Hard Choices: When Your Teen Needs Rehab

When is rehab the right choice? Sending a teen away is never fun, never easy. Parents struggle with the same hard questions.

Why can’t she just do a better job of controlling her behavior instead of going to rehab?
    Willpower to overcome unhealthy behavior is difficult for all of us. Even healthy adults fail to follow diets and lifestyle changes. How often do you fail to get to bed on time or exercise regularly? Expecting a teen to ‘will’ herself out of drug addiction is setting her up for a dangerous failure. By the time we are looking at the possibility of rehab, self-control has slipped too far from your teenager’s grasp. She needs help now.

Why rehab? Who needs to go?
    I recommend rehab when a person, teen or adult, has clearly lost control over the use of substances and is unable to regain control. Some individuals experience a feeling of powerlessness and ask for help, but many, especially teens, must be pushed to go into treatment by concerned parents. 
    Rehab stays of 30, 60, or 90 days can remove a teen from a life that’s spiraling out of control. The treatment center will try to keep all the residents substance free and focused on healthy goals. They will be pushed to face their addiction while isolated away from peer groups and pressures to take risks.

Will treatment work?
    Sometimes the result of a rehab stay is complete abstinence from addictive drug use, and other times teens return to drug use later. But even if a teen faces a future relapse, rehab stays may slow the progression of the addiction. 90 days away from escalating dangerous drug use may prevent serious overdose. Breaks from drug use may result in a more manageable illness later. Families usually push for treatment when their teen has lost control, and treatment is a place to contain and control dangerous behavior. 

What if we can’t afford it?
    Substance rehab can be expensive. Some insurance plans help with the cost. Many non-profit agencies allocate funds to aid with addiction treatment. If you’re worried about the cost of care, call your insurance company or research programs that administer or pay for care for the uninsured.

Can we just send him for a couple of weeks?
    Many families consider shorter stays in treatment when funding, or other stressors, make the decision to send a teen to rehab complicated. My recommendation, however, is for parents to commit to the longest-term treatment possible. Changing behavior can take a very long time. If your teen is in trouble, invest now and make the greatest difference in the long run.

Will she hate us if we make this decision?
    This question is a common one. Parents are afraid of the consequences of forcing a teenager into treatment. Your child may be angry, true. To help you decide whether rehab is worth the risk, I encourage you to consider the consequences of your teen not getting the help she needs now. Has she had a dangerous overdose? Is she taking risks that are likely to lead her to serious harm? If the outcome of choosing no treatment sounds scarier than the problems you’ll face if you follow through and make her go, then your teen probably truly needs to go to rehab for her own safety.

Aren’t there outpatient programs where she can get the same treatment and stay at home?
    Yes, and perhaps no. Teens are part of a family and community system. Their peer relationships and their identity in the family are extremely powerful forces. Keeping your teen at home and sending her to school each day, and then to counseling in the evening, does not extract her from her system and help her change in the same dramatic way she might if you pull her away. 
    Outpatient treatment is helpful as a first intervention for milder problems. If your teen had a single alcohol related incident, or was caught with marijuana once at school, outpatient programs are the place to start. But if your teen is exhibiting dangerous behavior or is using regularly, removing her from the system where she operates now is an important part of helping her change risky behavior. 

Won’t he go the rehab and meet a bunch of drug addicted new friends, and end up in worse condition than he started? 
    Parents often imagine that rehab is the worst place for a teen in trouble. While this is a sensible concern, in reality, teens in trouble usually have already built up a circle of troubled friends. However, peer concerns are one more reason to send a teen away from home for treatment, not keep them close to home local programs. If your teen goes to another city for treatment and meets a group of drug addicted peers, those kids won’t be nearby to sell him substances if they relapse after treatment in a far-away community. On the other hand, if your teen attends a program at home, peers from treatment may remain close contacts day to day.

This feels like a pressured decision and we don’t feel ready. Can we wait?
    If your teen is in crisis now, it may be best to act quickly. This is one of the hardest parts of coping with addiction the family. If you’re unsure, talk to professionals or other parents who can guide you. Attend a Parents’ Al-Anon meeting. Tell your story to a parent who has been there. Ask for advice from someone who has made a similar decision for his or her child.

Posted on April 13, 2015 .