Advice on how to help 14 year old wrecking his life

[Sunnysideup2]

I could really use some advice from anyone who has been through this or something similar. I’ll try to summarize as briefly as I can- my 14 year old son has ADHD, depression, and anxiety. He had always been a kid with buckets of energy, no filter, and operates like a light switch (he’s on or off). Up until the last year or so, we have managed it without medication, using self monitoring, checklists, mediation, mindfulness, etc. and with the help of his teachers he was a good student, played sports, and we had a relatively happy family life (he had moments where he struggled). Then he hit puberty, the pandemic happened and it all spiraled out of control. He became addicted to video games (worst was League of Legends) and home life started getting harder (lying and stealing computers from our bedroom to stay up all night playing). He is a computer genius and has hacked every Wi-Fi controls we have tried. He has even gotten burner phones when we take away his privileges. Fast forward to counseling for a year on video game addiction, and here we are finding out my 14 year old is addicted to drugs to self medicate. Started with marijuana, moved to shrooms, nicotine and cocaine (he has no money, so even more concerning on that front). We went into counseling (family and individual) only to hit a crisis point. The counselor said to begin looking for PHPs (partial hospitalization programs). After spending day after day calling and begging, we got a call back three weeks later and he got in a good PHP. The night after day one, he overdosed / tried to end his life. We ended up in the ER. They didn’t have any inpatient beds and after 12 hours sent us home (I was too new at this to understand I should have fought harder to leave him there). Now we are three weeks into the PHP. He tells them what they want to hear and for weeks now the focus has been on “communicating” better as a family. This week he finally stopped putting on the act 100% of the time, and they are beginning to see what we see at home. They can’t certify him to inpatient or residential because he is aware that they will and will filter what he says so they can’t say he is unsafe. The PHP is mental health, and when he “graduates” they will send him to a zoom drug clinic three hours a day. We’ve been told that in two weeks the PHP reduces services for the summer so he will most likely “graduate” unless they can show he is unsafe. Please give me advice!!! Where do we go from here as parents? We test him daily for drugs, we have all medications and sharp objects in our house locked up. The PHP wanted us to help “build trust” so we gave him his phone back with the agreement that he would only use Spotify for a week. The first day he “broke”the parental controls and is texting, calling, and FaceTiming whoever he wants. He even broke the no contact rule at PHP and is starting a relationship with a girl in the program. Our other children are now also in counseling because life is so difficult at our house. Our marriage is holding on by a thread. My son wants to go back to drugs and tells us all the time we can’t control him. We are a family that has chores, and rules, and everyone participates, we follow through with expectations. I’m not sure what else to do!?!? I love him so much, he is only 14 and wrecking his life. He oscillates back and forth from I’m so sorry, I want to be better to I’m going to to whatever I want. We have cameras on all sides of our house (outside) because he told us of all the times he snuck out to parties all night… we have our house alarm on at night. He tells us he can pick locks (we lock up computers, medication, etc). The PHP suggested this week we open a voluntary case with CPS. I’m so worried that I’m not doing enough to save my son, but I don’t know what else to do!!! He is a wonderful young man, with so many good qualities and a huge heart. How do I just let him wreck his life? I feel like every day I am trying to hold us all together, make sure my other kids are okay, have counselors, have some of my attention. There is probably so much more I could add here… but any advice?!?!? In terms of medication he is on Zoloft. He has tried Concerta, Vyvannase and Adderall. The PHP has us not giving him Adderall because he was abusing it (pocketing it, cheeking, etc). Advice please!!!

[Sunnysideup2]

I should add that we are parents that pay attention… we call to verify parents will be home for get togethers, we set limits, we monitor. It just never occurred to us that a 13-14 year old could become a drug addict during school hours on school property. Or that he would leave the house while we were sleeping and ride his bike 10-14 miles since we don’t live near anyone… he continually outsmarts us and we are at our breaking point. This is so hard.

[Hidden in reply to Sunnysideup2]

My experience from my school when I was young was that my 3 friends and 1 managed to pick and eat ‘fresh’ shrooms (or as Muppets call them now ‘gone off Marshmallows’- yes that’s what on Muppets these days and my 8 year old was asking me what is this ‘gone off Marshmallows) in the mountains whilst hiking with the whole class and chatting with out class teacher. Also overdosing on travel sickness tablets on a school trip because someone told us that this will give us hallucinations as LSD…Getting access to cheap wine on school trips… Getting access to weed on a skiing trip and making joints from Lira notes (back then it was not yet Euroes in Italy…). So yes all can happen under adults supervision.

So don’t blame yourself. Kids can and will. School normally doesn’t have a clue. It looks like you have a busy life and other kids and this is not your fault how he is.

It looks like your son is very intelligent- this is something that no one can take away from him. One day he may use this to his advantage and do something good in his life.

It looks like he abused his stimulant ADHD meds so this will be no go for him anymore.

There are non stimulant ADHD meds that you could ask his doctor to prescribe him? Discuss with his doctor what other options for pharmacotherapy for ADHD he has.

Also I wonder maybe physical health scare can change his attitude? Have you been checking his pulse and BP, has he had routine heart checks like ECG? High doses of meds in self medicating can impact negatively on heart health. Maybe explaining this and checking his physical health and telling him what risks there are to his vital organs- maybe this would make an impact? I mean, probably he will say that he doesn’t care but you can give it a go.

[Sunnysideup2 in reply to Hidden]

Thank you for your kind reply. It’s really crazy to me that you can go into a high school bathroom and get whatever you please. Thank you for the health scare recommendation. I do hope and pray every day he uses his intelligence for good one day.

[Hidden in reply to Sunnysideup2]

I’d say it’s not only street drugs kids are getting. Children are also buying and selling their prescription stimulants. There was recently a U.S. based large scale study published- about 25% of kids who are not prescribed stimulants have tried stimulants because they can buy or get them for free from friends who are prescribed.

I’d imagine when you say you don’t know where he had money from to buy weed, cocaine etc- he might have been doing an exchange for his prescription medications or selling his other medication to fund buying what he wants.

I’d have some honest talks with him which street drugs he is addicted to mostly. I mean, I think on other post you asked about the testing someone pointed out that it’s not possible to ‘get addicted to hallucinogens such as mushrooms, LSD…’. Have you brought yourself to asking him why he likes this stuff, what does it do for him? I can see how it’s kind of hard to get to this level but maybe such honest talks would help.

I mean, cocaine is a stimulant just like prescription medication such as methylpenidate or amphetamine… So clearly here he self medicated his ADHD… Also once he’s on cocaine then he can stay up all night and do gaming?

Then weed probably helps him calm down and sleep after using stimulants or hallucinogens? Have you had those chats with him, finding out ‘what it does for him’.

Zoloft is an antidepressant but maybe worth asking his doctor- if he’s got ADHD non stimulant medication, maybe even not for ‘permanently’ but temporarily just to help him with the addiction so he doesn’t feel the need to self medicate. Then maybe he can stop Zoloft? Because many non stimulant ADHD meds also treat depression and help with anxiety… Just so he’s on as few meds as possible. Then less chance that he will be trying trading, Seapoing the meds he’s on.

It’s not clear from your post- has he been not taking daily his stimulants such as Adderall and then he was taking more tablets at once so it gives him more kick or was he just trading them to others?

FDA Updates Warnings on All Stimulants for ADHD, Other Conditions— New language emphasizes potential for misuse, abuse, addiction, and overdoseby Sophie Putka, Enterprise & Investigative Writer, MedPage Today May 12, 2023

medpagetoday.com/publicheal...

MedPage is very good. It’s for clinicians but it’s free to read for everyone. It’s a good move that the stimulants leaflets get updated to acknowledge the risks of misuse and abuse and addiction…

[MaudQ]

When was the last time he had a full neuropsych eval? I ask because even in a PHP, surrounded by professionals, diagnoses can be missed. If your son has unaddressed issues other than ADHD that aren’t being treated he may continue to seek self medication or other behaviors. In my understanding, a PHP is designed to be a short term stop gap, so the people there have more of an urgency mentality than a long term strategy. A family friend started acting out in very dangerous ways as early as 8th/9th grade - it’s hard to truly control someone even if they are only 14. If it’s possible, it might help to try to be more compassionate with yourself. You have been doing the best you can with the information you had at the time. I’m so sorry you are going through this. I would also suggest family therapy and individual therapy at least for the rest of you (including parents) even if your son isn’t capable of participating. At least you can take care of yourself and sometimes shoring up another part of the family dynamic can help your child indirectly.

[Sunnysideup2 in reply to MaudQ]

Thank you so much for your reply! He is on waiting lists for a full neuropsych eval- the mental health field is so painful to navigate. We are all in individual counseling at this point, family counseling 2-3 times a week at the PHP (and they are supposed to help us set up continued family counseling for when he is discharged), and I’m taking my older child to yoga / meditation as well as an attempt to connect and regulate ourselves. Everything in the mental health field seems like a full time job- I’ve had to reach out to so many people and resources to get anything set up since it’s all wait lists and zoom only (my other kids want in person). I’m trying really hard to take care of so many other people’s needs… I recognize I’m not in a good place for taking care of myself. I’m also seeing a counselor. But at some point things are at a survive the day kind of mentality- and I’m a walking zombie of making sure everyone gets driven to where they need to go, are all having adequate time to talk about their feelings, and are eating meals. I’m just on auto pilot. I feel an intense feeling of loss - grieving the life my son had before all of this and where he is now, but I can’t even process it or let myself feel it or I will be useless at this point.

I’m also at the point where I have intense guilt- I spend all of my waking hours monitoring and worrying (because despite my best efforts he is going to do whatever he wants to do, I have no parental control anymore), providing support to my other kids, calling for appointments, and driving like an Uber that doesn’t get paid. My guilt is that I cannot live like this anymore, I cannot be his conscience, be everywhere, be his constant guide… but I feel so much guilt that the minute I let up he will be lost to us and never come back.

[MaudQ]

I know I’m just a random person on the internet 🙂 but I hope you can let go of the guilt part at least a little bit. If you went through your response above with a highlighter and highlighted all the stuff you are doing for your family, you would see what an extraordinary job you are doing. But saying, ok, I’ve done what I can do and now I’m going to let it play out, isn’t giving up, it’s just letting your actions have an opportunity to take effect. Letting go of the guilt and the white knuckling doesn’t automatically mean you’re losing your son: teens will surprise you. My friend who I mentioned above is finally stable at age 17. But whatever the outcome was going to be they had to start living for themselves regardless. If you can just grant yourself a little grace right now - you’re doing good, mama.

[Sunnysideup2 in reply to MaudQ]

Thank you, random stranger or not, those words were incredibly kind. Thank you. I’m trying to grant myself grace- it’s really difficult when we are in the thick of it. Being the one organizing all the services and implementing consequences has made me the constant bad guy and I’m just depleted and exhausted. Thank you, your words meant a lot.

[BLC89]

Hello Sunnysideup2,

I am so sorry you and your family are going through this. My suggestion is a residential facility for drug rehab and mental health. Since he is under 18 you still have leverage and can sign him up. I am not sure where you are located but here are 3 I found to give you an idea of what the offerings are.

I am guessing he is getting something out of outsmarting you. It feeds something in him. But I would say objectively that figuring this out on your own is above your pay grade you need support and you need support that has dealt with this type of behavior and succeeded. Keep up the family counseling and get your son the support he needs. He wants attention, of any kind, and these facilities can give him what he wants & needs.

Here are the three I found:

iamdiscovery.org -

natcheztraceyouthacademy.co... 

newportacademy.com/programs...

Good luck with everything. This is too much to handle on your own and not fair to the rest of the family because they are not equipped to deal with his behavior either.

I wish you all the best,

BLC89

full disclosure: I am an ADHD parent coach, have been married to ADHD for nearly 30 years and raised two ADHD kids

[Sunnysideup2 in reply to BLC89]

Thank you for your reply! We are finding that even though he is under 18, his rights are that of an adult at 14. We can’t just sign him up against his will. That’s what makes this all so hard. We keep trying to figure out how the system works so we can help him. It’s baffling.

[BLC89 in reply to Sunnysideup2]

Oh, well that adds to the complexity. Have you consulted an attorney, someone who specializes in mental health care? If he is a danger to himself or others you have some leverage but you need a medical professional on your side. The iamdiscovery.org is a school maybe you would have more luck with that, skip the healthcare BS (pardon me) and send him to a school that deals with this type of behavior but also works on the mental heath stuff too. Surely as his parents you can sign him up for any school of your choosing. I'm so sorry. If I think of anything else I'll post it.

BLC89

[BVBV]

I am so sorry to read what you’re going through. I really cannot give advice since my son is 10 but I always try to think ahead to worst case scenarios. Does he have any positive interests at this time such as sports or any extracurricular activities? If he could be in a positive environment with trusted adults/mentors outside of the family it may start to impact him. I wonder if someone outside the family can get through to people in difficult situations more than a family member. Is there anyway to pull him from his current school and put in to a smaller private school with greater control within their building? I wonder if there are any programs setup where he can visit with those in prison from drug offenses as a “wake up call”. Does he take any supplements? I’ve found that saffron + Vit D has been a good mood enhancer for my son, Olly makes a gummy that has both ingredients. It sounds like your son has so much potential I pray he finds his way back!

[Sunnysideup2 in reply to BVBV]

Thank you for your reply! He was in a small private school, and got expelled a few months ago. Because they were a small private school his access to services were less. Now he is at a public high school, where the 504 services are much better, but apparently so are the drugs. He is struggling with being a part of group sports and activities right now, not only because he uses the opportunities to engage in things he shouldn’t, but his anxiety definitely gets in the way. We had set up an internship with a family from our church to work in a business with the owner and receive some guidance and support (the owner’s grown son had similar challenges), but that hasn’t been able to happen due to the PHP. I’m hoping we can arrange it again later in the summer.

[Knitting20projects]

I’m concerned he needs to be in an inpatient or residential treatment program. He sounds like he is failing a PHP program IMHO. I am a pediatrician and would also be very worried if I heard this history at my office. Has he actually seen a board-certified addiction psychiatrist, or is he being managed by a mid level provider who is just under the supervision of a psychiatrist? I absolutely believe mid level providers can be outstanding (nurse practitioners etc) but your son needs an experienced person who can see past his minimizing and denial. And honestly, if he has an addiction psychiatrist who truly thinks the current plan is safe, then I would do whatever I could to get a second opinion from an excellent addiction psychiatrist. I am absolutely baffled as to in what universe any teen with his story would have been discharged home from a psychiatric hold and not admitted to an inpatient psychiatric unit. And no, the fact that he was not admitted is absolutely NOT your fault as a parent for not pushing hard enough. It was the responsibility of the ER psychiatric emergency staff to prove he was safe to go home; I transferred a teen and her furious dad to my previous workplace ER and that teen was admitted for much less risk than what your son demonstrated. His actions are telling everyone he is not going to fly with this plan. I am so sorry to be so forceful especially since I’m on an anonymous board, don’t know you personally, etc. I just had to say something. I don’t know where you live, etc, and I know residential programs can be very expensive. But I also know people usually regret the things they don’t do, not the attempts they make to help a struggling family member. If you have a PCP or pediatrician who knows your family and your son, maybe you could reach out to them, too? Maybe they have another family who has used a specific program in your area they can recommend. My metro area actually has an outstanding teen substance treatment program, but I don’t know if it would really offer more than what he has gotten where you live. Sending you support and strength.

[Sunnysideup2 in reply to Knitting20projects]

Thank you so much for your reply, it means a lot. I agree with you. It’s all been an uphill battle for us. I’ve found out things too late (like I should have refused to take him home from the ER) and it feels like he is considered “not bad enough” or that his rights as a 14 year old trump his needs. We have asked the PHP to help us get him into a residential treatment, but their answer has been to tell us to open a voluntary case with CPS. They agree it would be a good fit for him, but they don’t seem to be able to force it. It doesn’t help that it’s now “summer” and it feels like the PHP is full of summer vacations for the staff. (I get they are all people, it’s just hard as a family in crisis). It’s painful to navigate as a parent. I’ve spoken to so many resources (the 800 crisis numbers, my health insurance, his PCP, etc). It’s baffling that my health insurance is willing to pay for it all; I just can’t make him go against his will. The worry I have is that he will get discharged and once the honeymoon period is over things will get worse. I will not hesitate at that point to call the police, call an ambulance, and refuse to take him home from the ER. As much as it pains me, I am going at that point. I keep pushing at the PHP, I keep talking with his PCP, and I am hoping that the new psychiatrist I have set up through our PCP will help with medication more. The psychiatrist at the PHP is a fullly credentialed psychiatrist, he just seems to feel that medication is the last resort. I can’t seem to get him to see that we have gone through it all and are at our last resort. But I can’t have him see the new psychiatrist until he is discharged due to insurance and double billing. We really thought the PHP was going to do more to help us stabilize his meds and treatment plan- he didn’t have a psychiatrist going into all of this (his neurologist was prescribing for the ADHD and his PCP was involved). I’m disappointed in the lack of support from the psychiatrist at the PHP to be honest, and sadly he is not at a small rinky dink PHP. I did my research and had to work hard to find one that had actual individual therapy and family therapy along with group therapy. So many places are just group all day long. Despite my best efforts, I’m not feeling like we are coming out on the other side here yet.

[Knitting20projects in reply to Sunnysideup2]

I agree with you. I definitely am not a psychiatrist and don’t know your son and his diagnoses. However, I think whatever medication(s) can offer any decrease in symptoms he has been self medicating with substances would be a no-brainer at this point. I’d be asking if the Zoloft has helped his anxiety, if he has been on it long enough to see an improvement, and if he is on a sufficient dose (depression can be treated with lower doses sometimes, but anxiety sometimes needs higher doses). I also wonder, with the anxiety, if he could have underlying social anxiety, OCD, even mild autism that have not been identified? I’m reaching here, just to see if anything else could be feeding into this complex situation. About the medication, I’m wondering if any other medication could be useful, whether it’s to improve his emotional regulation, sleep, mood, cravings if that’s targetable——anything. I know many people are wary of medication, and I totally understand. I don’t mean you want to create a bigger problem. However, if there’s something driving this problem that they could help, maybe it would be worth it. I don’t know. I guess another option would be calling residential programs in your general area to see if they would ever accept a teen his age who has poor insight into his situation and clearly doesn’t want to be there. Isn’t that 99% of teens, and people with substance use disorders? Can you ask his therapist or psychiatrist about LEAP method of trying to engage him (Dr Xavier Amador — communication method)? Why does everything rely on him having insight? Seems like he won’t get there anytime soon & maybe at a residential program, if you could just get him there, he might gradually let go of his denial? If he were completely away from your family, his phone, etc.

[Knitting20projects]

PS Sorry, a couple of additional thoughts——1) can anyone at PHP pull strings to fast track the psychological evaluation? seems like it would be a very useful piece of the puzzle here; 2) you are doing an incredible job—-if everyone has eaten any food 2-3 times daily, showered in the last 3-4 days, and is wearing clean underwear, that’s a huge win; and 3) I’m assuming they are positive he hasn’t used anything that can be treated with medication-assisted treatment? (Opiates)? I don’t know if/when this would ever be used for a 14 year old but definitely used in adults 4) Do you think the mental health portion of the treatment has really evaluated what he is self medicating? (If he was initially self medicating prior to developing an addiction). Maybe just craving stimulation (Eg undertreated ADHD), but was anything else going on? No need to answer, I’m sure you’ve already racked your brain enough.

[Sunnysideup2 in reply to Knitting20projects]

Thanks! The PHP doesn’t seem to be able to fast track it, I’ve asked and begged for the Neuropsych eval. They are doing a good job, but keep reminding us that they are more of a “quick” get out of crisis sort of model (harm reduction, safety) and that they aren’t going to fix it all in the short amount of time. I definitely think the drug addiction was self medicating. We are supposed to discuss medication more in tomorrow’s meeting, it’s just hard because the psychiatrist at the PHP seems very against medication in young teens.

[Knitting20projects in reply to Sunnysideup2]

My only other thought = you might want to call CPS to give them a “heads up” about your family situation with your son. Explain your concerns about honeymoon period, possible failure when discharged, etc. They may know local resources better than anyone. Also, a caseworker may have “pull” to open doors to other resources and programs. I know it sounds scary but then, if your son acts out & you have to call police, the social services department will have more knowledge of what you have been trying to do for months. And you will have been able to explain everything at a calmer (marginally I know) time instead of in a crisis. Even though I know you’re managing crises daily. I don’t know if they will open a voluntary case or not but they will have a record of your call.

[HeartChaser]

Dear Sunny,

I can’t believe I found someone going through what I anticipate coming down the pike for my son. He’s 12 and showing every tendency your son has. Right now he’s lying, stealing and we live in a locked down home to try to keep him safe. I wish I knew the next step for you, but it seems you are my guide through this process.

We are considering neurofeedback which can help shift the brain out of survival mode and into my relaxed thinking states.

I can’t help you with your question of what to do next for your son. I’m so sorry you’re going through this but know that my family feels you and hears your cries for your son. Our family is hurting, doors locked, trust issues, stealing, sibling suffering, marriage strained, trying to stay a step ahead and always wondering what’s next…. And worst of all not having the professional help and advisement we need to help us care for our child. I hope you find some answers here and I hope you find ways to take care of yourself and allow this wonderful complicated son of yours to change you in miraculous ways. I think it’s our best hope.

Sending love.

[Sunnysideup2 in reply to HeartChaser]

HeartChaser, I am so very sorry you are going through this. It is so painful for all involved. My son just completed 5 weeks in a partial hospitalization program (PHP). I can’t say it’s fixed him- he still is manipulating all life’s privileges to do what he wants (meeting up off limit girl from the program at the movies when supposed to be just going with his friend, etc). What I can tell you is that I wish I had looked at the PHP sooner. I was so worried about the stigma and if it would do more harm than good. If you look for one, do your research. There are a lot of bad ones out there looking to make money off a mental health crisis. Look for a program that has individual, group, and family counseling and is staffed by a real psychiatrist. I can’t say it fixed my son, But at the moment he is clean from drugs, and tolerable to live with. They switched up his meds. They have him continuing in counseling (I feel like Oprah because everyone in my family now is in counseling “You get counseling, and you get counseling, and You get counseling”- sorry that was meant as levity). Either way, don’t wait it out. Get help. And my parental advice is to go on Amazon and order a urine drug test. I purchased a 12 panel one for hard drugs and a nicotine one that tests for nicotine, alcohol, and thc. If your son is working so hard to do what you know he is doing, there is a good chance he is outsmarting you- I never saw it coming. In the PHP they spoke with us about that he can’t live in lock down forever. That he will eventually turn 18 or get angry enough and turn 16 and emancipate himself. If he wants to do the things he wants to do bad enough- he is going to. I have to be willing to call the police when he elopes. I have to be willing to let the school know his struggles with drugs. And I have to be willing to know that he is going to lie, steal, and mess up over and over again. He already has. Until he chooses a different path all I can do is love him, make sure he is as safe as I can keep him, and focus on my other kids. And maybe my marriage, that’s in shambles right now with all of this. I am so sorry you are where we have been- it’s a long and lonely road. People are not wrong when they say to make sure to take care of yourself because this will wreck you as a mom. Also, my advice to you is to start setting up all the appointments now- make sure he has a neuropsych evaluation, make sure he has a counselor, a family counselor, a psychiatrist, etc. We didn’t have those things which made our crisis even more stressful because there is no help, and waitlists for everything. Call everyone- his PCP, school guidance counselor, ANYONE that you can think of. These are the people that pulled strings and helped us get appointments and counseling when everywhere I called said no new patients. Be relentless. Call back, be a pain, beg. That’s what it take’s unfortunately. Good luck, I send you my heartfelt support in this incredibly difficult journey.