If you have a family member who is struggling with addiction, you may be familiar with the erratic and unpredictable behavior that often accompanies drug abuse.
Your loved one is not in control of their behavior, and they can’t just stop drinking or using because they want to. They need treatment, and you can help them connect with that help.
Addiction is a chronic disease of the brain. The National Survey on Drug Use and Health (NSDUH) reports more than 20 million Americans struggled with it in 2016.
Drugs and alcohol make changes to brain chemistry that can impact impulse control, emotional regulation, motivation, and decision-making processes. When mind-altering substances are used repeatedly, chemical and structural changes take place in the brain, making it both physically and emotionally difficult to stop using them.
The American Society of Addiction Medicine (ASAM) explains that addiction involves dysfunctions in the brain that impact behavior. Addiction can cause various social, occupational, and psychological side effects.
Addiction can have far-reaching ramifications and permeate many factors of life. If your family member has an addiction, they may have experienced physical, financial, legal, and even criminal issues related to their substance use.
Even so, you may wonder how deep the problem goes. Per the National Institute on Drug Abuse (NIDA), there are 11 main criteria that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses to identify addiction.
If your loved one presents with two or three of the criteria, they are likely suffering from mild addiction, whereas four to five criteria are considered more significant or moderate addiction.
When your loved one struggles with addiction, they are likely to become secretive and often withdrawn. Their social circles may change, and they may start to spend more time alone or with others who are also using drugs.
Physical health and personal hygiene are often negatively impacted. Weight can fluctuate with drug use in either direction, depending on the drug of abuse. Since drugs often impact the immune system, illnesses may be more common. Physical health and appearance can decline, sometimes rapidly. Sleep patterns can become erratic. Mood swings are common and unpredictable. While under the influence of drugs or alcohol, your family member can be emotionally upbeat and seem either manic or mellow depending on the substance. During the comedown or withdrawal period, irritability, agitation, depression, and anxiety are common.
Addiction can cause problems with productivity and attendance at work and school. You may feel the disease most acutely, as you often take the brunt of your family member’s ups and downs, bad decisions, and the messes left in the wake of drug use.
Within the United States, NIDA reports that there are over 14,000 facilities providing specialized drug addiction treatment in a variety of settings and with a multitude of options. The right treatment for addiction is highly personal, and the level of care will depend on your family member and the severity of their disease.
If your family member is struggling with mild addiction and less significant drug dependence, they may find enough support through outpatient treatment services. This treatment allows them to live at home and keep up with other obligations while they get help.
Outpatient services are more flexible with therapy sessions which can be tailored to fit your family’s schedule.
You will need to be on board and supportive during outpatient treatment. Good support at home and a safe living environment are critical to its success.
When drug dependence and withdrawal are more significant, medical detox is often needed first. This will help to stabilize your family member physically. From there, they may go straight into a more structured addiction treatment program.
Intensive outpatient programs (IOP) and partial hospitalization programs (PHP) are a step up from standard outpatient treatment. These programs are more structured, and they usually provide care for a certain number of hours per week in block segments. Your loved one may go to treatment for four to six hours per day during the week and return home each night and on the weekends.
This is the most comprehensive form of addiction treatment. These programs can provide around-the-clock and highly structured programming with constant monitoring and supervision.
Inpatient programs can provide your family member the time and space needed to heal and focus solely on recovery. Residential treatment can also offer more amenities as well as variable treatment methods, such as nutrition planning, life skills workshops, educational programming, exercise and fitness programs, and adjunctive and holistic options.
Regardless of which treatment type and program is right for your family, NIDA recommends that a program last at least 90 days. This can allow the brain time to recover and for healthy habits to become more instilled, helping to minimize relapse.
Before entering into an addiction treatment program, a complete assessment and evaluation should be done. This will help you pick the optimal level of care for your family member. They should also be involved in the process of choosing the treatment program.
It can be difficult to have a conversation about drug use with your loved one. They may become defensive, or they may be in denial that a problem exists. An intervention can be a way to help them see that their drug use is impacting you and your family and they need to get help.
Interventions are structured meetings set up by family members and loved ones to get a person to agree to enter a formal treatment program for their addiction. The main goal is for the person to get help.
Professional interventionists can help families to set up, plan, and execute an intervention.
The National Council on Alcoholism and Drug Dependence (NCADD) publishes that when using a trained professional, interventions are almost always successful.
To host an intervention, you will first need to put together your intervention team. This is made up of loved ones who have been impacted by the drug use personally and who want to support this person as they get the help they need.
For the intervention to run smoothly, it should be highly structured and planned ahead of time.
Often, it is helpful to write letters to read to your loved one during an intervention. The letter should focus on specific instances in which their drug use has impacted you directly.
Families support each other. You likely feel the desire to clean up after your loved one when they make a mess related to their drug abuse. When it comes to addiction, these behaviors can become enabling.
Instead of helping your family member, you are actually perpetuating the addiction, Psychology Today warns. By continuing to enable them, you allow them to keep making bad choices. This does not offer them any motivation to make positive changes.
To truly support your loved one, you need to set clear and concise boundaries and stick to them.
Stop making excuses for their bad behavior, and don’t clean up after them anymore. This may help them to see that they need treatment and that drug use is a real problem that can be solved.
Enabling can go a step further into codependency, which is when a relationship becomes decidedly one-sided.
Family members and spouses of someone struggling with addiction often suffer from codependency. This occurs when you continually are doing more than your fair share in the relationship, and it has become emotionally self-destructive.
Codependence can stem from low self-esteem. You may no longer attend to your own needs, instead always putting your family member’s needs first. You become so tied up in their health and well-being that you are enabling the addiction.
Take a step back. Learn how to set safe boundaries while taking care of yourself. See a therapist who can help you set these boundaries. There are also support groups that can help.
Addiction doesn’t just affect the person struggling with it. It impacts entire families. Family members can play an integral role in treatment and recovery.
Be supportive, but also attend to your own needs. A comprehensive addiction treatment program can involve the whole family and help everyone to heal on all fronts.
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(April 2011) Definition of Addiction. American Society of Addiction Medicine. Retrieved March 2019 from (April 2011) Definition of Addiction. American Society of Addiction Medicine. Retrieved March 2019
(July 2018) The Science of Drug Use and Addiction: The Basics. National Institute on Drug Abuse. Retrieved March 2019 from https://www.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics
(January 2018) Drug Addiction Treatment in the United States. National Institute on Drug Abuse. Retrieved March 2019 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states
(January 2018) How Long Does Drug Addiction Treatment Usually Last? National Institute on Drug Abuse. Retrieved March 2019 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment
(July 2015) Intervention: Tips and Guidelines. National Council on Alcoholism and Drug Dependence. Retrieved March 2019 from https://www.ncadd.org/index.php/family-friends/there-is-help/intervention-tips-and-guidelines
(July 2012) Are You Empowering or Enabling? Psychology Today. Retrieved March 2019 from https://www.psychologytoday.com/us/blog/the-anatomy-addiction/201207/are-you-empowering-or-enabling
(2019) Co-Dependency. Mental Health America. Retrieved March 2019 from https://www.mhanational.org/issues/co-dependency