Q & A with Hazelden Expert

By Tanya Bui

Jim Steinhagen, the executive director of Hazelden Youth Services and the Center for Youth and Families in Plymouth, Minnesota, leads a nonprofit organization which helps young men and women ages 14-25 recover from chemical dependency. Steinhagen has studied addiction treatment for more than three decades. The organization’s surveys indicate that about 44 percent of the young people who went through treatment remained alcohol and drug- free five years later. He met with ThreeSixty reporter Tanya Bui to discuss teens, chemical dependency and the residential treatment process.

Q: Why is underage drinking and chemical dependency in teens prevalent?
A: If you look at the culture in our country, drinking is certainly considered a rite of passage from being a teenager to becoming an adult. The average kid sees 100,000 *beer or alcohol commercials by the time he or she is 18. If you think about the nature of those commercials and the psychology involved, it’s about (wanting) to look better and being the life of the party. If you want to be sexy, if you want to fit in- very few things are more important than peer approval for young people.

Q: What are some teen trends in drinking and chemical dependency?
A: What we’re seeing with young people is an increase in abuse of prescription drugs taken for non-medicinal purposes. Technology has made it easier to access drugs. Kids learn how to get drugs online. Alcohol continues to be a widely and very heavily abused drug. Young girls and young women are abusing alcohol and drugs at the same rate that their male counterparts are, and that’s a change. What we are also seeing in treatment is that about 90 percent of the young people who come here have a pre-existing mental health diagnosis-like depression, anxiety or attention deficit disorder.

Q: How does that complicate things?
A: If we don’t treat these disorders concurrently, the person probably won’t succeed. That means treating the whole person, dealing with the addiction and dealing with the mental health disorder. We also include the parents for an intensive, four-day parent program. The more complicated the case, typically, the longer time somebody needs in a treatment setting.

Q: What does chemical dependency look like?
A: With chemical dependency, the hallmark characteristic for this disease is denial. Typically (the addict) is the last person to know the problem is as serious as it is. The person who is addicted really does develop an elaborate set of defenses that really protect them from reality. Our job is to crack those defenses and help give them glimpses into the reality of the situation. Hopefully, they become as concerned about it as other people are. You’ve got to take away the chemicals in order for that to happen and even take them away from the environment they were in.

Q: What is treatment like?
A: Our model is residential so everybody who is a patient here stays overnight. It becomes a very intense experience. The primary phase of treatment is a month long and there are core principles within the model that everybody has exposure to. Since one size doesn’t fit all, a counselor’s job is to say ‘Okay, given this individual, these are the approaches I’m going to take… based on learning styles or personality styles or development, age.’ There’s always a counselor who is responsible for what we call a ‘caseload,‘ a peer group of six or seven young people. Those six or seven young people spend a lot of time with each other during the course of treatment. Peers who are working on the same issues really develop a strong sense of fellowship and it becomes a much more dynamic and effective therapeutic experience. We’ll do the group therapy with the peer group and we’ll supplement that with individual therapy.

Q: What’s the transition process into the outside world like?
A: Let’s say someone completes residential treatment and goes back to school. What we’re going to do is work with the school to see what services the school offers to them. We’ll have the patient come back once a week to meet with a peer group, so kids who are facing the same challenges offer advice to each other. They’re building a new peer support group for themselves, hopefully, because that’s so vital for success.

Q: How do you advise patients about their social lives and old friends?
A: The analogy we use is if you hang around the barbershop long enough, you’re going to get a haircut. If you hang around people who are drinking often enough, you’re putting yourself in a situation where chances are you’re going to start to drink again. There needs to be a change of friends and a support system for your efforts for recovery. If you’ve got friends who aren’t willing to do that, then you have to ask yourself, “Is this a friendship that I can continue at this point in my life?”

Q: What is recovery?
A: When we talk about recovery, it’s more than talking about being drug free. We’re really talking about a way to live life that helps them become the person that they’re supposed to be. There’s a quality to it that is filled with rewarding aspects that makes it worth staying on that path. But to achieve it, they really have to change their lifestyle, giving up certain behaviors that they’re really comfortable with. It leaves a big void. So one of the challenges is what do they fill that hole up with.

Q: What principles does the recovery process incorporate?
A: The patients we work with here are diagnosed as chemically dependent. The foundation of recovery is total abstinence from all mood-altering chemicals. Because if they (dependent teens) don’t (abstain), their biological make-up is such that, regardless of whether or not they’ve abused a certain drug in the past, the outcome will be the same. If they switch drugs or experiment with another drug, the outcome will be one that has potentially severe consequences. That’s a core principle in our program. The 12-step model Hazelden uses provides a framework for living to replace the chemical use and the drug addiction lifestyle that they know very well.

Q: If I’m worried about a friend, what should I do?
A: We ask people to be truthful and talk to your friend. Typically, the concern tends to be rejected, which can harm the relationship. Next, find another group of people who are equally concerned and go talk to the person. Does that make a difference? Talk to a school counselor and say “Help us help this person.” Go to the individual’s parents. You might feel like a rat for doing it, but you’ll feel a whole lot worse if the person winds up hurting themselves or someone else, and you haven’t done everything you could.

Q: What can be done about underage drinking and chemical dependence in teens?
A: You’ve got the liquor industry spending millions of dollars on lowering the drinking age to 18 or extending the hours that drinking establishments can be open-spending millions in advertising that is geared toward young people. I don’t see the likelihood that that’s going to change anytime soon. But as technology becomes more sophisticated, I think more research is being done on the consequences to the adolescent brain of drinking. We’re really seeing that the younger a person drinks, the more negative the consequences on the development of that person’s brain. As soon as we have data about the long-term consequences of that, maybe that’s going to be the kind of thing that parents educate themselves about, and they’ll take a different approach. Maybe then there’ll be a different tolerance in young people drinking than there is today, where the tolerance is extremely high.

Q: What’s a message you’d like teens to hear?
A: For those individuals who suffer from addiction, there’s hope. Life does not have to continue down this spiral of addiction and very painful life experience. There’s help.