Читать книгу Loving Our Addicted Daughters Back to Life - Linda Dahl - Страница 10
ОглавлениеAn eminent physician who has worked for decades with young people suffering from addiction describes the drug crisis today in words that should shock and awe all of us: “We are experiencing the worst drug addiction epidemic in United States history.”1
Whether it’s called substance use, risky use, drug dependence, substance abuse, substance use disorder, substance use disease, addiction, or alcoholism, taking mood-changing, mind-altering chemicals that may become habit-forming can at any point be harmful to the user. The label may carry shades of different meanings, but it’s the destructive illness that matters. Experimenting with alcohol and/or other drugs will lead only some to heartbreak and addiction, but, like in Russian roulette, nobody knows when the gun will fire.
The statistics about people suffering from the effects of addiction to alcohol and/or a raft of other drugs, especially opiates and, above all, heroin, are so chilling you would think we’d all be out marching in the streets as people did about HIV/AIDS. To cite just one statistic: heroin deaths were up 39 percent in 2013 from the previous year.2 You’d think we’d be besieging our legislators en masse for more treatments that work, prevention strategies that our kids can actually relate to, and vaccines to halt the horrors of addiction. But before we get to that, let me pose a question: What parent wants to believe they have raised a drug addict or alcoholic before the reality of it explodes in his or her face? None who I have met or read about during the years I spent researching this book. And that includes me, the mother of a daughter who was addicted from her teens into her twenties. Many seem to think it’s a problem that won’t ever touch their kids (that would be me). Take a recent nationwide survey of a diverse group of some 2,500 parents, which found most parents of twelve- to twenty-four-year-olds say they’re not concerned about their kids’ possible use. About 80 percent of these parents think they would know how to read the signs (if, God forbid, their child somehow started experimenting), but were only able to identify two out of thirty-eight possible indications of kids’ using.3 Even scarier are the results from a survey of middle-schoolers from my own community that reports the majority of kids don’t think their parents would mind if they used drugs.
Reality comes crashing down when good, smart, nice young people use drugs.
If you’ve picked up this book out of concern for your child or a loved one’s possible addiction, you’re not alone: Risky substance use is being called the leading public healthcare problem for young people in America.4 Addiction originates before the age of twenty-one in 96.5 percent of cases.5 The most current data show 1.3 million Americans ages twelve to seventeen—that’s 5.2 percent of adolescents—had a substance use disorder in 2013, meaning an alcohol or drug dependence requiring treatment. Nearly another million teens were illicit drug users who did not meet the criteria for dependence, and 1.6 million reported recent binge drinking (there is no official breakdown for young adults older than seventeen).6
Let’s turn now to our daughters, our nieces, our granddaughters, and children of friends and neighbors. Again, girls are more likely than boys to intentionally abuse prescription drugs to get high. Among twelve- to seventeen-year-olds, girls are more likely than boys to abuse prescription drugs, pain relievers, tranquilizers, and stimulants.7 As I write this, girls and young women are the fastest-growing group of addicts in the country. Yes, you read that right. The government estimates 58 percent of the 7,800 people over the age of twelve who tried an illicit drug for the first time in 2013 were females.8 Approximately 8.6 million women are reported to be addicted: nearly 6 million women to alcohol and 2.6 million to other drugs.9
Those of us who have faced the searingly painful reality of a young woman’s risky use or dependence agonize over why. Why are so many girls and young women with so much promise using and abusing substances that are so harmful to their health? The reasons are both complex and enlightening. Among them: risky (or binge) drinking and drug use, including opiates (painkillers obtained legally or illegally, and heroin) have become de-stigmatized for many kids of this generation. Also, there is a sense of entitlement and empowerment connected to drinking and drugging for some young women today that is intimately and insidiously bound up with youth culture and advertising. Are we aware of the rise in binge drinking? It has increased to the point that it now affects about 30 percent of high school students and up to 60 percent in many colleges.10 Added to the mix may be marijuana, cocaine, Ecstasy, methamphetamine, “designer” drugs, and many others I will describe in later chapters. Another reason girls turn to substances is that with the onset of puberty they often experience depression, eating and body image disorders, and/or anxiety at a significantly higher rate than their male peers—who, on the other hand, have higher rates of autism and attention deficit disorder.11 Finally, and crucially, young women’s substance use is often fueled by the experience of abuse and/or trauma. It happens far more often than we like to think. Young women are very good at keeping secrets.
Above all, what’s driving our current worst-ever drug epidemic for young people is the widespread availability of prescription painkillers and heroin. Opiates have acquired a reputation for giving the user the best feeling in the world ever, a perfect way to resolve the stress and social anxieties that go along with being a teenager. And because of their fast-acting, highly addictive nature, opiates are causing more and more kids to become dependent, with disastrous consequences. Opiates are derived from naturally-occurring alkaloids in the opium poppy. In contrast, opioids are synthetic, produced in the laboratory (although the effects of opiates and opioids are virtually identical). These drugs induce feelings of euphoria and drastically reduce the perception of pain. Because of the way they are processed in the brain they are wickedly quick to create a need for more in the user. Often, the new user will start off taking pills, graduate to sniffing ground-up powdered pills, and in many cases go on to inject it. And since a main culprit—the prescription opioid painkiller Oxycontin—has been made tamper-proof, more and more kids are turning to a more available and cheaper opiate: heroin. It floods the country, trucked in from Mexico, and is much cheaper than prescription pain pills—and potent. As with other “street drugs,” there is no way for the user to ascertain the strength of a given batch of heroin nor its adulteration with other substances (such as the potent painkiller fentanyl), making it even more dangerous. Another hazard stems from adolescent users’ tendency to mix drugs, such as taking opiates together with Xanax or alcohol.
Women are especially at risk of becoming addicted to opiates/opioids. As one expert explains, women “accelerate to injecting drugs at a faster rate than men . . . develop[ing] substance disorders in less time than men. . . . Women of all ages suffer greater physical, psychological, and social consequences.”12 In plain language, females get sicker on chemicals faster than males. I hammer away at this point because while the addiction rate is climbing among young women, they continue to be—as they have been historically—under-diagnosed, misdiagnosed, and/or not treated appropriately.
This book focuses on what we need to do to effectively help them, as well as ourselves. You will find the best prevention tools: knowledge about effective means of intervening and finding good treatment, and many new discoveries and techniques that specifically aid female addicts but are still not widely known or properly implemented. I will provide you with practical, time-tested ways of regaining your own well-being while dealing with an addicted daughter. In fact, taking care of ourselves may be the most important thing we parents can do!
There is clearly an urgent need for more effective prevention and treatment for everyone, from primary school on up. This includes taking into account important differences in the way girls and boys mature and handle stress. Young men and women who become addicted share many symptoms and have similar needs to recover, but there are also important differences between the genders that can be critical for proper diagnosis and treatment. For example, groundbreaking research in the study of hormonal fluctuations has opened up promising new therapies to help women avoid relapse as their hormones surge during their menstrual cycle. Other new findings targeting the specific needs of young women in science, psychology, and sociology are brought together for the first time in later chapters.
If you are a parent or caregiver who suspects or knows your daughter or young woman you care about is using addictive substances, I know you just want it to stop. You want it to go away. You want your daughter back. I know because I’ve been there. Faced with feelings of failure, fear, betrayal, anger, and shame, how can we choose or help her to choose the best action to take? We are in a serious, unending crisis, because dealing with addiction is like being on a battlefield. In such a state of mind, how do we evaluate and find effective treatment? Since every rehabilitation center’s website claims to be effective, how do we know what works?
While this book touches on the urgent needs of substance users who are pregnant or mothers, those with varied cultural, racial, or ethnic needs, as well as our young sons, the main focus will be on the legion of single girls and young women at risk. Some are hopeful that we as a country are at a turning point in terms of treating addiction as a medical and often a psychiatric disorder and I share their yearning that the best and latest science-based techniques will become widespread. But those of us who are affected by the disease of addiction now can’t wait.
What you will find in these pages:
• Best evidence-based approaches and new scientific research findings about young women and addiction
• Practical tips on how to assess a potential or actual addiction
• How to take meaningful preventive actions
• What kind of conversation works with your daughter
• The best way to assess her situation
• How to find and finance the most effective treatment
• The ways young women and men manifest signs of addiction differently
• How addiction affects women specifically
• Why underlying or accompanying mental health issues must be identified and treated concurrently in young women
• How differing evidence-based approaches in treatment can be crucial to both genders
• How triggers for relapse can be part of recovery and how they differ for women
• Tools and resources to help you and your family regain vitality and a fuller life
Treatment is increasingly being tailored to be effective for our young women today. Much has been learned in recent years to enhance their treatment, and today as never before parents have a key role to play in our children’s lives when it comes to addiction and recovery.
Brenda’s Story
More than one in four high school girls binge drink (five or more drinks on one occasion), and are five times more likely to have sex—and a third less likely to use protection—than girls who don’t drink. 13
Brenda, a bright, attractive young woman of twenty-two, is the oldest of three children in a stable family with two parents. She was raised in a lovely town in Southern California which, like so many suburban towns today, has a lot of alcohol and other drug problems among its young people. Her mother Abby tells their story.
“Brenda was a bright, beautiful, gifted child who got a lot of attention for her looks from an early age. Brenda seemed to have it all. She excelled in school and took up dance in pre-school. But by the time she was in junior high, in the eighth grade, she was already drinking. I didn’t know, but there were signs. She quit dancing, she took up with different friends, and some of the parents weren’t being responsible—they covered for her. When she got her driver’s license she was driving drunk. She wouldn’t come home. And she had an abusive boyfriend who terrified her—really creepy, horrible. He threatened the family. Her self-esteem tanked, and she started hanging out with the bottom-feeders. She became defiant about anything and would freak out in a second. I became afraid of her anger. I didn’t want to upset her but I became her target. I stopped functioning and worried about her every second. I lost a lot of weight, couldn’t sleep, and I was neglecting the family. Her dad just checked out; he was angry and couldn’t handle it.
“We tried counseling, therapists. They knew she was drinking, involved in risky behavior, but she snowed them. I realized I was in way over my head, and I had to come to terms with the reality. I thought codependency was being a mom, but I had to get real. And Brenda showed some signs that she knew what she was doing. She would leave these little ‘I’m sorry’ notes. She would sleep in Mom’s bed. I’m telling my husband her behavior’s not normal and I start looking for alternatives. The turning point for him was one night when she was drunk and was trying to get in the car and leave. We’re in the garage trying to stop her and her dad, who’s a big guy, had to pin her down. She was wild and she banged her head on the concrete floor. We called the cops and they took her to the hospital, where she was horrible, just violent. When she came home, we said, ‘You have one more chance.’ Brenda walked out. We realized she was going to kill herself.
“Two people had recommended a facility in Utah to us. We pulled her out of high school in March of her junior year. We knew nothing about the school in Utah except that it had been recommended. She flew out and we couldn’t see her for sixty days. It was a thirteen-month program where she would get her high school diploma, counseling, and treatment. And it was not cheap. We used her college fund to pay for it and borrowed on credit cards. It was money well spent. Our youngest daughter was so much younger that she was not involved and was okay. But our son would stay away from us, stay with friends. He started sobbing, saying it was his fault after Brenda went away. He was a straight arrow, never in trouble. He began having problems academically and I was worried about him, but he became a stellar athlete. Still, at the time he was so angry at her.
“It was a tough place in Utah that took in a variety of troubled kids and put them in groups according to their problem. There are lawsuits today by former students. But the timing was right for Brenda and her counselor was wonderful with her. After sixty days, we went out for weekends. When we visited, I got tense and had a hard time. I sobbed. I thought at first she was a wayward kid, I didn’t think she was an alcoholic. We hoped she would just grow of it. But Brenda said, ‘Mom, I’m an alcoholic.’ I was so sad about the stigma. Alcoholism runs on both sides of our family and her dad is a situational drinker. But I kept talking to her counselor—who was wonderful—once a week. And then there was a required weekend intensive seminar for families. There were about a hundred parents with a facilitator. The seminar made me really uncomfortable. It opened my eyes and changed me. I had been horrified by her behavior, but I learned it was not a reflection on me, even though I felt it was. I would hang on to stuff. I learned there that Brenda needed to hear us say, ‘We forgive you. But you need to forgive yourself so you can move forward.’ It was powerful for us parents.
“There was no access to the outside world at the center, it was a locked-down facility that was closely supervised. It was co-ed, but they were kept separate. To re-integrate into the outside world, Brenda had to work out a life contract with the family, which we all signed, in which she gradually earned more freedom. Her counselor told us all, ‘I guarantee success if you graduate the life contract.’ It was a six-month process, then she went away to college. There, she did get together with a second abusive boyfriend. He was not welcome at our home. It took her a year to let go of him. And she didn’t want to do the twelve-step program thing at first. She went to a women’s meeting and wouldn’t open up. But later she got into it and now she has a really good sponsor. And we’re supportive. Parents need to be supportive of twelve-step programs for their kids.
“Now Brenda has been in recovery for five years. She’s graduated from college and is going to get her master’s. She wants to work with junior high school students to educate them about the dangers of alcohol and other drug abuse. When I talk to her now, she’s loving her recovery and knows she wouldn’t be alive today without it.
“We know other parents, wonderful families, who have lost their children to addiction. What I tell other parents is: Don’t ignore it. Denial gets out of hand. Nip it early or it can be too late. Many parents aren’t holding their kids accountable. They think they are ‘protecting’ their kids. But you have to pull the trigger. Don’t be afraid of their anger. Also, parents are often divorced. But they have to be on the same page about this. You have to be uncomfortable enough to change. And it’s worth all of it.”
Notes on the Introduction
1. Andrew Kolodny, Chief Medical Officer of Phoenix House, a long-established rehabilitation center, and President of Physicians for Responsible Opioid Prescribing (PROP), in a Statement for the Record to Senator Levin and Senator Hatch titled “Buprenorphine in the Treatment of Opioid Addiction: Successes and the Impediments to Expanded Access” (June 18, 2014).
2. Center for Disease Control (CDC) statistics, cited in C. T. Arlotta, “How Obama Plans to Combat Prescription Opioid and Heroin Abuse in 2016,” www.forbes.com, February 6, 2015.
3. Hazelden, 2014, “Parents in the Dark,” http://www.hazelden.org/web/public/parents-drugs-children-survey.page (accessed October 21, 2014).
4. National Center on Addiction and Substance Abuse at Columbia University (CASA), June 29, 2011, “Adolescent Substance Use: America’s #1 Public Health problem,” http://www.casacolumbia.org/newsroom/press-releases/national-study-reveals-teen-substance-use-americas-1-public-health-problem.
5. CASA, June 2012, “Addiction Medicine: Closing the Gap Between Science and Practice,” http://www.casacolumbia.org/addiction-research/reports/addiction-medicine.
6. Substance Abuse and Mental Health Services Administration (SAMHSA), “2013 National Survey on Drug Use and Health: Summary of National Findings,” September 4, 2014, http://store.samhsa.gov/product/Substance-Use-and-Mental-Health-Estimates-from-the-2013-National-Survey-on-Drug-Use-and-Health-Overview-of-Findings/NSDUH14-0904.
7. Laxmaiah Manchikanti, “National Drug Control Policy and Prescription Drug Abuse: Facts and Fallacies,” Pain Physician, 10 (May 2007): 403.
8. SAMHSA, “2013 National Survey on Drug Use and Health,” 3.
9. NCADD, “Drinking and Substance Abuse Among Women in the U.S. on the Rise,” http://ncadd.org/in-the-news/483-drinking-and-substance-abuse-among-women-on-the-rise (accessed 27 January 2015).
10. Rob Turrisi, Prevention Research Center at The Pennsylvania State University, A Parent Handbook for Talking with College Students About Alcohol, Tufts University, 2010, http://ase.tufts.edu/healthed/documents/parentHandbook.pdf.
11. National Institute of Mental Health (NIMH), Women’s Mental Health and Sex/Gender Differences Research, June 20, 2003, http://grants.nih.gov/grants/guide/pa-files/PA-03-143.html.
12. SAMHSA/Center for Substance Abuse Treatment (CSAT), Substance Abuse Treatment: Addressing the Specific Needs of Women. Treatment Improvement Protocol (TIP), Report 51 (Rockville, MD: SAMHSA, 2009): 17 and 74.
13. CASA, Women Under the Influence (Baltimore, MD: Johns Hopkins University Press, 2005), 45.
