Talking To Teens: Expert Tips for Parenting Teenagers

Andy Earle: You're listening to Talking to Teens, where we speak with leading experts from a variety of disciplines about the art and science of parenting teenagers. I'm your host, Andy Earle.

We're talking today about how addiction really works.

There are a lot of unhelpful myths about addiction, about what causes it, and about how we should handle it and how we should treat it.

By understanding the underlying factors and the context around the individual, we can get a much broader picture of why someone is using substances and how to help them stop.

And this doesn't just apply to drug addiction. It also applies to things like anorexia, bulimia, purging, self harm.

We are here talking about this with Patricia Roos.

She is a Professor Emerita of Sociology at Rutgers University, and she's the author of Surviving Alex, about her son's battle with substance use disorder and eventual overdose.

Pat. Welcome to the Talking to Teens podcast. Thank you so much for being here.

Patricia Roos: Oh, thanks for asking me.

Andy Earle: Yeah. Wow. I've been reading through your really powerful book here, Surviving Alex: A Mother's Story of Love Loss and Addiction. And you tell the story of your son. Actually, it was really powerful for me. You mentioned your son born on December 17th, 1989. I was born on December 18th, 1989.

I found that really just hitting me in an interesting way, but you really go through his life and his story and his All kinds of struggles really starting from in his teenage years with struggles with food and restricting and getting into drinking and drug use throughout his life.

What set you on this path to advocating about this like you're doing?

Patricia Roos: We were destroyed when Alex died. And for us, it was just as one might imagine to lose one's child, they always say that's the absolute worst thing that can happen.

And I'm not sure it is, but it certainly was for us. And I struggled from the very beginning to want. To ensure that Alex was just not another 2015 statistic, right? I wanted his life and death to make a difference that people really would know who he was, right? And that he would make a difference in people's lives.

So I really wrote the book to honor him and all the others like him, because as someone of his age you know that this is happening to lots and lots of young people, especially. And just in the past year, we have about a nearly 110, 000 people who have died from overdose.

And it's just, if that were happening in any other kind of medical issue, we would be up in arms about it. But, it just, people seem to think these people chose it themselves and I have lots of arguments for why I don't think that's the case, but just to answer your 1st question, it really was a way to honor Alex.

And also not just honor him, but also therapy for me. We left on a trip within a short period of time to go out to Montauk and visit friends. I started that weekend to think about what it was that I would say, how might I write about Alex and have it make a difference.

I wanted people to know what it was like. This is one of my major goals really is to ensure that people really know what it's like. To live with someone who was a substance user and to recognize that it could, it's not just our family.

I always say that if it happened to our family, it can happen to any family because we are just your basic. Normal, good family. And if it can happen to us, it could happen to anyone, but let me just stop there because it gives you an idea of why I wanted to write this both to honor Alex, but also as therapy for me.

And it was a good way of compartmentalizing my grief into something that I thought could make a difference.

Andy Earle: You really come at the issues also from a lens of sociology and you're bringing in all kinds of data and it's not just your family story that you're talking about in the book. You're talking about substance use overall and trends over decades and where are we and how have we gotten to this point and how do we understand Really these issues and treatment and recovery So I think it's really interesting to dive into one thing that I found really interesting is you talk about different models for understanding addiction and there's two main models, you say the moral model and the disease model. And then that. There's also potentially a third model.

Patricia Roos: Yeah, thanks for pointing that out, because that's the 2nd, real goal of my book is to I saw it as being a memoir, but in particular, a sociological memoir so that I am a mom and a sociologist. And so it's really. Obvious that I would bring to this task this honor, the love that I have for Alex my own expertise within sociology.

So that's really, I think, what makes this book somewhat different from many of those that are basically memoirs, which are beautiful, beautiful memoirs. But I wanted my niche to be something different, and that is being a sociologist. So I think it's important to think about how we talk about, how we think and talk about addiction.

And I started from not much knowledge until we were Pushed into this that people within the addiction world called it the insanity of addiction. And I came to call it the carousel ride from hell because that's really what it is. I wanted to better understand how to think and write about addiction.

And so as you noted, there are really two main conventional ways of thinking about it, right? One is that people think that people make this choice, right? I want to get high. I want to take risks and so forth and therefore it's a choice.

And that's the way most people think about it. Researchers have really moved beyond that, but the general American public and lots of political candidates, right? Think about this as being a choice. And if someone can choose to do it, they can choose not to do it. And that's just too simplistic.

And the 2nd way of looking about it is the way I call it a brain disease, right? And this is the idea Of compulsion that if you take that 1st hit, and many people have told me that when they read my book, they said, that's what I thought, right? I thought that you just take that 1st hit of whatever it is, and you will be, it's just automatic compulsion.

You will be addicted to whatever that drug is and I just thought there's something wrong with these 2. There's something really wrong if you think about these as being the only two ways of thinking about addiction. These are personalistic kind of choices and this is my argument against them is that they think about it in personalistic ways, right?

And that makes it easier in some sense, because if you think, oh, if the person is addicted, then we can just take them and put them in jail. And then the families we can shun them and shun people who use substance users use drugs. And then that makes it easy, but it's so much more complicated, right?

So much more nuanced. And so that's really what I argue for and I say, look, I think that it's clear that. You can't throw out the idea of choice entirely, but the way to think about choice is made within a set of constraints or as sociologists like to talk about it, context, right?

Context is everything for sociologists. And so we think about, okay, you can make choice, but you make within A particular context of where you live, where you are historically, where you are in terms of, psychological issues, where you are in terms of socioeconomic status.

And If you take that into account, then that context becomes the location within which you make choices, right? So that's the context. And so that's what sort of complicates it substantially over a typical Personalistic choice and takes into account all those what we sociologists call systemic factors that exist really a lot of times outside of our control.

Andy Earle: And in a lot of ways. Also, it seems that you talk a lot about anxiety in the book and your son's anxiety and the extent to which he is coping using substances as a coping mechanism. But also it starts really before substance use with anorexia around.

Age 12, I think something like that.

Patricia Roos: Alex told us you think I choose to do this. By the time he was older, he asked us, do you think I choose this life? And we didn't have any other models to go by. So you mentioned anorexia.

in Alex's case, I think the issues that he had to address were really psychological kind of issues, such as anxiety and depression kinds And that in our house started fairly early when he was 12 into 13 years of age when he ended up just stopping eating and he felt that he looked chubby.

And he never really did look chubby. If anything, kids that age, think they look chubby, and they think, oh, my gosh. And so he asked his dad, what do I do? And his dad, jokingly said, oh, don't eat so many McDonald's and, do some crunches.

And Alex, took him at his words and then to the extreme within a short period of time. I look back on the pictures, all families have. scrapbooks full of pictures of their kids. And so we, of course, did the same thing. And I looked back on those when I was writing the book and it was so striking because here was Alex just happy and laughing and he had an incredible wit, a wicked sense of humor, just like his dad, he was such a good looking, laughing constantly smiling and yet in the pictures, it stopped within this abrupt period of time within about a month. It stopped and he was not smiling anymore.

He basically cut back. And he altogether stopped eating and we finally took him to a eating disorder unit. He was still 12 at that point. And he was the only male there because, as you likely know, anorexia is something that usually. Young girls get and women get very seldom men. It turns out that about a third of anorexics are men.

So sometimes they manifest in different ways, but people want to look buff, they want to have a six pack, and alex went in there and he stayed for 7 months through his 13th birthday through Christmas through New Year's Thanksgiving, he was there during all that period of time when he first went in, he weighed 68 pounds which was about 75 percent of what his weight should have been at that time.

So he was really, strikingly underweight and really looked. Hugely almost like death. He would look so poorly. And then the behavioral therapy worked and over a period of months seven months inpatient and another six months in outpatient, and then months and months of therapy, and he slowly came back. And so we thought we had dodged the bullet. And I remember a friend of mine at this time said, Pat, I heard that anorexia might be connected with drug use later on in life. And from that minute, from that very minute, I said, Oh, my God, this is something we really have to watch

And so he gained back the weight, was looking good. He started going back to baseball, that was his favorite sport and he was really super baseball player. And then it was shortly after he got out and we didn't realize how. Shortly it was, but he started drinking to excess and that really exacerbated over high school and then college and then after college, it got really that's when it really became worse.

Did that answer your question?

Andy Earle: Yeah, something really stood out to me here on page 80, your printed entry that he wrote when he was later on in rehab, but looking back at this time around age 12 he says this is the time when I became more aware of myself and my environment of a perfectionist.

And I thought this was really interesting. He says, I felt that if I was not the best at everything I did, I was a failure. And you mentioned something later in the book that his therapist said something of a similar thing like that. Relating to not wanting to do things that he's not going to excel at.

Patricia Roos: We hadn't thought about it. he hadn't really expressed that to us that explicitly. So that was mind boggling to us because of course, to us, we were his parents. We already thought he was perfect. Yeah, he seems to be doing great. We didn't think he could get any more perfect.

that was a good description of, The kind of voices going on in his head, The kind of voices that say you're not good enough, you're not perfect enough. You could be better. You could do this. You could do that. And yet he had all of those things, right? I think it's unusual for someone who has substance use problems to make it fully through high school, much less college.

And he was like an A minus student in high school. he was on the baseball team and he went to college Biology and minored in computer science and had honors in Latin, he did super well in college and yet he had that anxiety that just really And he thought that being able to control something, which is what he did when he had anorexia, he could control something that was outside of, most people's control.

Most people can't control themselves so that they don't eat. But then when drinking comes, that's another way, you lose it, lose yourself and you gain, Confidence, right? He talks throughout the chapter where he's in college, he talks about how drinking and then drugs gave him that confidence and he became popular, right?

He became well known. Everybody said he was their best friend. So many of his friends said that to me when I interviewed them was, He was my best friend, and I don't know if he considered me his best friend, but he was definitely my best friend. It's just like he had so many friends.

And so he wasn't you think that people who are, on the edges of society and do nothing except drugs or drinking. That wasn't him, right? He was just a sort of normal everyday guy who just was Whoa, at the beginning, just drinking too much and then drugs. And it wasn't until 2013 that he really just fell into that life entirely.

Andy Earle: Thank you.

Patricia Roos: a huge difference.

Andy Earle: So it was shortly after that that he returns to middle school. It seems like things are going well, and then he Kind of starts drinking during that point, Maybe took you guys a little while to figure that out.

Patricia Roos: Yeah, we didn't. We didn't know that until I read those descriptions that he wrote in from the rehab.

I didn't know how early he had started drinking. most people and most of Alex's friends, they moved beyond it into, they just started their life. And then they found that drinking and taking drugs were not compatible.

And with that adult life, sociologists call it a transition to adulthood. He saw his friends doing it and he was frustrated that he's thought, like, how come I can't make this next step. I tried and I couldn't, I failed at getting into the dental schools.

he was interested In medical school, and then he decided that he was interested in dental school. And he actually got on the wait list for 2 really good programs. And then he didn't get in and that just totally knocked him for a loop. And he just thought he saw his friends making that transition.

And so that really frustrated him because he felt like he wasn't succeeding.

Andy Earle: Yeah, especially going back to this idea of only wanting to do things that you can succeed at and really trying to avoid situations where you're going to fail

It's gotta be pretty devastating.

Patricia Roos: He knew that he could do science, right? He was. Really excellent in science. and so he knew he could do it. And then it's just okay, what do I do now? And so he did end up applied and was accepted right away into a master's program in business and science at Rutgers, which is where both my husband and I taught.

And so he went there for the first year, did well, but that wasn't. What he really wanted, and he just started deteriorating after that point. the deterioration really occurred when he came up against the criminal justice system and that's really one of the things that I try to focus on the most as I think about moving toward advocacy.

And that's where I've gone since I finished the book is to think about what do I want to do? I think the most important thing that I really want to. Stress is that we need to move away from a criminal justice approach to a public health approach. I think of my goals is to help move ahead and further this community of action that moves us in the direction of addressing issues of addiction through a public health approach, rather than an approach that throws people in jail,

And he just felt his life was over. He felt like there was no way that he was ever going to get out from under the criminal justice system. And I think if he hadn't felt that way that he would have been able to just. Get through the whole process. Here's a great example of this that I like to say that in New Jersey, the marijuana was illegal.

At the point when Alex was picked up for possession of marijuana and two or three years later, marijuana was totally decriminalized in New Jersey. Here he was getting heavily involved, having the criminal justice system come down hard on him. And then just a few years later. It was totally decriminalized.

So I think that's a really good example because that very arrest had multiple effects on him because he'd be in a rehab and then the criminal justice people would come and say there's a warrant out for your arrest because, you didn't come to this thing that you were supposed to come to while he was in a rehab That had massive implications on him. Just a marijuana, it wasn't even conviction. It was just an arrest for it. And think that's a good example of the sort of legal stuff that people have to face that young people especially have to face, but not only young people, but that people have to face That affect their lives moving forward.

And you read the criminal justice research, right? That get a conviction in a criminal justice situation, it's almost impossible to get a job. And so that's what he knew. He knew that. And he said I don't have any chance.

And he said that to us over and over again. So I know that was paramount right up there in his mind about worrying about that.

Andy Earle: You really share so much of your story and you've done so much research to pull into here.

And you have a powerful message, I think, For parents and really for anybody. So I highly encourage people to check out a copy, Surviving Alex, A Mother's Story of Love, Loss, and Addiction. Patricia, thank you so much for taking the time to come on the show today and speak with us. It's been really enlightening and an honor to have you.

Patricia Roos: Thanks for inviting me.

Andy Earle: Can you talk at all about where people can go to find out more or to engage further with you or follow updates from you or anything like that?

Patricia Roos: Yes, oh, thanks for asking. I think that's important.

So in addition to the book, at the back of the book, if there are any families that are listening who are worried or find themselves in the midst of the addiction insanity there's a set of resources that I recommend that people take a look at, but an updated set of that resources is on my web page.

So if you go to Pat Roos dot com that's basically my name, P A T R O O S dot com that's basically has an enlarged set of resources and describes the book and talks with the people I've been talking with, right? Like you, Andy.

Andy Earle: highly encourage people to go check it out.

We're here with Patricia Roos, talking about the truth behind substance use and addiction. And we're not done yet. Here's a look at what's coming up in the second half of the show.

Patricia Roos: And It's easier to see in retrospect to see, that was where it went bad. Because it's not like that.

It's important to understand why people get into drugs and get addicted to drugs.

Most people who take drugs are not addicted. The figure that people use is 10 percent of people who actually use drugs are addicted.

Every single Location where he resided was based on 12 step programs. And If you didn't do the 12 step if you didn't buy it if you didn't adhere to it, then you were bad. You were a psychopath.

Andy Earle: Yeah, it really sounds like a whole sort of system going on behind the scenes of referring patients and getting kickbacks and figuring out what's the maximum you can bill to the insurance.

Patricia Roos: why I'm writing about it, so that people can be aware of all the things that are going on.

Andy Earle: Want to hear the full interview? Sign up for a subscription today. It's completely affordable and your membership supports the work we do here at Talking to You can now sign up directly through Apple Podcasts. Thanks for listening, and we'll see you next time.