Friend is addicted to heroin. Do I tell her parents?
March 19, 2015 12:30 AM   Subscribe

I recently found out that a friend from high school is addicted to heroin. I have talked to a handful of other friends, but I'm not satisfied with the response. I think her parents could help. More details below.

I found a few older questions about heroin addiction, but most seemed to be about people with family that already knew or people who had already been through rehab. I want to get help for a friend who is an addict, but I don't know how.

I have been friends with her since late in high school. We don't talk regularly, but she's the type of person I make plans with when we're in the same city. We now live on opposite sides of the country. I haven't seen her in about 18 months.

Last week I discovered that she is addicted to heroin. I found out because I know her username on a forum, and she had recently made comments that made it clear that she's involved with opiates. I wasn't sure exactly what it was, so I started texting and calling to find out what was going on. After stalling for several hours, she finally talked to me on the phone and admitted that she has been using for about a year. She is definitely addicted. She is currently on leave from work. She initially planned to go to rehab, but she told me that now she "wants to get clean on [her] own before rehab." She thinks she can do it cold turkey.

This information overwhelmed me, so I contacted a handful of people from high school to get their input. I think she needs to go to rehab/detox/a clinic/anything but cold turkey. She is traveling to this side of the country next week, so I thought it might be a good time to talk to her in person and convince her to get help. Most of the people I spoke to agreed. The one person who doesn't agree - the best friend of the addict - feels very strongly about it. She thinks that we should convince her to transfer to a different city and that her friends can give her all of the support she needs to stop using. The main problem I see with this is that none of us live near her. The best friend lives on a different continent right now! I just don't feel like support via texting and Skype will be enough to get a heroin addict clean.

I feel like the only people left to tell who could actually help are her parents. She's visiting them next week. I am hesitant to do it because she's an adult (age 25) and should be able to make her own decisions, but heroin is heroin. I keep imagining her with HIV or Hepatitis, or losing her job completely, or ODing and dying. She's incredibly intelligent with a degree from a prestigious university and a job at a great company. And she's a treasured friend. I can't help but feel responsible since I was the first one to find out the information. The best friend absolutely does NOT want me (or anyone else) to contact the parents - she says it will ruin their lives. Difficulty level: very strict Bengali parents. She told them she was smoking pot a few weeks ago (said she was "tired of lying"), and they freaked out. I can't imagine how they'll react to heroin.

Should I call her parents or let this run its course without intervening? I am not sure I'm prepared to handle the inevitable fallout from my friends, but I think I'm less equipped to deal with the guilt if anyone happens to her. If you need clarification, I'm at opiateanon@gmail.com. Thanks.
posted by anonymous to Human Relations (51 answers total) 4 users marked this as a favorite
 
Hell no. None of your business. If she wanted her parents to know she would tell them herself.
posted by Violet Hour at 12:48 AM on March 19, 2015 [26 favorites]


My first reaction was to say, "yes, of course, call her parents". Maybe that's right, I don't know - "parents" might be able to help in theory, but what about these parents? Does the best friend know something you don't?

Your friend had a wish to disclose the pot; she's at least thinking seriously about quitting, and is set for a visit home. She may well bring it up herself.

(I would maybe talk to the best friend again, though, and ask her what grounds she has to believe texts and Skype calls will be useful support. And would definitely stay in contact with the person you're concerned about. Maybe, watch, and wait. Then again, this may be a unique window of opportunity. It would be horrible if the one call that did get made to her parents was from the hospital.)
posted by cotton dress sock at 12:54 AM on March 19, 2015 [3 favorites]


Hi. No. Absolutely do not out her as an IV drug user to her parents. Please do not underestimate the cycles of familial violence, forced incarceration, and unstable detox/re-addiction cycles, etc, that result from this kind of forced intervention, and how dangerous it is to the lives of the addicts who people try to "help" in this way, ESPECIALLY with a drug like heroin where the medical consequences of changing your tolerance through a detox/use rollercoaster can be fatal. She will tell her parents if and when she needs to tell them. Whether your friend is in a dangerous or maintenance stage of opiate dependency is, frankly, not something you can tell based on a single conversation you had with a person you "don't talk regularly" with and who you haven't seen in nearly two years. You found out she's a drug user by stalking her online, you pressured her into disclosing to you, and then went against her express wishes to out her as a drug user to a bunch of random people who went to your high school? Your desire to take control of this woman's life is disturbing, and you are currently a huge danger to her livelihood, life, and well-being. You need to back the fuck off.
posted by moonlight on vermont at 12:59 AM on March 19, 2015 [133 favorites]


This information overwhelmed me, so I contacted a handful of people from high school to get their input.

What? No. Do not do this. Do not contact her parents. Just because you have a bucket doesn't mean you need to carry water from the well.
posted by DarlingBri at 1:02 AM on March 19, 2015 [19 favorites]


If I were in your shoes I would make an appointment with or contact a professional who deals with addicts and ask them for their professional opinion on what to do in this situation. That would definitely be a step to consider long before contacting her relatives IMO.
posted by rancher at 1:23 AM on March 19, 2015 [17 favorites]


If there were a strong reason to believe telling her parents would actually be good for her, then you'd have a thorny ethical problem. But it appears that you don't have that here.

Why do you think telling her parents would help? It sounds like from the data that you have presented here (best friend thinks it would "ruin their lives"; they reacted very negatively to a disclosure of marijuana use) that it would very likely not be helpful. If you really can't imagine how her parents would react to heroin then telling them might be more like dropping a bomb on the situation then helping your friend.

Your impulse to help is commendable, and it sounds like you're only considering telling her parents because you feel like you're out of options, but based on what you're saying it seems like you could best help your friend in other ways, such as trying to convince her to consult a drug abuse counselor, rather than telling her parents, which would lead to an unpredictable and possibly very negative outcome.
posted by phoenixy at 1:36 AM on March 19, 2015 [8 favorites]


You shouldn't not be getting involved. Frankly, you've probably already pushed past reasonable boundaries by contacting a bunch of people from your past and talking to them about it.
posted by Justinian at 1:36 AM on March 19, 2015 [26 favorites]


[Please limit your comments to answers, don't post merely to castigate the OP. Thank you.]
posted by goodnewsfortheinsane (staff) at 2:24 AM on March 19, 2015 [4 favorites]


It sounds like she needs support and guidance and a lot more attention to help her through this, and you're hoping her parents can fill that role. Really, we all assume they have an obligation to fill that role. It sounds from this conversation that they're unlikely to excel at this.

Rehab is a process that can help via education and monitoring and contact and support, but she needs to engineer a life for herself where she can get support and companionship and understanding on a regular basis. You can't keep weight off with a six month gym membership, and you can't just go "cold turkey" from driving a car every day if you live out in a car-only suburb. At some point you need to completely re-do the infrastructure, and that's not as simple as "getting away from temptation": you need to replace the harmful habits with sustainable good ones.

Our lives shape the choices that are easy for us, and we can shape our lives to encourage us to make better unconscious decisions. You can help her do this, but only so much. Her parents can help her do this, but only so much (and many of the usual bag of parenting tricks backfire on adults and troubled children).
posted by rum-soaked space hobo at 2:38 AM on March 19, 2015 [1 favorite]


Please contact a professional for advice on how to support your friend.
The NAMI HelpLine can be reached Monday through Friday, 10 am–6 pm, ET.

1-800-950-NAMI (6264)

What kind of resources does the HelpLine provide?


Suggestions for coping with mental health symptoms or helping someone else.

Referrals to treatment services, community support services and other useful organizations.
posted by Little Dawn at 2:49 AM on March 19, 2015 [15 favorites]


No, you shouldn't. You've got the answer yourself.

She told them she was smoking pot a few weeks ago (said she was "tired of lying"), and they freaked out. I can't imagine how they'll react to heroin.

"Freak out," is generally not a helpful response. You think their reaction is unpredictable, so you are taking a pretty big risk that they may actually make things worse.

You and none of the high school friends live near her, but you are not her only options. If she went through university and landed a good job, she may have friends near her who are better situated to help and more up to speed with her current needs.
posted by Gotanda at 2:51 AM on March 19, 2015 [3 favorites]


Do not tell parents.

DO NOT.

If you want to help her, be her friend and provide support and encouragement instead of judgement. Talk to her. About normal things. Ask her what she had for lunch. Help her not feel like a freak who has to hide her life.
posted by zennie at 3:48 AM on March 19, 2015 [9 favorites]


I'm very much with moonlight on vermont with this.

I think you need to butt out entirely. Just back off. I think it was extremely messed up that after you grilled this out of her, and she confided in you, that you shopped it around to a bunch of random mutual friends.

I think you're already involved in this in a way you shouldn't be, and that the only way out is back, and well, out.

Absolutely do not tell her parents, and just like... Shut up about this. The only way you should keep talking about it is if she contacts you.

And I say this as someone who lives in a city with a crippling, gigantic heroin problem who has lost good people to this, knows people still struggling with it, and knows people who have gotten clean.

Your entire approach here has just been like... Violating. I will believe you that your intentions were good, but just blabbing this to a bunch of people in a verbal diarrhea way like that really helps nothing.

And seriously, do not tell her parents. I don't know what to do, but that's not it. And neither is anything else you've done. Complete inaction from day one would be an improvement from what's occurred.
posted by emptythought at 3:56 AM on March 19, 2015 [47 favorites]


I understand that you've gone completely into rescue mode because you're panicking about her safety. However she is an adult and telling her parents about her against her express wishes isn't helping her, and it may put her in a worse place than she is now. All you can do is support her in her choices, not force choices on her that you think she should make. Consider getting support for yourself from something like Al-Anon. But don't try to take this away from her. Ask her "what can I do to help you in this?" rather than telling her what to do.
posted by billiebee at 4:13 AM on March 19, 2015 [6 favorites]


She trusted you enough to tell you this, if you come on strong she will either avoid you or just start lying to you. Just be supportive, listen more than talk and every now and then ask her what can you do to help. Before you give her advice ask yourself if you are really bringing new information to the table, if not, hold it back. Reach out to her often but not to check her status or progress, just to say hi and remind her you are there.
I agree with others not to tell her parents, mostly because there is little or nothing they can do to help and a lot they can do to make things worse. Talking to your friends was maybe indiscreet but human.
posted by InkaLomax at 4:13 AM on March 19, 2015 [1 favorite]


I don't think telling someone's parents is a bad impulse - I actually did tell a high school friend's parents in a similar situation. But his parents were very cool and not the type to "freak out" about marijuana. I wouldn't tell these parents.

Heroin is very serious and you're a good friend for trying to help. I think cold turkey on her own is quite dangerous for heroin - people die from taking the same dosage when they relapse (which is sadly common). I imagine she is considering this plan because of shame over the addiction? Be a non-judgemental friend if you can, and let her know that she has nothing to be ashamed of and you just want help for her because you love her.
posted by rainydayfilms at 4:32 AM on March 19, 2015 [4 favorites]


I had a friend who used crack and *her* telling her parents was an important part of her treatment and rehab. Don't take this potentially healing step away from her. She'll get there and when she does, it'll be an important step towards healing.
posted by Toddles at 5:04 AM on March 19, 2015 [7 favorites]


Don't tell her parents, and don't tell any more of her friends. Your impulse to help your friend is great - but you're not going to do it by violating her trust and her privacy. The most likely thing that will happen if you keep doing that, is that she will stop confiding in you altogether and when she is ready to get help, she won't let you know and you won't have a chance to help her.

Talk to her in person, for sure. Let her know that you want to support her in getting off heroin. In advance of that discussion, do some research on resources in her area - are there hotlines? Detox clinics? A needle exchange? A harm reduction outreach program? Is Narcan/naloxone available in her area? Be prepared to give her all the resources you can find, not just on quitting, but on safety and harm reduction so that while she is using, she can use more safely. Ask her if she would be willing to take some of this information, and if so, give it to her. If not, let her know you want to help her however she *is* ready to accept help, and listen, and do whatever that is she tells you.
posted by Stacey at 5:05 AM on March 19, 2015 [3 favorites]


Shame doesn't cure anything. Her parents are no longer her lifeline because she's an adult now. Talk to her, back her up. Let her tell her parents, it is absolutely not your place to do so.
posted by h00py at 5:21 AM on March 19, 2015 [4 favorites]


I will tell you what someone told me when I had a question about a friend's heroin use: heroin addiction is terrible, it distorts people's personalities, it breaks up friendships. I didn't want to believe that and yet everything came to pass just as I'd been told - off the heroin, back on the heroin, off again, lying to people, overstating progress on quitting, lying about other stuff, relationships falling apart. A huge part of my social circle came apart around someone's heroin addiction.

Don't get too emotionally involved in getting your friend off heroin. There's not much you can do. Obviously, support her in any way she asks for, but be prepared for lies, fuck-ups, painful stuff - be prepared to find that maybe the personality she's showing you is not where she's really at.

Support her if she asks, but step back. I wish we had all done that (with the exception of very close friends and family) - we might have been able to rebuild something after the friend did get off heroin. (It took a long time and it's not like things are just awesome now, but it happened.) But there were so many lies and so much drama and we as a group were way too emotionally engaged in this person's struggle.

The thing is, it's quite possible that your friend is going to do an A-plus job of resolving this, but an A-plus job of getting off heroin is still a really fucked up mess. What is a massive success to the person living it can look like a stream of lies and drama and setbacks to everyone else, plus some really painful social interactions. It would be much better to be as supportive and gentle as you can without getting too enmeshed because your friend needs to work through some heavy, messy stuff before she's back on her feet.

Lots of people use heroin, even long term, and don't die or get HIV, though. IME with a couple of heroin users (who were both from originally fairly stable even if emotionally fucked up backgrounds) the issue was the addiction and the lying more than ODing or infections.

Don't tell her parents. You think they'll be able to intervene effectively but they probably won't. Tell only such people in your social circle who you are sure can provide the kind of help that your friend is ready to accept.
posted by Frowner at 5:22 AM on March 19, 2015 [12 favorites]


Please don't tell her parents.

Give her support if she asks for it.

Come to terms with the fact that she will not stop using until she is ready. It doesn't matter what she says - how much she says she wants to stop. She will not stop until she is ready. Shame, threats, lists of all her good qualities and how many people love her: none of that will work if she isn't ready to stop using. You cannot make her want to stop.

I'm sorry this is hard; take several deep breaths and step back.
posted by rtha at 5:27 AM on March 19, 2015 [6 favorites]


Nooooope.

If everyone who was addicted to heroin just needed the care and concern of loved ones to really kick the habit, almost no one would be addicted to heroin anymore. Don't play kick the can by telling her parents.

Caveat for people searching this question who, for the first sentence, thought you were both in high school until reading on: If you know a minor who is addicted to heroin, different advice applies.
posted by juniperesque at 5:32 AM on March 19, 2015 [14 favorites]


Others have covered the fact that choosing to tell her parents is not your choice to make, it is her choice. I would like to reinforce something that has only been touched on: telling her parents may seem helpful, but there is a decent chance that it could make her problem drastically worse. If her parents are the type who would freak out over an adult using marijuana, it is not likely that they know the best way to support and help someone with a heroin addiction. Telling them could result in them intervening a way that would throw her life into chaos, which is the exact opposite of supportive and could really harm her attempts to get clean. Are they really the types who would approach the situation with love and learn the best way to help an addict despite their preconceived notions? Or are they the types who would intervene in unhelpful or even damaging ways? Frankly, you can't answer that question.

So it's not just that telling her parents violates her autonomy, though that is an important consideration. There is also a reasonable chance that telling her parents could do real harm to her recovery. First, do no harm.

As others have said, just be supportive.
posted by Tehhund at 5:54 AM on March 19, 2015 [7 favorites]


In some cases I’d say yes, but as others have said, there is no reason to believe that her parents will be helpful in this case, even assuming their good intentions.

Some folks have suggested staying out of this entirely, and it’s true that is a way to significantly limit your stress, and isn’t something you should feel guilty about because this isn’t a super close friend at this point in your life. In similar situations, I have opted to take on a more active role, and despite not always ending up with good outcomes, I am glad that I supported people in bad places. My advice if you make that choice:

Since you don’t live near this person, there isn’t a WHOLE lot you can do, so recognize that you can’t save her. You can give her your opinions about the routes she takes, and practical advice about them even if you disagree with what she’s doing (i.e. how not to overdose during a relapse; how to find the support she needs if she moves).

Ask her whom you can tell/ talk with about this to form a support circle around her.
Back away if it’s taking up too much of your life, and get the support you need to deal with the stress this causes you. This could include reaching out to different friends outside of the situation, therapy, massages, etc.
posted by metasarah at 5:56 AM on March 19, 2015 [1 favorite]


If everyone who was addicted to heroin just needed the care and concern of loved ones to really kick the habit, almost no one would be addicted to heroin anymore.

I wish I could favorite this a hundred times.

Keep in mind, also, that once you tell her parents, you are going to plunge them into a living hell that could persist for years and years, maybe even for the rest of their lives. They're going to find out eventually and go through it all on their own regardless, but I personally would not want the burden of knowing that I took the step that will ruin their lives, especially knowing your friend is early enough in this process that they have no interest whatsoever in getting clean.
posted by something something at 6:08 AM on March 19, 2015 [3 favorites]


Also, on mature reflection: you don't know enough about her relationship with her parents to consider telling them, and you don't know what's pushing her to use. I assume some people end up using heroin basically because they have addictive personalities, it's fun and it seems socially acceptable, but the people I have known who used heroin were doing it (and actually, initially, other substances - pot isn't bad in itself, but it can be used badly) to cope with deep personal pain. In one case, pain stemming from a really fucked up family situation.

I think there might be circumstances - you know the parents well, you know the person well, you have some kind of idea of what's going on - where telling parents would be the best choice. This doesn't seem to be the case.

A mistake that people in my social circle made: staging an intervention and deciding that they would [take various social steps] unless the person took particular steps toward quitting. Whatever you do, don't do this - don't set up sides, don't make the person feel that your friendship is contingent on them doing something that is very, very hard for them.

A risk of telling everyone and creating a lot of feelings and drama and conversations is that you will give the person the feeling that she owes you something that she can't give, or that you're not on her side. (You will think you're "on her side".) You will give the person the feeling that her quitting is your business, and that her quitting somehow reflects on you or is morally important to you for your own reasons.

And then the biggest temptation for this person is just to drop you - you're way more demanding than the drug, the drug actually turns off the painful chatter in her head or whatever it does.

It's awful to see someone in such straits and know that you can't fix them. It's very hard to know that you can't fix them.

Also, understand that "better" is individual. Maybe your friend is never going to be "better" in some Hallmark card way - maybe she'll always be in pain and always have some weird relationships with various substances and practices. (That certainly has seemed to be the case with people I've known.) I think a mistake our group made was to feel like "oh, if this person just [does this thing that we think is easy but is actually very hard] then things can go back to how they were [or actually, how they seemed to be] when this person was using drugs to cover up their pain and therefore was a fun party person and the core of our social group". For me, it was very hard to accept that the person I had known was in part a construct of drug use and that recovery meant major personality changes. (And not just in a "now I'm not a party person!" way - in a "I have to focus on self-care now and can't be around as much, can't get as emotionally engaged with things as often, need to be by myself more" way.)

Also, watch out. Every heroin user I've ever known has lied and lied and lied, and two of three (now that I'm thinking of another friend I hadn't thought of in years) went on and off the stuff. These are not bad people, not stupid people, not selfish or uncompassionate people - just people in the grip of something terrible. But it can be shocking and painful to find out how many lies there are.

Be prepared for how to be a person's friend when you find out that they are back on the heroin or never really quit, or when you find out that they stole something to sell, or when you find out that they treated their partner in a very shabby way. If you want to be someone's friend through this, you need to be prepared for bad stuff, and you also need to set a boundary about what you won't accept. (For me last year, it was treating a partner really badly - I had to walk after a certain point.)

I don't know if it's inherent to heroin itself or if it's that the kind of people who end up on hard drugs tend to be in more pain than people who take other kinds of drugs, but it's a very bad addiction to have.
posted by Frowner at 6:32 AM on March 19, 2015 [9 favorites]


Talking to your other friends was completely out of line. Don't make this worse by talking to her parents.
posted by alligatorman at 6:39 AM on March 19, 2015 [8 favorites]


It doesn't appear to me - from reading your post - that you have much in the way of personal experience with addiction or rehab(not judging). There was a post earlier on Metafilter that linked to an extensive article about AA and its ineffectiveness. If you want to do research and help your friend personally (assuming she's open to it), treat it as a private issue that she wouldn't want to be known publicly. As harmful as addiction is, wrong headed treatment or exposure as an addict can have counter-productive results that can make a situation worse. Honestly? I would let her go cold turkey on her own if that's what she wants. If it doesn't work it may be the experience she needs to initiate getting professional help for herself. On the other hand, unless you know how much she is doing, the method by which she partakes, her sources for getting it, etc., I would feel you are not informed enough to make a judgment call as extreme as telling her family. Probably talking to her friends was not the best idea either. Making this anymore public could jeopardize her job, future, relationships with people close to her... All those things which will ultimately help her beat the addiction in the long run. Be a good friend to her, but be an informed one.

I have had personal experience dealing with heroin addicts.
posted by palindromeisnotapalindrome at 8:24 AM on March 19, 2015 [1 favorite]


I have been friends with her since late in high school. We don't talk regularly, but she's the type of person I make plans with when we're in the same city. We now live on opposite sides of the country. I haven't seen her in about 18 months.

What? Stay out of this.
posted by spaltavian at 8:28 AM on March 19, 2015 [6 favorites]


I would research the resources available in her geographic area with particular attention to programs that offer Medication Assisted Treatment (methadone, suboxone, etc.). I would give her that information, and urge her to seek professional help. I would not do anything else.
posted by ClaudiaCenter at 8:30 AM on March 19, 2015 [2 favorites]


You didn't cause it. You can't control it. You can't cure it. Please go to Al-Anon.
posted by BlahLaLa at 8:35 AM on March 19, 2015 [5 favorites]


To add: you've already done her harm by contacting her friends. Blowing up someone's life will not help them beat addiction. You're not doing an intervention here; you're pulling a fire alarm.

She's already acknowledged she has a problem and she has already stated a plan. It may not be the best plan, and you may not like it, but that's not your call; you are not a medical professional. This "everyone needs to know" attitude of yours is really a moral judgement, not an actual strategy to help her. (Again, you're not an addiction medicine specialist, are you?) Please stay out of this. You mean well, but you don't know what you are doing.

You say you're worried about the guilt you would feel if you did nothing and something happens to her. Consider two things: what about the guilt you would feel if you did something, and it only made it worse? More importantly, consider that you and your feelings aren't important here.
posted by spaltavian at 8:41 AM on March 19, 2015 [9 favorites]


This: I think her parents could help.

Doesn't really gibe with this: I want to get help for a friend who is an addict, but I don't know how.

The second part I quoted is the most important: you do not know how to get help for heroin addicts. Having good intentions is not a good enough reason to start randomly trying things that you think will help someone who is addicted to heroin.
posted by 23skidoo at 8:48 AM on March 19, 2015 [3 favorites]


I'd step back. And not tell the parents or anyone else.

Stepping back will also protect you from getting too involved. Whether the friend gets clean or dies, the road through opiates is no constuctive place for bystanders. To be blunt, step back to shield yourself from even more heartache if they die and step back untill they are permanently clean because until then, all through thteir trying to get there, they will be a shit person to deal with unless you are some saint. Assuming she gets clean I think you'd actually have a higher chance of rebuilding the friendship if you faded out now than if you became entangled with this f-ed up version of her. If you get involved now, things she does may permanently taint your view of her, to the point where the friendship forever loses merit, more than just knowing she used to have a heroin problem will.
posted by WeekendJen at 8:55 AM on March 19, 2015 [2 favorites]


I think this is not your burden, but you feel bad not making it your burden. You can't make this person move to your city so you can babysit her all the time. You can't think it's up to you to convince her what to do. That's more than you can reasonably handle, and your friend has to want to get help, no matter what you say.

I think you want to tell her parents to pass off the burden to someone else who will make it their responsibility. I get that. I would try to convince the friend to go into an extended rehab program. Send her some materials that explain going cold turkey doesn't work with heroin. You need to do that, and let her know you'll support her, but this can't be your problem. Try to support her and leave it at that.

The one problem is, even if she goes voluntarily to rehab, she can leave voluntarily too. One of my mother's friends had a son addicted to heroin. His parents paid for rehab (a lot of money) and he just left. He would also steal money from them for his habit. They didn't want to call the police on their son -- no parent wants to do that... they want to think they can help, and they believed this guy was a good kid who just needed their help. Eventually he ODed and died. I think if they had called the cops and gotten him arrested, a mandatory drug treatment program (one he wasn't allowed to just walk out on) could've resulted in a different story. He had drug issues for years and something had to give. So, if this is dire, you could consider calling the police. You have to weigh the consequences though, obviously, because getting arrested and having that on someone's record is not a joke.
posted by AppleTurnover at 8:57 AM on March 19, 2015 [1 favorite]


Send her some materials that explain going cold turkey doesn't work with heroin.

This, strictly speaking, isn't true. The OP sort of confused the term by implying not going to rehab constituted "cold turkey", but they are two different issues. Rehab or some sort of counseling would be a good idea; but cold turkey means not gradually winding down and not using something like methadone. There are many medical professionals that actually advise cold turkey for heroin addiction. (Heroin withdraw, unlike say, alcohol, is not life threatening. Incredibly miserable, though.)

OP, could you clarify if you actually confirmed that it was heroin your fiend is using? You stated that you saw her writing about "opiates"; but you don't indicate how you know for sure it's heroin or that's what you assume. In many ways, heroin is less dangerous than pharmaceutical opiates; the really dangerous aspect is intravenous injection. Is it possible she's insufflating (snorting)?
posted by spaltavian at 9:22 AM on March 19, 2015


I think you should absolutely tell her parents. The only reasons that I can think of for not telling her parents is that you know them to have been the proximate cause of her addiction (e.g., her dad raped her), or you know that they are likely to commit physical violence against her. Otherwise, your friend's chances of successful emergence from her addiction almost surely go up by having people close to her know about her addiction, particularly her family.

I'm a clinical social worker who has treated lots and lots of people with lots and lots of addictions, primarily addictions to heroin. Many people have covered the potential pitfalls of telling her parents, but they mostly come down to vague concern that she will somehow get worse if you tell. I'm not sure what that would look like, since she is already a heroin addict, and as such, in grave danger. I'm not aware of any studies that would suggest that telling close family members leads to worse outcomes for addicts, but I do know that there are lots of studies showing the absolutely central place of sober and caring social and family networks in recovery from addiction. I'm surprised by how much the answers here privilege personal autonomy over health, and reinforce stigma in the "service" of avoiding stigma. There's even an answer that specifically recommends preserving this woman the option to tell her parents as part of her (may happen, probably won't) recovery. Recovery is contingent for everyone. Those who have not told their family may do so during recovery, those who have, obviously won't have to. There is no reason to think that someone who "gets" to tell their parents about their addiction as a part of recovery do better than those who don't. I literally cannot think of a clinical reason why it might be important.

Look, the truth is that this woman is in a very very dangerous place. She is not making good decisions. Taking her at her word, she is addicted to heroin, and has no plans to try to get clean. ("I want to try on my own first, before rehab," isn't even code, it's completely clear addictspeak that means, "I have no plans to quit.") She will lie to you, she will lie to her friends, she is at grave risk for serious health complications and death. Regardless of what you do, there might be a bad outcome. The only ethical question that matters is: does telling her parents increase or decrease the chances for a bad outcome. The answer (with the two caveats I listed above) is clear that telling her family decreases the chance for a bad outcome. It does not guarantee it, but there is no good reason offered in this thread to think that it would increase the likelihood of a bad outcome. Most of the answers here amount to saying that your friend's privacy is more important than her health and her life. I find this a very problematic position to take, and I would urge you not to give it credence.

This 25 year old is on track to lose years and years of her life to addiction. And, that's the good outcome. The bad outcomes include death, HIV, Hep C, oozing abcesses, trading sex for money, repeated sexual assault, infertility, jail, etc. The more people who have a stake in her being clean who know about her addiction, the more likely it is that she will avoid that fate.

There is simply no question that, all else being equal, this young woman has a better chance of doing well if her parents know about this. I find the advice in this thread baffling, and truly believe, as a mental health and substance abuse professional that it is not only bad, but actually unethical. I'm not gonna lie, you may well lose a friend by telling her parents, but at least she'll be alive and may be able to thank you some day.
posted by OmieWise at 9:29 AM on March 19, 2015 [13 favorites]


this young woman has a better chance of doing well if her parents know about this

We absolutely do not have enough information to say this, and it doesn't sound like the OP does, either. Does the OP know, for certain, that the parents are not the proximate cause? I bet a bunch of money that the OP does not. The OP acknowledges that they cannot imagine how the parents would react to being told by someone who is not their child that she is using heroin. Telling the parents should not be the first step taken by someone who hasn't even spoken to this friend in 18 months.
posted by rtha at 9:41 AM on March 19, 2015 [17 favorites]


I don't think you are a bad person for stepping up.

Your friend is self-medicating pain and possibly depression or other mental illness. The advice to call NAMI for guidance is very very good. They are extremely compassionate and knowledgeable.

Heroin addiction is very serious and best addressed with help from doctors and addiction specialists, so pretty much no one in this thread can tell you what to do. Your friend's addiction can't tell you what is best for her. I think you need to call NAMI and from there research the situation.

If your friend is on leave from work and addicted to heroin, she's likely about to be fired, if she hasn't been already. You probably should be wary of giving any help that isn't holding her hand as she fills out intake forms and walks through the door and enters rehab - but again, the NAMI folks can advise you there better than me.

Thank you for trying to help. Remember only to do what you are advised by professionals. This is above your capabilities to handle. Help, but don't get caught up or overwhelmed. Best of luck.
posted by jbenben at 9:44 AM on March 19, 2015


[Folks, this needs to not become a debate among commenters. OP can bear in mind that we are working with limited information here, and knows the limits of their own information.]
posted by LobsterMitten (staff) at 9:45 AM on March 19, 2015


[One comment deleted. Calling out specific people in this thread is not avoiding debate.]
posted by LobsterMitten (staff) at 10:28 AM on March 19, 2015


I have a wise friend who was playing with her infant nephew one day, waving her hand over his face in the sunlight, playing with the shadows. Slowly she realised he wasn't reacting. She tried some more games with light, and on the way home she told her husband she thought her nephew might be blind.

But she did not tell the parents. When they told her a few months later that he was indeed blind, she was ready to be supportive. Why did she not tell them? Because she knew they were attentive parents and they would figure it out and she didn't want every retelling of the story to start with "and then Auntie noticed..." This was her nephew's story, her sister's story. They would come to it soon enough and she would support them.

She advised me not to be the bearer of bad news when it wasn't strictly necessary (not now, or not from me).

I think this advice may also apply in your situation. Who best to tell them? When best for them to find out? I don't see evidence that you are the person to be the bearer or that now is the time.

It is not your responsibility to fix this. Ease your heart another way.
posted by heatherann at 10:32 AM on March 19, 2015 [2 favorites]


You said her parents are Bengali. Does that mean that she has been born and brought up in an Indian cultural environment?

Given your approach in finding out about her addiction and discussing it with mutual friends, I would hazard a guess that you are also Indian.

I want to establish this because, I believe, the cultural context matters a lot in figuring out what kind of help she needs and what kind of help is she expecting. So far, almost all the answers are from a different cultural perspective and, hence, might be judging you too harshly in your approach till now.

If it is an Indian cultural context, her parents would get involved deeply, whether she (or they) wants it or not. The best course of action, then, would be to make sure that they are brought into the situation in a guided manner which can help them in working with your friend. Indian parents are very clueless about drugs and usually don't know how to deal with it. If they were to find out about it abruptly, say in an medical emergency, their reactions are guaranteed to be negative and unhelpful.

A lot depends on the parent's temperament and ability to deal with an unexpected situation. I don't know how familiar you are with them, how much do they trust you and most importantly, what is the nature of their relationship with their daughter. You need to evaluate these factors before you talk to them. There is a chance that with your guidance and support, they would be able to deal with it in a better than a typical Indian parent manner. I think you are banking on this chance when you think about talking to them but you need to be careful and get your friend's agreement before you talk to her parents.

There is a lot of social stigma around drugs in India and that might be the reason why she is planning to try a cold turkey first instead of going to a rehab or counselling session. Its a very tough situation for any addict and she does need a lot of help and support. But, due to social stigma, she might not ask for help until its too late.

Though I understand why you would talk to mutual friends about what should be done next, I hope you are aware of her reaction to others knowing about this addiction. I wish you talk to any one else only after taking your friend in confidence and getting her agreement.

The advice from everyone around not getting too emotionally involved is good. Although you have said that you might not be able to deal with the guilt if anything happens, but you have to realize you cannot really control the outcome. There is a good chance that, whatever you do, she might not be able to put all this behind her and become completely clean.

If you really want to help her, you need to talk to her and encourage her to get external help. Given the socio-economic context, the only problem in getting external help seems to be the social stigma and that is in no way more important than her life. She might need all her friends to stand with her and guide her parents in dealing with this rationally.

Remember, even if you do your best, you might still lose your friend to this addiction. You should be prepared for that eventuality even when you are helping her.
posted by TheLittlePrince at 11:24 AM on March 19, 2015 [2 favorites]


Update from the anonymous OP:
Thank you for all of the responses, both gentle and harsh. I realize now that talking about it with other friends without her consent was wrong. The comment from spaltavian about me pulling a fire alarm rather than having an intervention is true. It was poor judgment due to a combination of a feeling of urgency, a lack of experience with heroin use, and a selfish desire to diffuse the responsibility.

Just some clarifications:
-It is definitely heroin. Delivery method unclear.
-Parents "freaking out" about pot = they contacted her friend to urge her to talk to her and get her to stop smoking. It seemed to be out of concern and not anger.
-I have met the parents several times.
-I am not Indian.
-I do not have experience with substance abuse, but I work in mental health research and have access to resources on the subject.

I had an appointment with my therapist, did a lot of reading, and considered all of the responses here. And I'm backing off. I desperately want to help, but I'm afraid of making things worse for her than I already have. The people who can help her the most have the information they need to do so. Hopefully she gets the help she needs to recover and doesn't lose any more of her life to this drug.
posted by LobsterMitten at 12:15 PM on March 19, 2015 [11 favorites]


I want to acknowledge that your impulse to help and your concern for your friend is really amazing, regardless of how you initially reacted. I think being a friend, with an appropriate amount of distance, could be really helpful. Run it by a professional, but I was really struck by the lovely things you said about your friend. I think saying thing those things **to** her couldn't hurt & might even help. You also could tell her that you were so worried you wondered what to do, but after some deep reflection, realized that those choices are not yours to make. So, all you can do is be a friend who can listen when she wants to talk and support her as she tries to get clean. Then leave it at that. Don't debate methods, don't stage an intervention, don't loan her money, & don't make her struggle your own. If things get too intense, create some distance. That pretty much sounds like what you've decided to do, but I think it's easy to forget when we are down & out that everyone, especially those who care, often see us in a very different, positive light with lots to offer. Being reminded of that reminds a person they are deeply valued, & it's amazing what a difference that can make. No, it won't cure her addiction, but it's a small thing that could inch her closer to recovery. Good luck to you & your friend.
posted by katemcd at 1:05 PM on March 19, 2015 [6 favorites]


Excellent job OP, you are a good egg.
posted by Justinian at 1:27 PM on March 19, 2015 [4 favorites]


Thank you for the update, OP, I think you made the right call.
posted by palomar at 2:51 PM on March 19, 2015


OP, I think you are being thoughtful and considerate. You can let your friend know you support her recovery and hope she gets clean, and let her reach out to you if she needs anything more. Remember that this is not all up to you and understand that what you're doing is probably the best you can given the tenuous relationship you have. Chin up!
posted by AppleTurnover at 4:45 PM on March 19, 2015


I understand the justified concern about telling this adult's parents, but wow, I am really surprised by how many people are saying "none of your business, butt completely out". I tend to be super duper duper oriented towards privacy and caginess around independence, to a fault, but what? There is a wide and varied middle ground lying between "reality show intervention" and "good luck with that". Opiate addiction is a deadly disease; if you do care about this person I think you should offer what support is feasible, even if that's just as someone to check up on her more often than you otherwise might.
posted by threeants at 6:38 PM on March 19, 2015 [7 favorites]


I'm coming into this really late but would like to echo what everyone else is saying about NOT telling her parents. I hope you will see this. For all you know:

1) they have triggered her drug use through unhealthy relationships
2) she is telling you sordid details you will find titillating that do not have relation to her actual reality
3) they will make her drug issues worse through meddling and pressure
4) everyone in the family is doing it any ways so it seems normal

You don't know her well enough to discern any of the above. Those that do know her well enough to guess or know this may be uncomfortable to tell you.

Most close friends can tell without having to ask questions, or know in their hearts but don't want to believe (because addicts are often very functional in their day-to-day lives and wonderful, charismatic people). The best way you can support her is by being available to talk to her and by spending time with her as a friend doing the usual friend-type activities. The best way you can alienate her is by telling people who don't know. It may inflict deep shame, it may get her cut off financially and lead her into unhealthier lifestyles to survive... You just don't know her well enough to know. Simply being a friend is not an active role that makes an immediate visible difference, but it will likely have a deep impact on your friend and that is what matters - if you are strong enough to go into it with an addict for the long haul. I had my suspicions about an ex for years and standing there by him stole a decade of my life. It changed my personality and tore my world apart. I don't regret it but if you plan to involve yourself can you give this much to your friend?

I have had "friends" who did not know me well call my parents to report their fears about my well-being. I am sure they were concerned on some level but it was triggered more by their own self-doubts than the reality of what I was going through. In fact, it was more about them than me, I was just a tool for them to aid their social performance and reap the rewards of demonstrating superficial caring to a public audience. Their interference led to a lot of hassle and interference from my parents when I was not even suffering the problem I was accused of having. Specifically, it made my "friends" feel great about themselves, caused my parents undue stress, and caused me far too much grief and drama trying to prove I was not struggling with a health issue that is hard to prove one even has due to the secrecy involved.

I am not saying your friend does not have a problem. I am just saying you are the wrong person to get involved, especially if those who know her best (such as the best friend) are not supporting your plan.

My ex was a drug addict and his friends brought a lot of druggie drama to my attention because I was the only non drug user in his life (his parents used drugs too). Supposedly it was to help me help him and also to not allow myself to be used. In reality it was a group of people addicted to crack and heroin trying to enact vengeance on one another. They had no righteous motive. They only wanted to hurt my ex. The information helped me to move on but really brought me an unbearable amount of pain and suffering. From this experience I can say:

1) Her parents cannot move on, so if they are innocent parties in this I don't see how the contributions of a stranger to them will assist, especially if you have no intention of being there to help them when the fallout happens
2) You are the bearer of bad news and could end up with a bad reputation out of it, as a troublemaker, as a gossip (especially if your fears are blown out of proportion), or simply as the bearer of bad news

Sorry this is long, I do have a lot of personal experience with this and hope my words might help someone, anyone on either end of the situation.
posted by partly squamous and partly rugose at 7:44 PM on March 20, 2015 [1 favorite]


Someone close to me once got addicted to heroin after moving away from their family. A concerned friend got in touch with this person's parents, who then managed to get the person into rehab and provide other necessary support.

The friend in this case arguably overstepped their bounds, and meddled in a situation that didn't directly involve him. But at least in this case it was absolutely the right thing to do. A lot of things can prevent drug addicts from getting help on their own. They need a support network. If they are disconnected from their support network, the first step is to plug them back into it.

Some people are concerned about your friends' parents "freaking out" over drug use. I think that freaking out is an understandable and maybe even appropriate reaction for the parents to have. The question is, after they freak out, they will then provide your friend with support that she needs and won't otherwise have?

I can't answer that for you. Your friend's situation is not identical to the one I described. But your instinct to get the parents involved is not necessarily bad, and it's good that you are at least considering it carefully.
posted by mbrubeck at 9:11 PM on April 2, 2015


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