The reality that a loved one is abusing drugs or alcohol and fighting an addiction can be a hard one to face. Many families struggle with this news. It can be known for quite some time that a particular family member—a child, a sibling, a spouse or partner, or a parent—has been abusing addictive substances. Or it can be a total surprise that no one saw coming. These “hidden addictions,” as they are called, can seemingly sneak up on loved ones who had not suspected anything at all. Or they could be hiding in plain sight and have finally reached a breaking point where something must be done.
Either way, once this information comes to light, it is time to decide what to do about it. There is no one way to approach how to get a loved one to help with addiction, but having a road map helps when navigating the challenges that addiction and substance abuse treatment present.
Millions of people are affected by substance addiction every day. It could be a neighbor, a co-worker, or a stranger in the grocery store. All of them are someone’s relative, spouse, partner, or friend. In some cases, they may be your family member. According to the 2015 National Survey on Drug Use and Health, an estimated 27.1 million people aged 12 and older were illicit drug users in 2015. And in the three years since that survey was taken, addiction continues to take lives, whether people were recreational users or chronic users.
The U.S. Centers for Disease Control and Prevention has reported that nearly 64,000 Americans died from drug overdoses in 2016, an increase of almost 22 percent from 2015. According to its data, the overdose epidemic in the U.S. is spreading geographically and increasing across demographic groups, according to an analysis of its 2015 and 2016 U.S. data. Men and women of all ethnicities in urban, rural, and suburban areas of the U.S. are battling addiction.
“No area of the United States is exempt from this epidemic–we all know a friend, family member, or loved one devastated by opioids,” Anne Schuchat, M.D., the CDC’s principal deputy director, said recently to ABC News.
Addiction Signs: How Can You Tell?
Looking for signs of addiction can be akin to looking for a needle in the haystack or it could be like getting run over by a bus. It depends on the people involved. Those who have an addiction do not always show it, so it’s not always easy to spot it just by looking at someone. And then some people don’t hide it well, but some will notice the signs and not catch on because they may be going through a form of denial themselves. The specific signs and symptoms noticed can vary according to the substance(s) abused, but there are some general signs in different categories. If you notice any of these signs, your loved one may be struggling with an addiction.
CHANGES THAT MAY SIGNAL SUBSTANCE ABUSE INCLUDE:
Personal Appearance, Physical Health
- Poor hygiene
- Messy, careless appearance
- Deterioration in appearance
- Unexplained weight loss, weight gain
- Marks, lines on arms, which may be concealed
- Chewing gum, mints to mask breath odors
- Muscle deterioration
- Wearing dark shades at odd times
- Drowsiness
- Tremors
Mood or Emotional Behavior
- Agitation
- Anger
- Chronic fatigue, tiredness
- Confusion
- Irritability
- Uncontrollable mood swings
- Sadness
- Hopelessness
- Socially isolation
Psychological Changes
- Anxiety
- Depression
- Hallucinations
- Delusional thinking
- Insomnia
- Memory loss
- Paranoia
- Psychosis
Occupational or Educational Status
- Poor work performance
- Job loss
- A decline in grades, school performance
- Poor attendance at work, school
Changes in Habits at Home
- Locked bedroom doors
- Missing valuables, household items
- Excessive need for privacy; hard to get a hold of
- Frequent use of room deodorizers, scented candles, incense
Two or more of these could mean that your loved one is battling substance abuse if you’ve also seen them using drugs, alcohol, or other addictive substances while exhibiting these behaviors.
What you’re looking for is a pattern of use and abuse and the results of those changes.
Someone who is facing increased pressures at home, work, or in other settings and situations may be at increased risk of developing an addiction to drugs or alcohol.
Other Signs of Addiction Include:
- Strong cravings for drugs and alcohol
- An intense focus on obtaining/using addictive substances
- Strong need to use the substance(s) daily or multiple times a day
- Spending money on an unaffordable substance habit
- High tolerance for a substance
- Experiencing withdrawal symptoms once use is stopped/reduced
- Turning to addictive substances to cope with personal problems
- Exhibiting high-risk behaviors while high
- Failing to stop using despite previous attempts
- Continuing to use despite the negative consequences
If the family member you are concerned about demonstrates any of these behaviors, they could be struggling with addiction. Now’s the time to consider getting professional addiction treatment at a drug or alcohol rehabilitation center.
How Addiction Affects the Family
The entire family unit is affected when substance abuse enters the picture. The effects of addiction can also extend beyond the nuclear family unit and continue for generations to come. Addiction often is called “the family disease” because everyone can feel shame, pain, stress, and loss of trust, confidence, and even respect as a result of a person’s drug or alcohol use.
Family members also may feel anger, betrayal, or even helplessness in the face of their relative’s illness. Other families may go into enabling mode, covering up and hiding the person’s addiction to drugs and/or alcohol. This involves lying regularly, which also destroys trust.
The stability of the family’s household can be jeopardized as family members deal with their loved one’s problems. Some of those problems are:
Conflicts between family members, partners
These include arguments that can lead to communication breakdowns, hard feelings, distrust, and abandonment. These conflicts can turn violent and involve hitting, kicking, and slapping. In some cases, violent behavior can become deadly.
Money problems
If people with substance abuse issues miss work often or lose their jobs, that can put the household into financial instability, making it hard to meet financial obligations. It is not uncommon for families to struggle financially as a result of a family member’s substance abuse. Some families become homeless and face other hardships because of substance abuse.
Broken relationships
Substance abuse challenges can split families up. Children may be taken from their families and spouses/partners may leave the home taking the children with them.
Emotional hardships
Stress is common in families affected by addiction and alcoholism. This often leads to breakdowns in respect, trust, and integrity.
How Families Should Approach an Addiction Problem
Though many people are well acquainted with common signs of drug use, physicians, psychologists, and addiction specialists have the tools they use to determine whether or not a person’s drug use is a problem.
One of these methods is CAGE.
This simple questionnaire involves asking questions and tallying up a person’s answers. This lets specialists know whether or not someone needs help.
CAGE is a simple method that can let addiction specialists know if a person requires further assessments. But the National Institute on Drug Abuse says various screening tools are available to help people gain further insight into their drug or alcohol use.
The acronym CAGE comes from the questions that should be asked of someone who may have an alcohol dependency. The questions are:
- Have you ever felt you should cut down on your drinking?
- Have people annoyed you by criticizing your drinking?
- Have you ever felt bad or guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (as an eye-opener)?
In a June 2016 publication, the Indian Journal of Medicine mentions that CAGE-AID also has been adapted for families and is called Family CAGE-AID.
The study mentions that using this test is important because:
- If alcohol or drug misuse is caught early, less drastic measures such as an intervention can be effective.
- Using a family version of CAGE-AID may be more useful in collectivist cultures, such as India, where family members can help an individual recognize a problem that is invisible to them.
- Family CAGE-AID can also screen family members who do not use substances and check their stress levels or assist in diagnosis.
- Family CAGE-AID may also assist in diagnosing a person who misuses alcohol but is not available for conversation.
Emotions can run high upon the discovery that a loved one is using. The news can be a lot to take in as the family tries to make sense of why their loved one has a substance addiction. Common reactions include blaming the user, attempting to change or control the user’s behavior, or putting distance between the family and the person who is addicted. There’s sadness, frustration, and even anger. But none of these emotions are reactions that help the situation or the person who’s struggling.
“Many people don’t understand why or how other people become addicted to drugs. They may mistakenly think that those who use drugs lack moral principles or willpower and that they could stop their drug use simply by choosing to,” writes NIDA. “In reality, drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to.”
Part of processing the news of a loved one’s addiction is figuring out what to do about it and what can be done about it.
It often is difficult for families to know how to approach their loved ones about an addiction or substance abuse problem. Like addicted people, families and friends need time and support as they face the pre-and post-recovery period.
The relatives and friends of a person battling a substance abuse problem must prepare to deal with their loved one’s denial that they have a problem in addition to facing their own. Denial is a coping mechanism, or it can serve as a defense.
Common things people in denial say include:
“I don’t have a problem.”
“I can stop anytime I want to.”
“It’s my life, and I can make my own choices.”
“I only drink at [X] time.”
“I’m not as bad as [a certain] person when I smoke, drink [or insert other activity here].”
Concerned family members may even be accused of exaggerating their loved one’s substance use. The idea of talking to a family member about a substance use disorder can be intimidating and uncomfortable. It’s not an easy decision. Should you wait it out and let the person continue to struggle before they “hit rock bottom,” the belief that a person must go through a life-changing hardship before they wake up and seek help? Or should you say something now?
“One reason there’s a lot of stress around this decision is that it’s hard to know how the person of concern will react. But taking this necessary step is a life-saving measure, and it could be the person’s last chance to get themselves off the path of addiction, which, for so many, leads to sickness, permanent injury, and death.”
Also, consider that thousands of people struggle and fail to seek addiction treatment.
The 2015 NSDUH study presented data that showed an estimated 19.3 million people age 12 and older who were classified as needing substance use treatment did not receive it at a specialty facility in 2015. That’s almost 20 million people who needed services for a substance addiction but did not receive them.
Addiction is a Treatable Condition
NIDA describes addiction as a “chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” It also explains that addiction is considered a brain disease because of how drug use changes the structure and functioning of the brain. As a result of these changes, people who have addictions are said to be unable to control the impulse to use drugs despite the negative consequences.
It is important for the addict, as well as the addict’s loved ones, to understand this. While there is debate over whether addiction is a disease or actually a series of repeated habits that change the way the brain functions, there is agreement that a failure to stop using drugs is not about a lack of willpower or self-control.
The American Society of Addiction Medicine offers a short definition of addiction that wraps up with why addiction treatment is important. “Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death,” it writes.
Drug Addiction Hotlines
There are different types of drug addiction hotlines. All are intended to provide information and support, but there are differences in their funding and how they operate.
Some of the things that hotlines aim to provide are:
Drug safety information
Hotlines can answer questions about dangerous drug interactions, how to identify symptoms of addiction, and the safety risks of different drugs of abuse.
Preliminary substance dependency assessments
Hotline operators may provide some assessment over the phone, gathering information about user habits and whether the caller is experiencing withdrawal or dependency symptoms. This information can be used to determine what type of care is appropriate on a precursory level.
Availability of treatment and resources
Hotlines can provide referrals to either public or private treatment facilities. They may also have information on other resources, such as needle exchange programs or safe-injection sites for IV drug users.
Information on how to pay for treatment
How to cover the costs of treatment is a common concern. Hotlines may be able to provide information on working with your insurance company to pay for treatment or on accessing public resources for payment.
Advice on how to help a loved one with an addiction
Family members are often the people who call drug abuse hotlines to seek help for their loved ones. Family members can get support from these hotlines on how to talk to a loved one about addiction, whether an intervention would be appropriate or useful, and what they can do to help their loved one enter treatment. Many families are not sure where to begin, so hotlines can be a great place to start.
Answers about what to expect from treatment
Seeking out treatment for substance addiction can be a scary prospect for many people with addictions. Callers may be concerned about withdrawal symptoms, how long treatment will last, whether they should stop using substances before going to treatment, and what they need to bring with them to treatment. Hotlines can answer questions about all of these topics and support people as they prepare to seek treatment.
Encouragement to seek treatment and support with the process
The decision to seek treatment doesn’t come easily for most people. There are often many considerations to plan for, including time off from work, family responsibilities, financial obligations, and emotional hurdles to overcome before being admitted to a treatment facility. Hotlines can help people plan for their time away from home and provide emotional support as they contemplate the decision to seek treatment.
Aftercare support
Hotlines can also support people after treatment is over. Drug addiction hotlines may be able to provide information about local 12-step meetings or other addiction support groups. They may also be able to provide referrals for outpatient treatment or aftercare centers.
Seeking Outside Help From a Treatment Center
Researching
For many people, it is difficult to stop using drugs once an addiction is in progress. In many cases, the only way they are going to stop using it is if they receive outside help. Therefore, your loved one may need to seek treatment to stop the urge to use addictive substances. While addiction may never be cured, effective addiction treatment can help a person break these destructive patterns and start a new life that promotes health, well-being, and a presence of mind. You must get help for your loved one as soon as possible. Waiting for only delays helps and increases the possibility that your loved one will continue to use.
As you research a treatment center for your family member, there are things to keep in mind. Perhaps the first thing to tackle is stigmas often linked with addiction treatment. Going to rehab to address addiction or alcoholism brings many images to mind, most of them negative or fitting into a stereotypical view of addiction treatment. But addiction recovery isn’t just one setting or place or one idea.
There are many kinds of treatment facilities and therapies. There also various levels of care to treat addiction, from more intensive to less intensive. All addiction recovery and care are tailored to a person’s specific needs, including psychological, emotional, and social. Upon entering treatment, a person can experience any of these depending on their situation:
Your Treatment Options
Medical detox
Effective treatment for addiction starts with medical detoxification (detox for short). During this stage, users achieve medical stability by being slowly and safely weaned off harmful drugs as they experience mild to severe withdrawal symptoms. This process can take place from three to 10 days. Detox also may involve administering medications to help recovering users manage their health in this critical period. An assessment also takes place to figure out the best treatment program for the user.
Inpatient treatment
In this setting of high-level care, clients undergo intensive detox and rehabilitation services for substance addiction in medical clinics or hospital units. It is appropriate for people in substance abuse recovery who have serious medical conditions or mental health disorders. The treatment administered in this setting can include group therapy, psychotherapy, and family counseling.
Residential treatment
Residential treatment allows clients to fully focus on recovering from substance abuse in a structured setting with medium-to-high intensity. There is 24-hour medical support available in a setting that feels more like home and less like a jail or hospital. Recovering substance users can stay in these programs for longer times, if necessary. Residential programs can run from a month to 12 months. The severity of a person’s addiction along with other factors are taken into consideration before a residential program is recommended.
Partial hospitalization (day treatment)
Partial hospitalization programs (PHPs) are the connecting bridge between residential and outpatient programs. They provide a medium-to-high-intensity setting for clients who have completed higher levels of care, so they also allow more independence. Clients can still live away from a treatment center, but they are required to attend four to eight hours of treatment daily, or 20 or more hours a week. No 24-hour supervision is provided and clients do not receive around-the-clock medical assistance. PHPs are suitable environments for people with co-occurring mental disorders.
Outpatient treatment
Clients who are at this level of care receive their treatment in a low-to-medium in intensity setting. Outpatient clients commonly receive no more than nine hours of treatment a week at a specialty facility while continuing to live either at home or another place that is outside the center.
This amount could be less for recovering teen users. Some centers offer evening or weekend outpatient services so people can continue to meet outside responsibilities such as work or school.
Intensive outpatient treatment
Clients receiving intensive outpatient care can attend between 10 hours and 20 hours of treatment a week at a center while living away from the treatment center. It, too, is a medium-to-high intensity setting and offers evening or weekend services so clients can tend to their personal obligations. People who need a higher level of care than outpatient treatment may also find an IOP to be an appropriate fit.
Transitional housing
When clients transition out of treatment, they need a place to land as they learn or relearn how to live on their own and rejoin a community and society. Sober living homes (SLHs) are a common option for people who have achieved sobriety and wish to live in an environment that promotes and supports abstinence from using addictive substances. SLH residents are expected to maintain household chores and pay rent and be employed or actively seeking a job as they live in the home.
The Substance Abuse and Mental Health Services Administration offers a free Behavioral Health Treatment Services Locator for people who are seeking a treatment facility. Click the link to access it. If you’d rather call its national helpline, dial 1-800-662-HELP (4357).
Factors to Consider When Looking at an Addiction Treatment Center
There are more than 14,000 specialized drug treatment centers in the U.S., so choosing the right one for your loved one and your family just got that much more challenging. Not to worry, though, because the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) both offer solid guidance about what to ask and look for so you can have a clear idea of whether a center is the right one for your or your loved one.
The institute says there are five questions to ask when reviewing treatment program options. They are:
Five Questions to Ask
- Does the program use treatments backed by scientific evidence?
- Does the program tailor substance treatment to the needs of each patient?
- Does the program adapt treatment as the patient’s needs change?
- Is the duration of substance treatment sufficient?
- How do 12-step or similar recovery programs fit into drug addiction treatment?
SAMHSA also offers guidance on what to inquire about when reviewing treatment options. Its questions cover accreditation, medication, evidence-based practices, families, and supports.
First, you should ask: Is the treatment center licensed by the state and certified by The Joint Commission?
The Joint Commission (JCAHO) is a nonprofit organization that provides independent accreditation and certification of health organizations. Organizations that seek accreditation from The Joint Commission must first be approved by JCAHO. Those facilities must demonstrate high quality and performance levels before they receive accreditation from JCAHO. You can search for find accredited organizations on the Joint Commission’s website.
Here are other areas to consider and questions to ask concerning them as SAMHSA advises.
Accreditation
Has the program been licensed or certified by the state? Is the program currently in good standing in the state? Are the staff qualified? Does the program conduct satisfaction surveys? Can they show you how people using their services have rated them?
Medication
Does the program offer FDA-approved medication for recovery from alcohol and opioid use disorders? At this point, there are no FDA-approved medications to help to prevent relapse from other problem substances.
Evidence‐Based Practices
Does the program offer treatments that have been proven to be effective in treating substance use disorders including medication management therapies, such as motivational therapy, cognitive behavioral therapy, drug and alcohol counseling, education about the risks of drug and alcohol use, and peer support? Does the program either provide or help to obtain medical care for physical health issues?
Families
Does the program include family members in the treatment process? Family members have an important role in understanding the impact of addiction on families and providing support.
Supports
Does the program provide ongoing treatment and supports beyond just treating the substance issues? For many people, addiction is a chronic condition and requires ongoing medication and support. Quality programs provide treatment for the long term which may include ongoing counseling or recovery coaching and support. They also help in meeting other basic needs like sober housing, employment support, and continued family involvement.
Does Addiction Treatment Work?
Getting a loved one into drug or alcohol rehab also may require some convincing on your part as well. The family should know the benefits of treatment, which can help them persuade their loved ones to get help. NIDA has outlined the principles that make treatment effective, which emphasizes that no single treatment is appropriate for everyone and that treatment varies according to the kind of drug used and clients’ characteristics. It also notes that treatment doesn’t have to be voluntary to be effective. Drug treatment interventions can be successful, even if they are ordered by a court, a job, or as an ultimatum from concerned loved ones.
“‘Matching treatment settings, interventions, and services to an individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society,’ NIDA writes.”
NIDA
Here are other factors that the agency says makes addiction treatment effective.
Treatment needs to be readily available. Time is critical when it comes to getting addiction treatment for the people who need it. The idea of going to a professional treatment center fills many addicted individuals with doubt, so they must have access to services when they are ready to get help. “Potential patients can be lost if treatment is not immediately available or readily accessible. As with other chronic diseases, the earlier treatment is offered in the disease process, the greater the likelihood of positive outcomes,” NIDA writes.
Effective treatment must be multifaceted. This means it should address other needs in addition to the ones related to substance abuse. This includes any medical, psychological, social, vocational, and legal issues clients have, NIDA advises. Other factors such as age, gender, ethnicity, and culture should also be considered.
Approved medications may be part of treatment plans. It is common to use medication for treatment along with counseling and therapies for some clients, NIDA explains. People who are recovering from heroin addiction or opioid addiction may be given methadone, buprenorphine, and naltrexone to wean them off their dependence. Recovering alcohol users may be given acamprosate, disulfiram, and naltrexone for treating alcohol dependence.
Treatment programs should test for the presence of infectious diseases and provide targeted risk-reduction counseling. They also should connect clients to treatment if needed, NIDA advises. The agency goes on to say, “Typically, drug abuse treatment addresses some of the drug-related behaviors that put people at risk of infectious diseases.
Targeted counseling focused on reducing infectious disease risk can help patients further reduce or avoid substance-related and other high-risk behaviors. Counseling can also help those who are already infected to manage their illness.” HIV/AIDS, hepatitis B, and C, tuberculosis, are some of the health conditions that treatment should screen for when clients come into their care.
Treatment must last for the proper length of time. According to research cited by NIDA, recovering substance abusers need at least three months, or 90 days, in treatment “to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment.” Getting back on the path to health will not be a short process.
Treatment plans should be continually reviewed and changed as needed to fit the individuals’ current needs. Clients often need different kinds of services and components combined during the course of their treatment, NIDA writes. For example, clients may need medication or medical services In addition to counseling or psychotherapy, NIDA explains. Continuing care ensures clients are getting their best shot at recovery.
Source: National Institute on Drug Abuse.
How Do Therapeutic Communities Differ From Traditional Residential Program?
Traditional residential treatment programs will typically last for 30 to 90 days, whereas therapeutic communities are extended periods of treatment that are typically 12 to 18 mths or longer.
Traditionally, therapeutic communities offer structured living environments for their clients. If you are in a TC, you will live in an environment with other clients in the program. More than half of the staff working there are reported to be in recovery themselves or have certification in addiction counseling.
How Does Medication-Assisted Treatment Work?
In case you are not aware, there are many different medications that doctors commonly use throughout treatment. This type of treatment is called medication-assisted treatment (MAT) and is one of the main reasons that people are so attracted to professional drug treatment. From treating withdrawal symptoms to acting as a substitute for an addictive substance, medications used in MAT can easily aid in the entire drug treatment process.
While MAT is pretty much commonplace in the drug addiction treatment industry, some treatment centers prefer traditional methods of treatment over the use of medications. For this reason, it is important to contact the treatment center you are considering and ask about their policy for MAT and exactly what medications they use.
Substances such as Suboxone can act as partial opioid agonists, mimicking the effects of an addicted opioid but to a lesser extent. For this reason, Suboxone can greatly aid in opioid withdrawals, except Suboxone is known to also be addictive in itself. Other substances, such as naltrexone mitigate the effects of opioids, causing opioids to have little to no effect on the user.
This medication is used in treatment to reduce cravings, a powerful weapon when fighting withdrawal symptoms. Unfortunately, many medications in MAT come with risks, and the use of naltrexone comes with said risks.
Because it blocks the effects of opioids, many people (when relapsing) will dose themselves with more and more of the opioid to achieve the high they desire. The fact that naltrexone can push people to increase dose size can easily lead to an overdose.
All of the potential benefits and dangers of MAT should be taken into consideration when deciding which treatment center works best for you, so contact the treatment center beforehand to get the proper information you need.
Treatment Costs: How Do We Pay for This?
Treatment services are not without cost, and that is an important consideration when looking at programs. Even people with insurance benefits may find it challenging to figure out what is and what isn’t covered under the insurance plan.
If you don’t have insurance, SAMHSA says each state has funding to provide addiction treatment for people who don’t have insurance coverage. Find where to call for information about payment for services at samhsa.gov/ sites/default/files/ssa-directory.pdf. There are publicly funded treatment services. Click here to learn more about them.
If you do have insurance, it’s important to know what kinds of substance abuse treatment your plan covers. Many insurers generally do provide full coverage to clients who receive outpatient care over inpatient or residential care. The last two care levels run for a longer time, so they cost more. The key thing to remember is that you choose the treatment program and services that are most effective for your loved one’s recovery.
Depending on the health plan used, these services may be covered:
Services Which May be Covered
- Medical detox, which may include maintenance medications
- Inpatient care at an approved, in-network facility
- Long-term residential care at an approved, in-network facility
- Outpatient care with an approved, in-network provider
- Co-occurring disorders or mental health issues
- Aftercare counseling or therapy
Some health insurance plans include coverage for all substances to simplify things, but that doesn’t mean the provider will cover all treatment or therapies, or even medications. Aftercare services, which are essential to the addiction recovery process, may not be covered by a particular insurance company.
In short, the longer a person stays in a treatment program that provides around-the-clock care, and room and board, the higher the costs will be. Inpatient or residential treatment can last at least 30 days or more. Some treatment center residents stay for more than a year. It just depends on the person receiving the treatment.
NIDA advises that clients stay in a treatment program for at least 90 days or three months to be effective. “Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes,” it writes.
If you’re unsure about which services or programs your insurance plan covers, call your insurance provider or job’s benefits department to learn about your options. Check to see if aftercare services are offered and any kinds of therapies that have been recommended for your family members’ treatment or ones you or your loved one are interested in. Also ask:
Follow-Up Questions
- If you must submit required copayments
- Whether treatment expenses will apply to a deductible
- If you must choose treatment among a network of preferred providers
SAMHSA recommends reviewing the websites of the providers and sees if they have the five signs of quality treatment. To access care, the agency advises calling the facility for a timely appointment.
“If they can’t see you or your family member within 48 hours, find another provider. One indicator of quality is the ability to get an appointment quickly,” it writes. “Many programs offer walk-in services. Look for programs that can get you or a family member into treatment quickly.”
What Happens When a Loved One Goes Through Treatment?
Treatment programs are customized for each person so their needs and preferences are met. Most offer a combination of services to ensure the needs of the recovering person are met. Some of those services are:
Addiction education
Clients learn what substance abuse and addiction are as well as relapse and the effects addiction can have on all aspects of one’s health and relationships.
Co-occurring disorders treatment
People who have a substance use disorder and a mental health disorder can enroll in a recovery program that specifically addresses the complications that arise from both mental health disorders and substance abuse disorders. Addiction treatment generally follows the same guidelines, but therapy techniques may differ to ensure treating symptoms of specific mental health disorders are treated.
Behavior therapy
Treatment involves changing the thoughts and behaviors that often accompany addiction. Cognitive-behavioral therapy (CBT), a popular approach, helps clients address their negative thoughts and actions that are linked with their addiction.
By understanding how our thoughts influence our beliefs which influence our behavior, we can see the beginning of the path to substance abuse. CBT is structured to assist the user in recovery to “see the light” and learn how to change their thoughts and perceptions. The two main elements of CBT are:
Functional
The therapist and the patient determine why the user is abusing a substance. This involves identifying the thoughts, feelings, and actions to substance abuse and how to change them. This step explores the risks and provides insight into the user’s mind.
Skills Work
People tend to use drugs or alcohol as a way to cope with life’s challenges. This step involves actively finding new ways to cope with what life can throw at us. It involves unlearning old coping habits and learning new ones. It entails steps the user can take that leads to a healthier, sober life.
Individual therapy
Personal accountability is key to recovery. Personalized treatment for clients can help them address emotional and social issues that contribute to their desire to use drugs and alcohol. This includes helping them see the problems they have and motivating them to change course.
One type is motivational interviewing. Motivational interviewing encourages the client to state aloud their commitment to change rather than simply expressing the need or desire to change their behavior, like their behavior around drugs or alcohol. Hearing themselves make the statement of commitment to change has been shown to help clients focus on making those changes.
The therapist’s role is more to listen and less to intervene. To that end, there are three key elements to motivational interviewing:
- Collaboration: Some approaches to talk therapy or cognitive behavioral therapy rely on confronting the client about their behavioral patterns, thoughts, or feelings. MI relies on collaborating with the client to encourage them and offer them support.
- Evocation: Motivational interviewers draw out the client’s thoughts and ideas on their behaviors, the harm these have done, and their thoughts on changing. Most people who struggle with addiction have thought about quitting, realize that their addiction has harmed their lives, or have even tried to quit a few times before. However, they may have relapsed, or they may worry about what will happen if they quit. This step helps them solidify that they do want to change, and they can commit to the process.
- Autonomy: Many treatment models focus on the clinician as the authority figure, but MI focuses on the client as self-driven; the power to change rests with them. This focus helps the interviewer empower the client without telling them explicitly that they need to change or that there is a “right way” to change.
Typically, only one or two sessions are needed. You can return to motivational interviewing sessions if you need reminders of why you want to make positive changes, like staying in addiction treatment.
Group therapy
Group therapy sessions help clients connect with like-minded people and ensures they don’t have to go through their recovery journey by themselves. They also provide outlets and opportunities for growth and support.
Life skills training
Reintegrating into society takes work. Life skills training can help clients gain job skills and improve their social and communication skills. Courses they may take include anger management, stress management, goal setting, and money management. All of these are important as they start life anew.
Aftercare or continuing care.
Getting help after treatment ends is just as important as when it began. Loved ones need to know they are not alone as they work toward their sobriety goals. Joining a recovery alumni group or a 12-step group, such as Alcoholics Anonymous or Narcotics Anonymous helps many stays on track.
The Role of the Family in Addiction Recovery
When you’re looking for rehab for a family member with an addiction, take time to find out what programs and supports there are for the family. A program that offers therapy and ongoing support for all affected family members—from spouses/partners to children, parents, and grandparents—is important. Families are a support system for substance users, and everyone has a vested interest in their loved one’s recovery. Support programs are not just for the person in recovery either. Anyone who has felt the effects of a loved one’s addiction could benefit from family therapy.
You may want to consider family therapy if:
Reasons to Consider Family Therapy
- Your family member’s use has negatively affected you and others mentally, emotionally, physically, etc.
- Your family member continues to use despite your requests or pleas to stop
- Your family member’s use has put you and/or others in unsafe spaces, violent situations
- Your family is struggling with issues that may play a role in one’s substance abuse/addiction
- You want to learn healthy coping mechanisms with a loved one’s use or results of one’s use
A loved one’s decision to overcome addiction can only be strengthened with the help of family members. NIDA writes, “Family and friends can play critical roles in motivating individuals with drug problems to enter and stay in treatment. Family therapy can also be important, especially for adolescents. Involvement of a family member or significant other in an individual’s treatment program can strengthen and extend treatment benefits.”
Many substance abuse rehabilitation centers offer families a place to heal with a comprehensive family program. Such a program allows family members to participate in their loved one’s recovery process and healing. Facilities that offer residential services typically offer families regular visitation times that allow them to spend time with residents who live on-site at the facility 24/7 for a specified time as they receive recovery treatment.
Family programs are designed to encourage families to participate in educational programs that allow them to learn more about topics, such as how family dynamics play a role in the addiction process, and how they use strategies and techniques to improve communication and boundary setting. These programs also allow for role-playing and group discussions so everyone has the chance to be heard.
Addiction treatment is not just for the person who needs it. Clients and their families can both work on recovery from substance abuse together. For many families going through this challenge, therapy is the starting point for figuring out how to move forward together.
Family Therapy:
Clears the air. Everyone gets their chance to be open and honest about how substance abuse has affected them and their daily lives.
Focuses on support. The family of the recovering user and the user learn resources that are available to them and provide the needed support as they work recovery.
Helps the family regain resilience and strength. Family counseling can keep people on track as they experience the ups and downs of addiction recovery. There often are feelings of powerlessness, but with honesty and openness, and families can find their way back to trusting one another. Empowering family members is also about allowing them to achieve a healthy perspective about what is happening as well as learning what their personal limits are and what role they play in their family member’s healing.
Teaches how to curb enabling behaviors. The desire to help the people we love is normal. However, there is such a thing as performing actions that only helps one along in their addiction, and these are highly discouraged.
Examples of enabling include allowing the person with an addiction to stay in your home; giving the loved one money when they ask; bailing them out of jail when they land in legal trouble; paying off their bills; and more.
Family therapy teaches people how to avoid scenarios such as these and helps them learn new strategies that help them set boundaries and reinforce them.
Each person must take responsibility for their own behavior during the recovery process, the person in active addiction, and every family member.
Educate against addiction stigma. Family members must remain as supportive as possible as their loved one recovers from substance abuse. Part of that support requires changing how addiction is viewed. When it is viewed as a moral failing, a weakness of character, or any other negative thing, there is room for addiction stigma to grow, and that only hurts everyone who is working toward recovery.
Social stigmas are negative attitudes and beliefs that lead people to avoid, label, reject, stereotype, or discriminate against others. Friends, family, and community members can impose those attitudes and beliefs anywhere, and this is dangerous because many people who struggle with substance abuse will internalize these negative views and won’t reach out for the help they need.
Tips On Approaching Your Employer
Here Are Some Tips That May Be Helpful:
- Talk to your employer as soon as you can. Be candid and upfront.
- Learn about your company’s policies regarding substance abuse and getting treatment. Check with the human resources department.
- Be fully aware of your legal rights.
- Do not discuss the situation with coworkers as you are putting yourself at risk for gossip and hearsay.
- Have your treatment plan worked out before you discuss the situation with your boss. This way, your employer understands what you are about to do and sees that you have a plan.
- Be clear about how much time you need off and why you need it.
Employee Assistance Programs (EAPs)
Because substance abuse is such an issue in the United States, many employers provide employee assistance programs (EAPs) to their employees. EAPs can offer services and options for mental health-related problems, including issues with substance abuse.
If your employer has an EAP, take advantage of it.
Is it Time for an Intervention?
You may want to seek help from sources outside of the family to broach the subject of addiction with a loved one during a formal meeting. This is called an intervention. There are different ways to approach and carry out an intervention. You have to find the method that best suits your family’s needs. The primary goal, however, is to get the person’s help as soon as possible.
“In general, during an intervention meeting, the person with an addiction or substance abuse problem is confronted about their illness and held accountable for their actions. The meeting is also for affected loved ones, who attend this meeting to share how the actions of the person at the center of the addiction are affecting their lives.”
This gathering also presents an opportunity to talk about any co-dependent behavior of family members, who may not be aware that they are playing a role in one’s behavior. They could be engaging in destructive behaviors and encouraging them, which doesn’t help anyone involved. This is why such a meeting is needed.
Tips to Help Stage a Successful Intervention
Even with the best intentions, unexpected things can happen during an intervention. Here are a few before-and-after tips that can make the process flow easier.
- Think about the timing of the intervention meeting. Make sure the person at the center of the intervention isn’t going through substance withdrawal. A physically unwell person can make be a distraction and undermine the effectiveness of the meeting. Be mindful that there is enough time to hold the meeting and that distractions are kept to a minimum.
- Prepare ahead of time. Avoid a casually planned or rushed meeting, which can result in an unwanted end. Plan your Intervention meeting carefully to ensure the tone remains formal and civil and that the meeting stays on point. You may want to rehearse to improve the chances of the meeting going well.
- Consider giving the person a heads-up. Does the person need to be told ahead of time that such a meeting is taking place? Consider this person’s schedule and needs. It’s important, however, to not mislead the person. Getting them to the meeting under pretenses may lead to resentment and a refusal to participate in the meeting.
- Plan for objections. The family member who is the focus of the meeting may respond defensively once they learn the reason for the meeting. The person also could express denial about their condition or situation. Prepare possible responses to any objections and anticipate what can happen if any of them are rejected. The more you can prepare mentally for an outcome, the better, even if it is unfavorable.
- Have an interventionist, therapist other licensed mental health professional facilitate the meeting. This person may be the best person to run the meeting to ensure everyone is heard. Professionals are also able to help families learn about their treatment options. If possible, meet with the interventionist ahead of time so you can share your concerns about meeting with your loved one. The professional can also help you prepare questions, responses, and next steps.
- Keep the intervention focused. The emotional nature of intervention can blow it off track. Do what you can to keep the meeting moving toward its purpose.
What Should I Do With My Pets While I'm In Treatment?
The best option is to find a friend or family member who is not using drugs or alcohol and is willing to take them into their home while you are away or that can stay in your home for the duration of your treatment. Finding someone to be with them around the clock will help to relieve some of your worries about their care and well-being.
Alternatively, if you can find someone to come over and feed them, let them out, walk them, and/or give them medication as needed on a regular basis, that will also be a great way to make sure they are cared for until you return.
It is not a good idea to board them while you are gone. Boarding options for pets, especially for a long-term stay, can be very expensive. You don’t want to feel like you have to leave treatment after a short amount of time because the cost of boarding is rising every day. Instead, you want the length of time you spend in treatment to be based on your level of stability and true ability to stay sober for the long term.
In some cases, the best choice may be to transition your pet into a new home before you leave. Be careful not to allow this to take up too much time or to become an excuse for not going to treatment.
If you find that you are not connecting with anyone willing to take your pet, reach out to organizations that may be able to help, such as animal shelters. They may be able to connect you with a solution.
