Stigma Vs. Appeal

We have in our state the Utah Methampheteamine Joint Task Force whose job is to reduce the use of meth across the state. They're using the Montana Meth Project as an example of a successful program that has done well with its own stated goals of:

1. Increase the perceived risks of meth use
2. Decrease the perceived benefits of meth
3. Increase parent-child discussions on meth
4. Increase the social disapproval of meth use

Now for the question of the day. How do we increase the social disapproval of drug abuse in order to reduce the number of new users, while still not stigmatizing existing users so they are more reluctant to come forward for treatment?

I think I've got a pretty good handle on the first three personally, but that fourth one can be tricky. Where's the balance? Can people be made to think it's a vile habit and exert peer pressure to avoid meth without making users more afraid to get the help they need? Do we just sacrifice a few current users in order to scare away those who haven't started yet? Quite a moral conundrum.

Drug Court

The mother of our kids-in-care is getting ready for Drug Court. That's a program that lasts a year or more with intensive drug testing, rehabilitation, and training. It's a program where they plead guilty to one or more charges, and the judge puts off enforcement of sentencing and releases them into a treatment program for drug rehabilitation. If they graduate from the program, the charges are all dropped.

This is a positive step, although she'll be facing some difficult issues. It's easy to think clearly and plan while in the forced detox of jail. The hard part is actually following through after release when the temptations are always at hand. Then there are the issues of needing a place to stay, and a job.

Explaining all of this to children is tough. How do you tell kids ranging from 5 to 10 years old that their mother is in a program that will last at least a year before she can get out from under a list of felony charges? The timeframe is mindboggling to kids that age, and I don't have any idea how to meaningfully describe the charges in anything better than vague terms.

The kids deserve to know how things are going, but it's a delicate balance to describe things in a way that will mean something to each child. I can't tell them they'll be staying with their parents eventually, because I have no idea if that's true. I can't say they'll overcome their addictions. What I can say is that their parents love them very much, that they want to overcome their problems, and that it's good to write encouragements to them.

A Captive Audience

What do you tell someone when you absolutely know the message will arrive? Last week both parents of our kids-in-care were taken into custody on different charges after a court appearance. Now I know where they are, and can easily get a letter to each of them. But what do I write? I spent three days dwelling on that.

How about giving them advice? I couldn't think of a single thing I hadn't already said. They know all the advice, they've heard it, and quite often agree with it. Giving advice would be reduntant.

How about a good chewing out? I could write something that could peel the paint of even a jail's industrial cinderblock walls without even resorting to profanity. I could tell them all sorts of things about how I feel about their choices, lifestyle, friends, actions, and attitudes. Would it do them or me any good? Nope.

I was stumped. Then I read a report on a religious leadership conference that was held on February 10, 2007 in Salt Lake City. Two of the messages from that conference were about teaching. Finally, I had a theme that struck a chord with me. So what could I teach?

I'm not sure what the final step in the inspiration was, but I remembered the concept that thoughts lead to actions, actions lead to habits, habits lead to character, and character leads to destiny. Given that idea, what does everything hinge on? I decided to work backwards. If you know what you would like as a destiny, the rest can be determined from there until it all relies on thoughts.

With the letters I wrote, I already knew one of their biggest desires, to be a part of the lives of their children. From there, it all worked back to a matter of controlling their thoughts in order to get that result that they wanted. Controlling your thoughts is no easy task, but it's certainly easier than trying to address character, habits, and actions as well.

I have no idea how long they will each be in custody. It could range from days to months. It depends entirely on the court system, whatever plea deals they can work out, and availability of drug treatment programs. I've heard that being in jail can give you lots of time to sit and think. Hopefully I've given them each something to think about that will be more useful than dwelling on the effects of their enforced detox.

Who cares?

I mentioned previously how my wife's sister had run off to hide in a fit of anger or dispair, or whatever the excuse of the day was. Well, we found out this morning that she had come back, and was with her husband again at whatever friend's house they're visiting at the moment.

Her husband had called around looking for her last week, and to see if anyone had heard from her. At least he called to tell us he had no idea where she was and that she was missing. Neither of them ever tells us where they've run off to, so I don't know why he would expect us to know anything. We worried, but figured she would eventually show up again like she has previously. We also figured neither would bother to call us when she came back if past behavior held true.

Sure enough, we found out this morning that she's been back with her husband at least since yesterday. She called my wife to ask about visiting her children before going into a rehab program that they're trying to get into. That was our first indication that she was accounted for. My wife explained to her that when one of them runs off, please let everyone know when the runaway returns, so we can know to stop worrying.

Getting into an inpatient rehab may be able to keep court cases from turning back into warrants, which might explain their rush to try to get into a place tonight. Especially considering she slept in and missed her court date today. For those that don't know, excessive sleep is one of the signs of crashing after a meth high that can include several days straight with no sleep at all.

So the answer to the question in the title is that we care. The problem is that there's usually not much we can do except to track events and watch their lives progress like a slow-motion train wreck. Stephen R. Covey wrote in his book The 7 Habits of Highly Effective People that we should align our sphere of influence with our sphere of concern. That means simply that you should worry about what you can change, and not worry about the things you can't change. I sure hope we can do something that helps them change. I'm not ready to stop caring yet, and neither are their kids.

Does drug rehab work?

Don't you just love loaded questions? Depending on who you ask, you'll get radically different answers about the success rates of rehabilitation. Even about particular rehab programs, you will get huge swings of opinion. Take twelve step programs for instance. My sister-in-law believes they don't work. The funny part is that as long as she believes that, it's true for her.

I've read through the entire workbook for a twelve step program produced by my church. They worked with Alcoholics Anonymous to develop an adapted faith-based program. I was impressed with the program. It's designed for addicts of all sorts. Emotional addicts, chemical dependency, and a whole raft of other problems can all be addressed through the program with minor adjustments. I decided that reading it wasn't enough for me to really understand it, so I've actually gone through the first third (so far) of the material meeting all the requirements and answering all the questions on my own as a self-help guide.

So far, I don't see what there is to the program that wouldn't work. The twelve steps are represented by honesty, hope, trust in God, truth, confession, change of heart, humility, seeking forgiveness, restitution and reconciliation, daily accountability, personal revelation, and service. There's nothing shocking or contrary to be found in the whole list.

I can see how several of those steps can be terrifying to someone into a problem way over their head. It can be intimidating for me, when my goal with the personal review of the program is to change some fairly minor aspects of my life.

I can also see that such a program, when applied properly, can transform a person. It can help them to purge the part of their life that is destroying them, and replace it with peace, joy and success. Successful rehabilitation programs can give back things that seem impossible to achieve when viewed from the depths of addiction.

The answer is "YES," these programs can work. They do work, but not for everyone, and not with great predictability. No program will succeed if the addict is unwilling to change absolutely everything that needs to change. No fair holding onto that one questionable friendship. Keeping a stash hidden away for emergencies is admitting defeat. Thinking you know better than the ones running the program is a major sign of pending failure. Deciding you can skip a step because it sounds too hard or pointless will likely doom the effort.

The net result is that success requires several things, many of which are really hard to give. These things include submission, humility, and a desire to do whatever it is required to succeed. Success is also a bit different than some might expect. It may not mean getting back to the way things were. For some, that restoration is just impossible. Everyone else's lives keep moving forward, and if an addict checks out for a few years, the world just isn't the same when they come back. The children we care for have grown over the past two and a half years. Their parents just can't get that time back. But the parents can change, move forward, and be a part of the lives of their children in the future with planning and hard work.

Sorry for not having an easy solution that will work for everyone in minimum time, but that's the way things work. Free will plays a huge part, and if will is opposed to recovery, then recovery fails. If free will is applied entirely to recovering no matter what is required, then success is simply waiting in the wings for the work to be done.

If you are the one wanting to recover, make the sacrifice to start now with your entire heart. If you're concerned about a loved one, support the good decisions they make, and let them know that you approve of their good efforts. It could be all that's needed to nudge them from failure to success.

Planning for the Future

About a year ago I told my sister-in-law and her husband that I'd talk to them about how they were doing at the end of the year. These are the parents of the four children of which we have legal custody. That means it's about meeting time. My goal in doing that was to add a little bit of evaluating and reporting to their lives outside of court. Maybe they would change their behavior knowing that they would be responsible to talk about it later. They had asked at Christmas time if we could delay for a month and talk things over at the end of January, so I agreed to their request.

The reason for the review is that we'd seen them struggle over the previous 18 months or so that we'd had their children living with us. They'd split up, gotten back together, been deep into the drug scene, been homeless, wrecked the vehicle they'd neglected to insure, and who knows what else. I wasn't documenting things as well back then.

I'd hoped to give them another reason to do better, but the truth is that nothing significant seems to have changed this past year. Maybe they're keeping some big success story back so they can spring it on me and say "See? I won the lottery," or something like that, but I doubt it. The mom has shown some effort starting rehab again this month, but she's done that before too.

So how do you go about planning for the future when you have no idea what's coming down the road next? The only way we've found that works is to assume that the parents will take care of themselves for good or ill, and plan as if we will have custody of the children until they are adults.

Given this viewpoint, what happens if we're wrong and the parents straighten out, solving all their legal, moral and financial issues, and become paragons of virtue and pillars of society? Everyone is happy, we have a big family reunion, fill out any necessary paperwork, and Bam. Happy families for everyone.

So, what happens if we're right and progress is insufficient? The parents keep on doing whatever it is that they do, and we keep on planning for school activities, summer vacations, piano lessons, church, and all the other things that make up our normal lives. No waiting, no hanging out in the breeze until something happens. No second guessing. Life is consistent, and often very good to us.

I'm sure you've heard the expression "Pray as if everything depends on God, and work as if everything depends on you." We've taken that to heart, and plan our lives with our expanded collection of children as if this is normal life, and by doing so it really becomes normal life. Oh, and we won't stop praying for their parents either.

Enabling

We all face tough choices. When an addict comes to me for help, what do I do? It depends on a lot of things. Do I have the means to help? Do I have the time to help? Will what they are asking actually help them? The last question has to do with the concept of enabling.

For the purposes of this discussion, I'll define enabling for you:

Actions or lack of action that encourage or promote continued or worsened bad
behavior.

Now for some examples. Some of these are tough calls, and I don't even pretend to know the right answers in everyone's special conditions.

"Can you help me with rent? They're going to evict me if I don't pay by Tuesday."

Sorry, but paying the rent means that what was supposed to go to rent ends up going to drugs. This is tough. It may end up with them on the street, or hanging with friends. It may end up that they have nowhere to go but your living room couch. Despite all this, the hard lesson is that their responsibilities don't go away when ignored.

"I need some cash for a bus pass so I can get to work."

This is actually a bit misleading. They don't need the cash, really. (See the rent response.) What they need is a bus pass. The response here depends on how desperate they are. From what I've seen personally, buying the pass has been useful. It's helped to get them to both work and court appearances. The tough part is to keep it from being a new monthly expense on your part, so it needs to come with restrictions that you will stick to. It could be something like "I can get you a pass for this month, but next month is entirely your job." Then do not give in next month or you will have turned into their monthly transportation supplier.

"I can't get to work until my car has (new brakes/headlights/gas/whatever)."

Can you afford the expense? Let's assume yes. Is it your responsibility? Not likely. Can you do it as an act of compassion? So long as it doesn't involve the addict handling any cash. Will it help? It depends on the situation. If it's really a crisis they couldn't have avoided, I'm more likely to side with mercy. If it's something they could have done, but blew the cash on a high, then I'm inclinded to let justice rule.

You've probably noticed a theme here. Addicts are poor handlers of cash. Money in the hand tends to turn quickly into a high rather than going toward rent, food, auto repairs, or child care. Will they pitch a fit when you don't hand over what they want? Of course they will. You need to be strong and realize they will do almost anything and say almost anything to get what they think they need.

You will be called heartless. You will likely be sworn at. They may cry and tell you that you're the only thing keeping them from death in a gutter on some forgotten street. They may even threaten suicide. If you buckle and give them what they want instead of what they need, nothing will change. Learning that actions result in consequences is something everyone should learn as a child simply because it's so painful to learn it as an adult. It looks to me like it's even worse to learn about consequences as a drug addicted adult.

Their responses will tell you a lot about what they really need. It could be that they need jail, therapy, intervention, rehabilitation, or even just a bus pass. Every case is different, and you need to be aware of how your assistance will be used in order to know if it's the right thing to do.

Until you see them managing their own money successfully and paying their bills with money earned through their job, don't even consider sending cash their way. Once they are managing their own accounts, they won't need cash assistance for anything but emergencies.

We must all be compassionate and care for those who cannot care for themselves, but please never get confused between acts of compassion and enabling the destruction of another human being. Do what you can to help them to recover. That's quite often different from what they want.