COMMENTARY

Parenting the Addicted: Scenes From a Substance Abuse Clinic

Maya Hambright, MD

Disclosures

December 04, 2023

The mom who started giving her son her Xanax when he was 12. When he was 18 she told concerned friends he did not have a problem with heroin and booked a cruise to take him away from "bad influences." Three days before leaving for the trip, he did not wake up after an overdose.

The mom who buys fentanyl pills off the street for her 20-year-old son who claims his methadone dose is not enough and he needs the "fent."

A surgeon, who felt he had no recourse, called the police on his 32-year-old son, who was arrested for the sale and abuse of methamphetamine. He was incarcerated for 6 months and discharged to a treatment center. The son left the facility after 1 month; he was homesick. The father now prescribes psychiatric medications to his son, who is living at home without treatment. People are most vulnerable to relapse and overdose death within the first few weeks after leaving rehab. Cravings are high and tolerance is low.

The mother who buys her 28-year-old son a bottle of whiskey every night on her way home from work. He spends the day on the couch waiting for her. She is worried he will have alcohol withdrawal seizures and feels that she has no choice.

A 29-year-old man who is returning from an 8-week hospitalization during which he was treated for bacterial endocarditis for 6 weeks after using a dirty needle and developed sepsis. He was then transferred to another hospital where his destroyed tricuspid valve was replaced. His mother couldn't take him back on the weekend of discharge because she was renting out his room.

The mom who posts regularly on Facebook. Her last post was full of pride and excitement as she congratulated her eldest son on a job promotion and her youngest daughter on her engagement. She did not mention her 36-year-old middle son who lives with her and shoots fentanyl in the basement.

The father of a 26-year-old son, who is a successful drug dealer. He repeatedly tells his son how disappointed he is in his choice of careers. But every month he asks for money to cover the household expenses.

The parents who refused to let their son come home from rehab on Suboxone because they did not want him addicted to "another" substance. He overdosed and died within 2 weeks.

I am not passing judgment. I am observing. If asked, I do give my opinion — and sometimes I am asked.

I say there are no right answers; there is no right way to parent a child whose life is fragile and who is in pain. And whether they ask my opinion or not, I always guide them to parenting groups where they can share their experiences with so, so, so many others.

Addiction is the loneliest place, for the substance user and for the family. Through community support — in a safe, nonstigmatizing space — can healing and greater understanding begin.

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