If you have a friend or family member in addiction treatment, you may have many concerns and questions about what you can or should do. You can’t decide to attend or stay in rehab for your loved one, but you aren’t completely powerless. There is a lot you can do to encourage someone through recovery and to make yourself a part of a solid support system.
In many cases, it’s friends and family members that finally convince someone to enter an addiction treatment program. You can even help encourage someone to complete their treatment. However, post-treatment may be the most important time for family and friends to come alongside a person in recovery to help them avoid relapse.
For many friends and family members of people struggling with addiction, relapse is a serious threat that comes with the disease of addiction. In fact, as many as 40 to 60 percent of people who achieve sobriety after battling addiction relapse at some point. It may not be that high for people who go through the full continuum of care, but the threat is still significant.
Some people may do very well in treatment and still relapse, typically because they thrive with a high degree of structure but find it hard to resist cravings and manage triggers on their own. A good portion of addiction treatment will be devoted to developing relapse prevention strategies and learning to cope with triggers that may arise in real-world settings, but when someone enters independent life, they will encounter a variety of challenges.
If someone you love is in treatment, or if they’re just finishing treatment, there are a few ways you can prepare to help them avoid relapse when they reenter independent life.
“Trigger” is an often overused word in today’s culture, but it actually refers to a real psychological phenomenon that has a deep impact on a person’s behavior. A trigger is some form of stimulus that can cause a specific line of thought or even certain actions.
For people in recovery, a trigger usually causes intense cravings and a feeling that they need to use drugs or alcohol. In many circumstances, triggers are powerful psychological motivators that can cause compulsive drug use. Triggers can be internal, stemming from certain feelings, like depression. For instance, someone coming home through rough traffic after a stressful day may feel a craving to unwind with drugs or alcohol.
Triggers can also come from external sources like watching someone use drugs on a TV show or seeing a beer ad. In addiction treatment, people in recovery learn to identify and avoid as many triggers as possible and find ways to cope with ones that are unavoidable. That being said, friends and family members should avoid becoming sources of those triggers themselves. If they are willing to share, get a better understanding of what triggers the person and avoid presenting them those triggers. If they are triggered by TV drug use, try not to watch episodes of gritty crime dramas like The Wire when they’re around. And definitely avoid using drugs or drinking in front of them.
You may be surprised by how many people in recovery hear friends, family members, and even spouses tell them that they were more fun before they were sober. Effective addiction treatment does more than help people get out from under an oppressive substance use disorder. It also helps them address other needs in their life like finances, legal issues, and pursuing healthy goals. In many cases, people will come out of addiction more responsible than when they entered. And this can be jarring to their friends and family, especially to those who used to use or drink with them.
It’s important to recognize positive lifestyle changes and celebrate the good that a person is doing in their life. You may feel like you lost your old friend or even feel some jealousy that they are moving forward with their life. However, if you encourage and even join them on their path to pursuing positive goals, it will accomplish two positive things: it will help you reconnect with your friend, and it will encourage them to continue on the road to recovery, avoiding relapse.
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Enabling was important to avoid when you were still trying to encourage your loved one to enter addiction treatment, but it can also be important after treatment is completed. Certain thoughts and behaviors can lead a person into relapse. According to the cognitive-behavioral model, relapse doesn’t start when you first take a drink or a drug after achieving sobriety. It starts in your mind with your response to a high-risk situation or a trigger. A poor coping response can lead to coping with drugs or alcohol. An effective coping response can lead to an increase in self-efficacy and avoidance of relapse.
If a person in recovery stops going to 12-step or other support group meetings, starts to isolate, or shows signs of depression, they might be showing signs of a potential relapse. It’s especially telling if a person starts talking about relapse like it’s inevitable. If you start to see signs that a person is headed toward relapse or may have already relapsed, don’t ignore them. Ignoring the issue is a common way people enable addiction. Staying silent may tell the person that their behavior isn’t really a problem. You should also avoid facilitating behavior that may lead to a relapse like going to parties with the person where there will be drugs or heavy drinking.
Even though relapse is a real threat, it’s important to realize that it’s not inevitable. By staying committed to recovery, a person can successfully avoid relapse indefinitely. That being said, it may help to be prepared if a relapse does happen. It’s also important to recognize the fact that relapse doesn’t mean that treatment or the person in recovery has failed. It just means that treatment should be reestablished and that relapse prevention strategies should be reevaluated.
If a loved one uses drugs or alcohol again, the likelihood that they will continue to use will increase. It’s important to stay positive and encourage them to seek treatment help again. The earlier they return to treatment after a relapse, the better. Avoid negative reinforcement. Someone who relapses may feel immense disappointment and shame. Don’t add to that by saying something like, “How could you ruin your streak?” There is no such thing as wasted sobriety, and there is something to be learned, even in a relapse. As a friend or family member, your reaction to relapse can make the difference between a person hopefully trying again and falling into despair.
However, it’s important to recognize the limits of your responsibility. You can help, but you are not to blame if a person relapses any more than you are to blame when a relative with diabetes experiences a relapse of symptoms. Addiction is a chronic disease, though it can be effectively treated.
Bandura, A. (1977, March). Self-efficacy: Toward a unifying theory of behavioral change. Retrieved from https://pdfs.semanticscholar.org/e8af/4369e0533210860587b7add0c566b74b963a.pdf
Khaleghi, K., Ph.D. (2012, July 11). Are You Empowering or Enabling? Retrieved from https://www.psychologytoday.com/us/blog/the-anatomy-addiction/201207/are-you-empowering-or-enabling
National Institute on Drug Abuse. (2018, July). Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery