February 28, 2011
Addiction is recognized as a disease by the American Medical Association (AMA). Every year thousands of people across the United States must work with their family members to overcome these harmful behaviors that can ruin lives and destroy relationships.
An addictive behavior becomes most damaging once the drug of choice is used regardless of the negative consequences. But before seeking treatment, many people must fall all the way to the bottom in order to realize the seriousness of their condition. Some people will lose their financial stability and their family but still continue to use.
The Survivors Club has turned to psychotherapist Amy Klein, MA, LCSW, CASAC for her expertise with addiction in the family. Klein has thrived in private practice for 17 years and has experience working with adolescents, families, and addictive disorders. More about Amy Klein including her contact information is included below.
Identify the ProblemA developing addiction can be difficult to spot and other times a family member might not want to see his or her relative's true behavior. Certain behaviors are linked to the possibility of a substance abuse problem which include:
- Mood swings
- Fatigue
- Unkempt appearance
- Missed appointments, late to work or school
- Declining job performance or grades in school
- Changes in friends
- Changes in sleep patterns or eating habits
If you notice several of these behavioral changes in a family member, your next step would be to recognize whether they are addicted to a substance.
Someone is addicted to a substance if he or she:
- Chooses the substance over everything else
- Spends time thinking about it or how to acquire it
- Drinks or uses by themselves
- Uses early in the day
- Uses despite negative consequences in work or finances, relationships, or even health
If you have identified that a family member has an addiction, the next step would to be approach them about it.
Initiate InterventionAs a family member, it is important to remain supportive throughout this process.
"First, sit down with the person, tell them that you've noticed changes in their behavior," Klein suggests. "Tell them that you're concerned. Be supportive, but firm and use specific examples of what you've seen in terms of changes."
As a family member, try to keep your observations factual because accusatory or emotionally charged language will put them on the defensive. At this stage in the process, you want to demonstrate your support and your willingness to help them recover from the addiction.
Many families will work up towards an intervention. They will demonstrate their support and concern for the loved one in a series of nonthreatening conversations that address the problem, but if they are met with continued resistance, then an action intervention may be necessary.
CAGE is a tool used by Amy Klein to identify a substance abuse problem and something you can try as well. These questions may not be appropriate for a family member's first conversation but the underlying principles are good to keep in mind.
C: Have you ever felt that you need to CUT down?
A: Have you ever felt ANNOYED by others telling you that you are drinking/drugging too much?
G: Have you ever felt GUILTY or badly over your drinking or drugging?
E: Have you ever had an EYEOPENER/drink first thing in the morning to steady your nerves or get rid of a hangover?
If they answer yes to two or more of these questions, that is a significant indicator that a substance abuse problem exists.
Follow Through with Support and TreatmentAn addiction is serious. "They will need to get help and you will work on this together as a family," Klein says. "It's important for you all to understand what the person is going through but [the substance] is not an acceptable way to deal with stress or other issues in their life.
"Find a therapist who is well versed in addiction and make an appointment to go together to discuss what's going on."
It's imperative that you go to a therapist specifically trained in addiction because they will treat the addiction as a disease and not as a symptom, Klein says.
"The addiction must be dealt with first before other problems or issues can be addressed. If the person is using, their health, well-being, judgement are all compromised, and therefore, classic "introspective" therapy to "deal" with the problems, will not help at this time. The person needs to learn how use healthy coping skills."
Some outpatient facilities can offer an evaluation on what form of treatment is needed for the particular person. Options include attending an inpatient facility, the most intense form of treatment where the patient lives within the rehabilitation clinic and is fully immersed in the program. For outpatient programs, which can also be intense, the person continues to live at home and attends work or school. The person will attend a combination of individual and group treatment meetings as much as four times a week until the person graduates from the program.
In addition to these treatment options, the patient will likely be referred to a psychotherapist who is certified and knowledgeable about treating addiction.
Recovery is a Family Process"Family members need to get educated about addiction, this is critical and they also need to seek treatment themselves," Klein explains. "All too often, addiction is looked upon as only the problem of the using person. This is often not the case, addiction is very much a family disease.
"Treatment exists in many forms for family members. If the addicted person goes to inpatient rehab, at some point the family will be asked to visit and be involved in the treatment," Klein says.
"If the recovering person is in an outpatient treatment center, the family will most often attend group meetings once a week or twice a month depending on the program, but there will always be a family component to treatment programs."
Family members must learn that addiction is a disease and to avoid certain triggers for the disease, so they can help facilitate the recover of their loved one. 12 step programs for family members include
Al-anon/Al-ateen(for younger members) and Nar-anon. They offer resources for loved ones to help support the person overcoming their addiction.
In these 12 step programs, family members will learn "specific triggers that may lead to relapse," Klein says, "and personality traits/defense mechanisms that earmark addiction, such as rationalization, denial and projection.
"They will become familiar with the roles of sponsors, therapists, and the importance of meeting attendance."
RelapseRelapse is a normal part of the recovery process and does not indicate that all is lost. Every family hopes there won't be a relapse but that is an unrealistic expectation on the person overcoming their addiction.
A family can develop a contract with consequences for the recovering addict if he or she has relapsed several times. It is advisable to make these consequences more severe for each relapse.
"Contracts with consequences can specify anything the family finds relevant," Klein says. "If it's a person who has young kids, they may not be able to drive with them in the car for a designated period until they have clean time."
In order for this technique to be effective, the consequences have to make sense and be relevant to the family situation.
"Often a partner of someone who is using, won't want them in the house if they are still using, possibly around kids," Klein says. "Again, addiction is a disease where one needs to walk a fine line between being supportive and not enabling the behavior.
"Many behavior patterns have to be recognized, "unlearned", and replaced with healthy coping skills. This is not easy, the stakes have to be high and meaningful. It can sound harsh or unsupportive but, it's ultimately not and is in the best interest of the person."
Amy Klein, MA, LCSW, CASAC is a psychotherapist with offices in Pompton Lakes, NJ and Maplewood, NJ. She writes frequently for on-line publications and speaks on subjects such as: texting/sexting, bullying/harassment, peer pressure relating to drugs/alcohol use for teens, piercing/body tattoos and other forms of self-expression, cutting behavior, self-esteem and ownership in the workplace.
She trained at Hunter School of Social Work, NYU and the New School of Social Research where she received her MSW, Credential in Alcohol and Substance Abuse Counseling and Master's in Industrial Psychology. Amy Klein is formally a Licensed Clinical Social Worker (LCSW), Credentialed Alcohol and Substance Abuse Counselor (CASAC) and holds an MA in Industrial Psych.
She lives in Maplewood, NJ with her husband, Stu, and her four children, Jackson, Hunter, Georgia, and Ryder.
If you would like to contact Amy Klein please send her an email at amybethklein@gmail.com
