How to deal with a loved family member with an addiction
January 16, 2016 3:51 PM   Subscribe

My extended family always turns to me whenever there's a problem that they are having a hard time dealing with. Most of the time, I'm able to provide something based on research or I'm able to give helpful advice. This time, I need a little help.

I'm being very cryptic because there is absolutely a victim here (the person suffering the addiction). I'd appreciate it if we none of the responses focused on the relation of this person or the type of addiction it is.

-There is person who isn't related by blood, but is very close to much of my extended family.
-Some people are closer to this person than others.
-This person has an addiction.
-My family reached out to me after they found this out.
-My family didn't find out because this person offered this information. Some things didn't add up here and there, and they were acting differently, and they basically got caught in some lies and admitted the addiction AND THAT HELP IS NEEDED.
-This person lied about their day to day life. They weren't going out and being a productive member of society or whatever, they were feeding their addiction.
-Lots of time, money, and effort by many people in my extended family was wasted because that person created a web of lies to continue with the addiction, and in hiding it.
-This person took a long vacation from work (7 mos) to engage in this. That vacation is going to come to an end in about 2 mos, and they will NOT be able to balance both the addiction and work. The person was smart from the get-go and took a "vacation"(sabbatical) when the addiction became more important than work.
-My family considers themselves to be rather old-school, but they told me that they aren't viewing this addiction as a betrayal...but as a medical problem. I'm really impressed with them.
-Everyone wants to help, but they don't know where to draw the line. I'm extremely proud of my entire extended family because of this.

The main thing is that this person is an intelligent, loving adult who has been capable of living a normal adult life. They got caught up in this addiction, not through work, friends, or environment. Thats the really weird part. They are always involved with my family. 2 of 3 meals are eaten with various members of my family. The person's social support group is my family, My family is NOT EVEN CLOSE to knowing how to get the necessary elements in starting this addiction.

Most of my extended family lives in a metropolitan area in the US. Like all big families, there have been incidents of all sorts of "modern problems" ranging from alcohol, to drugs, to teenage pregnancies. We don't consider ourselves immune from that. It has happened, and my family dealt with it. They aren't strangers to big problems.

But this comes out of nowhere. The person admitted that they sought out this addiction as a curiosity, and once it started, it consumed their life. I don't want to talk about the person or the addiction, but my family would be less surprised if a 10-year old kid was a heroin addict. Thats how surprising it is. Even to me.

Things I will not divulge, because they don't matter here:
1. ANY identifying details about this person.
2. What kind of addiction it is. Its something real. And its sad, and it mirrors other addictions.

Some other details:
-Person has an excellent career (save this vacation). but if this gets found out, they will lose their position and be blackballed from the industry.
-The job does NOT involve children, other vulnerable people, lots of cash, or anything else that could pose a problem for anyone. No safety issues. They are pretty much behind a computer screen not making decisions.
-This addiction does not have a physical withdrawal. Its not like heroin is the problem, and the person is trying to go cold turkey. That is not what this is. Its a real addiction, but there is no PHYSICAL withdrawal...psychological...YES. Even if I had been picking flowers everyday for 5 months, and I stop cold turkey...I'll still be thinking about picking flowers for a while after that.
-Person will be starting up secretive counseling sessions with someone who is an expert at this. They are a friend of the family, and although no information about what happens in the sessions goes to the family, there is a system in place so that we know he IS involved in the counseling.
-So what my family is doing is trying to become more involved in this person's life. Rather than eating 2 meals a day with various members of my family, all 3 meals now as someone is always willing to have lunch with them.

What my family has a question about is:

How do we trust this person? How do we know when we are dealing with the person vs. dealing with the addiction? Its really easy to hide, and although the person is trying to move forward, addiction is powerful and people under those circumstances have done a LOT to deceive others.

People who are closest to this person are extremely hurt, but not angry. Like I said, I'm really proud of my family for their attitude towards this situation. They want to help, but they don't know what to do regarding trust. When and how do they trust this person?

People understand that there WILL be an amount of blind trust that has to happen. We just don't know when. Does this person have to reach a certain benchmark before we believe that they aren't skipping work and engaging in their addiction again? Is our willingness to trust this person going to hurt this person's chances of getting over the addiction?

My family is really hurt by this, but their general feelings are: Yeah, we have a reason to be upset...but our priority is on getting this person back to where they want to be.

Dear mods: If you can see any information that could be identifying (even gender, age, or whatever), you have my permission to change it. I'd actually appreciate it.

Dear mefites: I'd like to hear from you if you have dealt with loved ones who have had a consuming addiction and how trust was regained. Take care of your loved ones.
posted by hal_c_on to Health & Fitness (7 answers total) 2 users marked this as a favorite
Does this person have to reach a certain benchmark before we believe that they aren't skipping work and engaging in their addiction again? Is our willingness to trust this person going to hurt this person's chances of getting over the addiction?

In the best treatment modalities (and some of the mediocre and shitty ones) this is part of the process of treatment, setting up certain accountability agreements with family and other affected parties.

Ideally this person would be in a hospital-affiliated Intensive Outpatient Program (these are significantly more common than hospital-based inpatient programs except for initial detox under medical supervision if necessary, because overnight hospitalization is too expensive for most people or insurance companies to bear. "Residential" programs are overwhelmingly insurance scams with watery and often woo-heavy twelve step programs and are often unsafe like even at the most basic levels like security, food safety, medical care etc) and would be the initiator of any accountability agreements with your family members in ways that make sense to their specific recovery needs and relationship with those specific people. If the addict isn't driving this process, it will not work.

In addition, any of your family who are attempting to assist in this person's treatment need training themselves in how to do these things, and recommendations for doing that are best obtained from the admins of the treatment program. Be wary of your family attempting to invent their own treatment program, as this is how people die.
posted by Lyn Never at 4:09 PM on January 16, 2016 [2 favorites]

I'm not an expert in any of this, but I just wanted to point that you're being a bit contradictory in calling this an addiction and saying there is no physical withdraw. I think you're trying to contrast this with opiates or tobacco, etc. which really mess with your brain circuitry. However, my lay understanding is that the definition of an addition is that it's giving you some stimulus that is pleasing and that your brain has come to rely on, and so removing it will cause some withdraw of some level.

So to echo the above - be careful in trying to devise some treatment plan without a bunch of expert advice on how to handle the situation.
posted by lab.beetle at 4:48 PM on January 16, 2016 [2 favorites]

I think this person needs treatment beyond "secretive counseling sessions" and support beyond meals with family members.

Without this person's active participation in a program of treatment and recovery, I wouldn't hold high hopes for their continued abstinence, nor would I trust them much beyond my direct observation.
posted by ottereroticist at 8:05 PM on January 16, 2016 [2 favorites]

I also think that it would help your friend for you and your family to worry less about keeping their addiction secret and more about helping them finding and getting help from others in recovery.
posted by ottereroticist at 9:22 PM on January 16, 2016 [1 favorite]

Best answer: The Smart Recovery program is worth a look as it has tracks for the addicted person and with their support system. Online, free, self-paced, confidential, the works.

_Beyond Addiction: How Science and Kindness Help People Change_ was a very helpful read.

Most of the examples in the book and the program are for substance abuse, but the principals underlying recovery are the same and transferable to any addiction.
posted by egk at 3:51 AM on January 17, 2016

Best answer: It would really help if you were more specific: What is the drug/addictive behavior and what are the related problems? If the person has agreed to get counseling with an actual expert, it may well work. But I second the recommendation of SMART and Beyond Addiction. Also, Get Your Loved One Sober by Robert Meyers can be applied to many different addictions and may be helpful as well. I wrote a book called Recovery Options: The Complete Guide, which might also be useful.

Keep in mind there's an awful lot of myth and bad information out there about addiction— starting with the idea that people need to be coerced, confronted, held accountable, put in inpatient treatment, even require treatment at all in many cases.

The reality is that even if there is physical dependence, as with heroin, what drives addiction is the psychological need to continue the behavior and what the person gets from the behavior. It is *extremely rare* (though not impossible) for someone who is not young, does not have another mental illness, has no prior history of addiction and does not have a history of childhood trauma to suddenly become addicted.

Therefore, the first step for dealing with any addiction should be getting a complete psychiatric evaluation so that the real issues can be addressed. If you just try to stop the behavior without understanding why it occurs, it's very difficult to change.
posted by Maias at 3:25 PM on January 17, 2016 [3 favorites]

Listen to Maias. She's an expert on this topic.

What strikes me is that your family seems to be really, really enmeshed in this person's life. Both physically, in terms of the amount of time you spend together, and emotionally, in terms of your investment in making sure this person's life runs the way you think it should. There may be cultural issues at play that make this situation a lot less unusual than it would be in the median western culture family. But I'm still not sure it's healthy, either for you or for your relative, especially given the way your family is responding to this issue.

The relevant questions here are:
1) What does your relative want to do? And by want, I don't mean the part of your question you wrote in capital letters about admitting that help is needed. Lots of people, including lots of addicts, will tell you what you want to hear because they're afraid that you'll be angry or upset or unhappy or just because it's easier to say the right things even if they don't mean what they say. What does your relative actually want? Do they want to continue this behavior, or stop it? Do they want to seek treatment? See a doctor? A therapist? Do they want to go back to work when the sabbatical is up? Or do they want to seek some other path in life, regardless of what your family thinks is best?
2) What, if anything, does your relative want your family to do here? And again, I mean, deep down want, not what they say they want when confronted by the entire family who are demanding to take control of the situation. Do they want your family to help with that? Do they want your family to become more involved in their life? To check up on them or eat all meals with them or help with medical treatment? Do they want to see a therapist who is a friend of the family and who will break doctor-patient privilege to reveal to the family whether they are cooperating with treatment? Or do they, actually, when not being surrounded by freaked out relatives, want you all to butt out and leave them alone?

That's it. That's what matters. What does your relative, the person who is hurting, want? What to they think they need, and what, if anything, are they asking you to do to support that choice? Most of your question is about how your family feels and whether you can trust this relative again and whether family members should be doing more. That strikes me as--forgive my bluntness--very self-centered. Instead of asking, "What is the best evidence-based treatment for X addiction that I might be able to recommend to a relative who is struggling?" your question is all about, "How can we trust this person ever again?" and "How should we check up on this person to make sure they're not betraying us?" and "How do we make sure this person is doing all the things we've decided they should do?" The question is all about you and your other relatives, and hardly at all about how to help the relative who is actually suffering. I'm not saying that to slam you. I'm saying that because I hope you'll consider the idea that your focus on your own feelings and the feelings of other family members is distracting you from what's really important: being a source of love and support to a person who is struggling to find their own way through a difficult time.

I think you need to be really, really honest with yourself here about who is driving the push to classify this behavior as an addiction and the leap into a strict treatment program and the participation of your entire family in creating a tight net around them that you're hoping will prevent them from engaging in this behavior. Because I don't see anything in your question that shows that your relative is exercising any kind of agency here. I don't see anything that indicates that they have actually, independently, asked you for any help. I see lots of indications that your relative is willing to nod and agree when your family takes control and sets out a plan, but no indication that they actually want what you're imposing on them. And even if they do want some help, I think there's a decent chance that all of this control and forced contact with relatives and constant checking up is going to backfire. Because no one wants to feel like they're being checked up on and monitored, and one of the ways people react to that is by rebelling and hiding behaviors that the monitors wouldn't approve of. (In fact, one thought that occurs to me is that suddenly taking up a secret addictive behavior well into adulthood without an obvious trigger may be a response to feeling smothered by family and needing an outlet for those feelings, but not being able to find one without hiding things. Not that I'm saying your family is to blame, but just that this could be a really, really hard situation for your relative to be in, and turning up the pressure and control may make it even harder.)

My advice to you would be to back way, way off, and to advise your other family members that they need to back way, way off. Let your relative come to you if they want to ask for something specific, but let that be their decision that they control, not a decision arrived at by a consensus of the rest of your family. That means no putting together plans to monitor them, and no reports from their therapist to family members to prove that they're engaging in treatment, and no checking up on them to make sure that they're doing the things your family thinks they should. The number of meals per day they eat with whom is a decision adults get to make for themselves. Adults also get to choose their own medical professionals, decline medical treatment if they don't want it, and participate in medical treatment without being monitored by relatives. Right now, you and your family are doing all of the decision-making. That's both counterproductive and profoundly disrespectful of another adult's right to make their own decisions, whether or not you approve of or like those decisions.
posted by decathecting at 5:27 PM on January 17, 2016 [3 favorites]

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