Comments on: Parents of Addicts Question Expert Advice to Allow Harm

By: Mary

Mary — Thu, 03 Mar 2011 08:55:25 +0000

Amen to all of it!

By: recoveryhelpdesk

recoveryhelpdesk — Fri, 04 Feb 2011 01:51:38 +0000

Hi June, I wouldn’t assume that because she did not jump at the chance to go to a 30 day detox that she is in “denial.”

Please read my last comment more carefully. Note that I said that you should “help her (HER!) identify a way to work towards change that is both acceptable to her and likely to work.” And then support her in implementing her choice.

I did not suggest that you pick a path to recovery for her and then threaten her with jail if she didn’t hop on board your plan.

I think it is likely that she is not so much in denial but rather reacting to your effort to impose a path to recovery that she has not chosen, and does not appear to think would be helpful or effective.

Your daughter may be right. A 30 day detox may not be the appropriate treatment for her at this time –especially if she does not recognize any benefit in the option, and you are not able to articulate the benefit to her in a way that motivates her to accept this option. And there are other reasonable options.

On the issue of taking action that may result in your daughter going to jail, I would note that you may cause your daughter to experience serious harm with no significant benefit. Sometimes parents turn to the criminal justice system out of frustration and desperation. You have a long way to go before you have exhausted all of your other options to promote her recovery.

If you are feeling stuck, scared and confused, you might consider scheduling an educational session with me either for you or for your daughter or for each of you separately. You can read about this option under the HELP tab at the top of the page. I think you are at a point where you might really benefit.

By: june p

june p — Wed, 02 Feb 2011 20:53:04 +0000

Thank you. Hooray for the snowstorm!! I decidely stayed home from work and took your advice to sit and have a talk with my daughter. She was indeed “using” but claimed to be taking klonapins(sic) in addition to suboxone to help her detox. Although I did not see her administering the suboxone to herself. She is still in denial. I suggested that she go to a 30 day detox, to which she said “and what is that going to do?” I continued talking with her, and let her know that a few weeks ago I spoke with her PO and let her know I believe she tucks her urines when her color is called. She became increasingly upset and ask why I would do that, to which I replied that since she was cleaning herself up, she wouldn’t have to worry about being confronted on her screening. A few minutes later, she said that she’d let me know by Friday as to whether or not she would go to a rehab. She has an appointment to see her PO on the 2/8, and I believe she now wants to “skirt” the issue by admitting herself into rehab. As I of course will not object, I feel she would be doing it for the wrong reasons. Today is her 24th birthday, and its been over 9 years since she had a sober birthday. I would like next year (with the help of God) to see her clean and sober. I’m debating whether or not to call her PO and giver her a heads up on her continued drug use. If I do, there is a chance she could face significant jail time (possibly 2-1/2 years). I’m so scared and confused, I just keep going back and forth and can’t commit to a solution.

By: recoveryhelpdesk

recoveryhelpdesk — Tue, 01 Feb 2011 01:07:22 +0000

Hi June –”What to do” is not a quick and easy question to answer, as I’m sure you realize. A quick thumbnail sketch of the process:

Clarify your own needs and personal boundaries (these are about you and not about her).

Help her identify her own needs –what, if anything, she wants to change about her life and her relationship with opiates. If she is “happy” with things the way they are, then you either must work on helping her to feel safe acknowledging that she is not happy with things the way they are. Or, you must work on helping her become aware of the need for change.

Once she has identified a need for change, you must help her identify a way to work towards change that is both acceptable to her and likely to work.

Then, you need to support her in her way forward.

By: june p

june p — Tue, 01 Feb 2011 00:11:12 +0000

I’ve been reading your philosophy regarding having a loved one with an addiction, and have to agree with what you are saying. My 24 yr. old daughter, who was a star athlete, good student and loving daughter, has been addicted to opiates since she was 14-15 years old. I’v tried it all, tough love, which I believed contributed to her contracting HepC and intravenous use (now uses herioin). She is currently under the court jurisdiction, and is still able to get around the system (she tucks urines when her color is called). She lives with me, doesn’t work, runs amuck, and has roughly 5 weeks of probation left before she will be on her own again. I’m not sure what to do anymore. I know if I go before the judge, he will put her in jail, as she has time hanging over her head. She has already spent 30 days in jail. This didn’t work either. Help, not sure what to do.

By: Housing first for a heroin addict « Heroin Addict Parents

Housing first for a heroin addict « Heroin Addict Parents — Sat, 17 Jul 2010 04:24:14 +0000

[...] first article is about tough love. Like Heroin Helper, Recovery Helpdesk generally recommends that we focus on safety and minimizing [...]

By: Craig

Craig — Fri, 09 Jul 2010 02:28:42 +0000

His drugs of choice are marijuana and xanax. We obviously don’t know everything, but he has also experimented with many other things (acid, cocaine, mushrooms, codine, hydrocodone, ecstasy). He has never admitted to heroine or meth or any injections. When he was checked into the ER before rehab he was positive for pot and xanax. We have never had a positive test for the others, but he has stated use for the others listed. We believe his current use is marijuana (probably on a daily basis) with xanax and ecstasy on weekends or more frequent. He was smoking K2 soon after rehab because it would not show up on a drug screen. When he “crashed” before rehab it was from continued escalation of xanax use until he was almost incoherent…slurred speech, excessive weight loss, memory loss, physical appearance and posture became very poor. At this point he really just doesn’t “see a problem with his use”. He is about 18.5 years old. His use probably started “casually” late middle school, but smoking pot started probably on a more regular basis when he was 16 (after my Father died…they were very close…my Father was also an alcoholic). He has also been treated for depression in the past (zoloft), but never any other diagnosis for mental illness. He has been seen by physiologists, counselors and psychiatrists. I currently have great insurance that have allowed these options, but in a few months when he turns 19 his options will become VERY limited. He has great immediate family and extended family support available, but he is in the process of burning those bridges and relationships with his current behavior. He his very aware of all the above…we have very calm and blunt conversations, but he doesn’t care or believe the realities. Not sure he even really believes he is an addict at this point….says he can quit if he really wants to…just “has to suck it up and do it”.

By: recoveryhelpdesk

recoveryhelpdesk — Fri, 09 Jul 2010 00:58:30 +0000

Craig, Great questions and comments, which confirm my hunch that you are far from an example of “When Tough Love Goes Bad.” I don’t have time to offer you a thorough response at the moment, but I will, so please check back. In the mean time, could you give me some more details about your son’s history? Is he opiate dependent (addicted to heroin or pain killers like OxyContin? Thanks, Tom

By: Craig

Craig — Thu, 08 Jul 2010 15:06:34 +0000

I truly appreciate your thoughtful response! Very helpful.
I do have a few questions for clarification, learning and understanding based on your list of suggestions:
1. Let go of trying to control him (he will only resist)
– I believe we have learned controlling will not work. Not only will he resist, but you simple cannot control another person. They need to have their own passion or desire for their behavior, future and relationships. That being said, when someone is living in your home (with other children in our case) setting boundaries like curfews, basic chores, honesty, no illegal substances in the home, etc… seems appropriate. Given our past issues with drugs and honesty our son was also required to pass drugs test to be live in our home. When a test failed we allowed the option to stay, but he had to be willing to continue to work towards recovery…he would not. At least not yet…
2. Look for ways to support and influence without controlling
– We are maintaining contact and open lines of communication. Offering support for ANYTHING related to recovery. Encouraging him to participate in family activities, church with the family, etc… I believe part of our influence and support is by showing an example of a different lifestyle than he has chosen.
3. Stop worrying about enabling, it’s a red herring
– Similar to my first post. I understand the words, but there is a practical line for allowing someone to take responsibility for their own actions versus letting them use you as a doormat and running behind them cleaning up their mistakes.
4. Make sure you are and feel like allies and not opponents
– Done. At least in our mind. We have told him over and over that we believe in him, love him, know he can have a bright future. We recently offered to help him pay for college. This offer came with accountability and responsibility for working towards recovery. He initially accepted, but then refused the offer for help. He stated he would rather be able to use than accept our offer. We made it clear he was choosing a drug over 4 years of paid tuition. He appears to still be harboring some anger…maybe at us, maybe at himself, probably at the world. He wants this to be a us versus him thing, but we have continued to let him know we are on his side.
5. Look for ways to reduce the risk of harm to your son
– This is the most difficult for me to interpret in my situation. Part of the consequences for not living within our boundaries at home were losing some of our support. His car was in my name and cannot be transferred to him name (lease). So when he chose to leave he also chose to leave a car, home, etc… He still has his job and is self supporting for now (likely not long term given his income). We have helped with some basic needs…food. If he eventually loses his job and needs a home it would seem counterproductive to allow him a “free pass” without consequences. I am not willing to pay for his housing, car, food, utilities for him to live on his own and continue to use. Letting him drive a car in my name when I know he is a drug user would also seem to be me in a legal liability situation I am not willing to risk. He knows he can get some support from us, but has to also be working towards recovery. His statements to use are the typical “I can quit if I want.”, “I don’t need help.”, “If I want to get sober, I just have to suck it up and do it.”, “There is nothing wrong with what I am doing…it is legal in other countries, lots of people do it, etc…”
6. Make sure he understands that you love him and support him just the same whether or not he is using –you are in his corner and rooting for his success
– Done. See #4
7. Offer him the same emotional and basic physical needs support whether or not he is using (while maintaining appropriate boundaries to protect yourself or others)
– See #5. This is where we are struggling the most. The definition of the details for “appropriate boundaries” seems to be the thing we are grasping for. Do we pay his rent, allowing him to drive a car in our name, pay for his insurance, etc…I am really struggling that this would help him reach recovery.
8. Make it clear to him that your hopes for him go far beyond recovery
– Done. See #4
9. Make it clear to him that your goal is not to control him or his drug use, but you are concerned that he is having trouble controlling his own drug use and therefore is at risk for serious drug-related harm (recovery is a means to an end –freedom from drug-related harm)
– Done. See #4. We have also participated in counseling and family sessions where he has heard over and over the risks of his use. He has also heard that he has the freedom to succeed or fail on his own, we will not try to control him but offer support for sobriety.

By: recoveryhelpdesk

recoveryhelpdesk — Thu, 08 Jul 2010 02:27:53 +0000

Craig, Thanks for your comment.

I do not think what you describe is an example of tough love advice gone bad. You say that you chose not to expose your other children to drug use and the surrounding chaos. This is a reasonable choice. It sounds like your decision was effective in achieving this goal.

But “tough love” is not about setting reasonable boundaries to protect yourself or others in the household. It is about withholding physical or emotional support as a way to control the addicted person.

You do not describe your decision as a way to motivate your son to change his behavior. But maybe that was part of your plan. If so, it hasn’t worked so far. And that is a big part of my problem with “tough love.”

1. It isn’t an effective way to motivate positive change
2. Unintended but foreseeable serious harm often results
3. Other options carry less risk and better outcomes

Your son didn’t choose to recommit to recovery. Instead, he affirmed a plan to keep using, and moved in with a “drug addict roommate.” This means his risk of harm has increased.

Let’s say, for example, your son has been smoking marijuana and snorting prescription pain killers like Percocet or OxyContin. He has no place to stay. He is not willing to go to a homeless shelter, so he moves in with a “friend” who is addicted to heroin and pain killers. This friend injects, and teaches your son how to shoot up. Now your son has experienced a serious progression in his opiate dependence. And he is at higher risk for drug overdose, HIV and hepatitis C. This isn’t progress.

Tough love would emphasize enforcing “consequences” for his relapse. Kicking him out of the house would be one consequence, and no attempt would be made to facilitate a soft landing. In fact, the goal would be to let the person “hit bottom.” An alternative approach would be to look for ways to avoid kicking him out and re-stabilize his recovery (sounds like that happened). And if that failed, then an attempt would be made to help him find other safe housing (this may or may not have happened).

It sounds like transportation is an issue that may cost him his job. If he becomes unemployed, it’s easy to see where a drug habit combined with a lack of income may lead him to criminal acts, homelessness and incarceration.

You say that if he “get’s in trouble with the law, falls into major debt, suffers abuse or any other consequence it will be his choice.” But the problem is that people who are addicted do not have unfettered free will. Their ability to choose not to use drugs is compromised because of the physiological and psychological impacts of addiction. This is why, for example, heroin addicts often “choose” to share syringes with someone they know is infected with HIV or Hepatitis C. Because they are not able in that moment to “choose” not to use just because a sterile syringe isn’t available. And this is why intervention and support (the opposite of detaching and withholding support) is likely to be more effective at limiting drug related harm and supporting recovery.

It seems likely that it will be cold comfort to know that your son’s “choices” contributed to his serious harm. Especially if the harm was foreseeable and avoidable.

My question is, are you actively looking for ways to help him avoid getting in trouble with the law, falling into major debt, or suffering abuse? Or, are you just sort of letting the chips fall where they may in the hope that he will somehow experience the right amount of harm to learn his lesson, but not suffer so much harm that the cure turns out to be more destructive than the disease?

Your son went to residential treatment for 30 days and then IOP for a period of months with no use for the first few months. This was a significant attempt at sobriety. He obviously has some level of desire to be sober. I’m working off of limited facts so it’s hard to be too specific, but my goal would be to look for opportunities to re-engage him, and help him build motivation to make some positive changes in his life. Is he in a position to go to college, for example? I’d be looking for ways to help him stay employed and find safer housing. And I’d be looking to reengage him in talk about recovery.

Without pushing, arguing or judging, I’d try to hear from him about how he sees his past drug use, drug treatment and recovery as well as how he sees his current drug use and prospects for recovery. What are the risks, costs and benefits of his current drug use? Does he see a benefit to recovery (I assume he does since he went to residential treatment)? Does he see a path to recovery that he thinks can work and is acceptable to him?

What does he think prevented him from achieving his recovery goal last time? What does he think made him abandon that goal? What does he think it would take for him to re-commit to that goal? What does he mean when he says that he is “not that kind of addict?” Can he really limit himself to marijuana use, or in his case does that lead to use of other substances with more harmful consequences?

Is he succeeding at being the person he wants to be? Is he satisfied with his relationships with others in his life? Is he on track to have the life he envisions for himself, have the future he hopes to have, and achieve his goals for himself? If not, is drug use part of what is holding him back?

Some suggestions about how to approach your relationship with your son during this time:

1. Let go of trying to control him (he will only resist)
2. Look for ways to support and influence without controlling
3. Stop worrying about enabling, it’s a red herring
4. Make sure you are and feel like allies and not opponents
5. Look for ways to reduce the risk of harm to your son
6. Make sure he understands that you love him and support him just the same whether or not he is using –you are in his corner and rooting for his success
7. Offer him the same emotional and basic physical needs support whether or not he is using (while maintaining appropriate boundaries to protect yourself or others)
8. Make it clear to him that your hopes for him go far beyond recovery
9. Make it clear to him that your goal is not to control him or his drug use, but you are concerned that he is having trouble controlling his own drug use and therefore is at risk for serious drug-related harm (recovery is a means to an end –freedom from drug-related harm)

It’s good that you are maintaining contact with him. Keep in mind that he is almost certainly feeling ambivalent about his drug use. His recovery process is continuing even though he is currently using. Keep him as safe as you can as he works his way back around to another push for recovery. It will come, and probably sooner if you are actively engaged and supportive.