How are children’s substance abuse problems different from adult addiction?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

sign

No Drugs.
Photo courtesy of Pixabay.com

There are some differences between the substance abuse issues in children from those in adults, but they may be less than we used to think.

There are a lot of people who continue to think of substance abuse, addiction in particular, as an adult disease. That would be way wrong.

Most adults with a substance use disorder began their use at a young age. Seventy-five percent of all disorders, mental health, and substance use, begin before age 24. Half start before age 14.

Kids are getting into drugs and alcohol abuse earlier than most adults realize.

Larger treatment facilities will tell you about children as young as 5 that already are developing signs of alcoholism. Children frequently report that their drug use began as early as age 8.

That’s right folks, as soon as the end of the third grade we are already able to identify children at risk to develop an addiction, going to prison, or both.

Are there “Gateway drugs?”

There used to be much discussion of so-called “gateway drugs.” The idea was that up till you tried the gateway drug you were not at risk of becoming addicted. Once you take the gateway drug you are on the path to addiction. The drug that got blamed the most as a “gateway drug” was marijuana. While I think letting your third or fourth grader smoke some of your “medical marijuana” is a way bad idea, it has turned out that for most adult addicts that was not the gateway drug.

One reason that marijuana was implicated was that it was illegal. That meant that to procure marijuana in the first place you had to be breaking the law. Someone who was selling marijuana illegally and risking jail might also be selling other “harder” drugs. Breaking society’s rules on substance use is a bad direction to start out on, but there is more to the story than that.

For most children, the gateway drugs have been cigarettes and alcohol. Consider the cost to society of a child who starts smoking at an early age. There is good evidence to show that after trying that first cigarette if the child lights up a second one they are going to be smokers for life.

Look around any homeless encampment, any old-time A.A. or N.A. meeting or the public hospital emergency room and you will find a lot of smokers. Nicotine has been reported as more addicting than heroin. I have heard people in recovery from drug addiction say that it was harder for many of them to kick cigarettes than to kick the heroin.

Alcohol is also a severe problem for children.

The younger they start drinking the larger the risk. Some people have argued that there are places in Europe where children begin drinking at a young age and do not develop any higher rate of alcoholism than we do with a legal drinking age of 21. The biggest difference is that in those cultures children learn to drink a small amount with meals and as part of a social occasion.

Here in America, the tradition is that when you drink – drink all you can. These drinking occasions are times when a bunch of people are out to “party” and alcohol is a large part of that. The result is that children, teens, in particular, learn to drink heavily and to drink to get drunk. You do not take your grandparents to the party with you.

Drinking to get drunk, binge drinking is, of course, the riskiest way to drink.

Younger substance abusers go for cheap or easy to get substances. They are more likely to sniff paint or glue. They are also less likely to understand how risky a substance is; hence they go for synthetic drugs because they can get them without breaking a law. What they miss is that these drugs are “not for human consumption” for good reason. Some of these synthetic drugs can cause permanent brain damage.

Back to that gateway argument. It appears that it is not the fact that a drug is illegal, as in the status of marijuana in the past, but the fact that it is “illicit” that the child is sneaking to do something they are not supposed to do, that predisposes them to greater risks down the road.

One thing we miss is the relationship between substance abuse and crime. This is not solely the rule for adults. Children of any age who drink or do other drugs are more likely to do other crimes, behave in anti-social ways, and get into trouble.

One report said that on the order of 80% of all those in prison here in California were drunk or high in the 24 hours before they did their crime.

There is no doubt that being under the influence disinhibits you. Drug use also means you need money and that may lead children to do crimes to pay for their drug and alcohol activities. It is hard to keep asking mom for drug money unless she is also in the drug game.

Drinking and drug use may look different in youngsters than in their older compatriots but addiction and alcoholism start in the young and just keep getting worse.

As a colleague of mine keeps reminding us – any drug use by an eight-year-old is a problem.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Addiction, substance use disorder or chemical dependency

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs of addiction

Addiction.
Photo courtesy of Pixabay.com

What is the difference between addiction and chemical dependency?

A lot of different terms are applied to the usage of substances and problems that arise when people begin to experience difficulties with their use.

Various professions use different terminology to describe the same or similar problems and we don’t all use the same severity points to identify problems.

One way of understanding these differences is to think of substance use as being on a continuum. Let’s start with something most people are familiar with, alcohol use, and then add various drugs to the picture.

Alcohol use might range from no use to chronic daily drinking to the point of passing out. Fully 50% of the people in the U. S, who are old enough to drink, did not have a drink in the last 30 days. Clearly not everyone drinks and among those who do, not everyone has a problem.

Heavy Drinkers.

At the other end of the scale, the 10% heaviest drinkers consume 60% of all the alcohol drunk. The top 20% heaviest drinkers consume 80% of the alcohol sold in America. People at the high end of the drinking scale develop more and more serious alcohol use problems than those who consume less.

Among those who do drink, some people have one or two drinks on a special occasion such as a wedding or New Years’. People who drink at this level rarely have any problems. It is possible however to drink only once a year on New Year’s and end up drunk every time resulting in DUI’s or arrests.

The labels that will be attached to the person as their consumption of alcohol increases and problems begin to arise will vary with the profession and the reason the person is being given the label.

The person who has one drink and no ill effects would be considered by most of us an alcohol user but nothing more. The person who only drinks occasionally but when they drink has problems might be thought of as abusing alcohol.

The chemically dependent.

The medical profession often has special units which are called “Chemical Dependency units.” The people who reach these units have the most severe form of substance use disorder. They have reached the point of physical dependence on their drug of choice. Those who are chemically dependent on alcohol are at risk to die during withdrawal.

If someone has ever had a stroke, seizure, or experienced the D.T,s if there are any hallucinations occurring when the level of alcohol in this person’s bloodstream begins to drop, this person is at high medical risk and should be detoxed in a hospital or other medically managed facility. People can and do die from alcohol withdrawal.

People who are chemical dependent on other drugs may have severe physical withdrawal symptoms. The heroin or opioid user, for example, will have diarrhea, nausea, vomiting, shakes, and goosebumps. The withdrawals from opiates may feel like the person will die but deaths from opiate withdrawals are rarer than from alcohol. Overdose deaths are another issue.

Short of physical withdrawal is a form of substance use disorder that is called Substance Dependence. Clearly, not all cravings for a drug of choice are the result of physical withdrawal.

Someone goes through a 30-day treatment program, they have not used for over a month but the day they are discharged they use again. The craving is not a result of physical or chemical dependency but is a psychological need. Therapists would diagnose this as Substance Dependency. For the Therapist, this would include both physical and psychological dependency.

Alcoholism and addiction.

Twelve-step programs draw a different distinction. They would call this problem use of substances, addiction, or alcoholism. This addiction level of problem use may be reached even before psychological dependency has occurred. Addiction may begin at the point of wanting, craving, and thinking about the drug of choice even before the person has lost the ability to control usage. If you are struggling to control your usage then you have already reached a point of problem usage and probably would fit the description of an alcoholic or addict.

Substance abuse.

The lowest level of problem use would be referred to as substance abuse. This might be binge drinking, drinking more than planned or doing something dangerous after having consumed alcohol or another drug. The person who has a few too many drinks and then drives may be abusing alcohol but may not yet have developed alcoholism.

If this alcohol abuser can realize they have a problem and stop drinking to excess, they may be able to stop their progression to alcohol dependence, alcoholism, or chemical dependency.

Substance use disorder makes its debut.

The newer trend, now reflected in the DSM-5, is to avoid making fine distinctions between substance abuse, dependency, addiction, and chemical dependency and call all problem relationships with drugs including alcohol simply a substance use disorder.

Substance use disorder can come in mild, moderate, or severe forms.

Wherever the substance use disorder starts, it needs treatment long before it becomes an addiction or chemical dependency.

Whatever happens (It has happened with the DSM-5 and the new OCD-10 as of 10/1/15) with the DSM-5, expect the various professions and the recovery community to cling to their own special perspectives and their preferred terminology.

Did that explanation help with understanding the differences between Substance use, abuse, dependency, addiction, alcoholism, and chemical dependency?

Best wishes on your journey towards a happy life.

David Joel Miller, LMFT, LPCC

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Why we need to talk about mental illness, drugs and alcohol in combination

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

Why you need to know about mental illness, substance abuse, and co-occurring disorders.

Most people identify with one major problem, they have a mental illness, they are addicts or alcoholics or they may just have a “communication problem” with their significant other. No matter what you identify as your primary problem there are reasons you need to know about the other possible problems and how they may affect you.

Why “normal” people should know about both mental illness and addiction.

In the course of any given year, 25% of all Americans (numbers in other countries are about the same for most issues) will experience symptoms of a mental or emotional problem that are severe enough to be diagnosed. Most of those people will first see a medical doctor thinking that their loss of energy or their nerves is a physical, medical problem.

Most people who die from a mental illness have been to see a primary care or medical doctor in the 30 days before they die. When there is no medical cause for their suffering found they may fail to go for mental health treatment.

In their lifetime, about 50% of all Americans will experience an episode of an emotional or mental illness. Many of these issues can be mild if caught and treated early but untreated they get worse. The old practice of pretending you are O. K. even when you are in pain did and does not work. If you have a mental illness it needs treatment and getting it treated is no more giving in than going for treatment for a heart problem or cancer.

Many people will experience at least one episode of substance abuse, some get away with it a few times. Some abuse drugs and alcohol on a regular basis and do not get caught for a while, but eventually, most people have difficulties.

Even if you do not do drugs or alcohol there is a high likelihood that someone in your family or social circle will become an alcoholic or addict. For every substance abuse out there we estimate that there 5 to 8 people directly affected by the substance abuser’s disease.

Why the mentally ill need to know about substance abuse issues.

Not all mentally ill people abuse substances but the overlap is larger than most people would care to recognize.

Those with a mental illness are drawn to using drugs and alcohol to try to cope with their symptoms. Many Bipolar people like the mood swings that accompany alcohol use. If you like the mood swing you are likely to continue using or drinking.

When the depressed person drinks it helps them forget their problems for a while. Then the alcohol wears off and the problems return. There is often a rebound effect and the result is that your mental health issues are now worse than when you started. This leads to more and more frequent drinking.

Using drugs or alcohol to change the way you feel is a risky way to use them. If you are an emotional user you are at increased risk to develop an addiction.

Most psychiatric meds do not work that way, they do not suddenly and miraculously make you feel good, and then when the med wears off you feel worse. This is why psychiatric meds which only help you function, not cure your problems, need to be taken as prescribed and every day for a period of time before most of them will begin to help.

Why addicts and alcoholics need to know about mental illnesses.

A great many people in substance abuse recovery initially feel great, they are clean and this feels good. They the good feeling wear off and they are at high risk for relapse.

Many people began using and drinking at such an early age they do not know what it feels like to be without the drugs in their system. We often find that the early symptoms of a mental illness were there before the person first experienced drugs. But the long-term use obscured the emotional part of their problems.

Using drugs, the lifestyle, the drug, or alcohol experiences, distort your development. People who go for years using and drinking do not undergo the developmental milestones they should have experienced, and as a result, they are unprepared for life without drugs. The drug of choice and that could include alcohol or gambling or any other addictive behavior, has been your best friend and now when you give that friend up you may go through a period of grieving.

So drug and alcohol use may have hidden the symptoms of a mental illness, the emotional or mental illness may have been caused by the drug use or may occur when you give the drug up and discover that there is a whole lot of wreckage that you now need to clean up.

People just do not get through life having only one problem. The chances are high that you or someone close to you will have multiple problems in their lifetime. Having a mental or emotional illness and substance abuse or misuse is one of the more common cases of having multiple problems.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Drug programs are not about treating addiction

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

Did you think drug treatment programs were designed to treat addiction?

Drug treatment efforts in the United States are generally not about treating addiction. If we really cared about reducing addiction we would be doing things differently.

There has been a fair amount of criticism surrounding drug treatment programs and why there are so many people who have been through a treatment program and still use drugs. The reason this situation looks so bleak is that the majority of these programs were never designed to treat addiction despite what the program may be called.

Addiction is not the only area where programs are designed to do one thing despite being sold to the public and called by a name that implies they are supposed to solve that problem.

Having angered half the world with my posts on prayer and the role of spirituality in recovery I might as well anger the rest of the world with some comments about the defects in our political system.

Most drug treatment programs are not meant to get addicts off drugs!

Does that surprise you? It is only very recently and among a very small number of people; that addiction, alcoholism, and related impulse control disorders like compulsive gambling have come to be regarded as diseases.

The traditional approach to addiction was to consider those people criminals and lock them up until they quit doing drugs. Alcoholics were considered crazy and got confined to psychiatric facilities called “sanitariums.”  The high prevalence of repeat DUI’s (Driving under the influence sometimes called DWI, driving while intoxicated) and rearrests for drug use confirms that more than just locking them away is needed to solve this problem.

Some examples of possible treatments

Methadone maintenance for Heroin Addicts.

Methadone maintenance is not designed to cure addiction.  It is designed to reduce crime. The goal in this and most other drug and alcohol treatment programs is now and always has been on crime prevention.

The Heroin Addict with a $200 a day habit has to come up with that money every day or become very sick. There are ways to put the bill off, like getting an advance from the dealer, but that works for a very short time unless you are very, very wealthy. Eventually, you need cash. Drug connections are not charitable institutions, they want the cash.

Many Heroin users resort to stealing to cover their costs, burglary is a common way. To get $200 a day for drugs the addict needs to steal $2,000 worth of property. Fences do not pay retail. In the process of stealing $2,000 a day to cover their drug needs the addict may do $20,000 in damage. They do not care if they break a $1,000 window to steal a $1 item.

Giving the addict a $2 dose of “narcotic replacement therapy” will save as much as $20,000 in burglary and vandalism costs. What shocks me at this point is that the insurance companies are not lining up to fund this kind of crime prevention effort.

Remember that Heroin was discovered back in the 1800s and has been way out of patent protection for a long time. The only reason it is so expensive is that it is illegal. Doctors are not even allowed to prescribe it for clients who are addicted.

The replacement drug, most often Methadone, is not less addicting but more addicting than heroin. It is also not easy to get off. So the system does not treat the heroin addict. We get them hooked on another even more addicting drug.

Please do not misread this as my arguing for the legalization of Heroin or the end of methadone clinics. Keeping as much heroin as possible off our streets may reduce initial cases of addiction. Putting more Heroin on the streets will likely increase cases of addiction. I also know of many cases of people whose lives were changed by the use of narcotic replacement therapy (mostly methadone.)  Some people need that drug to get out of the illegal lifestyle and on to a legitimate job.

What I am pointing to is that this program like so many other government programs is not meant to help the people with the problem.

Drug treatment programs are designed to reduce crime not cure addiction.

Prop 36 or SACPA.

The “Prop 36” program in California which sent tens of thousands of addicts to treatment resulted in a number getting off and staying off drugs. The program has since been in large part “defunded.” The official title of the program was SACPA, short for Substance Abuse Crime Prevention Act. Clearly, the emphasis was on crime prevention, not addiction treatment.

Drunk Driving programs.

Further evidence for this hypothesis comes from Drunk Driving programs. Drunk driving programs do NOT treat alcoholism despite the high number of alcoholics with chronic medical problems who are driving up the cost of medical care for all of us. Programs forbid their instructors from talking about alcoholism.

Drunk driving programs are focused on teaching you how to drink more and still not get a DUI. Things like designated driver programs and spacing your drinks so you can continue drinking, the more the better, and still not get a DUI.

It is possible with the expansion of health care we will get serious about treating addiction, alcoholism, and mental health issues. I remain hopeful but skeptical. Past experience has made me that way.

Sorry to spoil your illusions. Drug treatment never was about the addict. But then you are not one of those people who believe in fairy tales like the tooth fairy or that food stamps are meant to reduce hunger are you?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Why violent people don’t get mental health treatment.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Why don’t violent people get mental health treatment?
Photo courtesy of Pixabay.com

Mental health treatment for violence.

There have been questions recently about why violent or potentially violent people do not receive mental health treatment to reduce their potential for violence. Some professionals have told us that the mentally ill are no more likely to become violent than anyone else. I have said this myself and it is largely true. But not for the reasons we might wish.

Our systems in America and I suspect elsewhere in the world, are designed to exclude those with a potential for violence from our definitions of the mentally ill and to exclude them from most treatment modalities.

I heard a few parents, mostly on the blogosphere, say they fear their own offspring; they have asked for help for their children and themselves and were denied services. I have had to sit and tell these parents that we just don’t have the sort of services they need. If those services did exist they still might not help.

Here are some reasons the potentially violent frequently don’t get treatment.

Most mental health treatment is voluntary. People can’t really be forced to treatment. When they are forced the result is that they don’t get honest and work on changing themselves but want to convince their counselor they are right and others are wrong.

With kids, we have some diagnoses that cover a lot of unacceptable behavior, conduct disorder, oppositional defiant disorder, and so on. I once ran a group for oppositional defiant kids. Guess what, almost none of them ever showed up for group. If parents can’t get them to treatment, professionals can’t help.

The only way to get many of these violent kids into treatment is to have their own parents press charges and have them arrested. These kids only get mental health services while locked up in juvenile hall or probation schools.

Parents have told me that their own child hit them, knocked them down, and threatened to kill them. Sometimes these are really little children, we wonder where they learned to say and do these things. It would be easy to blame their parents for teaching them to behave that way. But we know deep down they did not learn this exclusively from their parents.

Other times these are not little kids. They are big kids, often gang involved, but the police find their hands largely tied. In violence within the home, they are reluctant to take away someone’s child and incarcerate them.

The parent who a minute before called the police saying “Help,” my kid is hurting me, suddenly does not want them arrested and taken away. The jails are full and putting more kids behind bars is not likely to reduce violence in America. We have found from experience that the more people are incarcerated the more likely they are to become repeat offenders.

Even when we feel there is a high probability that someone will become violent, we can’t arrest people for what they may do in the future. Our system of justice requires us to punish people for what they have done not what they might do.

People with mental health challenges frequently avoid others. They are shy, depressed, withdrawn. My suspicion is that it is not the mental illness that increases the risk of violence but what happens to these children when they act oddly or different. The different are often bullied, not just physically but mentally and emotionally.

The answer for society has been to create the illusion of safety by expelling mass numbers of students. Homeschooling may be a blessing for a family whose parents can be great teachers but placing a kid on homeschooling who lacks social skills and whose parents say he is out of control is a recipe for disaster.

We know, though we don’t like to accept this, that we can identify these high-risk people, these different children, as early as the end of the third grade. They fall behind in school academically and socially, they get poor grades, act out, quit school, or get kicked out. Even when they are very smart they become isolated and lack of social connection is a high-risk factor for problems.

Drug addiction and alcoholism are rampant among kids today.  They report beginning their use of substance sometimes as young as age eight. Parents tell me that their child was never like that until they did drugs. Adults in drug treatment have said to me their problems began in the fourth or fifth grade or maybe middle school when they first got into drinking and drugs.

There is drug treatment out there for kids, but they are mostly voluntary programs after school. The kids who really want to get high do not show up for treatment. Parents have repeatedly ask isn’t there a program I can send my child to that will keep him locked up and away from drugs? The answer is that in most places there are no such programs. Society, in effect, tells the parents you had them, raising them is your responsibility; even when the parents tell us they just can’t get this child to behave anymore. Any person on drugs becomes unmanageable.

When the child reaches full size then society picks them up and puts them in prison, for a while, very briefly. Increasingly we find our prisons full and the time served shortening. Further, those who were diagnosed with various mental illnesses in the past find funding for treatment and reentry programs have been cut from the budget.

Most of those we are defining as mentally ill, especially in childhood, are the ones who do not sit still or get high grades. Those with ADHD and anxiety get treated. The angry, the hurt, the potentially violent, not many people what them around, and they get excluded from the system.

What are the potential solutions?

Briefly, as I am running out of space here, are my suggestions for solving some of our society’s problems.

1. Make people more important than things by supporting education and mental health services for all.

2. An initiative to work with struggling students in the second, third, and fourth grades, to identify high-risk students and to engage them in society by creating caring relationships with supportive adults. Shift the focus of school counselors from grades and getting into college to being successful in life.

3. Restore funding for mandated drug treatment programs. California’s Prop 36 program was working. When drug users are released from jails and prisons they need to be required to complete drug treatment programs. That means the rest of us need to be willing to pay for those programs.

4. Create and fund residential drug treatment programs and long term mental health programs or adolescents. Currently, the potentially violent teen gets out of the psychiatric hospital in a week or two, just as soon as they can convince staff that they really won’t kill themselves or others. We know that up to thirty percent of those who promise in writing not to kill themselves go home and do so.

5. Create and expand behavioral health courts where the mentally ill will need to stay in treatment and on their meds as a condition of staying out of jail and prison.

6. Reduce violence in our society by creating positive alternatives. I tend to believe it is hard to maintain a violent rage while reading a good book. It is much easier to stay angered up by playing violent video games and doing drugs.

There you have my over-brief thoughts on why the potentially violent are being excluded from our mental health systems, how we might change this if we just had the willpower and the changes that are needed.

What do you think about this?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What if your loved one refuses treatment?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Helpless person

Helpless.
Photo courtesy of Pixabay.com

What do you do when they get mad at you for suggesting they get help?

It is not unusual for people with a serious mental illness to refuse treatment. They don’t want to admit they need help, they are embarrassed or they don’t think that anything can help them. Sometimes people don’t want to give up their problems even when others around them see the need for them to change.

People with Bipolar Disorder may be especially resistant to getting treatment. They like the way the mania or hypomania makes them feel. When they slip into depression they may be more receptive but the second the depression lifts and the mania returns they are prone to stop taking their meds. This is very difficult for those around them.

People with a drug or alcohol problem are also resistant to change. They like the mood change their chemical friend creates and are unlikely to think the problem is the drug. They will blame others, make excuses, and offer plenty of reasons why they don’t have a problem. The harder you press them to change the angrier they will get.

Other additions, gambling, sex, and pornography are also more likely to be seen as a problem by those around the addict. So what does the family member do?

Unless the person with the addiction or the mental illness wants to change there is little those around them can do to make them change. The ill person needs to decide that this issue is causing them a problem and for a very long time they will insist that the problem is all those other people around them who don’t understand them.

If the person with the problem does not want help I highly recommend that the family member who wants them to change needs to get counseling for themselves. Continuing to insist that someone change to make you happy make us wonder who the mentally ill person is.  Ask yourself a few questions.

If this person never changes one bit will I be happy in this relationship?

Most people who have a mental illness or an addiction will not change until they find that they can no longer go on acting the way they have been. As long as a family member or friend stays in their life, helping them out and caring for them, they are unlikely to admit they have a problem. If you love them you may have to let them go, only to find when they have lost everything and finally get into recovery they may want to be with someone new who has not been through all the pain with them.

Staying with them means you will need to be prepared for whatever ride you end up taking. They may get arrested, become violent; leave you for their addiction or another person. They may think, at least for a while, that you are the reason they drink, do drugs, or are “stressed out.”

Can I accept that this is just the way things are?

Some family members conclude that they would rather put up with an ill family member and stay in the relationship even if the ill person never goes for treatment. Others will conclude they can’t take living with an alcoholic, drug addict, or bipolar person who is unwilling to get help. The choice is not a black or white one; these life choices are very personal. Just don’t fool yourself into thinking that if you stay around long enough and try hard enough your love will change them.

Consider also how far into this relationship are you?

If you have several children together that is one situation. If you have no children do you want to raise a child or children while the impaired person continues to act this way? Is it fair to put a child through this?

Too many people think they can change the partner, that a child will make the relationship better and that the other person will suddenly snap out of it and assume responsibilities when they have to. Occasionally that happens but not very often.

When the ill person will not come for therapy then the rest of the family needs to come to talk through their options and for help in coping with an ill family member.

Photo credit: Wikipedia

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel