Anna, the mom at the blog Let Go, Hang On wondered in a recent post whether or not she should rent a room in a rooming house so that her mentally ill and addicted daughter would have a safer place to live.

This, of course, resulted in a flurry of comments warning her about the dangers of enabling.  Here is my take on the question:

You do not have the ability to end your daughter’s addiction or stop your daughter from using by withholding supports.

You do have the ability to make your daughter safer by providing appropriate supports.

I would encourage people to step back and consider the reason that sobriety is desirable in the first place.  Because it keeps people safe from drug-related harm.

This is why I advocate a focus on safety.

Some things are worse than continued use.  Death, rape, prostitution, violence, HIV, and Hepatitis C, for example, are not an improvement over continued use.

Many people withhold support with the intent that this will constitute an end to the enabling that they believe is somehow the reason use has continued.

Withholding support is the extent of many people’s recovery plan for their loved one, and it is an ineffective plan.

Sobriety is a means to an end…freedom from harm.  Something is wrong when we become so obsessed and hyper-vigilant about avoiding enabling that we lose sight of this.  Especially when you are talking about somebody who is disabled and has had multiple treatment attempts.

Too often, withholding support out of fear of enabling isn’t about setting appropriate boundaries.  Instead, it’s about trying to control an addict’s behavior -while claiming powerlessness over the addict and the addiction, and claiming that only the addict can make a change.

I agree with NAMI (and federal housing programs for mentally ill and addicted homeless people like Shelter Plus Care which uses a “housing first” model) that withholding housing supports is not a safe or effective way to support treatment or recovery.  This is especially true for people with both major mental illness and addiction.

You might check and see if there is a Shelter Plus Care housing program in your area.  Pathways to Housing is one organization that operates this type of program in several parts of the country (there is one near me and I think they are great!).

Your daughter may be eligible for a housing voucher and professional supports from a case manager, nurse and others on a support team.  This would allow you to conserve your resources and allow them to grow (increasing your ability to help in the future if needed).

If there is not a program like that where you live, or she is not eligible, then it seems to me it would be reasonable for you to try your plan and see how it goes.  In the big picture, you will be making her safer and not less safe.

I spend my days along with my staff helping people who are opiate dependent get housing, get food, get jobs, get medical care, get dental care, get mental health care, get drug treatment and on and on.  And my program offers the same supports whether or not somebody is currently using. Some would say I’m a full-time enabler!

The funny thing is, 100 percent of our case-managed clients participated in treatment last year.  Turns out, this is a great way to help people transition from use to recovery. How is that for an intervention?

We don’t require a goal of abstinence, but virtually all have this goal for themselves and consider themselves to be in recovery.  Most are successfully abstinent…not because we would withhold basic needs support from them otherwise, but because the unconditional support has created the conditions for positive change.

Many have mental health issues in addition to the addiction issue, but we use this approach with everybody.  So while I think a “housing first” model which provides housing before mental health and addiction recovery is achieved makes sense for people who are mentally disabled, I also think it makes sense for everyone else too.

You have more power to help your daughter by providing appropriate supports than you have the power to hurt your daughter by so-called enabling.  So don’t be too worried.

Please allow me to repeat, you don’t have the power to end your daughter’s addiction by withholding supports.  You do have the power to keep her safer by providing appropriate supports.

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