Expert: Peter L. - 1/26/2010

Question
I noticed that you had experience in how to motivate someone to get help.  My son is a crack addict.  He has been to rehab twice (30 days ea), psy hosp for 1 week (got to the suicide stage), group therapy, went to NA but didn't like NA because they talked about using and that made him crave and would not come home and use.  That has been a while back.  he was 7 month clean then relapsed recently (9 time that went to every week when he got money) He does want to quit but I think he needs a program and a preventative program.  Money is an issue and he knows it but won't put his wife on his account.  He was laid off a couple of weeks ago and is 19 days clean.  He should get an unemployment check and I'm afraid he'll use when that comes in.  He's at the agitative stage and we're afraid to talk to him and make him mad.

Answer
Hi Joyce,

As you can see addiction presents very clear challenges to family members. I recently came across an article online that I'm recommending most of my questioners read, to provide some very clear education and perspective on why alcoholics and addicts do what they do.  

The link is:  http://www.bma-wellness.com/papers/addicts_dilemna.html

The difficulty your son is having so often is the case: treatment, relapse, NA, more treatment...
That is why we say recovery is a process rather than an event.  But you seem to realize that and are trying to help him achieve success.

Addiction deeply impacts the brain, resulting in corrupted or severely compromised decision-making, judgment, emotional stability, and overall character.  Monkeying around with brain chemistry, such as happens with crack and cocaine (and other drugs), gives rise to a syndrome of self harm or even self-destruction, even when the addict or alcoholic can see what's happening.  It is as if he or she is possessed.  As a result of this, family and marital relationships can be sublimated to the addict's relationship with his or her substance.  

I am only providing you with this background so you know what you are facing in trying to motivate him to succeed.  In the final analysis, if he doesn't respond to your attempts to help him, you will be left to the decision to let the consequences he will experience motivate him.  I have not recommended family members endure any extent of hardship they might experience with the life of an addict; there is a point where they must protect themselves and children.

It's understandable he is in the agitation stage.  That is both a process of early recovery and what we call Post Acute Withdrawal Syndrome, and what might be a way to protect the possibility of his using again.  With this uncomfortableness, if he experiences cravings and urges when he gets this money, he will likely use it for crack.  Sometimes a family member can offer to hold the money, but threats from the user are a real possibility if the family member doesn't give the money up with confronted.  I urge extreme caution here.

Since he has 19 days clean, he is off to a good start.  If he doesn't want to go to NA, and even if he eventually does, he should be in some form of treatment. It might be useful if you quote me or someone else, perhaps describing it as information you gleaned from the internet, that it is recommended that treatment continue for up to a year.  It doesn't necessarily have to be intensive, it could be just a relapse prevention group that meets weekly.  

In sum, he has to do at least 50% of the work here.  You and his wife can care, but he has to step up as well.  If not, I recommend a reconsideration of your intentions, based on how much harmfulness he is bringing to your home and family life.  He may have to experience even more consequences of his actions if he is to change.  I wish it wasn't the case, but I've witnessed this thousands of times.  I can tell people where their addiction will take them (and be usually right), but they may not comprehend what I say until they experience it themselves.

I hope this helps, and wish you the best.

Peter