- Addiction is a disease, not something anyone can cause.
- Help from loved ones driven by guilt can be very unhelpful.
- The more you learn, the better able you are to stop asking why your loved one keeps using and start examining what needs to change and how.
What is addiction?
In the simplest definition, a disease is something that changes cells in a negative way. Addiction changes how cells in the brain communicate, which re-wires how a person thinks, feels and behaves.
The brain beings to depend on drugs or alcohol to function. It becomes a need for survival, like food, shelter and sleep in a way that you may never fully understand.
Why can’t those in addiction just stop?
The power of choice is lost to the vicious cycle of physical, mental and spiritual suffering.
The Physical Cycle
- Over time, the body needs the drugs and alcohol to function.
- Without it, harsh and potentially deadly withdrawal symptoms kick in (like nausea and seizures).
- Continuing to use is the quickest way to stop feeling sick.
The Mental Cycle
- Drugs and alcohol become their “go-to” coping skill for triggers like stress, disappointment or even boredom.
- They don’t know any other way to deal with their feelings.
- Underlying mental health issues (like anxiety, depression or trauma) make things worse.
The Spiritual Cycle
- Life feels meaningless in the cycle of getting, using and withdrawing.
- Consequences (like hurting you, missing out, job loss or arrests) makes it worse.
- Until they live independently and finding real purpose, change seems trivial.
The idea that “they would stop if they really loved me” is not true. In fact, the intense shame they feel for hurting you subconsciously drives them to numb those feelings with drugs and alcohol.
Accept that this not something they can overcome on their own and push for comprehensive treatment to address the complex disease and any underlying issues.
What causes addiction?
A combination of factors contributes to why or how quickly the disease escalates:
The takeaway? No one is powerful enough to cause someone else’s addiction.
If you find yourself obsessing over all the things you “should have” done differently, know that worry and guilt only hold you back and lead to enabling.
Stay focused on being part of the solution.
What is enabling?
Enabling is a natural response that feels like helping but ultimately prolongs active addiction.
A general rule is to not do something for someone if they can and should be able to handle it themselves sober.
Enabling vs. Helping
When you “help” by covering when they miss events or giving them money, you’re not helping them escape the disease, you’re helping them escape responsibility.
Enabling let’s them live more comfortably in addiction at your expense.
As an example, don’t lend your car so your loved one doesn’t have to walk to a dangerous neighborhood to buy drugs. Instead, offer them a ride to an AA meeting.
As long as you’re not making it easier for them to continue to use or avoid dealing with consequences, they need all the love and positivity they can get.
What is recovery?
You may focus on stopping drugs or alcohol, but staying sober long-term requires changing behaviors, coping skills, motivations and relationships. It’s a whole new outlook. That’s what recovery means.
It’s unrealistic to expect your loved one to go back to the person they were or the life they had before addiction.
They will need to change to stay sober and prioritize staying sober moving forward.
What is relapse?
Relapse is not failure!
While you may feel disappointed and angry, try to stay positive. They already feel ashamed. Ideally, they continue to pursue a sober life and learn from the mistake.
If not, don’t downplay or support anything less than a real plan. This could involve trying sober living, attending daily meetings or even going back to rehab. They need to be doing whatever it takes.
More than 65% of relapses occur in the first three months. Addressing red flags directly upfront (like skipping therapy or isolating), helps minimize the destruction.
What treatment works for addiction?
What has become the standard is:
- 2-10 days of detox
- 30 days of inpatient rehab
- 3+ months of some form of outpatient therapy
That may sound overwhelming. But, trying to skip steps to get a quicker fix may prolong the suffering for years.
Treatment involves intense therapies (from one-on-one sessions to specialties like EMDR for trauma), combined with medicines that stabilize the brain and address underlying imbalances (including anti-cravings like Vivitrol).
If you’re waiting for your loved one to want treatment on their own, know that most people go after an open discussion.
How can I help someone in addiction?
The short answer: support without enabling.
The application of that advice is much harder. Be sure to read the separate question How can loved ones help in addiction?
JourneyPure.com doctors follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, count records, academic organizations, highly regarded nonprofit organizations, government reports and their own expertise with decades in the fields and their own personal recovery.
Volkow ND, Koob GF, McLellan AT. Neurobiologic Advances from the Brain Disease Model of Addiction. N Engl J Med. 2016 Jan 28;374(4):363-71. doi: 10.1056/NEJMra1511480. PMID: 26816013; PMCID: PMC6135257.
Ruisoto P, Contador I. The role of stress in drug addiction. An integrative review. Physiol Behav. 2019 Apr 1;202:62-68. doi: 10.1016/j.physbeh.2019.01.022. Epub 2019 Jan 31. PMID: 30711532.
Ishiuji Y. Addiction and the itch-scratch cycle. What do they have in common? Exp Dermatol. 2019 Dec;28(12):1448-1454. doi: 10.1111/exd.14029. Epub 2019 Sep 30. PMID: 31482585.
Substance Abuse and Mental Health Services Administration (SAMHSA): Treatment of Stimulant Use Disorders. SAMHSA Publication No. PEP20-06-01-001 Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2020.
Shapiro F. The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. Perm J. 2014 Winter;18(1):71-7. doi: 10.7812/TPP/13-098. PMID: 24626074; PMCID: PMC3951033.
Syed YY, Keating GM. Extended-release intramuscular naltrexone (VIVITROL®): a review of its use in the prevention of relapse to opioid dependence in detoxified patients. CNS Drugs. 2013 Oct;27(10):851-61. doi: 10.1007/s40263-013-0110-x. PMID: 24018540.
Sinha R. New findings on biological factors predicting addiction relapse vulnerability. Curr Psychiatry Rep. 2011 Oct;13(5):398-405. doi: 10.1007/s11920-011-0224-0. PMID: 21792580; PMCID: PMC3674771.
Li MD, Burmeister M. New insights into the genetics of addiction. Nat Rev Genet. 2009 Apr;10(4):225-31. doi: 10.1038/nrg2536. PMID: 19238175; PMCID: PMC2879628.
Ouimette, P., & Brown, P. J. (Eds.). (2003). Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders. American Psychological Association. https://doi.org/10.1037/10460-000
Odgers CL, Caspi A, Nagin DS, Piquero AR, Slutske WS, Milne BJ, Dickson N, Poulton R, Moffitt TE. Is it important to prevent early exposure to drugs and alcohol among adolescents? Psychol Sci. 2008 Oct;19(10):1037-44. doi: 10.1111/j.1467-9280.2008.02196.x. PMID: 19000215; PMCID: PMC3664402.
Buckley PF. Prevalence and consequences of the dual diagnosis of substance abuse and severe mental illness. The Journal of Clinical Psychiatry. 2006 ;67 Suppl 7:5-9.
Raypole, C. (2019, June 27). Enabler: Definition, Behavior, Psychology, Recognizing One, More. Retrieved from https://www.healthline.com/health/enabler
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