Yesterday afternoon I was whipping through my Gmail inbox and found a message from someone saying they were from Time Magazine and wanted to talk with me about my book, ASAP. There was no last name and the email address was one I did not know. Fortunately, just before I hit delete, I noticed the message had a phone number. And in view of the HealthDay News release (see website News section) mentioning the book, I thought someone might be interested in learning more. So I called. And a good thing I did. I reached a remarkable woman who writes for Time and other publications. She was completing an article addressing the challenges of treating teens with addiction. And although our situation might not be appropriate for the piece, it was refreshing, and frankly a genuine relief to learn that we are not alone in our deep concerns over the failure of current addiction treatment practices to help younger people. I am hoping that our voices, together with the very loud voice from Time Magazine and the other publications carrying her stories, to break through the clamor from the multi-billion dollar addiction treatment industry, to help other families learn the facts while they still can act on them. More later.  

When I began studying addiction, first as a frightened mom trying to find help for my struggling daughter, and later as a researcher determined to learn what possibly could be driving her and other young people to such dangerous behaviors, I thought that the debate over whether addiction was a disease or bad habit was little more than a matter of semantics. You know, a couch vs. sofa kind of thing, sofa sounding more refined.

As I studied and learned more, the distinction between the disease and non-disease camps became more clear. In time, based on my understanding of the studies coming out of addiction science, I came to accept the position that addiction was a disease. Not only did the research provide evidence of the disease, the classification also brought benefits to families and treatment professionals trying to help addicts recover.  As a disease, addiction carried less of a stigma than when it was classified as bad behavior.  It opened the possibility of insurance coverage for its treatment, a medical specialization was created to prescribe treatment for it, and an entire industry grew around it to care for those who developed the disease. 

I thought the matter was pretty cut dry. After all, medicine defined a disease as "any deviation from or interruption of the normal structure or function of any body part, organ or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown."  And since science had demonstrated that addiction was a dysfunction of the brain's neurotransmitter system leading to symptoms of compulsive harmful behavior, it clearly fit the definition of a disease. 

But recently I learned that it's not that simple and that the implications of the on-going debate are more far-reaching than I had imagined. 

What I did not know until very recently is that science has not yet actually pinpointed what and where the neurotransmitter system dysfunction occurs in an addict. And without this, it cannot be conclusively detected and addiction cannot be diagnosed through objective testing. This leaves enough room for the non-disease proponents to carry on their debate, countering claims from those embracing the disease theory. And it leaves the definition of addiction-as-disease so broad that it  allows such things as junk food and tanning to be shoe-horned into the classification right along with heroin and cocaine addiction.

As a disease without a known cause, means of detection or cure, there also is a tremendous attraction to pharmaceutical companies to develop and introduce new psychotropic drugs, designed to help manage the disease symptoms and suspected related mental conditions. Are these medications effective? Again, it remains a subjective matter.  And that begins a whole other debate. 

Disease or acquired dangerous habit?  It's a much larger issue than I had imagined. 

 

Over the years, I've read many studies reporting on the financial burden of addiction. Recently I came across a 2004 report from the Surgeon General and ONDCP that calculated the cost of addiction to society to be $524billion per year. This included medical, legal, social welfare and related expenses. I ran some quick figures and found that this total is equal to 3.7% of the US 2009 Gross Domestic Product. Yikes! If the human cost of so many high-potential youths being lost to their addictions isn't enough to get the public's attention, maybe the dollars can.  

Yes, weirder is a word.  At least in Austin it is.  The town has a slogan that seems to sum up its personality, "Keep Austin Weird".  Not to be outdone, our small town took it a step farther adopting the saying, "Keep Wimberley Weirder." I love it.

But in this case, my comment is referencing today's addiction news.  It seems that in North Carolina, there is a highly controversial program called Project Prevention that apparently is gaining popularity among the public. In a nutshell, the project's founding charitable group offers to pay cash to any addict who agrees to be sterilized.  Yes. I said sterilized.  I don't think it gets much weirder than that.

More tomorrow.

There are times, after spending days at my desk digging into the latest addiction studies, writing about what the findings might mean to future treatment, that I simply get tired and begin to wonder if all of this is worthwhile; whether it can make a difference to anyone.

I was in that place today. And then I opened my email to find good news. The founder of a leading non-12-step program was writing to say he had completed reading my book  - really liked it - and wants to discuss how we might advance some of the issues I addresses and ideas introduced in the book. It was like my spirit was jump-started. I said a silent prayer of thanks, hit print and decided to share the news with anyone stopping by this spot. Yipee!

So did you catch the other big news this week about the newly-defined tanning bed addiction? My cynical side simply can't help but wonder if somehow a political agenda could be driving the focus of some of the more recent research. Think about it. One of the top political causes today is the drive to fight obesity. And then this month we learned that fattening foods have been found to be as addictive as cocaine; that there is a newly-identified junk food addiction. Then, in the wake of a major campaign to prevent underage use of tanning beds, up pops a new tanning addiction. I'm sure this nothing more than a case of my imagination is running amok. But it's an interesting connection, don't you think? 

Have you noticed how reality has a way of crashing through our peaceful lives at the most unexpected and inconvenient times?

A couple of months ago, I was typing away, happily alternating my time between my office and ridge-top retreat, when a literary agent called to say she was interested in representing me and my work. Great news, I thought. But then she added that she only was interested if I agreed to two things.

And in came reality. I would have to come out from behind my pen name and start talking with groups to promote my book. Neither has been in my playbook.

In the meanwhile, news from the addiction science world has gotten me thinking about some of the basics we have been dealing with. Specifically, the recent finding that junk food can be as addictive as cocaine really threw me for a loop. What is behind this revelation? Is this opening a door for government to regulate or tax our snacks and fast food? Does such news risk trivializing the devastating effects of drug and alcohol addiction on our kids and society? 

So for now, there are a few new things to think about.  

Last night as I was posting a new article on our home page, I reflected back to one of my lectures from my years as a marketing professor at a DC university.  The lecture was about encoding and decoding messages in our communication.  The concept is pretty basic.  As we communicate through our correspondence, verbal exchanges, in promotion and advertising, we build specific intended meaning into what we say.  We encode our message with the thoughts and ideas we want to convey.  Those on the receiving end then decode the message, through their own personal filters, into what they understand or interpret to have been said.  It is amazing how often we miss the mark. 

 

 This is the reason that marketers and politicians conduct so many focus groups and other forms of research to learn how their intended audiences respond to their different messages.  Did the decoders “get” what was being said? With that feedback, those on the encoding end go back and re-work their words until the intended meaning is received.  In our daily conversation and in normal correspondence we don’t have that luxury. We simply assume or trust that what we say is being understood clearly and as intended.  Good luck to us.

 

Back to the article I posted, “Don’t throw the baby out with the bathwater," it was stimulated by a comment on my blog about a reader’s concern that I was trashing the 12-step program as a whole.  I thought I had been so clear in all my writing that the program is reasonably effective in helping the mature adult addicts for whom it was designed.  That the issue is the fact it fails miserably in connecting with adolescents 13 – 24 years old for whom it was not intended.  Again I am trusting that the new article is encoded properly. 

 

Think about all of our efforts to talk with our kids or other young people about our concerns over their changing behavior or with what we know to be a continuing eating disorder or substance use.  So often our words just spill out in moments of frustration without thinking.  What are the odds they are being received as intended?

 

How can we improve the chances that our meaning is clear to those receiving our messages? I was reminded of this fundamental marketing principle as I completed the article last night. It’s something I’m embarrassed to say I’ve neglected lately. We simply need to focus less on what we want to say and more on what it is we want our intended audience to hear and understand. Give it a try. It can make a real difference in how we communicate.

 

And by the way, the next time you look at the 12-steps, try decoding them as a young addict might. It paints a very different picture. 

 

 

 

Yesterday I went to chat with our local priest (Episcopal) about this whole crusade I’ve found myself on to expose the failure of today’s adolescent addiction treatment and to stimulate development of a new process, based on science, to effectively lead young addicts to healthy, happy and productive lives.  After some dancing around the point, I finally got to the big question that haunts me, Am I nuts to be doing this?

 

It’s one thing to uncover and define the problem we are dealing with.  Yes, it has taken years to do the research, analyze the findings, form sound conclusions and confirm their validity with the leaders in the addiction field.  But now, to apply those findings to define alternative new treatment processes for testing, with the goal of identifying a measurably effective treatment method for 13 – 24 year old addicts, both chemically dependent and eating disordered individuals, is something else altogether.  And though we’ve made real progress to date, the whole thing can be pretty overwhelming at times.  I suppose that’s why it hasn’t been done before. 

 

In the course of our discussion, he talked about the need to create fertile ground.  And with that, so many pieces began to fall into place. 

 

More later. 

I was looking at our website visitor numbers this morning and noticed an interesting pattern forming.  We get an awful lot of folks stopping by between

2 – 4am Central time.  The statistics we get tell us nothing about the visitors other than the time of day they came and their point of origin. But looking at the pattern today got me thinking back to the days when Sara’s behavior really began to unravel, big-time. We had no idea what was happening and were so frightened for her safety.  Sleep in those days was a fleeting experience. And too often, I’d wake with a start in the middle of the night, make a cup of tea and sit in front of the computer to search the Internet, once again, hoping to find a few answers to our growing list of questions. 

 

When we finally began to consider the unthinkable, that she might be getting involved with drugs, we talked ourselves out of the idea, telling each other - Not our little girl. 

 

If you have stopped by this website hoping to find something, anything really, to help you deal more effectively with a young person you fear might be abusing drugs and alcohol, here are a few things we wish we’d known and done back then.

 

First, if you suspect your child is abusing drugs and alcohol, he or she probably is.  We parents tend to be the last to suspect the worst, and so I believe that when it becomes apparent to us, it’s a good bet that it’s true. 

 

Should you confront the young person with your suspicions? Yes.

 

Should you expect to learn the truth? No. 

 

Would your child lie to you? Definitely. 

 

So what’s the point in asking?

 

By telling your child that you are worried about their health, that their behavior suggests they are getting involved with drugs and alcohol, you open the door to this most difficult subject, even if just a sliver before your child slams it shut in your face. But you, and they, will know that the topic is far from closed. 

 

And at this point you have a few choices. 1. You could do as we did when we first raised our concerns to Sara (of course that would be really dumb as we did pretty much everything wrong at that time), which was to accept her elaborate explanations for the recent behavior changes, allow ourselves to back off and even indulge in feeling relief.  2. Or you could follow so many parents before you, when your child doesn’t immediately come clean with the truth - start yelling, accusing, blaming and threatening the child. This is another very bad approach, sure to make an honest conversation that much farther away.  3. We finally hit on a successful approach to encourage Sara to talk with us, if only briefly, about her drug and alcohol use. We opened by laying out some specifics we’d seen change in her behavior and how frightened it made us feel. We hit on some of the very real and dangerous implications her new activities could have on her health, valued relationships, any meaningful goals she might have for the near or longer term, even her physical appearance, and any practical prospects for real happiness.

And what happened next probably had the greatest impact. We shut up. We gave her time to react - to vent, defend herself and even attack us for raising the issue. And then we assured her of our love and desire to help her get back on her feet.  And we asked how we could help; what she needed from us right then.  We kept it brief (at least as brief as I’m capable of making anything) and did our best not to fall into the trap of returning anger for anger. We had to repeat this approach many times before successfully keeping the door open for any length of time.  But we ultimately did.

 

As I was writing this, I asked Sara what we could have done differently or done better to get her to talk with us sooner about her developing addiction. She very simply explained that we waited too long to confront her.  She felt it was not as much a matter of how the topic was raised (as long as it was not confrontational) as when it was introduced.  And she was quick to reassure me that no kid (in her opinion) would start talking with a first or second attempt to pry the door wide open, and that a family should not give up. 

 

To those of you reading this in the wee hours of the morning, too worried about your child's health to sleep, please know you are in good company. Maybe you, or others who stop by, have found different approaches that have proved effective in opening a child to the difficult discussion about their drug and alcohol use. If so, we'd sure appreciate your sharing it here. 

More later.

 

Yes, Tiger Woods has entered Pine Grove Addiction Rehabilitation Center in Hattiesburg, Mississippi for 12-step program treatment of his Sex Addiction. (For more information on this form of addiction and its treatment, follow the link to theyoungaddict.com at end of my introduction at the top of this page.)

 

Now I’m not much of a golf fan. Actually I’m not a fan of the sport at all.  But I have been a fan of Tiger Woods for some time.  He just seemed to be everything one could want in a premier professional athlete - the kind of role model we would want to hold up to our young people.  Here he is, so smart, talented, handsome, seemingly kind and sportsmanlike.  He stood with his lovely wife, great kids, and doting father.  What more could we ask for?

 

Well on November 27^th, when he crashed his car outside his house and his wife bashed in the car window with a nine iron or some such golf club, we got our first glimpse into the real world of Tiger Woods.  And it was sad. One by one, at least nine women came forward, claiming to have been a mistress of his. He did not deny any of them. In fact, the only thing we’ve heard from him since the 27th came in the form of a written statement in which he expressed regret for his infidelities and his intent to become a better husband, father and person through rehab. 

 

Those of you who visit here and on my website frequently, know the issues I have raised regarding the 12-step program treatment used at over 90% of addiction treatment facilities. We have discussed that among young addicts, 12-step treatment does not work. We've shown that the program's mere 5% - 15% success rate among young patients can be attributed to reasons involving brain neurobiology, personal development and limited life experience of adolescents 24 years and younger.  It’s a real problem we need to tackle.

 

And that’s what makes Tiger Woods’ story so important.  Because the 12-step program was developed precisely for mature adults like him.  His brain is mature and fully wired. He has developed well as a person.  His Buddhist faith has given him grounding and his philanthropic work with children has shown his compassion. He knows who he is and what is important to him – though it seems he got pretty messed up in the area of fidelity and probably a few other places along the way. I have to believe that right now, he wants his wife, kids, reputation and career back more than he wants his addictive substances and behaviors of choice. 

 

Tiger Woods has all of the necessary characteristics, which are found in extremely few young addicts, to understand, appreciate and relate to the precepts of the 12-Step Program.  If he decides that he wants his life back, the program is likely to help him succeed.  In fact, it seems to suit him to a Tee. 

 

 

I used to travel to Mainland China a lot while I was in the business world.  Over the years, I watched tremendous change take place. Impressive new schools, modern residential districts, expansive industrial parks, all became a part of the landscape in a relatively brief span of time. One morning, after watching a busload of young boys, smartly dressed in starched light blue school uniforms, unload in front of one of the schools, I asked my host where the girls were.  He explained, in the same manner as if he were telling me the day’s weather forecast, that when a woman gets pregnant she has the test and if it is a girl, the baby goes away. Yikes!

 

When I gathered my thoughts again following this revelation, I asked him, then who will the boys marry when they get older? This seemed to stun him much as his announcement had startled me. 

 

Recently, I read a brief piece in the news about an influx of young women entering China from India. For what purpose? To become brides for young Chinese men.  The Chinese had ignored the implications of their one child rule, interpreted to mean one boy child, creating a generation consisting largely of young men.     

 

The US welfare laws of the 1960’s are credited with creating a generation of poverty-level children being raised in single parent households.  While the more recent welfare reforms of 1996 are charged with encouraging a new generation of poor children being raised in no-parent households. 

 

Societies seem to have a habit of creating “generations” of kids by doing what seems best or right at the moment, without looking into the future as to what the longer- term implications of their actions might be. 

 

Since the mid-‘90’s we have been sending increasing numbers of young alcohol, drug and eating disordered addicts into 12-step programs, knowing that only 5% - 15% of them will get well. By perpetuating this practice, we created a generation of young addicts who today are developing into under-productive, unhappy, unhealthy, marginally functioning adult addicts. 

 

And that’s about it.  So what do we do about it?

I know it’s a small step, but it was a real step none-the-less. Thanks to David, Victor and to those of you who sent comments to my email, for starting the discussion.  I hope others will join in as we carry on.

 

I think Victor’s comment about an addict needing to work the program for the 12-steps to be effective, is right on.  And that’s an important point to make.  The problem doesn’t seem to be with the program itself.  Rather, that the younger addict just doesn’t seem to connect with it. So then the question becomes, is it a matter that the younger folks simply blow the program off? Or is it that the program is out of sync with the way a young person is wired. Knowing that the portion of our brain responsible for our judgment, rational decision-making, our values, beliefs, and morals, simply isn’t fully formed until we are 24 years old helps explain why so many young people don’t seem to connect with the program; from a practical standpoint, they just aren’t set up for mature thinking and sound judgment yet.  

 

When I re-read the 12-steps this morning, I was reminded of how they call for an individual to re-examine their past and commit to a whole new way of life. And I wondered again, whether a 20-year old addict is fundamentally equipped to do that? I tried to imagine how I would have responded at that age? Oh Lord, I hate to consider it.

 

I’m sure the problem isn’t as simple as this.  But I’ll bet it’s an important part of it. 

Your thoughts?

 

 THE TWELVE STEPS OF ALCOHOLICS ANONYMOUS

1.    We admitted we were powerless over alcohol—that our lives had

       become unmanageable.

2.    Came to believe that a Power greater than ourselves could restore us   

       to sanity.

3.    Made a decision to turn our will and our lives over to the care of God

       as we understood Him.

4.    Made a searching and fearless moral inventory of ourselves.

5.    Admitted to God, to ourselves, and to another human being the exact

       nature of our wrongs.

6.    Were entirely ready to have God remove all these defects of character.

7.    Humbly asked Him to remove our shortcomings.

8.    Made a list of all persons we had harmed, and became willing to

       make amends to them all.

9.    Made direct amends to such people wherever possible, except when

       to do so would injure them or others.

10.  Continued to take personal inventory and when we were wrong

       promptly admitted it.

11.  Sought through prayer and meditation to improve our conscious

       contact with God, as we understood Him, praying only for knowledge

       of His will for us and the power to carry that out.

12.  Having had a spiritual awakening as the result of these Steps, we tried

        to carry this message to alcoholics, and to practice these principles in

        all our affairs. Copyright _ A.A. World Services, Inc.

Have you ever had one of those days when the path you’ve laid out for yourself just seems to overwhelm you?  And all you really want to do is say, screw it, and head in a different direction? Or better yet, simply turn tail and run away? 

 

You have? Then you know where I’ve been the past couple of days. 

 

As you know, we completed our little 33-day experiment in Sara’s recovery with pretty good results.  And that signaled that it was time for me to return to the task at hand which is to get started laying out hypothetical youth treatment strategies for testing.  At the same time, I need to begin gathering support from the public (you) so that we can loudly demonstrate the urgent need for something better to help our young people get well, and stay well.  

 

I was off to a great start when all of a sudden every ounce of energy in me was gone. And I don’t know if you’ve experienced this, but all these crazy doubts worked their way into my brain screaming at me, Are you nuts?  You can’t do all this – why don’t you just go get a job like a normal person? 

 

And then to feed the confusion, I checked the statistics on this blog and website and confirmed again, that we have tons of people coming every day, with the numbers growing daily – including visitors thus far from six countries, and I think we now have folks from every state stopping by (this is a very good thing, thank you).  But even as the traffic has been building, as of yesterday, not one of you has ever said anything.  (Other than the very kind thank you notes for my book. Much appreciated by the way.)

 

So here I sit tonight. And I just don’t get it. How are we supposed to build this groundswell demand for the treatment industry to test and adopt a measurably effective way to help our young addicts, if I can’t even get one regular visitor to say, boo!

 

And then it occurred to me, I’ve been running on so much about all the things I want to share with you that maybe I haven’t given you a chance to talk.  And I know I’m far too wordy, but that’s just the way it is. 

 

So here goes.  Do any of you share my concerns that hundreds of thousands of young addicts are failing to recover from their chemical dependencies and eating disorders with today’s best treatment programs? Do you ever fear for their lives? Do you have experiences to show how the system is failing, or is working, to help the young people you know? 

 

Any other thoughts to share?

 

A good share of the leaders in addiction science, research and treatment came to the field because of their personal involvement with the disease. In many instances, they have children who struggle or have been lost to addiction. Recently, several of the more prominent researchers have contributed greatly to our improved understanding of the how the addiction disease develops and is expressed in the younger person. I find it ironic therefore, that more specific attention has not been paid to carrying this insight forward into treatment, to develop a distinct regimen for helping younger people who are fighting this terrible disease. 

 

I was thinking about this last night while reading a report by one of my favorite researchers. His son tragically died as a result of drug abuse.  I shifted mental gears and reflected on all the years we’ve spent battling our daughter’s dual dependency addiction, especially these past 33 days; we called it our countdown to Sara finally settling in on her path to normal living.    

 

And that’s when it hit me. A possible reason why these brilliant addiction experts — scientists on the one side who understand the young addict’s brain development and their addiction disease; treatment specialists on the other who are familiar with the accumulated life experiences of their young patients as well as their terrible recovery rates — have not yet tackled the challenge of creating a unique treatment program to address the young addicts’ unique set of needs. 

 

For those of us struggling with our own young addict, it is just so darned personal, so difficult to remain cool and objective.  Addiction is such an angry disease.  It brings out the very worst, and sometimes the bizarre, in our children.  When they are under the influence, or at any time they are in and out of recovery, it’s as though they become someone we hardly recognize.  Someone we don’t even want to imagine or consider possible. 

 

If the experts were to focus on these young people, so much like their own children, who are suffering from real damage being done to their still-developing brains, damage no one yet knows how to repair; if they were to consider all the critical life skills these youths have yet to form and experiences they might never enjoy; if they were to look at them as precious young people, like their own children, with specific needs no one knows how to meet, it just might be more than they are prepared to deal with today.  And there will always be that lingering tinge of guilt that somehow they could have avoided this happening with their own children, or at least stepped in earlier before so much damage was done, especially since they are the experts in this field.  The challenge is so close, intimate.  What they see happening with these young addicts is what their children went through or are still experiencing.  And it’s very messy. 

 

It’s so much safer for the experts, and parents, to look at our young addicts as patients with a disease to be treated.  The same disease through which so many mature adult addicts have lived, recovered and gone on to enjoy full lives through AA’s 12-step program.  The youths have the same disease, don’t they? Why not treat them the same?

 

Speaking as one who has been in this situation, (minus the brilliant expert part) I know it is so much easier to look past the significant differences, in both neurobiology and life experience, between young addicts and their mature adult addict counterparts, and instead to focus on their shared symptoms of compulsive drinking and drug use.  Since we don’t yet know how to address the differences, since there’s a respected program in place to treat the symptoms, and since we know we have to do something soon as their young lives are at risk, we do as countless others before us have done. We hand our young addicts over to the 12-steps. 

 

Besides, the 12-Steps are so civilized.  The program conjures up tidy images of our children turning their lives over to God and dedicating themselves to a daily routine of sobriety and helping others get through their suffering.  But as we visualize this comforting scenario, in our hearts, and in the science community’s objective understanding, we and they all must know that this is not the scenario that’s being played out.  When we are honest with ourselves, we know that in dealing with a young addict, life is anything but tidy. 

 

Turning away from the evidence of failed current practices and the likely reasons for that failure found in the specific neurobiology and accumulated life skills and experience of the young addict, will only prolong the crisis of youth addiction. 

 

I am adding to our task list, a new priority: Motivate the youth addiction industry, science and treatment sides, to test the theory that failure of young addicts to respond positively to the 12-step program can be traced directly to these two factors.  If (when) verified, the path should be cleared for our efforts to drive new program development. 

 

Until last night, I really hadn’t considered the possibility that because so many of the top addiction authorities are parents of young addicts, in spite of their significant knowledge and great abilities, they likely suffer with the same insecurities, fears and doubts that have led us over the years to release our kids to the same program that might have treated our parents.  It’s clean, God-fearing and honorable.  It’s nothing like our young addicts. 

                                                        ***

Sara will wrap up our 33 day recovery focus for you on her corner of the home page this week.  The days have been bumpy, but we are ending on a very high note. We accomplished much, and the key lessons learned we'll discuss in coming days. I am glad that we did this.  And I am glad it is concluded. My main comment is to Sara, "Well done, love."

More later. 

 

 

The last of the author copies of my book went out yesterday afternoon.  Thanks to those who sent such supportive notes. I I hope that you enjoy the book and I'll be talking with you  soon.