Family Dynamics of Addiction And Recovery - Deciding What to do about an Adult Child's Addiction

When an adult child with addiction problems lives with his parents, those parents are faced with hard choices. The addict believes that he is only harming himself, yet the truth is that the addiction is hurting everyone and is typically tearing the family apart.

Parents and significant others of alcoholics/addicts in deciding upon a course of action must make decisions based on what they can live with. There is a huge difference between bottom lines and threats. If in fact, family members have decided that they are not willing to tolerate having an active addict living in their home, then they are at a bottom line.

A bottom line is different from a threat in that you know when you say it, you mean it, and that you can follow through. A threat may involve using the exact same words, but when you say them, you immediately wonder what you are going to do if it does not work.

So, when parents are at the place where they can say it, mean it, and follow through, they are in a position to lay down the bottom line, and tell the substance abuser that they have the choice-treatment or leave.

There are professionals that do interventions. Parents and other significant people can also do an intervention. If he chooses to move out instead of going to treatment at this point, it does not mean that there will not be another opportunity to offer treatment.

People are usually motivated to change in the midst of pain. When there are negative consequences that are causing emotional, psychological, or other distress, addicts can become willing to ask for and/or accept help. The help that they ask for is usually about wanting to be bailed out again, but when one's choices are equally unattractive, a treatment center bed begins to sound pretty good.

It is important to remember that getting clean and sober is a process. When confronted by a family member about the alcohol or other drugs, an alcoholic/addict initially denies that they are using and tries to engage the confronting parent in a debate, argument, or "prove it" session. The parent or significant other does not have to prove anything. They just have to describe the behavior that is problematic, how it affects them, and that they are not willing to continue to tolerate it. Parents can point out the connection between the dots, but not engage in an argument about it. They might say something like this "when you do this........, I think that you are using drugs. I feel hurt and scared and I am not willing to watch you destroy your life. You cannot continue to live with us the way that you are. There is a bed reserved for you at ......treatment center. Before you finish treatment we will help you figure out what to do next."

After the initial confrontation and offer for help, the alcoholic/addict will usually try to play "let's make a deal". This often involves a verbalized willingness to do some lesser treatment alternative, like AA/NA or Outpatient counseling.

Usually when someone is at the point where someone else is intervening on their behalf vs. having had a "moment of clarity" where they can really see that they have a problem and are ready for recovery, they are often not in a psychological or emotional place where AA/NA alone would be enough to establish and maintain abstinence. (Although it is possible).

This scenario is further complicated by the detox factor. If you don't know what they are doing, how much, how long, and last use, you don't know what kind of detox help is needed (if any). Some detox (without help) can be quite dangerous. It depends on the factors above.

Of course, when you have little information about these factors, you also don't know what level of care the alcoholic/addict needs. There are plenty of licensed alcohol/drug counselors who can do an assessment and make recommendations about a level of care.

One of the problems with that is that all assessment for addiction is based on self-report data. Although there are scales in many diagnostic tools that are supposed to be able to detect denial and dishonest answers, addiction can certainly go undetected.

All of this speaks to the complicated issue that parents are dealing with. Anyone in this process would benefit from professional help in figuring out how best to navigate these turbulent waters. I would encourage any parent or spouse in this position to get help for the process. Getting a loved one into treatment is just the beginning.