Saturday, 12 December 2015

What if nothing's working and your family is suffering? Three 'must-do's' for parents who are struggling

Hardly a week goes by without me receiving an email or a phone call from a parent who is having a problem dealing with their son or daughter and their alcohol or other drug use. Some of these mums and dads put on as brave a face as possible when they speak to me, while others are terribly distraught, some even breaking down in tears, desperate to find a solution to the problems they are facing with their child. This week I had four parents call me in just one day, all of whom were struggling with very different issues, but all telling me that they felt they really had no idea where to go to get help or advice.

Now I need to emphasise that I am not a trained counsellor or health professional, and I make sure I make that clear to anyone who calls me for advice in this area. I'm also not a parent so it is impossible for me to imagine what these people are going through. I am an educator and I do know a reasonable amount about the research in the area of parenting and alcohol and other drugs. When I am approached by these people I see my role more as one of referral, trying to direct them to the correct services, agencies, as well as health professionals who may be able to assist them with their problem. There are usually three pieces of advice, however, that I do give them, three simple 'must-do's' that any parent struggling with a teen and their alcohol and other drug use can and should do to help them get through this extremely difficult time. They are as follows:
  • Make sure you and your partner are okay before you do anything else - by the time these parents speak to me the vast majority of them are a complete mess! They have been struggling to deal with what has been going on in their home for some time and the whole family is suffering. Marriages are sometimes at breaking point and if there are other children (particularly younger siblings) they too can be affected terribly. Let's be clear here, if you're a mess then there is no way that you're going to be able to help your teen. Don't be afraid to get professional help - so many are afraid to do this, believing that it somehow means they have 'failed' as parents - nothing could be further from the truth. You can go to your GP and ask for a referral to a health professional who specialises in this area (yes, they do exist!) or if you feel comfortable speaking to counsellor at the school your child attends, they may also be able to assist. Whoever you speak to, you need to use the opportunity to talk through what you are going through and possibly even get some strategies on how to communicate with your son or daughter more effectively. It is vital however that this is all about you - it is not about fixing your child's problem - this is all about making sure you are ok! You can worry about your child's issue once this is done ...
  • Before you react to anything, walk away and count to 10 - without doubt, every parent I speak to talks about the clashes they have with their teen and often the reason they took the step to contact me is that these are escalating. These clashes are usually due to the child not doing something that was expected of them or flagrantly breaking a rule and then the parent reacting. If you want one simple thing that will almost automatically reduce the suffering in the home it is never, ever react immediately. You're angry, they've been found out and their back is against the wall - it's not going to end well. I'm well aware that this simple strategy does not go towards solving the alcohol and other drug issue you have with your teen but it does make life more bearable! When something happens, walk away - count to 10, make a quick call to a friend and vent, scrawl out swear words on a piece of paper for a couple of minutes - and then come back to them and express your concerns. Once the old pattern of reacting straight away is broken, you have a better chance of dealing with the issue in a more positive way (and you'll feel less stressed!)
  • Remember that you're the adult and they're the child - one of the lines I hear constantly from parents is "But they won't even meet me halfway ...". A key to good parenting in this area is the setting of clear boundaries and rules and making sure consequences are in place should they break those rules. That said, young people are still going to push against those boundaries and you will need to punish them accordingly - that's a normal parent-child relationship. Unfortunately, there are teens who are going to ignore rules altogether and no matter what you do, they're simply not going to tow the line. Now this is not the norm and if your child is acting out in a major way you may need to change the way you approach your relationship. Instead of keeping insisting that they at least meet you halfway, you may have to go 'over halfway', reach over and grab them and then pull them back! So much of this has to do with parents realizing that you're not going to have total control over their teen's behaviour, no matter what you do ... Now I'm not saying you do this the first time they do the wrong thing, but if you obviously have a problem and you fear losing them - you have to change tack! What I'm talking about here is essentially a change in attitude - no matter how mature they may think they are, you are dealing with an adolescent who doesn't have a fully developed brain. They aren't able to think through things rationally and everything is based on a 'gut reaction'. Remembering this when you are trying to talk to a difficult teen is not going to solve the problem but it may at least lower your frustration level.
If you do have a child who you believe is having issues with alcohol and other drugs you need to remember that you are not alone. You also need someone to talk to about it. If you have a family member or friend that you believe is appropriate - go for it - but in my experience, so often parents who go down this route end up feeling even more frustrated when the person they trusted ends up telling them not to worry and that 'it's just a stage they're going through'!

If you do need to talk through what is going on in your family and you want a non-judgemental ear to listen I advise parents to contact a wonderful organisation called Family Drug Support (FDS). FDS was formed in 1997 by Tony Trimingham who lost his son to a heroin overdose. It is a caring, non-religious and non-judgemental organisation primarily made up of volunteers who have experienced first-hand the trauma and chaos of having family members with drug issues. They have a Support Line for parents that operates 24 hours a day, 7 days a week - 1300 368 186.

As already said, the most important thing parents need to do is to make sure they're ok before they do anything else. This can involve getting professional help or simply having a great family or friend support network around them when things get tough. Remember, you're no good to your child if you're not coping well - when you feel good (or at least better) you're going to be able to deal with this type of issue much more positively and effectively ...

Wednesday, 9 December 2015

Pill testing isn't a silver bullet to prevent drug deaths, but it could be part of the solution

Over the past fortnight we have seen two deaths at dance festivals, apparently both due to ecstasy. Both of these are tragic wastes of young lives and, not surprisingly, the public wants answers as to what happened. It is important, however, that we wait for toxicology and the coroner's report before we jump to conclusions. But as always, the media approaches the usual suspects to make comment and, although we really have little or no information, wild statements are made about possible 'bad batches' or that aggressive policing contributed to the death. Let's be honest here, over the years I've been guilty of finding myself doing a media interview and being pushed into a corner and making a comment that in retrospect was not appropriate. I can also tell you that the last question you are usually asked is "What would you say to anyone who is considering taking ecstasy?" Trying to give a balanced response to that question in the context of of a young person recently dying is not easy - even the most experienced commentator is not going to get it right everytime!

For that reason I have avoided doing any media interviews around the two deaths. Put simply, at this stage we don't know what caused their death. We do know, according to their friends, that they both took ecstasy (and possibly other drugs) and that they subsequently died, so it is fair to refer to them as ecstasy-related deaths but that is about it. We don't know what substance they actually took (ecstasy could contain anything), we don't know how much of that drug was in their system and we don't know how they died (i.e., overheating, heart failure, etc) so it is difficult for anyone to really make comment on either case. When you say that you don't want to make a comment on the actual deaths, journalists move to questions about how to prevent this from happening in the future. I've avoided the media in this area as well but when I was asked to write an Opinion Piece for the Sydney Morning Herald on possible solutions I grabbed the opportunity to highlight a concern I have about the debate that occurs after almost every ecstasy-related death ...

Here is a slightly edited version of the piece (the words in bold are an extremely important addition to the piece and I thank Dr David Caldicott for alerting me to the issue - I hope it clarifies my views. It was never my intention to imply that people who conduct pill testing would ever suggest that if you know what you're taking, it is safe. That is certainly not the case - I was referring to users believing this to be true) ...

Two apparent ecstasy-related deaths in as many weeks is unprecedented as far as I am aware. Ecstasy deaths are rare, but when they do occur they receive a great deal of media attention. They are usually linked to nightclubs, dance events and festivals, a part of youth culture that many older Australians do not understand well, and involve drugs that weren't necessarily around when they were younger and as a result, they can cause great community concern. 

Two 'camps' quickly emerge in the days following a death – the prohibition lobby who demand that governments and police get tougher and those who hold more of a 'harm reduction' view who usually suggest that 'pill testing' is the way forward. The two sides bang heads for a couple of days, maybe a week, and then we just keep on as before until the next tragic death. That is until last year …

When a 19-year-old young woman died at a Sydney dance festival from an apparent drug overdose the call to get tougher was louder than ever. Since that time we have seen a greater police presence at dance festivals than ever before, particularly in NSW. The number of people charged with possession of illicit substances at these events has never been as high and yet, here we are, only a couple of month into the dance festival season and we already have two deaths. Yes, we can get tougher but from what we've seen over the past fortnight it doesn't seem to have made any difference as to whether people take illicit substances, or reduce the harm associated with that use. 

So what about the other side of the argument - would pill testing help? Let me start by saying I am totally supportive of this strategy but am worried that when promoting this potentially useful strategy we're promising something it can't necessarily deliver. Put simply, it's being made out to be some silver bullet to an extremely complex issue. 

Pill testing (or 'drug checking' as it is called in some parts of the world) would provide some limited information to users, usually about potentially dangerous adulterants that can be found in pills, tablets and powders. Different parts of the world conduct this strategy in different ways, sometimes a simple reagent test, whereas others offer a much more thorough testing regime. The whole concept is based on one of the key prevention messages we have around ecstasy (and other illicits) – 'you don't know what you’re taking'. Pill testing, therefore, allows the user to have a little more information about what it is that they're planning to use. Unfortunately, as far as many users are concerned, the whole concept is based on the false assumption that if you do know what you're taking, it is safe – something that is absolutely untrue. As far as ecstasy is concerned, the substance users are looking for is MDMA. Test a pill and find out that it contains MDMA and many users believe that this means that the pill is 'safe'. MDMA is not a safe drug and many of the deaths that have occurred across Europe this year have actually been due to MDMA overdose. Pill testing for adulterants would not necessarily have assisted in preventing those deaths. 

It was pleasing to see the Federal Government acknowledge that we can’t arrest our way out of the ice problem - the same thing goes for ecstasy and related drug culture. Tougher policing has certainly not resulted in less harm – the last fortnight has made that abundantly clear. Age-appropriate education, based on evidence and not simply scare tactics, a development of an early warning system about particularly dangerous substances disseminated by agencies that users are more likely to believe (police warnings are often ignored) and an agreed 'code of conduct' for party promoters (including appropriate policing) are just some of the areas that could be investigated. The tragedy is that we only talk about this issue when we have a death, when in fact we need to have an ongoing dialogue between all parties (the dance festival and nightclub industry, government, police and clubbers themselves) about how to move forward in a positive way in this area. Hopefully pill testing is a part of that dialogue but let's not kid ourselves that just one strategy is going to mean we won't see these kind of deaths in the future.

I'll say it again, I am totally supportive of pill testing but I am extremely worried that it is being put forward as a simple 'solution' to a very complex problem (not necessarily by the promoters of the initiative who are well aware of its limitations and that for it to be effective it must be a part of a range of strategies, but rather by the media who love 'black and white' solutions, the more controversial the better!). Let's be clear, even in countries where they have pill testing in place, we still see ecstasy-related deaths. As the title of the piece says - pill testing isn't a silver bullet to prevent deaths, but it could be part of the solution.

This is an updated version of an Opinion Piece written for the Sydney Morning Herald published on December 7, 2016. The original online version is also available.