He’s Almost 18 … I Can’t Force Him to Get Help

AiR member Liberty posted this comment about her son, soon to be 18 years old, whose increased marijuana and alcohol use is accompanied by a rejection of school, and conflict-ridden communications with the family. Below, Dominique Simon-Levine responds with some suggestions for this tricky and frustrating situation.
 

“I have a 17 year old high school Junior who will turn 18 in July. We have been battling failing grades, running away, fits of rage and the increased use of pot and alcohol over the last 16 months. We worked with a mediator weekly from September through February to get through the thick of the anger and complete breakdown of communication. Until my son started showing up high or not showing up at all.

I cannot make him do anything. I cannot make him go to a therapist. I cannot muscle him into doing his homework, or being respectful.

Things are bad. I am at a crossroads. Do I just let him fail? Let the natural consequences happen?

My intuitive approach to him is kind, compassionate and empathetic. This has not brought about any change. In the moment it make me feel better about my approach but ultimately leaves me feeling powerless and walked on.

After a year of working with my own therapist and a recent huge physical shoving match over taking away his phone privilege and driving privilege because he wasn't doing his work…we have decided that "confronting" (can't think of the right word) him about his drug use and how it is affecting our family needs to happen and we need to make a plan for him to get some help so that he gets off the pot and passes his junior year.

I am at the point where I have lost my son and I think he needs to go into a drug treatment program. I have been told that treatment programs don't take kids who only smoke pot. I don't know where to start and don't know if I still have any power over a kid who will be 18 in 10 weeks.

I am going back to watch all the videos again. But I had to reach out. Thanks.”
 

Dr. Horvath of Practical Recovery has responded to Liberty with the following comment:

"I'm sorry to hear of this complex and upsetting situation. Although substances are part of the situation, you suggest there are other issues as well. You mentioned working with a mediator. Given the success accomplished thus far, I suggest that you re-contact the mediator for further work. I hope that you can find middle ground such that you can use your kind and compassionate approach but still not feel walked on. Perhaps there are some natural consequences you had not considered that would not be catastrophically bad for him and could be allowed to occur? Yes, if pot is the primary substance no insurance carrier is likely to pay for residential treatment, but outpatient sessions for him (if he'll go at some point) and family sessions ought to be covered."
 

From Dominique Simon-Levine:   

As Dr. Horvath says in his response to your comment, the situation with your son is upsetting and complex. It is paralyzing to parent a teen who runs away or threatens to hurt himself, either willfully or passively, with or without substances. It’s the trump card that stops a parent short of limit-setting or allowing natural consequences.

A website is not the place to examine your situation in detail. The family needs quality professional help.

AiR addresses substance issues. If your son’s alcohol and pot use is crossing over into a substance use disorder (SUD), the diagnostic term for addiction, then we would suggest making this the focus of your actions.
 

Put Down the Other Issues

What we lay out on this site asks the family to put down other issues in your Loved One’s life, and to focus on the drugs and alcohol.

Can you consider dropping the battle to keep your son in school in order to graduate? You wonder about letting your son fail. High school can be completed later. He can get a GED. Is this a consequence you could let happen?

I realize your son may think he has won, that he no longer has to go to school. Or he may be shocked that you would step away. He is (almost) 18, though almost certainly a very immature 18. For better or worse, he is now responsible for making these decisions and for their outcome. 

Freeing yourself from the school issue, you can now use your influence and energy to address the drug use.

Your son’s age makes you unable to force him into care.

You should know that if you can afford it, private treatment will take a young adult with a cannabis problem. You will need money to pay for private inpatient care, at a minimum $3000/month for 6 months. If the drug and alcohol problems are still minimal, another possibility is a good private prep school. Prep schools help children grow up by making them responsible for themselves within a defined set of rules and a structure. It’s an opportunity to leave home, which might bring both of you some relief and even happiness. 

Getting him motivated to go to care or school will likely be difficult.

There are two big motivators for entering treatment: bad things are happening or the desire for better things to happen.

In modules 5 and 6  we talk about dividing the world into two buckets: the moments when your Loved One uses and the moments when they don't. We suggest you let go of the other issues and focus on your son’s substance use. This will clean up your message. Rather than taking away the car and phone privileges for not doing homework, both are metered out in times of sobriety.

Your son will turn 18 shortly. His world is about to change and this starts at home. If he is going to stay living with you, he’ll need a job and to pay some rent. He’ll need to be making real effort at curbing the alcohol and pot (perhaps by seeing the mediator or other researched outpatient care). Here is a good article that describes a Mutual Living Agreement with an 18 yr old.  

If your son doesn’t engage with this changed “worldview” within an adequate period of time, say 6 months, if he continues to use drugs and to disrespect family members, it may be time to support his transition out of the house. By support we mean a few months worth of rent, a bed, and some help moving out.

What we lay out here is a generic plan for families dealing with the very difficult situation of an older teen. We'd very much like to hear from other parents who are going through, or have gone through this.