frosty - if your teen age son is 5'9" and down to 100 pounds while testing + for cocaine and other drugs, you can and probably should get him in a hospital. Call your department of mental health and tell them you need a parent advocate to help you negotiate the court system and you need advise on getting your son admitted to a hospital for substance abuse that has reached life threatening levels. Take tons of notes and make sure they know your taking notes during each contact by phone or in person. This will help you keep straight who said what and also make them aware there is a record of the conversation. A tape recording is a good idea if you can manage it. This could be valuable if they stonewall you. If your telling the truth your son needs medical care and you may need the court system to help you get it, so get busy. Going the "easy" route by paying for one of these private for profit placements would be a terrible mistake. A boy as frail as your son may now be could be easily killed in the standard synanon style program.
[I know I probably seem like Maia Szalavitz's publisher - but you might want to get your son a copy of Recovery Options.
http://http://www.amazon.com/Recovery-Options-Complete-Joseph-Volpicelli/dp/047134575X
We've been going down this road with him for a long time. I appreciate your suggestions, unfortunately I have tried the mental health department option and there is no help forthcoming. As I mentioned before, I have tried to involve the court system as well as probation but these systems are overwhelmed and no help. He has been cited twice for non-drug related offenses in the past 7 months and is still not on probation. I know the probation officer his case will hopefully be sent to and she is a great resource but unable to do anything offically until his file is on her desk. He has been hospitalized before but in California cannot be hospitalized against his will unless on a 5150 involuntary hold (danger to self or others, meaning basically suicidal or violent.) He went to inpatient treatment in January but didn't finish the program. Since drug treatment programs are voluntary for minors in California I have no way to compel him to get treatment without sending him out of state. It comes down to the fact that he has the right to refuse treatment and does so, even though he is basically killing himself. I am not new to this, as we have been through many types of treatment.
Someone else mentioned that the problem was "diagnosis shopping" or something to that effect. He was already doing cocaine when he got busted twice for selling pot at school in 9th grade. He was also hospitalized the summer before because he basically flipped out. This was in Washington state, where again, kids over 12 cannot be hospitalized involuntarily unless they are on a psychiatric hold. At the time he met the criteria and was in the psych ward for three weeks. As far as a diagnosis went, none was forthcoming since they could not catagorically say that his mental condition was NOT caused by drugs. Since then I have found that hospitals will not admit if there is a possibility that symptoms are related to drug use. Psychiatrists are equally unwilling to treat kids on drugs.
To sum up, this forum is far from the first place I have looked for help for my son. I have probably spent thousands of hours reading, in therapy, attending parenting groups, courses, and Al-Anon. My son has seen many therapists, psychiatrists, and been through intensive DBT (dialectical behavioral therapy.) I do not want to institutionalize my son but I also do not want him to die as a result of his addiction. I belonged to a support group for parents of children like my son. As you probably know, there are much worse cases. I stopped going after a while because it was so depressing. The thing that most struck me was the near complete lack of success stories. Almost no one's child got better, whether they went the "troubled teen industry" route or not. Ditto Al-Anon. That was probably the most heartbreaking as the addict "children" of one group were in their 50's!
So if I am unable to help my son what can I do? By the way, both the police and the probation officer suggested therapeutic boarding school as one of two options they knew of that had any success with kids like mine. The other was to take away absolutely everything: no phone, no computer, no bed, no door on his room and only one change of clothes. Anyway, I will read the book you mentioned, as I don't think I have read it yet. Perhaps there is something in there I haven't come across yet.