coping with substance

abuse in your family?

substance abuse in your family > caregivers > dealing with the substance abusing parent > encouraging treatment

ENCOURAGING TREATMENT

If you have tried in the past, you probably know that you cannot force a person into drug or alcohol treatment. Even if the substance abuser is mandated by the court to participate in a treatment program, the decision to make the drastic life changes that will sustain recovery must come from within each person.

While you can’t force treatment, you can encourage it. The fact is, an addict will continue to use as long as the consequences of drug use do not outweigh the benefits. It is up to you, then, to see that the addict experiences as many consequences as possible, and as few benefits. Drug treatment providers report that most people say they go into a treatment program not because they wanted to stop using drugs, but because they wanted to stop having to sleep in cars or on building roofs. They were sick of being dirty and hungry all the time. This means that you can play an important role in helping the addict get better. But the kind of help you need to give is denying the basic comforts - a warm bed, a shower, food, and concern. In short: to help, you must refuse to help. It is not until the substance abuser is too uncomfortable that treatment will be sought.

In addition to not offering comfort, you can tell the substance abuser that you would like him or her to consider treatment. You can explain that treatment is effective, and that life does not have to continue to revolve around drugs or alcohol.

Because denial is one of the hallmarks of addiction, anything you say in favor of treatment is likely to be met with some sort of statement like, "Yeah, sure I use drugs occasionally, but I just do it with friends for fun. I can stop any time I want to." Your response to this kind of retort might be something like:

"Terrific. I think it’s great that you are in control and are able to stop. Why don’t you try to stop using drugs completely for 60 (or even 90) days, just to be sure you don’t need any professional help. If you find it is too difficult to stop on your own, let’s agree now that you will try an outpatient program."

You might also want to suggest that the substance abuser attends NA or AA meetings in your community for extra support.

If the substance abuser is not able to stop after 60 (or 90) days, then you might say something like:

"When we talked about this three months ago, we agreed that you would try an outpatient program if you needed additional help quitting. I’m glad you’re willing to try this route. A lot of people are able to stay off drugs by going to an outpatient program. I know you'll give it your best. But let’s agree now that if this doesn’t work, or you go back to using again, that you will try an inpatient program."

Encouragement should be the limit of your involvement with an addicted adult. Ultimately, it has to be the substance abuser’s decision to go forward. As a concerned family member, you can offer a phone book to look up numbers, or even a few places to call. But that's as far as you should go. You should not do the real legwork – making the first appointment, going to the admissions interview. (It is okay, though, to go with the addicted parent to the first intake interview.)

(Of course, the rules are different if the addicted parent is still a teenager. Then, you must treat this like any other health problem your child might have, and handle the research and the scheduling yourself.)

Dealing with treatment centers
Once the parent has become involved with a treatment program, you might want to try to stay informed on the parent’s progress. Most treatment providers adhere to strict rules about confidentiality, and may not be able to provide you with all the information you would like. You can encourage the substance abuser to sign a release of information form upfront, allowing the treatment agency to provide you with limited kinds of information. You can also try to establish a relationship with the treatment counselor, or any other social worker your family might be dealing with, to gain access to non-confidential information.

Talking to a child about a parent’s progress in treatment
While information is important for your understanding of the situation, this is not the case for the child. You might tell the child positive news, such as "Mommy is doing well, and getting better" but avoid long-term promises. If asked, you might say "I don’t know when she will be able to come back to live with you. We will have to wait and see. But right now we can be proud of how well she is doing."

Children should be told what relapse is, and that sometimes substance abusers relapse in the course of getting better. However, incidents of relapse and other failures should not be shared with the child. If the parent is scheduled for a visit, but because of a relapse, is unable to keep the date, a child can be told "Mommy can’t come back this weekend, even though she really wants to. We will try to reschedule the visit for a few weeks from now." Children don’t understand the nature of relapse, especially the fact that relapse is common and can be an important, positive part of the recovery process. Children see relapse as the end of the world when they have pinned their hopes on recovery, and it isn’t fair to share this information with them.