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What to Do if a Loved One is Addicted to Opioids

7 things to consider if someone you love is battling addiction, according to a substance abuse expert.

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If you were to believe TV dramas, you might think all you need to get a loved one off opioids is a living room couch, a room full of friends and family and one productive conversation insisting they get help.

In the real world, though, tough love interventions don’t work for everyone. “Every situation is unique and should be treated as such,” says Bruce Goldman, LCSW, Northwell Health’s director of substance abuse services at Zucker Hillside Hospital.

What families, and people struggling with addiction, often want is exactly what does not exist—a single, one-size-fits-all cure for an opioid-use disorder. The fact is, there isn’t one clear path to success. And success itself is different for every recovering person. Ultimately, the goal is for the person fighting addiction to be alive, reaching their own potential and goals—not yours.

There are no guarantees on the path to recovery. “I’ve been humbled by many years of doing this,” Goldman says. “I can’t predict how any patient will do. But I am forever and persistently optimistic and hopeful for every person I meet.”

Here are some important things to consider if someone you love is battling addiction:

Get help for yourself

People with loved ones living with addiction tend to resist this. After all, the person with the drug abuse disorder is the one with the problem, not you. But addiction is ultimately a family disease. Goldman says, “Families are dealing with a chronic, debilitating and sometimes lethal disease. They’ll need support and guidance to help them figure out what's the best plan for them to protect their own mental health and for intervening with their loved one.”

Open the lines of communication

Aim for open communication with no blaming, shaming, or belittling. Otherwise, it’s easy for your loved one to become defensive or to project blame back and refuse to accept responsibility for their own actions.

Let your loved one know that you are concerned and give them specific examples of what you mean and how it worries you. Demonstrate empathy and genuine concern. You want to find out what’s happening with them and enlist their help in solving their own problems.

Ask for something specific

When having frank conversations with your loved one, it may help to know just what you’d like them to do even if it’s getting a medical or psychological evaluation. You don’t have to immediately throw down the gauntlet or give them ultimatums.

Understand your own emotions

When you first learn someone you love is abusing opioids, you may feel angry, then panicked, then humiliated or full of guilt and remorse. Unfortunately, such intense emotions can make it difficult to have a reasoned, calm conversation. Instead, if conversations become accusatory, threatening, and angry, your emotions can add fuel to the fire, Goldman explains. These kinds of heated conversations may not get you what you want—your loved one getting help.

Goldman frequently sees families either underreact to addiction—living in denial, minimizing addiction’s impact and enabling the loved one—or overreact to addiction, fighting with, guilting, belittling and alienating the person with addiction or thinking catastrophically—that the worst possible outcome is unavoidable.

Neither is an effective way to respond to addiction. Instead, face the addiction, don’t ignore it, while still keeping your own emotions in check. It may not make the fight any easier in the beginning, but it’s an attitude that will be beneficial to you over time as your whole family copes and recovers.

Collaborate when choosing a treatment program

There are many different kinds of addiction treatment programs. A person recovering from addiction may ultimately try more than one approach. There is no one best treatment for opioid addiction, so what matters most, Goldman says, is understanding what a person is willing to do and what they think will help them. “You collaborate to get them invested in their own recovery,” he says.

Families should discuss options openly and trust their loved one to lead. “It’s fairly successful,” Goldman says. “Patients tend to know what they need and have a good idea of what will work best for them.”

Consider medication assisted therapy (MAT) for your loved one

It is possible to fight drug addiction with drugs. According to the National Institute of Drug Abuse (NIDA), methadone, buprenorphine, and naltrexone are effective for treating opioid-use disorders. MAT decreases opioid use and the risk of death from opioid overdose deaths. Using addiction medicine has also been shown to reduce criminal activity and to help keep people recovering from addiction in treatment.

The American Society of Addiction Medicine recommends MAT as part of a comprehensive recovery treatment plan and provides a treatment guideline for medical professionals who treat opioid-use disorders.

It is not, as families sometimes worry, just replacing one drug addiction with another. The substance abuse programs offered by Zucker and South Oaks Hospital, for example, treat addiction medically, prescribing addiction medication, along with psychosocial counseling and developing coping skills.

Think of it as having a chronic illness that requires medication. You may need to take medication forever for hypertension, but that doesn’t mean you’re addicted to the medication. The medication doesn’t cure the chronic illness either, so even if it’s under control, you still have the illness and management requires diligence.

“If you're diabetic and don't take your medicine or you eat a lot of cake and your blood sugar gets really high, that’s a relapse,” Goldman says. “Do we consider the patient a total failure? No. We continue to work with them, maybe change their medication, and educate them on managing their illness. Only with addictive disorders do we declare treatment unsuccessful and give up. It’s a chronic illness. There are ups and downs.”

“No one likes to be addicted. They’re petrified, frightened, and can’t find a way out.”
Bruce Goldman, Director of Substance Abuse Services; Northwell Health Zucker Hillside Hospital

Accept the discomfort of uncertainty

You may try an empathetic approach and it doesn’t work. You may try tough love and it doesn’t work either. Your loved one may relapse after not using for years. When your loved one starts recovery, you may not be as excited as you thought you would be. Instead of feeling relieved and celebratory, you may be exhausted or resentful. The path to recovery isn’t a straight line and not everyone will react a specific way.

“At the end of the day, no one likes to be addicted. They’re petrified, frightened, and can’t find a way out,” Goldman says. “A part of them wants to stop. Maybe you start with, ‘I can see how much pain you’re in. What can I do to help you?’”

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Published February 12th, 2019

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