Can out patient treatment be successful for opioid addiction?

Discussion in 'Family & friends' started by Whatnow92, Apr 15, 2019.

  1. Whatnow92

    Whatnow92 Newbie

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    Apr 15, 2019
    from United States
    Hello there. Longer post ahead, I just want to give some background. I hope I'm in the right place for this post, please correct me if I'm not. My husband and I have been together for 11 years. High school sweet hearts, super close, he's my best friend.

    However, this past December I found out that he has been addicted to taking opioids - hydrocodone, for about 4 years now. I had no idea. He hid it so well, goes to work on time, pays rent, cooks dinner, etc. We were a bit off/distant the last year or so but I never would have attributed it to this. One night when I kept pressing and asking what was going on with us he broke and came clean to me. I wanted him to get professional help right away. I told him I'd be supportive as long as I seen effort. He begged and begged for me to do it his way, he felt that since I knew now that he could taper himself off since there was no going back now. He gave me control of his bank account so I could see every financial move he made. It was hard, but wanting to keep his trust I agreed. I did let him know that if it doesn't work he has to go get help.

    Well, two months went by and he did it. He weaned off, it was hard but he did. Was able to pay his bills on time, etc. Things seemed pretty good during this time. I started to slow down on checking his bank every single day, because I wasn't finding anything. Not to mention by checking it every day it brought up such terrible emotions that I had to do this. Exhausting emotionally. I let a week go by, and now I'm kicking myself for it because I checked and sure enough cash withdrawals from the ATM. He relapsed.

    Now I know from research that relapse is part of the recovery experience but he lied to me... Even after I was very open with him the first time and I offered my help and understanding. Fooled.

    Now this time I THINK I have at least convinced him to try out patient therapy. Can this be successful? I'm just worried it's another excuse not to fully commit to getting clean. Has anyone had a family member find sobriety through out patient care?
  2. aemetha

    aemetha Sexy Potato Palladium Member Donating Member

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    Mar 4, 2016
    from New Zealand
    Hello @Whatnow92,

    One thing you need to understand is that there is a lot of misinformation about addiction out there. Much of this misinformation has been perpetuated by a fairly institutionalised, abstinence only, religious based, and mostly unscientific addiction treatment industry focused on 12 step programs. They would have you believe that the only way to overcome an addiction is to surrender to god, and admit to powerlessness. The thing is, it's utterly untrue. Not just most, but the vast majority of people who develop an addiction, including to opioids, get clean without any kind of help whatsoever. They do exactly what your husband has done - they acknowledge they need to stop, then taper or cold turkey off. Sometimes they have a little relapse, but they generally move on without any assistance at all. We're talking about 80-90% of people here.

    So, your husband might be right, he may be able to do this. It seems to me that the biggest issue you have right now is the deceit? The best way to deal with deceit is to disincentivise it. Take the way you described your approach with him...

    Okay, so while this is well intentioned - you're looking to get him help, you need to understand that this is an ultimatum, and the consequence of the ultimatum being called is potentially embarassing to him, and not his preferred option. So this is incentivising him to hide it from you. He doesn't want to tell you, because if he does you will react in a manner he considers unfavourable to him. The drugs don't make him deceitful, but rather the reaction to him using drugs makes him deceitful. That's not to say it's your fault he lied - he obviously is accountable for his part in his actions, but we do need to also recognise that people don't operate in a vacuum, and his action, is a response to your action. The way to resolve it is to attack both sides of that equation. Something like this:

    Your responsibility: Attempt to work with him to determine a way to proceed, and how you both will work through it if he does relapse. Set clear expectations that are acceptable to both of you. This stands a little in contrast to the previous approach, which is probably better described as "We'll try it your way and if it doesn't work you have to do it my way". Instead, see if you can talk it out and find a way that is agreeable to both of you, and which has a plan in place if it doesn't work. You also need to make an effort to take the approach of attempting to lift him up when he isn't succeeding, rather than looking down if he is failing - it's a subtle distinction, but an important one. Self-efficacy needs to be built up in him, and without it he is doomed to fail.
    His responsibility: He needs to talk to you, apologise for being deceitful, and make a genuine effort to find a common approach that you can both work with that takes lying out of the equation. He needs to summon up his courage and confide in you when he feels like he is failing, and trust that you won't think less of him if he slips up.

    So, basically, I think your next step is to have a good long talk with him, be realistic about it, and put in place an arrangement where he can talk about it when he needs to, which requires adjustments by both of you. Addiction can be treated outside of treatment, with out-patient treatment, or with inpatient treatment. It very much depends on the individual, and what support network they have around them as to how much help each person requires, but in terms of pure statistics - he's right that most people don't need an inpatient treatment.

    I hope that gives you something to work with, let me know if you have any questions, and best of luck to you.