Treatment Plan

Drug and alcohol addictions are treatable. The sooner you deal with the situation, the sooner your child can get well. When you suspect or know your child is using drugs, stop it as soon possible. Your first step should be talking with your child. Don't do this while your child is under the influence of drugs or alcohol.

Be calm and honest when speaking about drug-related behavior and its consequences. Teenagers need to be educated about drugs and alcohol. They need to know that using drugs is not okay or harmless, and they should be held accountable for their actions. Be clear that you intend to follow through on getting help. A parent's motto should be "never give up."

Denying the problem only lets it get worse. Eventually, you need to confront it and accept it. Once you do that and talk to your child, you need to get help. Your child probably won't be able to stop without professional help. Do not see this problem as a stigma, something that your teen can overcome by sheer will power or something that resulted from poor parenting. Accept and acknowledge the problem - that your child needs your love and guidance along with professional help. Part of getting help may include family therapy.

When you talk to your child, keep your emotions under control. Anger and yelling will only make your teen resentful and won't do much to curb the problem. You are the parent. Be kind and direct. Tell your teen you are worried and concerned. Express how much you love your child. Don't expect this conversation to be easy.

There is no one-size-fits-all approach to treatment. Often, because everyone's situation is different, various treatments are needed. Organizations such as Alcoholics Anonymous, Narcotics Anonymous and Al-Anon-Alateen for families and friends of alcoholics, can give you information about where to get help. Whatever you do, don't do it alone.

Many people with drug addictions need medical and mental health services. Those who stay in treatment for more than three months are more successful than people who stay for shorter periods. Often the more treatment someone gets, the better their chances for beating the abuse or addiction. According to the National Institute for Drug Abuse, those who receive medically assisted withdrawal with no other treatment don't do any better than those who received no treatment at all.

Support network

The support and care of family members, friends, doctors, school counselors, psychiatrists or psychologists are the building blocks to help a teen overcome addiction.

Where to go

Sometimes a hospital setting may be needed. Treatment centers devoted to just drug and alcohol addiction can also help. Your family doctor, local hospital, state or local substance abuse agencies and organizations such as Al-Anon-Alateen can refer you to treatment programs. Inpatient means your child needs to live temporarily at the facility until your child can overcome the addiction. Outpatient means the child does not stay overnight.

Types of therapy

People who abuse drugs but are not addicted to them usually get behavioral therapies such as psychotherapy, counseling, support groups or family therapy. Treatment for addiction is more intensive, involving medication and counseling. Medications help suppress cravings and help with the physical symptoms of withdrawal. Withdrawal means the drug has been stopped and the body, which has come to depend on the drug, goes through physical reactions because the drug is gone. Here are common types of treatment:

Medical detoxification. "Detox" addresses physical withdrawal symptoms while a user is slowly taken off drugs. A doctor oversees a detox program in an inpatient or outpatient setting. In addition to providing medication for symptoms of withdrawal, patients are given behavioral counseling intended to help them cope with a life free of substance abuse. Medical treatment is available to treat all kinds of withdrawal symptoms, whether a user has stopped depressant or stimulant drugs. If withdrawal is not treated, the patient will not be receptive to behavioral interventions. Even worse, someone suffering from withdrawal may become acutely ill and require hospitalization. Only after the condition is stable with medical treatment is the patient approachable for counseling.

Outpatient services. Generally, outpatient treatment does not include medications. Rather, such programs offer individual or group counseling and work best for people who might be working or in school and have a strong support system outside of the program. These programs are cheaper than overnight stay programs. Those entering these programs are usually abusers of drugs other than heroin or people who have not used heroin for long and have stable lives. Basically, these programs mostly offer drug education. Some types of outpatient programs may be more intensive and similar to inpatient services. For many of these programs, group counseling is usually offered and emphasized.

Behavioral treatment. Recovery from drug addiction and abuse is difficult. Relapses are common, particularly with drug addiction. A common therapy called cognitive behavioral relapse prevention teaches ways of acting and thinking to help kick drugs out of peoples' lives. People learn how to refuse drugs when offered and that relapse is not a failure. A successful technique is contingency management, which is a system of rewards and punishments to make the idea of staying off the drug more enticing than being on it.

Short-term residential programs. These programs are based on the Alcoholics Anonymous treatment programs. The person stays in a hospital setting for a relatively short time - three to six weeks. Then, they participate in outpatient therapy and 12-step self-help groups, such as Narcotics Anonymous or Cocaine Anonymous.

Long-term residential treatment. This offers 24-hour care, generally in a clinic. The best-known type is called a therapeutic community (TC). This is a highly structured inpatient service where people stay between six months to a year. People needing this type of treatment often have a long history of drug dependence or severe mental disorders. They may have been involved in crime, too. However, other types of long-term residential treatment may include cognitive-behavioral therapy. TCs help people re-enter society. The entire community, including the staff and the other patients, helps that person create social skills. Treatment focuses on taking responsibility for the person's own life. People examine their beliefs, sense of self and their behaviors so they can re-learn how to interact in the world. TCs can be tailored to the person's needs, but are generally used for individuals with severe drug abuse and significant psychosocial problems.

Agonist maintenance treatment. This is usually in an outpatient setting, often called a methadone treatment program. Methadone hydrochloride, or levo-alpha-acetyl methadol (LAAM), is used to help block some of the withdrawal effects of heroin and help stop the craving. This allows the person to stop looking for drugs and to function normally in day-to-day life. That means he or she can hold down a job and avoid crime. Being on this therapy allows people to be more open to counseling, social services and behavioral treatment. The best programs offer the maintenance program along with other types of treatment, such as counseling and references to medical, psychological and social services. These types of maintenance treatment programs tend to work better than TC. The doctor decides how long the person may be on this treatment. Patients are slowly taken off the medication, which has mild withdrawal symptoms.

More on Teen Substance Abuse

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This article was reviewed and updated June 2007.