The Hollywood depictions of addiction create a clear picture of what drug abuse and alcoholism should look like. The emaciated junkie shivers under a bridge in dirty clothes. They stare hopelessly through sunken eyes and matted hair at the track marks that line her arms. Liquor dribbles down the unshaven beard of the alcoholic. He sways both his body and the bottle unsteadily through the local bar. When we think of substance abuse, these are the images that we pull to reference. This is the standard by which we decide if someone may need help.
Addiction can take many forms. The situation can look as blatant as a scene from the latest blockbuster. More often than not, we find that the symptoms of addiction are as subtle and seemingly benign as a change in diet.
The Progression
Addiction often begins as recreation or need. A couple of beers after work on a Friday slowly turns into a daily ritual of constant consumption until bed. A prescription drug used to temporarily mitigate the pain of surgery becomes a crutch by which the user cannot function without. These changes occur slowly; rarely raising concerns as the user moves into mental and physical dependence. Consequences of addiction typically don’t begin until the user has lost both awareness and control of the situation, leaving loved ones mystified and wondering how this could have happened.
The BIG Signs
- Frequent intoxication
- “Blacking out” or failing to recall events or conversations
- Legal trouble
- Deteriorating health or hygiene
- Lying or manipulation
- Selling possessions for cash
- Trouble at work or inability to maintain employment
- Failure to handle responsibilities
- Prioritizing substance use above relationships and activities
- Sudden unexplained financial instability
- Hostility or agitation
- Defensiveness when confronted
The Subtle Signs
- Isolation
- Rapid weight loss or weight gain
- New friend group or acquaintances
- Disinterest in hobbies or activities which formally brought joy
- Loss of accountability
- Blaming troubles on others
- Excessive justification of substance use
- Emotional dysregulation or frequent and intense mood swings
- Changes in appetite or sleep patterns
- Wearing clothing incompatible with current climate (sleeves in the summer, shorts in the cold)
- Secrecy of communication such as deleting and concealing phone calls or texts
- Frequent absences or a sudden need to run an errand
The idea of confronting a loved one when we suspect addiction, can be frightening. Chances are that any mention of substance use in the past has been met with hostility or denial which often leaves us feeling discouraged or resigned. Intervention can seem overwhelming, but there are crucial considerations and steps in addressing addiction that could mean the difference between recovery and further descent.
How to Broach the Topic with Your Loved One
Considerations and questions for loved ones when talking about a possible addiction:
1. What is my relationship to the addicted person?
Your relationship to the person suffering from addiction plays a significant role in how you approach a conversation about substance use. This means considering how much you mean to the person abusing substances. Will he or she listen to your words? Would it hurt them to lose your friendship, love or support?
2. Do others share my concerns?
Depending on your closeness to the situation, it is usually easy to identify others who may have concerns. Think of family members who have witnessed changes in behavior and attitude, think of employers the using person may have let down, think of relationships lost or broken as a consequence of addiction. Making contact with others can provide both validation and support. It can also build a powerful collaboration of voices focused on a similar goal.
3. Do I have proof of addiction or excessive use?
As mentioned above, addiction is sometimes subtle; there are some circumstances where no concrete proof of addiction exists. It’s okay if you lack evidence but be prepared for denial. Individuals suffering from addiction feel an instinctive need to protect their substance use which means denying the problem at any cost; this includes lying, manipulation, threats and victimization. Having facts to thwart attempts at denial will help to disarm defenses forcing the substance user to admit to a problem.
4. How has this addiction impacted me personally?
Intervention is NOT the time for accusations or attacks. Although it is tempting to unleash the pain and hurt of addiction at the person who caused that pain and hurt, the result of this conversation will be much more productive if loved ones can stay focused on their own experience. This removes the addicted person’s ability to argue or dispute, as they cannot speak to the experience of another. Impact statements include facts but rely on feelings for their weight. Examples of impact statements include:
- “When you come home smelling like liquor, I feel helpless and scared. When I know you have been driving drunk, I wonder when I will get the call you’ve been hurt or died in a car crash. I am constantly anxious and losing sleep because of your drinking.”
- “When you ask me to lie or cover for you, I feel uncomfortable and unloved. I feel like I have to compromise my integrity to prove my love for you.”
- “When you don’t return my calls or disappear, I feel scared and guilty. I am scared because I’m afraid something bad has happened to you and I feel guilty because I am too scared of jeopardizing our relationship to confront you or offer help.”
5. What am I doing to support this addiction? What are other concerned parties doing?
It’s easy to dismiss this question as silly. Of course, you’d never help someone ruin their lives, would you be reading this if you were part of the problem? Although difficult to accept, many of us are responsible for unintentionally enabling a loved one’s substance use. Enabling could look like covering for the addicted individual by lying or making excuses to help them avoid consequences. Enabling can look like paying rent, utilities, legal fees or even providing groceries.
While we can often excuse this behavior as helping, it actually frees up any money our loved one obtains to spend on using substances. Sometimes enabling is as innocent as being a shoulder to cry on, offering emotional support or a couch to sleep on. It may be hard to discontinue these behaviors, knowing that they will cause suffering for the substance user, but it is important to understand that the strongest catalyst for internally motivated change is pain and discomfort. When we keep our loved ones comfortable, we remove the very struggles that could breach denial and inspire change.
6. Am I ready and willing to upset my loved one if it means I may save their life?
This aspect of intervention can be the most difficult for those who love the person struggling with addiction. As previously explained, individuals caught in the grips of active addiction will fight with everything to protect their substance use. The addicted brain has been retrained to see the use of drugs or alcohol as a primary survival need, making those who would jeopardize that use, the enemy.
Once you have revealed yourself as what the substance user perceives as a threat, you can expect a wide range of insults, accusations, and threats. The threats can be particularly jarring if your loved one feels cornered or trapped sometimes, they may even threaten harm against themselves or others. (Important Note: if someone has admitted to homicidal or suicidal thoughts or you are concerned, they may try to harm themselves or others, contact emergency services immediately.) Common threats include:
- “If you make me do this, I’ll never speak to you again”
- “If you don’t stop talking, I’ll tell everyone about (some secret or misdeed)”
- “If you won’t support me, I’ll find someone who will”
It is important to see these threats for what they are, desperate attempts to defend and maintain something that could potentially kill your loved one. During these moments we must remain focused on the goal of intervention; helping your loved one find recovery. Keep in mind that preserving a harmonious relationship, free of confrontation with someone you know is abusing substances means that you are essentially signing off on that behavior. The willingness to confront an individual in active addiction is an act of bravery and love, keeping the peace is not.
7. Do I have a plan? What is the option for my loved one?
The purpose of an intervention is to offer concrete help. This includes providing a plan for recovery such as detoxification services, substance abuse treatment (inpatient or outpatient), therapy, and mutual aid support groups such as Alcoholics Anonymous, Narcotics Anonymous, and Smart Recovery. Before engaging in an intervention, you should speak to a trained addiction professional to determine what level of care is most appropriate for your loved one.
These professionals can also help walk you through a plan of intervention and transportation should your loved one accept help. It is incredibly important to admit the addicted individual into treatment as soon as they accept. If the individual is able to delay entering treatment, they will oftentimes utilize the opportunity to use drugs or alcohol heavily and sometimes disappear altogether.
When you need help, we’re here for you.
If you think someone you love may be addicted, contact the addiction professionals at Mississippi Drug and Alcohol Treatment Center, today. We will help you build a safe and effective plan for getting your loved one the help they deserve.