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By Joseph Troncale, M.D.
Substance Abuse in the Family Identify it—Then Take Action
Drug and alcohol use, abuse and addiction are causing problems for many families today. When you suspect that your child, your sister—even your father or mother—may be in trouble, it's important to know what to look for. And what to do.
Signs of substance abuse and dependence are not that difficult to identify:
- money, alcohol or valuables missing
- changed behaviors: with regard to friends, usual schedules and activities
- new outbursts of anger, paranoia, defensiveness; significant mood swings
- decline in grades or work performance; absenteeism
- secrecy, lying, increasing difficulties with communication
- accidents, falls, illness, lapses of concentration
Of course, physical signs and symptoms of substance abuse depend on the substance being used. But common problems include changes in sleep patterns, appetite or mood. Other signs to look for: dilated or constricted pupils, lethargy or excessive drowsiness, slurred speech, recurrent sinus problems and excessive excitability or pressured speech.
Stick to Your Guns
To successfully "negotiate" the difficult situations that arise when relatives might be involved in substance abuse, follow these principles:
- The only person you can change is yourself. Do not alter your principles or behavior to make peace with addictive behavior. Consider getting help for yourself through Al-Anon or through other group or individual counseling.
- Do not give money or possessions to someone you suspect is engaging in addictive or abusive behavior despite begging or pleading. Set limits; express your thoughts and concerns without nagging. Maintain boundaries.
- Do not "fix" things for people who ask you to lie, make excuses or alibis for them. Maintain your integrity.
- Do not bend rules or withdraw if you are a parent. Set rules and stick to them. You do not have to be totally inflexible, but it is important to maintain contact over rules, know what activities are going on and stay "hands-on."
Substance abuse and/or addiction frequently accompany mental health issues. Some mental health issues are preceded by substance abuse. Conversely, some substance abuse is preceded by mental health problems. Sometimes it's difficult to know which is the culprit, but professionals who do abuse and addiction work may be helpful in this regard.
An addict active in his addiction is not generally rational except to rationalize addictive behavior. It is not helpful to get into arguments about behavior. It is helpful to state your own position and avoid being dragged into guilt or pain over the accusations such as "You don't care" or "If you really loved me you would help me."
Professional Help
If you're certain that definite substance abuse or addiction is ongoing, investigate professional counseling or treatment. Getting relatives or children into treatment may be difficult if they have no motivation to change.
There are no easy answers. People who are in denial or who like their drugs cannot be forced into changing.
One of the most painful conversations I have with relatives of substance-dependent individuals is when I tell them that the only way an addicted person can be forced into treatment is if they run afoul of the law or become suicidal or a threat to someone else.
This is not to say that the concerned parent or relative should stand back and live in the pain of watching their loved one sink deeper into dangerous or addictive behavior. In fact, getting help for themselves may be the first step into health.
Dr. Troncale is the medical director of the Caron Foundation, a not-for-profit organization located in Wernersville, PA, whose mission is to provide an enlightened and caring treatment community in which all those affected by the disease of addiction may begin a new life.
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