A Parent-Child Conversation About Addiction and Recovery

These days it’s challenging enough to raise a child, especially through the teenage years, but no parent is truly prepared to deal with an adolescent child struggling with a substance use disorder. It’s enough to tear a family apart.

What follows here is a dialogue between a father and son, with the son now nearly seven years in recovery, about their personal perspectives on the son’s addiction and eventual recovery as a teen. This conversation stems from one of Caron’s series of Family Services webinars.

A bit of background: Stevie, the son, went to treatment at Caron at the age of 18 and this September will be in recovery for seven years, living a happy, empathetic, and connected life. As a recovering young person, he attended college, then spent a year as a research assistant at Caron working on a brain imaging study. Stevie now works in the treatment sector helping adolescent and young men in early recovery.

The father retired as a senior executive after a successful career on Wall Street so that he could concentrate more fully on helping his family and other families deal with addiction. He spent a year taking graduate-level courses in addiction, covering psychopharmacology, neuroscience and public health. He now works full time as a volunteer at a national addiction nonprofit, creating educational materials and tools for families. He is a co-creator of the ongoing Caron parent podcast series, My Child and ADDICTION. He also recently launched a website, Love the Kid, Hate the Disease, found at addictionlessons.com, comprising a series of gritty and personal short stories that highlight important concepts and tools that helped him – and now hopefully others – in the eight-year journey through addiction and recovery with his son:

Welcome to you both and thank you for your willingness to share today. Let’s begin with a summary of your stories before we get into our questions.

Stevie:

I am a gratefully recovering alcoholic.

I started drinking when I was 14 years old, and I drank for four years. In those four years, I was hospitalized four times. I was in a psych ward for eight days. I became an everyday drinker, I drank at school, I drank and drove, I had the cops called on me in my own home twice. All of that happened very, very quickly. And I was a totally different person than I am today.

I won’t go into the full story here – you can read more about it on my dad’s website – but there are a few critical moments in my journey.

At a St. Patrick's Day party during my junior year in high school, during an alcohol blackout, I was kicked out of the party because I put my hands on a woman. I had never done that before, and I’ve never done it since. As I was walking home, I was suddenly overwhelmed by the weight of my depression, anxiety and disease. By that point, I had been drinking for two years, basically every day, and my drinking had already put me in the hospital twice. I found myself sitting on the railroad tracks, waiting to end things. Luckily, a girl who had been at the party was walking home along the tracks, and she pulled me to safety just as the train was approaching.

When I got home that night, I confessed to my parents how I was struggling and needed help. They took me to the hospital, which resulted in me being placed in the psych ward for eight days. After being released from the psych ward, I was forced to go into an intensive outpatient program. I was in that program for 11 months, and I fought it the whole way. Even at this low point, alcohol was my identity, and it was the last thing in the world I was willing to give up.

I continued drinking into my senior year. I became increasingly violent at home, and my parents called the cops on me again, and I made promises about stopping. I did stop for a while, with my eyes on an upcoming senior trip. Of course, on the first day of the senior trip, I drank again. I woke up in the hospital, not knowing how I got there.

It was in this moment that I understood I was powerless over alcohol. No longer could I blame my parents, my family, my ex-girlfriends, my friends, my depression, my anxiety – any of it. It was clearly me, and the best thing that ever happened to me was that I ran out of excuses. In that split second, I decided to accept the help that was offered to me.

I entered treatment at Caron, then after 28 days, moved to sober living. I did everything to the best of my ability to say yes to recovery.

After seven months, things were working so well that I convinced my addiction counselors, therapists and parents that I should be allowed to attend college. Of course, at college, I stopped doing all the things that had kept me in recovery for the past seven months, so I relapsed.

I found myself sitting in a class at 10 a.m. one Monday morning, after drinking until the crack of dawn, and I realized I had a choice to make. I could become a closeted alcoholic, estranged from everyone I loved, or I could accept help once again. It was in this moment, September 29, 2015, that I decided to not run away from sobriety, to not be ashamed about it, but rather make it a part of my identity.

The best analogy I've heard for this is the difference between trying to learn an instrument and being a musician. One of these is a goal, and the other is an identity. For those first seven months, my goal was to stop drinking. Now I wanted to be sober, and I knew what I had to do. I am now approaching seven years in recovery, a college graduate and working in the addiction sector.

One of the last critical points in my journey happened as I was getting set to celebrate my first year of sobriety with a share at my local 12 Step chapter. I got a phone call from my best friend. He had just woken up out of a three-day coma from an overdose, and he simply said, “I need you.” It was there and then that I realized I no longer had to do it for just myself. He was one of two long-time friends who got sober that year. That made a tremendous difference to me in my own recovery, both because I could be of service to them in their need and because I now had brothers in arms who could join me on my own journey.

Father:

I'm just so proud of Stevie, and I learn new things every time he shares his story.

I’m not going to go too much into my own journey in this, only to say that it was unbelievably hard. Challenging does not begin to describe the fear, hopelessness and anxiety I felt while my sixteen-year-old son suffered from active addiction.

I’ve learned a lot over the past eight years, hard-won lessons from dealing with my son’s process through addiction and into recovery, along with eye-opening advice and counsel from addiction experts and from parents who had walked the same path before me.

It is not easy to parent a child struggling with an addiction, and I frequently talk to parents who feel guilty they didn’t realize their child was using substances earlier or some other way didn’t do enough to help their child. There’s a story I share with these parents: Tom McClellan, Ph.D., who was the Deputy Drug Czar under President Obama and one of the most prolific and accomplished addiction researchers in the world, once told me that he had no idea what to do when his own two sons became addicted. If one of the most connected and knowledgeable addiction researchers in the world was clueless as a parent, then the rest of us should consider forgiving ourselves.

I have no regrets about how I handled my son’s disease, but looking back, there are lots of things I wish I knew before and during my son’s battle.

First, I wasn’t even sure my son had an addiction problem. Were we just dealing with typical teenage behavior, or was it something more serious? That uncertainty kept us from having certainty of our actions in dealing with this serious health problem.

Much later, I discovered the Diagnostic & Statistical Manual of Mental Disorders (DSM-5), issued by the American Psychiatric Association, which is the go-to reference manual for psychiatrists and psychologists in understanding and diagnosing mental illnesses.

The DSM-5 is the gold standard for diagnosing addiction. It has eleven simple “yes or no” behavioral questions that define whether there is a problem or not and whether the addiction is mild, moderate or severe. This tool cuts through the denial and clarifies whether there is a problem and, if yes, how big. These questions take one-minute to complete.

I immediately took the test (and you can too), answering for my son as if he were sixteen again with the symptoms he displayed at the time. It turns out that he didn’t have a mild problem – he had a severe addiction to alcohol.

My ability to make parenting decisions for my son would have been so much easier if I had known that he absolutely had this disease and needed treatment.

Second, choosing the right level of treatment is critical. A Google search for addiction treatment will be dominated by intensive programs at residential treatment centers, but research shows that’s often not the right starting point for someone with a suspected substance use disorder. Addiction treatment professionals know all this, but the average parent has no idea what type of treatment makes sense for their child.

There is an online tool called ATNA, which stands for Addiction Treatment Needs Assessment, which was designed by world-class addiction researcher Dr. David Gastfriend, in partnership with Shatterproof. Google, the company, loved the tool so much that it helped Shatterproof design the user interface. If the level of care has not been determined already by a professional, this is a great public resource to access.

Third, addiction recovery is a process. The addiction professionals we spoke with would always tell us that the journey from addiction into recovery is a process, but they never explained what the process was. I still wonder why it took me four years and a fellowship at grad school to find out about the research on this, which would have been so helpful for understanding what was happening with our son while he was going through it.

When I read the “Stages of Change” for the first time, I just couldn't believe how closely the research described our son's journey through addiction to recovery. Had I been exposed to this simple model early in the process, I would not have been so confused and unclear about what was happening. More importantly, I would have had a better idea of what role I should play at each stage.

So, I invite parents with questions to visit addictionlessons.com. No one has all the answers, but I hope our experiences will help guide people.

Thank you both for sharing. My first question comes back to the beginning. How can a parent know the difference between “normal” teenage behavior and needing support for a medical issue?

Father:

That's really hard. We have five children. Our youngest has a substance use disorder, but all of them at some point had an experience that could be described as an overdose on alcohol. Yet we had a feeling in the pit of our stomach that something was different this time.

I really wish I had known about the DSM-5 at that point, because it might have put a frame around what we were seeing so we could really understand this was a serious problem. We probably grounded Stevie each year for six months during 9^th, 10^th and 11^th grades, and we even took him to an addiction counselor at one point. I knew he drank too much, but I didn't know for sure that he had a problem.

When does the behavior become concerning?

Stevie:

As my father said, it's difficult to know. The person who has a substance use disorder is often the last person to admit what's going on. When I woke up in the hospital for the fourth time in four years because of my drinking, I had run out of excuses for my behavior. Up to that point, I would have blamed my drinking on anything and everything except myself. I was stuck in this vicious cycle of drinking with impunity until some catastrophic event – ending up in the hospital or having the cops called on me – then repenting of my sins, promising it'll never happen again, then trying to put guardrails around my drinking – only drinking beer, stopping drinking at 9 p.m., things of that nature. Within a few months, I would be back to drinking as I had before. Eventually, something catastrophic would happen again.

Even with all that, it was really hard to admit to myself.

One of the things you talk about in your stories is the importance of getting support for yourself as the father of someone struggling in addiction. Just how important was the support and, more importantly, allowing yourself to be vulnerable enough to receive that support?

Father:

I'm the last guy you would expect to go to a parent support group. I valued my independence, and I thought I had all the answers. I'm the perfect mark for this disease because it's a disease of isolation, and it’s just so much more powerful than any of us alone. I was a mess, and I really didn't know what I was doing. The clinicians and parents in those groups really helped me, and I’m so grateful. I mean what I say when I say I couldn't have done this on my own.

You don't have a choice about being vulnerable. If you're going to participate, you're inevitably going to tell people the gory details of what is happening in your family. That's just the price of admission.

I learned so many important things in these meetings. For example, an important moment of truth for me came at a parent support meeting. There was a father wearing a NY Mets hat in the meeting. In a nonjudgmental way, he looked at me and said, “Why would your son change if you keep fixing everything for him? What's the incentive?”

If I saw that guy on the street right now, I would give him the biggest hug in the world. His comment changed my entire perspective on what I needed to consider while parenting my son with active addiction.

Can you share how your son’s recovery journey impacted your marriage? How did, or didn’t, you stay on the same page with your spouse?

Father:

It was ugly. We knew our son’s life was on the line. Nothing was more important to us. I thought I was saving his life by having conversations with him and easing his problems. My wife, who probably was smarter about this than I, was more for chaining him to his bed so that he couldn’t ever move. This conflict put an enormous amount of stress and strain on our relationship.

What ended up happening was the four older siblings, who were no longer living at home, did an intervention, not for our son, but for us! They told us we weren’t helping – we weren’t helping our son, we weren’t helping ourselves, and we needed to figure this out. I decided to step away from making decisions. I told my wife that. What was interesting about her response was that her approach to dealing with our son moved to the middle, where we should have been all along. It wasn’t about imposing full lock-down, but neither was she letting him get away with everything.

She obviously asked for my opinion, but I was clear that she was going to make the final decisions. That's how we got on the same page, and it was a really, really big deal. The chasm between the two of us had left us vulnerable, and our son was smart enough to drive a metaphorical truck through it. He knew if he could get my wife and I arguing, he could go on his merry way. He was exceptionally good at it. Once we closed ranks, it was better for our family, for our marriage and for dealing with our son, quite honestly.

Speaking of the four older siblings, Stevie, how did you repair your relationships with your siblings?

Stevie:

Time, changing my behavior, changing the nature of our relationship. For those four years, it had been a one-way relationship. They were checking in on me, trying to come to my aid, but I never returned their calls. Frankly, I didn't care, though now I care more than anything in the world.

If I look at it from a 12 Step perspective and the making of amends, the words I said didn't matter. I first needed to live by those amends and be the little brother I knew I was capable of being. For some of my siblings, it happened very naturally, very quickly. For others, who were around a little bit more when I was deep in addiction and were more deeply affected by my behavior, our relationship was really strained. That took much longer, but the result has been a beautiful relationship. Just recently, I was up on the altar while my sister was walking down the aisle to get married.

It took time, and it definitely took a lot of work, but the work has really been worth it.

How did you make it through college sober, with all the temptations and the cultural norm there is around partying in college?

Stevie:

Well, I didn't make it, the first go-round. When I went back the second time, I knew I needed some sort of system in place to refrain from drinking. That first semester after relapse, I began commuting to school. The 60-minute drive to my 8:30 a.m. class, my schoolwork, the 12 Step meetings and the therapy sessions I was attending kept me busy.

The big change for me was that I underwent something of an identity shift. When I was first entering recovery, my goal was to quit drinking. Things changed when I made being sober part of my identity as a person. Back on campus, I made sure the people around me knew that this was a part of my life. For the people who were close to me, I let them know some of the gritty details of my past experiences.

I also think there's been a significant shift in the last 10 years among young people. There’s a greater understanding that people all around us every day are struggling with substances and mental health. Some of my non-sober friends in college became my guardian angels, checking in with me to see how I was doing.

I wasn’t much about going out to bars, but that brings up another challenge, that of feeling you're missing out on much of the social scene. That's where the tools of recovery come in handy – going to AA meetings, keeping up with a sponsor. As much as I was a “normal” student, I was still doing a lot of work outside of college to make sure I was staying sober.

Finally, and I think God very much had a hand in this, I had two friends get sober at that time. That was a game-changer. I had those brothers in arms to have fun with. Meeting the challenges with someone at your side makes all the difference.

I gather there were some co-occurring mental health component issues involved with your substance use. How are you managing that now as a person in recovery?

Stevie:

When you're in the middle of your active addiction, it can be difficult to tell if the mental health issues are leading to substance use or if it's happening the other way around. I am lucky in that, when I got sober and started to really engage in recovery work, a lot of the mental health stuff started to subside. In managing anxiety and bouts with depression, I relied on outside support. I saw a therapist every week for four years in college – it was a mandatory part of me being on a campus. I also had a sponsor. Both helped work through that stuff.

Father:

One thing I want to add, which my son didn't say, but the environment at college was really supportive. His friends would come up to me when I visited and say, “We're so proud of Stevie. He's the toughest kid on campus. He's an inspiration to all of us.” I don't know if you remember this, Stevie, but you once said to me that the strip of bars off campus was one of the safest places for you because your buddies had your back. That really stuck with me. I thought it showed the quality of the people you had surrounding you.

I also think there’s been a real sea change in people’s understanding of mental illness and addiction. There's a greater willingness to support people in their challenges. I think this generation is a lot better than my generation about these things. I'm grateful for it, quite honestly.

Stevie, as a person working professionally in recovery now, what do you say to parents whose child is struggling with an addiction?

Stevie:

I work in a sober living facility, so the people I work with have already been through 28 days of treatment. They’ve been exposed to what recovery looks like, attending 12 Step meetings or something else. I act as the liaison between the parent and the child who's going through addiction.

What I've learned from these experiences is that there needs to be a period of separation. For the child, it’s not only getting away from the environment they were in and taking a break from all the habits, temptations and triggers that come with that, but they also need a period of separation from their parents as they are first entering recovery.

One of the best things my parents did for me was force me to channel my own support system, whether it was a sponsor, a case manager, or my fellow participants in the program. I wasn't calling my mom at 11:30 at night to tell her about my problems. I was beginning to build my own channels of support, with people who had been through what I was going through. From my perspective, this slight separation allows both parties to start to recover, and then there's this incredible reunion that occurs, that we at sober living help facilitate, where both parties – parents and child – have done their own recovery work and they're ready to start redefining what a healthy relationship even looks like for them.

Father:

It's really interesting you say that Stevie, because I don't know if you remember this, but when you relapsed those first weeks at college, we met with the addiction counselor and your therapist, and you were really angry. You were angry at the world, but I think you were mostly angry at yourself because you had just flushed away seven months of sobriety. We were on you about going to AA meetings and other things, and at one point you looked over at us and said, “Get the F-- out of my recovery. This is my recovery. I'm going to do it. You can't keep asking me about every little thing.”

And he was right. He took ownership of his own recovery.

Of course, as parents, we wanted to be updated on what he was doing. What was interesting was, when we backed off, he became more comfortable sharing with us. Our instinct as parents was to try to hold him accountable, staying on top of what he was doing, but at that point, we needed to let him make his own way and let him share on his own timetable. Of course, by that time, he had almost two years of experience, through inpatient and outpatient treatment and sober living and on-going work in groups. At the beginning, we needed to be a lot more involved with him, but, at that point, our attempts to monitor him closely were not being helpful and he told us in no uncertain terms to back off.

You mentioned 12 Steps. What can we do as parents or support networks when we have a loved one who is sober but not quite embracing the 12 Steps? Does it make a difference?

Stevie:

Just getting exposure to the 12 Steps was so important in my recovery. I found people I could depend on, who helped me discover unity and fellowship. I was 17 years old, living in New York City for the first time in my life. Walking into meetings and going to a diner with a bunch of 35-year-olds was not exactly my idea of a good time, but what I came to appreciate was that I needed their wisdom, advice and camaraderie.

As for what to do with a loved one who is in recovery but hasn’t embraced the 12 Steps, my advice is simple: Don't force it. Encourage it, but don’t force it. The only person you can control in this world is yourself, so take care of yourself and attend Al Anon or other similar parent support groups to find the support you yourself need. Talk openly about how such meetings help you and encourage your child to seek it on their own.

For me, it took a little while, but the 12 Steps have made the difference for me, and they are still part of my program today.

Can you think of anything that might have made you find recovery earlier than you did?

Stevie:

Honestly, no, I don't think so. I was 16 years old when I entered treatment. I'm not sure I would have been able to internalize, intellectualize and understand what we touched on in treatment much earlier than that.

There were a few things that really helped me move through the process. My dad alluded to it, but one of the first steps was my parents getting on the same page about how to deal with my addiction. Then there were the 11 months of intensive outpatient therapy, where I was meeting with a counselor once a week. I was also involved in group therapy, and I attended 12 Step meetings at one point.

Unfortunately, what I really needed to do was fail a little bit harder. But that failure really opened my eyes to all the things that I had been hearing for a year. It was then that I truly began to enter recovery. That process – continually failing and having people there as a support system – was really, really important in getting me to a point where I was ready to accept help.

Father:

On my website, in the fifth story, I talk about the process. My son just described his process.

When I first read the research by James Prochaska and Carlo Di Clemente, I finally began to understand what the process was, and the research really described everything that our son went through. For the parents who are struggling with a child who is having difficulty getting into recovery, I recommend you read their research.

One of the things that came out of the research – and this really blew my mind – was that the problem isn't that the person with the substance use disorder can't see the solution. The problem is they can't see the problem! If I protected my son from all the consequences of his negative behaviors – at school, crashing the car, and all those things – it was going to make it harder for him to see the problem and to move to the next stage.

The first stage is called pre contemplation: “F-- you. I don't have a problem. You're my problem.” That’s where we started, and I imagine that is the same for many other parents. It was not until he reached that moment where he had nowhere else to turn and no one else to blame that he was ready to move on to the next stage in the process.

When he relapsed on that senior class trip, when he called us up and said he was powerless over alcohol – that was one of the most beautiful moments of my life. It was the very definition of a process, because what 17-year-old senior in high school is going to say, “I am powerless over alcohol,” without going through a massive process transformation?

Stevie, how do you stay grounded in your recovery after the initial euphoria?

Stevie:

There was an identity shift for me that made it possible for me to enter recovery. Things changed when I decided to be sober, to make it my identity. That not only changed my own sense of self, but it made it easier for me to tell people about my work to stay in recovery.

I understand the challenge of holding to that identity after that first flush of success in recovery. There's a funny comment I read somewhere that says, “I was shocked to find out that they weren't going to build statues of me for being sober.” That first year of recovery, you receive so much positive reinforcement. Your family is happy for you; everybody claps for you when you share your day at meetings. It's a sobering moment to realize that people eventually just expect you to keep up with these behaviors. This is just your life now, and people aren't going to clap for you forever.

For me, what made the difference was the opportunity to be of service to others who were beginning their own recovery journey. I had two friends go through treatment and enter recovery just as I was celebrating my first year in recovery. Being able to give back and be of service to them, and to others, has allowed me to stay focused and engaged.

How can you differentiate between positive reinforcement and just playing cheerleader for your child?

Father:

It's not easy. The way I think about it is, if it’s a healthy behavior, I'm all in, but I won’t support anything that is unhealthy. For example, if my son came home drunk on a Friday night early in the process but then wakes up the next morning and asks to be driven to some place so he can feed the homeless. Okay, so that's a great thing he wants to do, but obviously, I'm also furious about the drinking. How to respond? I encourage the healthy behavior every time. Maybe he’s just using it as a manipulation to get out of being grounded, but I'm going to remain pure to what I'm willing to do, which is I'm going to support everything that's healthy and good and support nothing that is unhealthy.

As for cheerleading, maybe I am a bit of a cheerleader. It’s my nature, and I view it as positive reinforcement. I have to say, I think positive reinforcement is underutilized by treatment providers. They hammer hard about boundaries and natural consequences. But the other side is really important, because the kids want to be loved. They want approval. So, take advantage of that and make an effort to catch your kid being good.

Have you seen a shift in the way people react when you share that you love someone who struggles with substance use disorder?

Father:

This comes up a lot, because I haven't had a drink in over eight years – not because I have a substance use disorder but in solidarity with my son. At a party, people invariably ask me why I am drinking club soda, and that leads into a conversation about 50% of the time. Which then leads to more questions, because many people are dealing in some way with substance use problems in their own lives and among their own loved ones. But never once has anyone looked down on me or said anything negative about my family situation. Just the opposite: “That's awesome. Congratulations!”

I know that there's stigma out there. People talk about it all the time. I have felt none of it.

Stevie:

When you're in active addiction, there's a lot of stigma and judgment. I think people find it hard to be empathetic. As you start to enter recovery, that changes. Many people have loved ones who are in active addiction or in recovery, and they really respect someone who is making a substantial change for the better.

For me, the big difference is simply taking ownership of it, not being ashamed of it and just putting it out there. I've been in situations where I have to say no to a drink. I would say 99.9% of people respect that. Some people will inquire further, and I just let them know that I’m nearly seven years sober and it didn’t go very well when I used to drink. Ultimately, I think everybody understands that.

How do you feel about the content of your father’s website, Love the Kid, Hate the Disease?

Stevie:

It's interesting because we don't really talk about it much. We don't dig up the past and talk about the crazy stuff I did for four years. I’m just living amends and moving forward, and I'm very grateful that my parents didn't use my past against me and things like that.

I will admit that my first time reading it, it felt raw. It's been edited a few times since then. It's an incredible piece of content, in my opinion, very informative.

My Dad created three versions of the content for me to review and decide where I felt comfortable sharing. The first one was fully anonymous – it didn't use my name – and the stories were more generic. The second version still didn't use my name, but the stories became more personal. This third version was the truth -- that's the way I like to look at it. It's what happened, and I believe telling the truth will help people the most. So, I told my dad that I would prefer he lay it all out there. I'm just not that person anymore, so I no longer have any sense of shame or guilt surrounding all of it. Of course, I feel bad for some of the things that I did, but I've really moved on and, luckily for me, I believe my family has moved on as well. So, I told my dad, if telling the full story can help others, then I'm all for it.

How are you two enjoying your relationship now as father and son after walking this path together?

Father:

I adore Stevie. We play golf and follow the Mets together. From my perspective, we have an awesome, personal father-son relationship. On top of that, I couldn't be prouder of who he is, who he's become and what he's been through. I think the world is just such a better place with Stevie being healthy.

Stevie:

For me, it's a totally new relationship. We joke about it now, but when I was in high school, my dad used to text me every day, at the same exact time, as he sat down on the Long Island Railroad to commute home. He would ask how my day was or something like that. During my junior and senior years of high school, I don't know if I answered those texts even once. So now, hearing him talk about us texting during Mets games, or going to play golf, it's a totally redefined relationship. There's a lot of mutual respect and love there. It's totally different, and I'm very grateful for that.

My dad will talk about how proud he is of my recovery, and all the steps I’ve taken professionally since then, and that’s all great. But the thing that’s made it all worth it for me has been the new and redefined relationships I found in recovery. My relationship with my dad is probably on the top of that list.

Thank you both for being vulnerable and sharing your stories. Your relationship is inspiring and I’m sure the work you are both doing is changing and saving lives!