Dealing with a prescription drug addict
Posted Jul 31, 2012
I'm sure we are all aware of the problem that our society faces because of drug addiction. In New England, and specifically in Maine, addiction to prescription medications is a major problem. If you accept the Stages of Change Model and apply it to drug addiction, whether it be nicotine, as we discussed in a previous blog, or oxycodone, motivating the addict to make a decision to change their behavior is key.
Motivational interventions have changed over the years. In the old days, the primary mode of intervention with drug addicts was often confrontation. Today it is more collaborative rather than confrontational and often begins with the current concerns of the individual addict and evaluation of their readiness for change. Connecting the motivational intervention to the core values of the individual requires that you understand what those core values are.
Being ready, willing and able to change requires personal strength and self-control. As DiClementi pointed out in a recent workshop I attended, this may be what people mean when they talk about the strength of character and willpower. As I have pointed out in previous blogs, self-control is not a limitless resource and must be conserved. It can be increased and strengthened by exercise of self-control, but these gains need time to be consolidated.
Working with someone with an addiction problem requires considerable patience. Offering empathy, hope and support is just as essential with someone abusing prescription drug as it is with someone attempting to stop smoking.
Working the dissonance between the life a person is leading and the life the person would like to lead is also now an important part of motivating change in the addict. It is also important to consider the situational resources and problems that a person brings to the table. This obviously involves looking carefully at the interpersonal resources and support that they have and the problem relationships in which they are engaged. Families can facilitate recovery or be a major hindrance in the recovery process.
This is also true for what people think and believe. Understanding what people have learned about themselves and the world and who they learned that from, e.g., who their role models are and have been, is another part of the process of helping people to recover from an addiction that may one day kill them. Considering the context in which they are trying to make the change is just as important as understanding the stage they are at in this change process. Persons with a strong addiction do not change because they want to, but because they are motivated to want to.
For those of you who are working with individuals who are attempting to change or for those of you who are attempting to make changes in your life, whether it is giving up an addiction or a really bad habit, I would encourage you to take a look at Changepowr! by Meg Selig. This book was recently published and received very good reviews by James Prochaska, one of the authors of the Stages of Change Model, and others, myself included. It looks in some detail at the stages and processes of change and provides specific activities and exercises that make the processes of change much more understandable and easier to apply.