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How to help a loved one

Discussion in 'Recovery Articles' started by 10outof10, Nov 28, 2011.

  1. 10outof10

    10outof10 Gold Member

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    This wiki is to explore some suggested techniques for helping a loved one. It comes with a health warning, one size does not fit all! Different things will work for different people and at different stages in their journey.

    In order to help someone who is using drugs, it is important one first of all understands the reasons they may be using drugs in the first place.

    [h="1"]Some typical motivations for using drugs[/h]
    • Achievements of pleasant mood states- (High, mellow, funny, happy, powerful, at one with the universe etc)

    • Avoidance of unhappy mood states (Depression, anxiety, anger, boredom)

    • Acceptance in a peer group

    • Celebration and communal experience - most people take drugs to have a good time!

    • Symbolic expression - Defiance of parents, other authorities, alienation from society or the culture, solidarity with peer group, being ‘like’ an admired role model

    • Performance enhanced - Sexual performance and enjoyment (e.g Cocaine, Viagra), enhanced work capacity (e.g. cocaine, amphetamine), staying awake and alert (e.g cocaine, amphetamine)

    • Personal insight and creativity (e.g. LSD, MDMA, cannabis)

    • Environment - Lack of opportunities and prospects people see available to them.

    • Pain management (physical and mental)

    • Curiosity - most people (especially young people) are naturally curious and want to experiment with different experiences.

    • Defence Mechanism - Ease the trauma and pain of unsatisfactory relationships and the physical and emotional abuse arising from unhappy home lives.

    • Natural Rebellion

    • Promotion & Availability - Alcohol and pain-relieving drugs are regularly advertised on television. Despite legislation, children and teenagers have no problems obtaining alcohol and tobacco from any number of retail outlets. Pubs are furnished to attract younger drinkers through music, games decor etc. Drugs more readily available especially with newer developments in drug trends like legal highs which are made easily available through the internet.

    [h="1"]Signs and symptoms of drug use[/h]

    This list is not exhaustive and there are many things included that may be completely unrelated to substance use. E.g this might be simply normal behaviour for any teenager! Where you are seeing multiple things included on the lists below, it may point to a possible substance issue and it would certainly be worth checking in with your relative or friend.

    [h="2"]Physical Signs[/h]
    • Loss of appetite, increased appetite, any changes in eating habits, unexplained weight loss or gain.
    • Slowed or staggering walk; poor physical coordination.
    • Inability to sleep, awake at unusual times, unusual laziness.
    • Red, watery eyes; pupils larger or smaller than usual; blank stare.
    • Cold, sweaty palms; shaking hands.
    • Numbness to emotions and normal feelings; usually apparent as the user seeming distant.
    • Puffy face, blushing or paleness.
    • Smell of substance on breath, body or clothes.
    • Extreme hyperactivity; excessive talkativeness.
    • Runny nose; hacking cough.
    • Needle marks often on the lower arms, legs or bottom of feet.
    • Nausea, vomiting or excessive sweating.
    • Tremors or shakes of hands, feet or head.
    • Irregular heartbeat.

    [h="2"]Behavioral Signs[/h]
    • Change in overall attitude/personality with no other identifiable cause.
    • Changes in friends; new hang-outs; sudden avoidance of old crowd; doesn't want to talk about new friends; friends are known drug users.
    • Change in activities or hobbies.
    • Drop in grades at school or performance at work; skips school or is late for school.
    • Change in habits at home; loss of interest in family and family activities.
    • Difficulty in paying attention; forgetfulness.
    • General lack of motivation, energy, self-esteem, "I don't care" attitude.
    • Sudden oversensitivity, temper tantrums, or resentful behavior.
    • Moodiness, irritability, or nervousness.
    • Silliness or giddiness.
    • Paranoia
    • Excessive need for privacy; unreachable.
    • Secretive or suspicious behavior.
    • Car accidents.
    • Chronic dishonesty.
    • Unexplained need for money, stealing money or items.
    • Change in personal grooming habits.
    • Possession of drug paraphernalia.

    [h="1"] When will I know their use is a problem?[/h]
    Although any kind of substance use may be considered a problem for a relative or friend to discover, this may well not be the case or the user may not perceive it as a problem. There are many users who are able to use substances safely and do not experience a negative impact on their life. There are many ways to minimise the harm for substance use and there is a good wiki available on harm reduction.

    It is also important to add that many people experiment with drugs for a period then move on from this without developing any form of addiction or dependency.

    Because different types of drug have completely different effects on different users its very hard to list definitive problem issues to cover all drugs. However, there are a few symptoms that most types of problematic drug use seem to share.

    • The user makes a concerted effort to stop using the drug yet fails to do so.
    • The drug impedes detrimentally on their job, livelihood or education, against the users own intentions.
    • Spending money on the drug even when they can not afford it, such as cutting back on essential necessities such as food.
    • Doing things to obtain the drug that they normally wouldn't do, such as stealing.
    • Making certain that they maintain a supply of the drug, and when they can't becoming emotional and unpredictable.
    • Continuing use after drug-related health concerns have been recognised by a medical professional.

    [h="1"] How to approach the issue[/h]

    Everyone is different, so what will work with one person may not work for another. There are many schools of thought on interventions. Some believe shock tactics and tough love are best and others believe in more supportive interventions. You will find many threads on the forum about different methods which have worked for them or people they know.

    As a general rule of thumb, treating people with core conditions of acceptance, genuineness, and empathy is almost always effective. Acceptance is about accepting the person, not the behaviour. Telling them when they are out of line but still valuing them as a person. Genuineness is about giving them straight talking, again telling them when they’re out of line, when they have hurt you and how you feel. Empathy is about trying to understand what things are like for them in their world. It’s putting yourself in that persons shoes as much as you can, it’s not to be confused with sympathy, which is a natural emotion but not always helpful in this situation. Anyone of these core conditions would not work in isolation; it’s when they come together that they work. E.g you can tell someone how much they have hurt you but when you balance this with the fact that you still care for them and communicate you want to understand why they did this it will be heard much better.

    The age old saying “you have to want to” is very true of addiction. Forcing someone to stop rarely achieves lasting recovery. Most addicts will have some part of them thinking about stopping although it may be a very tiny seed. This needs to be nurtured and slowly motivation can be developed for change. Sometimes an addict will simply not be ready to stop but by opening up the lines of communication, you will have ensured they know who to come to when they are ready. In these kind of situations, sometimes the best thing you can do is tell them to come back when they are ready. This might be by cutting off regular contact for a while. The important thing is you also have to keep yourself safe. There is no point in going to the ends of the earth to help someone who doesn’t want it and by doing this running risk of ruining your own life. Creating personal responsibility within addiction is very important as it inevitably empowers someone that they can take the control back if they choose too.

    [h="2"]Practical support[/h]

    Do

    Offer support to attend meetings, appointments etc. This may mean going along with them or simply picking them up and dropping them off.

    Get them information about detox, rehab and other support available. More often than not people benefit from outside support as sometimes a relative or friend is simply “too close”. Hearing from others in recovery can be very motivational and can help someone feel understood.

    Help them eat well, cook healthy meals and encourage them to eat.

    Don't

    Give them money e.g if they need money for rent and you want to help, pay the rent directly to the landlord, if they need money for travel, buy them a travel card.

    Try not to enable an addict to keep using. This is a difficult one as there is a fine line between support and enabling. Purchasing drugs for an addict is one example. There may be rare occasions when this is necessary i.e someone will die if they don’t use- this is fairly rare but drugs such as alcohol are dangerous to stop immediately. However, there is almost always another alternative to having to purchase drugs or alcohol yourself. Where withdrawal would be potentially life threatening, seek medical attention as there will be prescribed medications which can be used to manage withdrawal or an inpatient detox may be offered. Also be aware that addicts experiencing detox and withdrawal may become fixated on their symptoms and feel that they need to use “one last time”. Don’t go too far the other way though and lock them up to do cold turkey. It might get someone off drugs, but it could be dangerous for their health and could be very damaging to their mental state and your relationship

    [h="2"]Emotional support[/h]

    Do

    Offer love, reassurance, and support

    Be kind and caring

    Give them a hug

    Tell them you’re proud when they are sticking at it

    Be non-judgemental

    Listen! Let them speak and be willing to listen to why they have used drugs in the first place- this isn’t always easy!

    Don’t

    Expect them to change overnight, lapse and relapse are often part of the process- set a plan about how you will move forward if this happens.

    Expect them to be bright and cheerful. Detoxing is hard and often in the early stages of recovery people can feel depressed and worthless. Many drugs dull emotions and are a coping mechanism, so when they are removed it can cause buried emotions to flare up to the surface which can be very traumatic for someone. It is often important during this period that a person has support to cope with taking the lid off. Guilt can be major, factor in recovery, most addicts will have done things they are not proud of and will be carrying some form of guilt so again it can take some time for people to come to terms with this and find a way to move on. Drugs can also exacerbate mental health issues which can mean people will experience heightened or prolonged symptoms for a number of months after they have ceased drug use. Counselling and psychotherapy can be very effective as can medication so it is a good idea to get some support from GP or your local mental health service.

    Try not to blame them, be very critical or get angry about the past. This is especially true in the earlier stages of recovery. Guilt is a huge trigger for relapse and challenging someone too much early on in the process may simply drive them deeper into addiction. As an addict naturally progresses through recovery, you will find it easier to approach these issues and once you give yourself time to calm down, you are more likely to approach it a balanced and fair way which will tend to result in a more positive discussion for all. This doesn’t mean you shouldn’t challenge people at all or sugar coat everything, be honest, choose your time wisely and don’t continually hit them over the head with it!

    [h="2"]Boundaries[/h]

    Set appropriate boundaries and stick to them. e.g.

    Insist your home is drug-free
    Make it clear you will not give them cash
    Do not tolerate stealing

    When setting boundaries, it is important you make clear what will happen if they are broken. e.g. if found using drugs in your house you will ask them to leave. It’s very important you and anyone else involved in their care are consistent with these or it can undo a lot of good work.

    [h="1"]Support groups[/h]
    As much as the person you are supporting needs support, so do you. If you have your own place to get support and get the chance to offload, you will be much more able to help someone else. There are a variety of family support groups where you can meet like-minded people. Some support groups are better than others, and drugs-forum do not necessarily recommend any of the following examples:


    • SMART recovery Family and Friends
    • Famanon (Families Anonymous)
    • Nar-anon, Al-anon and Alateen
    • Adfam
    There are many really good local initiatives, there is often details of such support groups in your local Doctors surgery.


    [CAT]Recovery and Addiction[/CAT]
     
  2. baZING

    baZING Newbie

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    I'd like to make a suggestion on fixing "Boundaries."

    Right now it says "When setting boundaries, it is important you make clear what will happen if they are broken. e.g. if found using drugs in your house you will ask them to leave."

    I completely agree with this sentiment, but in the interest of best care for a loved one, perhaps it should be edited to reflect that it's rarely helpful to kick a drug addict to the street (in my personal opinion, anyway). Maybe the boundary should be "if found using drugs in your house, you will bring them to a treatment facility and give them the choice to stay or leave; though the house is no longer an option."

    Something along those lines? I'm not quite sure, but I know more than a few people who have been sent to the street, sold their wares or bodies for drugs, and ODed from doing too many from the excess social stress, or lower environmental tolerance for certain drugs (opiates in particular).

    Thoughts?
     
  3. 10outof10

    10outof10 Gold Member

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    hello,

    This is very much a draft and was hoping people would add.. Some is lifted off R and A threads too, so not all my opinion. The e.g is just an example to emphasize the point. Not necessarily suggesting the action should be done. Actually I don't agree that it's rarely helpful to be kicked out, I think it can really go either way and this is just different for different people. Ideal world is treatment facility but it's not that often possible to get someone in that day (in my experience). How strict you are with your boundaries may depend on you situation e.g if someone is chaotic and leaving paraphernalia around, I have young children at home etc then I'm more likely to be very tight with boundaries.

    I think it would be great for you to add in the downsides of kicking someone out so it allows people to come to a decision. Please feel free to go ahead from my perspective. I think we maybe want to give the arguments for and against and achieve more balance?
     
  4. Synesthesiac

    Synesthesiac R.I.P. Palladium Member

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    I agree with baZING, that should maybe be changed, though the current version is not too untenable to warrant a hasty edit.

    I added this part in the "When will I know their use is a problem?" section.

    Because different types of drug have completely different effects on different users its very hard to list definitive problem issues to cover all drugs. However, there are a few symptoms that most types of problematic drug use seem to share.


    • The user makes a concerted effort to stop using the drug yet fails to do so.
    • The drug impedes detrimentally on their job, livelihood or education, against the users own intentions.
    • Spending money on the drug even when they can not afford it without severely cutting back on essential necessities such as food.
    • Doing things to obtain the drug that they normally wouldn't do, such as stealing.
    • Making certain that they maintain a supply of the drug, and when they can't becoming emotional and un-predictable.
    • Continuing use after drug related health concerns have been recognised by a medical professional.

     
  5. baZING

    baZING Newbie

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    10outof10 and Synesthesiac,

    First, I do agree that it definitely doesn't need a hasty edit. I also think "rarely helps" was not really the right wording on my part; it's more that from personal experience I have generally seen it go more wrong than right when someone is sent to the street. I will do some thinking and play Devil's Advocate for both kicking someone flat out or directing them to professional care, because I do realize it's also not always possible and depends highly on the situation. I don't want to just throw some stuff together without much thought, so I'll mull it over a bit this evening and see if I can write up something that others can add or subtract to.

    Thanks for the replies!

    Zing
     
  6. baZING

    baZING Newbie

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    Sorry for a double post, but I forgot to add that part of the reason I think the boundaries section needs to be edited is that it should contain additional advice on dealing with minors, especially if they are legally under the concerned individual's care. I know there is an age limit on who can actually use this forum, but it's not out of the realm of possibility that somebody reading this article may be a parent, guardian, or other adult figure worried about someone who is under the age of 18. When I draft some suggestions for that section, I will try to include reasonable advice for minors/dependents as well.
     
  7. baZING

    baZING Newbie

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    I'm making a quick post to let you all know I'm still interested in helping to brush up the article in any way I can... just have a ton of IRL crap going on at the moment. As soon as I'm able, I'll read through it all again and see if I can make any suggestions.

    Best,

    Zing
     
  8. NeuroChi

    NeuroChi is not his mind Staff Member

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    This is a really nice article, I like the concept.

    I added the Category.
     
  9. baZING

    baZING Newbie

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    I just wanted to chime in quick here and let you know I have not lost interest in helping contribute to this article. I've been incredibly sick (cluster headaches) and while I've been on the forum plenty, if I work on this I want to be able to focus fully and make sure everything is of the high standard 10outof10 has so wonderfully set. Hopefully I'll be able to make a real contribution soon.
     
  10. Synesthesiac

    Synesthesiac R.I.P. Palladium Member

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    Not really on tpoic but you might want to look into magic mushrooms for cluster headaches https://www.drugs-forum.com/forum/local_links.php?catid=207&linkid=11568

    there are clinical studies in progress, they are proving very promising.

    I think this article is great, I've referred someone I know to it whos son is experiencing drug related issues at the moment.
     
  11. Emilita

    Emilita Titanium Member Donating Member

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    Minor spelling and grammar corrections.

    No new information has been added.