11. Treatment Principles for Allies


Here we’ll cover:

  1. Being a treatment Ally
  2. Treatment 101 - what to think
  3. Principles of effective treatment
  4. When is treatment needed?
  5. Situation check in

1. Being a treatment Ally

Having the right mindset is important.

We tend to not talk openly about addiction in our culture today, which can add pressure to a situation that may already feel like it needs a release valve.

The effects of addiction can be so distressing (loss of jobs, relationships, declining mental health, depression, physical danger), often our first reaction is to reach for a quick solve - most commonly, we seek treatment options.

Our first question might be:

How do I get him / her into treatment?

Before seeking treatment, as a friend or family member, we recommend first, considering how we the friends and family, fit into the process.

Our role as an ally is to support our loved one to take action on the best option for him/her, when they’re ready. We know first hand- this last part can be hard to swallow.

Research shows that the most effective way to get the results we’re hoping for is to listen for signs that show us our loved one is open to hearing our guidance. Any efforts to control the outcome or their decisions will drive more distance between us, when what we want and need is for them to feel connected and cared for.

2. Treatment 101 - what to know

Next we can prepare ourselves with these helpful facts to know about treatment:

  1. It’s an ongoing process. Patience and steadiness on your end are essential. It’s helpful to consider what patience and steadiness look like today in your situation. It has a way of changing frequently.

  2. Persistence and receptivity (aka, listening) are absolutely necessary.

Attempting to force anything just isn’t effective. It divides instead of connects.

  1. Relapse is a part of the process.

Take a deep breath. Now a big sigh of relief.

Like any habit, we don’t just change it overnight, or even in 30 days. Studies have uncovered that relapse is just one of the steps in change and healing. The more compassionate and accepting we are about this, the more connected with the person we’re concerned about we get to stay.

Relapse might feel hard to accept.

One of the most important things to know and practice is that it’s possible to set limits for what is acceptable to us and take care of ourselves first, without withdrawing the acceptance our loved one really needs as they wrestle with addiction.

As we know, connection is the opposite of addiction!

For a refresher, you can always revisit the exercise on limits or self care.

3. Principles of effective treatment

  1. Addiction is complex, but treatable. It affects brain function and behavior, so therapeutic approaches need to address rewiring patterns in the brain and give strategies to change behavior.

  2. Repeated substance use that disrupts life needs to be addressed as soon as possible.

  3. Effective treatment addresses more than just substance use. It gets at what is going on underneath the surface that is compelling a person to reach for drugs as a way to soothe discomfort.

  4. Staying in treatment for an adequate amount of time is critical.

  5. Medications can be an important element of treatment when combined with intensive therapies.

  6. Needs will change. A treatment plan must be assessed and modified continually to make sure those needs are being met.

  7. Many people who struggle with substance use are (unknowingly) self-medicating because of underlying mental distinctions that have gone unrecognized and undiagnosed. (Remember, compassion.)

  8. Detox alone does very little to change long-term use.

  9. Drug use during treatment needs to be monitored, as relapse is common.

4. When is treatment needed

Some kind of treatment or professional support may be helpful as soon as someone’s life is being disrupted by their substance use and, despite the negative effects, they continue with the behavior.

Let’s let go of the mythical rock bottom. No where in the book of life struggles, or in evidence-based research, does it say that a person dealing with addiction has to lose everything and everyone in order to change directions. It’s a fallacy that has been repeated, thus continues on, when we don’t know what else to say or do when someone is having a hard time making changes. “Well I guess s/he hasn’t hit rock bottom yet.”

If you’re concerned about someone you care about, that might define enough of a rock bottom. It doesn’t have to get worse. They likely just don’t know how to feel ok enough in their skin for long periods of time without the substances. So things don’t need to get more desolate or isolated; they need to get more connected.

If you completed the questionnaire in ‘Addiction 101’ and have a sense of how severe the substance use seems to be, that can also be a good indicator.

Just remember as an ally it’s important we recognize our motivations for wanting (and supporting) changes, as well as their motivations for using substances in the first place, and for wanting to stop.

Each motivation has rational underpinnings for each person.

By compassionately understanding their motivation for using substances to begin with, we can help them identify options for professional care and affect sustainable change.

The motivation for using substances tends to lie in soothing emotional pain or disconnection that they may not be able to recognize or name without some professional help.

Remember, too, that a decision to make a change or engage in treatment takes time. We can return to the conversation when motivations change, as they do over time. If a treatment conversation isn’t happening now, we don’t have to feel defeated.

Substance use care or treatment can be thought of on a continuum. There are different levels of care available for different situations and it’s important to keep coming back to this: treatment options need to match our loved one’s motivations.

5. With or without treatment

All is not lost if the person you’re concerned about isn’t heading for in or outpatient rehabilitation today.

Addiction isn’t only about a drug. It starts out being about relief.

Though in most cases medical professionals can be helpful, We the Village are all about knowledge of what we can control and there are actions we can take to help regardless of if our loved one is ready for rehab.

A Possible First Step:

For them (and for you) to identify the situational and environmental factors that spark their need or desire to use substances, as well as those situational and environmental factors where they’re happy to be substance free.

Focus on the situations in which our loved one is happy to be substance free, we can play a role by planning for these activities, engaging, supporting and promoting these activities.

A secondary way we might be able to help in even a small way, is giving attention to situational and environmental factors that spark a need or desire to use drugs. Those situations and environments bring up feelings so intense that a longing for relief is immediate.

Now, when even one of those factors is identified, work can be done on changing the relationship to the environment or situation.

Some people manage to heal addictive habits without traditional treatment by getting at the root of what’s prompting them to seek the relief drugs give them. These people have to be deeply motivated, though, by the life they get to have when they take repeated actions to change, and perhaps have a trusted friend, family member, or therapist that helps them to see and keep perspective. It helps to get a taste of what life inside feels like, not just what life on the outside could look like.

This explains why many people don’t stop all drug use at once, but instead taper off…

Because as we change our relationships to environments, situations, and people that create discomfort inside us, we begin to feel differently. And this takes time.

Recent research suggests that most people who struggled with drugs in their teens and 20’s were substance-free by their 30’s, and maintained that freedom in subsequent decades. It’s not an easy or short road, but it is possible and worth navigating through every big or little stumble.