Question: My 17 year old son uses soft drugs. I have known that he has been using drugs like marijuana since he was 15. I have tried everything I can think of to try get him to stop and nothing really works. He has been grounded on countless occasions, he has had to do volunteering at a local hospital, he has had his allowance cut…all the normal punishments I meet out don’t seem to be able to stop him because I can just tell that he and his friends are still smoking weed and probably doing other drugs as well. Should I give up? He says he only smokes marijuana on the weekends and that it isn’t a big deal. His grades are still good and he is not a bad kid. Maybe he is right and I am wrong to be getting so upset. If his marijuana habit doesn’t seem to be harming him should I stop battling him on this point? After all, he is going to be an adult soon enough.

Iona Health Says...:

As a parent, your expressed attitude demonstrates a strong concern about whether you are being an appropriate parent with your son. I understand that he regularly uses a mind-altering, mood changing substance; known as, marijuana. Your teenage son has been indulging, coping and/or managing his life chemically with marijuana since he was 15 years old, high school student (and other drugs if you assumptions are correct). I have worked with many teenagers who thought they were only getting “high” recreationally and found they were more dependent than they realized. From your question, I hear you questioning whether or not marijuana is not harmful. For more information about this go to websites:

• abovetheinfluence.com/facts/drugsmarijuana
• medicalmarijuana.procon.org
• drugabuse.gov/publications/research-reports/marijuana-abuse

I have been working in the addiction field with teens for many years and I have never heard of a drug b called a “soft drug.” What I do know about marijuana is that it’s often a gateway drug (like cigarettes and alcohol), and can lead to the use or abuse of more serious and dangerous drugs. This can lead to other problems; e.g. overdose, drug reactions, addiction, and potentially death.

I think you are right to be concerned. There is evidence that the younger a person begins substance abuse the higher his potentiality is to become addicted. Please understand this: Do Not Give Up! Instead, of shouldering the burden yourself, you may want to recruit support. Is his father involved with him or know about his substance abuse? Do the other boys’ parents know they are using marijuana and other drugs? Do you know how they are getting the money to buy marijuana or other drugs? Do you know where they are obtaining these substances from? Is your son the only family member who is engaged in substance abuse? Does addiction run on either side of his parents’ families? Has anyone else expressed a concern about his substance abuse? Has he ever been recommended for substance abuse treatment?

As you can see, there are many questions which need to be answered to accurately assess this situation and make any kind of appropriate recommendation. The main recommendation that I would like to make is for you to obtain the services of your son’s school counselor or, preferably a professional substance abuse counselor. Substance abuse is a medical problem and should be assessed by a substance abuse professional. When your son is accessed, you have him submit to a drug screen and know exactly what other substances he could be using. It is best advised to make an appointment, and later take you son for the evaluation. This is not any form of punishment as it is part of medical treatment. Your son may need some level of treatment, i.e., outpatient, intensive outpatient, residential or inpatient. If his problem is addressed sooner than later, he may only need outpatient treatment. After his assessment, the counselor will give your son and you his treatment recommendation for your son. This problem is not going to go away on its own after two years of regular substance abuse with regular using friends. Do not wait until his grades begin to suffer to address this. On some level, you knew something was wrong and that you may need to do something to help your son. This is a dark cloud that is brewing on the horizon of your family.

Additionally, I would strongly recommend that you seek support at one of the 12 step groups for families of substance abusers, e.g. Al-Anon, or Nar-Anon. These support groups can offer you support while dealing with your son’s substance abuse problems.

This is not easy for a parent to come to terms with their child’s substance abuse. I applaud your effort to figure out the best course of action for your son. If I can be of any further help, please let me know.

Respectfully,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: How worried should I be that I caught our 12 year old sneaking a beer alone in our garage? My husband says it’s not that big of a deal but the fact that he was doing it alone really bothers me. My son says it is just something he does once in a while and that he will stop now. This all just blew up yesterday after I swooshed in silently on my bike and caught him by surprise after school in the garage. Should I let it go and see if he stops like he says he will and like my husband says or should I get him to talk to someone right away to make sure there is nothing more serious going on?

Iona Health Says...:

First, I do not condone behaviors in adolescents which are normally reserved for adults. In today’s world, children and teenagers have already had much of their childhood chipped away from them by a push to place them more and more inside the adult world.

However, children and teenagers, by their very nature, are curious. They see or hear about adult pleasures and want to find out about them; especially if they have close peers who have experimented with alcohol and/or drugs and reported their effects. Modeling by family and peers and can enormously influence adolescents to experiment with alcohol, drugs, and sex. I would ask you to be curious about what could have helped stage both of your children’s experimentation with alcohol. I do find it interesting that both of your children have access to alcohol and choose to drink it secretly. Is there any possibility that some family member could be abusing alcohol to their knowledge? Where, when and from whom did they acquire the idea that drinking was “ok?” Do not exclude mass media and popular culture as an influence.

Your concern about teen drinking is a valid one as teens who drink alcohol regularly can become vulnerable to alcohol or other substance abuse/dependency than those who begin to use in adulthood. However, as parents, there is much you can do with your children about substance abuse. Here are some suggestions:

1.Secure all alcohol in the house or garage.

2.Remain calm and do not overreact. This can make forbidden objects and experiences more desirable to teenagers.

3.Determine if any peers are abusing alcohol or other substances. If so, you may want to talk with those peers, their parents, and lastly, limit your children exposure to any substance abusing youth.

4.Talk to your children’s school counselors. See if the school is providing substance abuse education so your children can make informed, wise choices.

5.Most critical, it is important that your husband and you agree on how you are going to respond to sensitive matters like experimentation, recreational use of alcohol or drugs, lying, stealing or sex; if these ever become family concerns. Children know when parents are conflicted about their behavior and find ways to take advantage of this divide. Parents have to stand together and support one another in parenting the children.

6.Allow your children to receive the natural consequences of their behavior(s). What would be the natural consequences for being sneaky and using controlled substances? Does your garage need cleaning or "eorganization, for example? An excellent resource for parents raising children is the parenting program Love and Logic." It can be found at: http://www.loveandlogic.com/

7.Consider taking your children to an open AA meeting. Many teenagers do not understand the downside of using alcohol and other drugs. By hearing the stories of recovering alcoholic may induce more respect for restrain with alcohol. To find an open alcoholic anonymous meeting in your area, go to: http://www.aa.org/lang/en/subpage.cfm?page=28

8.Find out what teen resources are available in your community for substance abuse prevention. There are prevention specialists in every community. See if you can locate and make contact with one of them for professional guidance and direction.

Raising teenagers is a challenging but worthwhile endeavor. Many people seek professional assistance when they run into some kind of snafu with their teens. If the suggestions I have offered do not provide you with your desired result, I would strongly recommend that you seek support and guidance from a mental health professional with experience with teens, substance abuse, and family therapy.

If you should need my further assistance, please do not hesitate to contact me again. I wish you and your family the very best of everything.

Respectfully,

John W. O’Neal, Ed.S., MSW, MA, LPC, NCC

Question: What do you do when you are 98% sure that your teen daughter did something but you can’t prove it beyond a doubt and so you don’t want to really punish too harshly on the off chance that you are wrong? I had noticed that my daughter, who is 14, seemed to be buying more stuff than she should have been able to based on the allowance she was earning from me but whenever I questioned her on this she would always say that a friend had given her that shirt or that she had traded her old phone to another friend for this much nicer looking phone that she had now. Stories that were a little hard to believe but since I had no alternate explanation and wanted to believe in her I went with it. Anyway, a couple of months ago I as good as caught her in the act of stealing from my wallet and when I confronted her on it she admitted that she had. She said that it was the first time she had done so and stuck with that story but I figure she had been doing it for a while. Anyway, we had a long and very serious talk about it and she promised she would not do it again. Yesterday there was money missing from my wallet again. I won’t get into the details but about 20$ was missing and there is no one else that could have taken it. My daughter swears up and down she didn’t do it but we were the only 2 people at home. I suppose there is an infinitesimal chance that I could have dropped a 20 out of the ATM or something, but it’s pretty unlikely. So the question now is what do I do about it? I told her after the last time I caught her that I would send her back to live with her mother if this happened again. I do not really want to do this, but now I feel like I am in a tough position. So I have 2 questions: Do I punish her severely if I am only 99% sure of what she has done. I don’t want to get it wrong, but in a situation like money missing from my wallet, I am not sure I am ever going to 100% sure. How do I deal with a child who repeatedly steals from me?

Iona Health Says...:

First, I would recommend that you be 100% sure your daughter is lying to you before accusing her of lying. Her lying and stealing appear to be a symptom of a bigger problem. Lying and stealing are both considered impulsive and control problems, and in its extreme may be indicative of addiction.

I would encourage you to identify and understand what the purpose of your daughter’s lying and stealing might be. The four things we know about behavior is that;

1. behavior has a purpose,
2. behavior is measurable,
3. behavior is predictable, and
4. behavior tends to repeat itself. 

As you have already indicated, you understand three aspects of your daughter’s behavior(s) except for its purpose.

The answer to your question #1 is 'no'. You do not punish for her behavior (lying, stealing, or both) unless you know for sure. If you do and are wrong, you could be punishing your daughter indiscriminately which could undermine your competency with her as the parent. Perhaps, it you were to look at her situation from a systemic perspective, you might ask “What could she be unhappy about since she has come to live with me?” Were her expectations different than what she is actually experiencing in your home? Does she secretly wish she had stayed with her mother or her former life? To follow this line of questioning successfully and accurately might require the services of a family therapist. My concern is that you are thinking in terms of extremes, i.e., staying with you or being rejected back home to her mother. It seems like your daughter could be already be experiencing enough (e.g., punishment and blame) as a result of being a victim of divorce (her interpretation). Could your daughter be angry about her disrupted attachment to mother (separation) and/or the difficulty of attachment with her father? 

The answer to your question #2 is 'unsure'. Stealing can result from many sources and the source of her stealing behavior would need to be identified before a solution can be determined. Much to consider…

As you know, this is not a simple matter. Rather than send your daughter back to her mother and miss an opportunity to build a loving relationship with her, I would recommend that you become more curious and begin to understand what could be “beneath her behavior” and address it directly with great care and love.

There are several good resources for parenting. One is Parent Magic by Dr. Thomas W. Phelan at www.parentmagic.com and the other one is Love and Logic with Dr. Charles Fay at www.loveandlogic.com. Many parents have found effective answers to the troubling behaviors from these two resources.

Finally, I think it is fantastic that you are asking a professional about what would be best for your daughter and you. If the information I have offered is not complete enough for you, I would recommend that you identify a family therapist who has training and experience working with troubled teens from divorced families.

I wish your daughter and you every success. If I can be of further assistance to you, please contact me as soon as you are able.

Respectfully,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: What states allow involuntary teen rehab? I live in RI looking for help for a 17 year-old male son. Have insurance. Looking for a GOOD wilderness rehab, heard high success rates with wilderness camp settings... Thanks Mom, Nicole.

Iona Health Says...:

Involuntary hospitalization is a legal procedure used to compel an individual to receive inpatient treatment for a mental health or substance abuse disorder against his or her will. Thirty-four states allow for some form of involuntary commitment. You are wise to consider laws governing involuntary commitment as every jurisdiction are different. Since you did not indicate the reason(s) you are considering involuntary commitment, I have to address this generally rather than specifically.

However, I would encourage you to contact treatment facilities in Rhode Island or any other state you are considering and ask them about their respective laws as they pertain to involuntary commitment for teenagers; particularly 17 year olds. I recognize that you are considering wilderness program(s) for your son and there are many excellent ones. Before making moves towards certain types of treatment or involuntary commitment, I would recommend that you obtain a formal assessment of your son and his particular issues. Since you have insurance, it should help you pay for a formal and comprehensive assessment, including treatment recommendations.

I commend you on recognizing that your son is faced with problems, but it would serve your son, your family, and you best if your son was offered a diagnosis, treatment recommendations, and an appropriate referral to a treatment facility based on your son’s unique cosmology.

If you need anything further from me, please do not hesitate to contact me. I wish you and your son the highest and future success.

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: My 18 year old daughter is addicted to crystal meth. I want to send her to rehab. I am not sure if she should go to an adult rehab or to a teen rehab. I know she is legally an adult but to me she still seems very much like a kid.

Iona Health Says...:

Meth Recovery: Adolescent or Adult Treatment?

Highly Concerned Parent,

I used to be the director of an adolescent substance abuse treatment program for several years. How we determined if we treated an 18 year old or not, often depended on whether they were in school. Some of the teens were not in mainstream schools, but were in alternative or vocational schools. With some of the 18 year olds, I often asked them "what group would you be most comfortable with?” We also used our clinical judgment to determine what their mental, emotional, or developmental age was; based on their decision making abilities, use of vocabulary, behaviors, peer relations, family relations, past history, and overall maturity. Believe it or not, the 18 year olds usually made the right decisions about which age group to be in treatment with. Recovery begins with making a new decision: not to use drugs or alcohol and to go into treatment. I recommend supporting your daughter in making the best decisions she can make; including about treatment. A word of caution, I would not put my daughter in a program where there was someone she used drugs with or obtained drugs from.

If you are not comfortable with her decision-making, you can have a professional assessment done by a substance abuse counselor. Most treatment centers usually prescreen their clients before they enter treatment to make sure that this person is receiving the proper level of treatment (outpatient, intensive outpatient, residential, or inpatient) and if the program is a good fit for the addict. Some individuals need to be involved in gender-specific treatment because of their past history with the opposite sex, i.e., acting out, or because the opposite sex would provide a serious detraction for the person early in recovery. This type of clinical judgment is usually made during the initial screening or assessment.

I hope with these guidelines your daughter and you will be able to choose the appropriate treatment program. Please be aware that it is not uncommon for individuals, early in recovery, to show a low motivation for treatment. This is very common and does not prevent recovery for the individual or his/her family. If you prefer, you can obtain a free assessment online at http://choosehelp.com. On one final note, addiction is a family disease and I would strongly encourage your family to participate in Al-Anon, Nar-Anon or CoDA support groups. 

I wish your daughter and your family a speedy recovery. If I can do anything further to assist you in this matter, please contact me.

John W. O'Neal, Ed.S, MSW, MA, LPC, NCC