Five Essential Tips For Families of Heroin Addicts

Sharing essential tips for families of heroin addicts is today’s guest author, Josh Butcher, founder of Ohio Addiction Recovery Center. When asked to share a bit of his background and reasons for founding Ohio Addiction Recovery Center, Josh explained:

I grew up in a middle class family in the suburbs of Columbus. From a young age I always felt like I didn’t fit it for one reason or another and throughout my adolescent years that feeling grew more and more, to the point that I made a decision to try alcohol. For me, drugs and alcohol were never the problem, the problem was myself and that I was trying to fill a hole within my spirit with something that took away an uneasy feeling I had. My entire teen years were filled with drugs and alcohol until the point that I found myself in jail. It was at that moment that I was given an opportunity to make a decision, go to treatment or go to prison. For me the choice was easy. 8 years later I’m back in my hometown providing a service to the people of my childhood community that is turning people’s lives around and restoring hope. My dream has finally came true with the advent of Ohio Addiction Recovery Center, I get to give back to the place that I took so much from in my addiction.

Five Essential Tips for Families of Heroin Addicts by Josh Butcher


Josh Butcher, Today’s Guest Author

Heroin overdoses and deaths have dominated the national conversation for the last several years. According to information provided by the National Institute on Drug Abuse, 4.2 million Americans have tried heroin at least once in their lifetime and 23 percent become dependent on the drug. The devastating effects of heroin abuse have had tremendous impacts in states such as Ohio which had second-highest number of drug overdose deaths nationwide in 2014.

If you are a parent or a family member of a heroin addict in Ohio or anywhere in the United States, is it absolutely crucial to provide the healthy and compassionate support that is needed for the addict to find help.

The following are five essential tips that your family can follow in helping your addicted loved one.

Do Not Enable

Perhaps the most important tip that families need to keep in mind is to not engage in enabling behaviors such as giving the addict money or giving them a place to live rent-free. By helping the heroin addict in this manner, you are allowing them to continue their behaviors without facing the consequences. Addicts are accustomed to manipulating others to get what they want, and when family members say no it can stop them in their tracks. If you utilize this tactic with your loved one, expect resistance—but you must stay firm.

Get Support and Get Educated

For families of heroin addicts, it is extremely important to seek meaningful support. A great place to find the support and encouragement you need in helping your loved one tackle their heroin addiction is through the resources provided by the Substance Abuse and Mental Health Services Administration (SAMHSA) website. SAMHSA provides informative articles regarding heroin addiction as well as a comprehensive directory of the treatment facilities and professionals you can turn to. By seeking meaningful support in this manner, your family is less likely to engage in enabling behaviors that can make your loved one’s addiction worse.

It is equally important to become educated on heroin as a drug and how people can become addicted to heroin. In the last few years, many of those who turn to heroin have abused prescription painkillers such as OxyContin and Percocet. For those who make the switch to heroin from these prescribed medications, they do so because of the cheaper cost and its wider availability.

Offer Your Loved One the Opportunity to Change

As the family of a heroin addict, you want to provide encouragement and support to your loved so they can bring about change in themselves. You are able to bring forth these “positive enabling” behaviors by eliminating any negative enabling behaviors as described in the first tip. You want to let your loved one know that you truly care about them, but you are no longer going to contribute to their addiction. If the addict does make a true commitment to change, you can assist them in finding a treatment center that fits their unique needs.

If you are looking for a treatment center in Ohio or elsewhere in the United States, finding one with a wide variety of effective treatment services that are proven to work is an excellent start. The best drug treatment programs offer essential services such as medical detoxification, individual and group therapy, life skills training and relapse prevention education. These services will provide your addicted loved one the tools they need to address and overcome their heroin addiction. In you need additional information on what to look for in an effective drug treatment program, The National Institute on Drug Abuse features an excellent guide regarding the principles of effective drug treatment.

Inform Other Family Members and Friends

While chances are good that other family members and friends may already be aware of the situation, it is good policy to speak to them and tell them truthfully about what is going with your loved one. You must be very clear to other family members and friends not to them with any financial assistance in any form or a place to stay. If the rest of the family is on the same page as you, it becomes increasingly difficult for your loved one to continue to act in the way that are accustomed. It may be very difficult, but if you choose to be open and completely transparent about what is going on, you can have a positive impact on the course of your loved one’s addiction.

Understand the Consequences

The importance of finding quality heroin treatment in for your loved one cannot be stressed enough. If you can’t get your loved one help, the consequences they can experience can be very harrowing. Your loved one can experience severe legal consequences and can end up in prison or jail. They may also wind up in the hospital or other medical facilities for extended periods of time. Unfortunately, your loved one may end up dying due to their heroin addiction. The positive steps you take right now will go a long way in helping your loved one find the help they need.

Are You Looking For Help in Breaking the Cycle of Heroin Addiction?

If your family is dealing with a heroin addiction, you may feel overwhelmed in your search for quality heroin addiction treatment. You may feel unsure of what to look for in drug treatment, and you may not know who to talk to in discussing options. A great place to start your search is the National Institute on Drug Abuse (NIH) webpage. The NIH website provides great information on addiction research, trends and statistics, and provides invaluable resources on where you can find the treatment that your loved one needs.
In addition to the information on the NIH website, you can contact your family doctor, physician or local health provider for the treatment options in your region. If your area features a non-profit recovery advocacy organization, they also can provide you with excellent information.

Chronic Pain Maps in the Brain – Implications for Pain Medication Addiction

One of the most surprising, “ah-ha,” “no wonder this happened” findings of my 12+ years research has been the fact that the brain controls EVERYTHING we think, feel, say and do – everything! This means chronic pain is “felt” in the brain.

I wrote about this concept in my August 29, 2014 article, “Chronic Pain and Opioid Addiction,” in which I covered the following key concepts:

  • The brain controls everything we think, feel, say and do through neural networks and brain maps.
  • Pain is in the brain.
  • Pain meds don’t just block opioid receptors – they also trigger massive releases of dopamine neurotransmitters.
  • A person can be physically dependent and not addicted to a pain med, yet the withdrawal symptoms can be the same.

How the Brain Maps Chronic Pain

When you injure yourself, pain receptors in the peripheral nervous system send pain signals to the spinal cord. At the spinal cord, bundles of sensory neurons in the dorsal horn act as a hub and send reflex messages to the injury site (take your hand off the burner, for example) and pain messages to the brain. These pain messages to the brain run throughout, triggering neural networks ranging from those involved with fight-or-flight, to those responsible to assessing this pain in context of similar pain, to so many more too numerous to count.

And this is where it can get “complicated.” If the brain attaches fear to the event – say fear about what you’ll be able to do now that you’ve broken your foot, or it attaches anxiety to the injury event – say anxiety about doing something, like exercise, that might make the pain worse, or it attaches worry about the prognosis for a full recovery, the brain starts to get the pain messages linked up with the emotions. So that if a person feels that twinge of fear when they move their foot, the brain “reads” it as pain. Additionally, if the brain is under major emotional stress around other things going on at the time of injury, say loss of a job, it can attach those stress-related feelings to the feeling of pain, as well. Thus when another job application they’ve submitted is declined, for example, their brain “feels” that old “pain.”

Not only this but pain often interrupts sleep and gets in the way of wanting to exercise. Both lack of sleep and lack of exercise in turn change brain chemistry, which in turn can lead to depression or a brain mapping that further inhibits sleep and exercise. And why would this be such a problem? When the brain does not get the powerful brain benefits of restful sleep and exercise (these actually “do things” to various parts of those strands of holiday lights), it interrupts normal neural network activity, which then exacerbates the problem.

Not only are there all of these sorts of emotion / thought-related mappings going on, BUT there are the brain maps around the chemical interruptions to the neurotransmitters and receptors’ portions of various neural networks. These interruptions are caused by the chemicals in the drug compound, itself.

Implications for Pain Medication Addiction

Opioid pain medications work in the brain in ways similar to other addictive drugs, including heroin.

Opioid pain medications work in the brain in ways similar to other addictive drugs, including heroin.

To explain this is to explain how opioid pain meds work in the brain | body.

A portion of the pain med compound binds to receptors at the injury site. A portion of the pain med compound binds to opioid receptors found throughout the brain and nervous system – the receptors on neural networks involved with the “complicated” bit above. And a portion trigger massive releases of dopamine neurotransmitters – the neurotransmitters responsible for the brain’s pleasure/reward neural networks.

With the surge of dopamine component of an opioid pain medication, the pain is not being “killed,” per se – rather it’s being overwhelmed by the content, euphoric, satisfied feelings that dopamine neural networks provide. And, of course, the brain likes that feeling, so it maps the desire for pleasure (which comes with the pain meds), in addition to all of the other brain mapping going on.

This is where the strand of holiday lights analogy described in my original post comes into play, again. Between the “complicated” stuff described above and the brain / body pain med interactions, there are so many strands (neural networks) with frayed wires, loose bulbs and power surges, that a person’s thoughts and behaviors and what they feel and how they react / respond is out of whack.

In the case of acute pain, which is normal, and lasts anywhere from a week or two to a few months, pain medications help calm all of the opioid reliant neural networks involved with injury pain. Once the injury site is healed, the brain no longer feels pain and the person is weened off their pain medication.

BUT, in the case of chronic pain, the continued feeling of pain MAY be being triggered by the “complicated”-related brain mapping around fear, anxiety, emotions related to other events going on at the time and the “ah” feeling mapped around dopamine described above. The brain can actually be hijacked, if you will, because it has maps that “tell it” that pain meds are the answer to “pain” – pain which is now triggered by emotions, memories and the drive to feel good – all of the cues it has mapped to be “answered” by the pain med.

For the Rest of the Story


  • neural networks, brain maps and pain,
  • acute vs chronic pain,
  • opioid pain medication withdrawal, and
  • what to do

check out my original article, “Chronic Pain and Opioid Pain Addiction.”

Related Posts


Detox: the Physical Process of Recovery

shutterstock_detox2Explaining detox – the physical process of recovery – is today’s guest author, Patricia L. Ryding, Psy.D. Dr. Ryding is the Executive Director of Beach House Center for Recovery, a drug and alcohol addiction rehabilitation center in Juno Beach, Florida. She is a licensed clinical psychologist who brings over 30 years of experience as both a clinician and an administrator in the behavioral healthcare field to her writing.

The Detox: The Physical Process of Recovery by Dr. Patricia Ryding

Dr. Patricia Ryding, Executive Director of Beach House Center for Recovery, explains the detox.

Dr. Patricia Ryding, Executive Director of Beach House Center for Recovery, explains the detox.

You didn’t become addicted to drugs or alcohol overnight. Over days, weeks and months, your body slowly responded to increasing amounts of the substance and transformed accordingly. So naturally, when you stop using, it will take time for your body to adjust once again. This process of withdrawing from drugs or alcohol is called detoxification (detox).

Detox is an essential part of recovery from addiction. You need to take your medicine to get better, so to speak. You can detox on your own, but quitting drugs or alcohol “cold turkey” comes with a long list of risks, including needlessly uncomfortable symptoms, increased risk of relapse or overdose, or in extreme cases, death. Your best bet is to undergo a detox in a medically supervised setting.

What to Expect During Detox

Symptoms of detox depend on the substance and length of addiction. If someone physically dependent on alcohol suddenly stops drinking, for example, he or she will start experiencing detox symptoms anywhere within about five to 10 hours to a few days after that last cocktail, with peak symptoms between two and three days.

Specific symptoms of withdrawal may include depression and anxiety; extreme fatigue; severe cravings for the drug or alcohol; restlessness; trouble sleeping; profuse sweating; body shaking; muscle weakness; facial tremors; feelings of panic or guilt; and nausea. Severe symptoms requiring medical attention include extreme excitement or agitation, fever, mental confusion, seizures or hallucinations.

Landing Softly: The Best Place for Detox

If your addiction is severe, the safest option for detox is in a recovery center, under the medical supervision of skilled addiction specialists. The reason being, not only can quitting drugs or alcohol without any medical help be unpleasant, depending on the length of the addiction and the substance to which you are addicted, it can also be life threatening. Inpatient detox also removes you from the environment where you got addicted to drugs or alcohol in the first place, lowering your chances of relapse.

Detox takes anywhere from a few days to a few weeks, depending on your addiction and individual profile. It consists of three important steps: evaluation, stabilization and the transition to treatment. Here’s a quick overview:

  • Evaluation: Treatment providers gather information about you and your addiction to help target the process. This stage includes blood tests; screening for other co-occurring medical or physical conditions; a look at your social situation; and a check of your overall mental and physical health.
  • Stabilization: The “peak” of the detox process, stabilization involves medical and psychosocial support to get you through withdrawal. It may include medication to help ease your symptoms; making sure you receive adequate nutrition; familiarizing you with what to expect during the next stage of recovery; and informing your friends and family of your progress (when appropriate, and only with release of confidentiality). Most detox programs use drugs—other opiates, barbiturates or stimulants—to help wean your body off the substance. Drugs are particularly important during detox from opiates, heroin and alcohol.
  • Transition: At the end of the detox process, treatment providers prepare you to enter the next stage of recovery. Many treatment programs help you transition directly into an inpatient program or provide information on outpatient programs you can attend.
    Not all detox programs follow this formula, however. As an alternative, some programs combine non-drug therapies, including acupuncture, exercise, nutrition, yoga, meditation, biofeedback or creative arts. Remember, not all drug and alcohol treatment programs are the same, and it’s important to find one that is a good fit for you. As you consider detox and drug or alcohol treatment for you or a loved one, keep in mind you are taking an important first step by recognizing the problem. Best of luck on your journey to the happier, healthier, dependence-free life you deserve.

Alcohol Awareness Month – Information and Help for the 90 Million Americans Affected by Someone’s Alcohol Misuse

I’m using Alcohol Awareness Month to share information and help for the 90 million Americans affected by a loved one’s alcohol misuse. 90 million. These are the moms, dads, husbands, wives, children, grandchildren, brothers, sister, grandparents, boyfriends, girlfriends and close friends who are affected by a loved one’s drinking behaviors; in other words, the people affected by secondhand drinking (SHD).

Alcohol Awareness Month 2016

Lisa Frederiksen Uses Alcohol Awareness Month 2016 to Raise Awareness About Secondhand Drinking - the Other Side of Alcohol Misuse

Lisa Frederiksen Uses Alcohol Awareness Month 2016 to Raise Awareness About Secondhand Drinking – the Other Side of Alcohol Misuse

Each April since 1987, the National Council on Alcoholism and Drug Dependence, Inc. (NCADD) has sponsored Alcohol Awareness Month to increase public awareness and understanding, reduce stigma and encourage local communities to focus on alcoholism and alcohol-related issues. I’m using this year’s Alcohol Awareness Month celebration to raise awareness about secondhand drinking – the negative impacts of a person’s drinking behaviors on others – impacts that greatly change the affected person’s overall physical and emotional health and quality of life.

Cause of the Drinking Behaviors that Cause Secondhand Drinking

Lisa Frederiksen shares information about alcohol misuse and secondhand drinking for Alcohol Awareness Month.Generally, drinking behaviors (see side bar) are not “intentional,” unless that’s how the person behaves when sober. Rather they are the result of brain changes caused by the ethyl alcohol chemical in alcoholic beverages interrupting the brain’s electro-chemical signaling process and thereby changing how the brain works.


  • how the body processes alcohol via specific enzymes in the liver which metabolize [rid the body of] the ethyl alcohol chemicals in alcoholic beverages at an average rate of 1 standard drink per hour;
  • standard drink sizes;
  • staying within normal or moderate drinking limits; and
  • the other variables listed in the side bar

can help a person avoid exhibiting drinking behaviors. It can also help a person protect themselves from secondhand drinking.

Why is Secondhand Drinking a Serious Concern?

Two reasons: the sheer numbers of people affected and its connection to stress.

The primary consequence of SHD’s impacts on a family member or close friend is stress. Coping with drinking behaviors triggers the fight-or-flight stress response system (FFSRS) centered in the limbic system, the reactionary part of the brain.

The FFSRS was “designed” in the human species to prepare a person to fight or run when faced with physical danger, and it causes a number of physiological changes to occur. For example, blood vessels to the skin constrict to lessen blood loss in the event of injury; the digestive system shuts down to conserve glucose needed for energy to run or fight; and heart rate increases to push blood flow to large muscles to allow a person to run more quickly.

The FFSRS also leads to dysregulation of the cerebral cortex (the thinking part of the brain) so that a person reacts immediately without considering the options when confronted with danger. As a result of another brain design feature – “neurons that fire together, wire together” – the brain “maps” the reaction (fight or flight) that kept the person safe. This map becomes a person’s default reaction the next time a similar triggering event occurs. This was especially important back in the day when early man’s only immediate threat was physical danger.

Today, however, and especially in families with untreated alcohol misuse, the FFSRS is more often than not triggered by things other than physical danger – emotional cues, for example, such as simmering fear, anxiousness or anger, memories and constant worry.

What Happens to the Person Experiencing Secondhand Drinking?

Coping with drinking behaviors causes ongoing activation of the FFSRS. When a person doesn’t fight or run, all of those physiological changes described above sit – “marinate” – in body organs, like the brain, heart and muscles, resulting in physical and emotional ailments, such as: sleep disorders, migraines, headaches, stomach ailments, changes in eating habits, dizziness, distracted “thinking,” depression, anxiety, memory impairment, heart disease and digestive problems.

In addition to these physical and emotional impacts, the chronic activation of the FFSRS causes a person to wire unhealthy coping skills, because their brain maps the behaviors that kept them “safe” when confronted with the drinking behaviors. These can include:

  • shutting down emotionally, retreating inside one’s mind when confronted with abusive or scary behaviors
  • being hyperaware of others’ feelings or actions and adjusting one’s own accordingly
  • yelling, crying, blaming, shaming or verbally lashing out
  • carrying pent up, explosive rage that spills out in other situations because it cannot be expressed to the person exhibiting the drinking behaviors
  • attempts to be especially good to make up for or fix the problem
  • withdrawing from family, friends or activities out of embarrassment over the drinking behaviors.

These reactionary coping skills and the physical and emotional consequences change the family member and interfere with their work, school, relationships and ability to see, let alone enjoy, the pleasures in everyday life. All of which explains why family members need help – not a one-size-fits-all kind of help – rather the kind of help that addresses their bio-psycho-social issues in order for them to reclaim their lives in long-term secondhand drinking recovery.

Recovering from Secondhand Drinking

In essence, repairing and healing the brain and rewiring new brain maps to change those compromised by ongoing stress is primarily centered around:

  • chemically rebalancing the brain (nutrition, exercise, sleep);
  • becoming aware of one’s cues and current brain maps (mindfulness);
  • fully committing to eating nutrient-rich foods, exercise and sleep; and
  • taking steps to change how one reacts to cues in order to wire new brain maps.

To help readers with these efforts and a more thorough understanding of SHD, I wrote a short eBook, Quick Guide to Secondhand Drinking: A Phenomenon That Affects Millions. [It comes in all eReader formats – the one linked here is to the Kindle version.]

Additionally, you may also wish to read some of my secondhand drinking and secondhand drinking recovery story as shared in my September 17, 2012 post, Behind Every Alcoholic | Addict is a Family Member or Two or Three…


As always, please know I’m happy to answer questions or direct readers to additional resources. Feel free to call me at 650-362-3026 or email me at



Narcissistic Relationships – Guest Author Darlene Lancer

In her post today, frequent guest author, Darlene Lancer, JD, MFT, helps readers understand how being raised by a narcissistic parent changed them and what they can do to overcome the consequences.

Darlene is the author of Codependency for Dummies and Conquering Shame and Codependency: 8 Steps to Freeing the True You, and her latest eBook is titled, Dealing with a Narcissist, 8 Steps to Raise Self-Esteem and Set Boundaries with Difficult People. She can be reached at or you may wish to follow her on Facebook or visit her website

Narcissistic Relationships by Darlene Lancer, JD, MFT

Since writing Codependency for Dummies, countless people contact me about their unhappiness and difficulties in dealing with a difficult loved one, frequently a narcissistic partner or parent who is uncooperative, selfish, cold, and often abusive. Often they are children of narcissistic parents who damage to the self-esteem and motivation of their children. These parents expect excellence and/or obedience, and can be competitive, envious, critical, domineering, or needy. The common factor among narcissistic parents is that their feelings and needs, particularly emotional needs, come first. As a result, their children learn to adapt, become codependent. They bear the responsibility for meeting the parent’s emotional needs, rather than vice versa.

Darlene Lancer, author of "Codependency for Dummies," shares her post on living with a passive-aggressive partner.

Guest Author, Darlene Lancer

Whereas their parents feel entitled, their children feel unentitled and self-sacrifice and deny their own feelings and needs (unless they, too, are narcissistic). They don’t learn to trust and value themselves and grow up alienated from their true selves. They may be driven to prove themselves in order to win their parents’ approval, but find little motivation to pursue their wants and goals when not externally imposed (e.g., by a partner, employer, teacher).

Although they may be unaware of what was missing in their childhood, fear of abandonment and intimacy continues to permeate their adult relationships. They’re afraid of making waves or mistakes and being authentic. Used to seeking external validation, many become pleasers, pretending to feel what they don’t and hiding what they do. By reenacting their family drama, they believe their only choice is to be alone or give up themselves in a relationship.

Often adult children of narcissistic parents are depressed, have unacknowledged anger, and feelings of emptiness. They may attract an addict, a narcissist, or other unavailable partner, repeating the pattern of emotional abandonment from childhood. Healing requires recovery from codependency and overcoming the toxic shame acquired growing up in a narcissistic home.

What is Narcissistic Personality Disorder?

Narcissistic personality disorder (NPD) requires specific criteria that must be met for a diagnosis as described in “Do You Love a Narcissist?” The disorder also varies from mild to extreme. But of all the narcissists, beware of malignant narcissists, who are the most pernicious, hostile, and are vindictive and malicious. Avoid them before they destroy you. Email me at if you would like a free “Checklist of Narcissistic Traits.”

Narcissistic Abuse

Narcissists use defenses to hide their deep and usually unconscious shame. Like bullies, they protect themselves through aggression and by wielding power over others. Malignant narcissists are maliciously hostile and inflict pain without remorse, but most narcissists don’t even realize they’ve injured those closest to them, because they lack empathy. They’re more concerned with averting perceived threats and getting their needs met. Consequently, they aren’t aware of the hurtful impact of their words and actions.

Narcissistic abuse can include any type of abuse, whether physical, sexual, financial, mental, or emotional abuse. Most often it involves some form of emotional abandonment, manipulation, withholding, or other uncaring behavior. Abuse can range from the silent treatment to rage, and typically includes verbal abuse, such as blaming, criticizing, attacking, ordering, lying, and belittling. It may also include emotional blackmail or passive-aggressive behavior. If you’re experiencing domestic or intimate partner violence, read “The Truth about Domestic Violence and Abusive Relationships,” and seek help immediately. For more about narcissistic relationships, listen to my talk.


Not many narcissists enter therapy unless they’re pressured by a partner or suffer an extreme blow to their image or self-esteem. It’s essential that children and partners of narcissists actively heal their codependency. Even if the narcissist refuses to get help or change, the relationship can markedly improve by changing your perspective and healing your codependency. In fact, learning about NPD, raising your self-esteem, and learning to set boundaries are just a few of the many things you can do to significantly better your relationship, as described in Dealing with a Narcissist: 8 Steps to Raise Your Self-Esteem and Set Boundaries with Difficult People. These steps are equally applicable to a relationship with an addict or any highly defensive or abusive.
©Darlene Lancer 2016

To read Darlene’s more in-depth article on this topic as it appeared on her blog, please click here.