My cousin is deep in the throes of a heroin addiction. Most of the family has either written him off or are totally enabling him. Being a professional who is familiar with addiction, I know that the only way a person can get clean and stay clean is through internal motivation. External motivation can get you into treatment, but in the long term it won't last. My concern is he has neither. I'm so scared of losing him. I was going to write him a non-judgmental, non-confrontational letter and include information about local treatment options. My question is, what else can I do? I have very little support behind me, as most of the family doesn't understand the disease concept of addiction. Any thoughts or ideas would be extremely helpful.- Emily.
Jay Westbrook: First things first – it sounds as though your cousin is very fortunate to have you, Emily, in his corner. You are obviously caring and informed.
One approach to this situation is to simply wait for your cousin to “hit a bottom,” i.e., for things to get bad enough for him to find that “internal motivation” to which you referred. The problem with this approach is that with a drug like heroin, that “bottom” may very well be death. So let’s look at what else might be done.
Commencing with the family, it sounds as if your cousin has successfully manipulated the family into a triangulated posture. That means that half the family has “written him off” and the other half is “totally enabling him.” This allows a triangulation where each half of the family is focused on the other half of the family, judging them, and talking negatively about them amongst themselves. This suits the addict’s desire, for as long as they’re focused on one another, they are not focused on the addict and his life-threatening self-destructive behavior. Perhaps members of the family would be willing to go to either Alanon (www.alanon.org) or Nar-Anon (www.nar-anon.org) to acquire information, education, and support. These two groups have free meetings for the families of alcohol and narcotic abusers, where the attendees share their experience, strength and hope on how they’ve coped with a family member’s substance abuse, and in some cases, how they have moved them towards treatment.
Finally, it does not sound as though your cousin is willing to seek treatment based on internal motivation. Neither does it sound as though the family has the training and skills to transmit that motivation to him. My best advice to you would be to use the services of a trained interventionist to build consensus within the family and to bring your cousin to a willingness to seek help.
Good interventionists are highly skilled at overcoming the myriad barriers to entering treatment, especially in difficult cases such as this one. You can just Google “interventionists,” and you will find many to sift through. If the volume of the search results seems overwhelming, you might consider using either Stasie Kardashian(www.LifeLineInterventions.net) or Ed Storti (www.StortiModel.com). There is a recent Fix interview with Stasie, and Ed Storti is spoken of in that article. Whether you use them or not, you will probably find great value in reading everything on their websites.
I hope this information helps you help your cousin find his way to treatment.
G Jay Westbrook, M.S-Gerontology., R.N, is a multiple award-winning clinician (Nurse of the Year), Visiting Faculty Scholar at Harvard Medical School, speaker and author who specializes in both substance abuse recovery and End-of-Life care and is an expert in Grief Recovery©. He has both consulted to and served as a clinician in multiple treatment centers and hospitals, guiding clients through their grief, and working with them and their families on healing broken relationships. His lectures to physicians and nurses include trainings in When Your Patient is a Substance Abuser: Currently or Historically. He can be reached at [email protected]. Full Bio.