Ryther - Healthy Children, Stronger Families

DXM is a dangerous new drug that teenagers are abusing found in common household cold medicines. Below is an interview with Kelliegh Kinst BA, CDP, Assistant Program Supervisor at Ryther’s Inpatient Substance Abuse program for teen boys. Parents and school administrators may be surprised about what they learn.

Where does DXM come from and what does it do?

DXM (Dextaramorphine) is added into cold medicines for suppressing a cough. Coricidin, Robitussen DM and Mucinex are the cold medications that reportedly have the highest concentration of DXM. Teenagers use DXM by swallowing higher than recommended amounts. In the past decade it has increasingly been consumed by teenagers to produce a feeling of intoxication similar to alcohol and ecstasy (MDMA).  In very high doses DXM can produce hallucinations and dissociation similar to PCP or Ketamine, (Inaba and Cohen, 2007). The impact that DXM use has on a teenage life is profoundly negative. The temporary high may be desirable, but in the long run, their lives are suppressed from the quick pull of this readily available new drug.

Why do kids start to abuse DXM?

I recently interviewed a client named “Steve” at Ryther’s Inpatient Substance Abuse program about the dangers of DXM abuse. I was astounded by what I learned.

Apparently, the cold medications are being stolen by teens so much more often than bought that the manufacturers have decreased their distribution of the products. Steve said, “Because it’s so readily available, it’s really hard to quit. I get triggered to use whenever I go into a Walgreens or a Safeway because it’s right there, waiting for me to put it in my pocket.” As a result, Steve feels that DXM has the potential to “ruin lives almost as fast as heroine.”

The real danger is that though the drug is widely used, there is a stigma against it in teenage social circles. Teenagers do not share that they’re using DXM because it’s seen as pathetic by experienced drug users—Steve compared it to a thief “stealing scrap metal.” When they don’t admit it to their friends, they don’t learn how to use it “safely.” They’re experimenting alone with doses way beyond what they need to get high. Without asking questions on how to use the drug “safely,” overdoses are occurring at a rampant rate.

Steve reported having this experience the first time he tried it: “I found out I had taken 3 times the amount that I needed to get high. I only discovered this after the fact, in my outpatient treatment class from a kid who shared about his own DXM use.”

What are the signs that a teenager is abusing DXM?

From: Inaba and Cohen, 2007

- Nausea
- Vomiting
- Blurred vision
- Bloodshot eyes
- Fever
- Diarrhea
- Urinary retention
- Sweating
- Dilated pupils
- Shallow respiration

What can parents do?

If you suspect that your child is using DXM, getting them an Alcohol and Other Drug assessment will determine if they are and what type of treatment they may need. Talking to your kids about the dangers of alcohol and other drug use may produce eye rolls and “OMG” Facebook posts, but it will also show them that you are invested. Turning to alcohol and other drugs as a result of peer pressure often stems from teenagers feeling invalidated or insecure. With regular check-ins and sound parental guidance, your teenager will have the assurance that they are cared for and loved. Which in turn can decrease the likelihood of them feeling  the need to seek fulfillment from alcohol and other drugs.

Things to keep in mind:

- This drug can be found in anyone’s medicine cabinet and is often stolen instead of purchased. Therefore, a lack of financial difficulties does not rule out the possibility of your child using the drug.

- Kids most at risk are ones who are isolated or kids who are already experienced with drugs as they will turn to DXM if they do not have access to their D.O.C. or, “Drug of Choice.”

- Other street names for this drug are: “CCC,” “tussin,” “orange crush,” and “dex.” (Inaba and Cohen, 2007)

Inaba, Darryl and Cohen, William, (2007), Uppers Downers All Arounders, Physical and Mental Effects of Psychoactive Drugs, Sixth Edition, CNS Publications, Inc. Medford, Oregon

15-year-old “Matson” came to Cottage B, Ryther’s Substance Abuse Inpatient Program, addicted to marijuana, ecstasy and alcohol, as well as suffering from depression and anxiety. Despite being a very bright sophomore in high school, Matson had poor attendance and was already behind on credits for graduation. He really had difficulty relating to his peers because of poor social skills and high social anxiety.

Matson wanted to get clean, but struggled to make friends outside his superficial “ready-made” peer group which was based primarily on their desire to use drugs. Matson explained that he could always make friends with other kids who were using drugs because they were easy to relate to without really knowing them. Additionally, it was easy to talk them when he was high—it took the edge off his social anxiety.

While at Ryther’s Cottage B, he worked with counselors to develop interpersonal effectiveness skills to help him make friends. He learned how to start a conversation and pay attention to the concept of personal space. He became able to use Cognitive Behavioral Therapy (CBT) to manage his depression. Learning new ways to make friends and relate to his peers helped Matson deal with depression without continuing to use drugs. He gained confidence and found that people like him just the way he is – clean and sober.

Ryther’s experiential therapies were also incredibly effective for Matson and helped him learn how to work within a team framework and communicate his ideas effectively. He could solve problems easily, but had a hard time explaining his thoughts and often came across as demanding or demeaning. Using leadership skills learned on Ryther’s Challenge Course, he learned that by taking a step back from a situation he could give himself the chance to think about how he would frame something and anticipate how others may receive what he was saying.

Matson’s family was also involved in the treatment process giving his parents ways to set appropriate boundaries for Matson.

After graduating from Cottage B, Matson has found a new peer group and is involved in school activities. He is expected to graduate on time. He looks forward to attending college, and is even considering graduate school.

In honor of National Volunteer Week April 16-20, here is an interview with volunteer Virginia Hassinger who teaches meditation to the teenage boys in Ryther’s Substance Abuse Inpatient program. She and several other members of the community at Sakya Monastery of Tibetan Buddhism are part of the broader spirituality program at Ryther.

How does meditation fit in with the program?      

Meditation is often viewed as a way to calm the mind. This is very true, but we also teach that mediation is a method to explore, strengthen and stabilize our own minds. The boys at Cottage B all have experience with mind-altering drugs. They have done some exploring already, albeit with vehicles that neither strengthen nor stabilize the mind. So, we are handing them the keys to an alternate vehicle.

Why do you volunteer at Ryther?     

Several years ago a friend asked me to help out with meditation classes at Ryther. I didn’t feel qualified to teach but she was very persuasive and a few days later I joined her for a class in the girls’ cottage. It was the first time in decades I had sat down with a group of teenagers. They were amazingly receptive and very direct in their questions and attitudes.  But the hook that brought me in was their gratefulness for the time we spent with them. They followed us to the door saying “Come back, come back.”

What happens in a typical session?        

We try some short meditation sessions (3-5 minutes) and then we talk about the experience. Some kids notice a brief sense of stillness and calm immediately; others have a very difficult time sitting still.

We teach them to use the breath as a single point of concentration. How often the mind wanders is not important. We learn to notice that it wandered without being judgmental. Then we take action, bringing the mind back to focus on the breath.  Even if they can only do so for a brief second that is a success. Building on that initial success is the main skill, the main practice. The mind wanders repeatedly but we can control it, bring it back into focus as often as needed, and let all discursive thoughts rest.

What differences do you observe after the session?

There is often a perceptible shift in the collective atmosphere by the end of a class. I remember a specific evening last summer when all eleven boys in the cottage attended meditation class. When I arrived several of the boys were arguing and jumping around. But after they all sat down for meditation something clicked. At the end of the class you could have heard a pin drop. Knowing that the class was over and that they finally had the option to run out and play basketball, most of them just sat with me and asked if they could “try it again” for 5 minutes. On that particular day they had noticed a difference — a greater sense of ease being around each other, and they wanted to hold onto that experience.

All of the residents in Cottage B have many life challenges to address, and like most of us they are caught up in the past or the future. Taking time out to notice the present moment is a valuable experience for them.  We encourage the boys to try meditation on their own. A few come back to us the in following weeks with more questions or comments.

What is your hope?

Our goal in teaching these kids is to provide options for a healthier and more stable mental life.  Although we are practicing Buddhists and willing to answer questions on broader Buddhist topics, we encourage the kids to examine their own family or cultural religious traditions. Most traditions do include a form of mediation. However they choose to approach mediation in the future, we hope to have planted a seed that will someday grow into a valuable mental skill.

To learn more about Ryther’s Substance Abuse Inpatient Program for teen boys, visit this page.

An interview with Beta Theta Pi Philanthropy Chair Danny Chandler and fraternity members James Coatsworth and Kyle Ahrens after a few of the fraternity brothers spent some time with the teen boys in Cottage B who are receiving inpatient treatment for drug and alcohol addiction. Beta Theta Pi is a unit of the Ryther League and visits frequently to help the boys expand their sense of what is possible if they work hard towards a goal…as well as play some basketball!

What did you find most interesting about your discussion with the teens?

Danny: At first, the boys were a little skeptical of us, acting as though we were completely different people than them, and as if we wouldn’t understand them. After a few questions about fraternity life and college life in general, they started to realize that we were not so different from them, and that we might have some good advice.

James: The entire group’s demeanor changed as the discussion went on. In the beginning, they were joking around, talking with each other and not paying much attention. But as the conversation continued, more and more in-depth questions arose, such as when we talked about addressing conflict in a house full of male adolescents. The boys were also very interested in college and had several good questions about higher education.

Did you feel like you could relate to them? Why or why not?

 Danny: Obviously there are differences, but at the end of the day we are all teenage guys who more or less think alike and act alike in certain situations.

James: It’s honestly difficult for me to relate to guys with a tough upbringing and understand what these boys have gone through, but I still enjoyed trying to relate, and it helps me grow by learning of their experiences. At the same time, we’re all guys. We all enjoyed playing basketball. We probably eat the same food, laugh at the same stuff and idolize the same celebrities.

Kyle: I am not too much older than these guys so I can relate to them in that we all like to play sports, laugh at the same things, and can have a good time together playing basketball (which was a great time, even though we lost the game).

How did basketball go?

 James:  It was fun! They were competitive, and Danny told me it was the most intense Ryther game he’d ever seen. The guys wanted to beat us, and they did just that. They worked as a team better than we did.

Was there a moment that you’ll remember?

 Danny: At the end of the game, I could really tell that the boys had a good time. They looked like they were happy with each other, joking around and having fun. Going into each of the small group meetings at the cottage, I really hope that the kids will have a good time and that we can make a positive impact. After the basketball game, I could see that we achieved this goal.

James: Shaking hands after the game. It showed me that the guys weren’t as tough as they tried to look. We played hard basketball for about a half hour, maybe longer, and everyone was happy for that whole time. The tension that hung in the air at the beginning was gone by the end of the game.

Kyle: Every time someone got knocked down, there was another guy there to help him up.

Contributed by Danny Chandler, James Coatsworth and Kyle Ahrens, UW Beta Theta Pi fraternity members and League members. To learn more about the Ryther League or to join, visit this page.

Thoughts on Policy Development and Child Development

In the news recently there has been a spate of sensational headlines involving children with firearms with some of those stories having tragic endings (see here and here). While I suppose it’s possible (though far fetched) for someone to argue that children have a Second Amendment right to bear arms, what is indisputable is they should not be allowed to carry firearms to school. When they do, someone is inevitably injured or killed. This concept is not a particularly controversial topic for discussion. Most people would agree that we should not allow first graders to carry guns. At the same time, in the face of compelling scientific evidence about adolescent brain development, we in Washington have a policy that allows thirteen-year-olds to make decisions about their mental health treatment, including Chemical Dependency treatment.

Given that we know that adolescent brains are not capable of making decisions that carry this kind of risk, it’s hard to imagine how anyone could justify it. While I object to this policy as a provider of care, my principle objection is that it too often paralyzes parents.

One rationale that I have often heard is that many times, parents use confinement in treatment facilities to bully and incarcerate argumentative youth. Indeed, I have seen such things happen. At the same time I have seen people driving on the highway clearly intoxicated, but I don’t conclude that we should not stop and arrest such people.

The fact is, we are the adults and are supposed to know better. I find it interesting that in the Child Welfare field, there are ardent advocates that believe that the children’s parents always know better. If that is true, maybe we ought to give all parents the same presumption of competence in all things relating to their children. In fact, we do most of the time, so it makes the State’s policy about children having the adult competence to accept or reject mental health or addiction treatment all the more curious. To allow a cocaine-addicted sixteen-year-old to check out of treatment  is the same as allowing the nine-year-old to carry a 9mm pistol in his or her backpack. Look for deadly outcomes from such a policy.

Contributed by Lee E. Grogg, Ryther’s Executive Director/CEO

The boys went golfing in the morning and went to the Mariners game in the evening! The weather was so beautiful, no one cared about the Mariners’ loss! Good day at Cottage B.