If someone you care about is using drugs or alcohol in a way that’s threatening their health, relationships, finances, career, and perhaps even their life, you no doubt feel overwhelmed and desperate to help them come to their senses.
But in order to truly help those who have lost control, it’s important to understand some of the realities of addiction:
1. It’s not about you. It can be tough for loved ones, especially parents and significant others, not to take addiction personally. It’s not unusual to think that something you did caused them to use drugs or that you could’ve spared them from harm if only you did things differently. But their addiction is not about you. Guilt isn’t productive for anyone’s healing, but your involvement in their treatment and recovery can give them much-needed strength and support. Practice forgiveness and let go of the past so you can have that new beginning you have all worked toward.
2. Detox does not equal treatment. It’s a common misconception that all an addict needs is to detox and get the substance out of their system, and then they’ll be able to stop using. Addiction is a disorder of the brain’s reward circuitry that erodes a person’s self-control and ability to make decisions in their own best interest. This isn’t a change that can be reversed overnight. It takes time and repeated effort for new thought and behavioral patterns to replace the old. Being aware of this up front can help all of you summon the patience you will need to travel the path toward recovery.
3. No one expects to become addicted. Addiction starts with a choice — a choice to use a drug or take a drink. But that’s a choice many of us have made without becoming addicted. In fact, about five out of six people who try a drug will not get hooked on it. So why does substance use become a problem for some people and not for others? There is no easy, single answer, but researchers believe it comes down to a combination of genetics, trauma from childhood, and other psychiatric problems, such as anxiety, depression, and bipolar disorder. By the time a person is addicted, their behaviors are conditioned, and the brain changes that have occurred make stopping seem like an impossibility.
4. The fact that someone has started treatment does not mean they have decided to quit. No one wakes up in the morning thinking that today would be a good day to quit. Usually they are brought to treatment because of the consequences of their addiction: They lost their job. Their spouse has left or is threatening divorce. They overdosed or are facing a medical crisis. Even with these storms brewing, someone with an addiction has to believe that their life will be better off of drugs than on them to start down the difficult path of recovery.
The first goal of treatment is to help people find their own motivation to make the changes needed. The commitment to change is not an all-or-nothing process. The person will likely do a lot of bargaining with themselves and everyone else: I don’t really have an addiction. I lost my job because my boss was unfair. I don’t have to quit, I can just use less. If your loved one could just choose not to use, they wouldn’t need treatment.
5. Deceit goes with the territory. Your loved one is going to lie to you, and you will want to believe them. They might actually believe it themselves. But what they are doing is protecting their illness, because their substance has come to seem as vital to them as air. This isn’t to say that you should excuse lying, only that you should understand where it’s coming from so you can take it a little less personally and avoid getting sidetracked by pain and resentment. Instead, keep the lines of communication open, but set clear boundaries that protect you and them, and that encourage a turn toward treatment.
6. People relapse for a reason. In many cases, substance use starts as a way of self-medicating distressing feelings brought on by conditions such as depression, anxiety, or trauma. These co-occurring disorders, as they are called, are common, and when someone with addiction suffers from depression, anxiety, or insomnia, they are much more likely to relapse. About a third of people with a diagnosable mental health condition, and about half of those with a severe mental health condition, have some form of substance use disorder, research shows us. Treating the whole person is critical to success.
The good news is that a variety of techniques and therapies can help — cognitive behavioral therapy; EMDR, which uses eye movement to stimulate the brain into processing negative emotions; and medications such as antidepressants, among others. The key thing to remember is that in order for your loved one to deal with one issue, they must deal with the other.
7. You can’t do it for them. There’s nothing more painful than seeing someone you love hurt themselves and those around them. Your natural reaction will be to shield them from the negative consequences of their actions. But picking up the pieces sometimes delays healing and extends the suffering for all of you. Instead, help them want to help themselves. For example, you can make it clear you won’t support them financially, but that you will be ready at a moment’s notice to get them to the treatment they need. You can also:
• Speak with an addiction professional. Their guidance can reduce your pain and strengthen your resolve.
• Look after yourself. It does no one any good if your loved one’s battle with drugs or alcohol takes you down as well. Support groups such as Al-Anon and Codependency Anonymous provide a place where you can learn from others who have walked in your shoes.
• Don’t give up hope. A recent Surgeon General’s report on alcohol, drugs, and health noted that there are approximately 25 million people in active remission from addiction in the U.S. Addiction can be terrifying, but it can also be overcome.
David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. As chief medical officer of Elements Behavioral Health, he oversees a network of addiction treatment programs that includes The Right Step in Texas and Clarity Way drug rehab in Pennsylvania.