Written for those who are affected by the addiction of a loved one, this book sets out the complex realities of dependency by looking at how addiction can become the whole family’s illness.
It is a no-nonsense guide to where your responsibilities lie when a partner, parent or child is dependent, detailing the emotional and practical dilemmas these situations can demand. Relatives will find knowledge, understanding, reassurance and practical advice throughout this book, regardless of the stage of addiction or recovery their loved one is at.
Through the many years experience of the Northlands Centre, evident in particular in the helpful case studies, this book shows families what they can do in the midst of this confusing and damaging situation. Above all, however, it offers hope: families need, and can achieve, their recovery too.
Over thirty years ago, Northlands became the first community-based, independent treatment centre in Ireland and the first small unit to take the treatment of alcohol problems out of the mental health setting. Since then it has been helping individuals, families and communities to understand and deal with the many issues that contribute to problems with alcohol, drugs, gambling and other addictive behaviours. Northlands has always had a strong ethos of working not only with the addicted person, but also with those who are involved in their lives.
Few Irish families in the past have escaped the scourge of alcohol addiction in a close relative. Today can be added the now commonplace dependency on illegal drugs and all of the social ills that accompany them from overcrowded A&E units in hospitals at weekends, needless road tragedies and the epidemic of petty crime
which seeks to feed the ‘habit’.
In Coping with a Relative’s Addiction produced by the Northlands Centre, Ireland’s first community based independent treatment centre for addiction 30 years ago the authors offer information, advice and support to those who are affected by the addiction of a loved one. Based on many years’ experience, some of which is recounted very effectively through helpful and frequently poignant case studies, families who are suffering are shown what they might do and can achieve in practical
terms in helping the addict to recover, as well as redeeming their own family life which may have become seriously disrupted and damaged by a selfish and hurtful
dependency that has infected the entire life of the family.
Despite the chronic nature and the anguished consequences of many of the addictions described this short guide of 8 chapters over 82 pages offers genuine encouragement, guidance and hope for recovery to addicts and their families. As well as offering a forensic examination of addiction, its routes, stages and consequences, one of the main tenets of the guide is that addiction must be challenged or it will have the final word and it urges those affected to seek the help which is out there at the earliest stages in order to the limit the damage caused. The final page includes useful numbers and other resources for those affected by addiction.
- Fr Paul Clayton-Lea Clogherhead, Co Louth, Intercom, April 2011
- PROBLEM, HABIT, OR ADDICTION?
I find it astounding now that it took me fifteen years to understand that addiction was the problem. The realisation of this was so gradual and slow. Mark was not ticking all the boxes that amounted to alcoholic as I understood it. I wish I had listened more to my own instinct. (Greta)
I questioned everything about my ability as a mother. I wondered if I should have left my husband. I even blamed myself for marrying an alcoholic in case this had been the start of her problem. (Jean)
I thought that if I behaved better, then Mammy might not drink as much. I tried so hard to make her stop. (Maria)
AM I OVER-REACTING?
It is often difficult to be certain about where responsibility for addiction lies. It is difficult to discern truth from exaggeration. We can feel very unsure, and doubt our ability to judge the situation. Where there is addiction there is always confusion: Am I over-reacting?
This chapter sets out to clear up the confusion. In order for you as a relative to understand what has happened to a loved one, we would ask you to bear with us in looking at addiction itself. Perhaps the thing that causes greatest suffering for families is the lack of clarity around the condition. Indeed, this is often what allows it to continue. The shifts from recreational to problematic to dependent use are subtle. It is useful to look at each pattern of use and examine how a person moves from occasional harmless drinking or drug use to the phase of full-blown addiction. What follows is a breakdown of the addictive process right from its earliest stages.
THE FOUR ROUTES TO ADDICTION
1. The gradual, social route
This is how many people learn to manage their substance use. Generally this begins as a pleasurable style of use in social situations, and does not evolve into problem behaviours for the majority of people. However, if social use over the years becomes heavy and frequent, the risk of addiction increases.
2. Heavy drinking/drug use from the start
The going out to get blocked or out of your head is a common approach in our culture, especially at weekends. This bingeing then leaves us more open to the possibility of mixing substances, which in turn leads to the heightened risk of accidents or overdose, or at the very least, embarrassing and uncomfortable memories of the night before.
3. Heavy use from the start to escape circumstances
Examples of these circumstances are unemployment, poverty and family conflict. Heavy substance use on top of a difficult or unstable situation does not help our ability to deal with it. It also gives us the illusion that our intoxication is the safest and most comfortable place to be, far removed from a harsh reality. The appeal is obvious and dependency can set in quickly through this route.
4. Heavy use to escape internal unease
Such use is a deliberate tactic to ease emotional , or physical , pain. We seek the distraction and the numbing effect of the substance. Oblivion is an easier place to be for us. In using it to avoid the source of our pain, we quickly lose touch with the reality around us and the feelings within us.
Even these distinct roads to dependency can become merged: someone who uses or drinks occasionally and within limits can turn to alcohol or drug-induced numbness after trauma or loss. Using or drinking in relation to the third point above , to escape the circumstances around us , can then often lead to medicating the painful emotions that such circumstances give rise to, in turn leading to the fourth point of escaping internal unease. The patterns of drinking or using, then, can quickly become more harmful when life becomes difficult.
It must be remembered that individuals slide into dependent use at different rates. Furthermore, the effects of addiction to drugs such as cocaine and heroin become more apparent at an earlier stage. For the purpose of clarity, we will examine the process of dependency by looking at the social route of addiction , where dependency and addiction is built up over time , from the initial, vague hints of trouble to the devastation of the later stages.
THE STAGES OF ADDICTION
The social route to dependency has pleasurable beginnings. Many people find that certain drugs such as alcohol and cannabis reduce shyness and self-consciousness; they ease the way into social situations and help us to relax. Other substances such as speed and cocaine provide us with a rush of endorphin hormones, boosting the sense of self-confidence and energy. With inhibitions dulled, even the introvert can be expressive, witty and outgoing. They no longer have to be on guard about what to say or how to say it.
At this stage there is little price to pay. If the intake is excessive there may be a few hangovers or comedowns, or some over-spending; indeed there may be a few embarrassments, but this is outweighed by the sense of an evening well spent.
The important aspect of this is the learning around the perceived positive effects of the substances. The feelings that they give are warm and comfortable. Drinkers/users have found a way to change moods, ease discomfort and distract from everyday concerns. They can get a high and return to a normal state of feeling when the evening has passed. In their view there are no serious consequences for them or those around them, and any damage done can usually be rectified or healed. It is still worth it. For many people this becomes their style of drinking. It remains social, occasional and generally within healthy limits.
THE EARLY STAGE OF ADDICTION
Now there is a subtle shift away from occasional use of the substance to a relationship being built up with the substance , it has become like a friend who can be trusted to lift the mood. Users knows that it will work, and gradually can come to see the drink or drug not just as a means to heighten the feeling of a good night, but to actively avoid uncomfortable feelings or moods. Using or drinking to relieve an emotion is a huge warning sign, and one that is often missed.
Now the use is more frequent. The body has learnt to tolerate the effects of the substance and it takes more to achieve the desired result. Increased use leads to increased need. While the ability to cope with the substance increases, the ability to cope with the demands of everyday living decreases. This is not just because more intensive use leaves the drinkers and users rather fragile at times, physically and emotionally; now they have found a quick fix, a short cut through discomfort. There is no patience anymore for the minor irritations, which are felt more quickly and more keenly.
The user becomes less patient, more irritable and more sensitised to criticism. Their edginess and frustration confuses those around them. Misunderstandings, atmospheres and arguments then happen. They become more defensive. They are hurt more readily. Their feelings are often uncomfortable. But they can find relief. They plan and anticipate the next session of drinking or drug use. They turn to the substance that they know will relieve these feelings.
Here the cause and the cure have been confused: the user has inadvertently turned to a substance to cure the difficulties it has caused. It is this belief that will drag people further into problematic use.
There is now a cost to those around the person using. Their short temper can be hard to live with. But now the user blames those who so easily provoke it. They believe that the problems are around them rather than within them, and they do not recognise the change occurring in their personalities. Those around them, however, feel it deeply and are confused by it. Already faced with irritability, the family wonders if they might be to blame. Then they may wonder about the drinking or drug use. There is no clarity about the amounts being taken, and questioning will likely be met with a defensive response.
The social route sees a gradual build-up of using over time. There have been good times and happy memories. But now things are turning rather sour. There are more hangovers and worse comedowns. As drink or drugs move up the scale of personal priorities, users become more defensive about the substance and more rigid in their need for it. They are frustrated by anything and anyone who threatens to interfere with their pattern of use. They are more easily stressed and less able to cope with difficult days than they used to be. They feel less euphoric on the chosen substance and less comfortable without it. They deflect the discomfort onto those closest to them.
There are signs of trouble at this stage that can be missed by the users: they do not see that the substance use is the cause of difficulties. The family may be more suspicious that the use is a factor, but in the face of defensiveness they may doubt their judgement.
This is a very important stage: if the drinker or user realises and acknowledges what is happening, it is possible to undo the pattern of growing dependency. It needs a serious change in thinking and lifestyle, but it can be done. If this realisation is denied, they will continue to justify the behaviour.
The family is also feeling vulnerable. They are aware of increasing substance use. They grow concerned: the user does not. They are told they are over-reacting; everything and everyone gets blamed except for the substance being used. There are always excuses. The self-doubt begins to set in. Have the family got it wrong? Are they over-reacting? Is this just a phase that their loved one will soon let go? For some people it may be a phase. But others will progress on their path to dependancy.
THE MIDDLE STAGE OF ADDICTION
Here, at some level, the person who is drinking or using knows that it is causing problems. Facing this reality, though, would demand that they do something about it, and this feels like too high an expectation. They believe that they cannot cope without this substance. Indeed, their ability to cope has been seriously weakened in the course of heavy use. It is easier to keep using or drinking than to stop.
And so they protect themselves from this demand. They avoid the people who might question their drinking/using behaviour and the places where it might be noticed. They may even avoid events where their chemical needs cannot be met. As with all pastimes, they seek the company of people who use or drink as they do. This may not be a conscious choice but it allows them to believe that there is nothing abnormal or extreme about their own habits. There is always someone who takes more than they do. They may also be self-medicating hangovers, withdrawals or comedowns with other drugs.
Lives and relationships are becoming disrupted. The user has become unable to separate issues or see their substance use clearly. Automatically they blame circumstances or other people. They are convinced that if all the other problems were removed, resolved or changed, there would be no problem with substance use. The substance, they believe, helps them cope with it all. And so they continue to seek solace in the very thing that is the cause of the disruption.
They are in a personal battle of control. They try to prove to themselves and others that they can choose the level of their use. There is a strong need to believe that they can still use socially and recreationally. They may only smoke joints before bedtime; they only take a few lines of coke at parties on the weekend; they give up spirits and stick with beer; they give up the drink for Lent. There are promises that the use has changed. Repeatedly promises are broken and remorse, although at times heartfelt, is short-lived. Inevitably they fall back into a pattern of excessive use very quickly.
They might change pubs, dealers, jobs, accommodation, towns, company , but the patterns of using ultimately stay the same. They run into a cycle of frustration and despair. And still they use.
There are contradictions now between values and actions, a failure to treat people with the care and respect they used to treat them with. They lie, neglect the family, and are offensive to the people closest to them. Alcohol or drugs have dulled inhibitions, judgement and conscience. Despite the need to believe that this is not their fault and that it has nothing to do with the substance use, there is a deeply disturbing underlying feeling present. But now they know how to deaden these feelings, and so they continue to use.
There are no more highs now , they are not happy with it and not happy without it. They are constantly in a place of emotional discomfort which using only partly relieves. They are totally preoccupied with getting supplies of the substance at the cost of the usual daily concerns.
Serious physical and emotional problems plague the user. They may have stomach ulcers, accidental injuries, loss of concentration and short-term memory. They are defensive, secretive, deceitful, bad-tempered and unpredictable. They lose interest in their appearance and health. They do not eat well. Yet they cannot see how ill they are, or how unacceptably they are behaving. The damage is obvious to everyone but themselves.
They have lost any control over their use, and they have lost touch with reality. They have also lost control over their lives. This damage is progressive. If they do not seek help at this point, then recovery will be more difficult to attain.
The family is also deeply troubled by this stage. They have no doubt now that the drinking or drug use is a serious problem. Family members are exhausted trying to challenge the behaviour and to emotionally survive the destruction that goes with it. At this stage it is often these family members who are the ones to seek support. Recovery frequently starts with them.
THE LATE STAGE OF ADDICTION
Now users lives are coming apart. They are in a state of chronic chaos. They are both physically and mentally ill with their addiction. They get drunk or stoned quickly on much smaller amounts. The damage done to the liver and brain means that they are unable to cope with the effects of the drug, to break down the chemical or to withstand the effects.
They are constantly in the zone of emotional pain: drinking or using is an attempt to feel normal. They face hellish three-day comedowns or hangovers. They emerge from blackouts with shakes and horrors. They experience distorted thinking and extreme emotional distress, sometimes involving suicidal thoughts or attempts. Depression and despair are constant and they can no longer escape the guilt, shame and hopelessness.
But still they try. The substance is the only crutch left and they cling to it.
All normality is gone, whether they are sober or using, in their lives and in their familys lives. If they cannot find a way to stop using now, it is likely that their addiction will kill them.
At this stage the family , if they still have a relationship with the addicted person , can do little more than provide nursing care to someone who is now physically and mentally sick. If it gets to this, the family members can lose sight of their own need for care and support. Emotionally they have little left to give, but can be trapped in the role of caregiver as the addicted person becomes more chronically ill.