So Your Kid Has a Drug or Alcohol Problem: Blame the Parents, Punish the Child?
I was all set to applaud the my local newspaper’s features editor for his recent column, “You’ll Never Convince Me That 20 Years In Prison Is Appropriate For Selling Drugs.” He ranted about lengthy prison sentences for drug-related offenses compared with sentences for more serious crimes. As a case in point, he wrote about a guy with quite “a rap sheet” recently sentenced to 20 years in prison for selling methamphetamine to a drug informant, making the following argument:
“Armed robbery, for a person of Cook’s criminal prolificness, gets a guy about 9 years in the slammer. Beat the bloody crap out of a guy to where you cause great bodily harm (”Soprano” style), and you’re looking at 13 years in the clink. You need to get up to the murder levels to hit presumptive sentencing that rivals Cook’s. Third-degree murder and second-degree unintentional murder will land you 20 in the pokey.”
For the most part, it’s a great piece with this one big exception:
“I’d say a few things. First, if I found out Cook sold meth to my daughter, I’d say I failed as a parent. Second, I’d say she made a decision to purchase meth and she should be punished for it. Third, I’d say Cook should be punished, too.”
When I shared the “failed as a parent” comment with members of the Family and Friends Group I co-lead at an outpatient program, the reactions ranged from indignation to sadness to fury to laughing about how ludicrous and unknowing the statement was.
Sitting at the table were a social worker, psychiatric nurse, social worker/psychiatric nurse, schoolteacher, and board member of a local NAMI (National Alliance on Mental Illness) group – all parents of young adult children with severe co-occurring substance use disorders and mental illness. I think they felt it was just another example of the stigma toward and lack of understanding of people with substance use disorders and how that stigma extends to loved ones surrounding them. I certainly felt it.
One of the parents said, “It’s not like we haven’t all blamed ourselves.” Every one of them had gone to the ends of the earth for their kids during many years of struggle.
I turned to several experts for their thoughts about the columnist’s comments on parental failure and punishing the child.
Blame the Parents?
Respected addiction journalist Maia Szalavitz, author of the new book, Unbroken Brain: A Revolutionary New Way of Understanding Addiction, said:
“Having a child with addiction DOES NOT mean you have failed as a parent, unless you severely abused, neglected, tortured or traumatized that child. Certainly, if you did any of those things, you are responsible for increasing the child’s risk of addiction. If, on the other hand, your child suffered trauma you couldn’t prevent – like death of a close family member, natural disaster, etc. – and/or had genes that made him or her vulnerable, you are no more responsible for the addiction than you would be if the kid got cancer because you have a genetic susceptibility to it and something in the environment turned it into a tumor.”
Tom McLellan, PhD knows substance use disorders well, not only as a long-time researcher in the field, co-founder, and chairman of the board of directors of Treatment Research Institute in Philadelphia, but also as a parent of two sons who struggled with addiction. (Not long ago, substance-related causes led to the death of one his sons.) He personally feels that he failed both sons. However, he does not believe “having a child with a substance use problem is the definition of a bad parent.” He explained:
“At a personal level, I know that I could have done more to prepare my two sons for what they would discover in junior high: that they would be offered alcohol and other drugs, NOT by some sinister felon, but by their friends and older brothers of friends; that because of their genetic history (virtually every male on both sides of their lineage had an alcohol problem), they would have a different reaction to alcohol (higher tolerance – able to immediately drink much more) than most of their peers; and that they had a special vulnerability to losing control over their use of alcohol and other substances.”
McLellan added, “I could have and I should have been much more explicit about giving my sons clear warning signs – well before they got in over their heads. Parents have the responsibility and the ability (if they become educated and aware) to detect and intervene concerning early-on signs of ‘abuse’ or ‘misuse’ or ‘harmful use’ before there is a life-altering accident or incident and before the abuse turns to addiction. With 20-20 hindsight I now see prevention the way I see sunblock – it doesn’t work if you do it just once, it doesn’t last long, it has to be delivered in different ways and in different contexts throughout the entire at-risk period – basically ages 10 – 21.”
Knowing Tom personally, I took issue with his points saying that the parents in our group (and I) feel so bad already. At this point, after years of dealing with co-occurring problems, blaming ourselves does no good at all, especially when all of our kids have been to multiple treatment programs that have, in many cases, failed the kids and done little or nothing to help the parents. I added:
“Looking back, I see some really naive decisions we made and dumb stuff we were blind to, but view it as very hurtful to parents to blame. I don’t think very good resources are out there or, if they are, parents are not made aware of them. I remember asking our school drug and alcohol counselor for help and getting nowhere.”
Tom’s response? “Yeah. I agree with a lot of your points.”
Punish the Child?
Whether we’re talking teens or young adults, the impulse of parents who discover their kid is using is often to take something away, kick the kid out, grounding, or to place other restrictions on things the young person enjoys.
If substance use appears to be early experimentation – say, the young person has used, purchased, or sold a substance – McLellan thinks punishment is in order (e.g., “no going out for the next month.”) He said it should be immediate, but in a modest, sensible, concerned way, and that the whole family should learn about and discuss substance use. He thinks that “a huge punishment levied in anger without any information or instruction – way after the mistake was made – is probably worse than doing nothing.” He added that regular monitoring of kids is important but that it needs to be done in the right way.
“If it is part of knowing who your kid is, what they like and don’t like, where they are, who they are with, etc. – it is all good. If it is ‘you are an untrustworthy ingrate and I will find you out’ – not so good.”
Quite differently, Szalavitz’s advice to parents whose kids are experimenting with substances is:
“Take a deep breath! Find out what’s going on with the child and how s/he explains the situation. Is this a new behavior or does the child have a long history of behavior problems? If it’s new, it’s most likely to be a teen thing – so realize that if you want to protect health, the best thing to do is not panic and then send them into a treatment program where you are basically forcing them to hang out with the kids you would ordinarily prefer they did not choose as peers.”
If you think help is needed, however, she recommends starting with a complete psychiatric evaluation done by someone not affiliated with a specific addiction treatment program. “Chances are, there are other issues if the child is addicted or heading in that direction. The most evidence-based and least likely to harm treatments for teens are family therapy and individual counseling.” She also stressed the importance of finding a counselor who specializes in working with teens, is empathetic, and “clicks with” your child.
In the end, she said, “Avoid punitiveness and battles over control as much as possible. Most teens with drug problems are hurting, self-medicating, and not going to be deterred by punishment. Help them see you are on their side, you want them to be happy, and you don’t want them to go through extra pain or take away their fun.”
“Punishing people with addictions for using drugs relies on a fundamental misconception about addiction. The National Institute on Drug Abuse and other experts define addiction as being compulsive behavior that defies negative consequences. In other words, punishment is the last thing you’d expect to help with addiction because if it worked, the condition, as defined, wouldn’t exist.”
Meeting Young People Where They Are with Family-Centered Approaches
Carol Katz Beyer and Barry Lessin, MEd, co-founders of Families for Sensible Drug Policy (FSDP), offer suggestions to empower families whom they say “are in a unique position to directly influence the development or resolution of substance use problems.”
They feel that punishment ignores the context of substance use in the child’s life, including the interaction of psychological, biological and social variables playing out in each person’s and the family’s life. (For instance, young people may be using because of an underlying mood disorder, loneliness, social anxiety, or because of family tensions – at the same time being predisposed biologically to a substance use disorder.)
It’s important to acknowledge that substance use occurs in the context of a young person’s process of development and is not assumed to be part of a disease process.-Anne FletcherThey stress the need for person-centered individual treatment for children that uses harm reduction approaches (such as helping them cut back or use less harmful substances) that meet kids where they are – all of which is more likely to engage them in treatment. It’s important to acknowledge that substance use occurs in the context of a young person’s process of development and is not assumed to be part of a disease process. Effective approaches, they say, “focus on helping them develop strategies and skills to make healthier choices and manage their emotions more effectively.”
Finally, Beyer and Lessin talk about the need for family-centered treatment such as Community Reinforcement and Family Training (CRAFT), which they describe as “a treatment model that focuses on empowerment by relying on our existing instincts, strengths, and resources. It offers us hope by helping us develop better skills to more effectively engage and intervene with our children.” (My next column will cover the new parent CRAFT on-line program.)
Szalavitz concludes that it’s important to let kids know that you’ll protect them from treatment that is disrespectful and will work with them until you find “something that helps them be their best selves.”
She adds, “Realize that this will take time, there will probably be slips – and most kids will actually be okay.”
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