates cognitive behavioral therapy and motivational psychology; and has meetings led by trained facilitators, who are not required to be in recovery. Many individuals chose to attend both SMART Recovery and AA meetings.
While addiction is a chronic disease, it is treatable. The substance use disorder continuum of care includes four levels of treatment: outpatient, intensive outpatient, residential and inpatient hospitalization. Attention to any co-occurring disorders, education, exercise, healthy relationships, medication (as needed), peer support and psychotherapy (which can reinforce motivation to remain sober) all benefit recovery. Support groups for families of addicts can reduce isolation; help individuals share tips and tricks they have found helpful; and provide education about how the disease of addiction progresses, treatment and recovery. For individuals with a substance use disorder, long-term encouragement from family members and self-help and support groups can result in a greater likelihood of sustained sobriety.