A: Dr. Fuehrlein
I want to engage my son and talk about getting help but I’m afraid of the angry outbursts and the backlash.
The brain of a person addicted to a substance becomes completely and irrationally focused on obtaining the substance over and over – often to the detriment of everything else that the person cares about. As a result, there are recognizable symptoms that are often very frustrating. For example, denial is a common manifestation of the disease of addiction. The person may not recognize that a problem exists, even when it is incredibly obvious to everyone else around. This denial serves to protect the addiction and to allow it to continue, despite many adverse consequences. Denial frequently presents as anger and frustration towards those asking questions.
Firstly, it is important to recognize that these angry outbursts are likely a symptom of the illness, much like a fever may be a symptom of an infection. The angry outbursts serve to deter you from asking questions and thus allow the addiction to continue more easily.
How forceful you should be with your questions and interventions depend upon many factors. Primarily it would depend upon the severity of the substance use and likelihood of imminent and severe adverse consequences. For example, if your son is injecting heroin and has had prior near-lethal overdoses, despite the possible angry outbursts, it is very important to discuss treatment with your son right now. If your son is drinking excessive alcohol but with no major consequences with no obvious imminent risk, more time is available to you to connect with your son in a less forceful and direct way.
Dr. Brian Fuehrlein
Associate Professor of Psychiatry, Yale University School of Medicine; Director, Psychiatric Emergency Room, VA Connecticut Healthcare System
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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