Substance abuse vs Self Medicating

Last night my 22 year old son was so anxious that he thought he needed to be hospitalized (He was hospitalized in June this year and July last year for pscychotic break.)
He was accepted into a mental health day program that is 3 hours a day when her first got home from the hospital a month ago but didn’t want to go. Now he is smoking pot, drinking several beers and smoking cigarettes and still anxious. We called the program director and he is going to re-assess but says that since Nick is using, he needs to do the substance use program before he will benefit from the mental health program.

Our son says the substance use is not a problem and that it is our disapproval that makes him anxious.

We can’t really force him to do the program since he is legally an adult but allowing him to smoke and drink as much as he wants at home does not seem to be helping. At least he is still taking his meds, but he says he would give up the substances if the meds worked and he feels they don’t work enough.

We are confused as what to do, we don’t want to enable but want to be supportive.

Self medicating and substance abuse are the same thing. The medication won’t work as well of he is doing those things. He needs rehab.

I’ve pondered this one a long time… It’s all the same thing…

I understand where your son is coming from… but the pot and the alcohol make it so the Meds Don’t work well… sort of a vicious circle.

I used to take XTC and acid and then complain that my meds didn’t stop the hallucinations… (duh for me) Same with pot… smoke pot… get paranoid during the come down… take my A.P.s… smoke pot… get paranoid during the come down and complain the A.P’s didn’t work.

then it all blended together… I grabbed the drugs because I was more used to them… I was addicted to them… I took them all the time… so when I ended up on doctor prescribed meds… of course they didn’t work. which helped me justify grabbing the pot and the whiskey.

Comorbid diagnosis is pretty common for us with this illness.

I hope an answer comes soon… It took me a long time and a lot of help to get clean and sober. It wasn’t until after that when the Ap’s started working.

Best wishes :v:

I used to smoke weed and drink but it only made me worse. I am now clean and feel more confident about my mental health. Somehow you have to convince him he shouldn’t use. Sorry, not much help.

my daughter is skitz paranoid by polar boarder line split my guess is i passed on mental issues to her.she is now 30 was dianosed at 15.alcaholic myth only makes things way worse.15 years of hell on earth hard alcahol would cause voilent rages ,wholes in walls ,cig wholes all over carpet ,2 times fires,phisical voilence her dad and placing her in instatutions repetedly.her dad is an emabler.i was lucky am well balanced with low med or would have sent me over short if they dont want to change take meds you can knock yourself out to no avail they have to want to

You cant force your adult son to do anything, but you CAN set boundaries around what goes on in your house. There can be a compromise ( smoke-but not in the house ) but you also want to carefully choose your battles. My son has been through the same thing, and it has taken me a long time to set those boundaries. But they work! I would say no drugs in the house-start with that. See how things go. Its really all up to how much you want to tolerate, and what your son wants to help himself. Setting conditons doesn`t do any good because there are some things out of his control. But you have a right to your own boundaries.

thanks comet i agree 100% there should be guildlines whats exceptable whats not,both parents have to back it.

Find a therapist who’s an addiction specialist and uses Motivational Interview Technique. If you have insurance, ship him off to The Meadows in Wickenberg, AZ; Betty Ford in Rancho Mirage, CA; or Hazelden in Minneapolis, MN. They’re all top notch for dual diagnosis.

If he can handle his self medication without any negative effects on his daily routines, or as long as it’s not seen nor heard? …it doesn’t seem unreasonable to allow it.
There are much worse alternatives…
This illness can rationalize the common sense out of knowing when to stop something, so it’s never a bad thing to set boundaries - as well as the consequences when breached.

There is a sense of security- no matter how much protest is involved- in knowing there are rules/limits/boundaries, and most important of all, that they will be enforced without fail.

It makes for good people to be around to behave well.

Everyone who has smoked pot heavily knows that it makes you anxious. Worries about your heartbeat, worries about people watching you, etc. - this is all too familiar to regular pot smokers and they know it is the pot doing it very well. Your son saying it is your disapproval that is making him anxious is the denial of an addict speaking, and it goes to show how far an addict can go to sustain his habits. Im not sure what advice to give you, but if it were my son, having been addicted to pot myself, I would confront him with this fact and press him to admit it. He gets away with such comments because you might not be familiar with the effects of pot.

On a side note, I have always found the term self-medication a deceiving euphemism. The notion of medication suggests that it is treating some problem, but most substance abuse isn’t treating any problem. Some people might say they abuse to forget their problems or something like that, im not sure, I abused because I was addicted to something I initially enjoyed for fun, the problems only came with the abuse so it was rather the source than a self-cure for them. I tend to think this excuse of abusing your problems away sometimes is merely employed to not fully accept your addiction.

Thanks, I agree. He says that the pots, beer, cigarettes calm him down. We don’t see it. We see that in the evenings he is so anxious and goes from one thing to the next. If he was functioning well with the medical marijuana I would be for it, but I see him struggling. We set the first limit last night saying no more than one or two beers a day(it has been between 2 and 5.) The therapist said to take it a bit at a time. Next week if he is still anxious we will begin to ask for limits on the pot.

I’ve had a similar experience, using substances to self medicate because drugs weren’t working. A drug/alcohol rehab place that also does mental health issues is my recommendation. Your son needs to learn healthy coping skills. DBT was very helpful for me. From what I have been told… addiction is like a switch that gets flicked on, genetic or tied to mental illness. Once it’s been activated its really difficult to turn off or unlearn the behavior.