It is impossible to explain to someone in the middle of addiction what the benefits of getting clean and sober are. There is a reason that their substance use has spiraled out of control, continues to progress, and results in the cold and stark fact that to feel normal substance use has to occur.
There are unlimited scenarios involving addicts resisting treatment, but ultimately you will end up there involuntarily. Understanding some of the difficulties you might face trying to get someone you care about into treatment will give you a better idea where to start, and perhaps what questions to ask.
TOO MUCH TO CONTEMPLATE
Long-running shows like Intervention not only highlight how people act under the influence, they also illustrate that substance abuse has no boundaries and affects people from all walks of life. TV shows are only snippets of reality. Addiction in actuality is far, far worse than the edited entertainment depicted on screen.
A person actively using will almost never see the benefit of being clean and sober. Life without substances is too much to contemplate. Almost nothing you or a professional can say is going to convince an addict that treatment is a good idea.
Outside forces are often the catalyst that lands an addict in treatment. Whether they are cooperative or not, they will be faced with education, information, counseling, writing and worksheet exercises, lectures, self-improvement, self-care, and other foreign concepts of living without substances.
Convincing an addict that being clean and sober is worth it cannot begin until after they have detoxed, become abstinent and can participate in treatment. How they get there is unimportant, as long as they get to treatment.
ARREST AS A MOTIVATOR
Faced with the inevitable consequences after an arrest, most people will gladly trot off to rehab as a preemptive move to avoid jail time, or lessen the severity of charges. Many of these people do not have a problem with drugs or alcohol, they made a poor judgment call and they got caught. These are the people that are unlikely to make the same mistake twice.
A large number of addicts and alcoholics who land in rehab via the courts are there under duress and have no intention of ever stopping substance use. There are a lot of people who repeatedly end up in rehab. They are resentful and pissed off at getting caught, and will bitch and whine about the injustice of it all.
They will begrudgingly hang out in rehab for the 28-day stint, participating as little as possible. One big obstacle to returning to old behavior is the random drug testing the courts usually require. You might see some clean time after rehab, but it is likely these people either don’t give a damn about the system, or they will find ways around the tests.
FEAR & RESENTMENT
There are a good number of people in rehab because their significant other has put their foot down. They filed for divorce, moved out, or threatened to remove any and all support, or are using the children as a bargaining chip.
These people are in rehab under duress harboring fear or resentment that they have been forced into this position. There are the usual stories of arguments, injury, passing out, blackouts, disappearances, brawls, and other dangerous behaviors signaling out of control substance use.
It is common to find Women who are the primary caregivers and homemakers who don’t work outside the home placed into rehab under duress. Partners have huge leverage over stay at home partners, which can be flipped at a moment’s notice and turned into a sort of weapon.
Threatening someone by vowing to take away their life is often necessary to get an addict into treatment. It should be done because you care about the person and want them to be well again. This leverage is not going to serve a purpose unless you are willing to follow through with the consequences as well as the positive rewards of having a healthy relationship.
There is a certain desperation in the narratives of people in fear of losing their relationships. Care must be taken to uncover whether the relationship is unhealthy, violent, controlling, or is, in fact, supportive and loving. Relationship counseling is a must.
Getting clean and sober because of threats of divorce or loss of a relationship should not be the sole focus of treatment. There is nothing wrong with entering treatment if you are unsure if you meet the criteria of full substance dependence or are heading in that direction.
It doesn’t matter how much or how often you use so much as what the negative outcome is and how it interferes with your daily functioning.
CHRONIC PAIN AND OTHER RX DRUGS
Many people live with chronic pain or other medical or mental health issues who are prescribed mind-altering medications. It is extremely common for people to become dependent on these drugs and to abuse them.
The negative consequences of prescription drug abuse are the same as any other substance. You can get a DWI for being under the influence of any substance that causes impairment.
A few years ago the makers of Ambien, a sleep aid, cut the maximum dosage for women in half. Although this drug is supposed to clear the system within four hours, women were having accidents on the way to work/dropping kids off or would go through their morning with no recollection of what they had done.
Dependency on pain medication is to be expected over a long period of time, even when the medication is not being abused. Their body gets used to a certain level of the substance and can suffer withdrawal without it.
Some medications work symbiotically and one will enhance the effects of the other. Mixing too many drugs, or taking a higher dose will have a stronger more unpredictable response. Adding alcohol or other illicit substances can be fatal.
The thought of facing life without medication for chronic pain is unacceptable to people. The thought of trying other therapies and non-addicting medications is not an option either.
No other therapies are considered until it is the only option.
PARENTS AS ENABLERS
Young adults still under the financial tutelage of parents will find themselves unceremoniously dumped into rehab when their parents are at their wit’s end and have had enough of the addictive behavior.
The young adult will be none too happy about their stint in rehab, believing that drinking and drugging is a rite of passage and ‘what young people do.’ Notwithstanding, tanking college grades, absence from class, inability to keep a job, wrecked vehicles, volatile relationships, medical scares, dishonesty, stealing from parents, and other antisocial behaviors will not cross their mind as being a problem.
Young adults appear to feel absolutely entitled to live at home and be supported by their parents for as long as they please. Or, they are moving home in droves because they can’t afford to live on their own.
Out of it young adults are not the type of roommates parents want.
A common thread in rehab is one of ultimatums. There are so many ways to end up in rehab. Partners, parents, employers, medical professionals, court systems, interventions, all get people to the doors of treatment.
A lot of people end up in treatment just to shut everybody the hell up. Not because they want to, they are just sick of hearing it and figure a few weeks isn’t going to make much difference in the scheme of things.
Ultimatums rarely bring about lasting change. No one likes being backed into a corner. Addicts are some of the best actors in the world. Just you watch.
The highlight of visiting days for some is the smuggling in of contraband substances or electronics.
Ultimatums usually bring about some crafty thinking. Be prepared for all sorts of shady behavior if your loved one is not accepting treatment with grace.
REHAB ISOLATES THE ADDICT
There are rules and regulations governing both outpatient and residential treatment. There are a safety and containment factor, not to mention peace of mind for loved ones.
Don’t be fooled for one minute that there is not a steady stream of contraband entering rehabs. Addicts are some of the most resourceful people you will ever meet. They will find ways to get what they want and need as far as drugs or cell phones are concerned.
There are also all sorts of rehab romances happening. Some remain hidden, some end up in the rumor mill, and some people don’t care if they’re seen. Rehab romance is a really bad idea all around.
Given, there is a small percentage of people who will engage in addict behavior and rule-breaking, you need to be aware that it happens.
BUT REALLY, WHAT’S IN IT FOR YOU
How do you get through to someone in the middle of a disordered life? A life of substance abuse, loss of reality, caught in a sick cycle of physical, emotional and spiritual pain. How do you convince them that being clean and sober is going to be great?
Truth is, it’s not always great. In fact, it can downright suck.
Having to learn new skills to successfully navigate life is hard. Being watched like a hawk. Having people taking score. Being treated as ‘less than’ because society has an idea that addicts are worthless human beings.
Learning to enjoy life and have fun is a process. It will not happen overnight. It has to be practiced. It has to be sought.
In early recovery, feeling tense and nervous all the time that you are going to screw up, along with high anxiety is common. Thinking that you can’t cope, or worrying that you are going to relapse, and getting stuck in your head is part of the process.
The concept of facing every single challenge in life clean and sober feels too big. Being in your own head for that amount of time is literally mind-bending in the beginning.
How can you possibly sell living a clean and sober life to someone who does not want to stop using?
Or to someone who knows nothing but dysfunction?
You can’t sell all the good things about rehab straight out of the gate. You can’t appeal to their rational sensibilities. Chances are that brain cell has been fried….
An addict at the threshold of treatment has no concept of the future. They have been living in the moment focused on seeking, getting and using their substance of choice. On top of that, they have literally checked out for long periods of time. There is no concept of reality or concept of self.
Generally, people in the throes of addiction really don’t care if they live or die; they just want that next fix. And the oblivion that provides. They don’t want to think or feel, or plan, or future trip. They just want to be left alone with their substance in their own little bubble. They’ll come out when they want something from you.
The concept of honesty, healthy relationships, hard work, responsibility, compromise, or following direction has long been distorted and absorbed by a selfish, angry, resentful, dishonest, combative and thoroughly unpleasant personality.
INVINCIBLE AFTER DETOX
I haven’t met too many people who go into treatment because they want to. It is usually because they have to. There is someone or something that is in danger of being taken away that gets them into a seat in treatment.
Detox is often glossed over as just a few days with or without medication help to get through it. In reality, it is one hell of a tough time. Alcohol and heroin are known to be two of the most difficult substances to safely come off.
An average detox is a few days to a few weeks, depending on the level of substance use.
It is after detox that the real healing and work begins. Once people start feeling better, their outlook improves. This is the time where they start making big plans to stage an amazing comeback.
For many, this is the first time they have ever heard about the nature of substance abuse and the consequences to mind, body, and soul. For many, it is literally a matter of being scared straight.
Others jump on the fluffy pink cloud of overconfidence only found in early recovery and declare that they are going to be the 1 person out of 100 to be sober in a years’ time. Not likely.
While safely tucked away from everything and everyone that has fueled addiction, in the quiet safe bubble called rehab, it is easy to literally have a good time, eat and be merry, have a quick flirty rehab relationship and block out what happens after rehab.
Rehabs in scenic locations can literally feel like summer camp.
Self-awareness begins in treatment. Most people don’t even know what self-awareness is.
WHAT CAN YOU DO?
You sell the consequences and you sell solutions. You work on fears. You lay it on thick. And you put a time limit on it.
Somehow the addict has to personally make the connection to substance use and all the negative consequences. Having the person identify that their problems are because of their behavior is the starting point. Their lives are unmanageable because of substance use.
You get mean. The consequences are going to get worse. You take steps to do the things you say you are going to do. And you follow through no matter what.
One statistic states that 67% or more of people who enter treatment each year are going to relapse within the first year. In rehab the statistic often touted is 1 in 100 will still be clean and sober in 1 year.
You can’t sell recovery until you sell consequences and solutions.
You have to keep a very short focus because that is all the addict is able to comprehend.
ENTER RECOVERY CONCEPT
Once the person admits that all of their current problems are caused by their substance use, you can then sell the concept of recovery as the solution to their problems.
All of the current problems will either cease or have a solution or a workaround.
The benefits of being clean and sober are unlimited. The first step is getting the addict to connect their substance use with all the drama, chaos, and consequences they have and offer the solution in simple terms.
Recovery is literally learning how to do everything all over again. This is where humility comes in. Willingness comes hard to an addict. Willingness means trying new ways to eat, sleep, work, follow direction, dig into deeply hurtful and painful parts of the psyche, and then put all the new information and skills into practice.
There is no switch that can be pulled to convince an addict that recovery is the only option for them. Chances are they don’t care if they are healthy or sleeping well, or eating a varied diet, or getting the prescribed amount of exercise each week. They don’t care that they will be homeless, or their relationships are blowing up. They don’t care about work, or school, or community. They care about their substance.
HOW LONG DOES IT TAKE TO SEE A CHANGE
It could take weeks, months, or years to fully understand or see the benefits of living substance free.
Addicts tend to be very stubborn people. They are also very smart people. Both of these qualities are an asset to recovery.
Life has many twists and turns and can be cruel and ugly. Life is not all rainbows and unicorns. But life is literally about your attitude.
A person in recovery gets to choose how their life looks. They get to choose what to do, and how to do it to the best of their ability. They get to make good decisions and trust their intuition.
When the crap hits the fan, an addict has to make a decision every single time not to pick up and use. An index of coping skills has to be scanned in the mind and the best one put into practice.
Recovery is a daily affirmation, it is a choice, it is a set of decisions.
An addict does not always make good choices. Shit gets sideways sometimes. Bad behavior will pop up. The longer someone remains substance-free, self-defeating behaviors will show up less and less.
In recovery, there are meaningful long-term relationships and support with like-minded people. There is fun and laughter, and shared goals.
In recovery, they get taken seriously and treated with respect. They learn to love themselves and treat themselves with compassion and care.
A person in recovery gets to participate in their life.
You should be prepared when faced with the question, ‘what’s in it for me?’ They get to stay alive. They get to have a life, a good life, a happy life, a fulfilling life.