Are you looking for addiction treatment for a loved one or friend? You’re not alone.
Every week I receive calls and emails from family members and friends trying to find treatment for their loved one’s addiction,* aka substance use disorder. These kinds of phone calls and emails are heartbreaking. Their panic, anger, fear, frustration, sadness, desperation and anguish are palpable as they ask me:
- How can I make them get help? I’m afraid s/he’s going to die!
- What makes one place better than another?
- What do I do when they won’t accept my insurance (or my insurance doesn’t cover their program)?
- Why didn’t the last rehab work?
- S/he tried AA and gave up but what else is there?
- S/he gets out of treatment in 3 days, and I can’t find a safe place for him/her to go – what do I do?
What’s especially sad for me is that I receive the same kinds of calls and emails over and over and over and over, again. It should NOT BE THIS HARD to find effective treatment.
And, yet, it is. It’s terribly hard. So I thought I’d use this post to share the following 7 things you need to know when looking for addiction* treatment for a loved one or friend. These are based on my study of the relevant research and my speaking and consulting/coaching work over the past 14 years, as well as what the people whom I help have told me has worked for them.
1 Understand addiction for what it is – a developmental, chronic, often relapsing brain disease
This is important because it will help you understand why your loved one hasn’t sought treatment or succeeded in their addiction recovery thus far. It will also help you understand what it’s going to take to treat your love one’s addiction because there is no one-size fits all kind of treatment, and that treating adolescent addiction is different than treating adult addiction.
A key resource that can help with this understanding is the National Institute on Drug Abuse (NIDA)’s “Drugs, Brains, and Behavior: The Science of Addiction” [alcohol is considered a drug]. Quoting from its preface that explains how science has revolutionized the understanding of addiction:
For much of the past century, scientists studying drug abuse labored in the shadows of powerful myths and misconceptions about the nature of addiction. When scientists began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society’s responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punishment rather than prevention and treatment. Today, thanks to science, our views and our responses to addiction and other substance use disorders have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of compulsive drug use, enabling us to respond effectively to the problem.
2 Understand the basics of how the brain works, wires and maps
Everything a child, teen or adult thinks, feels, says and does is controlled by brain cells (aka neurons) “talking” to one another and to and from other cells throughout the body via the nervous system — EVERYTHING.
This “talking” occurs through an electro-chemical signaling process, also referred to as neural networks and neural circuitry. When something gets in the way of this talking — like the chemicals in alcohol or other drugs (e.g., ethyl alcohol, THC, opioids, which change the chemical portion of this electro-chemical signaling process), that something changes the way the brain works and thus a person’s thoughts, feelings and behaviors.
For more on this and how it relates to a person developing addiction, please check out my article, “Understand Brain Maps | Change a Habit | Change Your Life.”
3 Understand the five key risk factors for developing addiction
Thirdly is to understand how powerful the five key risk factors are to developing addiction. In other words, it takes misusing a substance to chemically and structurally change the brain, but it’s these five key risk factors that make one brain more susceptible to developing addiction than another brain. This helps explain why one in a group of friends drinking or using the same amount will develop addiction and the others will not. Understanding these risk factors will help you better understand the kind of treatment your loved one needs. These risk factors include:
- genetics (one can’t help their genetics, but it explains a big piece of the puzzle of how one person develops addiction and another does not when both are using/misusing the same amount – in fact, genetics is 40-60% of the reason a person misusing alcohol or other drugs goes on to develop addiction);
- childhood trauma (verbal, physical, emotional abuse, neglect…for some this is also ACEs – adverse childhood experiences) which resulted in toxic stress, which can change a child’s brain wiring (brain architecture), and if not addressed during treatment and continuing care is often a trigger to relapse);
- social environment (given a person’s brain is wiring and mapping from birth, a child’s social environment has a significant impact on that wiring and mapping — a child’s brain developing in a calm, nurturing environment vs. a chaotic, neglectful environment, for example);
- mental disorder (also a brain disorder and one that needs to be addressed if it’s still present [co-occurring] so as not to be a relapse trigger to use/misuse because of the mapping of the substance as a soother of the symptoms of the mental disorder – 40% of persons with addiction have a co-occurring mental disorder); and
- early use (the brain developmental processes occurring from ages 12 – 25 are deeply influencial in the development of addiction in the person misusing alcohol or other drugs during this time).
I encourage you to pay particular attention to the childhood trauma | ACEs and mental illness risk factors I mentioned above. Why? Because of the way the brain works, wires and maps as I described in #2, and how mental illness and the toxic stress caused by childhood trauma and ACEs changes that wiring and mapping.
Specific to childhood trauma | ACEs:
Time and again when I speak before audiences or talk one-on-one with individuals or engage in conversations with therapists and other medical professionals, the answer is, “No,” when I ask, “Have you heard of the ACE Study?” This continues to shock and sadden me because the ACE Study was conducted in the late 1990s, and yet, understanding and using this Study’s findings can have a profound impact on a person’s treatment and recovery success. To learn more about the ACE Study and ACEs and find an extensive list of resources, please check out Jane Steven’s, founder/editor of ACEs Connection Network, post, “ACEs Science 101 (FAQs).” And check out her interview with Dr. Dan Sumrok in her article, “Addiction doc says: It’s not the Drugs. It’s the ACEs — adverse childhood experiences.”
And, I must say it again. If a person’s childhood trauma | ACEs are not treated — “healed” — the profoundly negative impact on a person’s addiction treatment and recovery can be huge because of the brain wiring and mapping that occurred around the trauma-related toxic stress triggering emotions and the reactionary coping skills that were mapped to stay safe in the midst of the childhood trauma | ACEs. Without treatment specifically geared to helping the person recover from their childhood trauma | ACEs, anything that triggers the deeply embedded trauma-related toxic-stress brain maps will continue to trigger the use of the substance that has mapped as the answer to, the soother for, those trauma-related toxic stress triggering emotions and reactionary coping skills.
Specific to mental illness:
Having a mental illness and an addiction is to have two brain diseases (aka disorders); two diseases that both need to be treated at the same time. Think of it this way. If a person has diabetes and lung cancer, medical practice would require co-occurring treatment of these co-occurring medical conditions. And as I explained the importance of treating a person’s childhood trauma | ACEs above as a key to their success in addiction treatment and recovery, so, too, is it important to treat their mental illness at the same time as their co-occurring addiction (disorder). To more fully understand this, I refer you to my post, “Co-Occurring Disorders Require Co-Occurring Disorders Treatment, and NIDA’s image above right.
4 Know what it takes to effectively treat addiction
First of all is to understand that treatment does not have to be residential treatment. Secondly is to understand that it must be individual — meaning targeted to the person, not a one-size fits all. Thirdly is to understand it takes time. Check out my blog post, “We Can’t Treat Cancer in 30 Days. Why Do We Think Treating Addiction is Any Different?”
If your looking for teen or young adult treatment, check out NIDA’s What to do if your teen or young adult has a drug problem? There you will find answers to the following questions (and remember, alcohol is considered a drug):
- How do I know if my teen or young adult has a substance use disorder?
- Why can’t some teens stop using drugs on their own?
- If I want help for my teen or young adult, where do I start?
- What kind of screening will the doctor do?
- If my child refuses to cooperate, should the family conduct an intervention?
- How do I find the right treatment center?
- What do I look for in a treatment center for this age group?
- Who will provide treatment to my child?
- Is there medication that can help?
- If my teen or young adult confides in his or her doctor, will I be able to find out what’s going on?
- What if my teen or young adult has been in rehab before?
- How will I pay for treatment?
- What kind of counseling is best for a teen or young adult?
- Will a support group help my teen?
- How do we keep things stable in our home until my teen is in treatment?
- Are there research studies available for teens?
- Where can we find information on specific drugs of abuse?
- Where can I find more information on treatment and recovery?
- An additional resource here is NIDA’s Principles of Drug Addiction Treatment: A Research Based Guide (Third Edition)
If your looking for adult treatment, check out NIDA’s What to do if you if your adult friend or loved one has a problem? There you will find answers to the following questions (and remember, alcohol is considered a drug):
- How do I know if my adult friend or loved one has a substance abuse problem
- Why can’t addicts stop using drugs on their own?
- If my friend or loved one asks for my help, where do I start?
- My friend has considered treatment but is afraid of what others will think. What can I tell my friend?
- If my friend or loved one refuses to cooperate, should we conduct an intervention?
- Can I explore treatment centers even if my friend is not willing to go into treatment?
- What should I look for in a treatment center?
- My friend or loved one is afraid of being forced to stop using drugs and what will happen. Do treatment centers force people to stop taking drugs immediately?
- Who will be providing treatment?
- What is treatment like?
- Do most treatment centers offer medication?
- My friend was in rehab before but relapsed afterward. How do we know treatment will work this time?
- How can people find a treatment center they can afford?
- I think my loved one takes drugs because he feels depressed—but he’s depressed because drugs are overtaking his life. How do we know which problem came first?
- I am worried that my loved one is driving while using drugs. What do I do?
- How can my friend talk to others with similar problems?
- I am not sure what drugs my loved one is taking. Where can I find information on specific drugs and their health effects?
- If my friend does go into treatment, how can I offer support?
- What if my friend wants to participate in research studies?
- Where can I find more information on treatment and recovery?
- An additional resource here is NIDA’s Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide
Armed with the information contained in these resources, you can now make a list of the questions you will ask a treatment provider (if you are looking for outpatient or residential treatment options) to confirm the provider can meet your loved one’s treatment needs. Your answers can also help you with the next two suggestions.
In both lists of questions shared in this section above, NIDA refers to using the SAMHSA Treatment Facility Locator. Click here to access a one-page PDF on how to use this locator.
5 Understand what you can do for “housing” after your loved one is discharged from a residential treatment program
This is really hard, I’m afraid. There is no standard of care for a sober living home (SLE), for example. Yet it’s often helpful for your loved one and you and the rest of your family if they continue their recovery and treatment outside your home. If that is your decision, please find the following suggestions:
- If your loved one is an adolescent, consider Recovery High Schools via the Association of Recovery Schools.org.
- For young adults 18 and older and adults, check out my article, “Sober Living Homes | a Soft Place to Land or??” and the National Alliance for Recovery Residences (NARR).
- For young adults in college, check out the 2017 National Collegiate Recovery Directory, produced by the Association of Recovery in Higher Education (ARHE),”the only association exclusively representing collegiate recovery programs (CRPs) and collegiate recovery communities (CRCs).”
5 Change how you talk about it
Always refer to the behaviors, not the person, because it is the behaviors that are the symptoms of this particular disease. Here’s what I mean by this statement.
Disease by its simplest definition is something that changes cells in a negative way. When cells change in a body organ, the health and functioning of that organ changes. In the case of lung cancer, for example, cancer cells in the lungs change the health and functioning of the lungs. Addiction changes cells in the brain, which in turn changes the health and functioning of the brain. Given the brain is the organ that controls everything a person thinks, feels, says and does, and develops as the result of contributing risk factors and brain developmental processes that influence that particular person’s brain wiring and mapping, it is now understood that addiction is a complex brain disease. But it is a disease and like other chronic diseases, it’s treatable.
One of the difficulties for accepting this disease model of addiction vs. lung cancer, for example, are the symptoms. With lung cancer, the symptoms might be a cough (often with blood), chest pain, wheezing, and weight loss. The symptoms of addiction include: lying, cheating, verbal/physical/emotional abuse of loved ones, neglect, denying the use or blaming someone or something else for the use/misuse, drinking or using huge quantities of other drugs (far more than “normal” people), and repeatedly breaking promises to stop or cut down. These symptoms make it very difficult to feel sorry for or want to help the person exhibiting them.
But when we keep this disease concept in mind, we can reframe our conversations to talk about their behaviors — their symptoms — and tackle our approach to helping them understand and treat their addiction, the same way we’d be helping them tackle and approach their understanding and treatment options if they had lung cancer, instead. We can see and love them as a person – our person – our person who happens to have the disease of addiction.
7 Get help for yourself
Family members and friends are deeply affected by a loved one’s addiction. The impact on them is primarily related to toxic stress. I refer to this impact as secondhand drinking | secondhand drugging (SHD). For this, I refer you to a series I wrote for Alcohol Awareness Month 2014 [Note: all references to secondhand drinking apply to secondhand drugging, which means you are dealing with a person’s drug misuse behaviors as compared to dealing with a person’s drinking behaviors.]:
- Part 1 Alcohol Awareness Month – Two Sides to the Drinking Equation
- Part 2 Why the Term Secondhand Drinking (SHD)
- Part 3 The Brain and the Secondhand Drinking Connection
- Part 4 Causes of Secondhand Drinking
- Part 5 Fight or Flight Stress Response System – Secondhand Drinking Connection
Another resource that can help is my eBook, “Quick Guide to Secondhand Drinking: The Phenomenon That Affects Millions.”
And, as always, know I welcome calls and emails with questions on how to get started or continue moving forward in your search for treatment help for your loved one. My email is lisaf@BreakingTheCycles.com, and my office number is 650-362-3026. I’m in CA on PST. If I don’t answer, I will call you back. There is no charge for these kinds of initial inquiry calls.
*NIDA (the National Institute on Drug Abuse) continues to use the term addiction and defines it as a chronic, relapsing brain disease. However, as NIDA also writes, “addiction” is not considered a specific diagnosis in the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which was updated in 2013. DSM-5 replaces the categories of substance abuse and substance dependence with a single category: substance use disorder. Given the general public still thinks of a person’s dependence on alcohol or other drugs as addiction, I used this term in this article.
©2017 Lisa Frederiksen