Treatment and recovery for substance use disorder is a lifelong process, one that often takes a toll on the well-being of family members.
1. Remember that opioid use disorder is just that.. A disorder
While it may be easy to fall into the trap of perceiving addiction as selfish or as a “choice,” when you compare drug abuse against other disorders, the concept isn’t much different — and it’s important to remember that as your loved one begins to heal.
Recognizing that addiction is a disorder rather than a voluntary choice can be challenging. It's often hard to reconcile how someone using opioids can remain rational in most aspects of their life while seemingly making conscious decisions around drug use. As a result, many families struggle to accept that drug use can become involuntary and compulsive. This can lead to anger instead of compassion, and accusations instead of support. Initially, the comparison between addiction and other medical disorders might be rejected. However, over time, many families come to understand and accept this perspective, which can bring a sense of relief. The science is clear: brain-imaging studies reveal significant changes in the brain areas involved in uncontrollable drug use, differentiating them from otherwise healthy brains. The good news is that these changes are not permanent. With a period of abstinence, the brain can heal, and individuals can fully recover.
2. Understand the difference between outpatient + residential treatment centers
Residential programs have long been viewed as the gold standard in addiction treatment. However, for individuals with opioid use disorder (OUD), these programs may not always be the best option, as the primary need is often medical treatment. While residential programs provide extensive services and support for mental health, it's challenging to determine who will benefit more from residential care versus outpatient treatment. When treating OUD with medication, which requires ongoing follow-up, outpatient care often proves to be more practical and cost-effective. At Empower Treatment, we offer both options and at the end of the day it varies individual to individual which is the best.
3. Know what questions to ask treatment providers
Such as:
- Do you restrict the use of any medications? If so, which ones?
- What is the duration of the program?
- Is there currently a waitlist?
- What is the cost of treatment?
- What are the typical out-of-pocket expenses after insurance coverage?
- How do you assist families in using their health insurance to cover treatment costs?
- What percentage of patients leave the program on medication?
- What kind of treatment do most patients transition to after discharge, and how do you ensure they are connected to that program?
- Do you follow up with patients after they have completed the program?
- Is there an option for post-discharge phone follow-ups with the primary therapist? Are these follow-ups scheduled or available as needed?
- What happens if someone struggles after discharge and wants to return to treatment?
4. Know that your loved one’s recovery isn’t your full responsibility, but that you do play a large role
In early recovery, individuals need an extraordinary amount of support—often more than you might expect. As the brain begins to heal, thinking and concentration can be impaired, and energy levels are often low due to difficulty sleeping, especially in the beginning. Practical challenges, such as lacking a car, job, or money, can also arise. Basic skills, like personal hygiene or job interviewing, might need to be relearned. All of this is a result of a serious chronic illness. If your loved one were battling a severe disorder other than addiction, how would you approach it? Would you help them learn new skills? Drive them to appointments? Offer financial support? Ensure they take their medication and stay connected with their doctor? Assist them in applying for a job?
5. Consider medication-assisted treatment (MAT)
For individuals with opioid use disorder (OUD), traditional rehab programs are often ineffective, with a 90% failure rate when not followed by medication to prevent relapse. However, combining recovery housing with medication-assisted treatment (MAT) can significantly improve outcomes. Recovery housing provides a supportive environment that promotes stability and accountability, while MAT, using FDA-approved medications prescribed by healthcare professionals, helps manage withdrawal symptoms, reduce cravings, and lower the risk of relapse and overdose death. Together, these two approaches offer a comprehensive solution that enhances the chances of long-term recovery, providing a balanced path forward for those seeking to overcome addiction.
6. Monitor medications
About 50% of people stop taking buprenorphine or XR-naltrexone after a while, and some do so because they feel they are back to “normal.” Many people question whether they need to keep taking it, especially when they feel so good. Yet they still have a chronic disorder, their brain is slowly healing, and they are exposed to stress and cravings, which leave them vulnerable to relapse. Getting off medication can make maintaining abstinence much more challenging. Here’s how you can help be their recovery partner:
- Be present when the medication is picked up from the pharmacy
- Help keep medication in a safe place
- Dispense it at scheduled times
- Supervise when medication is taken
- Accompany your loved ones for naltrexone or buprenorphine injections or implantation surgery
- Set clear expectations for taking medications in return for your support
- Clearly communicate benefits and rewards for taking medication and consequences for not taking it
7. Accept ambivalence as part of recovery
Ambivalence is a normal part of the recovery process. People struggling with addiction often face numerous stressors and triggers that make them want to use again. There will be days when your loved one feels committed to staying sober, and other days when they feel conflicted and may display addictive behaviors. Understanding and accepting this ambivalence can make it easier to navigate these ups and downs. Here's how you can support them:
- Ask open-ended questions to explore why they might be feeling unsure.
- Encourage them to reflect on their reasons for wanting to change and their belief in their ability to do so.
- Highlight their strengths and the positive steps they've already taken in their recovery journey.
- Acknowledge that the early stages of recovery are challenging and reassure them that these feelings are normal.
8. Create a contingency management plan (CMT)
A Contingency Management Plan (CMT) is a written "contract" designed to reinforce behaviors that support recovery while discouraging those that hinder it. This plan clearly defines expectations, sets boundaries, and outlines consequences. The guidelines and consequences are communicated explicitly, ensuring that everyone in the household understands what is expected of them and the potential outcomes of their actions.
9. Have everyone in the household review their relationship with drugs and put use on hold
Drinking alcohol or smoking weed in front of someone in early recovery can be a powerful trigger. Similarly, keeping painkillers around can be harmful. While your loved one may eventually no longer view alcohol as a trigger, it's important to be cautious during the early stages of their recovery. Here’s how you can help:
- Remove all drug paraphernalia from the home.
- Eliminate all alcohol and other drugs from the home.
- If you are prescribed painkillers, secure them in a locked place and avoid taking them in front of your loved one.
- Refrain from using any drugs, including alcohol, in their presence; establish a new norm by creating a drug-free environment at home.
10. Get help for yourself
The impact of addiction on a family often intensifies before it begins to improve. Even as your loved one makes progress in their recovery journey, it's crucial for family members to seek help and support. Don’t underestimate the importance of self-care for yourself and other family members. Reach out for support by finding a counselor, attending a family therapy support group for addiction, or participating in Al-Anon or Nar-Anon meetings. If you're struggling to cope with an addicted family member, consider encouraging them to see a therapist who can facilitate open communication and provide professional guidance. Taking these steps can help both you and your loved one navigate the recovery process more effectively.
Interested in learning more?
Refer to the Substance Abuse and Mental Health Services Administration (SAMHSA) site for recovery support services as well as information on mental health and/or substance use disorders (both drug and alcohol addiction) for yourself or a loved one.
Sources
1. Science Direct
2. SAMHSA
3. OPTUM
