TOUGHEST HURDLE TO OVERCOME IS DENIAL

It is often difficult for the family to admit something is wrong

Grania Litwin Times Colonist

Telling your drug-addicted child he or she isn't welcome at home
unless they get treatment or abides by the house rules is painful for
any parent.

"But it may be the critical move that eventually saves a child's
life," said addictions expert Dr. Ted Kardera. "It's the kind of
statement that may precipitate someone getting into recovery and
getting over denial."

Addiction is a progressive, fatal disease, Kardera said. "With drugs
you don't have the luxury of 20 years. You're looking at five to 10," he said.

A parent who wrestles with whether to tell a child to leave home
fears their child might not survive on the street or might die of an
overdose. "But by continuing to support the child a parent may be
enabling him or her," said Kardera, a specialist in addiction
medicine for 20 years.

He is a member of both the American and Canadian societies of
addiction medicine and is one of two physicians at the Cedars
addiction-treatment facility in Cobble Hill. He has also been
involved with the physicians' support program, assisting doctors with
addictions and chairing the interventions committee.

Kardera explains that telling a child he might have to leave home is
never a first step; it is a desperate measure that comes "towards the
end of the process."

First comes denial. "Parents say there is nothing really wrong, their
son or daughter is just going through a bad patch." More and more
evidence piles up. Marks fall at school, behavioural problems abound,
confrontations increase. In an effort to set things right, parents
remove privileges, impose curfews, seek advice from doctors and
counsellors, maybe put kids in treatment.

Family schisms develop. One parent says yes, another says no, and
kids play both sides against the middle. "There is so much disruption
you can't believe it. This disease destroys lives, families, relationships."

He advises that firm, loving guidelines should start early, but even
if they are imposed later, the situation will start to change when
parents become guilt-free and can say: "We're responsible to him, but
not for him. He suggests parents look into Al-Anon, a support group
for friends and relatives of drug or alcohol abusers.

Some parents blame drug abuse on genetics or peer groups, but Kardera
says that's academic. The bottom line is: Accept it, deal with it,
get on with helping the child.

And he, like most other counsellors, doesn't use the term "tough
love," which refers to a program founded in 1979 by two Pennsylvania
therapists. But whatever the terminology, the idea is to set
boundaries with compassion.

When it works, it's because the denial breaks down. "Denial is the
hallmark of addiction," he said.

The addict says: I've got it under control, it's not a problem, and
continues the abusive behaviour, whether it's drugs, sex, work,
gambling, alcohol -- in spite of negative consequences.

Often the family is in denial, too. One parent sees the problem, the
other doesn't. One refuses to give the child money, the other sneaks
it to them. They say, "My son can't be an addict" because that
reflects on them. Suddenly, too late, parents realize their child is
addicted and living a dangerous lifestyle.

So where should they draw the line? "That's the $64,000 question and
there is no right answer," Kardera said.

When and where parents take a stand depends on their tolerance and
perhaps their egos. "It's a process many of us struggle with. When is
parenting normal and when is it pathological?" Kardera asked.

It can take courage to be firm, Kardera said. "Children may be
furious, full of hate because you forced them to do something. But
when you see them move from anger to acceptance and back to love, it
is very, very powerful. That's the shift that makes it all worthwhile
because you have re-established family relationships."

Dr. Gabor Mate bristles at the mention of "tough love" because it
sounds adversarial and controlling.

"It's either love or not," he said, but quickly added that loving
kids doesn't mean parents have to "put up with crap."

"I'm not talking about people being pushovers -- if my kids steal
from me I call the cops -- but the real issue is not about setting
boundaries, but having a connection with the child.

"The most important thing is not what parents do, but who they are in
relation to the child. Am I punitive and vindictive when I ask them
to leave? Or am I saying: 'You have to go because I can't live with
this.' That's love, not hostility."

He said no drug-addicted child is sick in isolation. It's a family
problem. Somehow the child's needs were "significantly unmet" at some
point. Not because parents meant any harm, but because their
connection was inadequate.

"It's not the parents' fault, that's where language goes wrong -- but
the whole family has to heal," Mate said.

The more help parents get, the more compassionate they can be,
instead of being stressed out and reactive.

Why are children vulnerable to drugs? Why can't they say no?

Because the drug is doing something important, giving them emotional
pain release, oblivion, a connection with others, Mate said. "It's
not a police problem. It's a family problem. Hold onto your kids."

[sidebar]

AN ADDICT IN THE FAMILY

It is one of the hardest decisions a parent can make.

A child is addicted to drugs or alcohol, and refuses to get help. For
some parents, the only answer is to tell them to get treatment or leave.

Today, we present the final story in our three-part series looking at
parents and children who have faced that decision. Addictions
specialists say there is no solution that works for everyone, but
when everything else has failed, telling addicts they are no longer
welcome at home might break through the denial that is at the heart
of addiction.

Read the first two parts of the series at timescolonist.com