1. Effects of Drugs & Alcohol on Children & Families Christine Foster, LMSW Children’s Therapist

3. Archibald, H.D., "Dr. Elwin [sic] Morton Jellinek: (1891–1964)", American Journal of Psychiatry, Vol.120, (June 1964), pp.1217–1218.

6. Approximately 1 in 4 The National Institute of Health (NIH), 2012

7. Cycle of Addiction COAs are four times likelier than non-COAs to use alcohol or develop alcohol-related problems. COAs tend to initiate alcohol use earlier and engage in problem drinking at a younger age than non-COAs. The National Center on Addiction and Substance Abuse at Columbia University. (2005). Family matters: Substance abuse and The American Family. New York: The National Center on Addiction and Substance Abuse at Columbia University.

8. The National Center on Addiction and Substance Abuse at Columbia University. (1999b). No safe haven: Children of substance- abusing parents. New York: The National Center on Addiction and Substance Abuse at Columbia University.  #1 risk factor for a child being abused is alcoholism/addiction in the home.  COA’s are 4 times more likely to suffer neglect.

9. www.childtrauma.org

10. FAS FASD Texas Office for Prevention of Developmental Disabilities Wattendorf, D. MAJ, MC, USAF, and Muenke, M, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland. Am Fam Physician. 2005 Jul 15;72(2):279-285.

11. Photo courtesy of Sterling Clarren, MD – Brain at 6 wks

13. www.childtrauma.org

14. Common Challenges for COAs Behavioral Emotional Medical & Psychiatric Educational

15. Behavioral and Emotional Issues Depression Anxiety Eating Disorders Suicidal Ideation Victimization Addiction Lower Self-Esteem Poor communication skills Lower Internal Locus of Control Mistrust Guilt Shame Confusion Ambivalence Fear Insecurity

16. Medical & Psychiatric injuries, poisonings, substance abuse, mental disorders, diseases of the gastrointestinal and respiratory systems Children of Alcoholics Foundation, 1990 COAs had higher rates of admission for:

17. Educational Challenges Learning disabilities Repeated grades Attend more schools

18. Educational Challenges, cont. Truancy Delinquency Drop-Out Pregnancy Expulsion Institutionalization COAs tend to have higher rates of:

19. Characteristic Concerns of COAs

20. Children feel responsible for parent’s drinking or drug use. Characteristic Concerns

24. Children fear the person who uses alcohol or drug will get sick or die. Characteristic Concerns

28. Children feel angry with non-using parent Characteristic Concerns

31. Children are embarrassed by parent’s behavior. Characteristic Concerns

33. Children never know what to expect. Characteristic Concerns

35. Children are confused by the difference between “dry” and “drunk” behavior. Characteristic Concerns

37. Children sometimes want their parent to drink or use drugs. Characteristic Concerns

39. Family Dynamics

41. Common Beliefs in Families with Addiction

42. It’s not okay to talk about feelings.

43. Indirect communication is best

45. It’s not okay to express feelings freely.

46. Unrealistic expectations.

47. Don’t be selfish.

48. Do as I say, not as I do.

49. It’s not okay to play or be playful.

50. Don’t rock the boat. It’s not okay to play or be playful. Do as I say, not as I do. Don’t be selfish. Unrealistic expectations. It’s not okay to express feelings freely. Indirect communication is best It’s not okay to talk about feelings.

51. Four Services Areas at The Council Prevention programs Kids Camp at The Council Choices Program for Middle & High School Community Education Clinical Services Cradles Project Center for Recovering Families – Adult, Adolescent, and Children’s Services Recovery Support Services

53. FAQ’s Will the program give my child too much information? My children don’t know about my addiction. Are you going to tell them? What if my children tell people at school or in our community about my addiction? Will my child be exposed to too much? My child wasn’t really affected by my addiction. I was always away when I was using. Would this program do them any good?

54. Bag of Rocks FEELINGS AngryHurt ConfusedScared AshamedSad EmbarrassedShy FAMILY PROBLEMS Fights Abuse Addiction SECRETS

55. I didn’t CAUSE it. I can’t CONTROL it. I can’t CURE it. But, I can help take CARE of myself. I can COMMUNICATE my feelings. I can make healthy CHOICES. I can CELEBRATE myself.

56. Let your children know in an age-appropriate manner what happened when/if they ask. If they don’t ask or don’t know about your addiction, let them know before they are adolescents. Work on communication skills as a family and one on one.

57. Make promises you can keep. Be where you are supposed to be, when you are supposed to be there. Be consistent and fair with rules and consequences. Trust yourself to make decisions for your children. Trust others and seek help when you don’t know what to do.

58. ALL FEELINGS ARE OK!! Be aware of your own feelings and let them out. Do model your feelings appropriately. Avoid yelling and other displays of violence. Guilt and Shame- allowing your child to manipulate your actions.

59. Child’s View of Recovery

60. Change is scary-even if it’s what they have hoped for. What is my role now? Kids are confused about the “meetings” parents go to. Kids sometimes feel resentful about all of the slogans” and terminology. Children expect everything to be all better now. Sometimes parents relationship worsens after recovery. Children react to limits being set when there might have been none or inconsistently set ones be

61. Protective Factors Caring and Support High Expectations Active Participation Werner, E.E. & Smith, R.S. (2001). Journeys from childhood to midlife: Risk, resilience, and recovery. Ithaca, NY: Cornell University Press.

62. Important Messages COAs Need to Hear You are not alone. You are not responsible for the drinking or drug use in your family. It’s not your fault. You can’t control your parent’s drinking or drug use. Things can be better for you. There are people and places that can help you. All of your feelings are okay.

63. Play: A child’s work

65. Adolescence: Age 12-25 Apoptosis = Pruning 200 billion to 100 billion

66. Myelin = Processing Speed

70. USE IT OR LOSE IT PRINCIPLE Pruning (Apoptosis) clears out unneeded wiring to make way for more efficient and faster information- processing (thicker myelin) Rich experiences = Promotes building long chains of nerve cells needed for demanding problem-solving

71. From Immature, Child Responding to Mature, Adult Thinking: The Road to Executive Function Abstract; conceptual understanding Impulse Control Problem-Solving Decision-Making Judgment Emotion Regulation Frustration Tolerance Ability to Feel Empathy

73. How do drugs, alcohol, & trauma effect the brain during the pruning process?

74. Midbrain: Survival Mode Eat it Kill it Have sex with it

75. Limbic System 1)Survival: Fight or Flight 2)Pleasurable Experiences

76. What does Amygdala Thinking do for you?

77. Today’s Threats? No, you can’t have your IPhone.

78. But to a teenage brain…

80. HYPOFRONTALITY: FEAR

81. Dopamine: Calm, Happy, Signals Salience

82. Dopamine Release and the Hedonic (pleasure) Threshold

83. When Dopamine surges so does Glutamate

84. Photo courtesy of Anna Rose Childress, Ph.D., NIDA website, 2007

86. HYPOFRONTALITY = ARREST

87. If you arrest here but stop using here Age 12

88. Causes of Arrested Development Chemical Use Trauma Intense Emotions – Anger, Fear Overindulgence Stress Amygdala Never Forgets Hypercortisolemia

89. STRESS =  CORTISOL =  DOPAMINE = Anhedonia (Pleasure Deafness) Kevin McCauley, 2010

90. Neuroplasticity & Recovery Recovery is Brain Rehabilitation

91. Our brain can restructure itself based on our experience “My experience is what I agree to attend to. Only those items which I notice shape my mind.” William James, American psychologist Newborn 3 month old 15 month old 2 year old

92. Our Neural Networks Continue to Build Until We Die The more often neural pathways fire, the stronger the connections will become. “Neurons that fire together wire together.” Donald Hebb Canadian Psychologist

93. Prefrontal Cortex vs. Amygdala Thinking  All or Nothing: Concrete  Based on fear or anger reactions  Ignited by real or perceived threats  Begins adrenaline cycle  Fight or Flight Survival Mode Abstract; conceptual understanding Impulse Control Problem-Solving Decision-Making Judgment Emotion Regulation Frustration Tolerance Ability to Feel Empathy

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