Kristen

Welcome to the Close the Chapter podcast. I am Kristen Boice a licenced Marriage and Family Therapist with a private practice pathways to healing counselling. Through conversations, education, strategies and shared stories. We will be closing the chapter on all the thoughts, feelings, people and circumstances that don't serve you anymore. And open that door to possibilities and the real you. You won't want to miss an episode, so be sure to subscribe.

Welcome to this week's Close the Chapter podcast I'm so glad you are joining me for this episode. I'm having a repeat guest for a reason because we are in a mental health crisis. In particular teens, young adults are focused on teens in this conversation. So if you have kids, teens, grandkids, friends around the same age, you will definitely want to listen to this episode. Maybe you're a mentor of some kind, whatever that looks like. This is an important episode because we're talking about substance abuse post pandemic, what numbers have changed, what numbers have gone up? And then what are we going to do about it and how we're going to handle it. So pass this along to anybody that's a parent of a teen, please, so we can start the conversation or our teachers, educators, anyone you know that works with kids or has contact with them. This is an important episode to put out into the world. So feel free to share it with those that could hear and use this information. So Richard Caprio, Allah has been a mental health and substance abuse counsellor for over two decades, he retired from the manager clinic and Houston, where for over a decade he treated both teens and adults. He is the author of addicted child, a parent's guide to adolescents and substance abuse. And he was also on episode 174. So if you want to listen to our first conversation, he talks deeply into warning signs, we did not get into that. In this episode, we got into a little bit we really took a deeper dive in Episode 174. And we highlighted important information not really overlapped much in the two episodes. This episode, I took a deeper dive on how to handle this, how to approach this some things we're hearing from parents, and we really want to come from a place of not shaming parents, because this is emotional for the parents too. And you'll hear our recommendations for parents and what to do for themselves and for their family. So if you want the free healing guide, be sure to grab that if you haven't already done so at Kristen D boice.com. K r i s t e n, d Boice B O ice.com forward slash free resources. It's free, you can reuse it. I love it. So feel free to grab that. And then follow along on social media at Kristen D Boice. Just for helpful content on Instagram, Facebook, and then tick tock which I still haven't figured out is Kristen Boice interests. So without further ado, here's my important conversation with Richard. Welcome to this week's close the chapter podcast. I am thrilled to have a returning guest. Richard, welcome back to the close the chapter podcast.

Richard

Thank you, Kristen, it's a pleasure to be back here with you again to talk about this important topic. Really appreciate you having me back on,

Kristen

you reached back out and you said I have a new research one year post pandemic that I think's worth talking about. I completely agreed because we're seeing this in our practice with teens and usage of alcohol up tick. We've got vaping we've got increase in ADHD medicine. We've got a lot going on here. So I would love to jump into some of the highlights of this new research that you're seeing with teens. Sure.

Richard

Thank you prior to the pandemic, I think the thing that stood out the most is we were seeing a dramatic increase in vaping of nicotine and marijuana. And that's where teenagers would use an instrument or vaping pen. It would take marijuana or nicotine and turn it into a vapour and then they would inhale it. So for about three consecutive years, year after year, we were seeing a tremendous a dramatic increase in the number of teenagers that were vaping, nicotine and marijuana then the pandemic comes along. And a pandemic caused a significant decline in adolescent use of substances across the board. Why? Mostly because kids were pulled away from school their social engagements, their peers, their academic and as well as their non academic extracurricular sports activities. So we saw a rather dramatic decline in teenagers using substances across the board for that year, we now have data that just came out what happened with adolescent substance abuse a year after the pandemic, than what we saw was that there was a rebound an increase in teenagers turning back to substances. But still, for most drugs below the pre pandemic level, with the exception of alcohol. Alcohol seems to have returned to pre pandemic levels. But for most drugs, for example, if you look at all drug use, prior to the pandemic, it was about 37% of high school seniors, it dropped to 32% during the pandemic, and then it rose very slightly to 32.6% of high school seniors. If we look at marijuana, for example, prior to the pandemic high school seniors about 35% were smoking marijuana that drop down 30%. That was the largest one year drop in marijuana use among teenagers recorded in 48 years, it was a dramatic decline. It rebounded slightly went from 30.5 to 30.7%. Alcohol was the biggest rebound, it went from 55%, prior to the pandemic dropped all the way down to 46%. And then it rebounded back to 52%. That's a statistically significant increase. So alcohol rebounded much more so than than the other substances. So overall, we're seeing a slight rebound in teenagers returning to substance use. Now, obviously, it's going to take a number of years to see if that rebound continues, and we get back to or above the pre pandemic levels. But the indicators are that kids have returned to using substances but not as much as prior to the pandemic, we'll find out in years to come If that trend continues. And we actually do get back to the pre pandemic levels. I hope not, but the indicators are that we're moving towards kids getting back to that pre pandemic level.

Kristen

So when you say pre pandemic, you're looking at before 2020, just to be clear on the research,

Richard

I'm looking up to 2020. And then the pandemic 2021 is when we see the significant drop.

Kristen

Okay, and then there's 2022 numbers is where you're seeing the increase?

Richard

Yes, that's correct. So we go from 2020 pre pandemic, where the levels are fairly high, a significant decline in 2021, during the pandemic, and then a slight rebound in 2022. For most drugs, with the exception of alcohol, which rose the most so 2022 is the first year where we have an indication of how much of these drugs rebounded after the pandemic.

Kristen

Yeah, cuz 51.9% increase is what you're saying for is that when you say rebound, it rebounded to 51.9% of teens using alcohol. Is that what you mean by that

Richard

51.9% of high school seniors reported drinking alcohol? Well, during the pandemic, it was only about 46.5%. So it went from 46.5 to 51.9% of high school seniors telling us they were drinking alcohol.

Kristen

Okay, so what's the long term impact of these statistics?

Richard

The long term impact I think, is sort of a signal that we may be seeing teenagers returning to pre pandemic levels of using substances. And that we may see year after year as we move forward, some of these statistics increase as kids returned back to the pre pandemic levels. So we would see an increase in marijuana use, we would see an increase in vaping, we would see an increase in some of these other drugs. Alcohol probably will stabilise about where it is now. I don't suspect we'll see big increases in alcohol drinking, but some of these other drugs like marijuana, for example, we may see some more increases in those in the future years.

Kristen

Okay, so let's talk about practical terms here. So we're seeing that in our practice, and an increase in substance uses in teens since the pandemic, and in some cases, we have kids sneaking large amounts of alcohol. And so the parents put them in an intensive outpatient programme. And what that means is they go weekly, or daily for a certain amount of time, do therapy support group medication, and try to stabilise right that's more of a stabilisation, where they can make some movement there. We're not seeing a whole lot of headway people are making in some of these IOP programmes in relation to alcohol use, specifically some substance use. What do you think is going on with that?

Richard

My first question would Be for these kids have they had a comprehensive assessment? Have they had an assessment more so than just the alcohol and the drugs, because sometimes parents will focus on the alcohol and the drugs and they rush into treatment and they say, oh my gosh, the kids smoking marijuana, drinking alcohol, we need to put him in treatment for that. And they skip the step of getting a comprehensive assessment to either rule in or rule out, if there might be some other issues that need to be treated like anxiety, or maybe depression or trauma or some type of emerging personality disorder. And sadly, many of these conditions get undiagnosed and therefore untreated. So we put the kid into an intensive outpatient programme or outpatient programme that focuses on alcohol and drugs. And then we wonder, Why didn't that work? Why didn't it solve the problem? Well, it didn't solve the problem, because you didn't treat the entire problem. You treated the alcohol and drugs, but you didn't treat the anxiety. A good example of that is many of the teenagers that I worked with, when I was working at Menninger Clinic, who were smoking marijuana, were smoking marijuana because of anxiety. That's what they told me, they helped him with their anxiety. So if I were just to treat the marijuana and ignore the anxiety, the probability of those kids staying away from marijuana for any extended period of time was probably very low. If you have what we call a dual diagnosis where a child is dealing with both a substance use disorder and a mental health issue, you need to treat both those issues you need to treat the substance use and the mental health issue. But unfortunately, many of those mental health issues go undiagnosed, because they were never assessed in the first place. So my first question would be, did those kids did those children get a comprehensive assessment? And if they didn't, they should,

Kristen

I think that's spot on. Because that's the first thing we recommend. They go in there for some stabilisation, maybe some coping skills, we're seeing more general IOP rather than a specific drug or alcohol for teens, and particularly want to put them in a general ILP. But they're not doing a psych eval, the psychological evaluation assessing is there something else to your point going on, they just put them in the programme. And so we don't really know we're treating all the symptoms, but we don't really know what's happening underneath all of that.

Richard

We don't know what the cause is, we treat the symptoms, but we don't know what the cause is, well, it's like anything else, if you don't know the cause, you don't know if you're treating everything that needs to be treated. And that increases the likelihood of a teenager relapsing.

Kristen

So the first recommendation is yes, you may need some stabilisation, and at the same time, get an appointment for a psychological evaluation.

Richard

Absolutely, you want to get a substance abuse assessment, so that you get a clearer picture of the drugs that the child has been using. You want to get a good physical exam, to make sure that there's nothing physically going on that needs to be treated. And then you need a psychological a good comprehensive psychological exam to either to give you information as to whether or not there are any of these psychological issues like anxiety, for example, that your child is battling with, that needs to be treated. And then you can put together a comprehensive treatment plan that will address everything that your child is confronting.

Kristen

Very good. Now, let's talk about your research that you've found out about the use of increased prescription ADHD medication. Yes, there's some more about the findings there.

Richard

Well, what we discovered was that there was an increase in prescribe medications for ADHD, we think because it rose significantly in 2022. And I think part of that was maybe a little bit because of stress during the pandemic that kids were going through, and families were going through as well. But I think because kids were sheltered at home for such a long period of time, and many parents were sheltered at home for such a long period of time, we think what happened was that parents became more aware of their child's attention deficit problems and struggles because they were at home and parents were able to notice it better. And that led parents to be concerned about their child's attention issues, and they took their child to get them assessed to a physician. And that resulted in a diagnosis perhaps of ADHD, or some attention deficit difficulties. And they were put on prescribed medication. So that's why we think we saw an increase in the prescribed medications for ADHD. We think parents just became more aware of their child's attention struggles while they were at home during the pandemic.

Kristen

Do you think that has significant value for future? What are your thoughts on the impact of that now?

Richard

I think it brought to the surface that there are a lot of kids out there that are struggling with these issues that go undiagnosed and unnoticed they sort of get lost in everything that's going on in life from day to day, and they sort of struggle with this on their own, and they adapt and learn to get by it, it only really comes to the parents attention and to teachers attention when it gets to the point of really, academically or behaviorally affecting them. But there's probably a lot of kids that are flying below that level that are just getting by. They may be struggling internally with it. But it hasn't risen to the point where somebody says, Hey, this is a problem, we need to find out what's going on here. And unfortunately, that leaves us to sort of struggle on their own.

Kristen

So let's talk about the statistics on been drunk. So we were talking about the increase in alcohol use. Let's talk about is it important to track whether the child's been drunk because that was separated out in the research? Tell me a little bit about that?

Richard

Well, I think it's just an indication of the extent to which teenagers are abusing alcohol. That's an interesting statistic because it also filters into another area that the researchers look at. And that's harmfulness. This research has two interesting aspects to it. Aside from just measuring the substances that kids are using, it also measures and gets a handle on how available these drugs are availability, and riskiness. So they get input as to how available are these drugs. And across the board? What we see is that these drugs are readily available to kids, and they know it, we ask kids, how easy is it for you to get marijuana? 80% of them tell us it's no big deal? We ask them? How easy is it for you to get alcohol again, around 80%? Say no big deal, we can get it. So these drugs are readily available and kids know it. So then we asked them in the survey, how dangerous Do you think these drugs are? And again, across the board, what we see is that teenagers don't think the majority of these drugs are very harmful. And I mean things like alcohol and marijuana. They do see drugs like fentanyl and cocaine and hallucinogens as being more dangerous. But they don't think that drugs like alcohol, or marijuana or even vaping is very harmful. So the two key findings are these drugs are readily available, and kids know it. And they don't think that most of them are very harmful.

Kristen

Do you think it's important, we're changing the narrative around the impact that it has on your brain development and body? Like what impact does it have? So if they say it's no big deal? It's not a big deal. We know risky behaviours can happen if someone's drunk or using how does it impact brain development? And do we need to be educating them on that?

Richard

Absolutely, we need to be educating them on that. And that, I think, is one of the biggest failures that we have going in the education system, when it comes to trying to help kids stay away from drugs, it does no good to tell these kids that drugs are illegal or that they're bad for them. Or that they may get bad grades or not graduate or go to college or get a job because none of that means anything to them. But yet, that's the approach we use. And too many schools will have an assembly will bring in a law enforcement official will tell them drugs are bad for them. And they sit through that assembly and they don't pay attention because they don't care. And they don't believe that stuff. But what I found does matter to them. What makes a difference is a neuroscience approach. Because kids are very curious, they want to learn, they want to know how things go. They want to know what their brain does. And we know that our brains don't become fully developed until around age 2425. If we're looking for a way in which to reach these kids, I would start in elementary school. And I would start by just simply teaching them about the brain, not about drugs, just any Elementary School, teach them about the brain, what it does, what different areas are responsible for you got an area of the brain that helps you with talking helps you with walking helps you reason things through. So then an elementary school, they get a good understanding of how important the brain is, what it does, and the need to protect it. Then when they get into middle school and high school, once they have an understanding of the brain, which they learned in elementary school, then you can start to introduce the concept of what do drugs do to the brain. You now know what the brain does you know how important it is you know that you need to protect it. Now let's see what drugs do to the brain. And through middle school and high school, reemphasize to them every year, what these drugs do to the brain. And I think that's an approach that is likely to be more successful with kids because it's based upon a neuroscience approach. And it's based upon capturing their interest in learning about things and it focuses on helping them understand the importance of protecting the brain.

Kristen

That's a high level explanation of what alcohol and then what marijuana does, perhaps to the brain what would be a high level explanation.

Richard

The best example I can give you is what I saw when I was working with teenagers Zap Menninger Clinic. And these were kids who were very bright, very high levels of IQ. But they were smoking a boatload of marijuana, oftentimes multiple times a day. And when the psychological tests came back on those kids, what we saw in many cases was the processing speed of their brain was below average, their short term memory was impaired, and their motivation was very low. Now, most of these changes, you wouldn't readily notice they're not that observable. So parents would miss them, educators would miss them. But through psychological testing, we could uncover that some of these things were going on in the brain, the brain just wasn't processing the way that we would want it to process and the short term memory was impaired. So these drugs have the impact of producing changes within the developing brain. And I think the important thing to remember is, the adolescent brain is a developing brain. It's a maturing brain, it is very vulnerable to being impacted by these drugs in negative ways. And parents, I think, need to know that protecting that child's brain is a very important because it's vulnerable.

Kristen

What about alcohol? What does alcohol do to the brain? Well, alcohol,

Richard

any of these substances, whether it's alcohol, whether it's marijuana, whether it's nicotine, whether it's an illicit drug, like cocaine, or hallucinogen, all of these drugs, including alcohol, all eventually hit the brain in one way or another, they get to the brain. And therefore, each of these drugs has the potential for having an effect on the brain a negative effect on the brain. And it's a slow process, it develops, and it happens over time. So you're not maybe gonna see an immediate impact on the brain. For some of them, you'll see like marijuana, you might notice it slows the kid down, they become lazy, they're not interested in things, alcohol, much more likely is going to take time to see the damage on that. But again, the message that I say is protect that brain from all substances that are elicited, whether it's a drug or whether it's alcohol, because that brain, your child's brain, is in the process of developing critical skills, critical connections that need to be protected throughout adolescence and even into early adulthood.

Kristen

Okay, so here's what I did early on with, I don't know if you've heard of brain mapping, where you put electrodes for the audience that might not know you put like kind of a cap on the hookup electrodes to like, kind of take pictures of your different parts of your brain. This is how I understand it, feel free to jump in and correct me. And then they have kind of a database of pictures of other brains. And they can overlap the picture of your brain with other brains. And they can assess what might be going on in your brain, they can look at ADHD, what part of the prefrontal cortex is lit up or maybe not lit up, they can look at autism, they can look at many different types of mental health issues. They can also look at addictive brains. So I could tell very early on one of my daughters had a propensity. And I don't know if it was an we call it addictive brain. But when we did the brain mapping, it was called an addictive arrayed because it looked like other addictive brain. So early on, we were able to show her a picture of her brain and say, alcohol and drugs are absolutely a no go like you will be. Do you know much about the genealogy of an addicted brain? Is there such a thing? I mean, is this Do you know much about that?

Richard

Well, if my genealogy You mean a genetic component to a predisposition to substance, we have known for years that genetics plays an important role in a person's vulnerability to become addicted. Part of an addiction is genetics. And that's no different than any other disease. For example, if you have hypertension in your family, what does it mean? Means you're prone to getting hypertension, if you're a woman, and you have breast cancer in your family, what does it mean? It means you're at risk of getting breast cancer doesn't mean you're going to get the diagnosis or the disease, it just means that you are genetically wired, that places that disease at risk for you. It's no different than addiction. If you have a family history of alcoholism, if you have a family history of drug dependency, what does it mean? Like any other disease, it means you're vulnerable doesn't mean you're going to become an addict doesn't mean you're going to become an alcoholic. It means you're vulnerable, but it takes more than genetics to get a person across the line to become addicted. So we think that genetics plays 40 to 60% of a person's vulnerability. So what's the remaining vulnerability? Its environmental factors, its high levels of stress, its levels of of abuse. It's all of these psychological issues, anxiety, depression, post traumatic stress disorder, any type of trauma, any type of an emerging personality disorder. So when you take the genetic predisposition and you add the environmental stresses, the environmental factors, a person becomes more at risk of developing a disease. So genetics is an important role. But it takes more than genetics to push a person over the line to become addicted to a substance.

Kristen

Yes, we were doing it because she came to speak to our team at our office, I was like, Oh, this sounds interesting. Let's all get this done. And it was interesting because she was young. It's interesting, because how I understood it is it can turn on, like you're flipping a switch. So if you have early exposure to let's say, you have your first sip of alcohol young or you start smoking marijuana, you said there's a guarantee, but there's a more likelihood that that can activate the younger you are that addictive brain. Talk to me about that? Well, I

Richard

think that adolescence is a vulnerable time for any substance use. Almost all addiction begins in the adolescent years. There's some exceptions to that for hardcore drugs, and maybe even alcohol that might start in the 20s. But generally, adolescence is a very vulnerable time for a person becoming hooked on substances, whether it's alcohol or drugs, just about all addiction has its roots back into the adolescent years where a child might have started experimenting with a substance, they might not have gotten to the point where they qualify for a diagnosis of a severe substance use. But it starts on that path that may not emerge until they get into adulthood. The beginnings of addiction, I think, in too many times, far too often begins in adolescence.

Kristen

And there's some pretty heavy research around that, like how starting young can start the pattern.

Richard

And again, we get back to the brain, we get back to the brain being so vulnerable in those early years, makes a person much more vulnerable to become addicted, because you're pushing those drugs into that vulnerable brain.

Kristen

I like how you're saying vulnerable brain, I think that's a really helpful way to frame that. The other piece that I want to explore around this is parents that say things and they don't mean any they think they're being helpful. And maybe they are when they say I'd rather than drink at my house, because then I know where they are. And then the kids can spend the night and things like that. What do you say to that one, I'm going to give you a couple of these.

Richard

What I would say to that is that the research shows just the opposite have this in my book, the research shows that parents who allow their child to drink alcohol at home, those children go on to leave home and end up drinking more than children who came from homes, where parents made it very clear that drinking alcohol was not tolerated in the home or outside of the home. These kids who come from homes where the parents allow them to drink at home, go on to college, go on to jobs, perhaps and the research would show that they end up drinking more alcohol than kids who came from a home where it was totally and completely discouraged.

Kristen

Is it pretty staggering. The statistics do you know off the top of your head what those are,

Richard

I don't know the degree how much more it is I was just found it interesting that those kids did go on and ended up drinking more alcohol. I guess they were primed much earlier.

Kristen

That's what I find in my practice, that the younger anybody in this is proving through what you're saying and the research that I asked a timeline of when was their first sip of alcohol. We explore family history, mom, dad, caregivers, extended family, siblings we go through, or drugs or smoking or we look at all of that to explore. When did that get activated? How did that begin? And then some will say for example, I'm just throwing out some things parents have said like, oh, it's no big deal. everybody smokes pot, they're experienced that they're gonna do that in high school, they're gonna do that in college. It's not that big of a deal.

Richard

That's a very dangerous attitude. Because you have no control over it. The child might just start smoking marijuana. And if you have the attitude was no big deal. They're not doing it that often. Well, they may not be doing it that often right now, but you're sort of opening the door where it gets out of control or it leads to other drugs. So any use has the potential to spiralling out of control very quickly.

Kristen

And the other rationalisation Well, it's for marijuana. It's natural. It's a plant base. It's safer than drinking. I'd rather than smoke pot and drink alcohol because it's safer. These are some of the things hearing parents say because there won't be using marijuana on the side and therefore they're rationalising it. Not always but a lot of time I'm what's happening. And they're like, well, people use it for medicinal reasons. See, this is what I'm hearing. So talk to me about that.

Richard

Well, this idea that it's just a plant doesn't fly very well, because poison ivy is a plant too. But I don't want to be around that. The idea that it's legal in some states, marijuana, and therefore it must be safe, all misses the very critical point that what may be okay for adults is not okay for adolescents. And it's not okay for adolescents because unlike adults, adolescent brains, again, are in the process of maturing, and much more vulnerable to becoming damage than an adult. So an adult may be smoking marijuana, and they may be in their 20s 30s 40s 50s 60s, whatever. But their brains fully developed an adolescent smoking marijuana is pushing that marijuana into a developing brain at a very crucial time for that brain development. So what's legal for adults doesn't necessarily mean that it's healthy for adolescence.

Kristen

Here's the other piece. Well, I smoked, I drank, and I'm fine. Do you know what you could turn on for your kid your kid may be different than so what do you say to that?

Richard

What I say to that is to parents that might have been smoking marijuana in the 60s or 70s. Your marijuana is nothing like the marijuana that's on the streets today. The marijuana you may have been smoking back in your youth might have had a THC content of two or 3%. The marijuana that your kids are smoking could be as high as 60, or 70, or 80%. It is much more powerful. And there are much more dangerous drugs out there now like fentanyl, for example, that could be deadly to your kids. So the drugs that you were smoking back in your youth are nowhere near the drugs that are out there on the street today. They're much more powerful, and they're much more deadly.

Kristen

And then what about alcohol I drank when I was in high school, and I'm fine.

Richard

Well, many parents have and many parents continue to drink alcohol. But again, the message is your child's brain needs to be protected. And even though you might have drank when you were in high school, in college, you want to be very careful about allowing your child to drink in their adolescent years. And you need to help them understand that their brain needs to be protected. And that alcohol, like any other substance eventually works its way to the brain.

Kristen

Okay, so let's put this in practical terms. Let's say the parents are struggling with the child that's using. Let's say they're using marijuana, they're using alcohol, and they have no idea what to do. They're like, I don't know what to do to handle this. I feel like it's out of control. I don't know what to say or do what would be your recommendation?

Richard

Well, first of all, I would say that like many parents, this got to a point where it got out of control. And you got blindsided as a parent. And now you probably feel pretty bad, you probably feel that you messed up. How did this happen to my kid what went wrong, and you're probably in a crisis situation about what needs to go on. And this happened, because you did not know the warning signs to look for. It's like any other disease, any other issue. If you know what the warning signs are, and you know what to look for, you're much more likely to catch a problem early on and intervene. When I was at Menninger Clinic, many of the parents that I worked with, I would sit across from them. And I would go through their child's history of using a substance and they would look across at me and they would say I had no idea this was going on. Or they would say I sort of thought something was going on. But I didn't think it was this bad. These are good parents. These are very good parents doing the best job they can. They missed the warning signs because nobody told them what to look for. And that's the number one reason why I wrote my book was to give parents the warning signs, know what the warning signs are, you're much more likely to catch a problem and intervene before it becomes a crisis. But if you're to that point where it's a crisis, because you missed the warning signs, the first thing you need to do is have a conversation with your child. First of all, find out what's going on if you can. And by that I mean don't punish the child, don't threaten. You want to come at that conversation with an inquiring point of view. In other words, I'm noticing this or I'm concerned about this or I'm feeling that you might be using marijuana and that scares me that frightens me. Can you help me understand why I'm feeling that way? Now, that's a conversation that may blow up, may become argumentative child may become defensive or you might learn something. But regardless of where you are, as a parent, if you are concerned that your child is using a substance, then I think you need to get the assessments done that I recommend in my book, you need to get an addictions assessment. You need to get a physical examination and you need to get a psychological examination so that you can have the professional was give you a complete picture of what's going on with your child a diagnosis if it's warranted, and a treatment plan a plan of action, if it's needed. That's the first thing you should do if you suspect that there's a problem.

Kristen

Now, what if they can't get into appointments? This is the issue we're in. Now, because this is such a epidemic of sorts, they can't get a psychological appointment early enough, they can't get appointments, it's like they're on a six month waitlist. In the meantime, what would you recommend, while they get the appointment set?

Richard

First of all, I would say the first thing you probably should do is have a discussion with the school counsellor, the school psychologist or the school social worker, many of them are equipped to do some of these testing some of these preliminary tests, they're very capable of being able to do that. If they can't, then they can refer you to people in the community who can and can perhaps facilitate getting an appointment for you. But many of these tests, at least these initial tests can be done by a school psychologist, a school social worker, or a school psychologist, and you're much more likely to get an appointment in a more timely way, by working with the school personnel. So that would be the first contact I would make was with one of those school professionals, go in, talk to them, tell them what your concerns are, and ask them if they could do some of these preliminary examinations and assessments for you. And maybe that'll lead to giving you some recommendation as to whether they can do some counselling themselves, if they can recommend some type of outpatient treatment, and move forward from that. And that should not cost you anything because your child's in the school system, they should be able to handle some of these things without any cost to you.

Kristen

Yeah, and I know the school systems, the counsellors, and psychologists are overloaded, too, it's really an issue across the board. And I recommend parents also get their own help. So if they need to go do recommend 12 steps to or I always recommend therapy for parents if they can, if they have access to therapy, I highly recommend the parents getting help, too.

Richard

That is such a critical point, we often focus on the child and we forget that the parent is going through a crisis as well. They're questioning what kind of a parent am i How did this happen to my child, what went wrong. And the parent, as you pointed out, need support, they need a support system, maybe it's a support group, maybe it's a counsellor, maybe it's a therapist, but if your child is going through this struggle of substance use and is in treatment, you as a parent will need a support system around you because this is going to be a journey for you as well. And you're going to need that support system. So your point is right on target. Yeah, I've

Kristen

had lots of parents do Al Anon coupled with therapy. And it's been tremendously helpful. Or maybe adult children of alcoholics, maybe they were a product of a parent that had a dependency with alcohol or another substance. And they are in a communal group that says, I'm not carrying the shame and guilt that I'm a bad person, and I was a bad parent or whatever they're carrying fear that they have a support system, and then they can go on to get a sponsor. So if they need help, outside of regular hours, they have someone they can text or call.

Richard

Yes. And they discover that what they're going through what they're feeling is not uncommon. Many of the parents that they will be working with in a support group are going through the same struggles and experiencing the same doubts, the same fears and the same feelings.

Kristen

Now in terms of rehabilitation, if someone a team is using what are the statistics on rehabilitation, breaking the cycle of them getting sober and been able to cope with pain, hurt, emotions, loneliness, and tolerating that what are the stats on that? Well, what

Richard

we do know is treatment works. We have enough evidence to know that treatment works. Now for every child, that treatment is going to be different. There is no one treatment plan that fits all kids. Every child is unique. Every situation is different. Every treatment plan is different. Some kids will do very well in an outpatient programme, where they see somebody maybe once or twice a week. Other kids may do very well in an intensive outpatient programme where they see somebody several times a week, and then some kids will do very well in a residential programme. These are typically the kids that have not only a severe substance use disorder, but they also have a serious psychological issue. So they have a serious dual diagnosis. Those kids can do very well in a residential treatment programme that may last months, and I've seen some pretty remarkable success stories come out of those children that have been referred to a residential treatment programme. That gets back to the concept of having a comprehensive assessment and a treatment plan. That is specific for your child to determine the degree of the problem that the child is struggling with, whether it's substances and mental health, or both of them. And then a treatment plan that will target the treatment specifically for your child's issue. And whether outpatient intensive outpatient or residential treatment is the best approach. But regardless of which one is appropriate for your child. We know that treatment works, it can work. Now, I've never met a teenager that wanted to do an assessment. I've never met a teenager that wanted to go to treatment. But as parents, I'm guessing it's not going to be the first time your kid is told you know about something, not one of the kids that I saw come into Menninger Clinic wanted to be there, they fought, they bargain, they complained, they cried. But the parents held the line, it was a very, very critical time for that child, that parent put them into a psychiatric hospital. But don't be surprised if your child says no, I'm not going in for a testing. I'm not going in for assessment. And I'm not going in for counselling. They're going to say that. But you as the parent have to hold the line and demand that they get the assessments done, they get the diagnosis and the treatment plan done so that you as the parent know what the best option is for your child. And then you follow through with it, regardless of whether your child wants to do it or not.

Kristen

That's an important point. That's why the parent needs the support to be able to sustain some of these and make some of these really hard, and sometimes painful decisions for the parent. Yes, that is critical. Everybody needs support. Even siblings may perhaps a sibling that's going through a programme they may also want to have someone to talk to.

Richard

Absolutely. And it gets back to your point of why it is so critically important. Why it is so very important to parents have a support system, because these are tough decisions that you're going to be called on to make as a parent, and you being in a community with other parents that have had to make those very same calls will help you get through this.

Kristen

Yes, thank you so much for your heart, I can tell you care passionately. And I highly recommend your book, tell people where they can find your book, how they can find you. We're going to link the previous episode we did together because I think it's important, they can go back we talk a little bit more in detail about substances how they start developing. And then today was a great offshoot of what we talked about in our first episode,

Richard

I would encourage your listeners to listen to the previous episode, because I think one of the things we covered are some of the warning signs that parents can look out for

Kristen

deep into that which I thought was very powerful. The book

Richard

is called the addicted child, the parents guide to adolescent substance abuse. And I kept it to roughly 100 pages because parents are busy, they don't have time to read volumes of information on this. So I kept it short, the chapters are short, but the book talks about the brain and how drugs work in the brain. It talks about the assessments that are needed, it talks about the drugs that are out there on the street and the treatment plans and how to recognise a good treatment plan. And what questions to ask if you are sending your child to a treatment programme or residential treatment programme. The book is available on Amazon as either a Kindle or paperback, the easiest way to get to it is to go to the books website, which is www helped the addicted child.com. When you get to the website, there'll be endorsements and reviews you can read, there is a sample chapter, there's information on a parent workbook, which I think is helpful if you use that workbook in conjunction with a counsellor or a therapist so that you can get feedback on the workbook, then there's a link that will take you to Amazon where you can buy if you wish, either the Kindle version or the paperback version of the book, the link will take you right to Amazon.

Kristen

Wonderful. You are a wealth of information. And I am so grateful that we've had you on close the chapter podcast twice.

Richard

Well, thank you. It's been a privilege to be here with you.

Kristen

Yes, I've had few guests. Come on again. So I think this is an important topic. I'm passionate about it, because I'm seeing it in our practice epidemic levels. And I think we can't talk about it enough. So I want to be a resource where people can come and feel supported, feel understood and feel like there's hope because a lot of parents get in despair over what are we supposed to do? And how do we handle this? So thank you so much, Richard, and can't wait for our audience to dive into your book.

Richard

Well, thank you so much for inviting me back. It's been a pleasure to be here and thank you so much for your thoughtful contributions to this discussion.

Kristen

Thank you so much. Thank you so much for listening to the close the chapter podcast. My hope is that you took home some actionable steps, along with motivation, inspiration and hope for making sustainable change in your life. If you enjoyed this episode, click the subscribe button to be sure to get the updated episodes. every week and share with a friend or family member. For more information about how to get connected visit kristendboice.com Thanks and have a great day.