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Addiction and the Family

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

What can families do when they learn that their adult and independent child is now addicted to either heroin, opioid medications or methamphetamines? What does it mean to be addicted and what are the implications for the addict and the family?

Someone I know recently learned that their daughter is addicted to heroin. Of course, the entire family has reacted with shock and alarm at this news. She came to her parents because she could not stop using on her own and was extremely upset. When this person, who is not a patient and not even a friend but falls more accurately into the category of an acquaintance, asked me what they can do to help their daughter I was not surprised when what I said was rejected. What I said was that she needed to enter in a hospital detox program followed by a drug rehab program. I cautioned that the reason for these suggestions was the tendency to relapse with these drugs due to the craving experienced after detox. All of this was overwhelming for this person to process but I hoped that it would be discussed at home among the family and I made myself available for support as a friend.

Addiction is a brain disease. Whether the disease precedes the use of drugs is not clear. What is clear is that once the patient becomes addicted to a substance, their brain has been altered in ways that when they attempt to stop using they experience symptoms of craving which are extremely serious and can be life threatening. At this point the addict is no longer deciding to use drugs but is driven by a physiological process that is overwhelming and irresistible in its intensity.

Family members often react to the news of an addiction with shock and denial much as my acquaintance did. There is a tendency for parents to begin policing their loved one in the hope that they can prevent a relapse and control the individual much as they did when the person was a small child. There also a tendency to believe that family love and unity can help save the individual with the drug problem. To that end they beg and cajole the addict to not use. They falsely believe that if their adult child truly loved them the use of drugs would stop. These beliefs are as accurate as believing that a person could cure their self of cancer if they really wanted to.

Because parents and other family members convince themselves that they can prevent further use of drugs they reject drug programs and the use of medications to stop the addiction. Feelings of shame about the addiction probably add to the need to deny the sickness and the urgent need for treatment. If the addicted adult child lives at home parents often refuse to demand that they enter treatment or leave the house. If the individual can abstain from use for a few days family members often feel euphoric, believing that they have "dodged the bullet" of drug addiction.

However, reality soon sets in when the addictive process asserts itself once again as the addict cannot resist the cravings to use more drugs. The crisis then reasserts itself and the family may react in a number of ways that may range from denial that there is more drug use to anger and blame directed to one another. Feelings of guilt take over and parents explore where they went wrong in raising their child. They blame themselves and one another for the crisis.

Whatever the order of the next stages is will vary from one family to the next. All families will be forced to cope with a worsening situation that reaches unbelievable crisis proportions until the addicted person becomes ill, begins to steal money from parents and siblings if not from other people as well. What the family does not understand is that the only relationship that matters to the addict is to the drug of choice. This is not a moral issue but the result of an altered brain that demands more and more of the substance of abuse. Money, love, health and life cease to matter as much as getting the next "fix."

Ultimately, addict and family will be confronted with the need for an intervention which includes placement into a hospital for the addict to detox followed by a long and slow recovery in a drug rehab center where they will live and attend psychotherapy and twelve step groups.

Today, there are new medications that make outcome of treatment more optimistic. These medications block the craving for the drug and prevent any feelings of pleasure if the addict attempts to use again. There are now new medications for alcohol and opioid dependence. For opioid dependence (including heroin) the patient must be free of use for a month before the medication can be started.

Members of the family can get support for themselves by attending Alanon groups, or their equivalent, for families struggling with a loved one who is addicted. In addition, psychotherapy is helpful for family members. It cannot be over stated how much anxiety and depression parent, siblings and other family members suffer when their adult child is struggling with this disease.

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