Carolyn: (00:00)

Hello, I'm Carolyn Bradfield. And I'd like to welcome our listeners to the Audio Journal series from interact LifeLine. Interact LifeLine is a technology service focused on helping addiction treatment and collegiate recovery programs keep individuals connected to treatment, to community and to their families to improve recovery and reduce relapse.

**Introduction Music**

Carolyn: (00:27) Good afternoon everyone, or morning whenever you're listening to this podcast. This is Carolyn Bradfield. I'm the CEO of Interact Lifeline and we are starting a new series in our podcast called Interact Studios. In this podcast we're going to have conversations with people that are from our industry in the mental health addiction and recovery space. And hopefully people that listen will learn a lot from our talk. So what I'd like to do today is introduce you to Dr. Sandy Newes. say hi, Sandy so people can hear your voice.

Sandy: Hi everyone.

Carolyn: I'm in Atlanta, Georgia. Sandy is in lovely Asheville, North Carolina, and, Sandy and I have known each other for a number of years. We worked together in the industry at Phoenix outdoor, an outdoor behavioral healthcare program in North Carolina. Sandy was our clinical director, as well as our testing psychologist. And so I have a deep level of respect for her in terms of her understanding of working with adolescents and young adults who had been struggling with substance misuse and addiction. And beyond working with adolescents and young adults, Sandy also has had significant contact with their parents, to help them understand the journey that their own with their loved one in terms of working, and helping them recover. Sandy also in my opinion, is one of the best testing psychologists in the country and so she does a complete analysis of an individual to understand their learning styles, their behavioral issues, and their mental health issues to provide parents and the individual with a thorough understanding of what's causing them to struggle along with making recommendations to move forward and to be healthier. Sandy has an extensive history in training and education. She works with other clinicians to help them better understand how to work with at-risk clientele, and she is especially focused on those that are struggling with substance misuse. So Sandy, you've got a million credentials, to your name, but beyond what I just shared in terms of our personal experience together, round out for the audience, the other areas that you focus on.

Sandy: (03:21) So my broad areas are trauma, chronic stress, anxiety and self regulation issues of which addiction is a part of that. And I really believe that those are the underlying pieces in addiction. And so I have a private practice and Asheville as Carolyn mentioned. And not only do I test do testing, I see individual clients, about a third of my practice are adult or young adults, primarily in adults, some adolescents, but in early recovery or mid level recovery from addiction, as well as people who are struggling with chronic stress and anxiety. And I incorporate a real brain-based focus on working. So I use skills to help regulate the nervous system and help teach people how to balance their brains, which has everything to do with behavior. And I also incorporate neurofeedback into that. And then I do training around those types of things for not only clinicians, but also staff at therapeutic programs nationwide.

Carolyn: (04:24) You are by far one of the smartest people that I know and certainly well-respected in the industry. So again, you're welcome. so, and yeah, our first initial minutes in this conversation, we've used the word addiction quite a lot. And as a psychologist you've treated hundreds of adolescents and young adults that are struggling with addiction over the years. So let's get the audience a level set definition of what addiction really is. So in layman's terms, can you just give us a good understanding about what we're, what we're facing here, what really is addiction?

Sandy: (05:08) Sure. There's a tremendous amount of science around the way addictive substances impact the brain. And, but I'm not going to go into that right now, but it is really important to understand that this is a brain-based disease that people who, whose substance use moves into addiction have a different response to the same substances and their chemical responses and their brain respond differently than people who use and don't become addicts. And so essentially what happens is some kind of different chemical process happens in the brain that leads an individual, It can start in adolescence and move into adulthood. That leads them to become increasingly preoccupied with using the substance. That sets up a whole different brain-based kind of physiological response and that leads to increased preoccupations and ultimately cravings and those preoccupations and cravings lead to the individual really not recognizing the impact of their behavior or prioritizing the substance use above all of that. So it has nothing to do with willpower, moral or character. It has everything to do with the way the brain interacts with the substance that continues to worsen over time.

Carolyn: (06:27) You know, I'm glad that you mentioned that this is not what a lot of people think it is, which is a moral failing or a series of bad choices. But actually the disease has a real root in science and you know, a real brain disorder that makes these choices more and more difficult for a person that is seeking the substance, and Interact, We've been studying the government statistics. And so we know that once a person enters rehab for substance misuse and addiction and they come out after their 30 days, there's an extraordinarily high relapse rate sometimes, often as high as 85% in the first year. So what makes this disease of addiction so doggone difficult to treat?

Sandy: (07:17) Well, there's a couple of different factors. The first is that these traditional 30 day programs are really focused 100% on helping a person gets sober, which has to happen obviously for them to recover from addiction. But they teach all of these structures and they just don't hold up in the real world because the stresses that an individual faces away from the treatment program tend to override all of the understanding that the person has gotten in their treatment program where they were isolated from stresses of day to day functioning. Not to mention temptation for addiction. So, you know, there's that, there's the excessive focus on just plugging them into these structures that we hope will be helpful, such as 12 step that which can be helpful, but for some people isn't theirs. But bigger than that, I think there's a huge miss of the brain-based piece, which relates to the mental health issues that underneath addiction is suffering underneath that are mental health issues. And associated with all of that is the way that events, that one experiences in one's life impacts their brain. So stressful events, overwhelming events, traumatic events impact our brains. And then that sets us up for that physiological brain-based response to addiction that I already mentioned. So our brain gets into this place of activation from stress, from trauma, from difficult things. And then the substances have more of an effect. And so without addressing that underlying brain-based self-regulation piece, people leave treatment programs committed to sobriety. But the environment happens, life happens, stress happens, our brain gets into a dysregulated state, it gets more activated, it gets more stressed essentially. And then it becomes more and more difficult to simply not use by going to meetings and doing all the other things that are taught in these 12 step based programs.

Carolyn: (09:20) You know? So for my own personal experience with my daughter, she would go to a treatment program for 30 days. She would get clean and sober look great, but then come out and struggle. And for a lot of the reasons that you meant, you mentioned that it also seems to move that a lot of treatment revolves around looking at this as an acute disease. So after 30 days you're, you know, you're much better and not really the chronic disease that it is. You want to talk a little bit about, why addiction is a lifetime worth of management versus 30 days in rehab?

Sandy: (10:00) Well, it's because that once your brain, I mean, so there's so many different levels to that question. That's a really difficult question to answer. But I mean, at a neuroscientific level, once your brain gets hardwired into, you know, that this substance, there's literally neural pathways that are built in the brain that like this substance is the thing that makes you feel better. And so when that gets activated, that really takes over and becomes so preoccupying in a distorted way. People don't realize that. But beyond that, there's an inner part that, you know, there's an interpersonal factor. So most of the stressors and traumas and overwhelming events that we experience in our modern day life. You know, there's like events like car accidents and you know, difficult things, but it's a lot interpersonal, this family stuff or it's rejection or it's lost. It's, you know, getting bullied by peers. It's getting kicked out of the group. It's, you know, failing to make the soccer team. All of these things are really difficult, immense to navigate in adolescence. And they have something to do with deep belonging and struggles with interpersonal relationship, which set up relationships to be the thing that triggers people into getting overwhelmed and they're getting activated. And when we get activated and we get overwhelmed, our thinking brain literally goes offline. We know this also from neuroscience, that stress, that activation leads us to be unable to use our good thinking skills, which is don't go to the bar, don't pick up. That's a really bad idea. Go to a meeting, talk to your sponsor. That all requires your ability to kind of think your way through and make it happen. But what we know is when our brains get activated, I refer to as getting "out of the zone" that thinking brain goes offline and then often all of those things go out the window. So one of the missing links in treatment is that people have these relationships that are safe and kind of contrived essentially in a treatment program. And then we go out into the real world and relationships are hard and we're not teaching people how to develop and maintain and stay in and feel safe in relationship or choose people that they can do that with wisely. So there's all of these different kind of things that are essentially stacked against the addict ability to recover because we're missing some of those components in the treatment programs and relationships skills and self regulation skills and managing stressors of life skills like that's inherent. That's that is the whole life. And when you don't know how to manage those things and keep yourself regulated and keep stress from overwhelming, you, the capacity to really think through and keep using all the good coping skills that we learned in treatment becomes really diminished at times of heightened stress or activation. Does that make sense?

Carolyn: (13:08) Yeah, that makes total sense. And you know, you and I worked together at Phoenix outdoor and that program focused on adolescents, 13 to 17 years old. So all those skillsets of regulation, making good choices, that help keep you healthy are, are lots more difficult for an adolescent because they just aren't mature enough yet. So, you know, at Phoenix outdoor, we not only work with a number of adolescents, but we had a very robust family support program, so we had the opportunity to talk with and engage with lots and lots of parents. And so based on your experience in the program, how aware do you think parents are, and understanding the extent to which their kids who were coming into our program were struggling with the diseases still? Do you think they, they understood it, knew it or we're just not educated?

Sandy: (14:11) I mean, I think that hardly any of them understood or knew very little about it, especially at the adolescent level. I mean there's so many different cultural lenses through which we view substance use and some, you know, subcultural groups like using drugs and alcohol and adolescence is considered normal and it's just, it's almost considered a rite of passage in other groups. You know, it's so far from parents own worldview or their own lens or their own experiences, adolescents that they literally don't even see it when it's right in front of their face. And that's not their fault. It's because they're not watching for it. And then kind of all of that really culminates in parents really not knowing when, you know, quote unquote experimentation has become really problematic, either because they're, their child is hiding it so well or they're not being alerted by the schools or anywhere else, or they're just not conditioned to see it as a problem. But all of that, it's just parents are very uneducated about how serious that can get, how rapidly it can progress. And essentially more than that, like how much addiction really takes hold of a person. And I think that's the part that people just don't get, is that like intense preoccupation and how it drives somebody into their own world to where it seems like a completely reasonable thing to deal from parents or you know, do things that are extraordinarily hurtful to the people who care about them in order to get at the drugs or the alcohol that they're looking at. And I think that's the part that people don't get. you know, and then they start just trying to punish and shame the child and essentially that just contributes further to the problem. So by the time we get here, it's way more difficult to address the issues than it is if we'd, if parents were more educated and saw some of those more early warning signs.

Carolyn: (16:14) Sandy, as you know, from knowing me, that parallels my own personal experience. my daughter started using substances beginning with alcohol, then cascading into drugs at age 14. And I was completely uneducated about the risk that was out there. I had no idea about how much trouble that she was in at that point. so I appreciate and understand that my own experience paralleled, that of the clients that we worked with. So I've thought about this a lot, especially given the fact that my daughter is no longer with us. But if you could have a conversation with those parents when their kids are not in our program, but they were much younger, what warning signs should they pay attention to that their child might be at higher risk of developing this disease? What would you say to somebody who's kids eight, not 18.

Sandy: (17:22) The first thing is look at your family history. So there is undeniable research that families who for whom addiction runs in the family, whether that'd be alcoholism or drug addiction or just problematic substance use or heavy substance use that that runs in the family. If you can look back and the parents and the grandparents and the aunts and the uncles and going back, the more that there is, the more at risk your child is. And so that that simple fact alone should be informing parents view from minute one. If you have a strong family history of addiction or problematic substance use, then it's really important to begin really early taking active steps to keep your child from ever using. The second piece of that is that age of first use is strongly associated with addiction. So kids who start using earlier are more likely to become addicted. So if you have on 11 year old who's out experimenting with marijuana, this is not quote unquote normal behavior. I mean it is in some circles and it is among some groups, but this is not healthy. And so it's really important to come down really hard on that. And by that I mean, I don't mean like punitive and horrible. I just mean like take that as a tremendous risk factor. And if you've got both of those things, age, early, age of first use and a strong family history, then you're headed for trouble. Or you could be your, your percentages are much higher risk to looking at those factors. The next one is,

Carolyn: (19:07) Let me interrupt you because I want to explore that one thing a second. So my daughter was 14. So age of early use would definitely apply to her. And also from our research we understand that use has become pervasive in middle school. So kids are starting to use much, much younger than that. Talk a little bit about the developing brain and when it really gets developed and what happens when you interrupt that development with substances. I think people need to understand why early use well is critical,

Sandy: (19:45) Right. So in adolescence, essentially our brains become scrambled. So they did, they've kind of, associated adolescence with like around the age of three when you're born and you did start to develop neural structures and then kind of early on in childhood, those things sort of reorganize and restructure themselves. And kids go through periods where they cannot control their impulses is essentially the toddler years. And they've associated adolescence with that, that the brain kind of organizes itself through early childhood and in adolescence it all kind of splits apart and then restructures itself again. And so adolescents are extremely prone to problems with impulse control. They have difficult time regulating their emotions cause at the same time they're also separating from parents. That's part of their job is to create an identity separate from parents and other caregivers in school and things such as that. So all of this creates a perfect for drugs and alcohol to come in while the brain is restructuring itself, enter drugs and alcohol and suddenly pathways that are associated with wanting that substance are formed. So there's like literally neuropathways that create this connection to craving drugs and alcohol. At the same time. This is a really critical time for adolescents to be learning how to have healthy, increasingly more mature, connected, intimate relationships with people other than family members. Learn how to manage their emotions, learn how to make good, healthy decisions, learn how to control their impulses. Like, yeah, well, yeah, sure you want to drive your car a hundred miles down the highway cause it seems fun, but not a good idea. So you're not going to do it. But so all of these different things create this perfect storm where drugs and alcohol not only create neural pathways and again those with a history of addiction and their family are more versed for this. But then drugs and alcohol curb the normal development of some of these essential skills that set adolescents and young adults up to move into healthy adulthood where they can control their impulses, make good decisions, choose things that are healthy for them, recognize risk, what isn't, isn't safe for them to do what is or isn't good idea. And ultimately it really impacts the brain's overall developmental process. Now, brain doesn't fully develop until age of 25. We know that the frontal and prefrontal cortex, which is the thinking brain, is not fully developed until age 25. And so we add that into the mix and adolescence and into young adulthood and it really negatively impacts that part. And that part is critical for an independent, well-functioning, successful adult who's able to initiate decisions, engage in a career, raise a family, and have good, healthy relationships.

Carolyn: (22:53) So, you've mentioned this a couple of times in our conversation about, kids that are not in their zone. And I want to go back to, the focus that we talked about, which is, you know, the conversation we might have with mom and dad, much earlier, to point out what, who's at risk. So let's talk a little bit about the overly emotional child who's constantly blowing hot and cold. Who just can't seem to stay in the zone where they're not exploding or overreacting. How much should we as parents be worried when we have a child like that, as a potential risk factor for some that someone that might misuse substance and develop addiction. Talk about kids not staying in their zone?

Sandy: (23:45) That's a great question. So, I was actually gonna say that as kind of the third risk factor for parents to watch for, which is kids who can't emotionally regulate, and emotionally regulate means, you know, a child who just gets overwhelmed by their emotions and it can start when they're young with good emotions. Like it doesn't have to be all quote unquote bad or difficult emotions. But when you see a child who gets overrun with excitement or overrun with anger or overrun with anxiety, and they can't shift out of it and it skews their perceptions of things and they just get wrapped up in it, or when they get upset, they just lose control of themselves. Like they yell and they scream or they throw things and they just have an extraordinarily difficult time calming down. Like that is high, high risk for addiction right there. And the reason is is because enter drugs and alcohol and suddenly you can calm down, enter drugs and alcohol and suddenly that overwhelming anxiety that you're experiencing is no longer an issue. And you can go out into the world and talk to people and become really upset or mad, enter drugs and alcohol and suddenly you can calm that feeling. So these overwhelming feelings, enter drugs and alcohol and they become like seemingly the perfect tool. So not only that, like, Oh wow, does that ever feel amazing? But also then when you begin to use that instead of learning healthy, mature skills to regulate your emotions, which we call getting back into the zone, right? Then we don't, we miss the opportunity to learn the skills. And so the drugs and alcohol become increasingly more important for that. All of that then relates to the development of the brain, right? That frontal and prefrontal cortex, which is required to do that. So those three things all are, are happening at the same time. And it starts with a child who struggles with regulating their emotions in early childhood. And I'm talking again early childhood can be toddlerhood all the way up to like age eight, nine, 10. I have a nine year old right now who really struggles when he gets mad. All those things happen. And I know that that puts him at high risk and that's something that I need to monitor. So I need to teach him those skills now so that he doesn't need drugs and alcohol as much later to help him with it.

Carolyn: (26:13) Yes. I think that's an excellent point. You know, that if you've got a child that's struggling with that, just be on higher alert. The other thing that I know you and I mutually experienced when we've worked with adolescents at Phoenix outdoor, we observed that a large percentage of them have problems keeping up with their schoolwork. How might those kids that struggle with learning differences be at higher risk. Why, might they, why do we have such a large percentage that had learning issues in our program that focused on substance misuse?

Sandy: (26:54) Well, I mean, there's a lot of different factors to that too. There's kind of the internal experience of never quite feeling like you fit in, always struggling, always falling behind. So, you know, substances become a way to manage that, those self esteem issues. There's also the fact that many types of learning issues, especially, you know, ADHD being one of them also negatively impact the capacity to self-regulate. So it, it again relates to the frontal part of their brain that, you know, great brain in the front, the frontal cortex is required to regulate emotions. So when you have learning differences of some sorts, that part becomes even more impaired. Putting one at higher risk for the things that I just mentioned. And then there's the social aspects of it that, you know, using drugs and alcohol in adolescents and young adulthood is essentially a way to be cool. The way to get attention. It's a way to find, you know, social power and social capital, in a world in which maybe you feel like you're being left behind. And so that classic, you know, kid who like hangs on the outskirts and lures the other kids over to get attention and look at me, I looked at, I'm so cool, I got drugs. You should hang out with me. Isn't this fun? You know, that kind of thing becomes extraordinarily compelling for a child who's always felt like they're on the outskirts, not to mention the drugs and alcohol might help them figure out like, Oh, look at me, I can, you know, have a few drinks and be social. So helping to manage all the social anxiety. So certainly that puts kids also at higher risk for a variety, for a variety of different reasons. So it's also something to begin to notice in elementary school if your child is having learning differences, just taking those extra steps to know that they're at higher risk. So we got to watch more carefully and be more proactive from a prevention perspective.

Carolyn: (28:49) You know, I think it also falls that a kid can fall in both ends of the spectrum. They can either have learning differences, so they might get made fun of because they can't keep up. But then you take the kid on the opposite end of the spectrum that's super smart and they may be socially awkward as well, so they get bullied. You know, so I think that we, we as parents need to look at both ends of the spectrum as well. So, another risk factor that we're aware of and I know that we've talked about before, are something that we call adverse childhood experiences. So, you know, often times society worries most about the, the kid whose home life is in disarray there they've suffered abuse, violence, they live on the other side of the tracks. Their environment is really chaotic, but I think you and I both learned that children can experience other issues that they consider to be difficult or adverse that they have a hard time responding to. So I'll take my own situation with Laura. The year that she started using, she entered high school for the first time, she changed her sport from soccer to rowing. We moved to a new neighborhood and I got married, you know, so like you talk about like all these changes and, and, her balls. So talk a little bit about

the impact of these adverse or negative childhood experiences as it relates to

elevating, a kid's risk. What the parents need to know.

Sandy: (30:38)

Well, it's because of the way that it impacts our brains. Again, I mean it all comes down to brains and how addiction is a brain based disease. And so anything that's going to impact our brains can be ultimately associated with higher risk for addiction. And so what we now know is that, you know, they refer to it as trauma or adverse childhood events, ACEs, that the higher the, you know, the more of those that you have more impacts your brain development, which I can say more about but, it's important to recognize that these are, these events are anything that overwhelms a child's ability to cope or anything at all in a child's life that overwhelms their sense of safety and security and predictability in their world. And so why that impacts our brains is because then that activates the part of our brain that is 100% focused on keeping us alive. And it sets us into survival mode, which is a much more reactive mode, which is really adaptive when we live in the woods and you've got bears and tigers working about that are ready to eat you. So you can react really fast. But it's not really adaptive in a world in which there aren't really predators and where the predators are essentially other people, their family members or their people at school or their teachers. And that's just a brain-based. Again, that's not that really is that not that divorcing parents are really tigers, it's just that that sets up the, the survival part of the child's brain. And when the survival part of the brain is in charge, it's really reactive. We're scanning the world for threat. And again, it takes that thinking brain offline or it diminishes its functioning. So the more of these events that we experience more activated, our nervous system is in readiness to fight tigers or to run from tigers or to freeze in the face of tigers. And that puts us in a really reactive state, which in that reactive state is the exact opposite of what kids need to be able to learn, to be able to engage in healthy relationships, to learn math, to plan, and ultimately to control their impulses and to control their emotions because it impacts the thinking part of the brain. The thinking part of the brand new, slow, the survival part of the brain moves fast. When a child experiences overwhelming events, the survival brain is in charge. And so it diminished the capacity for the child to develop the ability to self regulate. And that ability to self regulate means emotions and behaviors. And that has everything to do with whether or not they're going to be able to choose not to use drugs or alcohol or to be able to regulate their use if they do choose to use.

Carolyn: (33:17) So one of the things that I know for sure with parents of, elementary school kids is that they don't feel like they should focus on a disease that their children may never get. But, the reality based on government research is that we know one in 10 adolescents will become addicted before they even leave high school. And now we've explored a lot of the reasons why you focused your conversation on the genetic link and how critical that is. It's the same as if somebody has a genetic link to diabetes. There's a much higher chance that, a child will develop diabetes in their lifetime. You talked about emotional regulation and the importance of, watching a kid more closely if he's becomes dysregulated. We've talked about learning differences, kids that can't keep up or that are overly intelligent, being different and, and struggling to fit in. And we've talked about these adverse childhood experiences that, the child has a fight or flight response to that really causes their brain to go into overload. So I'm sure people listening to this, if their mom and dad or grandparents were probably freaked out at this point, now that we've gone through that. but let's talk about what mom and dad should be doing to lower the risk. So if they could only do three things to lower the risk that their child will be one of those statistics, what advice would you give them? What are the top three things they ought to be thinking about?

Sandy: (35:07) That's a really good question. I mean I would really focus on that emotion regulation piece. And if you don't know what that means, right? That means you can look up mindfulness for kids, mindfulness in schools, and it's not all mindfulness. I talk about it as kind of trauma and resilience or self regulation skills, but mindfulness is an easy entry point to that. Teach your kids skills, how to regulate their emotions, teach them how to calm down, teach them to recognize when they're out of their zone and teach them ways to get back in their zone. Related to that, if you can, you don't get your schools on board with that. That's a really critical piece is to begin. And more and more schools are doing it. They're kind of recognizing that it falls under the umbrella of trauma informed care, but it's really a preventative tool. So get involved in, in ways with communities, with teachers in ways that your kids learn that and begin to just language that at school. Like normalize that. Like, Oh wow, you're having a hard time regulating your anger. How do we help you get back in your zone? Those kinds of things are so, so critical. the second is really educating your child and yourself. Like recognize what those early warning signs are, what is or is not normal and start talking to your kids about that early. Like one of the things that my friend says that her dad always said to her is that "some things are too good and you must never do them." And I think that's valid, right? Like, you know, teach kids about addiction, but this is a thing and let's not pretend it's not happening. Because even if it doesn't happen to your child's, certainly they're going to know somebody for whom it does. And you know, just begin to have an open dialogue and do your best to stay in relationship with your child. Spend time with them, keep those lines of communication open. And as part of that really monitor technology use, which is a whole separate conversation, but I'm convinced that too much technology use is a gateway drug and three, assess your risk factors like look at your own family history, look at your child. Does they, do they struggle with emotion regulation? are they at higher risk? Do they have a community of kids that they connect with that they feel safe and supported and valued and understood and if not, start early and try to help them find that. And then last just take active strides to really look for the places where they might actually be able to use and keep your eyes on it, right? Like, like you know, maybe consider drug testing early, but certainly supervise them very closely. Do not hesitate to monitor their phones. Look, listen, look at their calls, look at their texts, find out where they are on social media, pay attention and just tell your child that that's why you're doing it. It's my job as a parent to keep you safe. There's a lot of things out there that are not safe for you. Drugs and alcohol is a big one. And I'm going to watch you really, really closely while you learn the skills to be able to work through this to yourself. But until then, I'm going to step in and help you be able to make good decisions, because this could kill you and I'm not willing to let that happen. So really taking those kinds of steps from an early age, not from an alarmist perspective, but from a prevention perspective. And if you normalize it when they're in elementary school this is what we're doing to protect you for the future, then it's not so hard to bring it in later when you might get more pushback cause you're already doing it.

Carolyn: (38:53) So, in recap, the things that parents ought to be doing proactively are teaching their kids to, be able to emotionally regulate themselves, stay in their zone. I'm getting connected to schools and communities so that you know what's going on and that you're having conversations, educate yourself as parents, understand the disease, understand the risk factors and find an age appropriate way to talk to your children early so that they are educated and not scared, but they're educated. Monitor their technology, monitor the kids. Consider drug testing. I don't think there's anything wrong with it, but you know, as parents, your job is to keep them safe and you should do all those things. I'm going to add to that, list Sandy and you can comment on it. My personal advice, and this is after struggling with my daughter for 15 years would be as follows, adopt the attitude that it can happen to you. We grew up in the middle class neighborhood, we had great neighbors. My kid was girl scout, et cetera. You would never look at her and think that she's at risk. So I think we all need to adopt the attitude, no matter what we see in elementary school. It can happen to your kid. And once it does, it makes life a lot more difficult. The second thing I would advise parents would be to not be ashamed. it is no reflection on your parenting skills. It has no reflection on your moral failing if you have a child that develops the disease. So being transparent about it, asking for help, connecting with others that have expertise I think is critical, and not blaming yourself, for what's happening to your child. The third thing I would advise parents, and you mentioned it, but I want to bring it up again, which is when when your kids are actively seeking substances, they will do things that will terribly hurt your feelings. They will steal from you, be mean to you, try and misdirect you. And it's really not a reflection of how much they do or don't love you. It's just a part of the disease and you have to understand that they'll do things that don't make sense to you. But it is not personal, it's just a function of the disease. So if you could stand to give parents any last words of advice before we wrap up, what would you tell them? What would be your best piece of advice?

Sandy: ( 41:33) Intervene earlier instead of later. If you have a child that you can see as high risk and their risk is emotion regulation or anxiety, get them into therapy in elementary school there's no stigma, there's no problem work to create the structures before they ever use. And if they start using early intervene actively, quickly. So get them into therapy. Don't hesitate to put them in a treatment program as an adolescence if they need it. Wilderness therapy often also referred to as outdoor behavioral healthcare can be super effective for adolescents, but the earlier we intervene, the better it is. Don't hesitate to take, to really respond really, really strongly. And again, as you're, if you, your assessment of your risk factors goes up, then the degree to which sort of the magnitude of your response early on should also go up. Like don't wait until they're using heroin. You know, by that time the recovery is so much more difficult, take and take active strides to keep them from using. The longer that they can go without using, the more their brains will be developed. So, so start early, respond, you know, strongly get the structures in place to support them both avoiding using and that they have a place to go if they do use. And really beyond that, the biggest thing that's that I think is hard about recovery is for people, adolescents, adults, all of us to, to find community. And that's, I think one of the biggest things that I didn't mention that drives people back to relapse. So create community for your kids that isn't about technology. Help them find friends, help them find groups, socialize with other parents who share your values so that they have a place to land where they feel supported and they feel safe. And I think that that is hugely important and start that early.

Carolyn: (43:46) So Sandy, very good conversation. I thank you so much for your insight and wisdom. Hopefully, this will be shared around with parents, with grandparents and others that want to know more about the disease that need to understand who's at risk and ways to protect them. So this is Carolyn Bradfield and Dr. Sandy Newes with Interact Lifeline Studios. We thank you for your time and attention and we will end the podcast. Thank you so much, Sandy.

Sandy: (44:18) Thank you for having me, Carolyn. I appreciate it. You're certainly welcome.

Outro:

Interact lifeline here to make a difference in how people manage the disease of addiction, reducing the right of relapse and improving the recovery process. We offer treatment and collegiate recovery programs, a technology service to keep families connected to treatment, to support communities and to family. This is Carolyn Bradfield and you've been listening to our Audio Journal from Interact Lifeline.