“She’s so bright. Once she gets to college, she’ll make new friends and have a change in environment and will focus on her academics. The experimentation she did in high school will fall behind her.”
Ten years ago, my husband and I were wondering whether we should be looking for colleges or rehabs for our daughter. Note the wording: she was not taking a particularly active role in the college search. But the culture of our family, and her school, made college the ineluctable choice. After all, how could a family with high levels of education and professional success have a child with addiction—almost a “reverse stigma”?
My husband and I knew that Amy had used substances in high school—confirmed when she was caught showing up high on marijuana for cross-country practice. She also had diagnoses for anxiety and depression, and scored an ADHD diagnosis from a psychiatrist which, in retrospect, may have been more about her seeking Adderall.
She was a junior in high school when I found a Vicodin in her purse—and I had no idea what a big red flag that was. Despite plenty of counseling for her and our family, it appeared that she was going longer in between acute incidents, which gave us some handhelds of optimism that we were desperate to clutch.
During Amy’s high school years I thought she was going through a phase, or being bratty, or acting out. I did NOT realize how much emotional pain she was in, and how sick she really was, until I read her journals after she died. I still wonder if there was trauma she never told anyone about. But off she went to St. Louis University. She transferred to the nursing program at Boston College for second semester of her sophomore year—and loved BC.
After living the dream that semester, she took a three-week summer microbiology course—and earned an A, scoring 108 on the first test, and “only” 104 on the second. My husband and I looked at each other and reached the terrifyingly false conclusion: “she can’t be messing up THAT badly if she can earn those kinds of grades.” Wrong.
To paraphrase Sarah Allen Benton in “Understanding the High Functioning Alcoholic,” college often provides a student who is struggling with substance use disorders the environment to go “under the radar.” Students can choose peer groups where use is normalized. I’ve even heard university officials say that parents expect “right of passage” behavior despite a school’s attempt to promote student health.
Amy’s “final descent” in the fall semester of her junior year happened so fast that I didn’t recognize it for what it was. The big tipoff should have been that she was going through money awfully fast. Only in retrospect did I notice that my daughter was no longer spending money on tanning – something that had been a (dangerous) foundation of her vanity. The letter that arrived at our house about her being in danger of failing a course was another flare.
Fortunately, she connected with a drug counselor who himself was in long-term recovery, and was able to help her see how sick she really was. She invited me to a meeting with him at 3pm, November 16th, 2009, a time and date I will never forget. I was blindsided when she told me, “I’m a heroin addict.” After I uttered a profanity and slammed my keys on the table, Amy said that she wanted to take a medical leave of absence to go to treatment.
“You only have a few weeks left in the semester,” I protested. “Can’t you tough it out?” Her counselor shot back, “If your daughter just told you she had stage 3 cancer, would you ask if she could tough it out? No. You’d get her to Dana-Farber as fast as you possibly could.” That was the proverbial “two-by-four whack upside the head” that made me realize we were dealing with a disease.
Amy started treatment later that week; five weeks later, she died of an overdose at the facility.
Amy left the world the gift of her journals, which have been published. One mother who read them said, “You saved my daughter’s life. After reading Amy’s story, I took my daughter’s behavior much more seriously, and she was actually much sicker that knew, she went to treatment, and has sustained recovery for two years.”
What would I have done differently? 20/20 can be unhealthy and even dangerous—I did the best I could with what I knew at the time. But since I know a lot more now, having shared her story with over 21,000 people and hearing many of their stories, I’ll offer a few thoughts.
What Parents Should Know if Their Teen Has a Drug Addiction
First, as a colleague of mine at Boston Children’s Hospital said, “if you see a mouse in the kitchen, there are probably more behind the wall.” If you think there’s a problem, there probably is, and don’t err on the side of minimizing it.
Fortunately, ten years later, the science for treating substance use disorders has advanced, though it still has a long way to go. Use the analogy: if you saw suspicious growths on your child’s skin, you’d see a dermatologist to rule out skin cancer. Similarly, someone trained in adolescent substance use disorders should be consulted to provide a diagnosis and prognosis. We are talking about a child’s health and a disease that is increasingly fatal.
Second, know that more and more colleges have recovery housing and other programs to support vulnerable students. Indeed, considering time off before college could be indicated—“Semester Off” of Wellesley MA was started by Ilan P. Goldberg, MD, a Harvard-trained psychiatrist who, through his work with the college population in his own practice, came to realize the lack of services available to these students. I know several young people from nearby suburbs who earned full ride athletic scholarships, only to have their addiction cause them to drop out.
Third, the recent article in the Atlantic tells a recent story of a son’s addiction and death shortly upon entering college. Despite so much good work by so many people, this epidemic has been a moving target, and to see how much worse it has become since Amy died is truly crazy-making.
Colleagues and I console each other by saying that if not for these efforts, the morbidity and mortality would be even worse. In citing this article, I want to note the distinction that treating adolescents is different from treating adults, because their brains are different. Also, some of the issues young women bring to treatment may require different expertise than those of young men—as well as unique challenges faced by LGBTQ youth.
Fourth, don’t be afraid of support groups. Addiction is a family disease. Many communities offer a variety of twelve-step programs as well as other family support. If your family is struggling because of a member’s substance use disorder, you are not alone, although it may feel that way. I also found that support groups provided hope.
The stories I’ve heard of young adults who are in recovery and their family members who learned to cope—although it was years of struggling for many of them—are truly inspiring. I only wish my daughter’s story could have been among them.
Melissa Weiksnar has been an opiate epidemic educator (writer, speaker, and advocate) since 2010, using her daughter Amy’s story to educate about how addiction can impact any family. She published Heroin’s Puppet: The Rehab Journals of Amelia F.W. Caruso (1989-2009) and It’s Not Gunna Be an Addiction: The Adolescent Journals of Amelia F. W. Caruso (1989-2009) by Amy Caruso (2014-08-02)
She has formally shared with over 21,000 listeners in schools, community, healthcare, and religious settings across the U.S. She participated in the 2015 filming of the Jim Wahlberg film “If Only” and has spoken on numerous panels after showings of the movie. She also testified in Massachusetts for the Good Samaritan legislation which paved the way for widespread deployment of Narcan; Amy overdosed in a treatment facility that did not carry Narcan, which can temporarily reverse an opiate overdose until medical help is available.
Ms. Weiksnar attended Wellesley College and is a graduate of MIT, the University of Houston, and Harvard Business School. She spent the first part of her career in high-tech, including co-founding Synernetics Inc. In 2002 she switched to high school teaching, and most recently worked at the Center for Adolescent Substance Abuse Research at Boston Children’s Hospital. Ms. Weiksnar is married with two older children.