When Parents Drink and Drug

Anton Community Newspapers  • 

132 East 2nd Street

 •  Mineola, NY 11501  

When Parents Drink and Drug

by Andrew Malekoff© advance proof June 2012

The problematic use of alcohol, drugs and tobacco is unquestionably the nation’s number one health problem. While all segments of society are affected, the future of young people is most severely compromised by this epidemic.

There has been increased media exposure and public education on the rise of young people’s abuse of pharmaceuticals – prescription drugs – that often leads to heroin use and addiction.

Parents have been alerted to the fact that the most likely source of prescription drugs is the medicine cabinets of friends and family, where the pharmaceuticals can be easily attained at no cost; and, that the cost for a bag of heroin is less than that for a six-pack of beer.

Despite enhanced media coverage on these drugs, what the public hardly hears about anymore is the fact that there are millions of children who grow up in homes with parents who are addicted to alcohol and other drugs.

It has been estimated that approximately one in four children in the US is exposed to alcohol abuse and drug dependence in the family at some point before age 18. There are multiple impacts on children growing up in these homes. These young people are likely to become alcohol or drug abusers themselves without intervention.

Children who grow up in families with alcohol and drug addiction learn to distrust to survive. They learn how to walk on eggshells. The behavior and attitude of the addict and the related emotional tone in the home is a day-to-day mystery. When unpredictability dominates a child’s life, they are likely to be perpetually wary, always sensing disappointment or danger lurking nearby.

Children who grow up in addicted families become uncomfortably accustomed to living with chaos, uncertainty, unpredictability and inconsistency. These children have no idea what is normal. They live vastly different internal lives than their peers from homes where coping with addiction in the family is not a daily challenge.

Denial and secrecy are common for children who live in alcoholic or addicted families. Their lives are organized around concealing the truth. Asking for help is out of the question as that would trigger exposure to the outside world, disloyalty inside the family and it would evoke intense feelings of embarrassment and shame.

In an addicted family there is an ongoing and, most often, unspoken agreement to hide the problem to prevent exposure that will erode the image of a “perfect family.” Children may avoid bringing friends home and cringe at the thought of having the family secret revealed. Their own needs and desires take a back seat to fronting for their family and preserving the image that belies the reality.

It is hard to be a child in an alcoholic or addicted family. It takes a lot of energy just to get through the day. Growing up in such a family leaves children with little hope that things will ever change. Children who live in these homes often feel trapped, depressed, alone and desperate.

There are no simple answers, but there is help. Family members, friends, pediatricians and school personnel who are attuned to this problem can help to break the conspiracy of silence. Understanding the barriers, gently inviting trust and seeking professional support is the first step to overcome the problems involved. If you need guidance about how to proceed, call Tyrone Anthony, coordinator of chemical dependency services at the Leeds Place, a branch of North Shore Child and Family Guidance Center, at 516-997-2926.

Andrew Malekoff is Executive Director, North Shore Child and Family Guidance Center, Roslyn Heights, New York 11577
amalekoff@northshorechildguidance.org

HUMAN SERVICES HUNGER GAMES

Human Services Hunger Games

by Andrew Malekoff © 2012


I am gradually losing step with the pop culture juggernaut. By the way, juggernaut refers to a relentless force, movement or object that trounces whatever is in its path. The term originated from the Unstoppable Juggernaut, a fictional character who first appeared in Marvel Comics’ X-Men. I share this only to establish that I do have some pop culture street- cred.

Nevertheless, I thought Hunger Games was an eating competition until I discovered that it was a post-apocalyptic science fiction novel written by Suzanne Collins. The book features 16-year-old Katniss Everdeen who volunteers to take her younger sister Prim’s place, after Prim is chosen by lottery to participate in a government-mandated, nationally-broadcast, fight-to-the-death battle among 24 teens and pre-teen “tributes” living in 12 districts of the nation of Panem. The goal of the games is to be the last one standing.

I read Hunger Games with a dual consciousness. I was absorbed in the fabulous and chilling story and I was tuned in to the story as a metaphor. The last-man-standing theme reminded me of the struggle for survival that community-based mental health agencies in Nassau County face. I have addressed this extensively in my published commentary and testimony before legislative bodies for years. For instance, in a 2009 piece that appeared in the Albany Times Union I wrote, “More low- and middle-income families than ever are in need of low-cost, high-quality community-based mental health care. Yet, the state Office of Mental Health, along with the state Health Department, is aggressively pursuing a "reform" plan that will assure continued access to care only to children and families with Medicaid fee-for-service insurance coverage. This will leave a significant number of children and adults in the lurch.”

Just to show that I wasn’t “blowing smoke,” if you fast-forward to 2012 you will find that there are community-based outpatient mental health providers in our backyard that closed their doors, were taken over by larger corporate entities with no community roots, transformed their operations into per diem factories with little capacity for dealing with complex or crisis situations or restricted their clientele to a residual population of Medicaid-insurance carriers.

Others are working diligently to preserve the integrity, character and culture of non-restrictive, universal community-based care. When our children, and their families, face the worst of times they need a place to go that is easily accessible and available to respond to emergencies, offers a continuum of care and feels like home and not like a factory.

For many community-based mental health centers, from a family’s first contact to their last, the work requires collaboration, most of which is not fee-producing, with a variety of service providers. Hours are spent with school personnel, hospital-discharge staff, probation officers, preventive workers, case managers, family advocates and child-protective service workers, to name a few.

The children at highest risk need a continuum of outpatient-based triage and emergency services that allow for seamless, timely and successful discharges from hospital to community. Experience has shown that hospitals will often not discharge children to private practitioners. Families, particularly those with children who have serious emotional disturbances or are in psychiatric crisis, require more assistance than can be provided by private practitioners.

To continue to provide these vital services and keep children from needing higher and costlier levels of care, many local agencies have been making every effort to streamline service delivery while maintaining the best standards of care.

Although it is an uphill battle, it is a fight that we must continue and, hopefully, with a different outcome than the Hunger Games; one where we all remain standing and the character and culture of true community-based mental health centers remains strong.

Published on May 31, 2012 in the Anton News chain of 18 Long Island newpapers.

A CINEMATIC TAKE ON BULLY CULTURE

A Cinematic Take On Bully Culture

By Andrew Malekoff, April 27, 2012

Like many film-goers I have my list of favorites. Some are hilarious (Airplane), some are gripping (Wages of Fear), some are masterpieces (Godfather) and some are timeless classics (Wizard of Oz). And, then there are those that are so haunting that I cannot seem to shake loose of them. The darkly disturbing 2009 Austrian-German film, The White Ribbon, is one of the more haunting ones. Filmed beautifully in black and white with subtitles,

The White Ribbon portrays the residents of a northern German village, dominated by a baron, sometime before World War I. Inhabitants of this village appear to be sliding down a slippery slope of moral depravity. Men in positions of power - a doctor and a clergyman, for example – routinely mistreat women and children. Among the most brutal scenes is one where the town’s widowed physician verbally degrades a kind woman who had faithfully served as his caretaker and mistress.

Although it is only suggested, a number of the older children appear to have perpetrated despicable acts. Crops are destroyed, animals are killed, adults are injured and children are abused, including a child with Down syndrome. We bring our own meanings to films and modify our interpretations as time passes. After I thought about The White Ribbon for a while, I came to the conclusion that it contained a strong message about the devastating consequences that a culture of bullying can bring about.

Sometime after viewing the film, I thought more deeply about the children living in that German village. I realized that they would soon become young adults during the rise of Hitler. These children lived in an incubator in which the cruelty that they experienced, they perpetrated against unsuspecting and helpless victims. Their circumstances were such that they appeared to have been unwittingly primed to perpetrate the atrocities that would come to characterize the Third Reich.

In his 2009 commentary on the White Ribbon, for the San Francisco Chronicle, film reviewer Mike Lasalle noted that the idea of the film was “that the parenting and education German children received in the early years of the 20th century made them morally susceptible to Nazism…No child is trained to become a martinet, and no one says anything about a master race. Rather, the kids, from their elders, get quiet lessons in moral absolutism, sternness, emotional violence and heartlessness.”

Seeing this film led me to wonder about the early years of the 21st century when bullying has become such a prominent thread in the fabric of our culture. And the Internet and all of its gadgets have become the tools with which people of all ages systematically degrade others. But tools are tools. A hammer can be used to build a house or to crush someone’s skull. The Internet and modern technology are not inherently evil, but are tools that can be utilized for evil ends.

Although I do not know the answers to some of the questions that The White Ribbon has posed to me; the film, coupled with an acute awareness of the times we live in, brought these disturbing questions to mind: Have our children become susceptible to something ominous that we cannot yet fathom? If so, what is driving them? And, what are the times we are living in a prequel for?

This column first appeared in the Anton News, a chain of 18 Long Island, NY newpapers.

"TODAY'S WORK AT YESTERDAY'S PRICES"

“Today’s work at yesterday’s prices”

by Andrew Malekoff © 2012

One of the oldest, largest and most well-respected community-based human service agencies closed on January 27, 2012. Some 300 employees at Chicago’s Jane Addams Hull House Association were handed layoff notices and final paychecks and were notified of the immediate discontinuation of their health care benefits. This is a tragedy and an ominous sign.

Hull House was founded in 1889 by social worker and Nobel Peace Prize winner Jane Addams and her lifetime friend and community-activist Ellen Gates Starr. Hull House began as a home for disenfranchised citizens. The organization’s mission was “neighbors helping neighbors.” In its early years Hull House was organized to help immigrants to learn English and the principles of democratic citizenship and to improve the lives and working conditions of many of those living on the west side of Chicago. In recent years Hull House’s focus was on foster care, child care, domestic violence counseling and job training.

Hull House was a beacon for social justice. It was guided by three basic principles: (1) active and side-by-side participation with community residents in addressing local issues, (2) respect for the dignity of all individuals regardless of ethnic background, socioeconomic status, gender or age and (3) belief that poverty and lack of opportunity breed ignorance, crime and disease that are the result of financial desperation and not due to a flaw in moral character.

Hull House’s demise was the result of its over-reliance on government financing. Margaret Berglind, president of Child Care Association of Illinois, commented that “The government is asking you to do today's work at yesterday's prices." I agree.

At North Shore Child and Family Guidance Center we have not seen an increase in our government contracts for a quarter-of-a-century. We are not alone. As with Jane Addams over 100 years ago, we depend on private citizens to invest in our mission - to restore and strengthen the emotional well-being of children and families. Our donors understand what is at stake. They are more than do-gooders, despite the good that they do. They understand that what we do is cost effective, saving tens of millions of taxpayer dollars by keeping troubled young people at home and out of emergency rooms and costly institutional settings.

I have reported extensively on what I believed would be the devastating outcome of New York State’s plan to restructure the financing of outpatient community-based mental health centers. Although I agreed that the over-reliance on Medicaid financing had to change, I strongly disagreed with the planners’ neglecting to provide reasonable local assistance for underinsured middle class and working poor children. State officials told me that that these families could seek help privately. My argument, based on first-hand experience, was that private practitioners would turn away troubled children that only a community-based agency had the culture, resources and wherewithal to serve effectively.

We are beginning to see the consequences of clinic reform on Long Island. In recent years several major community-based mental health clinics have either closed their doors, been taken over by New York City-based conglomerates with no community roots or transformed their outpatient operations into per-diem factories with no salaried employees. Much of this has happened under the radar.

Was it the intention of the New York State Office of Mental Health to shrink the system of care? Although it is not their job to keep providers in business, it is their responsibility to ensure ample access and consumer choice and to make sure our most vulnerable citizens - our children - get care, regardless of their family's economic status.

I am certain that Jane Addams would have agreed.

To be published in the Anton chain of 18 Long Island, NY newspapers in February 2012.

OCCUPY THE BOYS' ROOM

OCCUPY THE BOYS’ ROOM
By Andrew Malekoff © 2012

The “Occupy Movement” has been greeted with mixed sentiment ranging from admiration to revulsion. On the plus side, the movement shows young people that folks of any age can come together around their own vision of the world they want. However, one does not have to attain revolutionary goals to work toward social change, as I learned some years ago when I was working with a group of troubled boys.

At the time, I was involved in developing an innovative school-based mental health program. I was filling in at the school, for a few weeks, for one of the social workers who had taken a leave. I agreed to work with her boys’ group. The boys in the group were teenagers with significant emotional difficulties, ranging from depression to explosive behavior.

In my first meeting with the boys, the discussion took an interesting turn. They complained that there were no doors on the boys’ bathroom stalls and that there was yellow soap in the dispensers. It was a bit of a detour, but I encouraged them to say more about their objections.

As I recall, Keith was the first to speak out: “Do you think they have any idea how humiliating it is to go to the bathroom with no doors on the stalls? There’s no privacy; it’s embarrassing. It’s like they don’t trust us; they’re treating us like little boys.”

Sam added, “It’s disrespectful, that’s what it is – it’s disrespectful.”

And then Kurt, getting back to basics, pointed out, “Man, it’s a lot of pressure when you gotta go badly and you know you can’t.”

Benji added “It says ‘Boys’ Room’ on the bathroom door! We’re men! Dammit! What kind of crap is this anyway!”

A little later, another group member, Rob, asked the others if it was true that kids peed into the soap dispenser. Jay said that he saw someone do it but no one could really tell until it was too late because the soap was yellow. To which one of the group members declared, “We have to get them to put pink soap in the dispensers! Then we’ll know if anyone pees in there. Then we’ll know.”

Being heard and really listened to was a rare experience for the dozen boys who comprised the group. They knew about what being misunderstood, rejected and isolated was all about; but not in this group where they felt connected to one another. They were angry and united – outraged.

In time their social worker rejoined the group. I filled her in about the boys’ quest for improved bathroom conditions. She then guided them to develop a list of bathroom improvements that would be presented to the principal. She led them through an exercise in which they rehearsed presenting their grievances. Then she urged them to request a meeting with the principal to present their case.

Many weeks later, I came to the high school after the dismissal hour and headed down a long vacant hallway to attend an administrative meeting. I pushed open the “Boys’ Room” door and was pleasantly surprised to find pink soap in the dispensers and doors on the stalls.

This story affirms that, working towards change does not require revolutionary goals. Supporting young people in taking action against social injustices – big and small – is a great way to help them to think critically, take a stand and prepare to become active citizens in community affairs.

To be published in the Long Island, NY Anton chain of 18 newspapers in March 2012.

A MYSTERY STORY

A Mystery Story

By Andrew Malekoff © 2011

A few weeks ago, in an attempt to fight off a cold, I ordered a bowl of chicken soup at a local lunch counter. One of the counter boys who is in his late teens asked me if I heard that the United States was just declared a war-zone by the US Senate. I said, “What are you talking about?”

He filled me in. But what he told me didn’t fully compute. What he said, in a nutshell, was that the US Senate passed a bill that would empower the US Military to arrest American citizens and detain them anywhere in the world without being charged or without a trial. I didn’t want to be dismissive. I questioned myself, “Why didn’t I hear about this in the mainstream media?”

I asked him where he heard this. He told me that he read about it on the Internet. When I got home I searched the Internet. What I found was some alternative-media commentary and the actual text of a recent bill (the National Defense Authorization Act - S 1867).

On the evening of December 2, 2011 the US Senate voted, by an overwhelming majority of 93 – 7, to approve what some commentators described as the darkest piece of legislation ever passed in America. Both New York Senators voted “yes.”

After reading the commentary about S 1867 I wondered, “Is there a real threat to our rights, or is this a radical spin?” If I was having trouble making sense of it I imagined others would as well.

The key issues in question are sections 1031 and 1032, which allow the President to authorize the U.S. Armed Forces to detain and hold in custody a person who was a member or part of al Qaeda or “an associated force” and participated in planning or carrying out an attack or attempted attack against the United States or its coalition partners.

I wondered what the fuss was all about. Someone, in a man-on-the-street interview that I found on YouTube, said of the legislation, “If you’re not doing anything wrong, then you have nothing to worry about.” Or, is the devil is in the details. For example, what does “member of an associated force” mean? Could it be stretched to mean anyone with a dissenting voice who government officials perceive as a threat? Could it be someone close to you who is exercising freedom of speech or association?

The interpretations of the commentators were that the legislation would authorize the US military to operate on American soil and to arrest and detain American citizens with no charge, no trial and no oversight. They concluded that by dismissing the right to due process this legislation, if fully enacted, leaves American citizens without the protections of the Constitution and invalidates the Bill of Rights. If signed into law, they reasoned, it could mean secret arrests, no due process, and no right to remain silent and to be tried by a jury of one’s peers, secret prisons, unlawful interrogation and indefinite detention without being charged with a crime.

Ninety-three out of 100 US senators signed on to this legislation. What am I missing? I couldn’t find anything substantial in the mainstream media about this. What should I say to my young friend next time I see him at the lunch counter? Does he have a right to be worried? Do we?

This “exercise” brought to my attention just how difficult it is for young people (and us older ones too) to synthesize the glut of information that is available today. The least we can do is to listen and be co-investigators with young people, attempting together to sort out the mysteries that besiege us in this information-age.

This column will appear in the Anton chain of 18 Long Island, New York newspapers in December 2011.

"GET SPIKED"

“Get Spiked”

Andrew Malekoff © 2011

In the five-year period from 2005 to 2009 there was a dramatic increase in emergency room visits related to non-alcoholic energy drinks, according to a report issued on November 22, 2011 by the Substance Abuse and Mental Health Services Administration (SAMHSA). Just about half of those emergency-room visits were made by 18- to 25-year-olds who were found to be using alcohol, illicit drugs or pharmaceuticals.

What are energy drinks? They are highly-caffeinated flavored beverages for sale in cans and bottles in grocery stores and vending machines. Children, adolescents and young adults - half of the energy-drink market - are the primary targets of energy-drink marketing.

One popular energy drink – Red Bull – bills its beverage as “developed for people who want to have a clear and focused mind, perform physically, are dynamic and performance-oriented.”

Another popular drink, ROCKSTAR, targets young skateboarders. Here is their rap: “Bigger. Better. Faster. Stronger. ROCKSTAR is the world's most powerful energy drink. Enhanced with the potent herbal blend of Guarana, Ginkgo, Ginseng and Milk Thistle, ROCKSTAR is scientifically formulated to provide an incredible energy boost for those who lead active and exhausting lifestyles – from athletes to rock stars.” Although they highlight the “herbal blend,” they conveniently leave out the 80 milligrams of caffeine listed in ROCKSTAR’s ingredients.

These are just two illustrations of seductive messages, aimed at young people and promising a quick-fix for improving performance. Parents, teachers, coaches and others who care about kids need to educate them to the fact that energy drinks are not the answer to better performance on the athletic field or in the classroom.

There are numerous studies that point to the medical risks of excessive caffeine intake (for example, arrhythmias, hypertension, dehydration and more serious medical conditions). When mixed with alcohol and other drugs, the level of danger increases dramatically.

The term “energy drink” is a misnomer for a product that should be more accurately labeled as a “stimulant drug-containing drink.” Some people believe that criticism about energy drinks is an overreaction - much ado about nothing. After all, as they might say, if the active ingredient in energy drinks – caffeine – is the same substance contained in coffee, what’s the big deal? No one is making a fuss about coffee or trying to get it banned or controlled.

Coffee tends to be viewed as an adult beverage, while energy drinks are aimed at the youth market with little regard for health risks and the consequences of mixing these beverages with alcohol and other drugs.

“Get spiked,” “Party like a rockstar,” and “Feel the freak” are slogans that clearly demonstrate the marketing strategies of energy-drink companies. “The language and images of such advertising are not directed at mature adults. If anything, the marketing of energy drinks removes all ambiguity about whom these products are meant to appeal to: teens and young adults,” according to Russ Paddock of the United States Sports Academy.

Parents, teachers and coaches need to educate young people about the risks to their health and well-being of using energy drinks as an easy alternative to exercise, sleep and a healthy diet – the “keys to quality performance, sustained success and overall wellness,” according to Pamela S. Hyde of SAMHSA.

The full report on Emergency Department Visits Involving Energy Drinks from SAMHSA's 2005 - 2009 Drug Abuse Warning Network (DAWN) can be found on the Internet at: http://www.samhsa.gov/data/2k11/WEB_DAWN_089/WEB_DAWN_089_HTML.pdf

This article will be published in the Anton chain of 18 Long Island, NY newspapers in January 2012.