In a few years as a criminal defense attorney, I’ve represented hundreds of people in various stages of crisis and recovery. Over that time, I’ve worked with dozens of families to help them figure out the boundaries between being supportive and enabling. While some of this is specific to people recovering from addictions, much of it applies to anybody who is having a difficult time, whether they are working through post traumatic stress, depression, addiction, or any other mental illness. What all of these things have in common is that a person develops behaviors to cope with a bad situation that become problematic when the person returns to a healthy environment (or gets into a healthy environment for the first time.)
- Keep on loving. Some people think that they need to distance themselves from the person in recovery, either to “punish” the person for their bad choices or to protect themselves. The problem is that addiction is about more than just bad choices—and it’s not contagious. Most people first took up a drug habit to help fill some other serious hole in their emotional life. They need social support now more than ever. If they can’t get that social support from people who are healthy and drug-free (that’s you), they are likely to look for it on the street.
- Post bail and hire counsel. Addicts often land themselves in legal trouble, and families often wonder whether posting bail or hiring counsel are enabling the person to continue down the path of ruin. Many families have asked me if they should leave their loved one in jail “to teach him a lesson.” My answer is that penitence is not what happens in the penitentiary, and no lesson worth learning was ever learned in jail. This relates to #1—if a person in jail loses the support of their family and friends, where do you think they will go for help when they need it? Not everybody can afford to post bail or hire private counsel, but you should do it if you can.
- Be careful about giving cash, but give aid-in-kind liberally. A bag of heroin in Boston costs about $20. And yes, an active user on the street will often spend their last $20 on heroin—before food, before shelter, before anything. If they have $40, they might get heroin and food. A better answer for somebody who can’t be trusted with cash is to give them food, give them shelter, give them rides—help them make sure their needs are met. Addicts on the street who can’t afford to eat may see the error of their ways and check into a detox—or they may mug somebody or rob a bank to get the money they need. The second result is at least as likely as the first. One solution is the Next Step Mastercard, which lets you put money on a debit card for your loved one, but restrict the places and times that they can use it. The fees are high even for a prepaid card, but if you can afford it this is an elegant solution. http://www.nextstepcard.com.
- Housing First. Many people have heard of the rat studies, where heroin-addicted rats would endure electric shocks and other tortures to get more heroin. What is less well-known is the later study in which heroin-addicted rats were placed in “rat paradise” habitats with other rats, clean bedding, pipe mazes, and other things that rats like. These rats turned up their noses at the heroin and detoxed. Humans do the same. When they do not want to run away from their life, they do not need to run into the waiting arms of the drug. If you can’t afford to have the person in recovery live with you—because you don’t have the space, or because their behavior is too erratic to be around all the time—help them make sure that they have shelter somewhere else. Homeless shelters are not a good solution for most people.
- Get yourself a Naloxone prescription. Naloxone is a drug that reverses heroin overdoses. Many states now allow anybody who has gone through a training program to obtain and carry Naloxone nasal spray (marketed as Narcan®)—often at no cost—to save the life of a loved one who may be at risk of overdose.
- Understand that relapse is normal. That doesn’t mean that you should blithely accept it, but a relapse doesn’t mean that an addict has “failed” at recovery or was lying all along. Recovery is a years-long process of replacing unhealthy habits and thought patterns with healthy ones, and most people have to try a few times before they stabilize. Watch out for relapses at any time when the person is under unusual stress—especially around losing a job, losing somebody who they are close to, losing housing, losing a romantic partner, etc. A recovering addict is likely to magnify the level of a crisis in their own mind beyond what a “normal” person would experience, and may turn to their old pal the drug for comfort. When relapse occurs, try to maintain a supportive attitude. Even though you can’t condone the return to drug use, your loved one needs to know that you are there to help them get back into the process of recovery.
- Don’t blame. Many families and friends feel the need to emphasize their disapproval of the drug habit. While it’s important not to communicate acceptance of drug use as normal or okay, cramming disapproval down the throat of somebody who is in crisis is counterproductive. In most cases, they know that what they are doing is dangerous, stupid, and taking them down the wrong path. They hate their lives, they hate themselves, and they want desperately to have it any other way. Boasting and macho behavior are often thin covers that protect them from having their desperation seen as a vulnerability that could endanger their physical safety. Your job, in supporting them, is to help them understand that they can come back to a healthy, happy life, and that you will welcome them—not to reinforce the belief that they have become permanent scum of the earth. A person who thinks that they have taken a one-way trip to a drug-addicted life of crime will often decide that their best hope is to be good at it, and to be so dangerous or offensive that people who want to hurt them will go away. The stray dog will bite if cornered—not because it does not want a warm bed and a steady food supply, but because it is afraid. Likewise the addict. If they have been living on the streets or haven’t had a stable housing situation, they have lived in a world where nobody loves them and nothing is safe. Even if they have not been homeless, they may still feel this way. It may take years for them to truly trust any person or situation, and the only way to support them in this process is to understand it, and to make yourself into an absolutely safe resource. Reinforcing the addict’s narrative that “I am a bad (or failed) person” is the opposite of creating safety.
- Take care of yourself. Don’t be the only support for the person in recovery, because you are likely to get pulled down with them if they fall. Set boundaries. Make sure there are times that you get down time, and that you get time to yourself. Make sure there are times when you are “off duty.” It will help if somebody else can be “on duty” when you are off, if necessary. Eat a normal diet, keep up a sleep schedule, and keep up your exercise. Put on your own oxygen mask before helping others. Find a therapist or a support group to help you process what you are going through.
- Be aware of “substitute addictions.” Many addicts who discontinue the use of one drug will transfer their addictive behaviors to something else. This is a very good thing, if the substitute addiction is legal, healthy, and easy to come by. A recovering alcoholic who clutches a bottle of Pepsi for dear life has replaced a dangerous drug with a relatively safe and inexpensive one, and is on the road to recovery. For another example, google “skydiving vs. heroin.” The flip side is that somebody who is recovering from a drug addiction should be very careful about their exposure to other drugs of abuse, especially alcohol. If you are living with somebody who is in recovery, you may want to eliminate alcohol from your home completely.