Visions Journal

But as parents, we never stop trying

A mother

Reprinted from the "Supporting Adult Children" issue of Visions Journal, 2019, 15 (1), pp. 8-10

Like many parents in BC, I have a child who struggles with substance abuse. This means he could overdose and die anytime he relapses or uses drugs.

My son grew up in a loving home, ate healthy food, had a dog, took music lessons and played sports. He had good grades, a part-time job and a circle of friends. Overall, he was an average teen, with no abuse or trauma in his childhood.

Following a sports-related injury, he was prescribed Oxycodone. By 17, he was using heroin. By 19, he was living in Vancouver’s Downtown Eastside, in trouble with the police for drug-related incidents. Now, at the age of 24 and after countless stints in detox, four recovery centres, a diagnosis of depression and social anxiety, years of counselling and family love and support, he is back in treatment after a year-long relapse that almost killed him—and, frankly, me.

The sobering facts of addiction in BC

In 2017, over 1,400 people died from drug overdose in BC. This number rose to 1,500 in 2018, three times higher than it was in 2015, the year my son started shooting heroin.1 Many of the people he knew from that time have since died by overdose.

There are few publicly funded spaces in residential treatment centres; most of these are in the Lower Mainland. The wait for one of these spaces often takes up to three months. Many parents (me included) have used all our savings to pay for non-publicly-funded treatment for our sons and daughters.

Since going into treatment at the age of 18, my son has been in programs with men much older than him, usually in their 30s to 50s. The only youth treatment centre in BC closed down before he aged out of it. He has been in treatment so many times from such a young age that he is losing his ability to socialize normally as a young adult. In many ways, the only similarities between my son and the other program participants is their addiction.

The youth residential treatment centre (still the only one in BC) has now re-opened in Keremeos, as Ashnola at The Crossing. We still desperately need more youth and young-adult publicly funded residential treatment programs that allow integration of the sexes and incorporate schooling and life and social skills. We need long-term treatment programs—from six months to a year—and we need treatment programs that address the unique needs of youth and young adults who identify as First Nations and as LGBTQ2S.

When they reach out

If a youth or young adult asks for help, the window to respond is extremely small. Most residential treatment programs require a period of detoxification (or detox, during which the person abstains from substances for several days) before the program considers a person for treatment. Detox is extraordinarily difficult and can be very painful.

There are not enough detox beds available, however. Most people can't get a bed when they are ready for one. By the time a bed is available, if they have been off drugs for more than three days, they don't qualify for detox treatment. Or, if they are using stabilization drugs (like Suboxone) under a physician’s care, they don't qualify for detox. Someone who requests detox may wait so long that they start to use again, or return to the streets.

Countless parents have detoxed our children at home—sometimes many times over—trying to keep them sober and alive long enough to be accepted for treatment. Residential treatment policies need to be more flexible, supporting people to enter treatment as soon as possible. Detox programs need to allow longer stays if no residential treatment beds are available. Discharging someone from a one-week detox program back onto the streets is a recipe for overdose.

Challenges faced by parents and family

When I speak with other parents about their experiences, I hear about common challenges that prevented them from getting adequate care for their child early on.

1. Treatment for substance use is currently voluntary

Under BC's Mental Health Act, if someone's mental health poses a potential danger to themselves or others, there are legal mechanisms to ensure the person receives treatment. We don't have the equivalent legislation for substance addiction. All substance-use treatment facilities in BC are voluntary. This means that when you know that your teen or pre-teen is exhibiting the early stages of substance abuse and addiction, you cannot make them go to treatment. They have to want to go. In the case of my son, this meant that for the first two years, when opioid agonist therapies (OATs) such as Suboxone could have helped, I had no power to ensure he went into residential treatment, or got other supports to stabilize him enough to attend outpatient treatment, or to at least finish high school.

2. Confidentiality and the rights of the child

In our current health care system, a 17-year-old's right to confidentiality trumps our right to know the details of our child's condition and treatment. In the case of my son, this meant that even though my son's counsellor and social worker both knew he was smoking heroin, no one told me because he didn’t want me to know. I did not learn the truth for almost two years, when my son told me himself. By this time, he had graduated to shooting heroin. Had I known earlier, I could have found him appropriate supports.

3. Confidentiality and the rights of the drug user

On many occasions, my son was MIA for weeks at a time ("missing in action," living on the streets and using drugs for days, sometimes weeks). I would search Vancouver's Downtown Eastside, leaving notes at injection sites and detox centres. Unfortunately, the confidentiality rules prevented youth drop-in centres, detox and treatment centres and prisons from telling me even if my son was not there. As a parent, I had no idea if he was on the street or in a morgue. When my son is using, he frequently loses or sells his ID. If he had died in this state, there is a good chance that no one would have been able to identify his body or contact me as next of kin. We need to know if our kids are somewhere safe, or if people have seen them.

4. The role of concurrent disorders

Our health care system has known for years of the link between mental health and addiction. People might self-medicate with drugs, or use drugs recreationally and trigger an underlying mental illness or create a new mental health condition. We need more supports for early detection and treatment of mental health conditions in young people. At the very least, an early assessment should happen as soon as a person is detoxed or accepted into a residential treatment program.

In the case of my son, chronic, debilitating depression and social anxiety resulted in off-the-rail relapses. Yet none of the recovery centres addressed this. In some cases, the treatment program even took him off his antidepressants. At no time has anyone crafted a plan to address the underlying mental health issues that are quite possibly the root cause of his addiction.

Supports for families

Some supports are available for families with a youth or young adult struggling with addiction in BC, through volunteer-led family groups such as Parents Forever (in Vancouver and Surrey) and SMART Recovery Family & Friends, NAR-Anon and Discovery.

The Foundry offers integrated health and wellness services to young people at seven locations in BC, including physical and mental health care and addiction counselling and support—sometimes family counselling. But we still need a Foundry-type program for adults over 24, including physical and mental health services, counselling support and dental options.

What other types of support are needed?

Many necessary supports for families caring for loved ones with addiction simply don’t exist in BC. Drawing on my own experiences, I describe a few supports that could have been—and still would be—game-changers for me.

1. Family inclusion policies

To ensure that services address the needs of diverse families, all levels of addiction treatment need personalized family integration programs. After all, we are the ones our kids call, we are the ones in anguish as they detox at home or use our house as a safe-injection site, we are the ones who pay for programming not covered by our social services system. We know our youth’s medical history, challenges and patterns. We need to be consulted and included because we are the ones there when treatment is completed or fails.

2. Free counselling for primary support providers

Many primary support providers suffer with depression, anxiety and post-traumatic stress disorder (PTSD) due to their child’s addiction. The constant upheaval has a devastating effect on the physical and mental well-being of the caregiver and on the caregiver’s career and finances. Part of the solution includes free, personal counselling for parents of children with addiction, as well as family counselling when the child is ready and when it can be a positive experience for all family members.

3. Free respite support for parents

As primary caregivers, particularly when our kids are trying to get clean enough to enter treatment, we often can’t leave them alone because their behaviour can be unpredictable and dangerous. We can’t leave the house, go to work, run errands; we never know what state our child (or our house) will be in when we return, or if they will leave the house and start using drugs again. We are trapped in our home for weeks or months at a time, in a state of panic. We burn out quickly.

Parents of young people with addictions need respite support so we can continue to provide care. Respite could be in the form of an experienced caregiver who comes to our home, or a place for our child to stay for a few days, or hours, giving us the opportunity to undertake the self-care we need.

For information on dealing with addiction in your family, visit From Grief to Action at www.fromgrieftoaction.com. To find out about services and support groups available in your area, go to bc211.ca or heretohelp.bc.ca. The FGTA coping kit for families with children using substances can be found at www.heretohelp.bc.ca/workbook/fgta-coping-kit.