Addiction, Treatment and Recovery

Its formal name is the Young Adult Track. In Betty Ford Center-speak it’s referred to by its acronym, “YAT.”

Whatever it’s called, why does California’s licensed addiction hospital offer specialized treatment for young men, ages 18 to 25?

According to Lead Counselor Patrick Smith, there are three reasons.

“First,” he says, “these young men inevitably are not your garden-variety alcoholic or addict, if there is such a thing. They often come to us cross-addicted, to a potent mix of drugs. Even after they’ve been here two or three weeks, some patients are still not substance-free – and their sleep patterns are still disturbed two or three months after entering treatment.”

Smith and his fellow counselors say the drugs of choice of their young charges are, in rank order, seriously-addictive opiates like Vicodin and OxyContin, cocaine, marijuana, alcohol, and so-called “benzos” (Valium, Xanax, Klonopin).

A second reason for specialized treatment, Smith says, is that many young male patients’ parents are integrally involved in supporting them financially, in getting them into treatment and in monitoring their progress on the journey to sobriety. “The family is the patient,” he says. “That’s true across the board here at the Betty Ford Center, but it’s especially true with these young men.”

Finally, Smith says, “Most of these young people have been using since they were 10 or 11 years old. To put it mildly, they have not had a normal childhood, or upbringing. They are physically, mentally and emotionally impaired. They lack even the most elementary living skills. They’ve been existing – and I use that word on purpose — in a bubble of addiction for at least half their life. They have so much to learn, although obviously priority number one is how to achieve and maintain life-long sobriety.”

What brought these young men to treatment at the Betty Ford Center? “The immediate answer to that question,” says counselor Craig MacLaughlin, “is that their parents brought them! But while that’s true, the actual causative factor is usually a legal crisis (like an arrest), a medical crisis (like an overdose), issues at school (like expulsion), a family intervention – or a combination of those factors.”

MacLaughlin continues, “Our young-adult patients usually don’t make the decision themselves to come here. They come because someone who loves them recognizes they’re in a downward spiral which they may not survive – and that if they’re going to survive, they need to leave alcohol and other drugs behind and learn how to live a sober life among sober friends in a sober community.”

Is there a flashing red light to alert loved ones that “recreational” drug use by a young family member has degenerated into a chronic addictive state requiring treatment? “Yes,” says Patrick Smith. “Sad to say, by the time many of our patients get here, they are injecting their drug of choice. They’ve found that’s cheaper and delivers a more potent high.”

“My message to parents and other loved ones is that if you see evidence of needles or needle marks, then the enabling phase is well and truly over. It’s time to get proactive, and get help.”

Young Adult Track counselors say it would be a mistake to view their patients as ‘losers,’ especially in an educational or professional sense. They describe a current patient, 23 years old, a high-achieving second-year medical school student.

“Unfortunately,” Patrick Smith says, “in driving himself to excel at his studies, the young man became addicted to amphetamines, and his life began collapsing around him. His parents reached out to us on his behalf, for help. I have no doubt he will learn how to live a sober life, he will go back to school, he will develop into an excellent doctor.”

How does the Young Adult Track actually work? For the first four to six weeks, the young men participate in the Inpatient Program, as do virtually all Betty Ford Center patients. They live on campus, in McCallum Hall. Their treatment team constantly evaluates their progress. When it’s recommended by the team (which works closely with the person’s assigned counselor), they move off-campus to a designated home, where they live with fellow “YAT” residents. The house is staffed 24/7. All activities are closely monitored. When residents leave the house for meetings and other activities, they always do so with a “YAT” buddy.

Johanna O’Flaherty, Vice President of Treatment Services at the Center, says the issue of trust is central to the lives of many young male patients.

“Trust is a recurring theme here,” Dr. O’Flaherty says. “Thanks to their addiction, trust between parent and child has inevitably disappeared, and it’s an extraordinary challenge to reestablish that trust.

“From the parents’ perspective, it’s been impossible to have meaningful communication with their son. The truth is, they haven’t been talking to their son. They’ve been talking to an addict. Those are two separate beings.

“Many of our patients have been using since they were nine or 10 years old. The parents don’t know who that person is. What they do know is, they can’t trust him.”

Dr. O’Flaherty says working on trust issues is central to the treatment process for many young men, and to their recovery.

There are five levels of treatment for the patients, and the young men must petition for “promotion” to higher levels, she says. “They want the freedom that comes with trust,” she adds, “but they have to earn that trust, and that freedom.”

Because so many of the young men have been what counselor Patrick Smith describes as “MIA – missing in action” for so many years, many life-coping skills that may appear elementary to others, must be taught. “Things like doing laundry, cooking food, keeping a bedroom neat, managing a checkbook – for most of us, that may all seem pretty conventional stuff. But for many of these young men, it’s a whole new world.”

Another part of the “whole new world” is building communication skills. “During their addiction, all that’s been important to most of them,” Smith says, “is their so-called ‘friends,’ street culture, and when and how to score their next hit. They’ve had no meaningful or intimate relationships – not with family members, not with anybody else, either. They have to work consciously on learning personal communication skills and forming new relationships and associations.”

Those communication skills also come into play as the young men develop longterm educational and career plans.

Fitness is also important. “We recognize,” says counselor Craig MacLaughlin, “that when so many of these young men arrive here, they’re in rough shape, physically as well as mentally.” Thanks to the Betty Ford Center’s state-of-the-art fitness facilities, men in the Young Adult Track have access to a wide variety of equipment that helps with cardiovascular training and strength-building. There’s also swimming, hiking (on nearby Mount San Jacinto) and mountain-biking. Kayaking expeditions are in the planning stage.

One of the most heartening aspects of treatment for young male adults is that the young men help each other.

“By the time someone has been here for three to six months, they’re acutely aware of where they were, where they are, and where they’re going,” says Patrick Smith. “To watch them reach out and befriend a new patient who’s just arrived in a state of anxiety and fear — that’s really pretty remarkable. That new person soon realizes that there is help, there is hope. It’s a wonderful cycle of affirmation.”

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