Expert: Caroline West - 2/21/2011

Question
QUESTION: Hi Caroline, this is Michele again.  I have the addicted family member who is not making progress.  I last asked you about suboxen and you gave me some very helpful information. After reading your answer I was committed to supporting his prescriptions for his physical and mental health.  Unfortunately, our status has changed again.  My husband and I agreed to send him to another half way house since he got kicked out of the last one. We also agreed to make sure he has food and, most importantly, his prescriptions.  He agreed and seemed to be very positive about it.  The day he left our home and was supposed to go to the new half way house (that he picked out) he went to a motel and has been there since.  We know where he is because we can see his car.  This was approx. 5 days ago.  He has, in the meantime, talked to my sister and borrowed money from her under the premise that he was leaving town for a job.  Definitely not the plan that we all agreed on.  Part of me says, "be patient... this is how addicts are.  What did you expect?"  The other part of me says he is not committed to sobriety if he will not accept free shelter, food and prescriptions.  I have provided that for the last 3 months (and others did before me) and he is not making progress.  I understand that 3 months is not enough time to be "cured" but not making progress is discouraging.  In one of your last answers to me you talked about enabling.  I think I have come to the conclusion that our family cannot help him on this journey.  We have all tried and not just with money.  I have phone numbers and addresses of homeless shelters and free rehab programs to give him, if I ever see him again.  I used to think that cutting him off was the easy way out for me. Giving him money to leave town would be the easiest thing to do and the most unhealthy thing for him.  So I prayed and prayed and said to myself, "You have to tough this out.  If you want him to recover, not just go away, then you have to be committed to the process."   I thought that if I would just be patient and provide the basics of life for him he wouldn't have to worry and could concentrate on recovery.  If I could just help him get set up in a rehab program, he wouldn't have the added burden of searching that out.  I know I cannot fix this, I really do.  I just wanted to do my part as a human being also someone who tries to follow God's teachings.  I was a little nervous about the money at first and guess what?  I got over that and was OK with providing for him. I know this is not really a question for you, but would appreciate any observations you have on my perspective.  If you feel you have said it all already, I will understand. I know that I have to make a decision and stick with it and you have been truly instrumental in providing an objective, expert opinion.  Thank you so much.

ANSWER: Hello Michelle.

I'm sorry to say this but he is not ready to quit. You have done everything for him but you know the saying that 'You can lead a horse to water but you cannot make it drink' I think that applies here.

Just to point out about prayers and God. God doesn't always make easy paths for us to get to the point we want to reach. Most of the time he makes it tough for us and maybe,as you have tried everything in your power to help your relation and it hasn't worked, then it could be God telling you to try something else,to have faith and to realize that what you have been doing is not working and to go down a different path with your relation. That could be taking a step back and no longer enabling him which is what you have been doing and it hasn't worked. He is still not committing to any plan. You have tried your best. That's my thoughts on it.

Yes I have said a great deal in our communications and I will always be around to talk to,but you have got to say to yourself that enough is enough and I think it is. It's not wrong to put your own needs first. You have put his first and it has not worked,so put yours first,what's best for you and what's best for your family and know that it is not an un-christian thing to do,it's a sensible thing to do and you are not being selfish,you are trying a new path and that's all. It may well be what your relative needs in the long run so please do not feel guilty. There are many paths to the same destination.

I would love you to take new steps regarding this situation and it saddens me that you feel afraid to do so,but trying something else is needed as the same which you are doing is not working. He is not ready to quit but that is HIS problem. At some point every addict has to take some responsibility for themselves and with all the help you are giving him,he is not.

I hope you find the strength and the courage to try a different course of action with him otherwise you will continue to go round and around in circles. And please know that I am always here if you need to talk. All the very best,Caroline.

---------- FOLLOW-UP ----------

QUESTION: Sometimes we just need to hear from someone we don't know; someone who can be objective and not tell us what we want to hear.  I didn't know this was going to be so hard.  We have never been very close and I didn't think I would feel so obligated.  I have had such a hard time because he is another human being who is so lost and pathetic. I am especially disturbed when I think about his life, what he is doing in a dingy motel room, how he has no family, not one single friend, no one to talk to,almost no money, and crummy health.  At some point I snapped out of it and realized he doesn't think like me.  This is not causing him pain the same way it is me. While I know he is in tremendous pain, he is not processing it the same way I am.  If he was in pain the same way I am in pain, then something would change.  I now believe that there has always been some sort of mental illness, maybe bipolar disorder, but why try to diagnose?  I can't change any of that either.  

As per your advice I am taking a different path.  My new direction is zero financial support.  As I said earlier, I will provide him with safe shelters and/or rehab centers but no more half-way house or staying with us even for the night.

Thank you for your support and telling me what I need to hear.

ANSWER: Hi Michelle,

I hear and feel your pain,I really do. And I totally understand your viewpoint regarding how you are viewing him, but you are absolutely right in what you said that he does not 'think' like you, addicts don't. The way you view him, I can guarantee you that he does not view himself like that which you also said and if he did, then he would be accepting your help and doing something about his life. One of every Addicts most common trait is taking NO responsibility for their lives or their actions. They cannot see what they are doing to themselves let alone what they are doing to those around them that care. Addicts sink so low but they cannot even see that for themselves. Some even think that they are the ones that are ok and it is in fact everybody else that has the problem-really.

One thing I do want to pick up on is what you said about him maybe having a Mental Health Problem. I know this is asking a great deal (and this is where my empathy/sympathy buttons get  pressed) he may need to get that diagnosed and given specific medication for it. If he does in fact have a Mental Health condition and it goes untreated, he will have no chance whatsoever of getting better by himself. I am so sorry to ask this but is there any way that he can be assessed by a Psychiatrist? If he can, then he can be given medication, which is in a totally different category to Opiates, and that will help sort his mood out and may be what could help him function a bit better. Those left with untreated Mental Health issues have little hope of recovery. I am not saying that if he has got an illness and he gets the appropriate medication for it that his drug problems will go away, but it will help him function a bit better and then it is his choice if he stays using drugs.

Again I am sorry to put this on you, and it is your decision and maybe the care provider he is under can get him assessed-do you think that can be arranged? I know you care about him and I know the way he is pains you a great deal, but do you think you could try this? Then leave that as the last thing you do for him. Most Addicts do have Mental Health problems too and I know how debilitating it is if left untreated. Which came first-the Mental illness or the Drugs? it is never easy to tell, but do get him assessed if you can and please will you let me know how it goes?

I know all this has been very hard on you and your family, but I am glad that you have been able to come to a resolution regarding the situation and how you are only now going to help him. I am glad that I could help. And once again, know that I am always here if you ever need to talk again. All the best,Caroline.

---------- FOLLOW-UP ----------

QUESTION: I would definitely be willing to have him assessed but he won't go.  The only way that I could see him going to a psych would be to get meds.  He loves meds of any kind and wants them for everything (headache, heartburn, digestion) I know his body is a wreck and they probably do help, it is just his enthusiasm for any kind of pill that is different.  I talked with my family about having him assessed last summer when it occurred to me that he is so illogical that this can't be on purpose.  While we all agreed that there is something wrong with his decision making ability (everything from immature jerk to pathetic) I was in the minority when I suggested that maybe it is mental disorder.  My family didn't rule it out, they just didn't believe that he is ill.  When I mentioned bi-polar to you I was really using it as a general illness for most addicts not necessarily for him. I do not see the extreme highs and lows usually demonstrated by those with bi-polar disorder. I do believe that he is extremely narcissistic, but I can't say if it is pathological.  Have you ever heard that individuals stop maturing (emotionally) around the time of the onset of addiction?  Dealing with this person is like dealing with a 14 yr. old boy.  He is smart enough to maneuver a conversation but so irrational that it is almost impossible to make progress.

All of this is moot anyway because he left town yesterday.  He guilted my sister into giving him money to leave town for "the job."  It has been 24 hours and no one has heard from him and I'm not sure that anyone cares.  He picked on the most fragile member of our family (a struggling alcoholic) to give him money.  He actually said to her, "Remember what it felt like when you were out of a job?  Just think about it (giving him money)"  She told me that after she gave it to him she was visibly upset and he said, "now don't be so upset that you go and drink."  This is what I mean my narcissistic.  He used her for his own gain.

I can't say that I am so angry I'll never talk to him again.  I think I am beyond that.  I am not even mad anymore, I just feel done.  Also, when he was using me it was easy for me to believe that I was in control because I never gave him cash.  I wasn't angry at him for how he was trying to manipulate me.  I am much more angry at him for how he has used our family.  I know my feelings will change but for right now, I am glad he is gone.

Answer
Hello Michelle.

It's unfortunate that things have worked out this way. The main thing I want to tell you is that he is no where near in the place needed to get free from drug abuse,he doesn't even come close. You've tried your best. Mental Illness (and there are several types,forms and degrees of them out there) usually goes hand in hand with Drug abuse. So many people I know who use/have used,have been diagnosed with something. But if he won't go and get assessed,then no one can be sure of what his primary problem is. I do think it was wrong of your family to disagree with you that he may have a Mental Illness. Like I said,it goes one with the other in most cases. Family are not always the best people to turn to but I admire how much time and effort you have put into helping this young man.

Yes most addicts like their pills,the more the better. Do you see now just from that,that this young man is not ready to quit? Plus what you mentioned about his maturity levels. There is a very popular school of thought that say the age at which the user began taking drugs,emotionally they are stuck at that age. And yes,they will act like petulant teenagers.

My advice to you now Michelle is to just let him get on with it. You have done your best for him for this stage of his life,and he may come back to you for help again at a later stage,where by then he may have had enough time to decide for himself that he needs to address his issues. He just isn't ready yet. Don't fully abandon him,but no more enabling;let him find out for himself how hard it can get. And you must allow him to take responsibility for his actions. God forbid anything happening to him,but he knows the risks,he knows the dangers and it is his choice to use and refuse help right now. And hopefully there will come a time when he is ready to accept help,just not now as it doesn't seem to be doing him any good. Which,again,is not your fault.

Let him hit his 'Rock-bottom' which every addict has to go through where they are at there lowest and most desolate and they surrender and accept help. Let him reach that stage by himself,and it will be then, and only then,he will be ready to finally accept help. Who knows,he may well be looking for that job,whether he lasts at it no one can say,but let him try.

Like I said,don't fully abandon him,always be there for him,just know when to pull back and learn to see the truth of what he is up to each time he returns.

Well,I hope i have been of some help. I'm sorry I cannot give you a brighter picture-I would if I could. And know that I am always here if you wish to talk some more. You have made the right decision Michelle. Take care,Caroline.