The Revolutionary Question to Ask People with Drug Problems
Instead of harping on the harm, get to the heart of the matter.
Posted August 17, 2020 | Reviewed by Lybi Ma
I would argue that asking about “likes” or reasons for the love of alcohol or any other drug is probably the most important question a counselor or helper can ask a person who has a drug problem. This is the exact opposite of the generally accepted approach, which is to begin discussions with a focus on harm, hoping to motivate change. The assumption is that if people knew about and fully grasped the extent of the harm from their drug use, they would surely quit. This, however, we know isn’t true. Usually, people with drug problems are substantially informed and alarmed about the harm. They continue using despite this knowledge; some of them requesting help and others not. What is most interesting from the helper’s perspective is: Why do people continue to indulge despite their knowledge of the harm? What is so compelling? To get to the heart of the matter, the truly revolutionary question is: “What do you like about drugs?”
Traditionally-trained counselors resist asking about drug benefits and consider it dangerous: “I don’t want to trigger or enable drug use.” First off, clients don’t need to come to a counselor to be triggered. That can happen anywhere, anytime. Triggers are all around them. The real challenge is helping them learn to deal with triggers. Second, helping people understand what they like about drugs – what motivates them to use drugs – is all about increasing self-understanding, which is something completely different from granting approval or encouraging indulgence. In fact, it is a very important part of the process of making decisions to change.
Rather than being helpful, focusing on harm generally elicits defensiveness. Individuals with drug problems see such probing as a power play; with people around them trying to talk them into something and control their lives. It can be insulting, too, as in: “Look at what you’re doing to yourself (stupid).” It creates an oppositional relationship.
In contrast, when people with drug problems are asked what they like about drugs, they usually seem surprised and say, “No one ever asked me that before.” Some of them actually say: “Finally someone who wants to listen to my point of view.” They recognize that someone is curious about them and their thinking, and not merely dedicated to trying to convince them to quit. This helps form an alliance – a sense of partnership and support that will be appreciated. It also helps in three other substantial ways.
Asking people what they like about drugs helps them validate their own experiences. They might start by saying they like drugs “because they feel good,” but as they dig deeper into answering this question, they uncover a meaningful explanation of why they are doing what they are doing, without attaching shame or judgment. They might, for example, come to realize that drugs “feel good” because they help them relax in social situations, or fall asleep at night, or overcome boredom, or manage anger, or cope with pain and depressed moods. They will see that their drug use has been an attempt to cope with life; not a result of stupidity or shameful impulses.
With an understanding of drug benefits, people are in a position to make fully-informed decisions about their drug use. They will clearly understand what they would be losing and why it will be a big challenge to succeed if they were to decide to quit or set new limits on their drug use.
A full understanding of what they would be losing helps people prepare for making changes and consider how they will take care of themselves without drugs or with less of them. For example: “How will I cope with stress if I stop drinking (or drink less)?” In this sense, it helps them carve a pathway to successful change.
People with drug problems have been beaten to death by probing discussions about the harm from drugs. It’s time to give them something they can use: Ask them what they like about drugs. This is not a setup question to get to the harm. It’s an empowering question that helps them understand and take control of their lives, including their drug use.