A: Dr. James Berry
If I talk to my son or let him come home is that enabling his addiction?
I was recently reminded by a wise mentor that the word “enable” has both a positive and a negative connotation. To enable in a positive sense is to help one become more “able” to accomplish something good. For instance, I enabled my 6-year-old daughter to successfully ride a bike by walking alongside her and keeping her from falling. On the other hand, to enable in the negative sense is to support another’s self-destructive behavior, either by directly contributing to the means of the behavior (e.g. giving money to buy drugs) or shielding from negative consequences (e.g. bailing out of jail). You should try to encourage the former and discourage the latter form of enabling when it comes to his addiction.
It is important to recognize that there are no easy answers and sometimes it is unclear how best to proceed. Whenever possible, try to get the support of others, preferably people who know you both and are able to clearly see how your behavior has either helped or may have harmed in the past. Learn from past decisions as the best predictor of future outcomes is past outcomes. You may want to find a counselor who can be objective or make use of mutual support groups such as Al Anon. As much as possible, I would always support keeping the lines of communication open with someone suffering from addiction.
Rarely would I counsel cutting off contact unless there are instances of abuse and potential harm to you by not doing so. You can always be available to talk and offer support but with clear expectations such as not while he is intoxicated. Letting him come home may be a different matter. I recommend being very clear about the limits of returning home and the consequences for crossing the limits. For instance, you may determine that a condition of him living at home is that he attends weekly therapy for his addiction. You would need to decide what the consequences would be if he failed to do so and be certain to follow through with the consequence. I also encourage you to consider a reward system for successfully meeting certain targets while at home such as negative urine drug screens.
Try to have an open conversation with him to find out the reasons why he is using. Be honest about the likelihood that some of these reasons make sense to you, such as helping him feel more calm or making him more social. This can provide a platform where the two of you can have a constructive dialogue. You can express your commitment to helping him as he works through these issues, but in order for him to continue to live with you, he needs to be committed to working through them and you need to have indicators that he is doing so.
Dr. James Berry
Associate Professor and Chairman of the West Virginia University Department of Psychiatry; Board certified in both General Psychiatry and Addiction Psychiatry
An excerpt from Navigating Addiction and Treatment: A Guide for Families, Addiction Policy Forum, 2020.
A Note From Addiction Policy Forum
Substance use disorders get worse over time. The earlier treatment starts the better the chances for long-term recovery. Many families are wrongly told to “wait for rock bottom” and that their loved one needs to feel ready to seek treatment in order for it to work. The idea that we should wait for the disease to get worse before seeking treatment is dangerous. Imagine if we waited until stage 4 to treat cancer. Decades of research has proven that the earlier someone is treated, the better their outcomes—and that treatment works just as well for patients who are compelled to start treatment by outside forces as it does for those who are self-motivated to enter treatment.
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