Expert: Paul Johnson - 10/11/2009

Question
My son is living at home and has been diagnosed since mid HS with depression and then bipolar.  He has tried many types of Rx meds and has been in therapy at least twice since the age of 15.  The therapists identified social anxiety as a main component of his troubles.  
I've been reading Atwood and reflecting on his childhood. He has always been very gifted intellectually and verbally yet only applied himself to what interested him in HS and college.  He barely passed HS and eventually was asked to leave college due to lack of progress. He does have encyclopedic knowledge of certain areas of intense interest, that started at a very early age (~6-7 yrs. old).  
My huge concern right now is suspected abuse of Rx medication, I have physical evidence that he is crushing zolpidem, and perhaps other Rx drugs that he is obtaining on the street, and sniffing them via a tube.  He needs immediate intervention, I fear for his life and I don't know what to do.  Short of having him arrested and committed against his will, where can I turn for help?  He doesn't have health insurance, my husband and I do and we would go in as a family to get him under our umbrella.  We all need help to manage this family crisis.  We live in the suburban Twin Cities ring.

Answer
Hey Lisa,

Thank you for your interesting and challenging question.

Your question touches upon an important aspects of people with emotional issues like any of the Autism Spectrum Disorders; That it is extremely tempting to "self medicate". Many individuals have discovered that if we can use street drugs or mis use pharmacueticals it can help us to cope with being unstable with interacting with others.

Your son has chosen to medicate him self as a coping mechanism. I am not sure if it truly matters what his actual diagnosis is. He feels the need to find some comfort. People use mood altering substances for one reason-they desire to alter their moods. What is his typical mood state? What is his desired mood?

We have evolved to a point where Chemical rehabilitation expects the addict to reach a realization and walk through the front door and request intervention. Naturally this depends upon the epiphany where the individuals recognizes s/he can not go on. The "old school" method involves an intervention where the family and friends of the individual confronts him or her and make them understand that we ALL see that they are out of control. When done correctly it is powerfully effective.

I think this is the best of the options, let me know what you try and the outcome.