There's a lot of pressure to use, to drink. One of the biggest problems (leading to relapse) is environment. —Dr. Anandhi Narasimhan
The church is quiet, the audience in the chapel attentive as 17-year-old Josh Stauffer stands at the podium, hands stuffed in the pockets of his dress pants, eyes down a little as if he's reading, though he's not. Teetering between adulthood and a child's world, he is tall, thin, handsome and — as he has been his whole life — painfully shy. But here he stands, clearing his throat lightly, trying to ignore the little shudder in his stomach.
"Hi," he says, addressing no one in particular in this Mormon congregation. "I'm Josh. And I'm in drug rehab."
The denial and efforts to hide his illicit drug use are gone as he shares his story in the setting where he's worshipped all his life, surrounded by friends, family and strangers. He has been lost, and his mom and dad, Melonie and Rod Stauffer, have tried to lead him home.
This time is different, though. This time, Josh is trying to find Josh, too.
One story, many variations
Josh's journey into drugs is an earthquake for the Stauffers. But experts say it isn't uncommon. The National Institute of Drug Abuse tracks drug use among teens. Each year, it surveys eighth- 10th- and 12th-graders about their substance abuse, noting most recently that marijuana use is up, while cigarette use is down. In its 2010 survey, NIDA said 21.4 percent of high school seniors admitted to smoking pot in the past 30 days. After marijuana, they were most apt to use prescription and over-the-counter drugs.
Alcohol use was even higher, though falling slightly — from 43.5 percent to 41.2 percent of seniors over the month they were surveyed in 2010 compared to 2009. Binge drinking dropped from more than 25 percent to 23.2 percent.
When seniors were asked about the entire year, numbers shot up. Alcohol had been used by 70.6 percent of the seniors, marijuana by 34.3 percent, stimulants by 10 percent. The list goes on. Substance abuse numbers are staggering, experts told the Deseret News, and the families and teens involved are impacted on multiple levels.
Teenhelp.com, a website dedicated to helping parents and teens with social issues like substance abuse, said even kids who don't use drugs know how to get them easily, sometimes on school grounds.
Josh describes getting lost in drugs: He tried marijuana in the ninth grade. At first it was casual; he felt guilty and worried that he'd be caught. Later, as he also did spice and mushrooms, alcohol and tobacco, he learned to deceive his parents, who would do almost anything to help him straighten up. The Stauffers hoped the juvenile court system would "fix" him, since the parents didn't know what to do.
His mom's first clue emerged when she found marijuana and a pipe in Josh's backpack. She flushed the pot and confronted him. "He didn't deny it. He was mad that I'd flushed it and that's when I knew it was a real problem," said Melonie Stauffer. She said she and her husband then tricked Josh into counseling that didn't work. He got in some legal scrapes and did community service for them — neither happily nor wholeheartedly. His mom looked into residential treatment options, "in case," but told herself Josh was going through a phase.
His escapades got bigger, the consequences more demanding. His grades plummeted and he started skipping classes. He was caught stealing. When drug testing was ordered, he figured out ways to keep using, at least some of the time. When he couldn't avoid a drug test, he ran away. Even then, though, he let his parents know he was OK. And as his life spiraled out of control, he didn't know he was actually moving closer to finding the path that would lead back home.
Lost and found
Josh has been lost and found before. His drug use is not the first time he's taken a wrong turn and slogged his way up a seemingly impossible hill.
When he was 3 years old, in 1999, while visiting his grandparents in Downey, Idaho, Josh wandered away as his parents were unloading the car. He'd been there plenty and sometimes explored with his cousins. So he ambled down the long driveway, then headed out the wrong way. For more than a day, volunteers searched before one decided to ignore reason and canvass a steep nearby hillside they all figured such a little boy could not possibly climb. There he was, only his tiny shoe visible at first, badly dehydrated and near death.
Recently, on this new journey to be found again, Josh sat at the dining room table with his mom and dad and one of his little brothers, Adam, 14, worrying about the approach of fall. Should he change schools?
He worried about his reputation, which he's dinged badly. Mostly, he has been worrying about old patterns and friends and temptations.
Now in residential treatment for drug addiction at a program called Lifeline, he has earned the right to go home for a few hours at a time. Sometime soon he'll move back full-time.
He's longing for that but knows he cannot pick up his old life. The Stauffers have to craft a blend of old and new that supports sobriety.
"Finding new friends is the biggest challenge," said counselor David Simonsen of Creative Solutions Counseling in Seattle. "Teens are usually all about being social. Finding new friends is not something they're interested in doing most of the time. They believe they can keep the same friends and stay sober. They are usually wrong."
Another daunting issue — and one over which a recovering addict has the least influence — is change, specifically someone else's. Simonsen said people in recovery are trying to change, but they return to lives with others who are unchanged.
"They have gone through a program and been taught how to change. They come back to a living situation in which no one else has changed and they don't understand what the teen has just experienced. Staying strong in an environment like that is often just too difficult," Simonsen said.
For some kids, home is an issue, especially if parents drink or use drugs. Numbers aren't readily available on how many teens who abuse substances have parents who do the same, but NIDA said 23.5 million Americans age 12 and older needed treatment for a drug or alcohol abuse problem in 2009. And the national organization Adult Children of Alcoholics reported that there are 26.8 million children of alcoholics in the United States, not to mention an unknown number of drug-abusing folks. The national child abuse prevention organization Child Help said as many as two-thirds of addicts in treatment may have been abused or neglected. Those are not Josh's challenges, but many youths coming from treatment face them, experts told the Deseret News.
Melonie and Rod Stauffer understand he cannot change alone. They chose Josh's program because it included them in therapy and education. Not every program does; not every parent wants to take part.
Kids in a controlled treatment environment usually do well, said Corey Markisich, outpatient director at Utah-based New Roads Treatment Center. Kids work on their own issues in rehab, but eventually they return to their families and schools and neighborhoods.
Those unchanged environments may also be unforgiving, the stigma attached to needing treatment another barrier to acceptance in the community.
"Stigma is a huge problem," Markisich said, which happens when adults are unwilling to trust a kid who has been in rehab or who has known drug issues. Teen peers may also attach that stigma — or a different one. "For a lot of adolescents, life is friends and having fun and hanging out." A "party" society of teens may view a peer who can't drink or use drugs as uncool. He noted that a lot of kids don't drink or smoke pot, but they abuse prescription drugs.
College-bound kids who have gone through treatment often ask Dr. Anandhi Narasimhan, a psychiatrist in Los Angeles, how to navigate socializing that so often means drinking or drugs. "There's a lot of pressure to use, to drink. One of the biggest problems (leading to relapse) is environment."
"They must reestablish themselves into another peer group that isn't using; that can be very, very hard to find," said Narasimhan. It can also be hard to win acceptance, given past history.
Going in (new) circles
For very different reasons, both adults and other youths may make a teen coming from treatment feel unwelcome and alone. Those feelings can send youths back to drugs or drink, which is why some in treatment change schools, several counselors said. Social media makes even that "clean slate" harder to count on.
Kids often exaggerate a teen's challenge when they talk about him with friends and family. "Someone can go into rehab because he was smoking marijuana, but by the time it circulates around school and the internet, it was a stabbing," Markisich said.
The best way for a community to help lost teens find their way back, he said, is to be supportive. "Guilt and shame can fuel substance abuse. Don't enable, but help them and love them." Youths, he said, will latch on to those who give them support and direction, who mentor and lead, who offer hope.
Narasimhan called addiction "a very powerful force." It takes a lot of support to overcome. Sometimes drug abuse is an ill-conceived attempt to self-medicate, an unwitting cover up to abuse or illnesses like anxiety and depression. In relapse, those issues remain, she said. And events, including bullying, can precipitate a slip.
A person's journey is his own, as is the decision to share it, she said. "Addiction is a medical issue. You don't have to let anyone at school know you're seeing a therapist, a doctor or were in a hospital." She encourages patients to let her talk to school administrators, to explain not the details of the diagnosis, but to see a student is given proper support. Beyond that, a family decides who knows what.
Find a different trail
Addiction is a disease, but it doesn't happen instantly. Neither does fixing it, said Amara Durham, director of marketing for the nonprofit treatment program Caron Texas in Dallas. The longer someone stays in treatment, the greater the likelihood of maintaining sobriety.
Caron Texas is a 12-step program that encourages those who emerge from treatment to continue the steps, "to do 90 meetings in 90 days. Find a place where one is comfortable and confident and get a network to help support them," she said.
Besides new friends, addicts often need new places and even new paths to get there, if old routes were part of the addiction or scoring the drug. "If you don't have a plan," she said, "it's easy to slip into an old habit."
If it takes a while to make new friends, she tells her young patients to be alone at school, then find sober friends for after school or through the 12-step programs. Some things can't be compromised.
The people who close ranks and won't accept a youth who's had troubles will eventually come around, she predicted, if they see a real change. Broken trust takes time to rebuild. One of the best ways to do that, she noted, is to help others struggling with the same issues.
Durham, too, believes recovery is a private matter, the person doing it the one who decides how much to share.
Hope is most important to recovery, the vehicle one rides out of the wilderness.
The road home
On the day Josh first visited home in April of 2012, after 120 days in rehab, he helped his mother find the drug paraphernalia he had hidden in his room. It was, she said, "a great moment." He is in phase 3 of 5 of the treatment program, an "oldcomer" helping newcomers learn the ropes.
He contemplates the future with yearning, but fear, too. "It's hard to think about what I will do besides drugs; it was such a big part of my life. … I'm not cocky about getting better. I know it's going to be hard."
He wrestles with what he calls social anxiety and said it was easier to get friends when he was using. That's a problem.
But he's willing to leave the past where it is and move on. He's learning to help others. He's learned that speaking up is hard, but not impossible.
Before, he said, he ignored God and spirituality. Now, he thinks they will carry him where he hopes to go.
So Josh Stauffer has reached, yet again, a fork in the road. Once more, it's leading him uphill. This time, his legs are longer, his back a little straighter, his resolve and sense of direction his own.
The lost boy is heading home.