rook

Our journey began 5 years ago when my daughter was 14. I'm going to give the abbreviated version. She had severe stomach pains, and her GI doctor thought she might possibly have Crohn's. Over the summer of '05, she was checked into the hospital about four times and received IV pain meds each time (you can see where this is going). Around the 2nd or third time in, the GI doctor started having second thoughts about the Crohn's diagnosis and started thinking it might be more anxiety related. So we started seeing psychiatrists for her anxiety and depression. Another therapist has recently mentioned borderline tendencies. Since then, she's been on prescription xanax and two several-month long stints of prescription pain meds with lots of shorter stints mixed in.

Fast forward to this fall and all of her legal supplies of pain meds had dried up (she was very good at manipulating her mother and I and the medical system to gain access to them). She then turned to street supplies of the pain meds. We quickly detected the suspicious behavior and confronted her, several times. After about of week of questions, she admitted to using street drugs. It was then that we first realized how strong her addiction was. Three days later she cut her wrist when she was home alone - not deeply enough to put her life in danger, but there were ambulances at the house and she'd left a suicide note.

After a week at the mental hospital she went straight to a drug rehab program. She's still there and will be for the better part of 2 more weeks. We are trying to figure out (with all the different MH professionals that are helping our family) what the next step is. All the advice we are getting is that she should not come home immediately, and we tend to agree. But of course the daughter has different ideas. One of her counselors at the rehab facility said she may not be ready for a halfway house at the end of her 30 days. She has very poor coping skills for a 19 year old, she has the depression/anxiety issues, she doesn't drive (too stoned on xanax to trust her behind the wheel), and has a 10th grade education. There is also the problem of keeping her covered with health insurance -- might have to go Cobra on that issue.

We went for a visit on Sunday and during a family counselling session my daughter indicated that she wouldn't go to a halfway house. She came up with a solution of going to live with relatives, since my wife and I had indicated that we didn't think it was such a good idea to go back to the previous living arrangement, at least not right away. However, the potential relatives all have their own problems (some pretty significant). I don't think it would be a good arrangement and I think (hope) they would all say "no".

It's her recovery. My wife and I have to keep telling ourselves that. I'm okay with leaving the halfway house as her best decision (whether she takes it or not is up to her and another matter) if that's truly the best option. Are there other options we should be looking at, given her dual diagnosis and her complete lack of living skills?

BTW, we are in a support group, we are learning about taking care of ourselves, setting boundaries, quitting trying to fix it etc. We've been lucky in that she hasn't been arrested, hasn't ruined us financially. I know the jail time or living on the streets could come if she doesn't want the recovery. God, it's hard.

Thanks for listening.

Impurrfect

((Rook)) - Welcome to SR!!

I'm an RA (recovering addict) as well as someone who has loved ones who are addicts. I haven't really dealt much with the MH aspect, but I'm sure others will be along who have or are. I do know that I'm grateful my family stepped out of the way and let me find my own way to "bottom" and back up.

I just wanted to welcome you and say "Good job" on getting support for yourselves! I'm sure others will be along shortly.

Hugs and prayers!

Amy

liesagain

so sorry to hear your going thru all of this with your daughter. I dont know the answer to your question but others should be along soon to offer advice and support.

outtolunch

She sounds similar to my now 21 year old daughter at 19, except my daughter had graduated from high school at 17 and worked many crappy jobs, while pretending to attend community college. Her first exposure to mood altering drugs were those prescribed to her, begining at age 14.

I am skeptical of premature medical diagnosis, especially for cognitively/emotionally immature teens. In some cases, such diagnosis carry the potential for lifetime excuses and dependency on family, men and/or the system.

My state recently passed legislation allowing unmarried adult children to remain on their parent's health care insurance policy to age 26. Many other states have similar legislation or are considering it. Most likely, your policy will cover her if she is a full time student.

It sounds like your daughter does not have the skills/education necessary to support herself, let alone cope with life as is. Is transportation an issue, too?

What's the real issue with returning home? Family conflict? Peer group in the neighborhood? Something else?

What's her plan? Does she intend to get her GED? How about career counseling? If nothing changes, nothing changes. And everything requires effort.

rook

She can stay insured until she is 24 if a) she is a full time student or b) I claim her on my taxes. To claim her she has to live at home and earn less than $3600 per year. Doesn't seem to fit well with the halfway house concept, unless we go Cobra, which is an option.


Yes, this is true. She might be able to hold down a job at a fast food place. We could provide income supplements, if she was moving forward.

My daughter needs to learn to drive. I've taken her out a few times but frankly she makes me nervous as hell. Maybe that would be better when she wasn't using.

I have a firm boundary that she cannot use while living in the house. Period.

When she went into rehab, our plan was that she would come home. But the recommendations that we are getting from my wife's therapist and the counselors at the treatment center are for her not to come home.

A big issue is the family dynamic. I work, but my wife stays home. My wife suffers from depression, and my wife and daughter feed negatively off each other. Probably my wife has strong co-dependency tendencies (still learning about that). They both get sick a lot. Between the sickness and depression, they don't seem to accomplish many of the things they need to to return to healthy living (exercise, education for my daughter, my wife doing her house work, making it to therapy appointments, basic housekeeping). I'm a fix-it person, so that adds another dimension. My daughter and I end up arguing with the wife feeling like she is stuck in the middle. Daughter also wants her independence. We all need healing. Can we do it all under the same roof with an addict in the very early stages of recovery? Sounds like we are setting ourselves up for failure.


She wants to come home. She does want to get her GED, but that has been the plan for at least a year-and-a-half and nothing has happened. Being off drugs will make a difference toward achieving that goal, but there are still the issues of depression and my wife needing to driver her, so there are two potential points of failure in terms of getting her to class.

In the beginning when I thought she was coming home after rehab, we were going to set some boundaries. But I am afraid we would just end up back in the same cycle.

One thing I know: I won't continue to live like we have. Firm boundary.

outtolunch

Unless something changed this year, I thought you can only claim her as a dependent on your taxes if she is a full time student or deemed permanently disabled.

Many young adults maintain their legal residences at their parent's house because of health and auto insurance, when they are in temporary housing situations. A half way /sober living enviornment is a temporary situation.

I was in your shoes, when my now 21 year old daughter was 19. In fact, my quest to find a sober living enviornment for her is what brought me to this forum. Like you, I am a fixer and had to learn some life lessons about controling other people, along the way.

Anyway, we ended up taking her back into the house with the same boundary....I will not live with anyone in active addiction. She relapsed and I gave her the choice to get clean or out, now. She chose to get clean and returned to community college. Down the road, she relapsed again and abruptly moved out and eventually got clean on her own, again.

She now lives with her BF, at his parent's house. He's a good guy and not involved with drugs or alcohol. He has not yet come to terms with how he is going to balance what he wants to do for a living versus being able to sustain himself and pay off student loans without benefit of room and board, from his parents.

In the meantime, daughter is working and buying one of our cars on a layaway plan. When it's paid for, she will get it and not a moment sooner.

There are no easy answers- one size fits all. I appreciate the added complexity of your wife's emotional state in all of this.

Until one can accept the present and cope with life as is/where is, relapse, poly substance abuse, other addictions and co-dependency remain very real possibilities. Is it possible she could remain in an emotionally rehabilitave enviornment, somewhere, for another 30 days?

I suspect you have probably put forth more time and energy debating alternatives than she has. If only we could transfer the long view to our children.

Chino

There are long term facilities in the US, six months to a year. They aren't mental health institutions, it's more sober living with full access to mental health professionals, addiction specialists. They are taught how to manage regular life and are required to work, go to school, etc. It's expensive for sure. One place I looked at for my daughter was about $5000 a month and in Texas, if I remember right. The upside, if you can afford it, is that the longer they are immersed in recovery the better their odds.

There's also the Salvation Army, which is long term and free.

Your daughter not wanting a halfway house tells me she isn't ready to grasp recovery. It's just my opinion and I could be wrong, but I say that out of my own personal experience.

The first time my daughter sought recovery was detox with no rehab and she refused it. The second time was IOP. The third time was inpatient rehab followed by a halfway house she was finally ready for. They weren't a good fit and she didn't follow up fast enough, I didn't enforce my boundary, and a predictable relapse happened.

My 22 year old RAD is on suboxone. She now wants to live in a halfway house or go to a long term program, but being on subs seems to keep getting in the way. I've told her when she's ready to wean down and jump off, I'm more than happy to send her but with one caveat: it will be at least 1000 miles away. No easy outs with that kind of distance! She's all for it, because she knows she'll need structure and I'm not the one to give it.

Knowing now what I didn't know then, we never should have let her come home the first time until she had substantial clean time.

rook

Minor update:

The professionals at the treatment center are emphasizing the addiction part of her illness and are saying that her behavior patterns are perfectly normal for a 19 yo going through recovery. They do not rule out the mental health aspects, but are uncertain if a specific MH diagnosis is even in order at this time.

Meanwhile, her normal therapist disagrees with this pov and is emphasizing the mental health portion of her disease, and is indicating that the addiction is a by-product of her psychological condition.

I'd love to hear any additional perspectives on dual diagnosis.

She leaves treatment in a couple weeks and both her treatment center counselor and her normal therapist are giving indications that she isn't ready to return home, but that she may not be ready for a halfway house either in terms of education level and general life coping skills. Developmentally, she's probably equivalent to a 12 or 13 year old, according to her therapist.

We may consider offering as an option a longer term treatment center such as Chino mentions (maybe in the 30 to 90 day range) that is capable of handling dual diagnosis. Anyone have any experience with one of these? We are thinking about including an option like this for her to choose from (moving back home probably won't be one of the options available). It would be a significant sacrifice to send her to one of these, but it would 1) give her more time in recovery in a safe environment; 2) give her some intensive 12-step and dialectic behavior therapy that can help her to begin building the coping skills she lacks; and 3) give my wife (and I) more time to manage our recovery so that the home dynamic is changed for the better when she does return.

I guess my biggest concern is whether she is ready for such an intensive treatment program. If she still needs to hit rock bottom before she is ready, I'd rather not invest in this kind of treatment now.

Any thoughts? Thanks in advance.

coffeedrinker

And I think this is the trickiest thing of all. We never, ever know if this particular rehab, this time of getting up on the wagon, will "stick". Some people only need one, some come to it young, but some are chronic, chronic relapsers.

I'm sorry I don't have much first-hand experience with your specific questions. But, I would MOST DEFINITELY opt for the non-live-at-home option. I could be wrong, of course (see above!) but I think it's a set-up for stress to have that. You can have firm boundaries in place, but it is still very difficult, and stressful enforcing them. Perhaps, when there is a longer period of sobriety, and it feels to you guys that she is in a really good place you can revisit that one.

My belief about mental illness is that when you have a addiction issue, you cannot properly diagnose, or manage, the mental illness. The addiction masks far too much. Which is the chicken; which is the egg? You and therapist have already asked this question, and no absolute answer is forthcoming. Her addiction has to be well under control before she can move forward with the other issue.

Glad you found this forum. It is a wealth of information.

Spiritual Seeker

Most young addict have to go through several rounds of rehab before recovery happens.
My dual-diagnosed son went to two short term rehabs and relapsed quickly thereafter ea. time. After The first rehab he came home. I know now that was naive thinking on my part...but I didn't know how cunning addiction is.

At 23 he went to a one yr. inpatient facility that is just for ages 17 -25 which treats addiction and has a mental health component for the dual - diagnosed
Most young people are if they got on drugs young. Sometimes the mental illness can improve, but only with sustained sobriety. My son was put on meds for depression, bipolar and borderline, but now two yrs. later is off meds.

After the 12 month inpatient primary care he went to 6 mos. in sober living house offered by the treatment center. He has remained sober.
Long term treatment is expensive. My son says it saved his life.
Many who went through his long term program have succeeded. However, even after long-term, some relapse.
PM if you want info about his facility.

Chino

The only thing we know for sure is that they'll be taught valuable tools for recovery.

rook

This email serves two purposes.

The first is to say THANK YOU for all that have shown your support so far. I've read each of your responses several times and got something valuable form each one of them. I wish none of us had to make this journey, but if there must be fellow travelers, it's darn good to know who you are.

Second, this serves as my fifth post, so now I can send a couple of PMs.

sistergldnhair

I also agree with the not coming home aspect. My son is now 24. He went to his first treatment in June of 2008, came home, and quickly relapsed. He told me not long ago that he had no intention of staying clean at that time. He had been using at that point since he was 14.
2 months later he was on a plane to a treatment facility in South Florida. He stayed there for 5 1/2 months, and it was rough. But they were a dual diagnosis facility, he saw a therapist and a psychiatrist. He was diagnosed with bipolar/borderline personality disorder...and is now on meds. He still at this time remains in South Florida. He did not stay clean and has bounced in and out of treatment and halfway houses for much of the past year.
He is now a "chronic relapser". But I know I he has the tools and he is in the recovery capital of the world. Meetings on every street. I'm letting him learn from his mistakes (finally) and not running down to rescue. It's been a long long road.
I know your daughter is young, but there are many many kids who at her age, do rehab and go to halfway houses and learn the tools. There are so many great programs that she can go to and learn the life skills needed, more so there are many good people in a good solid recovery that can help her.
true Mental Illness and addiction are similar issues, but one does not cause the other. It is a bad card to be dealt to have both, and these kids have to learn how to manage each one. Hand in hand.
Good luck to you and your daughter.

idahoone

((((Rook)))) My son is an addict as well- recovering at this point- but I have been in a similar situation to where you find yourself now. I used to post alot on this site but my posts disappeared. My son's journey started at 17- and he was diagnosed with bipolar disorder and drug addiction- scary stuff for a parent!! Over the next 5 years, he was arrested more times than I can count (many of them- I assisted in), he did outpatient treatment (which we participated in for 6 months, 4 times per week), inpatient treatment, treatment in jail, Drug Court, living in a halfway house (for a minute- too many rules), the "Rider Program"- military style prison program that is about 4 - 6 months long, and then finally prison....so we have been where you are. What I "hear" your daughter saying when she says I won't live in a halfway house is that she isn't ready- if she were truly committed to her recovery she would do it if that was her best/only option. Stick to your guns- no means no...she doesn't get to control the situation. By the way, my son has been drug free for 2 1/2 years (at least) and he quit taking the meds for bipolar disorder in the fall of 2007- at least for him, being drug-free seems to have made the symptoms of bipolar disorder disappear. I personally think the diagnosis was not accurate- hard to accurately diagnose mental illness when they are using (his primary drug of choice was meth- but he used everything except heroin)

So, I offer my prayers to you and your wife and your daughter....

Marlie

An insurance agent told me an insurance trick to keep older children on a parent's medical insurance. Just enroll her in a JC in the required number of units. The child just has to be enrolled and they will be covered. My agent explained that the insurance companies need only proof of enrollment.

BTW, I also have a daughter who began using at the age of 14. At 19, she lived in a sober/hallway house. I believe it was the sober house that straightened her up. She saw 30 and 40 year olds whose lives were destroyed due to substance abuse.

rook

Unless something changes, we'll probably go the route of additional residential treatment for dual diagnosis. Between her young age and the MH issues, she's not at all equipped to deal with life on life's terms at the intensity level that they will hit her in a halfway house. It's not that it would be hard on her, its that she flat out doesn't have the coping mechanisms. It would be like expecting someone in an English as a Second Language course to write the next great American novel.

Now that she is detoxed and taken the first tentative steps toward recovery, this is the first real opportunity that she'll have to address the MH issues. Intensive work on those over a multi-month period in a sober living environment just seems to be the next step. As Chino pointed out, she'll at least be taught coping skills that she doesn't have now. Those coping skills will be put to use:

1) At a halfway house, which is still a distinct possibility after the dual diagnosis treatment.

2) If and when she has a relapse, because I definitely see the benefit of allowing her experience the full consequences of her addiction once she gets exposure to a few more coping skills.

3) Basically, the rest of her life as she deals with life on life's terms.

rook

Also, she has backed off of most of her "I won't" statements.

"I won't go to IOP!" - when faced with a halfway house, she changed her tune and suggested going to an IOP.

"I won't go to a halfway house!!" - she changed her tune when she realized that all the other options were worse.

"If I can't come home now, I don't want you to visit on Sunday, and I'll never, ever live with you again!" -- 20 minutes later she calls back and apologizes.

Maybe she isn't ready for recovery, but she needs to deal with the MH issues sometime, and while we have her sober seems like the best opportunity. If she relapses, so be it -- I can't control that.

teke

welcome to sr.

sorry i'm so late seeing this and i'm sorry about your daughter. i understand you not wanting to invest in something that you don't know will work. unfortunately there is no guarentees with rehab of any kind. for your daughter to get better, she has to be willing to do whatever it takes, agree to whatever options she has as for rehab and commit to work, work work on herself. if she refuses anything, maybe she's just not quite ready anyway. thats how it was for me.

it took me a lot of tries and quite a few stints in rehab, nothing worked until i was ready to make it work for me. you and your daughter are in my prayers.