Understanding Addiction

Supporting a loved one through addiction is tough. You may be feeling helpless or frustrated—or both—as you watch your loved one suffer. But you’re not alone. Substance use disorder is a behavioral health condition affecting 21 million Americans, yet it is one of the most misunderstood and stigmatized conditions. We hope, with your help, we can change that. 

This section will introduce you to key facts about addiction, provide information about signs that your loved one may need help, and outline strategies to talk to a loved one about addiction. We’ll also provide you with the support and resources you need to protect and support yourself as you help a loved one work toward making healthy changes. Lastly, we’ll offer some solutions for addiction.

Addiction facts

Addiction is a chronic disease characterized by the following features:

  • Compulsive drug use that is difficult to control despite harmful consequences
  • Can cause changes a person’s brain, overriding their self-control, judgment, decision-making, and ability to resist urges to take drugs
  • Consistent use can lead to tolerance, meaning someone may have to take more drugs to achieve the same effect
  • Is a progressive disease that will get worse if left untreated
  • Has a high incidence of relapse (returning to use), at a rate of 40 to 60 percent
  • Substance use disorder is an entirely treatable condition
  • It is a myth that someone needs to reach rock bottom to obtain help

There are five main stages to addiction: 

  • Experimentation
  • Regular/continued use
  • Risky use/tolerance
  • Dependence
  • Substance use disorder (addiction)

The causes of addiction are complex and often involve genetic, environmental, and developmental factors. It is difficult to predict if someone will develop substance use disorder even if they regularly use substances. However, the more risk factors present, the greater the chance that taking substances may lead to addiction. 

Why is addiction stigmatized? 

Sadly, less than 10 percent of people with substance use disorder get the help they need. One of the main reasons people don’t seek help is the stigma associated with addiction—they are worried about what people may think of them. Studies show that this stigma arises out of the misheld belief that addiction is a choice and that individuals should be able to control their drinking or drug use. 

Signs a loved one might need help

You may have noticed changes in your loved one’s behavior, but you may not know the other signs that indicate they may need help. Addiction affects most areas of a person’s life: physical and mental health, family and relationships, school or employment, social life, finances. 

Key things to watch out for include:

  • Loss of interest of withdrawal from social activities
  • Drinking or taking more substances than before
  • Putting themselves and others at risk
  • Experiencing relationship difficulties 
  • Loss of work or dropping out of school
  • Increased desire or cravings to use, and irritability if they can’t
  • Secretiveness or defensiveness around use
  • Mood swings
  • Changes in sleeping and eating patterns
  • Rapid weight changes
  • Depression
  • Lack of interest in maintaining personal hygiene
  • Low or no energy

If you notice these signs, it may be time to talk to a loved one about their addiction.

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Ways to talk to a loved on about their addiction

Talking to a loved one about their addiction isn’t easy. You hope for the best for them and you want to alleviate their suffering, but you may be feeling anxious or confused about how to handle the situation. You may have already tried to broach the topic and were left with mixed feelings and emotions — or worse, the conversation ended in a heated argument. 

We want to reassure you that it is possible to talk to a loved one about their addiction while supporting yourself, maintaining boundaries, and not feeling like you are responsible for their well-being.

We’ve listed our top tips for talking to a loved one about their drinking or drug use. 

Educate yourself

  • Understand the key features of addiction, how it manifests itself, and how the condition progresses (see yesterday’s email). 
  • Research withdrawal from relevant substances and the risks associated with home detox. You can learn more about detoxing from alcohol here and drugs here
  • These facts may help bolster your position as you talk to your loved one.

Choose an appropriate time and place

  • Talking to a loved one while they’re intoxicated or under the influence of drugs is futile. The discussion could turn into an argument and you could both be left with hurt feelings.
  • Instead, try to find a time when your loved one isn’t drinking or using drugs, and when they are calm and able to focus. 
  • Ensure you’re in a private environment where you won’t be disrupted. 

Boundary setting

Boundaries are crucial between the person struggling with addiction and their loved one. Oftentimes, in this relationship dynamic boundaries can become blurred, with the sober person taking on the responsibilities, feelings and well-being of their loved one. The recovery process helps to untangle this dynamic and replace it with one in which each person takes responsibility for themselves only. In this scenario, appropriate boundaries include:

  • Talking to your loved one about their addiction, but not expecting them to follow your advice or agree with your perspective. 
  • Knowing that moving forward with recovery not your decision. Your role is simply to provide relevant information. 
  • Taking care of yourself. You are only responsible for you—you cannot support others if you do not put yourself and your needs first. 

Conversation starters

A calm discussion highlighting facts and recovery options can be conducive to change.

  • Try talking to a loved one in a calm manner, expressing your concerns in a caring and non-judgmental way. That might look like expressing concerns about their drinking and how it’s impacting their health, relationships, and responsibilities. 
  • You may want to encourage them to open up about why they’re using substances and if they are struggling to cope. For example, they might be stressed at work, feeling lonely from a breakup, or grieving the loss of a loved one.

What to avoid

If not handled correctly, confrontations about drug or alcohol use could result in your loved one becoming more withdrawn or secretive about their use:

  • Avoid emotional appeals
  • Do not threaten, punish, or shame the person
  • Avoid lecturing
  • Don’t take their actions or responses personally
  • Do not cover up for them

Tips for talking to a loved one about their substance use

Educate yourself

Choose an appropriate time and place

Set healthy boundaries

Prepare some conversation starters

Know what to avoid

It might be helpful to prepare yourself for this conversation by having resources and information available. 

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Resources for Families and Loved Ones Struggling With Addiction

Now that you have a better understanding of addiction and how to handle a discussion about it, we want to provide you with helpful resources that care for you and your loved one. 

Importance of self-care

As we mentioned above, it is critical that you care for yourself in this process. That might look like:

  • Setting boundaries, such as taking time out from your loved one and not taking on responsibilities 
  • Going to therapy
  • Finding support groups (see resources below)
  • Working on your own stress and well-being

Treatment locator tools

The Substance Abuse and Mental Health Services Administration (SAMHSA) have published an interactive tool that helps you to locate treatment across the United States. You can search by service type, including co-occurring conditions, and state. You can find the tool here

Support for family and friends

There are a range of support groups for family, friends, and partners of loved ones struggling with addiction, including:

  • ALANON is a 12-step-based support group for anyone impacted by addiction
  • SMART Friends & Family. An alternative to 12-step programs, SMART provides effective and easy-to-learn tools to help you and your family
  • Workit Health Friends and Family is an innovative online support program for anyone who has a friend or family member impacted by addiction
  • Therapy. You may want to consider accessing a therapist, either through your primary doctor or by searching for one who specializes in addiction.

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Understanding the Decision-Making Process Toward Recovery

Having a better understanding of the decision-making process involved with changing cycles of addiction may help alleviate frustration and enable you  to support a loved one through the process of seeking recovery.

The steps in overcoming addiction have been summarized by researchers as a six-stage process (also referred to as the transtheoretical model):

  • Pre-contemplation: This stage represents creating awareness. A person may not be aware that they have a problem with drugs or alcohol—they may even think that using substances is pleasurable and has a positive impact on their lives. You may notice some denial and/or avoidance at this stage. Seeing the impact of their use, however, can help the person face up to the severity of their use and enable them to progress to the next level: contemplation. 
  • Contemplation: This stage represents some willingness to face their use of substances and receive information, and they may even try to moderate and stop. However, this stage also means a lack of commitment, either to a particular method of recovery or to long-term change. This stage can last for days, months, or even years. They may also move back to the precontemplation stage, or forward to the preparatory stage. What is critical at this stage is that the person receives non-judgmental support and encouragement.
  • Preparation: This stage occurs right before the person is ready to take action to cease their addiction. That’s why it’s important to have resources at hand and be ready, at their signal, to remove triggers from their home. 
  • Action: This stage represents the change in behavior, such as stopping use, attending a treatment center, starting medication-assisted treatment, or accessing digital and in-person supports. A loved one will benefit from identifying ways to cope with life stressors so that they can move to the maintenance stage without returning to use. 
  • Maintenance: This stage is focused on maintaining the positive behavioral changes. That might mean moving from detox to a treatment center or accessing other recovery supports like meetings and clinical support of a therapist or telehealth digital support. Just like the action stage, it is critical that the person has developed effective coping skills in order to avoid relapse.  
  • Relapse: Oftentimes, relapse is part of the process of recovery. The process of change is a spiral and those seeking to address addictive behaviors may move in and out of phases for some time before ceasing the addiction.  
Illustration of the decision cycle

Remember that while this may appear to be a sequential process, in reality a person may not cycle through stages 1 to 6. In fact, researchers refer to the stages as a spiral because many people taking action to modify an addictive behavior do not do so successfully on the first attempt. They state that relapse and cycling through the stages occur quite frequently as a person attempts to change their relationship with addictive behaviors.

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Solutions to Addiction

There are many pathways to recovery from addiction. It is a common myth that recovery exists only in church basements or rehab centers. In fact, a leading study found that tens of millions of Americans have successfully resolved an alcohol or drug problem through a variety of pathways: 

  • 53.9 percent reported using “assisted pathways” that consisted of:
    • Mutual-aid groups (45.1 percent)
    • Addiction treatment (27.6 percent)
    • Emerging recovery support services (21.8 percent)
  • Just under half of those who did not report using an assisted pathway say they recovered without the use of formal treatment and recovery supports. This is also referred to as natural recovery and is associated with less severe addictions.

We’ve written two informative blogs about pathways of recovery that you might find helpful:

  1. Non-Clinical Pathways to Explore on Your Recovery Journey
  2. What to Look For When Choosing Addiction Treatment, which covers the clinical options available. 

The Workit Health Solution

Workit Health delivers personalized psychotherapy to individuals in varying stages of opioid use disorder. We know that psychotherapy is a generally effective addition to MAT, especially if the approaches are tailored and flexible. In addition to the online curriculum, Workit counselors provide real-time support through text messaging, video calls, or phone calls. Our counselors are thoroughly trained in evidence-based counseling modalities.

If you’re interested in learning more about the Workit Health program or have any questions, please reach out to us by calling 855-659-7734 and choosing option 1. Our care navigators will be happy to help.

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References

  1.  Center for Behavioral Health Statistics and Quality, 2017. 2016 Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration, Rockville, MD.
  2.  Ashford, R. D., Brown, A. M, Curtis, B. (2018).  Substance use, recovery, and linguistics: The impact of word choice on explicit and implicit bias. The Journal of Drug and Alcohol Dependence, Volume 189, 131-138.
  3.  The Recovery Research Institute. (n.d). The Real Stigma of Substance Use Disorders. Retrieved December 27, 2020, from https://www.recoveryanswers.org/research-post/the-real-stigma-of-substance-use-disorders/
  4. Prochaska, J.O., DiClemente, C.C., & Norcross, J.C. (1992). In search of how people change: Applications to the addictive behaviors. American Psychologist, 47, 1102-1114. PMID: 1329589.
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