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Parenting in a Time of Drug Abuse

Even under the best circumstances negotiating a path from childhood to adulthood poses tremendous challenges - for parents and their teenagers.

The parents struggle to maintain a balance between keeping their kids safe and close and giving them the chances they need to grow, between holding their children accountable for their actions and preserving some form of loving relationship.

Teens struggle to assert their independence in a world that's new - filled with possibility and fraught with danger.

Add drug and alcohol abuse into the mix and figuring out the process can be overwhelming for both parents and their children.

Area medical and mental health experts who work with drug and alcohol addicts and with families in stress say there is no one way to deal with a child. Each person is unique. Each person develops at a different pace. As dangerous as generalizations can be, they do agree on some guidelines that can help parents and their teenagers maintain an honest, open and caring relationship.

Keeping communication lines open, avoiding accusatory statements, reminding kids that their parents love them and care about them and that they value them not for being an athlete, or for wanting to go to medical school, or for the grades they make, but for themselves are all keys in passing the baton of responsibility from parent to child.

If and when systems break down parents need to reach out for help and support whether or not their child is willing to seek help.

"Every case, every family is different," said Brian O'Sullivan, Li.S.W., and manger of the outpatient mental health clinic for Hallmark Health. "Every child develops at a slightly different pace. Parents walk the line of accountability to the family, while at the same time allowing kids to test their wings. And kids send warning signals when they are having trouble flying."

Certainly going to extremes - "Hey son, let's go smoke a joint," or turning a home into a concentration camp - are definitely two paths to avoid, say the experts.

"I wish I had a formula," said Cheryl Enos, M.S., a veteran therapist of 16 years. "But I don't. Keep an honest and open relationship. That doesn't mean you smoke pot together. Locking kids up doesn't work either."

"That is a problem for many families," said Punyamurtula S. Kishore, M.D., M.P.H., who treats drug addition in the Melrose area through offices in Woburn and Brookline. "A lot of alienation comes when parents don't let their children become individuals. The more families I meet, the more awestruck I am about how little they know. Parents have very little clue about what happens when their children hit the youth culture."

One way to bridge that gap is to pay attention to what kids watch on TV, what they do on the Internet, the books they read and the music they listen to.

Paying attention doesn't necessarily mean banning a TV show or music.

"If you're watching TV with your teenager and you see people engaging in unprotected sex, make a comment. If characters are drinking, wonder who is going to drive them home. You're missing an opportunity to discuss real issues if you just turn the TV off. If you're seeing it, use it as an opportunity to open up a discussion," said Anya Koutras, M.D., of the Malden Family Health Center and assistant clinical professor at Tufts School of Medicine.

Parental accountability

Some parents must also look at their own value systems when looking at their children. Sometimes this means examining their own alcohol or drug use. Or looking at why they value their children.

"Kids need to have something to look at beyond school," said Koutras. "What do you want to do beyond school? Kids getting Cs and down. These students feel mediocre. Look to their artwork. Their music. What makes them feel unique. It's a great way to connect."

Kishore said he often treats athletes, especially football and hockey players, for OxyContin addiction because their parents urged them to take the prescription painkiller so they could play through injuries.

"They see their kids a sports stars," said Kishore.

"Parents need to send the message that they are concerned about their children because they love them," said 0'Sullivan. "We're concerned about you not because you want to go to medical school, but because we love you. They need to reaffirm their unconditional love for their child."

Parental drug use and the parent role model is also important.

"Actually, smoking pot together, that happens a lot," said Enos. "If you have a classroom full of kids from alcoholic homes and they see a drug-education video, that video isn't going to help a lot."

Maintaining child accountability and communication

Keeping communication open between parents and teens is one goal. Keeping kids accountable for their actions must also be part of that goal.

"Teens need to be held accountable for their actions within the family and the family needs to hold each person accountable for those responsibilities," said O'Sullivan.

Setting ground rules for when kids have to be home, for example, should be a joint agreement between the parents and the teen. Parents need to set the ground rules with the teen and have the teenager "buy into the rules" and then set some kind of a common understanding about what not keeping to the rules means.

"One would hope the original discussion gets it said," said O'Sullivan. "We agreed to the rules. What message are you sending us that you can't live by them? You hope to get some response - 'Maybe I'm not as good at managing my life as I should be,' or, 'Maybe I'm out of control in some way.'"

Sometimes, holding kids accountable can be terrifying for parents.

O'Sullivan says he sees families in his practice in which the child may owe a drug dealer thousands of dollars.

"The flip side of anger is the parent's desire to protect the child," said O'Sullivan. "If parents are paying off drug dealers for $5,000 to $10,000, the are covering for their kids. Parents shouldn't do it. If a person doesn't learn accountability at 15 or 16 or 17, it is much more difficult at 30."

The parent in such circumstances, of course, doesn't let the child dangle, waiting for the drug dealers and their baseball bats to come calling.

"What it means is we're not going to give you $5,000 so you won't be attacked," said O'Sullivan. "What we will do is get you treatment. Let's report this to the police. Take any other option than paying off the debt and saying, 'Don't do that again.' If a kid is really addicted, parents should think about how much heroin or Oxy that translates to."

Extreme measures

For some families, the addiction goes far beyond the measures discussed so far. The child is out of control, to the point of endangering himself and other, innocent family members. The child ignores or rebuffs efforts to treat the addiction or goes right back to using after the latest rehab stint.

At this point, parents have a tough choice. They can try again. They can expose the family to further danger and deterioration. Or they can move on.

"We have a clearer line," said O'Sullivan of when it's time to take drastic steps. "The law determines who should be committed. Parents have it much muddier. We're dealing with one family where the family went to the police and pressed charges. They realized the stakes are very high and the situation was out of control. They were willing to do what it takes."

"If a child or teen refuses to get treatment or do anything, if a parent is getting services for himself, to help cope, the parent will know when that time comes," said Enos.

If drug treatment doesn't work, if the child doesn't respond, the experts said it's vital for the parents and other family members to continue their own treatment. The effects of drug addiction don't stop with the addict. Go to Alanon or Narcanon meetings, they say. Stay in family counseling.

"Detaching with love doesn't mean you have to dance with these people anymore," said Enos. "Living with something like this, even if it's on the periphery of a family, is still stressful as is the process of letting go."

Even if parents seemingly do everything "right," that's no guarantee a child will grow up drug or alcohol-abuse free. Genetics also play a role. Some people are more prone to addiction than others.

"The best parents can do is to feel good about what they are doing and knowing they are doing the best they can," said Enos. "Ultimately, the children will make their own choices."

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