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She’ll Need More Help After Jail

Waiting to Cross Street in the Rain

help4t reaches out with a question about addressing treatment for her Loved One. Soon to be released from jail,  she will have some real decisions to face and this family member wonders how to best support her in this next phase. Right now she seems to be saying a lot of the right things, but it’s hard to tell where that is coming from…

My 26 year old daughter is in the same situation, (lifestyle etc.) except that she is being held in jail, awaiting trial for a 2nd DUI (prescription drugs). She was picked up on a warrant for missing a court date. She has been there for 3.5 weeks and will be there until 3/29 when she will appear in court and is considering taking a plea. In MA the conditions will be, 2 wks inpatient drug/alcohol rehab, 6 months OP, 2 years probation with daily call in for drug screen. Perfect for abuses, and I have finally convinced her psychiatrist that he has become her new drug dealer (2 yrs now) by prescribing her adderall, Klonopin, and Gabapentin. She had been mixing these with alcohol and when she ran out, she went back to cocaine her drug of choice. She has requested an appt with dr. when she gets out (she thinks he is going to give her the scripts) and he has requested I come as well. He said the only thing he will prescribe her is possibly a mood stabilizer to help with the impulse control as he has diagnosed her with Cluster B personality disorder. DBT is the treatment I want her to receive. My question is, now that she will have over a month of abstinence and she seems to be saying all the right things for recovery going forward, (although her disorder allows her to be so convincing) how do I help her get what she needs when she is out. I am fearful that she will get out and go back to her apartment and start living same old same old. She has a job that they are holding, enrolled in College classes and living with a fairly sober roommate, although she had not been there much recently due to her non sober activities. Please advise as I am not sure the best way to encourage her when I talk to her daily or when I pick her up when she is released. One side note, she is talking about doing the jail time instead of probation 2 additional months on a work release, and then no probation etc. I am not sure what is best and how to handle. Thank you for your time.

Help4T, you are sure in the thick of it. You convinced your daughter’s psychiatrist that he was, for all intents and purposes, a drug dealer. Unbelievable. This alone is a huge feat. He heard you and, when she comes out of jail, will address the multiple addictive substances he put your daughter on. Since she is in jail she has been given no choice but to stop the Adderall (stimulant ADD drug), Klonopin (benzodiazepine), and Gabapentin (nerve pain drug).

It is up to your daughter to decide on more jail time or getting out earlier with probation. If she chooses to get out earlier, she’ll have to do a number of treatment-related activities to fulfill the terms of her probation. Doing more time in jail/work release would allow her to come out free and clear. Let it be her call.

Her apartment, job, and college classes are all on hold waiting for her to return. She is a motivated young woman!

Since everything is being held for her, your daughter could be absent for a while longer (?) while she attends treatment. I agree with you, Dialectical Behavior Therapy/ DBT is a good idea (see Resource Supplement for DBT description). It is the gold standard for personality disorders. McLean’s in Massachusetts has a two week program that is paid for by insurance. We have seen another member’s son go there (it is not enough but at least it’s a good start).

McLean’s has several DBT partial day programs. They are excellent but not inexpensive.

When looking for DBT, make sure it is not a “watered down version” of DBT. Full DBT includes an individual therapist session and a group session weekly, plus 24/7 phone support. See the topics sidebar on the right for other posts which discuss DBT.

Does anyone on this site have experience with other DBT programs in Massachusetts?

As for how to get your daughter to leave jail and enter treatment, the answers for this are in the Learning Modules. We suggest you review Learning Module 4 on communication and Learning Module 8 on how to intervene with treatment.

Your daughter is talking the talk while in jail. You are right to not trust this completely, but it is a hopeful sign. We suggest you do your homework on DBT programs and provide her with a planned treatment talk before she gets out of jail. Probation would make it easier for you to engage her into treatment but even if she chooses to complete the time without probation, a small loving planned talk of what you are willing to do is an important next step, something like:

You have a lot in place to return to. I am proud of all that you done. Jail is a crossroads. It’s an opportunity to come out clean from all drugs and step down on a path to recovery. It’s up to you. What I’ve done to help is research programs in the area that offer the best treatment. Here is what I’ve come up with. I will do everything I can to support you in getting this help (help pay, help keep her world on pause while she gets treated, etc.) So what do you say, let’s get you out of here and make sure it never happens again. You are my daughter, I am here to help you, to partner with you. Your addiction is a strong foe, but together we have a chance to see you get healthy and happy. Thank you for listening. I love you dearly.

You have been through a lot with your daughter. Over the years, through the ups and downs, you’ve seen how things can change. Though we want so much to protect our children and make sure that they don’t make bad decisions, we can’t force them to behave in a certain way. But we can be there for them, be an ally in their recovery, we can communicate and listen to them in ways that invite connection.

Lean back into the Learning Modules, and remember to pull yourself in when you are becoming fearful about what the future holds for her. The more centered in the present you can be with yourself in this time, the stronger an ally you can continue to be for her when she needs you.

It is very encouraging that you have gotten through to her psychiatrist about the prescription drugs that were a part of the problem. Let her see what kind of insight and support he can offer her in this next phase. He too can be her ally in finding a positive path forward. Along with this, finding those options for DBT in your area would create an ideal place to land for her as she emerges from her time in jail.

What she’s been willing to consider (or not consider) in the past may be different than what she’s willing to consider now. She is older now, and she may have a different perspective – remember, things can change on a dime. You just never know. Even though it’s very hard to reign yourself in when you start becoming fearful about what she may return to, it’s worth reminding yourself that these patterns can change. She is lucky she has your love and support. Let us know how this goes. We are always here for you.

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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. Quick question please – as I mentioned I am attending my daughters psychiatrist visit with here this evening.

    His reason for insisting I am there I believe is to keep my daughter honest. He now feels that she was lying to him about so much, including the need for adderall (said she needed it as a child, which she never did) as well as for college classes now, which I know she failed last semester even though she was on it. He did not realize this. These are the topics I will be up against tonight as well as knowing many other things that have occurred that he was not aware.
    I need to know how best to use CRAFT when meeting with both of them. As you said, I do not want to get “caught in the weeds” but need to confirm truth from fiction.
    Thank you.

    1. In general CRAFT is about moving forward, day by day. If the psychiatrist needs to call out your daughter about falsehoods, there is probably not much you can do. Perhaps this is the part where you step out, or ask to not be involved. Your focus is on what’s next and how best to support your daughter. Your daughter is sick with addiction. When she worked with the psychiatrist before, she was drug seeking and needed to lie. How does this not happen going forward. That is for him to suggest solutions.

  2. My daughter was released on Friday and unfortunately the judge was extremely lenient with her. She does not need to fulfill the 2 week inpatient, nor do the 6 month out patient. She is on administrative probation, which means she can “mail” in her info to probation instead of appearing and no mandatory drug or alcohol testing. Although it states no alcohol, drugs, incl medical marijuana. If she breaks probation, (caught drinking, etc.) she goes back to Framingham for 6 months.

    Her first night out, she went back to her apartment and went out with friends, stayed out all night and was drinking.

    We had a deal with her that if she made appointments with intensive outpatient for her impulsive personality disorder etc. and made appointments with a new therapist for twice weekly etc. we would pay her Cobra and help with rent and food as she is now looking for work. She has not provided this, so we are not helping out financially. She is extremely overwhelmed as she has limited money saved and many bills etc. She is blaming everyone else for her problems. More of the same. I am going to her psychiatry appt with her on Wed night as he does not want to see her without me. He is going to tell her he no longer feels she needs the meds he had previously prescribed her (thank God) and that he may provide a mood stabilizer and recommendation for additional treatment elsewhere.

    She is desperate for help in learning how to control the impulses that have gotten into this mess. Fortunately she will not have her prescribed meds any longer, but will abuse alcohol and what is to stop her from that or worse.

    I am at a loss as to how to handle this. I am out of patience about right now and have told her she can not move home, that is not an option. Reading through the modules for guidance, but not in the mindset to accept them. I am also mad at the system for not enforcing more restrictions.

    1. Update – disengaging with her yesterday and last night I believe helped. I wished her well today and hoped that she could be productive in her aftercare. She ended up just telling me that she did go to see her professors today and they are letting her make up the work that she missed. Which is great because she did have an A average. She feel so good about her self with that. And she was honest with them for a change.
      She said that she has set up a few interviews for jobs. And has made phone calls for outpatient DBT therapy, the numbers that I have provided. She was very clear headed when we spoke and she said she knows she can’t do it alone.
      I guess time will tell but today is a better day.

      1. A better day indeed. How fortunate that she is showing these signs of motivation and seems ready to face some of the consequences of her behaviors. Your love, compassion and strength in setting the limits you need to set are all showing her the path to recovery that is there for her. Thanks for the heartening update. Well done!

    2. The criminal justice system is not designed to help people into treatment and recovery, though there’s a sputter of effort coming from drug courts. I don’t blame you for being angry. The system missed an opportunity to put some clear limits around your daughter, limits that would have pushed her in the right direction.

      All of what you describe can be considered consequences of her use. Step back for now. Let her feel the overwhelming mess her life is in. You are correct not to help out financially. Read Dominique Simon-Levine’s full response to help4t here:
      https://alliesinrecovery.net/discussion_blog-im-all-out-of-patience

  3. I think it’s interesting that she is considering doing the jail time with work release. Could she get that to include weekly counseling and group session releases with verifications? Maybe she thinks she will be able to get drugs while on work release but maybe she is earnest and appreciates being locked away from the substances.

    1. Actually, I asked her that same question. And from what I understand they would take her and drop her off at her job in the morning pick her up in the evening and drug and alcohol test upon arrival back. If she is caught with anything she goes back to detainment for the remainder of her time. Weekends would be spent in detainment.
      She feels that she would save a lot of money with probation costs not to mention that they keep approximately 80% of her pay and put it into a savings account for when she gets out.
      When I heard this part of it, I felt better about it. Because I feel that 2 to 3 months on this particular work program would be better than her going once a week for drug and alcohol testing. That has not worked in the past. I feel like it would be a good chunk of clean time for her. Not to mention that she would be working every day as a requirement. Something she has been a unable to accomplish the last month or so before her detainment.
      She would also need to complete the inpatient program for drug alcohol and mental health issues as well as the additional drug alcohol programs for an 0UI that the state of Massachusetts requires.

    2. I am not sure about the requirement for the inpatient portion I will hear that on Friday. As of now she has agreed to go to the intensive outpatient for two weeks at McLean whenever she gets out. Which might be a nice break after working 2 to 3 months. Then she would get two weeks off for which she would probably have vacation time. And with her savings I will be able to pay the rent for her while she’s on work release and she can pay me back with what she saved.

  4. Thank you so much for your advice. I have spent sometime re reading the modules which has been helpful.
    I have gathered information on McLeans which seems a good fit. I will talk with her today when I visit.