Ketamine addiction

Dear parent community, my son is going to turn 21 this weekend. He's in what should be his junior year in college, but he's changed his major and has been taking only two classes at a time lately, so he'd have to spend 3 more years before he gets his degree, EVEN if he passes all of the classes he takes. He's been struggling with depression and addiction to marijuana on and off since he was 16. This past year, he stopped using pot, but then just a few months ago he told me he started using small amounts of ketamine to help with his depression. I suggested that he sees his psychiatrist (he has one since the time of his first depression when he was prescribed antidepressants) and finds a medication that works for him with his help. He refused.

In the meantime, he started exhibiting the classic signs of drug addiction which I've been confusing with depression until now: he is always tired, doesn't get out of bed until late morning (unusual for him), doesn't take a shower until late night (again very unusual for him). Most importantly, he completely gave up on school and says he wants to drop out, although his reasoning doesn't make sense - again sign of his drug addiction.

He has enough money he's made while working to support himself for a while, even to buy a car if we take away the one we bought for him when he was a high schooler. So I don't think that taking away our monetary support or taking away the car would do much. But, I don't know what else to do. How can we get him to stop using ketamine and start taking meds as prescribed and doing therapy?  I've been searching online and saw a company that helps families do interventions, but I have no idea who these people are and if that kind of thing works.

Losing hope.

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RE: Ketamine addiction ()

This is not drug addiction specific, but we have found the book I’m Not Sick, I don’t Need Help by Xavier Amodor to be very helpful in understanding our teen and getting some movement. 

RE: Ketamine addiction ()

I don't have direct experience with what you're going through, but your description of your son's behavior reads more as DEPRESSION to me than drug addiction. Those are classic signs of Depression. I think interventions can sometimes work, but he needs treatment for Depression. Personally I think it's reasonable to give him a deadline to graduate - my dad did this with my brother, and it was fair. Allow your son another 18 months of tuition and explain kindly that you simply cannot afford more than this. Give him plenty of notice and help him meet with his counselor and create a plan so he graduates. I can only say, be kind and compassionate. He for sure needs professional help. Would any of his friends intervene?

RE: Ketamine addiction ()

What a difficult situation. My heart goes out to you and your son. I can't tell you how to get your adult son to do as you would like him to do, but I can offer some suggestions for moving forward.

My young adult son also struggles with addiction and mental health issues and has since he was a teen. Although he still uses, he is functional and in a better place emotionally than he has been in many years. Our relationship is healthier than it has been in a very long time.

Over the years, I have tried many modalities to address the situation. Psychotherapy and psychiatry for my son have not been effective because he is not a willing participant. Perhaps that will change one day. I've researched endless programs and interventionists over the years. Without a willing spouse, I've not moved forward with any of them. I hold out hope that one day my son will enter recovery willingly even if reluctantly, and I am here to encourage and support him if and when he's ready. Statistically, many people recover without a formal recovery program. I would be cautious of researching on the internet—fine if you follow up with first-hand input. The industry is not well regulated and the wide range of approaches is not always clear in marketing materials. 

In the meantime, I've found resources that have been enormously helpful to me in managing and living with my situation.

1. Al-Anon, particularly parent groups: Although the organization is an umbrella, each group is unique. If you are interested in finding a group, consider trying one a few times before moving onto the next until you find one that suits you. Most are on Zoom during these days of on-going pandemic. In these groups I find the comfort of a group of people who understand. I have connected with people I meet in the group outside of the group to exchange resources such as names of local professionals, programs, etc.

2. Allies in Recovery: This is an evidence-based approach to addressing your loved one's substance use that centers on compassionate and effective communication. I find the learning modules clear and easily implementable. The skills I've learned have been a game changer for my relationship with my son and my ability to influence him in a more positive direction.

3. Patrick Alle, Interventionist: Patrick came highly recommended to me. Although I have not hired him to do an intervention with my son, he has been a helpful resource to me. I have friends who have used him for interventions and have found him to be quite helpful.

You clearly love and care for your son. Take care of yourself, too. I wish you both healing.

RE: Ketamine addiction ()

First, I'm so sorry that your son is struggling. There has been a strong shift away from "tough love" approaches when a loved one has an addiction. My family has been greatly helped by the science-and-evidence-based support for families provided by the Center for Motivation and Change, in NYC. They have recently expanded to California, both remote and in-person services. They have a free 20-minute assessment for families -- "a practical, compassionate and effective roadmap for those who are concerned about their loved one’s substance use, or want to learn ways to prevent it."

Even if your son is not yet ready to take steps towards recovery, there are many ways you can effectively support him without enabling the addiction. Good luck to you and your family.


RE: Ketamine addiction ()

Your son is self-medicating for depression. The "classic signs of drug addiction," constant fatigue, hypersomnia, confused thinking -- these can easily all be symptoms of depression alone.  Your son may also have addiction issues -- pretty common for depressed folks -- in which case both issues have to be addressed as intertwined problems.

Your post says your son refuses to see his psychiatrist.  As a veteran of a lot of therapy, I suspect you may need a different psychiatrist.

There's an old saying: therapists are like shoes, they have to fit.  For the client, the therapy the relationship is inherently close and intense, and depends as much on the therapist's temperament and personality as that of the client.  The fit also shifts over time, so a therapist that was a great fit at one point may not be later.

Second, some therapists just aren't very good -- in any profession, half the practitioners are below average, and some are real stinkers even if they sound good on paper.

Third, your son has to be able to trust his therapist.  My kid's best friend has some serious issues and definitely needs therapy, but she's in conflict with her parents and therefore doesn't trust the therapist her parents picked out.  She is worried that the therapist will report on her to her parents.  Net result: the therapy is likely doing no good, may even harmful, even if the therapist is otherwise fine.

One option is to find three to five potential therapists, set up one or two appointments with each, and let your son choose the one that he's most comfortable with.  You may also want to separate the therapy function from the drug-prescribing psychiatrist function.  This way you will have a wider, and frankly less expensive, range of therapists to choose from, and they will be less medically focused, which may help in the trust department.  Any physician can prescribe antidepressants.

Good luck. I was a mess when I was your son's age -- believe me, things can get a lot better, but it takes time.

RE: Ketamine addiction ()

Dear Parent,

I agree with other comments that it is time to change psychiatrists.

I recommend you and your son at least interview Phil Wolfson, MD. Phil helped my teen through a very serious depression (we went through several therapists and psychiatrists before finding him). And, he's an expert on Ketamine. His background may help your son to build the trust with him. I think he practices now in SF and in Marin (415.550.1700). It's well worth the inconvenience of the drive.

I thought this advice from anonymous on 2/7 was very good advice: "One option is to find three to five potential therapists, set up one or two appointments with each, and let your son choose the one that he's most comfortable with."

I wish you and your son well.