There are several components of substance abuse treatment but for the sake of simplicity the focus of this article will be on three: intervention, treatment, and aftercare. Each of these categories have a number of elements, all of which are important to an individual’s chances of staying sober. An intervention requires the counselor to both recognize the critical issues creating the problem and the ability to communicate a viable course of action. Treatment involves individual, group, and family counseling. Aftercare is most important because this is the time when all other aspects come together to establish a sober way of life.
What Happens in Treatment?
In an outpatient program like Insight the time a person spends in treatment is usually about 12 weeks. This sounds like a considerable amount of time, but in reality there is a lot of information to pack in a short period. Most people don’t come into treatment with a tremendous amount of self-awareness and breaking through denial is an arduous process. Ultimately, the point of treatment is to establish a strong foundation for long term recovery. It is dangerous to expect a person with a drug/alcohol problem to be focused on issues outside of learning how to stay sober on a daily basis. A young person who is dependent on drugs and alcohol needs months of repetition to learn new and better coping mechanisms. This doesn’t mean life has to come to a complete halt but it does mean that expectations should be shifted. By the time someone is discharged from treatment there will be a clear plan of action on how to move forward in sobriety and in other areas of life.
What Happens in Aftercare?
Aftercare is where the rubber meets the road for a person in early sobriety. Through the course of treatment the recovering drug abuser has recognized the nature of his/her problem, become aware of the primary triggers that lead to using, and identified the relationships that have been harmed as the result of continuous drug and alcohol abuse. It takes time to develop a serious drug and alcohol problem and the destruction can be far-reaching. It takes much longer to clean up the mess and move forward. Most people in early recovery need several months (sometimes years) to change what has become a default mode of coping. In aftercare the newly sober individual has a specific plan of action and a lot of emotional support. In Insight the after-care and follow-up part of the program takes place over a two year period. Remember treatment usually lasts around 12 weeks. A person in aftercare continues individual counseling, support group meetings, and social functions while reintegrating into main stream life. The key is that this reintegration is as a sober person. This transition takes time.
It has become common for young people with substance abuse problems to go through multiple treatment programs. Sometimes this is due to a parent not knowing what else to do. In other cases it is because another round in treatment may be necessary to save a young person‘s life. A young person’s motivation to enter drug rehabilitation is usually different than an adult’s. In most instances a young person enters rehab because of outside influences; parents, school, or the law. Adults often enter treatment because of similar factors but can usually see more clearly the responsibility they have for the problem’s existence. What adults and young people have in common is that without significant lifestyle and attitudinal change, long term recovery will not take hold.
Addiction Treatment and Approaches
A philosophy that is gaining momentum in treatment is MAT. MAT stands for medication assisted treatment. This approach is in response to the increasing rates of opiate addiction and is built on the premise that addiction is a brain disease. In other words, the addict is a victim of brain dysfunction. His or her behavior is as the result of something being “organically” wrong. Yet again, we are at the place of treating drug issues with more drugs. Although it seems easier to accept that someone is suffering from a brain disease, the fact remains that if an individual is to achieve long term recovery he or she must address all areas of life. Harm reduction methods, MAT, or any other alternative substance abuse treatment may provide temporary relief and may open the door to long term recovery but the addict must change his or her behavior.
Recovery Doesn’t Always Feel Good
Today it is popular to avoid feelings of discomfort. Who likes to feel any kind of pain? Unfortunately this has led to an increased desire to make sure addicts “feel ok” rather than work through issues. Referring to an addict as an addict is not shaming or demeaning. It gives an individual the opportunity to acknowledge and address the problem. Whether there is an issue in the brain or not the door needs to be open to the recovering substance abuser to own his or her behavior. This can be uncomfortable but with the appropriate level of support the person in recovery will not feel lost or alone. Substance abuse affects a person physically, emotionally, and spiritually. For recovery to be effective all areas need to be addressed.
Substance abuse treatment for young people is full of different philosophies. New innovations come up on a regular basis. In spite of this constant pursuit of a better way, effective substance abusetreatment for young people usually comes back to some simple techniques. Problems surrounding substance abuse treatment for adolescents include:
a misunderstanding of the pressure young people feel
a lack of alternatives to the drug and alcohol subculture
failure to address the whole family
a lack of follow-up and aftercare
There is no perfect approach for all young people but there are some key elements a parent can look at regarding a program under consideration.
1. Who Is Being Served?
One issue often forgotten is that an adolescent does not think like an adult. An adult who has been abusing drugs and/or alcohol for several years has suffered a number of consequences . This person has to realize in a clear way the gravity of the problem and must have a depth of willingness to change that an adolescent isn’t capable of reaching. A young person needs to simply recognize the aspects of his life that have been directly harmed by drug/alcohol abuse.
2. What Is the Motivation
When reaching young people the carrot is almost always a better motivator than the stick. This isn’t to say that one must be permissive when counseling a teenager but a young person needs something to look forward to. Adults are often tricked into believing a substance abusing adolescent can be “scared straight.” Any young person abusing drugs and alcohol is desensitized to this kind of tactic. It never works.
3. It Better Be Real
One of the keys to helping teenagers with drug problems is to meet them where they are. When an adult tries to act like a teenager it comes off as non-authentic and condescending. Talk to a young person as a first class citizen. When seeking help make sure the counselor or therapist really understands adolescent substance abuse. It is very easy to mistake a drug and alcohol problem for a serious psychological disorder. If a young person is abusing drugs and alcohol the substance abuse issue has to be dealt with first.
Substance abuse allows a young person to feel accepted, provides a social outlet, and provides a coping mechanism. If recovery doesn’t involve an element of peer support, real social options, and better tools to deal with feelings the chances of it working are slim. Beware of anyone who promises quick vocational, educational, or disciplinarian solutions. Horses will not help a young person stay sober nor will massages, yoga, or diets. Recovery is not fast and easy.It takes time for an individual and a family to heal.
Teen drug abuse continues to be a tremendous problem in our country. Although the substances young people abuse change, the plague of addiction is the same as it has been for decades. No matter how people try to solve this issue it continues to grow. There is no simple answer as to why this scourge remains but there are some simple steps people can take to provide young people with some alternatives.
Remember The Angst Of Adolescence
Most young people can’t wait to become adults. In the mind of a teenager this is the time in life when there are no longer any restrictions. Unfortunately, in society today many teens are expected to act as adults before they are truly capable. Rather than adolescence being a time in life when a person can make mistakes and learn from them, in the age of “zero tolerance” and increased isolation, young people are often left to fend for themselves. At some point almost every teenager will have to face the temptation of drugs and alcohol. It is impossible to predict who will wind up with a serious problem but there are certain factors that increase the odds.
Be Available And Listen
Most of how a person views the world starts at home. Throughout childhood and adolescence other factors start to influence how someone thinks but the foundation is laid early on. In substance abuse treatment the person with a strong emotional footing is more likely to grasp a program of recovery quickly. People that grew up around a lot of dysfunction, instability, or spent very little time with positive family members will have a more difficult time connecting with basic concepts common in treatment. At this point figuring out “why” a teenager has a drug problem is far less important than having a stable and secure environment in which to heal. Most teenagers thrive on friendship, security, and (most importantly) fun. Often what they need more than anything else is to be listened to. An easy response to adolescent substance abuse doesn’t exist but society can make a difference with a shift in attitude.