We are nations in crisis. There is hardly a family that has not been affected by addiction. The statistics on the matter of opioids, alcohol and marijuana are alarming:
- 105 US and 23 UK lives (the highest in Europe) lives are lost each day to an opioid-related overdose
- At least 1 in 8 people in the US and UK experience an alcohol addiction
- 16.2% of americans smoke marijuana as legalisation rolls out, the 2nd-highest rate in the world; in the UK, only 6.2% admit smoking it.
What can we do? I am a fierce advocate for systemic change on the micro (individual), mezzo (family) and macro (community) levels. In the wake of our national drug crises, action must be taken to help loved ones and their families achieve health and wellness. In this article, I’ll start by describing what addiction is. Then, we’ll look at what not to do: bail out your loved ones. I’ll guide you through the 7Cs of change, to end on a note of hope. First know this: if your loved is caught up with drugs, you did not cause it.
Let’s begin with unpacking a definition of addiction. Addiction is defined as a “chronic, relapsing brain disease characterised by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain. These brain changes can be long-lasting, and can lead to the harmful behaviours seen in people who abuse drugs. Addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of the underlying organ, have serious harmful consequences, and are preventable and treatable but, if left untreated, can last a lifetime”.
Addiction is typically characterised by any combination of the following: dysfunctional emotional response to experiences and circumstances, inability to quit the drug and stay quit, cravings, impaired behavioural control, impaired ability to see problems with one’s behaviour and impaired ability to see problems in interpersonal relationships. Addiction takes many forms from alcohol and other drugs to process disorders. Consider the following list of possible non-drug addictions: eating disorders, gambling, love, sex, shopping – even digital addiction. These addictions often overlap and the difference between them and substance use disorder can be blurred. And they can twirl with other co-occurring (mental health) disorders.
Addiction creates a volcano effect.
Like a volcano that slowly and steadily builds pressure, steam and corrosive lava, addiction erupts with a powerful force and disrupts families and friends, colleagues and associates, business partners and co-workers. And because one form of addiction bleeds into another – co-occurring mental health disorders such as depression, anxiety, personality disorders, juxtaposed with medical problems such as chronic pain, legal or school issues – many family members feel like they are constantly caught in pent-up destruction and despair. They struggle to find a quick fix with the next bail out for a loved one or for an employee. Emotions hiss and pop. However, a heated concoction of nagging, pleading, begging, lecturing, or screaming will not work.
Add to this… chronic pain issues.
There are over 133million people in the US and almost 28million in the UK – 1.5billion worldwide – who experience chronic pain. This is often treated with a prescription pain killer, an opioid that is highly addictive. Substance use disorders often start with a simple prescription. Whether or not someone is “addicted” is confusing to many family members. They believe their loved one’s problems have a firm medical rationale.
Chronic pain is clinically defined as “pain which is persistent and lasts more than 3 months”. Our bodies are designed to heal in 90 days; after that, emotions fuel our pain. Our thoughts and feelings drive us into the belief that we need painkillers. University of Arkansas findings in 2016 on opioid use are alarming: with a 10-day supply of opioids, 1 in 5 become users a year later.
Families can make addiction worse.
Families often respond to addiction in ways that do not help anyone. They become codependent. In fact, addiction and codependency become soul mates… holding each other hostage. Codependency is defined as “excessive emotional or psychological reliance on a partner, typically a partner who requires attention due to an illness or an addiction”. A codependent relationship causes the loved one of the person experiencing addiction to make excuses for their behaviour. I don’t really like the term “codependency”. Instead, I call this phenomenon “the ultimate bail out”. But bailing out a loved one is counterproductive. You fuel the addiction. You get in the way of progress.
How can you know if you are making an addiction worse? Below are signs to look for:
…“No” is not part of your vocabulary
…Always saying “yes” to whatever is asked of you
…Apologising to others for your loved one’s behaviour
…Calling work, school, or rearranging appointments for your loved one
…Difficulties showing intimacy
…Difficulty setting limits or boundaries
…Feeling anxious and fearful about being abandoned or rejected
…Feeling responsible for a loved one’s problems
…Feeling trapped in your relationship
…Giving money or not realising money is missing from your wallet
…Keeping addiction a secret
…Lying to the person so as to hide the truth
…Making excuses for your loved one
…Making up stories about why your loved one is the way s/he is
…Needing to be in control
…Needing to look good to the outside world.
If you or a loved one are also in a relationship with someone who has a substance abuse or mental health disorder, below are some more common behaviours you might be taking on.
…Accepting that the situation will not change: “It’s just this way”
…Being a martyr: “Look what I do for her”
…Being a victim: “Look what s/he has done to me and our family. Poor little me”
…Being unable to distinguish the difference between you and your loved one’s problems
…Blaming situations or other people instead of the addicted loved one: “He has such a tough boss” or “She has a mean teacher”
…Blaming your loved one who has an addiction for everything that’s not right with your life
…Feeling angry and resentful about someone’s behaviours and still bailing them out
…Feeling angry with righteous indignation towards the person
…Finishing your loved one’s sentences for them
…Ignoring the addicted individual’s negative or dangerous behaviours such as stealing, lying, fighting, or legal trouble
…Not being able to label your feelings beyond mad, sad or angry
…Putting the addicted loved one’s needs first
…Refusing or denying there is a problem
…Repeating that “everything is alright”
…Inability to share, know or express feelings
…Using excessive “we” terms, rarely “I” or “me”.
Change is possible: change agreements.
Despite the destructive and painful reality of addiction and its grip on circles of families, friends and business associates, change is possible. There are several parts to this. The first is to learn about substance abuse, process disorders, mental health
and chronic pain. The second is that you need not be part of the problem – be the solution! Let the 7 Cs guide you to a new way of being:
- You did not Cause your loved one’s addiction
- You alone cannot Cure the addiction
- You alone cannot Control the addiction
- You can take better Care of yourself
- You can learn to Communicate your feelings
- You can make healthier Choices
- You can Celebrate yourself and your growth.
The third aspect of change is creating healthy boundaries for you and your family members and the loved one with addiction. Here are questions that need to be asked related to building honest and healthy boundaries:
> What is okay behaviour and what is not okay?
> What was okay before treatment and how has that changed?
> What was not okay before treatment and how can you make it better this time?
> What gets confusing?
I always tell the families I work with that they must be able to wake up each morning, look themselves in the mirror and know that they are worthy and can stick to the boundaries they have set and their personal recovery map. To assist in this process, clients and families can collaboratively develop Change Agreements to help guide the way.
These are written documents in which a person clearly articulates what they are willing to do to support their loved one in recovery. Plus, you get to define ways in which family members are going to do to take care of themselves. Change Agreements often include family members attending Al-anon and other support groups and/or professional counselling as well as setting firm limits on their financial and other types of supports for recovery. Expectations are concisely articulated. For example, a loved one could engage in treatment as outlined by a professional. This usually includes randomised drug testing, attending meetings, attending intensive outpatient treatment.
The key notion is that healthy boundaries are critical for personal health and happiness. Once a loved one experiencing addiction seeks treatment, all family members, friends and colleagues and business associates must take a hard look at their own behaviours and re-draw these boundary lines to find change.
Fourth, it is of paramount importance for the codependent to begin to take care of themselves, physically and emotionally. Turn to your personal values to find strength. This might come in the form of spirituality or a connection with a higher power. Al-anon, other support groups, meditation, mindfulness, exercise and social bonding aid in the healing process. Lastly, movement starts with a willingness to change, sprinkled with fierce love and commitment to family and loved ones, coupled with the tools necessary to change. When those are in place, family members (you) no longer have to travel a pity path that leads to cajoling and bargaining, no longer will you mortgage your home or blame others or pivot your life around trying to stop your loved one using.
You can help your family with addiction.
I am here to proclaim, announce, shout that you can overcome the sleepless nights, the GPS tracking of cell phones, you can relinquish the baited breath waiting for that overdosed unconscious voice on the phone that disrupts your 4am reverie. There is no need to start and finish everyone’s sentences or be an indentured to the endless employment of the royal “we”. You no longer have to make up false stories in your head about where your loved one is or is not, nor do you have to sign that a medical marijuana card for your 15 year old is OK.
You can unequivocally tell the truth without shame, guilt, fear, humiliation or fear of recrimination and a scapegoating that you are the bad sister, mother, father, brother, husband, wife, partner, lover, grandparent, business manager, or personal assistant. Because now you know you do not have to have all the actions. Now you can take positive action.
Be the warrior! Be strong. Be vunerable and be the non-codependent YOU!