Enthusiastic SobrietyIf you’re reading this book, there’s a good chance you’ve asked yourself a question that almost every parent eventually asks: “Why does my kid keep getting high?” It’s a fair question, and it’s one that usually comes after months or years of trying to make sense of something that doesn’t seem to make any sense. Parents tell us about the good life they’ve tried to provide. They talk about vacations, birthdays, family dinners, school events, and all the ordinary moments that make up a childhood. They tell us how much they love their son or daughter, and then they look at us wondering how alcohol or drugs could possibly become more important than everything they’ve worked so hard to give them.
Over the years, we’ve learned there’s usually another question hiding underneath the one parents ask out loud. They may never actually say the words, but it’s there in almost every conversation: “Why aren’t we enough?” or “Why is what we've given them not enough?” If you’ve ever found yourself asking one of those questions, or something similar, we hope one idea will stay with you as you read this book. Your teenager or young adult is probably not choosing drugs over you. More often than not, they’re choosing the relief alcohol or drugs provide.
That doesn’t mean your teenager is consciously thinking, I’m in pain, so I need relief. That’s not how most young people experience it. They simply know they want to feel good, and getting high feels good. In fact, for some of them, it feels great. Looking back, many of us who found recovery eventually realized we weren’t just chasing the high. We were chasing the relief the high gave us. At the time, we didn’t have those words. We just knew we’d found something that quieted the noise inside, even if only for a little while, and we wanted to feel that way again.
That doesn’t excuse the lying, the broken trust, or the chaos that substance use brings into a family. Those things are real, and we’ll spend a great deal of time talking about them. But we’ve learned that if we misunderstand why a young person keeps going back, we’ll spend our time trying to solve the wrong problem. One of the biggest misconceptions we’ve encountered is the belief that young people continue using simply because they like getting high. Getting high certainly feels good, but that’s rarely the whole story. The young people we’ve come to know over the years don’t describe their experience as finding a drug. They describe it as finally finding something that made them feel different, and for some of them, that difference felt like the answer to a question they’d been asking for years without ever knowing how to put it into words.
That’s where this book begins. Before we can talk about recovery, consequences, or what parents should do next, we first have to understand why getting high became so important in the first place. Once we understand that, many of the decisions that once seemed irrational begin to make a great deal more sense.
Experimenting
One of the words we hear all the time is “experimenting.” Parents will tell us, “I think they’re just “experimenting,” and young people will often say exactly the same thing. We’ve come to think that the word deserves a little more attention because, when you stop and define it, an experiment is simply a way of finding out whether something works.
Think back to science class. You have a hypothesis, you test it, and then you repeat it to see if you get the same result. If A plus B equals C once, you do it again. If A plus B still equals C, you’ve learned something. The experiment is over because you have your answer. You don’t keep running the same experiment for six months. Once you know it works, you’re no longer experimenting. You’re simply repeating the result.
The first time a young person gets high really isn’t much different. Someone hands them a joint, a cart, or a pill. They don’t know exactly what to expect, so they follow everyone else’s lead and wait to see what happens. They pack the bowl, light it, inhale, and get high. A few days later they do the same thing. They pack the bowl, light it, inhale, and get high again. Maybe they do it one more time just to be sure. Same result. They’ve learned the formula. The experiment was a success. They now know exactly what they have to do if they want to feel that way again.
From that point forward, they’re no longer “experimenting.” They’re using.
This is where we think parents accidentally confuse two very different things. We’ll hear someone say, “My son has just been ‘experimenting’ for the last six months,” or, “She’s only ‘experimenting’ on the weekends.” We understand what they’re trying to say, but six months isn’t experimenting. Weekends for months on end isn’t experimenting. The experiment ended the moment they learned alcohol or drugs produced the feeling they were looking for. From that point forward, they’re using.
That distinction matters because it changes the conversation. An experiment answers a question. Using repeats the answer.
Use breads mistrust
The problem isn’t simply that they learned how to get high. The problem is what they learned while they were high. They weren’t sitting there trying to analyze their emotions or figure out why they suddenly felt different. That’s not how most teenagers think. They simply knew they felt good. For some, it was the first time they could remember feeling that way. We’ve heard young people describe that first experience with almost identical words: “Oh my God… this is what I’ve been missing.”
Then another thought quietly follows. “All those adults told me this was terrible. They told me bad things were going to happen. How could something that feels this good be so bad? They must have been lying.”
That’s why the experiment can become so dangerous. They’re no longer trying to find out whether alcohol or drugs work. They already know the answer. Now they’re going back because they remember how they felt. They’re not chasing marijuana, alcohol, or pills. They’re chasing relief, confidence, acceptance, peace, excitement, or whatever feeling they experienced the first time. Once someone believes they’ve found something that makes life feel better, it’s easy to understand why they keep going back.
Dallas
Dallas was eleven years old the first time he got high on marijuana. He was spending the afternoon at a friend’s house playing video games when his friend’s older brother walked into the room and asked if they wanted to smoke weed. The timing couldn’t have been better because just a week earlier Dallas had gone through drug and alcohol education at school. Looking back, he laughed and told us the class probably had the opposite effect of what it was intended to do. Instead of making him less curious, it made him wonder what everyone was talking about.
He told us he wasn’t trying to rebel. He wasn’t looking for trouble. He was simply an eleven-year-old who was curious enough to find out what marijuana felt like. He also had absolutely no idea what he was doing. He remembered being scared to death. It was hot outside, and he could feel the sweat running down his back. The whole time he kept thinking somebody’s parents were going to walk in and catch them. He watched everyone else carefully, trying to copy exactly what they were doing. When it was finally his turn, he took the biggest hit he could, coughed so hard he thought his lungs were coming out, and waited.
Then everything changed.
As we listened to him describe what happened next, it became obvious why this story has stayed with us for so many years. He said the fear disappeared. He stopped worrying about getting caught. He stopped worrying about the sweat running down his back. Everything that had been making him anxious just seemed to disappear. Getting high also gave him a sense of connection to his peers. He felt included, as though he finally belonged.
When we asked him what it felt like, he sat quietly for a moment before saying, “I felt complete. It was like I’d finally found what had been missing.” Then he smiled and told us the very next thought that went through his mind. “How could something so bad feel this good? They lied. They all lied.”
A few minutes later, while we were still talking, he said something we’ve never forgotten. “That first high, I was in. I was so in. I decided in that moment that I was going to smoke pot for the rest of my life, every day, sitting on the front porch with my grandchildren as the sun came up and as it went down.”
Think about that for a minute. An eleven-year-old had already imagined the rest of his life around marijuana. He wasn’t thinking about addiction or consequences. He certainly wasn’t thinking about what his life might look like ten or twenty years later. He believed he had found the answer to the way he felt inside.
When we talk about the hole in the gut, sometimes called the hole in the soul, this is what we mean. Dallas didn’t have those words when he was eleven. He wasn’t trying to describe anxiety, depression, loneliness, or emotional pain. He simply knew that before he got high, something inside him never quite felt right, and afterward it did. Looking back, we’d say the marijuana didn’t actually fill the hole. It temporarily covered it up. But an eleven-year-old doesn’t know the difference. All he knows is that he finally feels complete, and he now knows exactly how to get back to that feeling.
That’s why this story matters. Dallas didn’t leave that backyard believing he had discovered marijuana. He left believing he had discovered the solution to the way he felt inside. The experiment was over. He knew it worked. From that day forward, he wasn’t trying to find out what marijuana felt like anymore. He already knew. He was using because he wanted to get back to the feeling he’d found that afternoon. Once someone believes they’ve discovered that kind of relief, it becomes much easier to understand why they keep coming back, even when the consequences begin to pile up.
Good Drugs and Great Drugs
Dallas’s story naturally leads to another question. If marijuana felt that good for him, why doesn’t everyone who tries marijuana have the same experience? That’s one of the biggest misconceptions we’ve encountered over the years. We tend to assume that drugs affect everyone the same way, but they don’t. The same substance can mean something entirely different to two different people because the drug isn’t the whole story. The person using it is part of the story too.
We’ve come to think about this by making a distinction between what we call a good drug and a great drug. Almost every drug feels good to somebody. That’s why people use them in the first place. But every once in a while, a young person finds a drug that seems to answer a question they didn’t even know how to ask. It quiets their anxiety, softens their loneliness, gives them confidence, slows down a racing mind, or creates a sense of peace they’ve never experienced before. Suddenly, they can dance at the party. They can talk easily to a boy or a girl. They have confidence in areas of life where they never had it before. They no longer feel alone in a room full of people; they feel connected. At that point, the drug has become much more than something that feels good. It has become what we would call a great drug because it appears to solve a problem that nothing else has been able to solve.
Unfortunately, that’s where things begin to change. In the beginning, the young person is chasing the feeling they had the first time they got high. They remember how complete they felt, how peaceful they felt, or how comfortable they suddenly became in their own skin, and they naturally assume they can recreate that experience. But over time, the brain adapts. The same amount no longer produces the same effect, and little by little that magical feeling becomes harder to find.
At the same time, something else is happening that often goes unnoticed. When the drug wears off, the young person doesn’t simply return to where they started. They often come back feeling just a little bit lower than before. The first few times that difference may be almost impossible to notice, but eventually it becomes significant. They’re no longer using because they’re trying to get back to that incredible feeling they had in the beginning. They’re using because they just want to feel normal again. That’s one of the saddest transitions we see because it usually happens so gradually that the young person doesn’t recognize it while it is happening.
Once that happens, some begin looking for something “experimenting” with other substances. It isn’t necessarily because they’re thrill seekers or because they’re trying to become harder drug users. They’re trying to recreate the feeling they remember from the beginning. If marijuana no longer produces that feeling, maybe alcohol will. If alcohol doesn’t, maybe mushrooms will. Maybe LSD. Maybe cocaine. The substance changes, but the goal stays exactly the same. They’re searching for the feeling they experienced when the experiment first became a success, and many spend years chasing something they’re never quite able to find again.
Sam and Jerry
Whenever we explain this to parents, we introduce them to Sam and Jerry. Neither one is a real person, but together they represent thousands of teenagers and young adults we’ve worked with over the years. Before we go any further, we should warn you that nobody ever wants to be Jerry. Parents usually laugh when we say that, but by the end of the story they understand exactly why.
Sam is nineteen years old. Jerry is twenty. On a Friday night, Sam pulls into Jerry’s driveway to pick him up for a party. Before they ever get there, though, they’re already starting from two very different places. If we could somehow measure how they’re feeling emotionally on a scale from one to ten, Sam begins the evening at about a seven. Life isn’t perfect, but he’s doing pretty well. He’s looking forward to seeing his friends, listening to music, and having a good time. Jerry, through no fault of his own, starts the evening at about a three and a half. He couldn’t necessarily tell you why he feels that way. He just knows that he does. He wonders whether he’ll fit in, whether he’ll say something stupid, whether people really like him, and whether everyone else seems to have life figured out better than he does.
At the party, someone offers them both a drink, a cart, or a pill. About an hour later, if you walked through the house, you couldn’t tell them apart. They’re both laughing. They’re both talking. They’re both relaxed. From the outside they’re having exactly the same experience. Inside, though, something very different has happened. Sam has gone from a seven to a ten. Jerry has gone from a three and a half to a ten. They both arrived at the same place, but Jerry traveled a much greater distance to get there.
That difference is what matters. For Sam, getting high felt good. For Jerry, getting high felt magical. The self-doubt became quiet. The insecurity disappeared. The constant second-guessing stopped. For the first time in a long time, he wasn’t worrying about what everyone else thought of him or whether he measured up. He simply felt comfortable. That’s why we say nobody wants to be Jerry. Sam enjoyed the experience. Jerry believed he had found the answer to the way he felt inside.
Eventually, the party ends, they both go home, and the drugs wear off. Sam doesn’t wake up back at a seven. Maybe he wakes up at a six and three-quarters. He had a great night, but he’s basically back to being Sam. School still matters. He continues to have goals. He cares about his future. The party was something he did, not something that changed the direction of his life.
Jerry’s morning is different. He doesn’t wake up back at a three and a half. He wakes up a little lower than where he started. Now he doesn’t just remember feeling uncomfortable. He remembers what it felt like not to feel uncomfortable. He remembers what it felt like to be a ten, and now he knows there’s a way to get back there. That changes everything.
The next morning, Jerry calls Sam and says, “What are we doing tonight?” Sam is confused. “What do you mean?” Jerry says, “Let’s find another party.” Sam laughs and tells him he can’t because he has a big test coming up and needs to study. Getting a good grade matters to him. Jerry doesn’t understand the answer because, from his perspective, the choice doesn’t make sense. Why would anyone choose studying over feeling the way they felt the night before?
The answer is that Sam and Jerry aren’t chasing the same thing. Sam had fun. Jerry found relief. Those are two very different experiences, even though they may look exactly the same from the outside. For Sam, the party fit into his life. For Jerry, the party had become much bigger than the party itself because it wasn’t really about the party anymore. It wasn’t about the music, the people, or even the drug. It was about getting back to the way he felt while he was there.
As time goes on, Jerry keeps trying to return to that first feeling, but something begins to change. The drug doesn’t work the way it did in the beginning. What once felt like a ten becomes a nine. Then an eight. Eventually the goal is no longer to feel amazing. He’s just trying to feel normal. We’ve watched this happen over and over again, and it usually happens so gradually that young people don’t recognize it while it’s happening.
That’s also why some young people begin “experimenting” with different substances. They aren’t necessarily looking for a bigger high. They’re looking for the relief they remember from the first successful experiment. The substance may change but the goal stays the same. They’re trying to get backy to the feeling they remember from the beginning
Before we leave Sam and Jerry, there’s one more thing that’s important to understand. This story isn’t saying Sam could never develop an addiction or that Jerry was destined to develop one. That’s not the point. At this moment in their lives, Sam simply had less to gain from getting high than Jerry did. If Sam continues drinking, smoking marijuana, or “experimenting” with other drugs, his relationship with those substances can change too. Repeated exposure teaches the brain, and what begins as something that simply feels good can eventually become something that feels necessary. Jerry just reached that point much sooner because the relief he experienced was so much greater.
Parents almost always stop us here and ask the question we’ve been hoping they’ll ask. “Why did Jerry start at a three and a half in the first place?” That’s exactly the right question, because once we understand why Jerry started there, we can finally understand why one young person experiences a drug as simply good while another experiences it great.
The Hole in the Gut
After more than fifty years, we’ve learned there isn’t one answer that explains every teenager or young adult. Sometimes it’s anxiety, trauma, bullying, rejection, loneliness, or loss. Often, we can’t point to one defining event at all. We’ve worked with brothers and sisters who grew up in the same home with the same parents, the same opportunities, and many of the same experiences, yet one seemed comfortable in their own skin while the other spent years wondering if they were enough. Somewhere along the way we stopped looking for one explanation because there simply isn’t one that fits every family.
Instead, we’ve found it more helpful to think about it another way. Imagine Jerry has a hole in his gut. It isn’t a real hole, and it isn’t a diagnosis. It’s a picture that helps explain something we’ve heard teenagers and young adults describe for years: a feeling that something is missing, unsettled, or not quite right inside. Some people carry a very small hole. Others carry one that feels enormous. Some hardly notice it’s there most days, while others seem to wake up with it every morning. They spend years trying to fill it with popularity, romantic relationships, money, drugs, alcohol, sex or anything else they hope will finally make them feel complete. Sometimes those things help for a while, but sooner or later the feeling comes back because none of those things were ever designed to permanently fill the hole.
Now think back to Dallas. He didn’t know anything about holes in the gut. He wasn’t trying to understand brain chemistry or explain emotional pain. He simply knew that before he got high, something inside him never quite felt right, and afterward it did. When he told us, “I felt complete. It was like I’d finally found what had been missing,” he was describing the same thing we’re talking about here. Looking back, we’d say the marijuana didn’t fill the hole. It temporarily covered it up. Dallas didn’t know the difference. All he knew was that whatever had been bothering him on the inside was suddenly quiet.
That’s exactly what happens to Jerry. He isn’t thinking about dopamine, addiction, or any of the science behind what he’s experiencing. He’s simply comparing how he felt before he got high with how he feels afterward. The self-doubt is quiet. The insecurity is gone. The constant pressure he carries around every day has disappeared. For the first time in a long time, he feels comfortable in his own skin. Once someone experiences that kind of relief, it’s much easier to understand why they’ll want to experience it again. Parents naturally focus on the drug because that’s the part they can see. Jerry isn’t focused on the drug at all. He’s focused on the relief it gave him. Until parents understand that difference, they’re often trying to solve a different problem than the one their teenager is actually experiencing.
The hopeful part of this story is that the hole can be filled without alcohol or drugs. Our experience has taught us that, and we continue to watch it happen over and over again. Recovery doesn’t simply take something away from a young person. It helps them build the very things they were hoping the drug would give them in the first place. They develop genuine confidence instead of borrowed confidence. They find real belonging instead of chemically manufactured belonging. They build friendships based on honesty instead of getting high together. They discover purpose through service, self-worth through responsibility, and a community where they finally feel accepted for who they are instead of who they’re pretending to be. None of that happens overnight, but little by little the hole begins to fill with things that actually last.
That’s why we’ve come to believe recovery isn’t simply about helping a young person stop getting high. It’s about helping them build a life where alcohol and drugs are no longer the answer to the way they feel inside.
Does It Matter What We Call It Abuse or Addiction?
One of the questions parents ask us all the time is, “Do you think my teenager is an addict?” It’s an understandable question, but after more than fifty years we’ve found ourselves asking a different one. We usually ask, “Are alcohol or drugs becoming more important in their life?” because, for us, that’s the question that tells us where a young person is headed.
The truth is that not every teenager who uses alcohol or drugs develops an addiction. Some experiment and stop. Some abuse substances for a period of time without ever becoming dependent. Others gradually develop a dependency that eventually grows into addiction. Those differences are real, and they’re important when we’re planning treatment, but they don’t change one thing we’ve believed for a very long time. Every one of those young people deserves help.
We knew a young man named Mark who was fourteen years old. People would sometimes joke that he was barely rude to a drug, meaning he had only gotten high a handful of times. In their minds there was no way he could really have a problem yet. Mark didn’t see it that way, and neither did his parents.
The problem wasn’t that Mark had years of substance use behind him. The problem was that he would do almost anything to fit in. If someone offered him five dollars to do something stupid, he’d probably do it. He took extreme risks, rarely thought about the consequences, and desperately wanted to feel accepted. He wanted to belong, and he was willing to do just about anything if he thought it would help him find that connection. Alcohol and drugs weren’t the whole problem. They were simply one more symptom of what was already going on inside him.
Technically, Mark didn’t meet the clinical definition of addiction. You could have called him an experimenter or a substance abuser, but none of those labels changed the fact that he was a fourteen-year-old headed in the wrong direction. More importantly, he had something many young people don’t have until much later. He had a willingness to stop.
Willingness matters because recovery cannot be forced into a young person from the outside Parents can set boundaries, create consequences, and seek help, but the real work begins when a young person becomes even a little bit willing to tell the truth, take action, and try something different. Mark’s story matter not because the substance was severe, but because his willingness gave recovery something to work with..
Because Mark’s willingness, he worked a modified version of the Twelve Steps, just as we do with most teenagers. He was able to identify at least a part of his life that had become unmanageable, and he threw himself into recovery. As he did, we watched him begin finding the things he’d really been looking for all along. He developed healthier friendships, made better decisions, found people who accepted him, and discovered he didn’t have to risk everything just to feel like he belonged.
When Mark graduated, we faced an interesting question. Most of our graduates continue their recovery in AA, NA, or CA, but because his history of substance use was so limited, it wasn’t immediately obvious where he fit. When we asked him what he wanted to do, he didn’t hesitate.
He smiled and said, “I’m just going to go to AA. Working the Steps has made my life better.”
That conversation took place more than ten years ago. Mark still goes to meetings. He still enjoys recovery, and he’s still living the principles he started learning when he was fourteen. We’ve often wondered what might have happened if someone had told him, “You don’t qualify yet. Come back after you’ve done more damage.” Thankfully, nobody did.
That’s why we’ve never been comfortable telling a teenager their story isn’t bad enough yet. We don’t ask someone with cancer to wait until it reaches Stage 4 before recommending treatment, and we don’t think young people should have to earn the opportunity to recover by accumulating enough pain to satisfy a definition. Some of the worst consequences happen long before someone meets the clinical definition of addiction. It doesn’t take an addict to overdose. It doesn’t take alcoholism to get behind the wheel after drinking and change someone else’s life forever. It doesn’t take years of substance use to lose a scholarship, destroy trust at home, damage an important relationship, or make a decision that follows a young person for the rest of their life.
One of the lessons we’ve learned over the years is that alcohol and drugs don’t really care what we call the problem. Whether someone is experimenting, abusing substances, becoming dependent, or living with an addiction, the consequences continue moving in the same direction if nothing changes. That’s why we’ve always believed the earlier the investment, the higher the return. We’d much rather meet a family while they’re asking, “Is this becoming a problem?” than years later when they’re asking, “How did things get this bad?” Early intervention gives young people the opportunity to change direction before alcohol or drugs become the organizing force in their lives.
At the end of the day, we’re much less interested in finding the perfect label than we are in helping a young person’s life move in a different direction. If alcohol or drugs are becoming more important than family, school, friendships, responsibilities, or the future they once wanted, that’s enough for us to begin helping. We’ve never believed a teenager should have to lose everything before they deserve the opportunity to find something better.
The Tack in the Foot
Bob Meehan had a way of teaching that made people remember stories for the rest of their lives. He didn’t usually begin by explaining an idea. Instead, he’d smile, lean back in his chair, and say, “Let me tell you a story.” Before you knew it, everyone in the room understood exactly what he was trying to teach.
One of Bob’s favorite stories started with a famous rap artist coming to St. Louis for a sold-out concert. The place was packed with teenagers. The music was loud, the lights were flashing, and everyone wanted to be just like him. About halfway through the show, the rapper was exhausted from performing. Someone brought a chair out onto the stage so he could sit down for a minute. As the audience watched, he slowly took off one of his shoes, then pulled off his sock. He reached down beside the chair, picked up a thumbtack, held it high enough for everyone to see, and then pushed it straight into the heel of his foot.
The entire crowd cringed. People covered their eyes, others yelled out in disbelief, and everyone wondered what in the world they had just witnessed. The rapper never reacted. He calmly pulled his sock back on, slipped his shoe over the tack, stood up, and finished the concert. If you watched carefully, you could see a slight limp, but otherwise he acted like nothing had happened.
A few days later, a teenager named Billy was sitting on the bleachers during gym class. Billy had been at the concert, and he happened to be one of the popular kids at school. During a break he took off one of his shoes, pulled off his sock, found a thumbtack, and pushed it into the heel of his own foot just like the rapper had done. Then he put his sock back on, tied his shoe, stood up, and went back to gym class. He walked with a little limp, but otherwise acted as though everything was perfectly normal.
A couple of weeks passed before Billy came home complaining that his knee hurt. His mom didn’t think much of it. Like a lot of parents, she figured it was probably growing pains, handed him a couple of Advil, and told him to give it a few days. When the pain didn’t improve, she finally scheduled an appointment with the doctor.
Bob always described the doctor’s office the same way. It was a little run down. The carpet was worn, the furniture had obviously been there for years, and one of the fluorescent lights flickered every now and then. After examining Billy’s knee, the doctor smiled and said, “I think a knee brace is exactly what you need.”
Billy wore the brace, but a few weeks later he came home complaining that now his hip hurt. Once again his mom assumed it was probably just part of growing up. She gave him a couple more Advil, waited a few days, and when that didn’t help, she made another appointment.
This time, as they walked into the office, Billy’s mom noticed something had changed. The lighting had all been replaced, and the place looked a little nicer than it had before. The doctor examined Billy, nodded thoughtfully, and said, “You know, it’s amazing how many young people are coming in with hip pain these days. I think it’s time we got you a cane.”
Billy couldn’t imagine walking through the halls at school with a cane. Seeing the look on his face, the doctor smiled and said, “Don’t worry. You’ve got great insurance. Come downstairs with me.”
The doctor led Billy into the basement, where there was an entire room filled with canes. Bob always compared it to one of those old department store tie displays. You’d press a button, and the whole rack would slowly rotate so you could look at every option before making your decision. Billy watched cane after cane come around until he spotted one with a dragon wrapped around the handle and bright red eyes.
“That’s the one,” Billy said. “If I have to carry a cane, I might as well have a cool one.”
So Billy went back to school carrying a dragon cane.
A few weeks later his hand began hurting from using the cane. Calluses had formed, and they were becoming pretty painful. His mom tried the same routine she’d used before. She gave him some Advil and hoped it would get better. When it didn’t, she scheduled another appointment. While she was talking to one of her friends about Billy, her friend suggested it might be time for a second opinion. Billy’s mom agreed that wasn’t a bad idea, but since they already had another appointment scheduled, she figured they’d just see what this doctor had to say first.
The doctor looked at Billy’s hand and immediately knew what to do.
“I’ve got the answer,” he said. “You need a glove.”
He reminded Billy that he still had excellent insurance, so down to the basement they went again. This time Billy picked out a nice leather glove that matched his dragon cane perfectly. He walked out of the office convinced they were finally getting somewhere.
A few weeks went by, and now Billy came home complaining that his shoulder hurt. By this point, his mom was getting pretty used to hearing that something new hurt every few weeks. She did what she’d done before. She gave him a couple of Advil, figured maybe it would work itself out, and hoped this would be the one that finally got better on its own. It didn’t. So she called the doctor’s office and made another appointment.
When they walked in this time, Billy’s mom almost couldn’t believe she was in the same building. The old carpet was gone. Beautiful new flooring had been installed, the furniture all matched, and everything looked clean, modern, and expensive. It was a far cry from the little dingy office where they’d started several months earlier.
The doctor came in, listened while Billy explained that now his shoulder was hurting, nodded his head a few times, and said, “I think I know exactly what’s going on. Why don’t we move the cane over to the other side so you’re not putting so much stress on this shoulder, and we’ll put this arm in a sling for a while.”
Billy figured that made sense. After all, the doctor had been right about everything else so far. They put his arm in a sling, switched the cane to the other hand, and sent him on his way.
A few more weeks passed, and now Billy started getting terrible headaches. Not just once in a while, either. They were becoming more frequent, and they were bad enough that his mom finally started wondering if maybe they needed to look somewhere else for answers.
She was talking to one of her friends about everything Billy had been dealing with, and her friend finally said, “Have you ever thought about getting a second opinion?”
Billy’s mom admitted she probably should. She already had another appointment scheduled with their regular doctor, but she decided after that appointment she’d try someone new.
The regular doctor really didn’t have anything different to offer. Billy was using the knee brace, using the cane, wearing the leather glove to protect his hand, had his arm in a sling, and now he had headaches. They talked about a few possibilities, adjusted a couple of things, and Billy’s mom left more frustrated than when she’d arrived.
A few days later they walked into another doctor’s office. It wasn’t nearly as fancy as the first one. Nothing matched. The furniture was just ordinary office furniture, and while everything was clean, it certainly didn’t look like a place that had been making a fortune selling knee braces, dragon canes, leather gloves, and slings.
The doctor spent quite a while talking with Billy. He asked when all of this had started, what had happened first, and how one problem seemed to lead to another. Then he asked Billy to stand up and walk across the room.
Billy slowly walked across the office carrying his dragon cane, wearing his leather glove, with one arm resting in a sling.
About that time Billy’s mom said she needed to use the restroom, so she stepped out for a minute.
The doctor walked over to Billy, knelt down, looked at his shoe, and said, “Billy, would you mind taking your shoe off for me?”
Billy took off his shoe. “Now your sock.” Billy pulled off his sock. The doctor looked at him and smiled.“Billy, you’ve got a tack sticking out of your heel.” Billy looked right back at him and said, “I know.”
The doctor laughed a little and said, “Well, if you take the tack out, your knee will quit hurting. Once your knee gets better, your hip won’t have to compensate anymore. Then you won’t need the cane. If you don’t need the cane, your hand won’t keep getting calluses, so you won’t need the glove. Once you’re not leaning on the cane all day, your shoulder will settle down, and before long your headaches will probably disappear too.”
Just then Billy’s mom walked back into the room. She could tell by the look on Billy’s face that something had happened.
“What’s going on?” she asked. Billy answered before the doctor could. “He wants me to take the tack out.” His mom looked at the doctor like he had completely lost his mind.
“We’ve spent months trying to figure this out,” she said. “He’s had appointments, braces, a cane, a glove, a sling, and now you’re telling us the answer is taking a tack out of his foot?”
The doctor simply smiled and said, “Yes, ma’am. That’s exactly what I’m telling you.”
Billy shook his head, “I’m not taking it out.”
His mom agreed with him. They got up, walked out of the office, climbed into the car, and drove right back to the first doctor because they were convinced this new doctor didn’t know what he was talking about.
Meehan would then look at the audience and very loudly yell “take the tack out, we have got to stop treating the symptoms and get to the root problem.”
What We Learned
Everything we’ve talked about in this chapter eventually led us to one conclusion that changed the way we looked at recovery.
Long before we were working with teenagers and young adults, we were trying to figure out our own recovery. Like most people, we thought recovery meant learning how not to drink or use drugs. It didn’t take us very long to realize that simply removing the alcohol or drugs wasn’t enough. We were still the same people we had been the day before. We still had to learn how to live. We had to learn how to build healthy relationships, how to be honest, how to ask for help, how to take responsibility for our lives, and how to find purpose without relying on a substance to get us there.
When we eventually began working with teenagers and young adults, we weren’t trying to create a treatment philosophy. We were simply sharing the things that had helped us. As more young people and families came through our doors, we started noticing the same patterns over and over again. Young people responded when recovery became more than avoiding alcohol and drugs. They responded when it gave them connection, responsibility, purpose and a way to feel comfortable in their own skin. Little by little, those experiences became the foundation of what is now known as the Enthusiastic Approach.
Somewhere along the way, we realized we’d been asking the wrong question. The question was never, “How do we get a young person to stop getting high?” The better question was, “How do we help them build a life where getting high no longer solves the problem?” That one question changed the way we looked at almost everything. Instead of focusing only on taking something away, we began focusing on helping young people find something better.
That’s why you’ll probably notice this book spends less time talking about alcohol and drugs than you might expect. Alcohol and drugs matter, but they aren’t really the point. The more important question is why they became so important in the first place and what can take their place once recovery begins. That’s the journey we experienced ourselves. It’s the journey we’ve had the privilege of walking with thousands of teenagers, young adults, and families, and it’s the journey we’ll continue exploring throughout the rest of this book.
As we close this chapter, there’s one more thing we hope every parent hears because it’s something we’ve been saying for more than fifty years. You didn’t cause it, you can’t control it, and you can’t cure it. Addiction has a way of convincing parents that if they had just loved their child more, parented differently, made stricter rules, not dropped him when he was a baby, or made better decisions, none of this would have happened. We’ve never found that to be true. We’ve worked with wonderful parents whose children struggled with addiction, and we’ve worked with deeply dysfunctional families whose children never developed a substance use problem. Life is rarely that simple.
What you can do is learn. You can begin to understand what your teenager or young adult is experiencing. You can learn to respond instead of continuing to react. You can stop carrying responsibility that was never yours to carry, and you can become part of a recovery process that offers real hope. None of those things will guarantee the outcome you want, but they will change the way you walk through it, and they’ll put you in a much better position to help when your son or daughter becomes willing to accept it.
At the beginning of this chapter, we asked why a teenager or young adult would continue using alcohol or drugs even as the consequences kept piling up. We hope the answer makes a little more sense now.
They’re usually not choosing alcohol or drugs over you. They’re choosing the relief they believe alcohol or drugs provide. That doesn’t make the choice any less painful for the people who love them, but it helps explain why consequences alone so rarely solve the problem.
Addiction has a way of convincing parents that if they had loved their son or daughter more, parented differently, made stricter rules, made fewer mistakes, or somehow done everything perfectly, none of this would have happened. We’ve sat with thousands of parents carrying that weight, and we’ve learned that guilt rarely helps families move forward.
Before we can begin talking about recovery, though, we have to make sure we’re treating the right problem. If alcohol and drugs are the tack, then no amount of treating the limp will ever solve what is really causing the pain.
For more than fifty years, we’ve been asking a different question. Once we recognize what the real problem is, how do we help a teenager or young adult become willing to do something about it?
That’s where our story really begins.
Tack in the Foot
© 2026 The Enthusiastic Approach Staff