5.6

The Myth of Tough Love: A New Tool for Supporting Loved Ones through Addiction.

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I’ve noticed a disturbing pattern as stories rage across the major networks on the epidemic of addictions facing the United States. They are missing a key piece. 

Yes, we need better policies and of course, medical intervention and treatment is invaluable—including more training for doctors who prescribe opiate painkillers. But few stories acknowledge the untapped power of a family or community to support a loved one through addiction.

Because after all, even when a person ends up in a support program, they often return to their former surroundings—and old patterns are bound to arise.

How can a family be prepared prior to treatment and throughout recovery? This led me to investigate those working on the cutting edge of addiction’s research to understand how to transform a desperate situation into one of understanding and mutual support. Below is what I learned from interviews with the an advisor to the White House and a leading research expert.

Former deputy director of the White House Office of National Drug Control Policy Tom McLellan says the administration and public need to question the underlying assumptions about addiction.

In 2009, McLellan accepted a nomination to be the government’s No. 2 drug-control official and advisor to Vice President Biden. At the time, his youngest son had recently overdosed on anti-anxiety medication, while his older son was in residential treatment for alcohol and cocaine addiction. He saw the offer coming so quickly after his son’s death as a sign and took the job to make a difference.

“Family members know if nothing is done that there can be lethal consequences,” says McLellan, PhD, also the chair and co-founder of the Treatment Research Institute. When substance abuse becomes chronic, McLellan says that it’s pointless to punish the person. He says the tough love approach is the most common and also, often lethal.

“Sometimes the first use of a drug can lead to permanent damage, or even death,” says addictions specialist Dr. Bob Meyers. “The notion of waiting for someone to hit bottom before doing something is ridiculous.”

Meyers says this forces families into a painful cycle with limited choices: either force the person into rehabilitation or detach and wait until they hit rock bottom—but often, the bottom means death.

Traditional interventions are based on moral models which assume substance abuse stems from a lack of willpower. Alcoholics Anonymous, founded in 1935, asks the addict to give their will over to a “higher power.” Addiction is viewed as a result of human weakness—a defect in character. Al-Anon, an offshoot program for family members of an addict, advocates for disengaging from a loved one who is drinking or using drugs.

“A traditional intervention has the family write down everything the substance user does to them or how they’ve gotten in trouble, essentially all the bad stuff they’ve ever done,” says Meyers. “Then they invite them in and tell the person what a jerk they’ve been—on and on.”

Meyers, currently working at the University of Mexico’s Center on Alcoholism, Substance Abuse and Addictions, has co-authored five books on addiction including Get Your Loved One Sober: Alternatives to Nagging, Pleading and Threatening.

Meyer’s father was a heavy drinker who never received support. He refused to accept that family members are powerless to influence a drunk or addict, which motivated him to dedicate his life to designing a new approach.

“What I’ve created with CRAFT (Community Reinforcement and Family Training), says Meyers, “comes from really loving someone and wanting to support them. When certain programs talk about ‘loving detachment’ to me that is an oxymoron—there isn’t ‘detached love,’ if you care for someone you can help change them.” Meyers teaches the interpersonal skill set he invented after years of research, in workshops around the world. He added that nowhere else was the idea of “shaming” the addict so prevalent as in the United States.

A 2002 study conducted by researchers at the University of New Mexico and published in the journal Addiction showed that motivational interviewing, cognitive behavioral therapy is far more effective in stopping or reducing drug and alcohol use than the model of A.A. Despite this research, the faith and abstinence based models remain the dominant approach.

“I worked with a mom who would berate her kid when he came home telling him he was late and reeked of pot—or whatever,” shares Meyers, ”but then I got her to say things like, I’m glad you’re home and safe, it’s nice to see you. The kid started believing his mom loved him and that’s what finally got him to come see me.”

Meyers and McLellan teamed up recently with Cadence Online to make Meyer’s CRAFT protocol more accessible for families by hosting the educational module online. Through interactive videos and extensive role-playing exercises, parents navigate through five key modules designed to help them understand their child’s drug use pattern, improve their communication skills, develop methods of behavior management, and learn when and how to suggest treatment entry.

According to the Treatment Research Institute, 90 percent of substance use disorders begin before the age of 18, which is why the duo started by targeting parents as key influencers.

“Parents find it difficult to believe, but in almost every survey in high school, kids rate their parents as the most influential people in their lives,” said McLellan. “Parents have power they don’t exercise. They give the kid access to a car, a credit card or pay their tuition. Those are all factors with proper instruction that can help them gain control of their kids behavior when the kid can’t.”

Brain imaging studies show physical changes in areas of the brain that are critical to judgement, decision making, learning and memory and behavior control. Addiction researchers believe that these changes alter the way the brain works and may explain the compulsive and destructive behaviors of addiction.

“The thinking behind it is that through positively reinforcing your child, you can understand what’s underlying the addiction—sometimes strong feelings of anxiety, depression or isolation and then support them to get more help and stay connected during treatment and recovery,” explains Meyers. “Families can see, okay, maybe if I do something different then I’ll get a different outcome,” says Meyers. “They’ll look at a different way of interacting so they don’t lose touch.”

The Center of Disease Control and the National Institute of Drug Abuse reports a steady rise in overdosing in the past 15 years. In 2010, there were approximately 38,000 fatal drug overdoses in the United States alone, more than double the number in 1999. Overdose is the leading cause of accidental death in the U.S. surpassing traffic fatalities, and gun related deaths.

“The most rewarding thing for me is that the public is now understanding addiction as the chronic illness it is,” says McLellan. “That allows for there to be possible advances, without that realization, we are in trouble.”

 

 

Relephant Read:

Transforming a Decade of Drug, Alcohol & Relationship Addictions.

 

Author: Cayte Bosler

Editor: Catherine Monkman

Photos: Jacksoncam/Flickr

 

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Ronald Behhsodit Mar 28, 2016 8:39pm

What ever happened to an open mind? AA has saved hundreds of thousands of lives. It may not be the only way out of addiction, but it certainly works. If it’s not for you, no one is forced to stay. There is more than one way to combat addiction and Gos knows we need all the resources we can get. I am incredibly disappointed in this closed minded article,. It sounds like an informercial for one method., and the descriptions of the AA principles are absolutely inaccurate. Shame on you.

Spring Hill Jim Nov 29, 2015 6:16pm

I gather by your comment that you regard the Big Book of AA, which was written in the early 20th Century by Bill Wilson as fact and not fiction? It is clearly his very warped opinion of alcoholism and his sick family and multiple wives that he has written about. We know for a fact that the man had this spiritual awakening, where he is skyrocketed to the 4th dimension while on an acid trip. We also know for a fact that his last wish on his death bed was for alcohol, so he obviously had his disease under control! Alcoholism is not a disease. It is a behavior. Alcohol doesn't just appear out of nowhere and insert itself into the body of those who are born with this disease. Cancer is a disease. Can you imagine going to your doctor and he gives a diagnosis of cancer, then tells you the best treatment is to go to some meetings, get a sponsor, pray, and work these 12 steps and you will have about a 5 percent chance of living, or you can just stay at home and do nothing and you have the same percentage of beating the disease????. Oh, and when you die of cancer, it is your fault, not the fact that the treatment was ineffective. Your entire argument is based on your assumption that the people in AA wouldn't lie and the Big Book is fact not fiction, and both of those are complete lies. They are a bunch of liars and thieves after money and power, and they don't care about you and your livelihood. For the most part, the people in AA are good people who have just been brain-washed and taken advantage of. They kicked me out because I was "too smart". I have never in my life heard of someone being too smart. What they meant was I was not going to be able to be brain-washed, and I would ask questions that they didn't have the answer for. Everything was dumbed down to simple cliches, so everyone walked around sounding like AA robots, unable to think for themselves because that was all part of the plan. They are salesman selling a product from the 1930's that doesn't work for the majority of people, and as Silver pointed out it wouldn't be so bad if it had no effect on the other 95 percent, but it actually causes them great harm. The goal of AA is to brain-wash you into thinking you need them to survive, and without the group you are sure to die, or be put in jail, or maybe in an institution. It is really quite remarkable that Bill Wilson was able to create a cult that has lived and thrived in mainstream America and the world for so long, without anyone asking any questions…..because they don't like questions. There are no questions, it is all black and white in AA. The problem is we all know that the world is not black and white at all but various shades of gray are everywhere. I will give Bill W. credit however for creating a cult that has permeated every fabric of our society from the medical to judicial and even the media in Hollywood. All from Bill's interpretation and vast medical knowledge. We all know that his book was nothing more than the ideas based off of the steps of this Christian cult called the Oxford Group. I think that what you are really afraid of is that people will read actual facts and then you can no longer state that the Big Book is all fact and alcoholism is a disease because some group decided to categorize it that way so that insurance would pay for this "spiritual", faith healing cult and label it "treatment". I believe you deep down know the truth, but just like everyone else can't deal with the fact that you have been lied to. We all wanted to believe it was true as well. Hell, it has to be true right if 95% of treatment facilities in the US use the 12 steps as their method! Finally, the truth is getting out, and it is scary to think that you just like everyone else in the rooms have been lied to, manipulated, brain-washed and sold a lie when your life is at stake! The people behind all of this self-destructive, self-loathing, manipulative cult didn't know that the Internet would basically shed light on the truth. Thankfully, those of us who have gone through similar experiences are able connect with each other, and compare our stories, and it doesn't matter where you came from, it was all the same.. However, most importantly we want this "treatment" that harms most people replaced with something else, anything else, but a cult's teachings. You also just proved that it is a cult, you had to make sure that nobody else just read what you read because if they did, they would look at you a little differently. It's scary stuff, I understand. It was so scary I just wanted to die.

Am in the Fl Nov 28, 2015 10:32pm

Wow. I’m just going to comment on the article instead of all the things I want to say in reference to above comments. I had to stop reading them because it was making me a little sad. The article states that AA says alcoholism is a weakness and a defect of character. No where in any AA literature does it say anything even remotely close to that. AA describes powerlessness which means once an alcoholc starts drinking they are unable to stop. perhaps the authors interpretation of this is “weakness”? Step 6 discusses defects of character that are ever present in the actively drinking alcoholic. It absolutely does not describe alcoholism itself as a defect. The Big Book of AA clearly explains that alcoholism is NOT a moral weakness or failure. It explains that alcoholism is a disease, which I think we can all agree on since the American Medical Association STILL describes it as such. Motivational Interviewing and CBT are common practices in treatment for addictions. They are extremely effective tools when used to compliment 12 step programs. I think it’s nice that parents are utilizing the tools described in this article as far as ways of communicating with their loved ones in a non threatening,, non punitive manner. But at the end of the day the problem is still the problem: their loved one is still using drugs because the parents are allowing it to happen in their home. So they don’t put their loved one out on “the street” because that would be “tough love”.. Their loved one has an even greater chance of overdosing because they are using drugs In The comfort of their home with no consequences. You can’t just start using CBT on an addictive addict and expect it to be effective. So now what do the parents do? The Johnson Method of interventions is not to tell the addict everything thats wrong with them. It is to tell the addict how much they are loved and that they are WORTH getting better. It is to tell the addict that their disease has temporarily robbed them of all their amazing qualities. It concerns me that articles are being written on this highly sensitive issue with information that is not accurate or valid. People read this stuff and become misinformed. Please fact check. Opinions are one thing, we all have them. But to put false information out there and claim it as factual is irresponsible and dangerous.

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Cayte Bosler

Cayte Bosler is a correspondent for Unreasonable.is She writes about social entrepreneurs solving big, global problems. She has degrees in the Humanities and Peace and Conflict studies and is pursuing a degree in neuroscience. Her work appears in the Boulder Weekly, The Atlantic, Collectively.org and National Geographic.