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All in All, She’s Moving Forward

check father daughter tree branch
Illustration © Eleanor Davis

AiR member help4t's daughter returned from rehab in December. She recently shared an update and asked for guidance:

It has been awhile since I wrote in. My daughter came home from Rehab in December. She has completed her IOP program and has/is attending DUI classes. She is working as a server at a local high-end restaurant and is doing well there. She is struggling with her alcohol use and has dabbled with coke a few times (I drug test her now that her IOP is complete). She has said she would like to continue with IOP but the program she was in said she had completed. (I think because she had called out a couple of days in one week (due to partying the night before) and one day in another,(due to a work conflict) they felt she was not 100% committed.)so they completed her after 8 sessions. 

She just admitted to me that she knows she has a problem with alcohol and it scares her to think it could get worse. She said when she gets her license back she will stop because she will never want another DUI. I think she may believe this but not be able to follow through. 

I feel she is asking for help in her own way by wanting another IOP and telling me her feelings on alcohol. I just need to know how to guide her from here. She lives with us (her dad and I) and we are driving her to most of her appointments and work, which is nice because we are able to keep a closer eye. She has dropped the couple of friends who were heroin addicts and has found new friends and reacquainted with old friends who had dropped her due to drug use. All in all I feel she is moving forward and what I have learned and put into play from AIR is working great for us. I just need guidance in how to proceed from here. Thank you.

The catch with many Intensive Outpatient Programs (IOP) is that you have to be clean and sober to get in and to stay in.  IOPs, as they are called, are structured half-day programs that typically meet 3-5 times a week for a short period, usually 8-12 weeks. They are a favorite of insurance companies, so are more likely to be covered by insurance. Insurance companies will guide families to IOPs as a starting place, as opposed to inpatient stays.  This is fine if there is a stable home life to return to each day; it is not so fine for individuals in unstable housing or without housing.

Your daughter is still dabbling with alcohol and coke, but is mostly holding on, maintaining a job and, importantly, talking to you.  She is choosing to be with friends who disagree with her drug use. You are able to urine test her so you know what is really going on.  I commend you for not using the tests as a way to punish or confront. The result of a urine test is information ONLY.  Your ability to frankly talk with your daughter about her feelings regarding the use is really impressive.

I agree, “all in all…she is moving forward.”

I also agree your daughter needs something more than driver education. What did she like about the IOP? The group process? The individual counseling? The self-help groups they are asked to attend?

It’s time for a little more work on your part. Can you find additional community supports for her, perhaps an early recovery group, a therapist, a young person’s AA meeting…? Dialectical Behavioral Therapy is being used quite successfully for substance problems and is taught in a group and individual format. 

Would she consider taking medication that curbs the craving for alcohol: disulfiram, naltrexone or acamprosate (see our page on Medication-Assisted Treatment (MAT) in the Supplement).

Is she athletic? Could you Zumba together? Is there a mindfulness or meditation group you could go to together?  Swaths of unstructured time are the enemy of recovery… I worry that she has her days free now that she is out of IOP. 

I get the sense from your comment that you and your husband are maintaining the right distance from your daughter: an observing but non-judgmental stance. You’re holding on to yourselves as she continues to drink some and to even occasionally use drugs. You are supporting her with a healthy home life and transport to appointments. It is a process. Your daughter didn’t entirely get sober overnight…. but she is wrangling with the pros and cons of drinking. Good. Keep her moving in this direction, as best you can.

And finally, make sure you and your husband are taking time for yourselves … like daughter-talk-free dinners together.

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LEAVE A COMMENT / ASK A QUESTION

In your comments, please show respect for each other and do not give advice. Please consider that your choice of words has the power to reduce stigma and change opinions (ie, "person struggling with substance use" vs. "addict", "use" vs. "abuse"...)

  1. We have had a very bad couple of weeks. My daughter has gone on several 2 day binges over the past few weeks. From what I can tell, something or someone says or does something (I think pointing out the using) and she goes off and does more. She has not yet joined another IOP, and again probation let her off with a “see you next month”. I then found out she was seeing her ex boyfriend (former heroin addict, who appears to have gotten his life together a bit, but whom she has said was a trigger). I flipped out with her went to get her at his house and said if she sees him she can’t live with us, so she left. My husband and my sister also lost it with her, as they are so fed up. I found out that he had left her at a bar drinking while he went to work a few hours. I went to see her there and as I expected she was under the influence of some drug, not sure what, and drinking. She was angry and upset that her Aunt laid into her and said things. The truth hurts is what I told her. I tried to calm her down. Said we could work on things together but that she needed to get help if she wanted to come home. She said she didn’t want to come home and would stay with friends or a shelter first. I ended up meeting with her ex and told him I didn’t approve of this relationship now for sure. That she needs serious help and he can’t give it. And leaving an intoxicated young woman in a bar alone was not cool. I asked him to please try and talk to her and encourage her to get the treatment she needs. I left her with him and went home. I have shut off her phone, because I was mad. I am really struggling now with how to move forward using the tools I have learned here. I know I did not handle this well at all this time. I know from her friends that they were staying away lately because of the excess drinking and up all night etc. This is why I know she sought out the ex boyfriend because he allows her to do as she wants and does not say anything. I also know her self esteem is zero. She needs help and I just do not know what to do. Thank you.

  2. My son is an adult, 12 years out on his own. The boundaries have to be different from a child or spouse living in my home. Contrary to help4t’s situation, it would not be appropriate for me to talk to health care providers or make appointments for him, and certainly not to go with him. Although I have given him contact information for services, he sometimes seems to stall on moving forward, even though he has agreed to therapy. Is anyone else dealing with this?

    1. Dear Sugarplum,
      Absolutely, yes. Our situations are nearly identical. My son says he wants to quit drinking, makes appointments, and then doesn’t keep them. Then he says he can quit without help. The stalling is difficult, but I think there are a lot of factors for him. He admits that he’s an alcoholic with serious health problems from drinking, but he is shy and embarrassed and doesn’t want to let “strangers” into his life. While it may not seem appropriate to go with him, if he asks, I will go. If he tells me he has an appointment, I will even offer to go with him.

  3. Thank you for your comments and advice. Her free time is what worries me as well. She does much better when she is busy. She had mentioned to me that she wanted to join a gym. I will be sure to see that she gets that in motion. What she liked about the IOP was the individual counseling and the groups. (although she has never been a fan of AA, but liked NA groups.

    I would love to hear more about Dialectical Therapy. I read what is online here, but don’t understand how to find a group here in MA for her to attend. Any suggestions for me?

    She has said in the past that she was not feeling the need to go on MAT because she felt she was in control and could stop if she wanted. I will bring this up again now that she appears to be struggling with this issue.

    I am going to take your advice and make her an appointment with a counselor who deals with these issues. She has said she would be willing to go and talk to someone. I had left it up to her to schedule, but I think I will take the initiative and find someone for her to see. I may even attend a few with her as she indicated this may be something she would be open to.

    My husband and I have been able to find the time for us.. finally now that she is slowly moving in the right direction, it is easier to have “daughter” free time.

    The scariest part for me is that she is on probation for another 18 months and if she is caught doing anything drug or alcohol related she will be sentenced for some time. I would hate to see this happen where she is making good progress. She does have a great rapport with her PO, which is good. This is something I need to handle better or it is going to be a long 18 months for me.