How do I know if my son is using a vaping device? I know it’s a huge issue right now, but I’m not sure what to look for. He says he’s not doing it.

Aside from actually finding a vape pen, it is very difficult to tell if your child vaping, and particularly if they’re vaping nicotine (as they won’t show any tell-tale signs of impairment that marijuana might). That said, consider the following:

• Do you know your son’s friends? Have they changed recently? Someone’s friends often mirror their own internal orientation, so there may be some clues there.

• Are you on your son’s social media and cell phone? You would be surprised at the amount of evidence that is posted in plain sight.

• Does your son seem to have either too much or too little money? Adolescents involved in vaping and drugs have to buy the products, and some are also involved as middlemen to sell to their classmates.

This should give you a good start! Good luck with your son, and I really hope he is making healthy choices.

My wife needs to go to rehab, and we don’t know how to pick the best place—there are so many options.  How do we make the best choice?

This is a really good question—there are a huge array of choices for treatment, both local and across the country.  Further complicating the issue is that, if we are being honest, the treatment field is rife with poor practice and sometimes outright fraud. Here is my take on how to find the best place for treatment (also consider watching TLDR: Addiction on this topic from the resource list):

• Get a recommendation from someone you and your wife trust, such as her therapist (if she has one) or primary care doctor. It is much easier to navigate the industry when you have a guide than if you are trying to figure out how to make sense of marketing material.

• For residential treatment, it is convenient to work with a local facility, but not necessary if there’s a program elsewhere that is a better fit for her needs and circumstances.  Having a local option makes it easier to have family visits/therapy, which is an important part of the recovery process. It also will save on transit costs. That said, traveling for treatment is absolutely worth it if you she feels she is a better fit at a different site.

• Each treatment center approaches the process differently. Some strongly emphasize the 12-step approach and spirituality, whereas others emphasize techniques more based in psychological principles and sciences. Some make a point of presenting clients with real-life challenges and situations during treatment. Others do not, which typically requires more support after discharge to help facilitate the transition back to familiar patterns, places, stressors, and potentially triggers to use again. Finding a program that meets your particular needs is very important!

The decision of where to go is a tough one, so please do make sure to reach out for support. Take care, and my thoughts are with you and your family.