A mindful approach to teen drug use

For Mountain View teen Max Aboudarham, slipping into heavy drug use happened without even thinking about it. During his senior year in high school, he recalled how smoking marijuana progressed from a casual weekly habit to a daily routine. In the back of his mind he knew it was destructive, but he let the cravings get the best of him.

“I knew I was smoking too much and it wasn’t healthy, but I didn’t want to admit it,” he said. “I was a teenager and I didn’t think I needed help.”

The problem came to a head when his parents discovered alcohol and marijuana residue left behind from a party at his father’s house. It wasn’t the first time, but it was clear at that point that he needed help, said Aboudarham, who was 17 at the time. But instead of seeking out an 80-year-old strategy like Alcoholics Anonymous to get clean, Aboudarham found he was able to conquer his addiction through a new substance abuse treatment strategy — rooted in “mindfulness” and mental health — that’s been catching on throughout the Bay Area over the last two years.

Starting this fall, the Community Health Awareness Council (CHAC) is launching a new 12-week treatment program designed to ease teens off of drugs and alcohol through a combination of therapy, education and so-called metacognitive awareness, which empowers adolescents to take a step back and understand the root causes and cravings surrounding substance abuse. The program, called Mindfulness-based Substance Abuse Treatment for Adolescents, is intended to ease a growing drug use problem in the North County caused in part by easy access to prescription drugs including heavy narcotics, according to CHAC staff.

Mindfulness-based substance abuse treatment is a fairly new field, borne out of a need for a more effective treatment program to replace the standard, abstinence-only mentality of Alcoholics Anonymous or Narcotics Anonymous, said Veronica Foster, a clinical supervisor at CHAC. These programs may work for some people, she said, but AA at its core is a faith-based treatment model for adults with a serious addiction program — not for adolescents stuck in a cycle of habitual drug use. Even the act of announcing your name and admitting you’re an addict can be a huge step in the wrong direction.

“The adolescent brain is not the same as the adult brain, and it’s very harmful for an adolescent to self-identify as an addict when they aren’t,” she said. “That’s a lifelong sentence, and for high school and college students, they don’t even feel safe in those rooms.”

In her practice at CHAC, Foster said she’s already folded a therapeutic and mental health component into her substance abuse treatment in a one-on-one and family setting. But with so many calls coming in seeking help for teens struggling with drug and alcohol abuse, she is forced to put potential clients on a waiting list. The new program is expected to serve a 12-teen cohort, and would allow CHAC to expand the service and meet the demand.

The upcoming CHAC program is modeled around a 2015 curriculum published by East Bay psychologist Sam Himelstein, who found positive results after testing the program in a juvenile detention center in the Bay Area. Himelstein told the Voice that the substance abuse treatment for teens is a “pretty thin” field, and the intervention programs are largely ineffective and rely on a strict “don’t do drugs” credo and finger-waving that rarely resonates with teens.

“I wanted to bring something that adolescents would be receptive to,” he said. “If they don’t show up in the room, it doesn’t matter if you’re the best therapist out there, they won’t get the treatment.”

The core philosophy of the curriculum revolves around building “authentic” connections with teens, and truly addressing the root causes of why they started taking drugs, Himelstein said. Sometimes it’s trauma or anxiety, other times it’s an attempt to fit in with their peers or simply an experimental phase in their lives.

Some teens are turning to drugs because of an emotional disconnect in the family, and using drugs as a way to “grieve” for that loss of emotional support, Foster said. Whether it be high-functioning parents in the corporate world or a single mother working long hours to support her family, lack of quality time can take a serious toll on teens, and there’s a constant stream of media messaging pushing the idea that pills and alcohol are the solution.

“There’s just this cultural conversation about how, if you don’t feel good, you need to take something,” she said. “It’s a part of our cultural narrative, and a lot of times teens don’t understand the danger and don’t understand what it’s doing to them mentally.”

Reliable, recent data on teen drug use in Mountain View is remarkably hard to come by, but a 2013-14 survey of Mountain View-Los Altos High School District students found that 26 percent of juniors reported drinking in the last 30 days, and 11 percent reported “binge drinking” more than 5 drinks within two hours during the same period. The survey also found 17 percent smoked marijuana at least once over the same period. More broad data from the U.S. Department of Health and Human Services found that 7 percent of California high school students reportedly used inhalants, 6 percent had used cocaine, and 5 percent had used pain relievers for “nonmedical reasons” within a year of the survey.

Foster said teen drug use has gotten worse, but it’s difficult to pinpoint the underlying reasons why. It could be that a rise in anxiety and ADHD diagnoses is pumping more prescription drug into the community, making it easier and more acceptable to illicitly take drugs like Adderall and Xanax. It’s also something teens have relied on to make money, selling pills for $20 each to other students.

The underlying strategy of mindfulness-based substance abuse treatment is to give teens the mental strategies they need to recognize cravings, take a step back and control themselves — fighting an initial, reactionary urge to use drugs and alcohol as a coping mechanism. Aboudarham said “meta” awareness of his addiction, and watching his own thoughts from a different vantage point, made him feel impervious to addiction. Now 18 years old and graduated from high school, he said he’s sobered up and stopped smoking.

“Veronica never criminalized my smoking. She just wanted me to be constantly aware of when I’m smoking, why I’m smoking, who I’m smoking with — the whole situation,” he said. “I realized that I can be sober and still have fun, and the only way that happened is because I was the one who got there.”

The new group treatment program will consist of 12 weekly two-hour sessions at CHAC’s headquarters in Mountain View starting this fall, though the exact date has yet to be determined. The program costs $600 per person, which adds up to about $25 per hour, but Foster said stipends will be available and that they do not want to turn anyone away. Similar programs based on Himelstein’s curriculum are also launching at Choices Teen Therapy in Campbell and the Youth Services Bureau of San Mateo.

The format of CHAC’s program includes meditation as a staple strategy, which a growing body of neuroscience studies have shown can be an effective approach for mental health therapy, including substance abuse treatment, Foster said. The program also veers away from policing teens and pushing an abstinence-only message, she said, because teens can successfully self-monitor, be self-aware and in control of their lives without being told what to do.

“Adolescents are smart, they’re savvy, they’re extremely resilient, and they can, on their own, make really good choices. But they need to be given that space,” she said.