He’s Out of Treatment for Heroin, and Smoking Pot at Home
AiR member Ivy2015 wonders how to handle her son's pot use during his recovery from heroin—the outpatient program he's attending suggests letting it slide for now…
"Hello. I am new to this program, and I very much appreciate all that I have learned here. My son is a recovering heroin addict. He went into treatment in Florida on Christmas Eve, and he was there for 45 days. When he was released from treatment, he tried going into a sober living house nearby. A lot of things went against him while he was there, and against our better judgment, we let him move back in with us. Things quickly started to deteriorate once he got home, and he relapsed with weed. We tried to get him back into in-patient treatment, but insurance would not approve it because it was just weed that he was relapsing with. He is attending outpatient treatment, but he continues to use weed…. And sometimes pretty heavily. I started researching the internet and found out about your program. I have been implementing the positive talk with him for a couple of days now, and we have had some days that are just great, but we still have some days that aren't so great. One thing that is really frustrating is he continues to smoke pot in our house. The treatment center does not recommend kicking him out, and my heart tells me they are right. I have also nicely asked that he stop doing this in my house. I know that I cannot control what he does, but when he is living in my house I feel that I should be able to have some boundaries. I just do not know an effective way to put a stop to this, or if I even can. Also, on two different occasions we have had company at our house. Both times, he has been high. It is super embarrassing to me, and these people specifically came to her house to see him. I know that we are supposed to try to get away from him when he is using. But, I don't know how to implement this in this situation. Any suggestions for the two issues would be greatly appreciated. We are kind of in a holding pattern right now. Things need to either turn for the better with the outpatient treatment (he just started), or the worse, so that we can get him more inpatient help. Any advice you have would be greatly appreciated. Thank you so much again for creating this website. I am so impressed with all it. And I wish I would have known about it 5 years ago. Thanks again!"
Your son came home from treatment and has since started using marijuana. He is still abstinent from heroin. From what you wrote, the outpatient place he is now attending knows he is using marijuana and has counseled you to not kick him out.
A couple points about the marijuana. Is marijuana a new drug for your son? Or has he always been a marijuana user? Many people quit their drug of choice and go onto “the marijuana maintenance plan.” Marijuana is easily available, relatively inexpensive, it has few dramatic and chaotic consequences, and gets you high. Perhaps not the way your drug of choice gets you high, but it’s a high. The outpatient treatment program is likely addressing the marijuana to some extent, but probably views it as less harmful than a return to the heroin use. For some treatment programs, marijuana hardly moves the needle, as you found out when your insurance company refused to pay for inpatient treatment.
The fact that the program he is attending is talking to you suggests he has signed a release with the program. If they are counseling you to not ask him to leave your house, then they should also be willing to share their opinion about the marijuana and what they plan to do about it.
We are in a unique time right now. The danger of the opioid epidemic is changing how we treat substance use disorder, with marijuana often getting more of a pass. It is very true that keeping your son off of opioids is the number one concern right now.
Now, as before, people use pot as a last gasp drug before abstaining completely from all drugs. So the treatment program is, in all likelihood, dealing gently and patiently with his pot use, making him aware of it and suggesting he moderate or drop the amount he uses. It is also likely that they are helping him find alternatives to getting high, things that bring him even a modicum of pleasure, and helping him track the use of these things and their success against the pot use.
As a family member, I would want to hear some version of this from the treatment program. Hearing this would help with your decision about whether or not to hang on—tolerating some pot use and allowing him to continue to live with you.
This does not mean he gets carte blanche to be high when he's home. And this is the hard part, as you note in your question.
The marijuana use could form the basis of a family meeting, ideally with the treatment program, in which you calmly and lovingly acknowledge your son’s huge effort at coming off the heroin, but your unwillingness to see him high on pot in your home.
Learning Module 6 talks at length about this. Something like:
“You are welcome in this house when you are not high. If you need to get high, please wait until you come down to come home. It makes me so upset to see you high on anything. I understand that you are not done with the pot. I am willing to respect this. Please, in turn, respect my need to be calm and at peace in our home. I can’t have you high here. It completely ruins my mood. Can you understand this and respect this for now?”
If you suspect he is high at home (after some version of the above has been said to him), remove rewards:
- Don’t sit with him in the same room: go to another room…or put away dinner and go out;
- Keep a neutral stance: don’t say anything about the pot use, avoid being chatty.
Things are clearly not normal. You don’t accuse him, or bring up the fact that he looks high. You simply step away. You rely on your gut to decide whether he is in fact high. Step away, remove rewards, and allow natural consequences to occur.
The next day, when he is no longer high, perhaps you review the particulars of the deal you had struck, and explain that if he can’t respect this need of yours, as a family you will need to help him find someplace else to live.
It’s a boundary—not that huge of a boundary—and one that you are going to have to hold. I hope your son tires of the pot quickly and learns that there are many other ways to enjoy life.
Thank you for writing in. Recovery from addiction is a process. It is very hard on the family. Thank you for being willing to be there for your son.
Hello….I recently asked a question about my son and the issue he had with motivation. The Allies in Recovery website offered awesome advice. Thank you for that. After some time, we figured out that due to some several traumatic incidents that happened over the summer, it caused my son to relapse back to hard drugs. This seems to be due to these two very traumatic incidents and because he fell into a deep state of depression. He says that the depression is what caused him to relapse and he would like to get more extensive help for depression and PTSD
……. which he was recently diagnosed with. However after doing an evaluation on him, the local area hospital wants him to be treated for the addiction first. He has been already receiving ongoing treatment for addiction since March. They want to do intensive outpatient which is what he’s been doing. He feels that he really needs more guidance and help in the area of depression and PTSD. And he has been searching for help in those areas. I feel that by forcing him or pushing him to go to the treatment for addiction, he will not be as vested into the program. I want him to be part of coming up with a resolution for this. But, I feel very unsure about how to proceed with it. He still lives with us at our home, so we have asked him to start changing a few of his behaviors around the home. He seems to be doing pretty well with those adjustments. The things we have asked him to do is allow us to give him his Suboxone and antidepressant everyday so that we know for sure that he is taking it. We have also asked him to get out of bed at a reasonable time and not sleep the whole day. In addition, we have asked that he either walk or ride his bike with us three to four times a week for short periods of time so that he is getting outside in the sun. Last, we have asked him to at least work part-time at his job so he’s getting some interactions with other people. We see that he is really making an attempt in these areas so at this point I’m not sure what the best course of action would be to take. Should we just follow his lead and let him control his care or should we kind of try to encourage to do more extensive treatment for addiction?
Hi Ivy2015,
Our son also struggled with Substance Use Disorder (SUD), depression and trauma at the same time. The professionals that were working with him also wanted him to have about a full year of sobriety before tackling the mental health issues in a deep way. They addressed the depression somewhat but only minimally addressed the trauma. It was explained to me that they would be working on these co-occurring disorders but the main focus needed to be on the SUD. It is my understanding that treatment for trauma is very specialized and needs to be handled carefully. When someone is early in recovery and is not yet equipped with the coping skills necessary to deal with their trauma they are more likely to turn to the only coping mechanism they know, drugs. Our son did wait the full year and then sought out a trauma specialist, not just a counselor that does talk therapy. Have you thought about speaking to a trauma specialist and getting their take on whether your son should be treated at the same time he is working on his early recovery?
Your question of, “I’m not sure what the best course of action would be to take. Should we just follow his lead and let him control his care or should we kind of try to encourage to do more extensive treatment for addiction?” is a lot more complicated and difficult to answer. I have had to use a trial and error approach to discover what might have success and what might not. What has worked with our family is a compassionate and caring approach that allows our son the respect to make choices and decisions for himself regardless of how awful I believed those choices to be. We have a ‘guide but let him learn’ method while still maintaining our own personal healthy boundaries. Meaning when he makes choices we are not fond of, we respect his decision, but we are not going to support or become a part of it. When he makes decisions toward the path of recovery we will stay engaged and supportive within our means.
I don’t know if my sharing helps any, maybe something will resonate with your situation. It can be helpful just to know that others have gone through the same things!
Remember, you are not alone. Wishing you the best.
“Your son is lucky to have parents as engaged and committed to his life as you both. What is most beneficial to your son is that he focus on two outcomes: 1) reducing his symptoms (depression, anxiety, addiction) and 2) improving the overall quality of his life. The first is really about problems, and what he wants to have go away. The second is about creating the life he really wants, it’s all about what he wants to bring into his life, what he wants to create for himself. And the energy, processes and focus necessary to deal with problems is very different than the energy, processes and focus necessary to bring things into existence, to create a passionate life.
So, first suggestion is to be aware of how much time you (or your son) spends in the rut of problems, and solving problems, versus seeing life through a lens that is all about focusing on a good life…..”
Read Treatment Expert John Fitzgerald’s full response to Ivy2015 here: https://alliesinrecovery.net/discussion_blog-seek-treatment-that-aims-to-solve-problems
Thank you for this awesome advice. It was so helpful. My gut instinct was to follow my son’s lead with his treatment. That has always worked best in the past, but I really wanted professional advice. Since my posting, we have found a therapist that treats addiction, trauma, and depression, and my son is seeing her twice a week. He is doing awesome. It warms my heart to see him in this healthy state, and I know with 100 percent certainty that the AIR modules have been a big part of it. Thanks again!!
First of all, I would like to say I am very thankful for the Allies in Recovery site. It has helped us with our 23 year old son so much. I appreciate all the hard work Dominique and the other members have done to make this such a great resource.
In December of 2017, our son went into inpatient treatment for heroin addiction. He was there for 45 days. When he got out of treatment, he went into outpatient treatment. Currently, he is still going to outpatient treatment and sometimes he sees a therapist and psychiatrist. However, he is a regular cannabis smoker. He has also been diagnosed with depression and PTSD. He is currently trying to obtain a medical marijuana card. We have stopped trying to get him to quit marijuana. It seems to be the lesser of two evils. There’s one thing that is concerning to me, however. Sometimes, he is very motivated to work, get more education, and go to therapy. At other times, he gets extremely tired, and just wants to stay in his room playing video games and watching TV. When I go into his room and talk with him, he is very pleasant to be around and very polite. But, at some point I want him to be able to stand on his own two feet and live on his own. With his sporadic motivation to work, it makes it difficult to save money and excel in his career. I’m unsure if it’s his depression, the marijuana use, or something else that is causing him to occasionally be so tired and unmotivated. I’m also feeling like I’m in between a rock and a hard place. If I push him too hard, I’m worried it will stress him out and cause him to turn back to heroin. But if I don’t push him hard enough, I’m worried that will also hinder him in becoming an independent adult. Any guidance and this area would be greatly appreciated. Thanks again for providing such a great site for moms like me.
I forgot to mention, my son is on Suboxone. He has been on it for 5 months. I know this can cause fatigue, as well as, isolating behavior. I’m just not sure what type of doctor would be able to help him.
Dear Ivy2015:
I am very glad to hear your son accepted and completed treatment for heroin addiction. He is currently abstinent from the heroin but you are concerned about his marijuana use. You have chosen not to address the marijuana as it is the lesser of two evils.
CRAFT researchers at the University of New Mexico suggest just the strategy you have taken: addressing the more pressing and dangerous drug first. In your case, the family applies the behavioral and communication strategies specifically to heroin, and “allows” the pot use.
We’ve written elsewhere about marijuana use, how strong the drug is in its current form, and how it dampens motivation, in a sense making the person a passive observer of their own life.
Read Dominique’s full response to Ivy2015 here: https://alliesinrecovery.net/discussion_blog-the-pots-a-problem-but-i-fear-pushing-him-back-to
I can totally see how emotionally stressful this is ….. as a mom you want to protect him and have him home and near you. I also feel that it is a priority to keep him off of heroin. My question: is there any difference in the “heroin high” vs the “marijuana high”?
I often hear how marijuana is not addictive but I don’t fully buy into it especially with someone whose brain is used to stimuli from recreational drug use. Does this mean that the brain is again relying on a substance to avoid relapse or is an individual able to “CHOOSE” when he wants to use marijuana??
I am very happy that he is off of heroin. I hope that I will have some good news to share about my loved one too at some point.
Also am very familiar with the feeling of embarrassment when friends and family witness the “high”. I know that I should not be hiding from this but it is very uncomfortable for me with sharing this addiction and addictive state.
It’s been a long struggle and it is not a smooth trip to recovery. Prayers for you and all of the people going through these struggles.