A Family Member’s Road to Understanding the Disease of Addiction
“Why Can’t They Just Stop?!”
Many family members of addicts and alcoholics ask themselves this question and in some cases, ask the person as well. It is difficult for many family members to grasp why addicts do the things they do. Why do they use until they are sick and depressed? Why did they leave treatment again? How are they homeless again? Why don’t they want to get better? Why can’t they just stop?
Addiction is a disease. It is not something that can be cured with medication or surgery. It is a lifelong disease that changes the way someone’s brain works. It changes their cognitive functioning, their behavior, their mood. No matter how many times you ask someone to change and no matter how many times they promise you they will, there is no guarantee. Without a strong sober supportive network and in most cases treatment, the slimmer the chance is of them succeeding in their sobriety.
Defining Strong Sober Supportive Network
What exactly does a strong sober supportive network mean?
Strong: Those who are consistent and available to the addict or alcoholic. Those who have strong boundaries, but caring demeanors.
Sober: Those who are sober- free of drugs. Those who do not promote or glorify drug use and do not use drugs (and alcohol is a drug) in front of the addict or alcoholic.
Supportive: Those who support the addict or alcoholic, yet do not enable them. Enabling will be discussed in more detail later.
Network: A network can be composed of a person’s friends, family members, community support group (AA, NA), co-workers, sponsor, and peers in recovery.
Remember an Addict in Sobriety is Sober from All Drugs
Those in sobriety need to abstain from all drugs. This may seem like a given, however, there is still a permissiveness towards certain drugs. For example, marijuana is a drug that is glorified in the media and in all realms of our society. Many people in treatment believe they can just smoke marijuana recreationally because it is not possible to become addicted to it. Actually, according to the National Institute on Drug Abuse (NIH), marijuana causes dependence on the part of the user and causes withdrawal symptoms when stopping the drug, including irritability, difficulty sleeping, and cravings (https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive). Many people seek treatment for marijuana abuse alone.
What does the Disease Model of Addiction have to say about this?
Addiction is classified as a disease by the American Medical Association, among other medical associations. The disease model of addiction also states that addiction is a disease, much like cancer or diabetes, therefore the person who is addicted to something cannot simply “stop” doing it (http://www.centeronaddiction.org/what-addiction/addiction-disease). Addiction rewires the brain to only crave the drug, despite the many health, relational, and behavioral consequences that may have occurred due to one’s use. All drugs hijack the brain’s reward pathways and inhibit the prefrontal cortex from functioning at its full capacity, which means that trading one drug for another (for example, marijuana for heroin) will still affect the brain in the same way- it will still be dependent on a drug. The prefrontal cortex plays a huge part in one’s decision making, motivation, learning, judgment, and planning. Considering that the brain is not even fully developed until the age of 25, with the prefrontal cortex taking the most time to develop, one can understand that a person who has been using for many years might have significant issues in these areas. Many family members say “You should have known better!” or “How could you make such a bad decision?!”, however, when one understands the effects of addiction on the brain and how that influences the addict’s or alcoholic’s actions, one will think twice before asking those types of questions.
In Defense of the Family Member
As a family member of those in addiction, I understand that these questions cross our mind from time to time. It can be very difficult to see our loved one get struck down every time they try to get it together. However, after learning about the disease of addiction, the brain, and drugs’ effects on the brain, I became more sympathetic and aware. I also had to learn the line between enabling and supporting.
Enabling vs. Supporting
My male cousins come from a family where all the boys are addicts, have had bouts of homelessness, been involved in crimes, and have used for most of their lives. My aunt and their sisters have spent many years bailing them out of jail, giving them money, taking them to treatment only to watch them leave several days later, and letting them sleep on their couch when it was too cold outside. This is an example of enabling- it perpetrates the addiction and allows the person to get used to this cycle- which eventually leads to conflict and to the enabler feeling taken advantage of and overwhelmed.
My close family friend was stuck in a pattern of enabling for a long time. Her son was in his active meth addiction at the time and was living and working in a garage. She would come by to wash his clothes and bring him food, as he was not eating at the time. He repeatedly told her to stop interfering with his life, so she did. She decided that taking care of him was only bringing her down, and she found a Nar-Anon meeting. Here she found comfort in talking to people who were going through a similar situation and learned to develop firm but loving boundaries.
Nar-Anon is a support group for family members and friends of addicts (http://www.nar-anon.org/Al-Anon). Al-Anon is a support group for family and friends of alcoholics and Al-Alateen is for teens who have been affected by another person’s drinking (http://al-anon.alateen.org/). You do not have to be religious to attend these support groups. Everyone attending the meeting is in the same boat as you to some degree. These support groups help you to become a supporter not an enabler and give you the steps you need to get through this period in your family’s life.