Tag Archives: Substance Abuse

Can I force my loved one into rehab for their addiction? 

After 10 years of working in the field of addiction treatment I have seen and learned a lot. Every day I receive phone calls from all types of people including many who have a loved one who is spiraling out of control, caught in the cycle of an addiction. An addiction to alcohol, prescription medications, heroin, methamphetamines and other drugs including marijuana. Although now legal in CA and some other states marijuana these days is stronger than ever and the number of reported cases where an individual is delusional, paranoid and hallucinating is skyrocketing. Most people minimize marijuana but let me tell you, the weed these days is no joke. At the end of the day, the substance isn’t really the most important factor. If an individual is using any type of substance and causing damage to their bodies, their families, their work life, the bottom line is that they need professional help. But what do you do if you try talking to this person and desperately try to beg and plead with them to get help but they just wont?

The simple truth is that the individual with the addiction is unlikely to change until they feel some serious pain from their own consequences.

Addicts and any of us for that matter usually don’t want to change until they themselves are faced with the harsh reality that their behavior and choices are beginning to cause them to lose any and all of the relationships, income, possessions, , their job, food and any other resources of value in their life. Most often times the loved ones in their lives can see clearly what is happening and take on all the negative emotions and consequences that the addict should be dealing with themselves.

The only way an addiction treatment center can help someone change is if an individual truly wants to change. They don’t always need to be fully excited about going into treatment, I mean who really dreams about going to rehab but you can help a loved one find their willingness to change and accept help for their drug and alcohol addiction. When a loved one rescues their addict out of the consequences of their addiction the addict really hasn’t felt the full magnitude of their own choices and behavior. You see an addict addict has an impaired brain and their frontal cortex has been damaged. That’s the part of our brain that provides us with the ability to have good judgement. When this is impaired they lose the ability to clearly understand how their addiction is not only ruining their lives but also greatly affecting their loved ones. So where most people can see that getting a DUI and getting arrested will cost substantial time and money and hardship which will likely cause them to make a different choice the next time they are faced with choosing to drink and drive or call an Uber the next time, the addict may minimize the incident if mom or dad is taking out loans to bail their son out of jail and pay for an attorney to help him reduce the penalties associated with the DUI. Consequences and clear boundaries are what make all the difference in the world when it comes to an addict finding their willingness to receive help.

For about the last year I have received a phone call every few months from the same woman with a son who is in his 40’s. She calls frantically looking for help for her son usually after something bad has just happened. She is often exhausted and overwhelmed and has  usually been bringing him food to his house and in pure emotionally agony begging her son to go to a treatment center for help.  He has now been charged with 4 DUI’s and is facing prison and she is beside herself with worry and fear. Yet her son has never called us once to do the over the phone assessment we need to do. The willingness to even talk to a counselor about how he can begin to change is not there. It looks like prison is the likely path for him. The best thing she can do is seek support and help for herself because the worry is literally killing her. This is so so sad because she is suffering so much but she could learn how to step back and focus on taking care of herself instead of putting so much energy into someone who is unwilling to change. This would likely help her son wake up and call us or another treatment center and ask for help. She could simply hand him the number and say I hope you get help and leave the number with him. He is capable of dialing the number. We will answer and all he has to do is say I need help. Some people just won’t ever seek help but that doesn’t mean that 2 people or a whole family have to suffer because 1 person is unwilling to change. Many years ago when I was caught In the codependency cycle myself and my own life was sinking because I was so focused on my significant other who had a raging alcohol addiction that I thought I could change, someone helped me by shining a light on my situation and gave me this analogy. They said, “He’s the Titanic and you are holding on to a sinking ship and he is taking you down with him. You can’t control it. “ At that moment, it clicked for me because at that time I was completely exhausted, emotionally, physically, my work was suffering, my health was suffering and I was completely obsessed to the point of totally neglecting myself in every way. I was going down too and I had to stop or I was going to end up worse off than he was. My happiness was my own responsibility but I was giving all my power away to someone else and not taking responsibility for my own life.

Addicts will take out everyone and everything in their path as long as they are allowed to. So here is where things can change…..

What about having an intervention? Will this work?

Many times per week I also receive phone calls from people who call up saying, “I have a son and our family is going to have an intervention tomorrow, we want to know if you have a bed in your facility?” This is where I want to say “WAIT! STOP RIGHT THERE, Is there a professional leading the intervention?"

Addiction is a highly complicated brain disorder that causes the brain of an addict to become hijacked. Which in turn causes the individual with the addiction to lie cheat steal and focus solely on one thing, getting more of their drug of choice and to stop at nothing until they do. Dealing with an addict requires highly skilled professionals who know that the hell they are doing. It requires a great deal of education and understanding. An intervention done by the family without a professional usually ends in a worse disaster. If you are reading this and considering doing your own intervention….. PLEASE do not do it. Stop and get some professional guidance. What is most likely to happen is a huge family argument and lots of emotions being spilled out all over the place, threats, physical fights and in the end? The addict runs off faster and harder to their first love, their drug of choice to numb the pain and sink deeper into their addiction and isolate themselves from their loved ones ever more than before. Basically a home made intervention done with inexperienced individuals will almost always cause a greater disaster than where you began. This will push your addict deeper into their addiction.

What a trained interventionist provides is a great deal of education and leadership on how to most effectively change the direction of the entire family dynamics and to help the loved ones learn what is enabling the addiction to continue and how to set proper boundaries with the addict . An interventionist will educate and walk you through the process and be there for you every step of the way. An interventionist also provides an emotionally detached person who cannot be manipulated by the addict when it comes times for the actual intervention. They are your quarterback. Don’t do it alone.

When 3 or 4 people who are close to the addict all get on the same page and simultaneously begin to get clear on what is helping and what is harming and start to say no I will no longer help you until you get some help for your addiction, then the addict loses the power to be able to manipulate their loved ones and the addict will begin to become more concerned with human survival than scoring more heroin or running off to the liquor store.

When you let a loved one move into your house and provide them food and money to keep their cell phone working, insurance covered, car payment covered, you are enabling their addiction to survive and thrive. This is harming them. It is not helping them at all.

Most people do not by any means intentionally try to bring harm to their loved one. They usually are providing for their addicts basic human needs while worrying themselves sick, secretly hoping they can control or coerce their loved one into getting help.

All the begging, pleading, criticizing, arguing and tell their loved one how much they need to get help and how hard all of this is and how they are spending all their money on trying to help them. Trying to guilt and shame them into getting help almost never works.

So how do you help a loved one find their willingness to seek help for their addiction? Clear boundaries and follow through works almost every time

Here is a simple statement that you can use for guidance.

I love you and it’s become clear that I cannot help you get past this addiction. You need help from experts who know about your illness. I can no longer provide any help to you financially, emotionally or in any way until you are willing to seek help for your addiction. I am willing to help support you financially and/or emotionally until you decide to seek help. Until then I will no longer provide any help financially and or emotionally and I will no longer allow you to live in my home, buy you food, pay for anything at all for you because it is not helping you and the stress is causing harm to me.

Now, the most important part of speaking these type of words is making 100% sure that you can and will follow through on what you speak. NEVER set a boundary and then allow anyone and especially the person who is addicted to violate the boundary. If you speak it and then don’t follow through you render yourself powerless and the addiction will gain more power over you and your loved one.

Most loved ones need help and support to actually be able to do this. It’s not easy for a parent to actually cut off any type of support and contact with their adult child who is actively destroying their life. It is natural for us all to attach to those we love and it can be excruciatingly difficult to have your adult kid begging for food or money. Excruciatingly painful to kick them out of the house and know that they are living outside in harsh conditions and not feel extreme anxiety and worry about them. These emotions are difficult and you need support from qualified people to get through this. However if you provide your loved one with the choice to either choose help or choose addiction then the choice has become theirs. It is necessary and healthy to give your loved one a choice. Choose to become healthy or choose to stay in addiction. By stepping out of the chaos and taking care of yourself by seeking support and guidance through this extremely complicated time you are helping your loved one find the survival skills within them to fight for their own life. Addiction is no joke and it takes lives every day. The drugs these days are harder and stronger than ever and if you want to help your loved one you need to seek help and put on your own oxygen mask for yourself first. Hand the consequences back to your loved one and let them deal with their life themselves. By helping them pay their bills, provide them food, provide them shelter, hire them an attorney to minimize consequences you are helping them avoid the very crisis they need to wake up and accept help.

Debunking Myths About Substance Abuse

Pathways -- Debunking Myths About Substance Abuse -- 08-23-16Common Myths About Substance Abuse and Addiction

Ever since Richard Nixon's "war on drugs" started over 40 years ago and Nancy Reagan's "Just Say No" campaign began in the 1980's, addiction treatment professionals have been fighting an uphill battle against myths and stereotypes related to substance abuse and addiction treatment.  Considering that substance abuse and addiction treatment cost this country about $600 billion per year in medical, criminal, social, and economic costs, it is high time (no pun intended) to debunk some of these myths and stereotypes.  This article attempts to do so by providing a brief summary of some of the myths and stereotypes and talking about the realities of substance abuse and addiction treatment.

Myth #1:  It's impossible to prevent substance abuse.  People who are going to use drugs are going to use drugs.

This myth is supported by the scare tactics, fear, and hyperbole surrounding substance abuse.  Instead of looking into the reasons that people decide to abuse drugs, the "war on drugs" has turned substance abuse into a criminal and moral issue where people requiring addiction treatment have weak character or bad morals.  The reality is that several risk factors are very good indicators of an individual's likelihood to abuse drugs.  These include environmental factors like growing up in poverty or in a dangerous neighborhood, living in an alcoholic household while growing up, losing parents at an early age either through death or divorce, and mental and emotional factors like learning disabilities and mental disorders.  When we begin to address these risk factors,  then we will begin to prevent substance abuse and leave the "Just Say No" mythology behind.

Myth #2: Addiction is a voluntary behavior.

While it may be true that many people start out as recreational drug users or social drinkers, the progressive nature of addiction eventually leads addicts to a point where choice is no longer an option.  Over time continued drug abuse and heavy drinking will change the addict's or alcoholic's brain in such a manner that compulsive and uncontrollable substance abuse becomes their reality.  No matter how much will power they may have, their physical and psychological dependence on drugs and alcohol makes get clean and sober almost impossible without some form of addiction treatment program where a workable solution for staying off of drugs and alcohol is attainable.

Myth #3: Marijuana is not addictive and it's not a gateway drug.

While many people who use marijuana recreationally have no major consequences, other people do develop dependence on the drug and you would be hard pressed to find a hardcore drug user who didn't have some amount of marijuana use in their drug use history.  Certainly the same thing can be said about alcohol which is legal.  So this is not an argument one way or the other for the legalization of marijuana.  Rather this is a statement that addiction is a personal issue and any form of mind altering substance can contribute to the progression of the disease of addiction.  So, for anyone who has addiction as part of their make-up marijuana should be avoided.

Myth #4: Someone has to want to pursue addiction treatment for it to be effective.

Many people enter into addiction treatment programs against their will by either a court order or through family pressure.  This does not mean that the treatment for their addiction that they receive while they are in the program will be ineffective.  In fact, many studies have shown that people who enter into addiction treatment programs unwillingly do better than average in their addiction treatment efforts.

Myth #5: Substance abuse treatment should be a one shot deal.

addiction treatmentLike many chronic diseases addiction may require more than one treatment.  Certainly it is common for people with diabetes to undergo continuous treatment to keep it under control, and it is not uncommon for people with diseases like cancer to undergo more than one treatment when their disease returns.  Certainly many people with substance abuse problems have quit "cold turkey", but the majority of people requiring addiction treatment will require longer term treatment or in many cases repeated stays at addiction treatment facilities.

 Myth #6 Addiction treatment doesn't work.

With the growing acceptance that addiction is a disease, substance abuse programs have changed their treatment methodologies accordingly with the understanding that there is no "magic bullet" for addiction treatment.  The reasons why people become addicted to drugs and alcohol vary.  So it is important to provide a variety of addiction treatment methods which can address the needs of the individual addict.  By improving the way addiction treatment is applied and working on the reasons why people got involved with substance abuse in the first place, the success rate for addiction treatment has shown drastic improvements.  Recent studies have shown that addiction treatment reduced drug use by 40 to 60 percent.  There are also side benefits demonstrated by effective addiction treatment including a reduction in crime and HIV infection and improvements in addict's ability to become gainfully employed after treatment.

This is certainly not a complete list of the myths and stereotypes surrounding addiction treatment and substance abuse.  The bottom line is that knowledge is the most important asset one can have when seeking help for themselves or a loved one.  The road of recovery from substance abuse is usually a long one, but the destination is worth the effort.  Especially when you consider the consequences of untreated addiction.  Addiction is a disease, and diseases kill people.  Or at a minimum they make their quality of life so poor that life just isn't worth living anymore.

If you or a loved one is struggling with substance abuse and is seeking answers about addiction treatment, contact a professional in the field of addiction treatment.  Unless your family doctor is a specialist in addiction medicine don't trust their advice without doing research on your own.  The knowledge you acquire through doing the work yourself may be the difference between life and death.

Related Blogs

New Discoveries In The Science Of Addiction

New Discoveries In The Science Of AddictionOpioid addiction is a serious problem across the country. An estimated 2.1 million people in the United States are dealing with an addiction to prescription opioid pain relievers. Another 500,000 suffer from a dependency on heroin. The consequences of these numbers are devastating, and unfortunately, the number of cases is rising.

Overdose deaths are soaring; they have more than quadrupled since 1999. Of course, this isn’t news—media outlets have been covering the many occurrences of heroin-related overdoses and fatalities throughout the country, in both rural and urban areas. Most overdoses are fatal. Sometimes this is from using alone, but it’s often from fear of arrest. Users are reluctant to call 911 and report using illegal drugs, and those who are using with the person in danger may be equally afraid of the police.

Treating Opioid Addiction

Finding viable treatment options is vital for saving lives across the nation. Scientists have been creating new technology to help people live more normal lives while recovering from drug dependency. In many cases, the symptoms of withdrawal are too severe for individuals to cope, and so they return to taking the drug. Because of this, quitting alone is rarely effective—and in some cases, it can be dangerous.

Medication-assisted therapy, or MAT, is the most effective way to treat opioid addiction. Buprenorphine is the gold standard drug for treatment. It’s a partial opioid agonist, working similarly as other opioids, but more safely. This helps provide relief from withdrawal symptoms with greatly reduced risks. Buprenorphine can allow for:

  • Less euphoria and lower risk of dependence
  • Less potential for misuse
  • Relatively mild withdrawal issues
  • Blocked effects from other opioids
  • Support during treatment
  • Suppressed opioid withdrawal symptoms
  • Suppressed opioid cravings
  • Reduced opioid use

These benefits have helped the drug become a popular answer for addiction problems across the nation. The most effective MAT treatments available take advantage of the medication.

Atrigel® From Indivior

One of the methods pending FDA approval is RBP-6000. It’s made possible by the Atrigel® system, which is a delivery complex placed subcutaneously on the addict. It works the same way as a nicotine patch: it’s stored on the body and diffused over time.

The main difference between it and a nicotine patch is that it’s injected into the skin instead of being applied on top of it. RBP-6000 is stored in a polymer matrix that’s completely biodegradable. Another compound (n-methyl pyrrolidone) ensures that the buprenorphine is controlled and released over a period of about a month. This type of steady, dependable application helps further reduce the risks of withdrawal symptoms and other opioid cravings.

Because of the opioid abuse epidemic that we’re facing, the FDA has granted RBP-6000 fast-track designation. The sooner it’s released on the market, the sooner people can begin battling their addictions. The pharmaceutical company, Indivior, hopes to apply for approval in early 2017.

Probuphine From Titan Pharmaceuticals

Another alternative to dissolvable tablets (the method originally developed for buprenorphine), is Probuphine. It was developed with the ProNeura platform, and like RBP-6000, it’s placed beneath the skin. That’s where the similarities end, however.

A physician places four small “rods” within the patient’s arm. These sections are each no bigger than a matchstick. They sit comfortably within the skin and release a constant, low dose of medicine for an astounding six months—which means much more consistency for the patient and less roller coaster–like withdrawal symptoms. The FDA has already approved the treatment.

Many clinics are learning how to properly administer these implants. Because they require no maintenance for such a long period of time, it’s easier for individuals to focus on therapy and quitting other opioids.

Whether it’s subcutaneous gel or small implants, treatment options for opioid addiction are increasing. New discoveries are leading to dependable and effective solutions that help patients find a more natural rhythm in their lives.

Your Guide To Substance Abuse Interventions

Substance Abuse InterventionsAddiction can change a person’s life. Substance abuse can alter priorities, motivations, and personalities. When a person doesn’t want to face a personal drug abuse problem, someone else must step in and offer assistance. Interventions are designed to help an individual realize and accept the need for treatment.

What Is A Formal Intervention?

Most interventions involve education, preparation, and some form of meeting. Since many substance abusers experience extreme denial regarding the substance abuse, interventions are designed to help addicts understand how behaviors impact themselves and others.

An intervention should never feel like an accusation, punishment, or forced communication. Instead, it should serve as a supportive and eye-opening experience for the person suffering from addiction and those wanting to contribute to the recovery process.

When Is An Intervention Needed?

Not all substance abusers require an intervention. Some recognize the problem with little or no input from loved ones or communities. Others, however, can’t see how addictive behaviors can negatively affect others. The addict may not realize or may deny a substance abuse problem. Anyone who needs motivation to seek rehabilitation, therapy, or outside support can benefit from an intervention.

Types Of Interventions

Intervention methods aren’t one-size-fits-all. Depending on the level of denial and an individual’s relationship with a support network, some types of intervention prove more effective than others. Some of the most common types of interventions include:

  • CRAFT (Community Reinforcement Approach and Family Training Model). Instead of sitting down with someone who suffers from addiction, this approach values a more indirect approach. In this method, loved ones use encouraging strategies to help the addict arrive at the conclusion of recovery. CRAFT works because it focuses on indirect motivation instead of a direct confrontation.
  • Johnson Intervention Model. The stereotypical intervention model, this approach relies on the success of a surprise meeting and confrontation. During this type of intervention, loved ones may share the effects of addiction and pledge their support to the recovery process. This approach can put a substance abuser on the defensive and can move the person farther away from successful treatment.
  • Invitational Model. Like the Johnson Intervention Model, this approach requires an in-person meeting. Instead of a surprise, however, the substance abuser is provided details of what will take place and must make a personal choice to attend the intervention.

Recovery specialists also use other intervention models that blend the approaches of these three basic models. These intervention approaches all serve the ultimate goal of bringing awareness of the problem into the substance abuser’s life.

How To Stage An Intervention For A Loved One

Investing in an intervention typically indicates a substance abuser crossed an invisible line. The addiction is causing noticeable harm to the addict and to the surrounding community. Realizing the possibility of a DUI accident, seeing a loved one’s personality slip away, or recognizing poor performance in daily activities all serve as impetuses for staging an intervention. Consider these tips for creating a successful encounter:

  • Formalize the plan. Do consider asking for help from a qualified recovery specialist. Someone who understands addiction can guide friends and family in the right direction and reduce the risk of negative consequences.
  • Research. Try to discover how much alcohol or drugs affect a loved one’s life. Understand the recovery process for certain substances, and explore possible treatment programs available to the individual. Many substance abusers must check into an inpatient facility to detox and begin the road to recovery.
  • Commit to consequences. Consequences can serve as a powerful motivator. If the individual doesn’t agree to the terms of the intervention, consequences—such as avoiding enabling activities—can serve as more of an eye-opening experience.
  • Stay in touch. Someone needs to follow up after an intervention to ensure the loved one stays in treatment, feels supported, or has access to recovery at any point.

Addiction is a powerful enemy. People who suffer from substance abuse need support, guidance, and tough love to recover fully and permanently. Consider partnering with a team of professionals and loved ones who can commit to helping someone overcome substance abuse.

Substance Abuse Treatment In The Military

Substance Abuse Treatment in the MilitaryMany people use drugs and alcohol as coping mechanisms. They find relief and distraction with routine consumption. Stressful jobs or past experiences increase the chance that an individual will turn to substance abuse. Naturally, the strain that those who serve in the military endure puts them at an even higher risk for substance abuse.

The suicide rate among our country’s service men and women is rapidly escalating. Experts agree that repeated deployments to Iraq and Afghanistan are likely connected to this number. Our forces are traveling to hostile lands multiple times; for them, deployments can feel interminable. The result is that more and more military personnel are seeing longer and more frequent tours of duty.

A Rise In Military Suicides

For the past seven years, military suicide rates have been on the rise. Experts are now claiming that this could be the new “normal” statistic. In 2015, there were 256 suicides for active-duty personnel alone. An estimated 18-22 veterans commit suicide each and every day.

Although all suicide rates have increased nationally, the statistics involving soldiers’ suicides are particularly grim. Those in the military—both who have been sent to wars and those who haven’t—suffer the loss of those men and women. The loss of like-minded individuals and friends at such a rate can cause anxiety and stress. This is one of the reasons why so many veterans and active-duty individuals turn to drugs and alcohol.

Searching For Relief With Drugs

Illicit drug use rates are actually lower in the military than they are among civilians. Of course, they are likely being tested during active duty, when there is little downtime. When they are on base, drugs are much more difficult to procure, and drug tests are common. Instead of using illegal drugs, however, many military personnel rely on heavy alcohol and tobacco use. Others will fall victim to cycles of prescription drug abuse.

Unfortunately, searching for relief through these outlets increases the risk of suicide. Alcohol, for example, is a depressant. Despite the fact that it’s associated with fun and socialization, drinking can pull a person’s mood even further down if he or she is already depressed. In more than 25% of suicides, the individual was intoxicated at the time.

Prescription drugs can boost this risk, too. Dependency and withdrawal symptoms, such as hallucinations and mood swings, may be enough to encourage suicide in an already depressed individual. Painkillers, psychotropics, and antidepressants are some of the most powerful drugs available with a prescription, and they are also ones that present the greatest risk of suicide with their use.

Other Drug Risks

Even without considering the increase in suicide rates, abusing alcohol and other drugs is dangerous. Tobacco is known to cause lung, mouth, and throat cancer among users. Different applications offer different targeted risks, although mouth and throat cancer are the most common. Using cigarettes or chewing tobacco also increases the risk of heart disease and damages the physical appearance. Long-term use manifests with yellowed fingers, rotting teeth, and less elastic skin.

Alcohol causes dangerous and often deadly accidents. Driving under the influence is a factor in 28 fatal crashes per day. It also contributes to countless non-fatal but serious accidents, such as slips falls. Regular consumption negatively affects the liver, gastrointestinal system, and esophagus.

The risks for prescription drugs vary widely depending on the drug in question, but most present strong withdrawal symptoms with continued use. These effects can range from tremors and itching to hallucinations.

Seeking Help

It can be remarkably difficult for active duty personnel to seek help for a drug or alcohol dependence. There’s usually a stigma associated with addiction, particularly among the armed forces. Strict no-tolerance policies can leave staff fearful that seeking assistance will cost them their jobs. Such factors prevent many people from finding the guidance that they need.

There are a few veteran programs available, which the VA partially funds. Individuals must qualify for treatment and enroll in one of the care programs. Active duty personnel are left with fewer options, and unfortunately, this inequality is rarely discussed. It’s hard to cope with deployment on its own, but substance abuse can make it even more difficult.

For now, private treatment facilities are the best option for military staff seeking help. These organizations offer special care while catering to their patients’ specific needs. Different options are available depending on the severity of the addiction, so individuals can get the help that they need to abstain and recover.