Thank you to Dr. V.C. Karumanchi and Ryan Olson from La Frontera for making this visit and project possible.
Where: Casa Lucero, a La Frontera facility in Tucson, AZ
When: June 14, 2016
Who: Two clinicians and a dedicated recovery coach
Objective: Learn about local youth substance abuse prevention efforts in order to educate peers about youth substance abuse prevention.
Takeaway: I received inspiration for how to spread awareness of youth substance abuse and discovered a good resource for youth substance abuse prevention.
By Meena Venkataramanan
On the outskirts of Downtown Tucson, adjacent to an apartment complex and across from a cathedral, rests Casa Lucero, a youth substance abuse treatment clinic that is part of La Frontera, an organization of youth substance abuse prevention centers around Arizona and in New Mexico. On June 14th, I visited Casa Lucero and interviewed two youth substance abuse clinicians, Aurora Thrush and Diana Spray, and a dedicated recovery coach (DRC), Lillian Castro, about their experiences working to alleviate youth substance abuse in Southern Arizona. Thrush has been working to alleviate substance abuse since 2009, but specifically started working with youth in 2012 because she “really likes the age group” and believes that adolescence is a crucial time since adolescents are figuring out who they are and are faced with many obstacles and challenges. Castro has been with La Frontera for just over ten years, and has always enjoyed working with children and wants to provide a safe haven for them. Spray has been working with teenagers since 2013, and enjoys doing intervention work and increasing prevention efforts.
Each day is different for these three staff members. As clinicians, Thrush and Spray have a daily schedule of hourly appointments where they work with patients who have had past trauma, but also have crisis sessions for already-enrolled teenagers who are having a crisis and walk into the clinic without prior notice. As a DRC, Castro says that she could “start out [her day] in a meeting and end at a detention center,” since she works with more high-risk patients that may be hospitalized or in the Department of Child Safety (DCS).
Though there isn’t a single profile to adequately describe a victim of youth substance abuse, when I asked whether there are common qualities these adolescents may share, Thrush mentioned that many of them suffer from early childhood neglect and that there “isn’t a lot of strength and support” for them. Spray added that many of them are or have been in foster care or the DCS, and Castro remarked that they are stuck in a vicious cycle of arrests, probation, and relapsed substance abuse. When I asked what drives these adolescents to relapse, I learned that many of these teenagers have families that struggle with substance abuse and are constantly exposed to drugs and alcohol. In the poor socioeconomic communities where they reside, it is easy to come across teenagers dealing drugs in broken-down community facilities such as parks and playgrounds. These teens genuinely believe substance abuse is normal and that all of their more-affluent counterparts are engaging in the exact same behavior. “The community is so entrenched in bad behavior,” lamented Thrush, adding that community efforts to alleviate youth substance abuse are desperately needed, since substance abuse, according to Spray, is “part of the culture” of these families. “As social workers, we make a difference, but we only spin our wheels on a community level,” concurred Castro.
When I inquired what community rehabilitation should ideally look like, I was met with a variety of equally thoughtful responses. Thrush hopes to transform the societal response to victims of substance abuse, and hoped for the establishment of more treatment centers than detention centers so “when a child is picked up [by the authorities], he or she is sent to treatment instead of being given a slap on the wrist.”
Castro asked “Why don’t we send the parents to treatment?” She remarked that because youth substance abuse is aggravated by family environments, entire families should be sent to treatment instead of just adolescents. Because according to Spray, many parents push for individual youth substance abuse treatment programs, but “there has to be family involvement” in order for real changes to occur.
Youth substance abusers come in all shapes and sizes. Spray said the average starting age was around twelve years old, in the midst of puberty and middle school peer pressure, but Thrush added that it could be as young as eight or nine years old. Castro mentioned one of her patients who “started using heroin at age five and will be 18 soon…he has been in DCS since he was a baby,” proving that to these children, drugs are just a normal part of growing up because of toxic environments and easy access. “Just as my mom taught me to eat a tub of ice cream and watch funny movies when I’m stressed out, these parents teach their children to get drunk or high,” pointed out Thrush, illustrating the similar stress both users and non-users face but the radically different ways they deal with this stress.
The drugs themselves vary as much as their users do. Right now, the clinicians, Thrush and Spray, have many cases involving marijuana and Spice (synthetic cannabinoids), but the DRC, Castro, mentioned a rise in chemical drugs such as cocaine, meth, and heroin. Sometimes, Thrush added, the teenagers use multiple drugs regularly, such as “meth two to three times a week, with Spice and marijuana regularly in the background.” With such frequent use, withdrawal symptoms are intense and include severe insomnia and trembling. At La Frontera, clinicians are careful not to medicate teenagers who are abusing drugs or alcohol, because they believe substance abuse treatment ought to come before additional medication. In terms of specific treatment programs, “adolescents start with the least restrictive- groups- and then move on to a higher level- such as 60-day programs, and then lockdown facilities,” said Castro. These outpatient groups aren’t for everyone, however, Spray warned. “Sometimes, one-on-one treatment is more appropriate, because teenagers can find ‘connections’ in groups to deal more drugs to.” Assessments are used to diagnose patients, and are based on a multitude of factors, including intensity, type of drug, frequency, mental health, individual motivation to improve, and family background, but clinicians can also add their personal recommendations to the results. In the end, many of the sessions include either motivational speaking or cognitive behavioral therapy, through which “the patient’s own rationalizations, or assumptions about drugs, are challenged,” according to Thrush. In this way, patients are encouraged to find alternatives to drug and alcohol use to cope with pain and stress, and are asked essential questions such as “What role does my addiction play in my family setting?” and “How can I increase my coping skills?” Because “for many of these children, using becomes their coping,” said Castro.
On a final note, I wanted to know what advice these ladies had to teenagers who constantly face pressure to use drugs or alcohol as well as teenagers who are trying to spread awareness of youth substance abuse in order to alleviate it. Thrush regularly encourages all teenagers, including her own children, to act as good friends and choose good friends, since the “types of peers you surround yourselves with reflect on you and the people around you.” She always asks patients what types of sports or activities they enjoy, because she is trying to find their passion and encourage them to pursue it instead of using drugs or alcohol. She also hopes that drug-free teenagers will overcome their fear of speaking up about the issue to their drug-using friends, because she knows that drug use is often considered “cool” in popular culture and that many people keep quiet about it and condone the dangerous actions of their friends. By not being afraid to address the issue and surrounding oneself with good peers, Thrush is confident that teenagers can resist pressure to try drugs and alcohol and can help alleviate the issue by spreading awareness.
Though relapse rates are high at Casa Lucero because of noxious, yet stagnant, environments that hardworking teenagers come home to every night, success stories drive these clinicians and coaches to keep working to fight substance abuse with an air of optimism. Thrush recalls a teenage girl who was addicted to marijuana but ultimately quit using it and began to pursue her passions: poetry, music, and drama. Creative self-expression has been her ticket to a better pathway- one free of substance abuse. Similarly, another teenage victim of substance abuse expressed a desire to join to military. After a long treatment process, this teenager got off his medications and stopped using drugs, and just recently graduated military boot camp, proving that dreams can come true. Because in the end, a collective aspiration to success and an unyielding hope for improvement are what ultimately keep Casa Lucero (and similar programs) running and the dream of a world without substance abuse alive.