The financial toll of substance use disorders in the United States exceeds $600 billion every year, including $193 billion for illicit drug abuse and $235 billion for alcohol.1 But the cost of substance abuse, addiction and dependence on the individuals who abuse drugs and their families can’t be expressed in dollars and cents, particularly when substance abuse occurs among young people whose lives are just beginning.
Young adults between the ages of 18 and 25 are abusing drugs at higher rates than in the past. The abuse of prescription drugs, which include stimulants, opiate painkillers and sedatives, is highest among the 18 to 25 age group, and daily marijuana use among young adults of college age is at its highest rate in over 30 years.2,3
The abuse of prescription amphetamines like Adderall and Ritalin among young people nearly doubled between 2006 and 2013, and 40 percent of college students and 36 percent of non-college students between the ages of 18 and 25 reported abusing alcohol to the point of intoxication at least once in the last 30 days.4
If you believe your college age son or daughter is addicted to drugs or alcohol, these statistics are a testament to the fact that you’re not alone. You’re likely battling a number of emotions—fear, anger, denial, frustration—and trying to figure out what your next steps should be. Navigating the world of addiction, treatment and recovery can be challenging, especially when you’re looking for answers online, where misinformation is rampant.
Treatment is Essential
If your child is addicted, comprehensive treatment will almost certainly be needed. The majority of people who have an addiction can’t stop abusing drugs or alcohol based on willpower alone, no matter how much they may want to stop.4
Therapy during treatment delves into the issues surrounding the abuse that led to the addiction, and it’ll help your child change self-destructive patterns of thought and behavior and cope with stress, cravings, and triggers, all of which are essential for successful lifelong recovery.
Whether your child is ready to get help for a substance use disorder or is in denial that there is a problem, the best way you can help to overcome a drug or alcohol problem is to educate yourself about drug abuse and how resulting changes in the brain lead to addiction and dependence.
Drug abuse, addiction and dependence are not the same thing, although they’re closely related. Understanding the differences can help you decide how to proceed and what kind of treatment your child might need.
What is Drug Abuse?
The University of Maryland Medical Center defines drug abuse as:
- The act of using any illegal drug
- Using prescription medications in any way other than as prescribed
- Binge drinking, which is defined as consuming enough alcohol over the course of two hours to raise the blood alcohol level to .08 percent—typically four drinks for women and five for men5
- A complete loss of control over drug or alcohol use.
- Neglecting hobbies or activities once enjoyed.
- Attendance problems at work or school.
- Neglecting responsibilities at home, work or school.
- Taking risks to obtain drugs or alcohol, or taking risks while under the influence.
- Relationship problems with family, friends or co-workers.
- Becoming defensive or combative when someone tries to address the drug or alcohol problem.
- Hiding the extent of the drug or alcohol abuse from others.
- Changes in appearance due to an increasing neglect of hygiene.
- The inability to stop using drugs or alcohol despite the problems it causes with physical and mental health, relationships, finances and the law.
- Keeping your feelings inside so that you don’t come across as “nagging”
- Accepting your child’s justifications for abusing alcohol or drugs
- Minimizing the addiction by telling yourself it may not be that bad or that it could be worse
- Protecting your child from the consequences of her addiction, such as making excuses for her behaviors, giving her money, or bailing her out of jail
- Worrying constantly about the consequences of your child’s addiction
- Lying to other family members about her drug abuse or avoiding contact with others so that you don’t have to explain anything
- Aiming the anger you have toward your addicted child at other family members; and engaging in activities like excessive shopping, exercising or eating as a way to cope with your reality
- Managing cravings and stress
- Having a safe and stable place to live
- Participating in productive and meaningful activities every day
- Having a supportive network of people
Drug abuse often results in consequences like problems at work, home or school; legal troubles like DUI and possession charges; relationship problems with family, friends, or co-workers; and engaging in risky behaviors, such as having unprotected sex or driving while intoxicated.
Abusing drugs or alcohol can lead to addiction and dependence. The factors that determine whether an addiction will occur are about 50 percent genetic and about 50 percent environmental and cultural, according to the National Council of Alcoholism and Drug Dependence.6
What is Addiction?
Addiction is characterized by compulsively using drugs or alcohol despite negative consequences.7 People who are addicted to a substance of abuse are unable to stop using that substance, even if they have a desire to quit.
Addiction results from changes in the functions and structures of the brain. When psychoactive substances cause dopamine to flood the nucleus accumbens, or the reward center of the brain, the memory center, known as the hippocampus, records the memory of the pleasure it produces. The amygdala, associated with survival instincts and memory, creates a conditioned response to certain stimuli associated with drug use, and cravings for the substance begin to occur.
With repeated exposure, the nerve cells in the nucleus accumbens communicate with those in the prefrontal cortex, which is responsible for the planning and execution of tasks, and the result of that communication is the uncontrollable urge to engage in the source of pleasure.8
According to the National Council on Alcoholism and Drug Dependence, the signs and symptoms of addiction include:9
Addiction is a complex disease of the brain, and willpower and good intentions are rarely enough to help someone with an addiction quit using drugs or alcohol.
What is Dependence?
Dependence on drugs or alcohol is characterized by withdrawal symptoms that set in when drug or alcohol use suddenly stops.
When someone chronically abuses drugs or alcohol, the brain compensates by changing the level of activity of certain neurotransmitters. For example, the brain compensates for chronic alcohol abuse by reducing the activity of the neurotransmitter GABA, which produces feelings of pleasure and relaxation, and increasing the activity of glutamate, which is responsible for feelings of excitability.
These changes in neurotransmitter activity lead to tolerance, which means that it takes increasingly higher doses of drugs or alcohol to produce the desired effects. Eventually, these brain changes become the regular way the brain operates.
At this point, when alcohol or drugs are withheld from the body, the increased or suppressed activity of neurotransmitters and their subsequent rebounding cause withdrawal symptoms, which may be so intense that the person with the dependence turns immediately back to drug use if only to ease the discomfort.
While someone can be addicted to drugs without being physically dependent on them, addiction and dependence most often occur together.
Addiction is a Family Disease
You probably know all too well that addiction doesn’t just affect the person who is addicted to drugs or alcohol. Your child’s addiction has far-reaching consequences for the family, which is why the National Council on Alcoholism and Drug Dependence calls addiction a “family disease.”10
Addiction affects the stability, finances, unity and physical and mental health of the family, leads to dysfunction within the family system and increases the chances that younger children in the household will engage in substance abuse and other self-destructive behaviors later on down the road.
Maybe your child is ready and willing to seek help for an addiction. If so, the family’s involvement in treatment can dramatically improve the chances for successful long-term recovery.10 Family involvement in treatment will likely include attending educational workshops specifically designed for family members, attending family support group meetings, and engaging in family therapy with your child and other immediate family members.
If you’ve tried to talk to your child about his addiction but were met with denial or hostility, you may feel completely at a loss as to how you can help your child admit he has a problem and agree to seek treatment.
Whether your child is ready to get help or he insists—and maybe even believes—that he doesn’t have a problem, arming yourself with knowledge about the disease of addiction and learning how it has affected the family system is essential for either helping your child recover or leading him to the realization that he needs help.
Enabling and Codependent Behaviors
Addiction leads to unhealthy and harmful attitudes, beliefs and behaviors among family members, many of which you may not even be aware of. These include codependent and enabling behaviors, which must be identified and changed in order to restore function to the family system and fully support your child’s recovery.
Enabling and codependent behaviors can perpetuate the cycle of addiction.11 Enabling behaviors are actions that directly or indirectly support your child’s substance abuse. You and other family members may engage in these behaviors out of fear, out of love, or both, but they are almost always to the detriment of your child.
Enabling behaviors include:
Codependent behaviors are the result of adapting to your child’s addiction and the dysfunction it causes within the family system. These behaviors lead you to become so engaged in your child’s addiction that you neglect your own and other family members’ physical and mental health and emotional and spiritual wellbeing.
Codependent behaviors include:
Understanding how family members may unwittingly support a loved one’s addiction, and learning how to replace unhealthy beliefs and behaviors with those that will support your child in the best possible way, is essential for improving the chances that your child will seek help, and it’s crucial for helping to ensure a positive outcome after treatment.
Family Support and Therapy is Essential
Individual therapy for the family members of an addicted loved one is essential for helping to restore function to the family system, getting your loved one to seek treatment, and effectively supporting him during and after treatment.12
Therapy offers you and other family members a safe place to address and work through the complicated emotions associated with your child’s addiction and learn healthy and productive ways of communicating with him, whether or not he has agreed to treatment. Age-appropriate therapy for minor children in the household can effectively reduce their risk of developing a substance use disorder or engaging in other destructive behaviors later on.
Additionally, family members should participate in a support group like Al-Anon, Nar-Anon, or Alateen, which helps reduce feelings of isolation, frustration, anger and fear and helps you more effectively lead your child to the decision to seek help for the addiction. Support groups offer a sympathetic ear, helpful advice, essential resources and coping skills and strategies.12
Intervention for Your Treatment-Resistant Child
For the child who is in denial or resistant to treatment, holding an intervention may lead her to the realization that she needs help.
An intervention is a meeting with your child that’s planned by you and other concerned loved ones, during which each of you explains to your child how the addiction has directly and personally affected you. You’ll offer her the opportunity to enter a treatment program right then and there, and each loved one in attendance outlines clear consequences that they’re prepared to follow through with should she refuse treatment.
Interventions that are planned and facilitated with the help of a professional interventionist have a 90 percent success rate in getting the addicted individual to agree to treatment.13 You can contact a mental health professional, addiction counselor or a drug or alcohol treatment center to learn more about staging an intervention.
Choosing a Treatment Program
Finding the right treatment program for your child is essential for ensuring the best chances of successful recovery. All high-quality treatment programs will adhere to the principles of effective treatment as described by the National Institute on Drug Abuse, and they should utilize research-based therapies and best-practices treatment protocol.14 Therapy should be provided by qualified and licensed mental health professionals, and the program should take a holistic approach to treatment that addresses issues of mind, body and spirit.
Inpatient, or residential, treatment programs are best for those who are ambivalent toward recovery, have a long history of drug abuse and addiction, or who have a mental illness that co-occurs with the addiction.
Inpatient programs are typically more effective than outpatient programs. However, if your child is highly motivated to recover and has a high level of support at home and in the community, an outpatient program will allow him to continue working or attending school while being treated.
Detox is the First Step
If your child has developed a physical dependence on a substance, a high-quality treatment center will offer medical detox, which is supervised by a team of medical and mental health professionals. During detox, all traces of the substance will be allowed to leave the body, and brain function will begin to return to normal. Medications will be administered as needed to help alleviate the intensity of withdrawal symptoms and, in some cases, shorten the duration of detox.
Complementary treatments may be available to further increase comfort and wellbeing, including yoga, acupuncture and massage therapy. During medical detox, your child will be evaluated for any mental disorders, and a comprehensive treatment plan will be developed.
After detox, treatment will begin, and it will involve various traditional and alternative therapies that take place in individual, group, and family settings. Cognitive behavioral therapy (CBT) is one of the most effective and widely used treatment therapies. CBT helps your child identify self-destructive thoughts, ideas, attitudes and behaviors and replace them with healthier and more productive ways of thinking and behaving.
Motivational interviewing is another effective therapy that helps those who are ambivalent toward sobriety become intrinsically motivated to recover. These and other therapies will address the many complex issues behind the drug abuse that led to the addiction, and your child will develop coping skills and strategies to handle stress, cravings and triggers.
Once the treatment program is complete, an aftercare plan will be developed based on your child’s individual needs. The aftercare plan will likely include ongoing individual, group and family therapy and participation in a peer support group.
Depending on your child’s needs, spending some time in a sober living facility may help ease the transition from rehab back to regular life, and vocational rehab can help your child hone her job skills and assist her with finding and maintaining employment.
If a mental illness co-occurs with the addiction, the aftercare plan will include ongoing evaluations of the mental illness and any medications used to treat it. Legal or educational assistance are also available to those who need it.
Through ongoing individual and family therapy and participation in a family support group, you and other family members will be armed with the information and resources you need to help your child through the early and most difficult months of recovery. You’ll learn the mechanics of relapse and how to best support your child to promote long-term sobriety, and the family will continue to work together to improve communication and restore function at home and repair damaged relationships and broken trust.
Hope Is the Foundation of Recovery
The Substance Abuse and Mental Health Services Administration cites hope as the foundation of recovery.15 Additionally, the four major facets of recovery include:
Your child’s successful recovery will be based on his existing strengths, his inherent values and abilities, the coping skills he develops in treatment and the resources available to him.
No matter where your family stands at this moment, there is always hope. The better you educate yourself and take care of your own physical, mental and spiritual needs, the better you can help your child. The more you participate in your child’s recovery, the better the chances are that your entire family will emerge from the ordeal of addiction stronger than ever before.
- DrugFacts: Understanding Drug Abuse and Addiction. (2012, November). Retrieved from http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction
- Prescription Drug Abuse: Adolescents and Young Adults. (2014, November). Retrieved from http://www.drugabuse.gov/publications/research-reports/prescription-drugs/trends-in-prescription-drug-abuse/adolescents-young-adults
- College-Age and Young Adults. (2015). Retrieved from http://www.drugabuse.gov/related-topics/college-age-young-adults
- Monitoring the Future 2013 Survey Results: College and Adults. (2015, April). Retrieved from http://www.drugabuse.gov/related-topics/trends-statistics/infographics/monitoring-future-2013-survey-results-college-adults
- Drug Abuse. (2013, February 8). Retrieved from http://umm.edu/health/medical/ency/articles/drug-abuse
- Addiction: Family History and Genetics. (2015, April 25). Retrieved from https://ncadd.org/about-addiction/family-history-and-genetics
- Is There a Difference Between Physical Dependence and Addiction? (2012, December). Retrieved from http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence
- How Addiction Hijacks the Brain. (2011, July 1). Retrieved from http://www.health.harvard.edu/newsletter_article/how-addiction-hijacks-the-brain
- About Addiction: Signs and Symptoms. (2015, July 25). Retrieved from https://ncadd.org/about-addiction/signs-and-symptoms/signs-and-symptoms
- Substance Abuse Treatment and Family Therapy. (2004). In Treatment Improvement Protocol Series (Vol. 39). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64269/
- Stairway to recovery: Changing Enabling Behaviors. Retrieved from http://www.uphs.upenn.edu/addiction/berman/family/changing.html
- Family Disease. (2015, July 25). Retrieved from https://www.ncadd.org/family-friends/there-is-help/family-disease
- Intervention: Tips and Guidelines. (2015, July 25). Retrieved from https://ncadd.org/get-help/intervention
- Principles of Drug Addiction Treatment: A Research-Based Guide. (2012, December). Retrieved from http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/preface
- Recovery and Recovery Support. (2015, October 5). Retrieved from http://www.samhsa.gov/recovery