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Alcoholism and Addiction (Opiods, Amphetamines, Cocaine, Heroin, THC): Recognizing the Emergence of Addiction in Family

Updated on May 15, 2017

Recognize Addiction: A step-wise approach

The impact of addiction and alcoholism on a family can be devastating. Often families of addicts get stuck in a cyclical series of events associated with their family member's use, which can affect all aspects of their lives from finances to emotional health. It is very difficult to watch a son, daughter, mom, dad, sibling, or other struggle with this disease, but if the addiction becomes chronic and extends for a long period of time, there can also be rejection of the addict by family members due to frustration with their constant relapses and their apparent refusal to get better. The addict may be stealing from their family to buy their drug of choice or they may be using up other resources, including a family member's time and emotional health. This creates resentment and sometimes, families throw their hands up in the air and say, "I'm Done, I Just Can't Do It Anymore."

In order to prevent the above mentioned series of events, it is important to recognize the signs of addiction before it becomes a chronic problem. There are multiple resources available to addicts and their family members, but the first step is to recognize that a problem exists, which is sometimes the hardest step. Denial is a very common symptom of addiction. Sometimes an addict doesn't even think that a problem exists, which makes it more difficult for family members to intervene. Alternatively, an addict may deny that there is a problem even though they know that there is because they don't want to have the shame that comes with admitting that they are addicted to a substance. It is the combination of denial and shame that most commonly prevents families from intervening early in the disease. I am employed as a Physician Assistant and work in occupational medicine where I treat orthopedic injuries and pain. Almost every patient that I see during the course of my day is prescribed an opioid for a period of time. Not everyone becomes addicted to that opioid, but there is a sizable portion of the population that will, in fact, progress to addiction even with short term use of opioids or alcohol or other drugs. It is a constant balancing act on my part trying to effectively treat their actual pain while monitoring each patient for signs of addiction and abuse.

I believe that my career as a Physician Assistant in this field of medicine uniquely qualifies me to have a frank discussion about warning signs of this disease. I am required to monitor things like urine drug screens, state prescription databases, and to ask certain questions to try to gauge whether addiction is occurring. Unfortunately, most people don't have these resources in place and are not educated enough on this topic to recognize addiction in a family member or close friend. I would like to provide some information that can be used as a resource in this regard.

It is important to note that most drug users/addicts will go to great efforts to conceal their use from friends and family, which makes it so hard to recognize in its earlier stages. However, there are early warning signs. Some families choose to "look the other way" at first and ignore the problem, but this approach should not be used. If you consider the impact that drug abuse/alcoholism/addiction can have on the physical and emotional health of a person and family as a whole, you will clearly realize that the risks outweigh the benefits of the "wait and see" approach. You risk losing your loved one to both physical ailments as a result of long term abuse and neglect of their health that coincides with addiction and to the psychological/emotional impact that the disease can have if addiction is permitted to continue.

What am I looking for?

The warning signs of drug abuse/addiction are typically rather classic when considered as a whole. It is usually a painful and emotionally tolling process to accept and acknowledge that a problem likely exists, but it is a necessary step towards helping your loved one get help. Common warning signs include:

  • Major changes in personality behavior, including: Irritability, Lack of empathy, Isolation
  • Work problems, Financial issues,
  • Relationship problems,
  • Lack of interest in things that used to be enjoyable,
  • Change in energy levels, including days of extreme fatigue and days of manic behaviors (pressure speach, flight of ideas, lengthy text messages)
  • Frequent illness, flu-like symptoms,
  • Phone calls taken in private/at late hours, as well as frequent errands, occassionally following a brief phone call, with excuses for short trips out
  • Dramatic shift in life goals with lack of progress towards meaningful/career oriented goals (education, career)
  • Change in eating habits, sudden weight loss, sudden weight gain
  • Aggression,
  • Lack of sleep.

These are the more common warning signs and, when you start to identify more and more of these signs, the chances are more likely that a problem exists. Has your family member been prescribed a possibly addictive medication? Frequent doctor visits? How many of the examples listed above have happened in the last weeks or months? Likely, if you can identify many or all of the above, a problem exists that needs to be addressed. However, considering these warning signs, one must also consider other major life changes that could be causing them other than addiction. A recent loss of a family member? A new relationship? Mental illness can also present similar to addiction, but, typically, the difference can be seen when you confront your family member about the changes in behavior. Someone trying to conceal an addiction, will almost always deny that behavior changes have occurred, laugh it off, or avoid the conversation altogether, get annoyed or angry. In contrast, someone who is going through a significant depressive episode, abusive relationship, or other, may be more receptive to a conversation about the changes in behavior and more concerned that you have become aware of these changes.

Okay, the warning signs are there, now what?

Firstly, approach the family member in comfortable setting, don't accuse them of anything, offer your support and understanding, and don't pass judgement. It is important that you do not push too far initially, let them lead the conversation, ask unassuming questions and don't ever tell them in a direct manner that you suspect drug abuse/addiction.

Unfortunately, In the more extreme cases, which happens more often than would be thought, a family member who has an addiction problem who is confronted will completely shut themselves off to further interaction and isolate further, maybe cutting off contact for months, which is very serious and scary considering the morbidity and mortality associated with addiction and the dangerous situations that the addicted family member can become involved in just to pay for their drug of choice.

You need to know....there ARE resources available for family members who are dealing with addiction. Contact an interventionalist, your family physician, or a mental health specialist. You should always get professional help before trying to pursue it further in a family member who appears to be resistant or in denial.

You need to remember, this isn't about your feelings, you need to make yourself available to hear their perspective and be open to understanding their feelings, this is a complex issue and, eventually, once treatment can be initiated for the addicted family member, you will then have a chance to discuss your feelings in a controlled environment, without the risk of further isolating your loved one. Programs are available at this point for family members of addicted persons, they are so beneficial to the healing process as a whole, for the whole family and also helpful in the continued efforts for the addict to stay clean once through rehab. Educate yourself thoroughly so that you can be a resource, a help, and this will prevent you from enabling in the future, or, even worse, being a problem that causes the family member to relapse down the road. Family is so important to an addict who is in early recovery and, an accepting and educated family member, is the most influential resource that can be provided to a recovering addict. Don't use their history against them, judge them or pressure them, it's a delicate process with very serious implications if handled incorrectly.

Addiction and it's affect on families

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In any situation, if addiction is suspected, it is important that you don't hesitate to step in and get the right professional support on your side. Overdose is a very real concern and every day that a drug abuser continues to use drugs places them at great risk for morbidity and mortality from their disease.

The following is a great site that has many resources, including links to state specific support, rehab, addiction counseling, programs, message boards, books, holistic approaches, relapse prevention, information on the 12 step program, NA, AA, success stories, intervention referral resources, residential treatment centers, international help, etc. You name it, you can find it on this site. There is also a great message board for families members who are dealing with addiction in their family, with a great community of people who reply to your posting, pray for your and support you through your hard time. It is very worth checking out and is sort of a gateway to other resources in this regard....


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