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Experts Speak About Addiction Recovery for Young Adults

Michael Fishman

At the National Collegiate Recovery Conference Wednesday at Kennesaw State University, Michael Fishman, Director of the Young Adult Program at Talbott Recovery Campus in Atlanta, neatly summed up everything he had learned in 22 years of treating addiction in young adults. The recurring theme of his keynote address: It’s complicated.

“Most young adults are generally poly-substance abusers,” he said.

They aren’t just using marijuana; they’re also drinking, Fishman says. It’s not just opioids, it’s opioids and anti-depressants or any other combination. And that complicates the picture for doctors trying to get to know their patient’s true diagnosis.

“The drugs and alcohol may mask the underlying pathology,” Fishman said. Withdrawal symptoms, he added, “cloud the picture,” as do toxicity and detox.

Additionally, many young adults suffering from addiction are also suffering from mental illness of some kind, what Fishman calls “dual-diagnosis.” Depression and anxiety are common in substance abusers and the addiction may begin as an attempt to self-medicate, which Fishman says doesn’t work.

“Ask any young person who self-medicates how that’s working out for them,” he said with a laugh.

The three-day National Collegiate Recovery Conference was hosted by Kennesaw State University's Center for Young Adult Addiction and Recovery and featured addiction specialists from college campuses across the country.

At a separate address Thursday, John F. Kelly, Program Director of the Addiction Recovery Management Services at Massachusetts General Hospital, echoed Fishman’s assessment.

“Young adults,” he said, “have the highest rates of co-occurring psychiatric problems.”

According to Kelly, who is also a consultant to the White House Office of National Drug Control Policy, this is a serious cause for concern because of the impacts not only on the patient, but also on society.

“Drugs and alcohol account for more than $500 billion in economic impact,” he said. “It costs more than heart disease.”

In fact, he said, excessive alcohol consumption alone costs the nation $2 per drink, citing a 2011 report from the Centers for Disease Control.

Substance abuse in young adults is a systemic problem, Fishman said, leading to changes in the brain.

“Alcohol use disorder is associated with abnormalities in the pre-frontal cortex,” he said, the part of the brain responsible for decision-making and moderating social behavior.

Additionally, he said, “drinking at an early age impairs maturation.”

When asked by the audience which drugs he saw abused the most, Fishman said opioids — prescription drugs such as Oxycontin, hydrocodone, and roxicodone and illicit drugs such as heroin.

“Eighty percent of what I see is opioid dependency,” he said. “It’s rampant.”

He added that often young people become addicted to prescription opioids but when they become too expensive they seek out cheaper alternatives, such as heroin.

Abuse of prescription drugs by young adults, he added, “is an epidemic right now.”

Treatment is imperative and should include a specific and consistent structure, Fishman said. Also important is family involvement.

“Parents are often afraid if they set boundaries they [their children] will run away,” Fishman said. Young adults “need a sense of family support,” not the “potential for sabotage.”

Photos: JJIE.org

Mom Needs Help with Troubled, Pot-Smoking Teen

Need help with my troubled teen. He is stealing from family members smoking weed very angry punching walls. I have tried everything he is only 16 years old and heading in the wrong direction reaching out for help please help me to save my child.

~Stephanie

---

Last year, my 20-year-old cousin was arrested for possession of oxycontin.  After that, we discovered he had been addicted to it for at least a couple of years.  He went into rehab, for two months and when he got out, he seemed to be fine.  He has dropped out of college, but has been working for about six months now.  Though he doesn’t earn a lot at his restaurant job, he has virtually no expenses.  But, in the last few weeks, he’s been having money problems, not paying his rent and other bills.  He says he just isn’t managing his money well.  But we’re afraid he’s using again.  He’s more distant than before, but denies he’s back on the drug.  We can’t force him back into rehab, indeed we don’t even know for sure that he’s still got a problem.  What should we do?

~“C”,  Atlanta


My name is Neil Kaltenecker and I am the executive director of the Georgia Council on Substance Abuse, a non-profit statewide organization dedicated to reducing the impact of substance abuse in Georgia’s communities through education, advocacy and training. We believe that addiction is a public health crisis that needs a strong and organized response from policy-makers, communities and individuals and we aim to give voice to recovery communities in order to highlight the reality of recovery.

I am also a person in long-term recovery from alcoholism which for me means that it has been more than 21 years since my last drink or illegal drug. And I talk about my recovery because I strongly feel that everyone should have the opportunities that I’ve had to get well, and because of my recovery I have become a better spouse, step-parent, sister, daughter, friend and co-worker.

Problems such as those described above are experienced by thousands of families and loved ones all over the country and underscore the need for education on issues related to harmful alcohol and drug use and addiction.  Substance abuse is often misunderstood and this can lead to prejudice, discrimination and stigmatization. In this space, I will be addressing these types of issues and will attempt to reframe the focus in order to help youth and families not only get the help they need to recover but also attempt to reverse policies that discriminate against people in or seeking recovery.

Both of the letters above reflect a deep concern for the behavior of a young person who is acting in ways that are out of the norm for each of them. Adolescent substance use is likely to have a long-term impact on both the individual, the family and on society.  According to Michael L. Dennis, Ph.D., Chestnut Health Systems and Kerry Anne McGeary, Ph.D., University of Miami (1999):

High rates of marijuana and alcohol use among adolescents are related to many other problems. Relative to non-users, adolescents who reported weekly marijuana and alcohol use are about four times more likely to report past year behavior problems related to attention deficit-hyperactivity disorders, conduct disorder or delinquency (57 percent vs. 4 percent), dropping out of school (25 percent vs. 6 percent), being involved in a major fight (47 percent vs. 11 percent) and being involved in one or more illegal activities during the past year (69 percent vs. 17 percent). Moreover, they were 8 to 23 times more likely during the past year to have:

  • Committed a theft (33 percent vs. 4 percent)
  • Damaged property (31 percent vs. 3 percent)
  • Shoplifted (41 percent vs. 4 percent)
  • Been on probation (16 percent vs. 1 percent)
  • Been arrested (23 percent vs. 1 percent)
  • Sold drugs (31 percent vs. 0 percent)

These, and other, risky behaviors are a cause for concern and a formal, clinical assessment may be warranted for further direction from a professional.

To Stephanie, I’ll say, your son's behavior could well be the result of chemical dependency in the form of heavy marijuana use. He is in need of an assessment from a qualified professional who will have suggestions regarding a course of treatment or intervention. His behavior should settle down enough for him to be able to start to recognize the impact drugs are having on his life. The key to this recognition is for him to be able to talk honestly about his drug and alcohol use.  Whether this happens in a safe group setting or with a caring individual that he trusts is up to him. His behavior is likely to level out once the craving for drugs are not setting his behavioral priorities. Many youngsters have experienced the same symptoms and have gone on to have healthy relationships and a positive future.

Also to “C,” in the case of your cousin who returned from rehab and who may be using again, relapse is common in young people and doesn’t mean that he can not or will not get back on the road to recovery. I urge families to approach their kids with the same concern that is conveyed so clearly in their letters -– “I am worried about you and want you to know that I’m here and available if you would like to talk” -– is a good place to start.

It must be recognized that as with other chronic health conditions, recovery from addiction is self-directed, meaning that each person is in charge of their own recovery program. Connections to positive messages, people and activities are typically an essential part of getting well, as is understanding that people can and do recover!

The views expressed herein are entirely those of Neil Kaltenecker and do not necessarily represent the views of the Juvenile Justice Information Exchange, the Center for Sustainable Journalism or Kennesaw State University.

SAMHSA Twitter Chat to be Held Today

Get your questions about recovery from addiction and treatment answered by experts during a Twitter chat held today from 3:30 to 4:30 p.m. ET and hosted by the Substance Abuse and Mental Health Services Administration.

This event will create a dialogue with experts in the recovery, treatment and prevention fields, to allow the public to ask questions and learn more information. They hope to spread the message that prevention works, treatment is effective and people can and do recover.

This September #RecoveryChat will celebrate Recovery Month and will be co-hosted by Dr. Westley Clark, director of SAMHSA’s Center for Substance Abuse Treatment and Kathryn Power, director of SAMHSA’s Center for Mental Health Services.

You can participate by following and tweeting with the #RecoveryChat hashtag on Twitter.

SAMHSA also encourages you to share your stories about planning or attending Recovery Month events, key discoveries of what worked or what didn’t work for you or others in recovery.

Many Recovery Month events are family-friendly but only a few are youth-focused, according to the Recovery Month team. In past years, organizations have also hosted kickball games and teen-focused forums.

If you’re not available for the chat, you can tweet your questions to @RecoveryMonth in advance, using the hashtag #RecoveryChat. Or if you aren’t on Twitter, but are interested in asking a question, you can post questions on the Recovery Month Facebook Page or send questions by email torecoverymonthfan@samhsa.hhs.gov.

An earlier chat held by SAMHSA in July focused on young people and recovery. The transcript of the chat can be read on the Recovery Month website.

Teresa Johnson On the Academics of Recovery and the College Campus

In a world where celebrities, athletes and the superstars of society pop in and out of rehab and treatment centers as if going to a day spa, it is easy to be misled to believe that one stop fixes all.  Today the public is led to believe that addiction and recovery is a destination rather than a process, and for too many of today’s young adults, this image glamorizes addiction and minimizes the hard work of recovery.

The debate over whether addiction is a chronic illness, disease or self inflicted behavior has long separated our society and addiction continues to carry a moral stigma. The stigma associated with addiction is damaging enough when we are talking about an adult, but what about today’s young people? Is it okay to brand a young adult in recovery from addiction as a problem, not worthy of our emotional and financial support?

Before you answer, think about this – it is estimated that there are more than 50,000 college students inAmericawho suffer from alcohol, drug, eating and other addictive disorders. Some of these students have acknowledged their addiction, sought treatment for it and have incorporated into their lives, strong, successful recovery programs. As the director of Kennesaw State University’s Center for Young Adult Addiction and Recovery where student in recovery from addiction participate in a peer recovery program,  I see their struggles and their successes everyday. Our job is to provide those students with a supportive place that offers opportunity and hope while empowering them to succeed in college and in life.

But if we continue to allow ourselves to label them as problems because of age old fears and worn out misconceptions, we are essentially turning our backs and telling them that they are not worthy of our help. If these students were afflicted with another type of chronic disease, the outcries would be loud and the support would be plentiful. So how can we best allocate resources and support a generation of young adults trying to turn their life around?

I believe that the best investment we can make in college-age student’s recovery is to be open and real about the addiction epidemic that has infiltrated our young population.  Parents and patients alike expect the addict to be “fixed” after investing thousands of dollars in treatment. And then they keep their fingers crossed as their son or daughter enters the collegiate world.

Finding resources for the recovering addict and alcoholic on the college campus today is limited.  Money is found for prevention, education and even to some degree treatment for an unseen population, but barriers spring up when we admit we have alcoholics and addicts on the campus by offering recovery support.  Supporting recovery in college would be admitting that we have a problem.  However, I submit that supporting recovery on the college campus does not mean we have a problem, on the contrary it means we have a solution.

For the thousands of young adults on the college campus today who are in recovery from addiction, unseen and anonymous working a program and living committed to recovery, who do the hard work of self reflection and community building, I say BRAVO!

In order to advance at all in our handling of addiction and these precious human resources, we as a society must open our minds and the doors of our universities and colleges to offer hope and a visible community of support.  Join us on campus at Kennesaw State University Sept. 10, 2011 to celebrate National Recovery month at the Run for Recovery. The Run for Recovery (click here to register) is just one of hundreds of celebrations taking place during the month to support and honor those in recovery. Join the Voices for Recovery sponsored by the Substance Abuse and Mental Health Services Administration.

Teens Facing Preventable Addiction Leading to Costly Health Problem for Nation

Teen addiction is “the largest preventable and most costly public health problem in America today,” according to a recent report discussed by the the Chattanooga Times Free Press.

Researchers at Columbia University National Center on Addiction and Substance Abuse found that 75 percent of high school students nationwide have used addictive substances, such as cigarettes, alcohol, marijuana, cocaine or prescription drugs. And these numbers don’t include incarcerated adolescents or those who have dropped out of school.

Addiction is more likely for “the underdeveloped teen brain,” heightening the possibility of impaired judgment and bad decisions throughout life, the report says.

It also says that teens who are exposed to parents' substance use disorders are more than three times as likely as other teens to have a substance use disorder themselves.

The blame for this abuse not only rests on parents, but also lawmakers and advertisers, the researchers say. Solutions presented in the report include setting a good example at home, higher taxes on tobacco and alcohol products and the elimination of "marketing efforts to adolescents that makes addictive substances appear attractive."

"We rightfully worry about other teen problems like obesity, depression or bullying, but we turn a blind eye to a more common and deadly epidemic that we can in fact prevent," Susan Foster,  who works for The National Center on Addiction and Substance Abuse, told the Tennessee newspaper.

Health advocates say parents should talk to their children early and “must be the ground forces in the war on addiction.”

Costs associated with teen substance abuse include an estimated $68 billion toward underage drinking and $14 billion in drug-related juvenile justice costs, the study found.

The study is coming out just as September, designated as national Recovery Month, approaches. Recovery Month promotes the societal benefits of treatment for substance use and mental disorders. JJIE has more resources and information related to drugs and alcohol.

Neil Kaltenecker On Amy Winehouse and Addiction

Amy Winehouse died of addiction. Though toxicology reports are so far inconclusive, we can look at her life and know the cause of her death. Many of us know what addiction looks like up close and personal and most, if not all of us know what addiction looks like from the gripping images of famous people struggling in front of us. Hopefully, we can convert this recent casualty into an opportunity  for  learning, and strive to create a better way to prevent this treatable chronic health condition called addiction. We know that people can and do recover!

Those who do not survive addiction leave behind grieving families, friends and communities who may question what they could have done differently. To this tremendously agonizing question there is no single or simple answer. We can, however, start to look at addiction differently and recognize that with support, awareness, allies and hope -- recovery is possible and it benefits everyone. We know from the National Institute of Drug Abuse and others that:

  • About 570,000 Americans die each year from the abuse of alcohol, tobacco and illegal drugs
  • Genetic factors account for 40 percent to 60 percent of a person’s risk of developing a substance use disorder
  • In 2009, some 2.6 million people received treatment for substance use disorders at specialty facilities, yet 20.9 million people aged 12 or older still needed treatment but had not received it in the previous year
  • Those who begin drinking at a later age are less likely to develop a substance use disorder than those who begin before age 21
  • Individuals treated for alcohol misuse are approximately 10 times more likely to commit suicide than those who do not misuse alcohol, and people who abuse drugs have about 14 times greater the risk for suicide
  • For every $1 invested in treatment, taxpayers save at least $7.46 in costs to society
  • About 20 million Americans are living in long-term recovery

Addiction, left unaddressed, will and does kill. Opportunities for recovery should be readily available in a variety of settings. If you have questions about how the tragedy of Amy Winehouse could have been averted, ask someone in long-term recovery. We are your friends, neighbors, co-workers and family members. We are community leaders, doctors, therapists, laborers and teachers. What you may find is that there are many ways to recover. Recovery is a life-long process, and people in recovery can experience improved relationships, better mental and physical well-being, and newfound abilities to deal with problems in a healthy manner.

Recovery from addiction is about recognizing that each person must be a central participant in his or her own recovery. There is hope for everyone. Although types of treatment and recovery services may look different, all services should offer choice, honor the individual’s potential for growth, focus on their strengths and attend to each person’s overall health and wellness.

Seeing active addiction played out on the public stage conjures up many feelings -– enthrallment, disgust, pity and compassion, just to name a few -– and it may be argued that public scrutiny and pressure can render recovery even more elusive.

We can all agree that last week we lost an incredibly talented young person to addiction.  Let’s use this tragedy to focus on ways that we can support those who need help. And we can begin by looking to those of us in long-term recovery and identify and explore the opportunities we were afforded that helped us get well. We recover, we get better, we thrive and we live to tell our tales to help others.

September is National Recovery Month where millions of people in recovery and our allies celebrate recovery and educate communities about substance use disorders. For more information, go to www.recoverymonth.gov

 

Chad Hepler: Beyond Intervention

Chad Hepler’s story of addiction began when he was 14 years old. What started as a search for social acceptance and a hit of marijuana culminated in a parent-led intervention and stint at a wilderness treatment center.

“Marijuana IS a gateway drug,” he said. “I don’t care what anybody says.”

His drug use may have started with marijuana, but soon began to regularly include alcohol and experiments with other substances. Hepler may have found what he was looking for at a young age, but the lifestyle was anything but sustainable.

Today, as Hepler speaks with high schools students about the dangers of addiction, he likes to make the comparison between the beat-up life he left behind and the new one he’s forging from its ashes. In one hand he holds a picture of himself, bloody and bruised after an altercation with three off-duty state patrol officers, in the other a front-page newspaper story of him and his newly published book – “Intervention: Anything But My Own Skin.”

Hepler graduated with a Bachelors in Psychology from Kennesaw State University near Atlanta, Ga. in 2010 and is currently training to become an addiction counselor.

He has been clean for more than three years.

Visit www.interventionbooks.com for more information.

Part Five: The Big Trouble With Oxy

Just joining us? This is part five of a five part series. Start from the beginning.

Scott Merritt, a certified addictions counselor and licensed therapist in metro Atlanta, estimates that about 40 percent of kids in Cobb County high schools use illegal drugs, including alcohol.

Though federal officials say the rates nationwide are lower, Merritt isn’t pulling that 40 percent out of thin air.

“It’s from talking to teachers, administrators, kids and parents,” Merritt said. “Whatever the drug of choice is in a particular school, that drug is extremely easy to get.”

And in many schools today, that drug is OxyContin.

OxyContin is the brand name of a time-release formula of oxycodone. The U.S. Drug Enforcement Administration found that retail sales of oxycodone increased six-fold between 1997 and 2005. In schools in suburban Atlanta, an OxyContin pill sells for about $20 per 40-mg tablet.

“It’s expensive, so you’d think it’d be harder to get,” Merritt said. “But it’s not. Whether kids are getting them from their parents’ medicine cabinet, or getting them off the Internet, they are getting them. And they are selling them and using them.”

And an OxyContin addiction is a very hard one to kick, Merritt said.

“It’s one of the hardest, because for one thing, a lot of people taking OxyContin were already addicted to something else,” he said. “And they might have no desire to get off of it. As therapists, we have to work through that resistance.”

Lynn Abney, a licensed professional counselor who works with Cobb County’s juvenile drug court program, said in suburban neighborhoods, prescription drugs don’t carry the same stigma as illicit drugs, such as heroine or methamphetamines.

“That is not necessarily a good thing,” she said. “Often, people start taking them – kids or adults – legitimately. They are prescribed them for a real injury. But then they start overusing them and developing a tolerance, so they have to take more to get that same relief. It’s prevalent in the high schools, and it’s not that rare in middle schools. And kids are mixing them with anxiety medicines or alcohol and it gets very dangerous.”

Abney’s experience tells her that people abusing prescription medicines almost always are abusing another drug as well.

“Most people who take these drugs do cross-use,” she said. “And they have no idea the potential effect of mixing these drugs.”

Part Five: A Day In Drug Court

Just joining us? This is part five of a five part series. Start from the beginning.

Cobb County, Ga’s., Juvenile Court Judge Juanita Stedman’s office overflows every Wednesday at 4 p.m. For an hour, with therapists and probation officers filling every chair and – with several sitting on the floor – Stedman and her juvenile drug court team do a rundown of every kid currently in the program.

One by one, Stedman calls out the name of each of 30 or so kids. The assigned probation officer and counselor chime in, giving her an update on how the week had gone for the juvenile.

For these kids, failing a drug test, disregarding a curfew or skipping out on house arrest, most likely means the judge isn’t going to let them go home. More often than not, someone shows up on Wednesday night with one or both of their parents, and ends up being taken to the county Youth Detention Center here in suburban Atlanta.

For the most-addicted kids, or the ones with the most rebellious attitudes, a stint in YDC is fairly common. But it doesn’t take long for kids to realize that Stedman, who can be as compassionate and loving a woman as there is, isn’t one to be tested.

"Todd, why do you think I'm so upset with you?" Stedman asked one of the teenagers in a previous class.

"Because I smoked?"

"You smoked pot three days after I released you. Did you not think I looked serious?”

"Yes ma'am, you did."

And she was. Todd went back to jail that day.

Not everyone succeeds in drug court. And almost all of them will relapse at some point along their path to recovery.

Lynn Abney, a licensed professional counselor and part of the drug court team, said watching kids relapse is one of the hardest parts of the job for her and her teammates.

“I’d say more times than not, we expect relapse,” Abney said. “It’s an unfortunate part of the illness. But I’m a firm believer that even with a slip up, the kid is further along than he or she was at the last slip up. A lot of times, it’s two steps up and one step back. If someone is truly an addict, you at least hope that the time between relapses gets wider and wider. Sometimes it’s about managing relapses.”

Abney, and a handful of other counselors working the Cobb County juvenile drug court, make in-home family counseling visits with the kids – maybe weekly at first, then less often. But it’s a way for this to be more than just a justice or law enforcement program.

“To me, the No. 1 reason it is as effective as it is, is the accountability of the legal system and the clinical treatment of therapy,” she said. “It’s like treating someone with a major depressive episode – medicine is OK and therapy is OK. But medicine and therapy is the best, together. Our program is more successful than just incarcerating or just doing therapy.”

Not everyone who goes through the drug court will succeed. The grip of drugs and alcohol can sometimes prove to be too much.

“It’s tough,” Abney said. “Sometimes what you can do is not going to be enough. I think sometimes, we try too long with some families. We’ve seen tragedies where someone did not have long-term success. Still though, we believe that something that was done or said was helpful. It might not have saved them or prevented relapse, but we were planting a seed. If it didn’t help that kid, maybe it helped his brother, or his friend. Those are things we have to hang on to when we see things go bad.”

Continue reading: The Big Trouble with Oxys

Part Four: Redemption and Temptation

Just joining us? This is part four of a five part series. Start from the beginning.

Kyle Boyer

Kyle is now only a little more than four and a half months clean.

His last relapse came during the Thanksgiving break of 2010.

John, his father, had just had shoulder surgery. He’d been diligent in having his prescribed Vicodin on his person at all times, just to help ease the temptation.

Kyle once stumbled across it when his dad left them on the counter.

“I just grabbed the bottle and tossed it at him, like, ‘Really?’”

The second time he wasn’t thinking as clearly.

“I went into his briefcase to get an adapter and they were there,” Kyle said. “It surprised me and I just poured some in my hand and took them without even thinking about it. I immediately told my parents and I felt so rotten with shame and guilt.”

Kyle knows that he is a different young man now that he has a relationship with Jesus. But Jesus never promised Kyle he wouldn’t be tempted.

“Some days are easier than others,” he said. “A friend in recovery compared what we are training for to a pro fighter. The boxer trains for a specific day to fight. We train for sobriety and to stay clean and we don’t know when we’ll step into the ring and have to fight the temptation. When I start thinking about drugs, I try to stay occupied. When I’m bored, it’s the worst.”

On March 4, Kyle received his 90-day chip at Celebrate Recovery, a Christian-based 12-step program that meets at Vineyard Church in Kennesaw on Friday night.

Each week, a group ranging from 30 to 60 addicts, gather for dinner, a lesson, some praise music, then small group discussions. The leader is Mark Collini, Chris’s dad.

Being at Vineyard Church every time the doors open is one of the ways Kyle keeps from being bored. He’s there on Sundays, Tuesdays, Wednesdays, Thursdays and Fridays. He does youth group and drama as well as the recovery class there.

The other thing keeping Kyle’s hands from being idle is his art. Since he was first on house arrest, Kyle has been using spray paint to craft dozens of pieces of art on poster board, masonite, glass and hardwood. He’s participated in several local art shows and has sold several pieces though his website, kyleboyerart.com.

One of those paintings hangs in Stedman’s office.

“He gives us part of the proceeds for our non-profit Reconnecting Families program,” she said. “We obviously didn’t ask for that, but it’s a nice thing for him to do.”

The rest of the money is for a mission trip he plans to take after graduating this spring.

*****

Like thousands of other recovering addicts, every morning, Kyle has to make a decision not to use drugs.

“It can be frustrating at school, because in many ways, it’s Temptation Island for me,” he said. “There are so many people that are stoned every morning. That used to be me.”

And at night, his rest is often robbed by dreams of relapsing.

“I’ve been having a lot of ‘using’ dreams lately,” Kyle said. “It puts me on edge. The worry comes and goes, but there’s a part of me that is always afraid I’ll relapse. I know the guilt and the shame I’ll have, and the hurt that I’ll cause others.

“But I also know I’m not alone in this battle. I’m not the same person I once was. I wouldn’t have the power and strength to do this alone. And I don’t have to do it alone.”

Bill Sanders has written and reported stories out of metro-Atlanta for 15 years.
Multimedia credits: Clay Duda