A Guide for the Families of Addicts and Alcoholics
I am active in recovery and have also lost a family member from this disease. I wrote this as a basic guide to help other people who have loved one’s who are addicts and alcoholics. This guide is based on research I conducted to try to understand how to help my brother and from my own experiences – both with him and getting clean and sober myself. These are also things I wish I had shared with my family members.
Also, the terms used; Substance Use Disorder is the mental health term for what is commonly referred to as alcoholism and/or addiction. I use the terms synonymously as well as the terms alcoholic and addict to describe individuals suffering from substance use disorder. The terms used are just a means of making this guide as broad as possible.
In 2014 20.2 million Americans had substance use disorder, which was 8.4 % of the U.S. population. Given the statistics, it is not at all uncommon for families to have one or more members dealing with this disease. The goal of this article is to help families, with members afflicted with addiction and alcoholism, determine how best to deal with common issues that arise and help support loved ones on their path to recovery, individuals dealing with alcoholism and addiction, who become active in their own recovery, increase the likelihood of becoming happy, healthy, and productive members of our society.
Understanding the disease
One of the biggest issues that parents, siblings, children, and spouses of people struggling with addiction and/or alcoholism encounter is the difficulty of understanding this disease. The first step a family member can take when trying to help a loved one is educating themselves. The more an individual knows about alcoholism and addiction the better equipped they are to support their loved one when they are ready for help. There is an endless supply of information online so it is important to check the source of the information.
Some organizations that may be helpful are AA, Al-anon, NA, and Nar-anon. These organizations are all 12-step peer support programs. Going to these fellowships can help in numerous ways. Both NA and AA are programs that your loved one can be directed to once they are ready to receive help. This recovery community can help your loved one connect with others who are dealing with the same issues and can offer suggestions for how they can stay on the path of recovery. Al-Anon and Nar-anon are fellowships of family members of addicts and alcoholics. Al-anon and Nar-anon can offer support, and help you gain a better perspective on how your loved one’s behavior has impacted your life.
How the Disease Works
Those who are do not suffer from the disease of addiction, often times struggle with understanding why a person doesn’t just stop using drugs/drinking. Unfortunately, for addicts, they are unable to stop using even if they want to. This does not mean they are not responsible for their recovery. It seems that often the hardest thing an addict/alcoholic has to do is finally admit they need help to escape the grip of this disease. It is important to remember that an addict is often described as “someone who uses when they don’t want to”. (NA Basic Text).
The progression of the disease varies from individual to individual. t is impossible to tell how long it might take someone’s use of alcohol are narcotics to reach a point where it is noticeably affecting their lives, behaviors, and ability to function in day to day life. he early stages of the disease often go unnoticed, are those stages are attributed to simple teenage rebellion. However, once a family becomes aware of their loved one’s disease, one of the worst things to do is make them feel alienated and divided from the family. Addicts and alcoholics need love and support to have the best chance of succeeding in their recovery.
How to be caring but not enabling
The disease isolates the addict and alcoholic, making them feel unwanted, less than human, as though they are a monstrous, vile creature incapable of being loved. The stigma attached to addiction, can make that person feel as though they are the lowest member of society and can never fit in. Unfortunately, as the disease progresses the addict and alcoholics’ morality may also deteriorate as the obsession to continue getting high/drunk becomes the most important thing in his or her life. The feelings of isolation contribute to that loss of a moral conscience. This can makes caring for the addict/alcoholic that much more difficult.
There is a fine line between caring for an alcoholic/addict and enabling their disease. One thing that should be avoided is giving them money directly. An addict/alcoholic may provide numerous reason or excuses for why they need money. You can still help with ensuring their basic needs are met by going to the store with them to purchase food, hygiene supplies, clothes, etc. However, it is generally not a good idea to supply them with money directly.
You can also suggest they get involved in a twelve-step program. Understand that you cannot force your loved one to attend and it is up to them to make the decision to actually attend meetings. Most 12 step meetings provide free literature that you can provide your loved one, explaining what happens at meetings and how these programs have shown success in helping others stay clean. Try not to get discouraged if they refuse to attend one of these programs.
There are still other ways in which you can help direct your loved one into recovery. If they complain about the lack of trust you are exhibiting, be firm. Tell them that you love them, and that it is not them that you don’t trust them, but the disease. Be kind and as gently as possible, but also assert that you want them to get better. Explain that you are taking steps necessary to keep your family safe and not enable their using.
If your loved one begins to steal from you or anyone else to support their drug or alcohol habit, it is time to begin considering whether living with you is still an option. This is a difficult decision to make. You can stage an intervention or talk to your loved one about their behavior and why you don’t want them to continue living with you. Point out that you don’t know how to help them if they aren’t willing to help themselves. Consider what your personal boundaries are and stick to them. You should never put your own sanity and/or safety at risk to cater to your loved one’s disease.
Determining if an intervention is necessary
An intervention is a meeting of family members, friends, and co-workers along with the individual in crisis. Whether or not your loved one may benefit from an intervention depends on their personal awareness of their addiction. Interventions are generally used when an individual is in denial about their disease.
Before staging an intervention, there are a few questions you may want to consider. Will your loved one be receptive? Can you help them become more receptive? How willing do you believe they are to change? What might best help them to want to change? Are there people that are close to them that might be influential in the addict/alcoholic’s decision-making process?
Once these questions have been considered the next step is to determine how you want to run the intervention. While family and friends can stage an intervention on their own, it may be best to get a trained interventionist to facilitate. An interventionist can help the addict/alcoholic avoid feeling as though they are under attack.
Here are some resources on how best to plan and stage an intervention:
Drug and Alcohol Treatment Facilities
It is likely that your loved one will need some form of drug and alcohol treatment to help begin on their road to recovery. It is helpful to understand the various different levels of care to determine which may be most effective for your loved one..
Detoxes and Short-Term Residential Programs
Detoxes are medically assisted programs where the immediate issues related to withdrawals are dealt with. Anyone that has been abusing opiates, opioids, benzodiazepines (Klonopin, Xanax, Ativan, Librium, Valium, and Tranxene), or alcohol may be in need of a detox. The withdrawals from these substances are extraordinarily difficult and sometimes fatal, in the case of alcohol and benzos. Withdrawal should be done only under medical supervision. Finding a detox can be done through contacting the IME Helpline at 844-276-2777 or going to https://www.samhsa.gov/ .
Most detoxes last approximately a week. After completing a detox program many of those dealing with substance abuse have found they need further help to develop the skills necessary for long term recovery. There are a multitude of options available to those in need of additional care.
IOP and Long-Term Residential Programs
The first option is a short term residential treatment. Short term residential programs offer groups and housing for people dealing with drug and alcohol related problems. They are often a stepping stone toward long term recovery.
There are Intensive Outpatient Programs (IOP) available that offer longer term treatment. Individuals live at home but attend a program normally consistent with regular weekly work hours. This means they are working on their recovery in a specialized setting throughout the day but will be allowed to return home each evening. IOPs will sometimes provide transportation to their programs. However, remaining at home does make it much easier for the addict or alcoholic to fall back into old patterns of behavior. Therefore, if the addict or alcoholic is to remain at home the family can offer its support by helping to keep the environment drug and alcohol free.
There are also long-term treatment facilities that offer both housing and IOP. These facilities are a great option for individuals where the home environment may not be ideal for recovery. This type of program can also help maintain one of the suggestions of 12-step programs, “avoid people places and things you used with or at”. Such programs are often an ideal setting for both your loved one and yourself. It gives both the addict and their family time to heal.
Sober living homes, are house-shares where all the occupants have decided not to use. All of the residents in a sober living home typically help each other to stay clean and sober. There are different types of sober living facilities, some where there is a small staff that helps to guide residents into recovery. Others are completely run by the residents themselves.
Helping with long term recovery
Once a loved one has begun their journey on the road of recovery, there are numerous ways to show your support. Take an interest in what they have to say about recovery. Ask about the steps and traditions of whatever fellowship they belong to. Ask about the different kinds of meetings they attend. . Take pride in what they are accomplishing, and considering attending any milestone celebrations you are invited to.. Keep in mind that many 12 step meetings only allow their particular members to openly share. Encourage your loved one to tell you about their experience and any expectations they may have if you accompany them.
Help with Triggers
Try to be supportive of the life changes your loved one has made. Plan family events with them in mind. Even if a loved one states they are comfortable being around others who are drinking or using drugs, that may change once they are in that environment. Consider planning events where there are no substances present. If that is not possible, help your loved one create a safety plan. The greater their support network, the more options they will have if presented with a situation that triggers unwanted feelings.
If you and your loved one attend a family function where alcohol is present, try to be supportive without constantly overshadowing them. Make yourself available. Ask the person hosting if your loved one can bring a friend for support. Encourage them to communicate with others in recovery ahead of time. You can also help create a plan, allowing your loved one to leave the event if it becomes too difficult for them.
Be Aware Your Own Use of Alcohol or Other Drugs
Keep in mind that if you drink or use other drugs, using those substances in front of your loved one can be detrimental to their recovery. If they are working a recovery program, they will most likely be told to keep their distance from anyone who is using drugs or drinking. Therefore, if they say that they would rather not attend or visit you at any time, be understanding. Try to take comfort that they are doing what they can to be successful in their recovery which often leads to happier healthier relationships.
Dealing with relapse
Something to keep in mind is there is a difference between a slip and full-blown relapse. A slip often happens in early recovery. An addict or alcoholic may use something that is not even their drug of choice, but they will have used a substance, no matter what it is, they will have lost their clean/sober time. A slip is a singular occurrence, which is immediately followed by an admission of having gotten high/drunk. The admission of having fallen short, is extremely important. It means they are still recovering and involved in recovery, and your reaction will be the difference between full blown relapse and it being a singular occurrence.
Assess the Situation
If an addict/alcoholic tells you that they used, ask them how it happened. Ask them if they talked to their sponsor, (if they don’t have a sponsor, let them know that you’ve heard it’s an important part of most recovery programs). Let them know you want to help them. Ask was this a slip or are you relapsing. If you determine it was a slip, a brief occurrence before they start truly recovering, then simply continue being supportive.
A relapse is different. It’s marked by deceit. An addict/alcoholic won’t want to admit they are using after one occurrence. They will continue using, it will go on for months. You’ll start to notice signs that they have slipped back into their addiction/alcoholism. The main thing is they aren’t the one telling you, you’ll find out from someone else, or learn about it through physical and behavioral signs they’ll present.
If your loved one relapses especially after an extended period of abstinence from drugs and alcohol. They will be embarrassed, devastated, and it will be difficult for them to admit that they have fallen back into addiction or alcoholism. The best thing to do is not to accuse them of not trying hard enough, but rather to simply be understanding and supportive, when they do want help again. There is little help you can offer at this point.
At this point your loved one is in a precarious situation, they have gone back to using alcohol are drugs. Your loved one is full of shame, guilt, and remorse, but they are also plunged back into the deepest depths of their disease. Often, at this point all their moral values are eroded, they are looking for any excuse to keep using, to avoid 12-step programs, to avoid getting clean and/or sober. Be firm, the best thing you can do for them at this point is trying to get them into treatment.
Five key things to do once relapse has occurred:
- Don’t give your loved one any type of direct financial assistance, they do not need your money, and will use it for drugs.
- Don’t let your loved one live with you and make certain family members are aware not to do so either.
- As often as possible offer your loved one help getting into treatment, whether through emotional support or financial support.
- Offer to take them to lunch, dinner, buy them a cup of coffee. Spend an hour or more with them and let them know that you love them and that you care for them.
- Don’t blame yourself.
It is important for family members of alcoholics and addicts to remember to take care of themselves. When your loved one is actively using alcohol and/or drugs it’s difficult to deal with the stress that comes from worrying about them and their safety. Even after they enter recovery it’s a struggle not to be caught up in concerns about whether or not they’ll be okay.
Nar-anon and Al-anon are support groups and will help deal with the stress related to their using. These programs will also help you understand some of your loved one’s processes in recovery. It will be helpful for you to build a network of people going through some of the same issues you are, so that you do not become overwhelmed.
There are also numerous things you can do to help yourself relax and take your mind off the issues your loved one is dealing with. Here are some helpful sites to deal with general stress:
There are simple and clear steps to take to help a loved one deal with alcoholism and/or addiction. Offering help and setting boundaries is beneficial to your loved one’s long term recovery. Be aware of issues related to alcoholism and addiction, while continuing to educate yourself on these issues. The best way to help your loved one is by trying to understand the nature of alcoholism and addiction.
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