Using Respect as a Key to Sobriety

Erich Engelhardt and I wrote earlier blogs on the adolescent brain. In this week’s offering we report some startling new data reflecting just how vulnerable this age group truly is to life-long addictions. At some point information like this, we hope, drives policy. A concerted campaign against smoking has resulted in a dramatic decrease in teenage cigarette abuse, from 75 percent of kids having tried a cigarette in 1976 to 42 percent in 2010. And only 4.7 percent of the 12th grade class of 2010 smoked more than half a pack per day, compared to 19.2 percent in 1976. (Monitoring the Future) But an alarmingly high percentage still imbibe alcohol, 71 percent of 12th graders in 2010. This is not benign. A drink here and there really does have the potential for a whole lot of damage. And only a very small percentage of kids who use actually get treatment, less than 10%.

The latest news from The National Center on Addiction and Substance Abuse (CASA) at Columbia University in New York about teen age drug and alcohol use is not good. One in four Americans who began using any addictive substance before 18 are addicted, compared with one in 25 Americans who started using at age 21 or older. The CASA report found that 10 million high school students – 75 percent of the total – have used addictive substances including tobacco, alcohol, marijuana or cocaine; and 20 percent of them meet the medical criteria for addiction. In fact, CASA is dubbing adolescent substance abuse as the #1 public health problem in the United States.

We wish there were some surprises in this report, but our experience at CASTLE have prepared us for this news. Almost 1000 unique cases have crossed our threshold in just three years, a significant percentage have come for more than one visit, and a few for more than three visits. On average we have 16 kids in our program on any given day, and have for 365 days per year for the last three years. This translates to 17,520 patient days. That’s a lot of days.

These are kids using everything from heroin to alcohol to marijuana to huffing dust-off to drinking cough syrup and everything in between. They come from good homes, broken homes, supportive or abusive homes. They have contact with state social services or state criminal agencies. They are in gangs, not in gangs, trying to get out of gangs. Many come here angry or sad, craving to use, anxious to get out. But here is the remarkable number. Despite all of their potential for aggression we have had fewer than 50 real fights among all those patient days. Fewer than 50.

Why? We are convinced it is because we treat kids with respect. Frequent readers of this blog will have heard Dr. Shrand say this before: when is the last time you got angry at someone you really believed was treating you with respect? You don’t. The brain is not designed to work that way. Anger is an emotion determined to change the actions and behaviors of someone else. Why would you want to change another person who sees you as valuable?

Addict. The definition from the online Encarta dictionary is “somebody who is physiologically or psychologically dependent on a potentially harmful drug.” When you create a mental image of an addict what does your brain design? Usually someone who is not to be trusted, has a moral deviance, and should be doing better. If you were seen this way, how would you respond? This view of another person is unfortunately fraught with disrespect, even disgust. It results in the ostracism of the person struggling with addiction, and may even drive them further into the world where the only pleasure is the internal one of getting high. Our aim is to shift this perspective of those struggling with addiction, treating them with respect, and helping to re-kindle their sense of value. It is through the eyes of others, through social connectedness, that sobriety can take hold.

The first step in treating our teens with addiction problems is to recognize the problem. CASA has helped do this, and the results are startling. I hope they are sobering.