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Addiction and stigma seen through a family

Presentation focuses on how everyone in the household is acutely affected by drug misuse
B.C.'s child advocate, Mary Ellen Turple-Lafond, speaks in Richmond about addiction and its equally evil twin, stigma.

Once addiction moves into a home, it has a way of taking over, making itself one of the family - albeit the most unpredictable and destructive member.

It sends a child to school without lunch, or without clean clothes. It picks fights and forgets to pay bills.

And with addiction comes its equally dysfunctional twin, stigma. Stigma forbids children from bringing friends home after school, for fear of embarrassment. It forces a child to cover for a parent, lie to others and make excuses to hide from society's watchful eye.

This dysfunctional pair, addiction and stigma, are like spoiled children, demanding all the attention until eventually, the family's true children become invisible.

Mary Ellen Turpel-Lafond, B.C. Representative for Children and Youth wants to raise awareness of these scenarios and destigmatize addiction when she comes to Richmond next week.

As part of National Addictions Awareness Week, Richmond Addictions Services Society (RASS) presents its annual talk next Wednesday, Nov. 20 at the Ralph Fisher Auditorium in Richmond Hospital.

Turpel-Lafond will talk about the effects of stigma from addiction on families - both when a youth suffers from substance misuse or a parent.

"Awareness is crucial," she said. "I'm looking forward to raising more awareness and talking about families affected by parental addictions. We need more of these discussions so the community can work together to engage each other."

Richmond has many arms and legs in place to address these issues, and whenever possible approaches it through a "family lens," attempting to engage the entire household and keep it intact.

Some of the main organizations include RASS and Touchstone Family Association, as well as, the program Supporting Families Affected by Parental Mental Illness and/or Addictions.

"Substance abuse affects the whole family," says Rick Dubras, RASS executive director. "We encourage the whole family to come in so we can collect collateral information and get every perspective."

He sees alcohol and marijuana use as the more common substances misused in Richmond. However, there's been an increase in prescription medication and heroin abuse.

Seeing signs, emotions

Although engaging the whole family is ideal, not every family member embarks on the path to recovery at the same time.

Many times the first point of contact with a family is through the child, as the majority of RASS' clients come from school referrals, according to Dubras.

It's a similar process for Touchstone Family Association, which provides another avenue for families to go down.

"If kids are going to school dirty or without a lunch, schools notice. We work on that first, then go deeper and find the underlying causes, usually there's a parental addiction involved," says Dave Cooper, director of programming at Touchstone.

Both Dubras and Cooper start by forming relationships with the child to develop trust before going deeper. Years spent making excuses for a loved one, protecting a parent's unpredictability and missing out on social events that involve parents for fear of embarrassment take time to let go of.

Often, RASS counselors begin by taking a youth for coffee, playing tennis or making sure they're there when the youth needs them, even if that means evenings.

"We build a rapport with them," says Dubras. "We give them someone they can count on and vent to. They talk about feelings of guilt and shame. They're also dealing with loss and neglect."

Besides developing a tendency to lie and an inability to rely on adults, kids still remain loyal to their parents and the need to protect them is strong.

"Kids can be very defensive of their parent," says Dubras. "Sometimes it's easier if it's a teenager who is more able to separate the two, but a child who's eight or 10, it's very hard for them to open up. We have to make it clear that it's not about blaming the parent."

A play in role reversals

This protectiveness of a child leads to a gradual role reversal where child becomes caregiver and, in the worst-case scenario, potential drinking buddy, according to Turpel-Lafond.

"You see a narcissistic pattern with parents addicted to substances," she says. "They over share and confide in their child. They victimize themselves and the child becomes their caregiver. Then, as they get older, the child is their friend, a potential drinking buddy; it becomes a way to bond. This pattern needs to be stopped and caught earlier."

She cites studies that have shown children who grow up with a substance-abusing parent are more likely to abuse substances themselves, as coping mechanisms. The role reversal isn't missed by Dubras and becomes one of the first aspects counselors discuss with a child.

"We make sure they're aware of their boundaries and where their responsibilities end," he says. "They aren't responsible for their parent. They can't control the behaviour and they need to know they didn't cause it."

But muddled in this role reversal still remains a loving relationship and a connection to their parent, no matter how fraught with resentment and shame, according to Turpel-Lafond.

It occurs during the glimpses when the parent is sober and attentive, when they're strict, showing they care.

"Oftentimes, the parenting is all over the map," says Cooper. "When they're sober, they're more rigid and strict, but when using, they're flexible. Kids get messed up with what's going on."

It's a tumultuous relationship that can have lasting impacts on future interactions and relationships, says Turpel-Lafond. "Children have been denied the opportunity to have a normal childhood. They don't go to their graduations because they fear embarrassment, they don't have friends over."

Seeking help

Some of the leading causes for substance abuse by a parent stems from a tendency to self-medicate and cope.

Parents use alcohol or drugs to overcome a past trauma or help with an underlying mental illness such as anxiety or depression.

It usually means the parent recognizes there is a problem, but lacks the proper support.

"When faced with the reality of losing your child, people can change," says Turpel-Lafond. "Foster care isn't the only solution, but we can be more strict in our response and make it clear that this is a possible solution."

Since foster care is generally the last resort, places such as RASS and Touchstone work on counseling the family, whether through one family member or all.

"If the parent isn't willing to seek help, we continue with the rest of the family," says Cooper. "We still keep reaching out to the parent, though, and sometimes we're successful."

When an addiction has been identified, Touchstone staff bridge the family member suffering from substance misuse with a treatment centre.

However, they stay on to ensure stability and help the family member with his/her parenting abilities. It's a similar practice to Supporting Families Affected by Parental Mental Illness and/or Addictions, a support group cofunded by Vancouver Coastal Health and the Ministry of Children and Family Development.

"We believe that for every parent, the most important thing is that they want to be a good parent, they long for it," says Roz Walls, the program facilitator. "Sometimes they need help with developing that ability."

Walls works with the parents in a support group while their kids (under 12) participate in a simultaneous group with leaders from RASS and other community organizations.

"We build resilience, the children need to see their parents moving forward," says Walls. "We want to help kids socialize with each other and recognize their emotions, develop that emotional literacy. Worry is a huge thing because every child loves their parent."

Walls says the child support group has a worry box where children can put their worries away and try to have fun.

"Kids can be incredible once they understand what's going on," says Walls. "In many cases, the addiction has made the child invisible. We want to make them visible and restore that relationship between parent and child."

Walls' support group generally focuses on post-treatment, where families have been referred through places like RASS or Touchstone.

Getting rid of stigma, finding solutions

Turpel-Lafond sees destigmatization and community collaboration as keys to preventing family situations from reaching crisismode.

Programs and school talks to address addictions generally target high school students, starting at the age of 13 - an age she thinks is too old.

Instead, more programs should reach out to children in elementary school as well, who may already be dealing with a parent who suffers from an addiction.

Cooper also sees stigma play into a parent's healing process, where they can be reluctant to enter an addictions services centre. At times like this, he says counselors continue to work with the parent.

"If we see cooperation, we can help them ourselves," he says. "We would truly like to transition them, but sometimes it's walking into that addiction centre that's the most difficult."

The association recently developed a new program targeting parents with anxiety and depression, after seeing the need in the community. Adults often use substances to cope with these two common mental illnesses.

Touchstone continues to adjust their programming to what they see through families who come in and keep in communication with organizations such as RASS.

"This type of discussion (her talk at next Wednesday's event) is exactly what we need to do," says Turpel-Lafond. "We need to talk about it and engage all levels of the community.

"There can be more resources created for young people to turn to if they're living with an alcoholic parent. But the key is more awareness and open discussion."

RASS presents "Destigmatizing Addiction" in Richmond next Wednesday, Nov. 20 at the Ralph Fisher Auditorium from 7-8:30 p.m. Refreshments and coffee/tea will be provided.

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