A few adolescents and young adults ask for help themselves because they feel so sick, guilty, or frightened that they don’t know where to run. An Illinois high school student on cocaine and alcohol went to his school counselor and said, “I think I’m going crazy. Help me.” But it is much more common to have parents propel their child into treatment while that child is still trying to con everyone into thinking there’s nothing wrong. Some kids do not give in until you are at your wit’s end.

The experts disagree about the best way to get your child to an assessment interview or into treatment. Some say, ‘She has to come willingly”; others say, “Use every trick you can think of if that’s the only way.” Here is a checklist of alternatives for you to consider for your own child:

1. Give him an ultimatum that he must go for help or be confined to home. One father told his son he couldn’t go out the door until he went with him first to the local counseling center. The boy was petulant and angry, but he knew the only way out of the house was to go with his father. If you use this method, be sure you not only mean what you say, but are able to carry it out.
2. Withdraw any and all financial support—allowances, chores that are rewarded with cash, cash presents, etc. (The danger here is that your child may start dealing in drugs to get money.)
3. Impose strict sanctions. When asked what she would do if her child flatly refused help, Carol Burner (whose daughter had a drug problem) said, “Then we’ll make it as rough as possible at home. We’ll take away any belongings of value. We will ensure that they only go out to attend school and we will alert the school to the problem. If they get busted, we’ll let them spend a night in jail. If they run away, we will report them no the police. If they’re old enough to support themselves and insist on using drugs, our home will be closed to them. In short, we will only support a desire for help, not dope.”
4. Get help for yourself so you can act more forcefully. A counselor says, “Many of the parents we see practice ‘crossed-finger parenting.’ They try something and hope it will work. We give them back their parenting power and show them how they can get their child to come in.” Formal intervention, in which a counselor, the family, and friends meet with the drug abuser and present him or her with objective evidence of the harm the dependency is causing, is less common for teenagers. However, it can be very successful with young adults and is described in detail in Vernon Johnson’s book Intervention: How to Help Someone Who Doesn’t Want Help.

Sometimes parents have to use desperate measures. A mother tricked her child into joining a treatment program by telling him they were going to look for a secondhand television set. Once inside the unmarked building, he was whisked back to an interview room. A father captured his daughter and drove her to the hospital after “I tried everything. She had been drinking since she was fourteen and couldn’t stop. At fifteen she was failing in school, not coming home nights. A school counselor told me about an inpatient program. I talked to them and we decided that was where she belonged. My son and I went to get her at school without telling her, and found her already outside, cutting classes. My son raced her down an alley, caught her, and forced her into the car. She’s now been sober for three months.”

Although these drastic, controversial approaches are not for everyone, they should be considered if you are stuck. You may have to act while your child is still reluctant, and the time when he is finally motivated to change may not come until treatment has been going on for some time. When a child is using drugs or alcohol he cannot make clear decisions in his own best interest.