Addiction, Lies, Consequences and Recovery

The blogger at Her Big Sad posted a response to my recent post Parent of an Addict Asks: When Does the Lying End?

Here’s my comment in reply in the hopes of doing some clarifying and continuing a good conversation:

Thanks for reading my blog, commenting on my blog, thinking about what I wrote, and being so kind and gentle in your sharing of a different perspective!  I appreciate all that.

I also appreciate you pointing out where I could stand to clarify…

When I say that people often lie to avoid the consequences of telling the truth about drug use, I’m just making an observation.

I don’t seek to impose consequences for a few reasons:

1.  They aren’t very effective (check out the relapse rate after release from jail, or the ER)

2.  Major consequences already exist (overdose, HIV, Hep C, loss of money, loss of family, loss of child custody, loss of job, loss of housing, negative emotions etc.), and I don’t need to add more

3.  I spend a lot of my time working to limit drug-related harm (preventing drug overdose, transmission of HIV and HCV, incarceration, homelessness, loss of child custody etc.) so it would feel pretty odd to seek to add to the harm or “consequences” at the same time

4.  I don’t see drug use as a moral failing, or something that morally or ethically justifies punishment

5.  I want to establish a therapeutic relationship with my clients and not a power relationship with my clients (I’m a counselor not a probation officer)

6.  Focus on consequences is ineffective and removes focus from what is effective… putting together a realistic and workable recovery plan, removing barriers to recovery, supporting recovery, reducing harm, and not adding to harm

I would also like to be clear that I encourage parents to set boundaries to protect themselves and other family members, but not to impose “consequences” in the sense of “punishments” intended to somehow force recovery.

Not having somebody live with you who is likely to steal is an example of a good boundary to set for your own benefit.  It may also be a consequence, but it is much more likely to be an effective personal boundary than an effective incentive for recovery.

Also, let me clarify what I mean when I said,

“Often these consequences are counter productive to long term recovery.”

Let me give a common example:

Client has a probation officer who says, “I’m here to help you, I just need you to be honest with me.”

Client has a recovery plan, get’s into treatment, gets a place to live and a job.  This isn’t easy.

Client relapses.  Client is “honest” with the PO.  PO puts client in jail for their “safety.”

PO does not allow for the relapse response plan to go into effect.  As a result, a minor relapse results in discharge from treatment, loss of housing, loss of job, loss of trust in the system and the process.

People sometimes take years to come back from this kind of a set back.  It may be years before they even feel able to try again.

The consequence was reactive and counter-productive to long term recovery.

As I like to say, real recovery is safe and sustainable.

The PO put the person at risk (decreasing safety not increasing safety).  And instead of helping to re-stabilize the person following a relapse, they caused the person to become significantly more destabilized.

The medicine was worse than the ailment.

Her Big Sad wrote, “In the ten years I’ve been dealing with this in my family, I’ve not heard of one addict who got clean and stayed clean, while not experiencing consequences, or while sitting around, warm and cozy, with full rights and privileges normally given a non-using, productive member of society.”

In my experience, people suffer more than enough consequences without needing to have more imposed in the name of recovery. I have helped hundreds of clients successfully transition from current use to long term recovery without imposing a single consequence.

In fact, my program is built on a “low threshold” model.  For example, we interact with clients in the same respectful and one hundred percent supportive way whether they are using or not using.

We don’t require people to have appointments (walk-ins are fine).  There are no consequences for missed appointments other than a phone call checking in to see how the client is doing and inviting them to reschedule or stop in when they have time.

Our focus is on enabling recovery.  To do that, we need to be in contact with our clients whether or not they are using, whether they are in jail or out of jail, and whether life is such that they can keep appointments or not.

We need them to feel safe communicating openly with us so that we can help them problem solve.  We need to be on the same side -and it has to feel like we are on the same side.

Consequences are not useful to us.

If you haven’t already, I would ask you to read my post about “hitting bottom,” because I think it will add to this.

So when I say, “If you don’t like the lies, your best option is to help create a recovery environment that supports your loved one in becoming more open with you,” I’m advocating for taking this kind of approach as a parent.

Set appropriate boundaries for yourself (and explain them in that way), but don’t try to assert control by imposing consequences.

Your power to contribute in a positive way to your child’s recovery comes from your status as a parent.  Your appropriate support is highly meaningful and effective.

Her Big Sad also said, “Since there are consequences to certain truths at my house, the lying stops not when it is safe to tell the truth (I’m using); the lying stops when the truth is safe to tell (I’m not using).”

The problem with this approach is that you may not hear the truth until (unless) your daughter is already successful in recovery.

As a treatment provider, I’m not satisfied with the “wait until they hit bottom” approach, or the “come talk to me when you are already sober” approach.  I want to intervene now, build motivation to change in a positive way, and support recovery every step of the way.

This is an approach that can work for parents too.

My point is that by letting go of the need to control or impose consequences you can place yourself in a better position to be a part of a process that results in earlier and more effective recovery.

I realize this is a non-traditional approach.  But I think it is a more effective approach, and one that is more respectful of individual dignity and choice.  It also is more humane.

I’ve got lots of personal experience with this approach, and I know it works.

Thank you for contributing to an interesting and respectful conversation.

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