Drug Rehab Center

By Geoff Thompson, Program Director

Sunshine Coast Health Center

A requirement for living a fulfilling life is feeling a sense of belonging in the world. One of the key problems with those suffering from addictions is that they feel they are different. They feel they don’t fit in. They feel they don’t belong. Clients at Sunshine Coast are often asked to think back to their life in active addiction: did they feel they just didn’t fit in, that they didn’t feel that they were the same as others, that something was wrong with them? Perhaps they became something of chameleons just to fit in with different groups of people. In fact if you listen to the stories of addicts, this is one of the most common themes. If you are in recovery, listen for this at the next 12-step meeting you go to, or read any of the stories in the Big Book, or watch a drug movie such as Barfly with Mickey Rourke or Panic in Needle Park with Al Pacino. You will hear what it’s like to be an outcast in the world.

So a great deal of life in recovery is often spent finding a sense of belonging in the world. So often, clinical staff at Sunshine Coast Health Center hears from those clients who have slipped or relapsed that they didn’t feel this belonging. Here’s a typical example: ‘I cleaned up, did everything suggested to me, I’m living this middle class existence…and I’ve never been so bored in my life!’. Other clients report that they don’t find a sense of belonging at 12 step meetings. Or even at home. In short, they still don’t feel comfortable in the world.

So how do we pull off this trick of feeling completely comfortable, whether at an AA dance or at work or at home? This article looks at some of the strategies people in recovery can use.This is an important point: To find a sense of belonging in the world requires action. Clients are often reminded that they are the authors of their lives. Waiting for someone else to help may mean waiting an eternity. 

Tip # One: Start asking yourself, “What does Life demand of me?”

Addicts are notorious for demanding that people (and situations) change to suit their own needs and expectations. What this looks like in daily life is that they usually go about their lives making demands on the world. Some examples: I demand that I be able to use drugs, even though they are illegal. I demand that I be allowed to drink and drive, because I’ve run out of booze and I really need more. I demand that I be allowed to leave the family for three days to get loaded and then be forgiven. I demand that I be the centre of attention. I demand….I demand…I demand. For Sunshine Coast clients, this may remind them of the story King Baby.

Alumni at Sunshine Coast are often asked: “What are you prepared to do for your recovery?” One of the reasons we ask this is because so many clients come into treatment making demands on recovery: ‘I will stay in recovery if and only if…’ and then come the demands. ‘I came into recovery to learn how not to use my drug of choice….but I demand that I be allowed to have a beer or smoke pot because they were not problems for me’. Or how about this one: ‘I will take risks…but I demand that I only have to take risks that I’m comfortable with’. Or this one: ‘I demand that my recovery progress only if my family is fully supportive’.

Some clients get upset when they call a government office and then get put on hold for 30 minutes. They are demanding that someone answer their call immediately. Some clients get frustrated when they have to wait 90 minutes at the hospital to get their blood tests done. Some clients get upset when there is no space in the van to go to the recreation complex. Some get upset when their family members do not visit.

In all these examples, the person is making demands on others and on situations. The reason that this is dangerous for recovery is that anyone who makes demands on Life is still an outcast, still on the outside of life looking in.

A much better approach is to stop demanding that people act a certain way or think a certain way. The strategy to accomplish this is to ask yourself, ‘What does Life (this situation) demand of me?’ The genius of this approach is that people in recovery then join in with life. When they join in with life, they’re no longer on the outside looking in, no longer an outcast.

Tip # Two: Start connecting with others in the community

Another approach to feeling a sense of belonging is to get involved in the world. 

It probably isn’t a surprise to you to learn that researchers have found a very strong link between recovery and volunteering. And, as we remind our clients, at every 12-step meeting there are really three meetings: the get-together before the meeting, the meeting, and the get-together after the meeting. The reason for this is that you need to feel ‘part-of’ the group.

Here are some examples of things that Sunshine Coast alumni are doing: volunteering to be the contact person for Sunshine Coast clients when their program is over, volunteering to sit on a Board of Directors, volunteering to be the Group Service Representative of their AA group, helping out serving Christmas supper in a poor neighbourhood, coaching a minor hockey team, giving talks to high school kids on the dangers of drugs, raising money for a charity, helping out at the local amateur theatre group, helping promote environmental awareness, joining a political party, etc. It’s quite remarkable that those alumni who do these things also say they are doing well in recovery.

It’s a strange thing, but most of us don’t even know our neighbours. It’s hard to feel a sense of belonging when we don’t even know who’s living next to us. Lots of people in recovery go out of their way to be good neighbours. Some typical examples are helping out shoveling snow after a snow storm, holding a neighbourhood barbeque, joining a neighbourhood-watch program or an ‘adopt-a-street’ program to pick up litter, sending Christmas cards to each neighbour, inviting a neighbour over for coffee.

Tip # Three: Start taking action to make different parts of your life more appealing

It’s interesting that people who are fulfilled in recovery do things that are very meaningful to them.

Some alumni have worked jobs that they find no longer a challenge. In recovery, they have returned to school or are pursuing other careers.

Some are near retirement or have other obligations, so they cannot realistically give up their jobs. But they have done things to make the job more interesting such as relocating to another company office, shifting to a new location, asking their manager if they could work toward a higher position, giving up working overtime, sitting down with someone they have a conflict with and working it out, sitting down with their manager and expressing what is troubling them, etc. All of these strategies have the same purpose: to make the job more comfortable to go to.

As well as making work more interesting, many alumni have made their home life more exciting. Here are some of the strategies alumni have used: Wednesday night is family movie night, doing something special for each member of the family once a week, having coffee in bed with their partner on Saturday morning to talk about their relationship.

Tip # Four: Start looking at the positive

We all know that life is filled with misery. In fact, psychology researchers have discovered, as have artists, that our greatest fear is the knowledge that we will die. This is what the so-called ‘midlife crisis’ is all about: we’ve lived half of our lives, we’re not as physically resilient as we used to be, and we have gained the wisdom to begin reflecting on what we’ve accomplished.. And we also know that we will likely get sick or have an accident or have to deal with the goofy things our teenagers do.

We all suffer. People in recovery may find It’s easy enough to complain about the jerk at work or the AA member who smokes pot and yet takes a cake. It’s easy to dwell on our own weaknesses and the weaknesses of others.

But it is also true that we have many gifts: freedom of choice, freedom to change the way we look at ourselves and at the world, freedom to find something meaningful even in the worst possible situation. We’re not like a rat in a cage, who is trapped. We have the blessing of changing our situation and our attitudes. Remember that passage in the Big Book that says, “nothing happens by mistake”? We have the wonderful ability to learn and grow even from our worst failures.

We’ve known for thousands of years that we react to things according to how we make sense of them. It’s not the things in life that are important, but how we interpret them.

Geoff Thompson – MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, discusses Wayne Dyer’s movie “Ambition to Meaning” as it relates to depth psychology and the realization that you are an important, worthwhile, living, breathing human being.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for Sunshine Coast Health Centre discusses why any mood altering substance should be avoided, especially in early addiction recovery, to avoid relying on these as a crutch.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services at Sunshine Coast Health Centre, discusses signs to look for in early addiction recovery that show whether someone is on track with their recovery or not.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services at Sunshine Coast Health Center, talks about addiction treatment as a foundational tool in recovery and offers steps to take in the case of a slip or relapse.

By Daniel Jordan, General Manager

In yesterday’s post, we discussed the 3 Cs of Addiction Test which described the roles that 3 key characteristics play in determining whether an individual is abusing or dependent on a bad habit: compulsion, control, and consequences. A bad habit could include drugs, alcohol, coffee, even using a cell phone.

At one point in the article, online gaming was reviewed to see if it fits the profile of a true addiction, meaning that it met all 3 criteria in the 3 Cs of addiction test. The conclusion presented in the article was that unless one could define squandered opportunity or wasted time as a negative consequence, online gaming did not meet the criteria of an addiction. This brings us to a very real dilemma of our modern times: is our growing fascination with the Internet a good thing?

A Modern Dilemma: Our Growing Reliance on the ’Virtual’ World

It seems that Western culture is struggling with the Internet and whether it is better to live in the ‘virtual’ world of games and chatting or the ‘real’ world with all of it’s imperfections and inherent risk. Well, at least for some adults, it’s a dilemma. Ask most children and they don’t see a problem. Kids will tell you that online gaming and chatting is not only harmless, it’s fun. Appealing to a parent’s role as guardian, kids will  often argue that playing video games or chatting online is far better than going out and getting drunk or getting mixed up with kids that are up to no good. Most parents can’t argue with that logic since, above all, they want their children to be safe and out of harm’s way.

Most Parents Are Ambivalent About Online Gaming

Many parents, therefore, are ambivalent about online gaming. On the one hand, they know that kids are vulnerable to accidents in their youth, particularly during the experimental phase of drinking and drugs. Drinking and driving; parties that turn violent due to drugs or alcohol; invisible, tasteless date rape drugs; etc., etc. These are all examples of life in the ‘real’ world, where teens can, and do, get hurt. Furthermore,  most parents can remember some of the foolish stunts they pulled as kids and shudder to think if their kids even did half of the things they did at that age.

However, many of today’s parents know that something is missing in the lives of their children. The days of playing street hockey all night on the neighbourhood streets of many Canadian communities seems to be a thing of the past. Kick the can, hide-and-go-seek, touch football, snow men, tree forts, and kite-flying have all suffered a similar fate. Kids won’t miss what they never had but, based on their own childhood memories, many parents would agree that their kids are paying a price for growing up in the age of the Internet.

Another ‘Harmless’ Pasttime: Smoking Pot

In this way, the debate over online gaming is reminiscent of another ‘harmless’ pasttime: smoking pot. Talk to most kids nowadays and they will tell you that marijuana is no big deal. They understand that the police and the courts give most pot smokers a slap on the wrist. Some kids even mistakenly believe that marijuana is legal.

However, pot smoking is far from harmless as anyone who works in addiction treatment can attest. Motivation can be a struggle for anyone who habitually uses marijuana. Many who use marijuana find it’s a great way to cope with life’s challenges. Rather than deal with life on life’s terms, many resort to a few puffs, relax, and move on – never learning from making difficult situations or working through the consequences of poor choices. In many ways, marijuana is the ‘perfect escape’ – cheaper than booze, supposedly harmless, and culturally acceptable.

Here again, parents are ambivalent. Many parents rationalize that it’s better for their kids to smoke pot than use other ‘hard drugs’ such as cocaine or crystal meth. Some parents even think it’s okay if their kids smoke a little weed at home rather than being out on the streets beyond their protective gaze. 

Escape as The Real Danger of Online Gaming, Smoking Pot and other ‘Harmless’ Activities

It is not until we look at motive does the real danger of many of today’s so-called harmless activities come into sharper focus. If one is only playing video games and smoking pot on a recreational basis, then perhaps there is no harm. However, if the real motive is to escape reality, then perhaps then one could argue that excessive online gaming or pot smoking does lead to negative consequences.

So what does escaping reality mean for a teenager? Here are some scenarios:

Peer Pressure (developing social skills) : In the virtual world of online gaming, players can be interact with other kids free from being judged about what they wear, who they hang out with, how they look, or what they say. Players can assume an alias or even disappear where they can see other players but the other players can’t see them. This ability to control the terms of human interaction is one clear benefit to players who would prefer to avoid the ‘hassle’ of the real world which can be unpredictable and intimidating.

Dealing with Boredom (learning to be creative): online gaming is a great way to escape boredom. Any parent who has ever observed online games will notice there is a lot of activity and lots of noise. Visually, kids are attracted to these games just as adults are attracted to the bright lights and ringing bells of a casino. Furthermore, online games require a great deal of skill that kids seem more than willing to develop over days, weeks, and months. Finally, games such as Warcraft and Maple Story never end. There are always more villains to conquer and new virtual lands to invade.

The cost of such compelling games is that kids do not learn to be creative. The game provides everything they need. Most parents will remember their own childhood where, out of sheer boredom, games would be invented and enhanced, modified and eventually discarded. Then other games would be invented and the process would repeat itself. All they needed was some cardboard boxes, some old clothes, even an old tire tube. Whatever was on hand.

Becoming an Adult (learning to be Independent): as kids approach graduation, they begin to think about their future. What are they going to do for a living? How am I going to support myself? The transition from adolescence to adulthood can be difficult but not if your world revolves around online gaming. After all, with an internet connection and a computer you’re pretty much set. As a result, many kids can fall into the trap of thinking that not much needs to change in order to continue a lifestyle built around online gaming. This is particularly true if kids are allowed to stay home while they attend post-secondary education or work to save up enough money to buy their own place.

Conclusion

Families of today have new challenges that are coming at an ever-increasing rate. Parents are often torn between letting their kids be kids, keeping them safe, and preparing them for adulthood. Online gaming is a perfect example of a new technology that many families did not even know about until just a few short years ago. Individuals who work in the addiction treatment industry are keeping a close eye on whether society’s growing desire to ’escape’ and new technologies will fuel even more addiction. Perhaps society’s ability to stay firmly grounded in the ‘real’ world will depend a lot on the collective will to live a balanced life, use technology in moderation, and connect with face-to-face with friends and family.

Often when families call our treatment center for help, they often struggle with being uncertain whether or not their loved one has an addiction. Even professionals in the field sometimes confuse addiction with substance abuse so it’s not surprising when families have trouble telling the difference. While there are a number of tests out there, we recommend a very simple test we call the “3 Cs of Addiction.”

Basically, the 3 Cs stand for 3 characteristics that must be present in order for a bad habit to be considered an addiction. An addiction can be to a substance such as drugs or alcohol, or to a process like gambling or sex.

Unfortunately, the word ‘addiction’ has become part of pop culture and is increasingly being used to describe anything that brings so much pleasure that one can’t help themselves. Chocolate and coffee are common examples, neither of which meet the criteria for a true addiction. This can be better understood with a review of the 3 Cs as follows:

C #1 – Compulsion

Compulsion is obsessive behaviour that individuals demonstrate when it comes to their bad habit. The key here is that compulsion happens before the individual indulges in their bad habit. Examples include:

- excessively talking about your bad habit

- daydreaming about your bad habit

- spending most or all of your time with people that share your bad habit

- scheduling your day around your bad habit

C #2 – Control

Control refers to what happens after you start consuming or participating in your bad habit. Once started, people who have no control have an inability to:

- set limits on the amount consumed

- honour basic commitments such as oral hygiene, housekeeping, making dinner for your kids, or showing up for work

- engage in risky behaviour that endangers the health or well-being of one’s self or others

C #3 – Consequences

A consequence is defined as the outcome of an action. In order for a bad habit to qualify for C #3 the consequence has to be of the negative variety and the bad habit must continue in spite of continued negative consequences. Examples include:

- continuing with the bad habit even after your doctor warns you it is killing you

- repeatedly getting into trouble with the police

- falling in debt but continuing to spend on your bad habit

- refusing to quit your bad habit even after your spouse leaves you

The Most Important C: Consequence

It is important to note that having one 2 out of 3 of the characteristics would suggest that an individual is only abusing a substance or a process. Typically, the ‘C’ that separates most people with dependencies from those that only abuse is consequences. For most individuals, when the consequences of continued abuse get bad enough, the individual typically stops or cuts back. Not so for the addict.

Applying Specific Bad Habits to the 3 Cs of Addiction Test

Let’s look at some specific bad habits to see if they are true addictions based on the criteria established by this test:

Coffee – coffee can be a morning ritual which could narrowly count as C #2 – compulsion. However, most people rarely drink more than a few cups a day (C #1 – control). As for consequences, coffee doesn’t fit the bill. You may get cranky if you have too much caffeine and it may even stain your teeth or give you bad breath but these consequences are not grave enough to meet the 3 C criteria.

Internet Gaming – many children and teenagers are spending excessive time playing online video games. These games can range from single-player to massively multiplayer online role-playing games (MMORPG)  where hundreds, even thousands, can be playing the same game online. Popular MMORPG titles include the World of Warcraft and Maple Story. Internet gaming also includes online gambling which is now a multi-billion dollar industry (see the Gambling section below).

Individuals who participate in online gaming certainly exhibit clear signs of an inability to control the amount of time they spend playing once they start. Online gamers also exhibit signs of compulsion as many kids will find other ways to play even when their parents restrict their use such as going over to a friend’s house to play or going to the local internet cafe. As for consequences, the biggest negative consequence is the amount of time lost to being on the computer. This is time that could arguably be spent involved in other more fulfilling activities. Whether wasting time, however, can be considered a negative consequence is debatable. 

Sex Addiction - Patrick Carnes, a noted psychologist and author on sex addiction refers to sex addiction as “a compulsive behaviour that completely dominate’s an addict’s life and can include: compulsive masturbation, compulsive heterosexual and homosexual relationships, pornography, prostitution, exhibitionism, voyeurism, indecent phone calls, child molesting, incest, rape and violence.” Patrick Carnes even describes sexual anorexia, similar to eating disorders, is a form of addiction where depriving oneself of sex can create feelings of power and invincibility from emotional pain.

However, many other sex experts, particularly sexologists, argue that compulsive sexual behaviour is not an addiction since sex is a perfectly natural activity, necessary for reproduction.

The Diagnostic and Statistical Manual of Psychiatric Disorders, Volume Four describes sex addiction, under the category “Sexual Disorders Not Otherwise Specified,” as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used.” According to the manual, sex addiction also involves “compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship.”

Sexual compulsivity, however, definitely meets the criteria for the 3 C Addiction Test since marital breakup is often the result of those who choose to engage in prostitution, internet porn while incest, rape and voyeurism can and does lead to legal problems. However, such behaviours must be repeated in spite of negative consequences in order to meet the 3 C criteria.

Gambling - one of the better known addictions, can certainly lead to compulsive behaviour as many gamblers have been known to spend hours away trying to figure out how to beat the house. As for control, many gamblers have been known to promise themselves they would limit their bets to $100 and end up losing their homes by the end of the evening. The consequences of gambling can range from personal bankruptcy to divorce. For the addict, however, superstition and a distortion of the real odds of winning keep the compulsive gambler coming back for more.

Alcohol - I intentionally left alcohol to the end after reading an interesting 12 Step study guide titled, “A Program for You: A Guide to the Big Book’s Design for Living.” Of interest in this book is how the Big Book distinguishes between the 3 Cs of addiction, albeit using a different terminology. For example, the Big Book uses the following terminology:

compulsion = a mental obsession

In the Big Book, Dr. Silkworth describes how alcoholics often feel: restless, irritable, and discontented when they’re sober. Over time, the alcoholic begins to believe that taking a drink will relieve these feelings until the idea becomes an obsession.

control = a physical craving

The physical craving is part of what the Big Book refers to as an “allergy to alcohol” or a “reaction to having alcohol in our system.” According to A Program for You, the word “craving” always refers to the body.

What the Big Book says About Other Types of Addictions

According to A Program for You, the Big Book recognizes that there are different kinds of obsessions such as compulsive overeating, and gambling. Both of these obsessions lead to “lives exactly like those of alcoholics who are still drinking”: They go on binges, then swear they will never do it again. But sooner or later, they start feeling restless, irritable, and discontented. Then the obsession kicks in and their minds convince them that a little bit wouldn’t hurt.

Interestingly, A Program for You concludes that “all obsessions are pretty much the same. The fact that we’re allergic to alcohol isn’t what’s most important. The important thing is that we have an obsession in our mind.”

Conclusion

So, remember, the next time you hear the word “addiction” being used in the media keep in mind that true addictions should meet the three criteria: compulsion, control, and consequences.

Self-Help Groups

Gamblers Anonymous

Overeaters Anonymous

Sex Addicts Anonymous

By Cathy Patterson-Sterling, MA, RCC

Director of Family Services, Sunshine Coast Health Center

Research and studies show that the impact of addiction on men and women can be different for both genders. Here are some differences at a glance

Men:

• are more likely to have a drug abuse or alcohol abuse problem than women
• have much higher rates of chemical dependence than women for all ages except the 12 to 17 year age group
• tend to higher rates of “social drinking” when compared to women
• tend to start using cocaine recreationally as a way to bond with other men. Women, on the other hand, typically initiate recreational cocaine use as a way to bond with the men in their lives

Women:

• tend to proceed more rapidly to drug dependence compared to men
• tend to have higher rates of “social smoking” when compared to men 
• are more vulnerable to HIV/AIDS through injection drug use when compared to men. Approximately two thirds of AIDS cases among women result from injection drug use. AIDS is now the fourth leading cause of death among women 15 to 44 years
• tend to begin abusing drugs at a later age than their male counterparts
• who have been treated for drug addiction have a higher incidence of childhood sexual when compared to men. Studies indicate that up to 70% of women in drug abuse treatment reports have histories of physical and sexual abuse with victimization beginning before the age of 11
• who have been treated for drug addiction have a higher rate of disordered eating when compared to men. For example, as many as 55% of bulimic patients are reported to have drug and alcohol use problems.Overall, 15-40% of females with drug abuse or alcohol problems have been reported to have eating disorder syndromes, usually involving binge eating
• have higher rates of co-existing substance abuse disorders and other psychiatric disorders compared to men. Data from a study on female crime victims, for example, indicate that those suffering from post-traumatic stress disorder (PTSD) were 17 times more likely to have major drug abuse problems than non-victims

Women who seek addiction treatment are in need of female-sensitive services for a wide range of medical problems, mental disorders, and psychosocial problems. Furthermore, there is a stronger likelihood that women with addictions have been victimized earlier in life so this means that they have special psychological and psychiatric needs. For this reason, non-punitive and non-coercive treatment facilities are recommended for female populations.

One can conclude from the information above that women have very specific treatment needs especially considering that their cocaine addictions may start out as attempts to connect intimately in relationships and that women also have a higher incidence of medical and co-existing mental health issues compared to men. With the above differences in mind, one can also make a strong case for gender-specific treatment in which men’s drug and alcohol programs are designed for men’s needs and the same is provided for women with their exclusive issues. 

If gender-specific treatment is the gold standard, then the question remains as to why so many men and women remain in co-ed treatment settings. Is this simply a case of economics – ensuring as many admissions as possible? Or does co-ed treatment have some special redeeming qualities in terms of care for clients? The writer will leave it to the reader to ponder such controversial questions.

References

www.alcoholaddiction.org - “Men vs. Women in Substance Abuse” – April 13, 2008
www.4therapy.com – “Women Often Experience Addiction Differently Than Men”

Stepanie S. Covington Ph.D., LCSW - Center for Gender and Justice

By Cathy Patterson-Sterling – MA, RCC

When parents consider their top five fears for their children, a common one that is noted is the fear that their child will grow up to become a drug addict. Many parents believe that they can “drug-proof” their children by keeping them busy in endless activities so that they are distracted from ever hanging out with “bad crowds” of youth. Other parents may even provide lectures about how drugs ruin people’s lives and emphasize the need to stay in school. Regardless of these techniques, the reality is that parents cannot be with their children at every moment and inevitably all youth will have to walk through the “gauntlet” of experimentation with drugs and alcohol. Chances are youth are going to be exposed multiple times in their lives to both alcohol as well as drugs.

Teen Drug Trends is a parent’s guide to understanding and responding to teen drug use. This guide has been produced by retired Port Moody Police Sergeant Robb McGirr and financially supported by The Members of West Vancouver Police Association and Port Moody Police Services Union.

The Problem with “Scare Tactics” When Talking with Your Kids About Drugs

In his presentations to families, Robb McGirr provides a technique called “Conversation A and Conversation B.”  He suggests that parents often muddle their messages to youth by blending a “scared straight talk about drugs/alcohol” filled with all kinds messages such as: drugs kill, instant addiction, and drug use leads to homelessness.  Along with this talk, parents will often threaten their children with a list of consequences if they ever get caught with drugs, alcohol, or pariphernalia. 

The problem is that young people walk away from such talks more afraid of getting caught than of the drug itself. As a result, any questions that youth have or discussions around experimentation become hidden  from their parents. In essence, all thoughts and behaviors related to drug/alcohol use go “underground” and kids then rely on their equally misinformed friends for questions they have about alcohol and drugs.

Conversation A: Reviewing Basic Information on the Effects of Drugs and Alcohol

Therefore, Robb McGirr suggests that parents are a most valued source of information from children followed by teachers, media/written information, and then peers. In “Conversation A,” parents impart their wisdom about alcohol and/or drugs. Children have the option to not agree or follow the advice. During such a conversation, parents may discuss the risks involved in using alcohol/drugs, the problems with excessive use, a fact that once kids continue using alcohol/drugs that they slowly begin to give up on their dreams, that kids with prolonged use of alcohol/drugs start to numb their feelings and over time feel like they cannot cope unless they are “high” or under the influence, eventually kids can settle into this cycle and use crime (theft and/or prostitution) as a way to pay for their alcohol/drugs. 

The 3 Cs: Distinguishing Between Substance Misuse and Addiction

With Conversation A, parents can talk about when substance abuse becomes self-destructive while using various “measuring sticks” or tests to see if there is a problem. One such test is the 3 C Formula. If people answer yes, to all three C’s there can be a problem.

Control: Can I set limits with my habit and stick to them?

Compulsion: Am I placing a lot of energy into my habit and planning my life around opportunities to use my habit?

Consequence: Are bad things happening to me as a result of my bad habit, and I continue on using my bad habit anyway?

Another measuring stick is that drug or alcohol abuse means using these substances as a way to navigate through problems. It is not normal for people to “drown”, “numb” or “mood-alter” their feelings away with chemicals. Such actions are self-destructive and parents can explore with their children ways to deal with situations in ways that are not self-destructive as they discuss strategies of self-preservation and personal safety. Youth need to learn to self-preserve and not self-destruct because they are worthy of love, happiness, and great accomplishments in life. 

Conversation B: Preventing Accidental Injury or Death Through Experimentation with Drugs or Alcohol

“Conversation B” is much different in that this conversation is not negotiable. For example a parent may say: “My greatest fear is that something bad will happen to you and it is my job as a parent to try and keep you safe until you become an adult whereby you will then start to make these choices yourself. I need to know that you are safe and can you help me with my fear? Ie.) calling me when you will be late, not getting in a car with someone who is drinking and driving, calling me if you need a ride, etc.” Also in this conversation there are “house rules” that everyone follows i.e.) we are all home tucked in safe by 1:00am, we call if we are going to be late, we ensure we are with safe friends, etc. These house rules need to be followed so that we can all be safe.

The overall goal is to try to delay first use so that youth are older and have more stronger refusal skills when they first try alcohol and/or drugs. This way, they can make wiser decisions around stopping and not becoming self-destructive with these substances. If a parent’s child is already using, then this moment becomes a teachable opportunity to really discuss “Conversation A” and at a separate time cover “Conversation B.”

Conclusion

Youth are naturally curious and will be exposed to a variety of opportunities to use alcohol and/or drugs. As parents we can do our best to impart wisdom about these substances while also helping our children to “keep their eyes on the prize” by maintaining their dreams. Drugs and Alcohol steal dreams and youth may receive instant belonging with a group of rebellious kids, but the cost is that they settle into a social group that gives up on ambitions and relishes in the self-destructive use of substances. Eventually youth who continue on with drug-use feel like they need these chemicals in order to just cope with life. Therefore, when children hold alcohol and drugs in their hands, they are making a choice that can impact the future course of  their lives.   

A Resource for Parents

Parents may want to take a look at Drugs of Abuse: An Identification Guide that is published by Sunshine Coast Health Center. This guide explains the short- and long-term effects of a variety of drugs and does so in an easy-to-read format with lots of photos.

The Sunshine Coast Health Center website also has a School Drug Abuse section which has help for teachers, families and students.

About the Author

Cathy Patterson-Sterling, MA, RCC, is Director of Family Services at Sunshine Coast Health Center, a private residential alcohol and drug rehabilitation program for men. In this capacity, Cathy is able to provide families of clients the support they need from the moment of the crisis before entering addiction treatment through to their entry into family programming and beyond (family aftercare is also provided). With a strength-focused addiction family therapy approach, substance-affected families are able to transform as they begin their own healing journeys alongside clients.

By Geoff Thompson - MA, CCC

William R. Miller, a world-renowned addiction expert, told us in 2006, “Addiction is not well understood.”

Miller’s comment seems almost bizarre considering all the money and effort invested in cleaning up and preventing addictions. According to the most comprehensive study in Canada, the annual per capita cost of dealing with addiction in this country was $725 in 2002 (this includes enforcement). This works out to $18.9 billion for a single year. One US government study put the 2005 cost in the US at $276 billion. The same figures are true for other Western nations. A 2008 study from PricewaterhouseCoopers, for instance, concluded that each UK addict cost British taxpayers $1.4 million.

The annual budget for the National Institute on Drug Abuse, a US government research agency, is $500 million. And that’s just one of dozens of private and public outfits. Results of thousands of studies are published in more than three-dozen English-language scholarly journals dedicated to the subject. Dozens of major conferences are held each year offering the latest theory and practice. Universities offer courses on addictions, and many grant advanced degrees in it.

The US and Canada spend staggering sums every year on prevention programs (though Canadian figures are difficult to collate). The most famous is Drug Awareness and Resistance Education (DARE), which the US government subsidizes with a $1 billion. Treatment for addictions comes with an even bigger price tag. Alicia Busch of Harvard University’s addiction research program estimates 600,000 treatment slots for drug addicts (not including alcoholics) in the US. If we rely on the US government’s studies of the cost per person for treatment, this puts the annual treatment budget into the tens of billions.

Given all this time and money, can Miller’s comment be accurate? If we don’t really understand addiction, then what are we doing in all those prevention and treatment programs?

Sadly, Miller is right. And he is just one of many experts who have admitted publicly that we’re still trying to figure out who these alcoholics and drug addicts are and what motivates them to begin and keep using, even though they know what will happen.

One example of our confusion is the effort to prevent addiction. According to a 2006 report from the US General Accountability Office (GAO, the US government’s watchdog), the most widespread drug prevention program in schools, DARE, isn’t worth the money. Health Canada came to the same conclusion in 2001. Also, according to the GAO, the US President’s 2006 $1.2 billion ad campaign to prevent kids from using drugs was not merely ineffective but actually made drugs more appealing for some teenagers. Scholarly studies of another prevention program, the Victim Impact Panel (VIP) of Mothers Against Drunk Driving, showed that attendance at VIP actually increases the chance that someone convicted of DUI will get another DUI. 

Treatment providers seem equally baffled. Studies of mainstream programs have shown that the average program helps only one in four clients stay abstinent for some period of time up to a year—after that, it’s all downhill. Studies at the four-year mark found only 7 percent still clean and sober; at seven years, 5 percent.

Many claim that the answer to addiction is the twelve-step program developed by Alcoholics Anonymous. As powerful as this program is, independent researchers and AA’s own internal surveys confirm that the program does not seem to have any enduring appeal for the vast majority of alcoholics.

The public generally assumes that professionals know what they are doing—that is, until the problem hits home. That’s what happened to Robert Shapiro, the famous lawyer. Shapiro’s son died from a drug overdose 18 months after completing treatment. Questioning what had happened, Shapiro began investigating. On the October 21, 2005, edition of the television show, Larry King Live, he reported “the most successful program in the world [has] a 12 percent success. He also mentioned the old joke: “[P]eople who go into rehab for 28 days…will relapse on the 29th day.”

So what’s going on? Should we just wave a white flag and surrender to this terrible thing called addiction? Far from it. Shapiro’s investigations convinced him that addiction was a lot more complicated than he had been led to believe, but it also gave him hope. We’ve learned a great deal after 40 years of study. We now know, for instance, that certain approaches to prevention and treatment are effective, even if much of what is currently practiced doesn’t seem to work that well.

In future articles I’ll describe what the experts and the addicts tell us about what it means to be addicted and what it means to find recovery. It’s a fascinating discussion, and one that tells us as much about ourselves as it does about those with addictions.

About the Author

Geoff Thompson, MA, is the Program Director at Sunshine Coast Health Center, a private addiction treatment facility for adult men. His book, A Long Night’s Journey into Day, explores Eugene O’Neill’s life to uncover the truth of addiction and recovery.