Breaking Stigma: Substance Abuse

"Image courtesy of Baitong333 / FreeDigitalPhotos.net".

In light of the recent death of "Glee" cast member Cory Monteith, the first part in my series of "Breaking Stigma Through Understanding" will focus on substance abuse. Television shows such as Dr. Drew's Celebrity Rehab and Intervention often paint a picture that addicts/alcoholics can be turned around in a short period of time with intense inpatient work.  This is a gross misrepresentation of the story of addicts/alcoholics who struggle to stay sober for years after initial treatment and cause confusion when individuals relapse, sometimes for the very last time. The story of Cory Monteith is not unlike that of many individuals who have struggled with substance abuse. This article hopes to help readers understand the complicated nature of the disease, and address why inpatient treatment alone is not enough for recovery.

The vast majority of research that has been conducted in this field supports the medical model of substance abuse, holding that the disease is not purely psychological, but that this disease is hereditary, has genetic markers, and that individuals with the disease have biological differences in the way their bodies process substances.

Now, imagine your loved one has been diagnosed with diabetes. Due to the nature of this disease, your loved one's body is unable to regulate blood sugar levels without medication and strict dieting. Sugar levels must be monitored daily, and his or her lifestyle has to change forever in order to avoid serious medical complications. Now imagine that you do not help your loved one learn what to eat and what not to eat. You make no changes in your lifestyle; in fact, regardless of knowing that your loved one can't have sugar, you continue to buy sugary foods because that individual is an adult and should be able to control themselves. You bargain with your loved one; "Okay, you can have one night a week where you eat unhealthy foods," but when one night turns into two or three, you are outraged. You are confused by your loved one's behavior...if he or she didn't want to be diabetic anymore, wouldn't they just do what he or she is supposed to?

So many who have never dealt with substance abuse themselves cannot imagine why anyone would continue to use drugs or drink when there are so many negative consequences. In my work at a substance abuse recovery center, I have worked with thousands of individuals and their families. Family members are often stunned when their loved one relapses despite being given tools to help them stay clean while in treatment. A big issue with their mindset is believing that a stay at a rehab is adequate enough to help an individual maintain long lasting sobriety without continuing treatment, and without any lifestyle changes from those around them.

Can you imagine yourself telling your diabetic loved one that he or she should be able to maintain a healthy blood sugar level simply through will power? Can you imagine what your diabetic loved one must think and feel when cakes, cookies, soda, and other non-diabetic foods are easily accessible in his or her own home? For those who have no direct experience with substance abuse, this analogy has been used by many in the field to illustrate the complicated nature of substance abuse. It is not a disease of will power; it is a biological disease, and despite any claims you have seen on television, there is no "cure." Recovery takes a tremendous amount of work to obtain, and an equally demanding effort to maintain. Remember, addiction effects the entire family. At times, the addicted individual distracts the family from larger issues. All members of the family must change along with their loved one; recovery works best when everyone is active.

Individuals who think they may have a loved one dealing with substance abuse can help in the following ways:

-Remaining non-judgmental and not accusatory are very important. Despite undesirable behavior, the individual may be experiencing serious problems emotionally, physically, and psychologically. A gentle and loving approach will be more helpful in working with your loved one. Let him/her know you are on his/her side.

-Examine the ways you may be enabling the drugging/drinking. Do you have substances that are easily accessible? Do you give in to outrageous demands or addictive behaviors to avoid confrontation? Have you gone back on promises designed to help the individual stop using (i.e. have you threatened to not allow the individual to live with you if the behavior continues, but you have not kept to your word)?

-Educate yourself on the nature of substance abuse and codependency. Attending an Alanon/Narcanon meetings have been shown to be helpful for family members dealing with an addict/alcoholic loved one. Carrier Clinic offers a free Codependency program every Saturday and Sunday from 10am - 1:30pm.

-Get help for yourself! Everyone does better when everyone is in treatment. 

- Visit The Substance Abuse and Mental Health Services Administration here for more resources