Impulsive teen and how to handle acohol, drugs & trouble with the law

[Anonymous]

I’m the father of an 18 year old teenage boy that was diagonsed with ADHD over 6 years ago. The last couple of years have been very difficult dealing with typical teenage issues but with alcoholism in his family background and the impulsivity issues of ADD I need help!! He has been picked up drunk by the police or an ambulance then taken to the hospital because he was passed out cold. He has been arrested twice for basic mischeif and released with 3 conditions. 1> no alcohol 2> no drugs 3> must be in the house between the hours of 10pm and 6am. These charges occured before he was 18 but now that he is 18 and if he breaks any of these conditions he will be charged as an adult and therefore a criminal record.

He has continued to break these conditions and he knows he will be charged as an adult. This doesn’t seem to be enough to stop him. I believe the lack of impulse control has a large role in this but not sure how to handle it. We have tried medication again recently, first with addoral but he didn’t like it so now we are trying a slow release ridalin 20 mg. The problems are does he really take the medication each time or just pretend and sells it instead.

He has been going to counciling once every two weeks for a couple of years now to discuss whatever he feels like talking about. He has recently been to a Psycologist that claims he has had a long standing degree of low grade sadness and short term deeper states of depression. He has now been given a prescription for this that will start next week.

Last night he broke conditions of his release and has not shown up yet or called. I’m sure because he knows he is in trouble and doesn’t want to face the music! I’m trying to figure out what is my next move. How can I find a way to help him with self regulation and impulse control for starters!

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[Saffron]

No answers for you, but I have a son with similar issues and just wanted to say that the fact you haven’t given up on him is the best thing he has going for him, so well done, Dad. Hang in there.

If only you could pull him out of his quick-sand situation and send him to a completely different environment, such as a wilderness or ranch retreat of some kind. Somewhere where all of the rules and variables are changed and he has a fresh chance to believe in himself again with a challenge he can meet.

I’ll be watching to see what Dr. J replies. Good luck.

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[Patte Rosebank]

It’s always very difficult when the law assumes that everyone over the age of 18 is responsible for him or herself, and cannot be forced to accept treatment for any medical condition unless that medical condition has made the person likely to harm him/herself or others. So you can’t force your son to take his medication, unless things reach a life-or-death crisis, or unless you can get him to sign a power of attorney, specifically stating that he authorizes you to make all medical decisions regarding treatment, on his behalf. If you can get him to sign such authorization, then you can force him to take his medications. But rather than immediately invoking that power, it’s always best to emphasize co-operation—helping him to keep a little journal, documenting which meds and what doses he took, and at what times, and how they made him feel. If he can see that the meds are making him feel better, he’ll be more likely to take them properly. If, however, the journal shows that they aren’t making him feel better, then you can show the journal to his doctor, and adjustments can be made to his meds.

Saffron’s idea makes a lot of sense. By getting your son out of his current environment, and into a place that’s surrounded by nature, you’d be giving him a clean slate (and we all have a great deal of enthusiasm when we start things) and the calming elements of nature—which will also be a bit stimulating, since it’s an unfamiliar environment that needs exploring and adjusting to. Most people benefit from getting back to nature, and I’m sure your son would too. The important thing is to emphasize that you’re not punishing him by sending him away. You’re sending him to a lovely peaceful place that will help him recover. Kind of like a spa.

The alternative would be an institutional environment (like jail or an inpatient psychiatric facility), which would be the worst place for a person with ADD to be sent to. We can’t handle a soulless, rule-bound, concrete environment, where the individual is required to completely submit to the rules of the institution. That’s why so many of us have trouble in school.

The jails are full of people with mental issues, who were sent there because the justice system is based on a “crime & punishment” model. A far more sensible way of dealing with these people would be to have them psychologically assessed and then given proper treatment for any conditions that are diagnosed. However, this is more expensive up-front than just convicting them and tossing them into jail, which is why the jails are so full.

The best thing you can do for your son now is to continue to give him your love and support, and to look into retreat-based facilities for people with ADD and other conditions that cause behavioural problems. You should immediately discuss this with your son’s doctor, and have him/her write a letter “to whom it may concern” documenting your son’s problems and that there is a legitimate medical condition behind them—as well as outlining why the doctor believes that sending your son to jail or a facility for the criminally insane would do more harm than good. By presenting this documentation, and proof that you are seeking an inpatient facility (albeit one that might be considered “alternative”) in addition to medication, you may be able to convince a judge that your son is seeking treatment, and that a punitive approach would be inadvisable.

Bona fortuna!

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[Patte Rosebank]

P.S. – Drug abuse and alcoholism frequently occur in those with ADHD. They try to self-medicate with these things (and with caffeine, and with risk-taking behaviour). By getting proper treatment for ADHD, with properly prescribed and monitored medication, they don’t feel the need to self-medicate, so the risk of drug abuse and alcoholism is actually greatly reduced.

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