ADDICTIONS: PREVENTION & HEALING
In August 2017, some prominent TV channels and newspapers reported incidents of school students, including girls, being addicted to substances. In debates that followed, with representations from different sections of society—parents of teenagers, mental health professionals, school administrators, and civic authorities—each section held one or other section responsible for the phenomenon of teenage addiction. This article suggests that all these sections are jointly responsible. It highlights the role that each of these sections of society can play in substance-abuse prevention, and how they can interactively collaborate with one another.
Deepa, a twenty-year-old college student, told a friend: “My studies are in a mess. Worse still my personal life. I don’t know what to do. All this happened after I started taking drugs. I think I want to kick the habit, but I have no idea how. I am scared of telling my parents.”
These students, who had admitted that they were addicted to substances, and that they needed help to overcome the habit, had taken the first major step towards recovery. They would need the help of medical practitioners, trained counsellors, and the active support of family and friends to undertake the journey towards recovery.
The help addicts need
Persons who have become addicted to substances may sometimes want to break away from the habit. However, each time they actually stop consuming substances, they experience unpleasant physical and emotional states, called “withdrawal symptoms.” These include: mood swings, sleep disturbances, chills, tremors, nausea, and an intense craving for the substance. They often get back to consuming substances in order to alleviate these overpowering symptoms, and find it hard to break free despite their good intentions.
Such persons often need the assistance of medical practitioners to flush the addictive substances out of their bodies, while also helping to regulate the unpleasant withdrawal symptoms. This procedure is called detoxification. Detoxification is normally carried out at a medical facility. Patients are often housed at rehabilitation homes for several weeks or months after detoxification where they receive other forms of assistance to break free from their addiction.
Sometimes medical practitioners prescribe alternate measures after reviewing the extent and duration of patients’ addiction, and their level of emotional and mental balance. They may prescribe substances that act as substitutes for the addictive substance. At other times they may assist the patient to gradually reduce the dose of the substance consumed while living in their normal setting.
The procedures just spoken about help patients to withdraw from actively using substances. However, they would also need the assistance of counsellors and support groups to help them live substance-free lives.
Counselling: A Great Help
Handling personal difficulties
Students often resort to consuming substances to alleviate the stresses or pressures of day-to-day living. Some are unable to measure up to their parents’ expectations, or to cope with the pressure of their studies, or academic failure. Others end up being lonely because they are unable to connect with family and peers. Still others might have been physically, emotionally or sexually abused. Persons often experience much emotional pain, or feel stressed on account of these experiences. They then use substances to get relief from the pain they experience, and gradually get addicted. Counsellors help their clients to release painful emotions surrounding these experiences. They also help their clients to build up their ability to handle similar stresses that they may experience in the future. These interventions give them a sense of control over their lives, and reduce internal pressures that might drive them to consume substances.
Handling difficulties with the family
Family members of persons addicted to substances sometimes contribute to the person’s having recourse to substances. This happens when parents are unable to spend quality time with their children, when they are too strict with their children, or when parents give into all their children’s demands without helping them to assume personal responsibility for their deeds, or due to other conflicts within the family. On the other hand, addicted persons may actually hurt family members, or contribute to tensions within the family by their errant or substance-induced behaviour. Counsellors help addicted persons as well as their family members to see how they may be contributing to one another’s tensions. They help the addicted persons and their families to reconcile their differences, and to engage in mutually supportive and enhancing behaviours. They also help family members to clarify expectations and set reasonable boundaries for future interactions. A major external source of stress is released when family conflicts are ironed out. This often leads family members to positively help the addicted persons on their journey to recovery.
Anticipating the lure of ‘friends’ after rehabilitation
Addicted persons continue to crave for substances even though they have undergone detoxification procedures, and even though they have decided to refrain from using substances. Counsellors help patients anticipate that after being discharged from the rehabilitation home, ‘friends’ with whom they earlier consumed substances may invite or induce them to return to the habit. They teach ways of avoiding and dealing with these potentially toxic situations and interactions, thus empowering patients to re-gain control over their lives.
Support after discharge from rehabilitation homes
Addicted persons face a number of challenges after they are discharged from rehabilitation facilities. They have to manage bouts of craving for the substance that may cause them to a relapse. They will have to face circumstances that initially led them to experiment with substances. In addition, they will have to slowly get back to their regular family, academic, or professional lives with the day-to-day challenges that accompany these tasks. They are able to negotiate these challenges more easily when they continue to see their counsellors after discharge from rehabilitation facilities. Over a period of time they become more confident to manage these challenges on their own.
Some addicted persons also join self-help groups like Alcoholics Anonymous or Narcotics Anonymous. Such groups adopt a structured set of procedures generally called the “12-step Programme” to help the recovery process. Members of such groups support one another during moments of emotional difficulty or when members are in danger of relapsing. Older members who have managed to remain substance-free over extended periods of time stand out as beacons of hope to inspire new members to adhere to the path practiced within these movements.
Prevention better than cure
Recovering from addiction to substances is an uphill task. In addition, there are very few centres in India that are equipped with all the supports necessary to deal with the challenges of rehabilitating addicted persons. Hence, it is best to prevent others from getting addicted in the first place. Preventive efforts focus on assisting students who are at risk for addiction in their personal struggles, and developing support systems within their families, schools, and communities.
Giving Right Information
A standard IX student began skipping school and consuming alcohol with a group of peers who were not able to handle their academic requirements. A standard VIII student could not connect with his peers, and also found that his parents did not have time for him due to their professional commitments. He began to drown the pain of his sadness and loneliness by sniffing whitener.
Struggling students are often lured by peers who tell them that substances help release stress, and that it is ‘normal’ for young people to experiment with substances. Preventive measures need to focus on correcting faulty information about the use of substances, and helping students build skills to handle their academic tasks, life tasks, and social interactions.
Vulnerable students are likely to experiment with substances when peers and media advertisements give them the message that it is ‘normal’ to do so because the ‘majority of persons’ consume them. They are not aware that playful experiments could gradually lead to addiction. In addition, they are uninformed about the negative effects of consuming substances. It is best to guide students by giving them factual, unexaggerated information about the ill-effects of substances, and their addictive potential, in a matter-of-fact manner. Counsellors take care not to reveal how substances are ingested and where substances are obtained from. They also avoid presenting gory pictures of addicts as this might lead more adventurous students into dangerous experiments. Helping students realize that their estimates of substance consumption within the general population are higher than actual consumption rates helps change their perception that substance use is socially acceptable. These interventions help students develop an informed ‘mind-set’ that helps keep them from experimenting with substances.
Learning to say ‘No’
When some students use substances, they may attempt to invite or induce their peers to join them on such ‘trips’ either for fun, or to release stress. Students are able to desist from accepting these ‘invitations’ or to withstand ‘pressure tactics’ when they are taught resistance skills. Resistance skills training involves having prior knowledge of the addictive and harmful effects of substances, and unambiguously communicating one’s unwillingness to consume them. Students are helped to rehearse ways of handling ‘tricky situations’ and communicating their refusal in an effective manner. They are also cautioned not to accompany peers who consume substances to isolated places, or to visit their homes when their parents are not around, to avoid being pushed into using substances.
Learning Study Skills
Students feel that they are in control of their lives when they are able to master the content of individual subjects, and succeed academically. Learning study skills helps students negotiate this crucial task. They learn techniques to improve memory and concentration, to read and write, to take examinations, to manage time more effectively. Students who suffer from learning disabilities need additional assistance, and are at best referred for assessment and professional help.
Learning Communication Skills
Students who are shy and who withdraw from others often lack communication and social skills. They find it difficult to develop healthy associations among peers, to articulate and communicate their feelings and needs, and to protect their boundaries. Hence they are unable to access sources of support during times of crisis, and in addition, often fall victims to bullies and to those who might pressurize them into using substances. They are less likely to resort to abusing substances when they are taught to develop healthy relationships among their peers, to speak about their feelings and communicate their points of view, and are empowered to communicate assertively.
Vulnerable withdrawn students can be helped to develop social and communication skills through guided group exercises. For example, students can be taught to share non-threatening personal information with their peers, and to respond empathetically to similar disclosures by their peers. At a further stage, they can be helped to articulate and express their views on a variety of situations and topics. Additionally, they can be taught how to work in teams, and to give and ask for help when needed. After sufficient practice within the group these students can be guided to practice skills they have learned amidst their daily interactions with peers, family, and teachers. Debriefing sessions are generally conducted after such real-life interactions where they are given an opportunity to share their success stories; and where they can be given further assistance to deal with the difficulties they faced. At a later stage, they may be taught skills to resist those who might induce them into using substances.
Happy homes: Key to Substance-free Living
Sixteen-year-old Rajesh looks forward to sharing time with his family every evening. His parents have helped cultivate these moments ever since he and his sister were very small. Each member of the family would speak about the activities they had engaged in during the day, or their plans for the next few days – like the children’s upcoming sporting or academic events. They planned special family outings during these moments. They listened to one another’s struggles – like their parents’ tiring day at work or with household chores, or the children’s difficulty with homework or nasty companions. They listened to one another with an open heart, and then did whatever they could to help. Children would make special efforts to help out with family chores. Rajesh would assist his younger sister with her studies. Parents would make time to hear out difficulties the children had with their peers or teachers, and volunteer to accompany them to challenging or special events at school.
Family moments like these help parents and children bond with each other. They also build children’s potential to communicate effectively and handle future life challenges, and play a significant role in keeping children from experimenting with substances. Here are the ways in which Rajesh’s parents have helped him through these family moments.
Rajesh’s parents developed strong bonds with the children when they:
- Listened to their children’s struggles, and supportively helped them cope with these difficulties;
- Assisted the children to set and achieve academic goals;
- Familiarized themselves with their children’s interests and activities; and appreciated, encouraged, and fostered their abilities and talents;
- Allotted time for fun, and encouraged healthy pursuits like sports, art, music, etc.
Rajesh learned to communicate effectively because his parents:
- Communicated with the children in a nurturing and open manner, allowing the children to express their points of view;
- Helped the children to resolve conflicts and crises they experienced, and supported them when needed;
- Taught the children to receive and do acts of kindness.
The parents helped Rajesh live a value-driven life by:
- Modelling positive values, emotions and behaviours;
- Collaboratively working out value-driven household rules, and demonstrating firm and consistent limit-setting;
- Teaching the children to develop healthy associations in school and the neighbourhood; and to keep a respectful distance from peers who participated in activities that harmed themselves or others.
Rajesh and his sister grew into secure, happy and well-adjusted persons because of the way their parents interacted with them. Surveys in the U.S. have indicated that adolescents who have meals five times a week or more with their families, and share in family interactions similar to those of Rajesh’s family, are less likely to get addicted to substances. Building up a healthy family atmosphere is an important step towards helping children live substance-free lives.
Most families do not share the ideal relationship that Rajesh and his siblings enjoyed with their parents. And many parents may not always have the skills that Rajesh’s parents demonstrated. Workshops can be conducted to help these parents learn and cultivate skills to effectively communicate and bond with their children.
It is not too difficult to build up the skills of ‘unskilled’ or ‘uninformed’ parents. However, some other parents—like those who are violent or addicted to substances—may actually harm their children by the kind of life that they lead, and the way in which they interact with their children. These parents would need more specialized help and interventions.
The Empowering School
Sr Metilda, a high school principal, noticed that some of her students used substances like gutka and cigarettes. A worked she attended made her aware of other kinds of substances that students commonly use, as well as their ill-effects. She shared this information with her school teachers, and sought their assistance to identify the kinds of substances their students commonly use. The teachers jointly suggested ways in which they could help their students stop ingesting substances, and shared their plans with a representative group of parents. Some parents observed that a number of substances that the students consumed were available in the neighbourhood of the school. They suggested ways in which civic authorities could help restrict the availability of these substances. The intervention of teachers and parents helped the school create a substance-free campus over a period of time.
Children generally look up to their school teachers. Teachers interact with their students for six to eight hours of a working day. They need to be keenly attentive to their students’ activities and struggles. Thus, apart from teaching academic subjects, they can play an active role in building up their students. School managements play a wider role by implementing structures to support initiatives undertaken by teachers.
How Teachers Can Help
Teachers may feel motivated to embark on a substance-prevention programme when they are made aware through workshops of the variety of substances that students commonly use, and the way in which substance consumption cripples their lives. While functioning within the school set-up, teachers can also help to clear the way for parents to accept and develop a helping relationship with their children who are using substances. Informed teachers can also direct parents to professionals and institutions offering specialized assistance.
Helping Vulnerable Children
Some children are vulnerable to the lure of substance abuse: Children who face academic difficulties and are socially withdrawn; those who hail from broken or conflict-ridden homes; or from neighbourhoods where substance-consumption is rife.
How can teachers help such students?
By reaching out to them, listening lovingly to their struggles and referring them for guidance. This prevents them from falling victims to peers who may misguide them into using substances.
- Referring students with learning disabilities for professional assistance; and conducting workshops to help students who are academically weak to cultivate general study skills that may help them across subjects;
- Enlisting the help of counsellors to teach socially withdrawn students to cultivate communication and social skills in order to interact effectively with others;
- Helping vulnerable students to participate in co- and extracurricular activities to help them bond with other school students and feel a sense of connection with the school.
These initiatives help vulnerable children overcome their feelings of isolation by healthy bonds with peers, teachers, and schools systems. Building these bonds keeps students from falling prey to misguided peers.
Building an informed and safe school
Inspired by the example of the principal cited earlier, school managements can strengthen the efforts of teachers by:
- Initiating substance-abuse prevention workshops for teachers;
- Conducting brief but informative, interesting, interactive and developmentally appropriate substance-prevention workshops for students;
- Ensuring the presence of trained counsellors in schools;
- Conducting parenting and substance abuse prevention workshops for parents;
- Enlisting the assistance of parents, NGO’s, and civic authorities to ensure that the vicinity of the school is free of peddlers.
Three steps will enable students live substance-free lives—helping them with academic problems (so that they feel successful), teaching them relationship skills (so that they make friends), and protecting them from those who experiment with drugs.
A Proactive and Vigilant Community
A report in the Mid-Day on 5th September 2017 narrated how an NGO and the local police in Mumbai responded to cries for help from school and college students enmeshed in the world of drugs, alcohol and prostitution by conducting workshops for students and parents. Likewise, NGO’s, mental health professionals, and local law enforcement officials can jointly play a key role at the community level to implement a substance-prevention programme.
Awareness programmes in the community
Civic groups can engage various media of communication such as street plays, puppet shows, films, documentaries, seminars, group discussions, media articles, television and radio programmes, and social media networks to sensitize children and adolescents to the dangers of consuming substances. Awareness programmes could be conducted in schools and colleges where a large number of students have already fallen prey to consuming substances.
Dealing with peddlers
Peddlers are an important link between substance traffickers and users. It is vital to prevent them from operating. Interventions that help contain the influence and operations of peddlers include:
- Increasing public awareness about street substance peddlers;
- Involving residents and NGO’s to help identify peddlers;
- Acquainting police personnel with drug-prevention laws, and training them to enforce restrictions on peddlers through the force of law.
The Key
Rehabilitating persons who are addicted to substances is an uphill task. It is wise to prevent students from using substances in the first place. Initiating awareness programmes in schools and communities; assisting struggling children and adolescents to handle their personal struggles; and creating supportive and protective networks within families, schools, and communities is the key to creating a substance-free society.
Substance abuse is rampant. Its effects are tragic. Our young people are the main victims. We need to act—urgently and effectively. We cannot close our eyes, or pretend everything is fine, or act helpless. The steps indicated in this article (with the awareness provided by the previous one) can help families, schools, colleges and churches to prevent tragedies and heal those already in the grip of this addiction.
Face the reality. Prevent. Heal. Provide a safe setting for the young.
Fr Ajoy Fernandes SDB
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