In an ideal world, every addict that arrives in drug rehab would be cognizant of their disease and determined to get well. But when dealing with addiction, ideal situations are rare.
There is ongoing debate about whether an addict who doesn’t want help can be helped. Many believe that only the addict can help themselves. They have to want to quit. But in the midst of active addiction, few addicts want to quit. In fact, most addicts are, by their very nature, unwilling patients.
Changes in the brain, which has been hijacked by drugs, leave the addict powerless to truly see themselves and make rational decisions. Because they have come to depend on drugs to function, they will make excuses, justify the indefensible and put off treatment as long as possible.
There are many ways in which addicts are pushed into treatment: court order, divorce, loss of child custody and hospitalization, to name a few. While some flounder along the way, many go on to achieve lifelong sobriety regardless of the fact that entering treatment wasn’t entirely “voluntary.”
Most addicts develop the motivation to sustain their recovery after being helped into treatment, when they start learning about their disease and feeling better than they have since they started using. We have techniques for getting addicts into treatment that work, if not right away then over time, even in the seemingly most hopeless situations.
So how can family, friends and colleagues help the unwilling addict?
Get Educated About Addiction. Addiction is a chronic, progressive brain disease characterized by compulsive drug-seeking even in the face of job loss, damaged relationships and other negative consequences. Only when it is treated as such can concerned loved ones provide the level of support, patience and understanding the addict needs.
Practice Self-Care. Loved ones can educate, encourage and persuade, but they cannot control the addict’s behavior. What they can control are their own thoughts and behaviors, including putting an end to any enabling and getting support from self-help meetings for loved ones of addicts (such as Al-Anon) and/or working with a therapist.
Set Limits. Loved ones often put the addict’s feelings and needs first and become enmeshed in the lies and chaos. Setting and enforcing boundaries not only allows loved ones to resume control of their lives, practice healthy detachment, and safeguard their own health and well-being but also helps the addict face the natural consequences of their actions. While loved ones may gladly help the addict look for a job or choose a treatment center, they must set clear boundaries around behaviors they deem unacceptable (e.g., asking the addict not to come around if they are drunk or high or refusing to loan money or pay their bills if they are using).
Stage an Intervention. Addiction interventions are a highly effective way to break through the addict’s denial and get them into treatment. By staging an intervention, loved ones can get the addict’s attention and help them understand the consequences of their destructive behaviors before more serious consequences ensue.
In some cases, a one-on-one conversation may suffice, whereas others may require a more coordinated approach, often in the form of a formal intervention attended by a close group of friends, family and/or colleagues and led by a professional interventionist. A professional can help assess the situation, recommend treatment facilities, and ensure that the process remains productive and healing for all involved.
If at First You Don’t Succeed…
Will any of these approaches ensure that every addict agrees to treatment and stays sober for life? No. That is not the nature of any chronic, relapsing disease. What they do provide is the message that help is available and there are influential people who care enough to help the addict find their way.
In some cases, the addict may be angry and resentful and require time and ongoing encouragement to recognize the need for change. This can be particularly trying for loved ones who must stay close to the addict (without rescuing or enabling) even as they self-destruct, if not for the addict’s sake then for their own peace of mind that they did all they could.
In most situations, loved ones can help “raise the bottom,” bypassing a great deal of suffering along the way. Whether the addict is “ready” or not, getting involved is an act of love, which can be a powerful force in breaking through addiction.
David Sack, M.D., is board certified in addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of addiction treatment centers in California, Florida, and Tennessee.
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From Psych Central's website:
You Don't Have To Hit Rock Bottom | Therapy Soup (March 5, 2012)
Last reviewed: 5 Mar 2012