I also haven’t observed that the key issue is whether or not someone is not “done.” I think it is closer to the truth to say that the issues is about whether or not someone has found an acceptable and workable path out yet.

I guess I would need to learn more about your daughter’s specific situation to have an idea of what that path might be for her, and what the barriers might be that have prevented her from finding that path or making more progress so far.

Let me know if you would like to schedule a time to chat at junkjunk.ning.com and maybe we can figure some of that out.

I’d give her a chance to size me up and figure out where I am coming from. You may need to take some time to signal a change in where you are coming from if what follows is new for your relationship with her.

I’d start with what she wants/needs (not what I want/need).

These may be practical things relating to housing, employment, medical issues, legal issues. She may not immediately identify treatment/recovery as her priority.

That’s fine. It’s all related to recovery.

I’d start with a need she identifies. An area where she wants help and support.

I’d help her with no strings attached (not, I’ll help you with this if you agree to do x, y, z).

As a provider, I have professional boundaries. I’m not going to let her move into my house or get involved with her financially either! As a parent, you have your personal boundaries. Just explain them in terms of yourself, and with love.

Dont’ bet me wrong –sometimes it is appropriate for a parent to allow their adult child to live with them, or to support them financially. I met with a mother and son today, and the son is living at home for now. Nothing wrong with that. You are telling me that is not where you are at right now. Nothing wrong with that either.

I’ve taken the time and made the effort to become educated about addiction and recovery, and resources in my area. This is an area that you should focus on too, so that when the opportunity arises, you can be a good resource for your daughter.

Over time, you will find times that you can offer information/options, or identify and address misinformation/myths that may be preventing her from accurately understanding her options. Maybe this is about avoiding overdose. Maybe it’s about safer injection. Maybe it’s about avoiding incarceration. Maybe it’s about exploring treatment options.

Tell her about an article or website you found interesting. Tell her about a resource or treatment program you’ve heard about. Does she know anyone who has been there. What has she heard about it?

What are the options locally or otherwise for free/affordable treatment?

My focus is on looking for opportunities to support her in reducing harm up to and including abstinence from opiates or other drugs. My focus is not on controlling her.

The program I supervise is 100 percent voluntary. We don’t require abstinence or even having the goal of abstinence. But 100 percent of our clients in case management last year participated in treatment.

Most people want recovery at some level. We are just very good at setting the stage for recovery so that recovery becomes a realistic option for people.

It is something of an art. But it is really just about taking an approach that is informed, non-judgmental, non-coercive, respectful, helpful, and supportive. Isn’t that what you would want if you were in her shoes?

As a parent, you have an opportunity to do the same.

1. Get the right mindset
2. Let her observe the change in approach
3. Acquire the knowledge necessary to be an effective support as you go
4. Provide support as you are able

I’m not sure how helpful that is…I feel like it’s kind of just a quick sketch…but I hope it’s a start.

I’m at a loss to know what steps to take. Our safety requires that she not live with us. Our finances require that we not bankrupt ourselves paying for treatment, especially since we don’t know if she is truly seeking recovery, or seeking a 90 day pj party/warm bed/further delay of facing her wreckage

Might you suggest a few things you feel we could do that might enable her to find recovery on her own? (did that make sense?)

The whole detach with love/stay involved thing still troubles me, and I value your opinion too.

Thanks again.

When I first got into MMT (methadone treatment) 10 years ago, I was using IV heroin. I was mostly a RX pain pill addict but for 6 months my husband and I were using heroin. I had never been on MMT before and did not know much about it so I simply looked at it as a way to keep from getting sick when I could not “score”.

The clinic did take UA’s regularly and none of ours were “clean”. They did not give us takeout doses due to this, bot otherwise we were not penalized. They did not threaten to discharge us from treatment, lecture us or in any other way punish us. They treated us with respect as fellow human beings.

Had we been shamed and punished, I have no doubt we would have quit attending. As it was, though, we had reduced our heroin use and were seeing medical personnel (the nurse) on a daily basis. And even better, I got the opportunity to see other patients who WERE doing well–people who came in once a week instead of every day–people in business suits, with nice cars, who looked clean and healthy–and I was impressed and wanted that for myself.

I was only in treatment briefly–about 4 months–when I had to leave to serve a jail term for a positive UA while on probation. However, I remembered how I was treated with dignity and respect, and how well so many of the patients I had seen were doing, and when I relapsed again 4 years later, I went back into MMT. This time I went in with more knowledge and a different goal, and I have been free of illicit drugs since that first day over 5 years ago. I have also become a major advocate for MMT patients nationwide, sit on several major BOD’s of national orgs, administer two major MMT patient forums, teach classes at my own clinic, and have restored my personal life to one of productivity and responsibility.

And I credit this in large part to the way that first clinic treated me while I was there.

As you said, the “consequences” of our use are extreme in any event–loss of career, children, home, freedom, health, etc. If we truly view opioid addiction as a medical illness–and are not just giving lip service to the idea–then surely punishment would not be viewed as “therapeutic”, and having more and more consequences heaped upon them does not “cure” what is in effect a biological disorder of the brain chemistry, not a character defect or moral flaw.