1- What to do if a loved one has an addiction problem?
This is a difficult scenario. Boundary setting such as enabling can be a difficult concept to understand and implement. A good starting point to where to start is attending https://al-anon.org/. Another good starting point is finding the book, “Freeing Someone You Love from Alcohol and Other Drugs: A Step-by-Step Plan Starting Today!” by Ronald L. Rogers. One of my addiction medicine teachers swears by this book stating that when a colleague or friend asks him what they should do for a loved one with addiction he recommends reading this book.
When communicating with your loved one, make sure you separate him or her from the drug. The language here is important. Say that you are “mad at their drug use” and not “mad at him or her.” The difference in language may not appear to be big, but the usage of language can make your loved one feel attacked if said in certain ways.
2- My loved one doesn’t want to get treated. What can I do?
This is a tough situation and the best approach is an individualized approach.
A clinician/physician/counselor is typically trained in the stages of change. What to do for the person varies on what stage of change the person is in with his or her addiction. Sometimes when a person is in the pre-contemplation there is little anyone can do. In the past clinicians would say there is nothing to do if the person does not want to change, however, now clinicians know this is typically the wrong approach. A trained clinician will use Motivational Interviewing techniques which have been proven to make people more aware of problem drugs and behaviors so that they become more motivated to change to live healthier happier lives.
These stages o and what is recommended are summarized below:
- Precontemplation- Unaware there is a problem or unwilling to change → Relationship building
- Contemplation- Aware of a problem, but not ready to change; may ask for information → Education
- Preparation- Considering a behavior change soon; may ask for advice → Behavioral
- Action → Making a behavior change → Support
- Maintenance- Successfully changed behavior; using less energy to maintain the gains that have been made → Relapse prevention (plan ahead)
- Relapse → Patient uses substances/does unwanted behavior after quitting → Assess stage of change
Pictorially, the stages of change can be depicted as:
How a clinician and how a family member or friend should treat someone with addiction, however, differs and giving generic advice without knowing the specifics is extremely difficult to do. I go over the stages of change here, however, just so that you know that sometimes people are in the precontemplation of change and having a loved one not wanting to get treated or stop is a normal part of the process.