There’s a famous study about rats and heroin that shows why decriminalization and mental health intervention is the way to treat addiction. To summarize, they gave lonely rats the option of food or heroin if they hit a lever, and guess what they usually picked? Yep, heroin. Like humans, many animals need social connection. If you separate a rat from its family and friends and put it in a cage, it’ll self medicate and starve itself. What’s even more interesting to me is when they reunited rats with their friends, they were able to slow down the rate they hit that heroin lever and would go for the food again. This study shows why our society is plagued by addiction. Addicts are hurting, which is why they start using. It’s why all my friends did. And when their addictions take over, people abandon them. They lose the little support they had. At a time where they need even more support, from professionals as well as family and friends, they get less. They spiral down and find themselves on the streets doing anything they can to get their next high so they don’t feel sick.
My best friend was a good example of that. She was abused as a child, lived with an abusive boyfriend she hated, lost her brother and father to addiction, had inadequate mental health support, and she was heartbroken. She tried to kill herself. She met people who were already addicts and pulled her into the same addiction she swore she’d never fall victim to because it killed her loved ones. She hit rock bottom, and someone offered her heroin to ease the pain. Now most of them are dead, including her. Her ex boyfriend is an alcoholic and former crack and pill addict, but he had no problem calling her a junkie and shaming her for her addiction. When she died, she only had a few people she could talk to. Addiction makes people do terrible things like steal and lie, but their brains are rewired by the drugs. That doesn’t excuse their behavior, but my point is that they are sick. It is a disease, not a moral issue.
This doesn’t mean it can’t make people who love an addict angry. Sure, I’m angry at her for leaving her kids, and for throwing her life away. If you feel these ways about someone you love, seek therapy. As I have said, loving an addict is very painful. You often have to watch a loved one slowly kill themselves. You hope that they decide to save themselves, and you try to guide them to the tools and resources that can help them, but you can’t save them yourself. There is a lot of grief, guilt, and anger that comes with that. Counseling is important for everyone involved, not just the person addicted. If you are looking for a counselor for this reason, it helps to find someone who has specific certifications in drug and alcohol counseling. If you live in the US, look for someone that has the acronym CADC after their name (certified alcohol and drug counselor). LADC is also acceptable, but most counselors have advanced degrees.
Also, I feel I need to clarify this point: although it is true that people with severe addictions need support and hope, you don’t have to keep someone in your life if they hurt you. That is a personal decision. My friend who died from cancer this year had a tragic story with her ex husband. He became a heroin addict; she loved him very much but he stole and lied a lot. She had two children and didn’t want him around them while he was high and engaging in illegal activities. Although it hurt her, she had to divorce him. She told me about the regret she had, but she needed to get away from his toxicity. I absolutely support people who need to protect themselves from the pain that posple with addiction can inflict on their lives. He still had a mother who talked to him, unfortunately she also enabled his addiction and gave him money. He eventually overdosed and died. My friend never got over losing him, but she knew leaving him was the right thing to do for her family. It also showed him that his behavior was not ok, and she hoped it would help him change. I believe addicts need people who love them no matter what and can help them find hope and support, but this is tricky because they do a lot to alienate themselves, and in the end people need to protect themselves. This is why I am a big supporter of 90 day treatment programs and step down recovery such as sober living houses. These options should be available to every person with a serious and life threatening addiction. Sometimes family and friends needs to distance themselves and offer to be there if an addict shows a commitment to healing by getting the help they need. Sometimes people need to just cut them out of their lives completely. That’s ok. An addict, with the help of professionals, can learn to develop a new support system.
I always wished I could save my friend, but I knew I couldn’t. I knew that relapse rates were extremely high with opiates, and that she didn’t get the addiction treatment she needed to support her in overcoming an addiction that changes your brain chemistry. I used to tell her that heroin rewires your brain. She thought she could kick it cold turkey. She was tough, and she often dealt with the initial stages of dope sickness and physical withdrawals thinking she was out of the woods. She had many relapses. I asked her if she’d consider methadone or suboxone. She said no, she didn’t need that. I tried to explain to her why it would help her. But one day she admitted to me she wanted to die, and I knew things were really bad. She’d wanted to die for many years. Then the heroin took everything from her: her kids, her apartment, her self worth. Most of her family hated her. I’m grateful for her sister in law, who still accepted her. I think she has a lot of guilt because the night my friend died, she turned her away from staying at her house because she was high. She did the right thing, but survivor’s guilt can be difficult. Despite a few people, my friend was isolated and alone. (Her family hated her even in death, which is why I had to get involved so she could have a gravestone). Love is unconditional. Once you love someone, circumstances shouldn’t change that. You can hate their behaviours, you can distance yourself, but never hate them. If I truly love someone, I can never turn my back on them, even if I keep my boundaries to protect myself.
Loving an addict is painful though. If you love someone who is battling addiction, it’s important to get mental health support for yourself as well as them. Don’t give them money or enable them, but definitely offer them support. If someone with an addiction has burned all their bridges with those that love them, it’s important for society to show them there is hope. Doctors, nurses, therapists, etc need to give them lists of hospitals and treatment centers. If they don’t have insurance, they need to help them apply for medicaid. My state has amazing medicaid. My friend needed people to believe in her so that she could then take advantage of the help being offered to her. She needed that support so she could stop hating herself. I only wish she had found a therapist she connected with. It’s true that some people aren’t ready to change, and you can’t make them. Some people do want to die. But you can still let them know you care and that there are ways out. Sometimes I think I should’ve talked to my friend more than twice a year, but I know I did what I needed to do for myself and still let her know she was in my thoughts and wished her the best.
A lot of addicts don’t realize that a drug has damaged their brain, or they don’t understand what that really means. I’m sure many people have seen that stupid and useless, “this is your brain on drugs” commercial where they throw an egg into a frying pan. I’m not talking about drugs causing issues with memory and thinking. Marijuana causes temporary issues with this, but I smoked weed daily and graduated college with a 4.0 GPA. I’m talking about how heroin, coke, alcohol, pills, etc. destroy the pleasure centers in your brain. When your brain is constantly bombarded with artificial dopamine and other happy chemicals, it gets bad at producing them for itself. Addicts have a more difficult time finding joy and happiness in life as a result, long after they have gotten the drug out of their system. Then combine this with the fact that they often have pre-existing mental illnesses, and it’s a recipe for disaster. Opiates have such a horrible relapse rate because the psychological addiction lasts long after the physical withdrawals are gone. Opiate addicts are at high risk of relapse in the first year, and even for years afterwards. People with these addictions need constant, healthy social support and mental health treatment. They often need to change their social circles and lifestyle.
Therapists can help addicts find meaning in their lives. They can help them have realistic goals, not just for happiness but for self esteem and connection. They can help them learn healthy coping skills to manage stress and negative thoughts. It’s about taking someone with an addiction out of isolation and self loathing and giving them the support they need. It’s also about helping people learn mindfulness, and finding ways to notice small amounts of joy or happiness in everyday life. For example, I love going for hikes. I love the natural high I get from exercise, but I also love the beauty of nature. It’s where I feel connected to all things. Sometimes it’s about just stopping and noticing that you are ok, in the moment. You are breathing, and you’re ok. That’s hard for trauma survivors to do. The other day my daughter was laughing really hard at something silly I said. I was able to slow down and just enjoy the moment. Life is challenging and you can’t always be happy, but you can find contentment in moments like that. And of course it’s about learning to sit with your pain, which again can feel very overwhelming. Especially if you have had a lot of trauma and pain in your life. People with addictions often don’t have a lot of support, so sitting with pain can be hard. You need to feel loved and supported to take on the battle within yourself. This is why they need to be surrounded by healthy people who care and professionals that can help them slowly get to this point.
Different methods work for different people. I never liked the Alcoholics Anonymous model, but it helps some people. The important thing about AA and NA is the social support it provides. There are recovery coaches that are covered by most insurances or free services in most communities if AA isn’t the right fit. These people are trained peers, much like sponsors, who meet with you, text or call you, and help you through your battle with addiction. When I was in grad school, I took classes on addiction. I liked that my professor wasn’t pushing Alcoholics Anonymous or NA as the only way to heal from addiction. Like him, I very much agree with harm reduction and motivational interviewing. It means you meet an addict where they’re at. I find that if you try to force complete abstinence on someone who has used substances for years, it is generally met with resistance and then they’ll leave treatment. With motivational interviewing, you gently try to teach them about addiction and why it is harming them, but you don’t force them into abstinence. You assess their readiness to change. Some people aren’t ready, so you try to teach them how to stay safe and reduce the harm that their addiction causes them. You build a connection with them so they trust you, and you hopefully guide them to a place of change. Throwing someone in jail and labeling them bad just increases the likelihood that they’ll relapse. They taught us relapse prevention, and this also includes plans for relapse. They taught us to teach someone struggling with addiction to be compassionate with themselves if they relapsed. Again it comes down to self compassion. If someone hates themselves, they won’t try to get better. They hate that they’re in pain, but they also feel that they deserve to be. It’s an awful way to live. I truly believe the key to fighting any addiction is to treat the mental health issues that underlie it. I was able to quit alcohol even though I didn’t think I needed to because I had a few people who cared enough about me to point out I was more at risk for suicide and assault if I drank. My mental illness combines with alcohol to put me at high risk. That’s how I finally accepted that alcohol was damaging to me. They didn’t shame me or try to force me to quit. They just showed compassion and concern. I may not be abstinent from alcohol my whole life. I may decide to use the harm reduction method, which is different for everyone. For me, this means I won’t be drinking alone or with people I don’t know.
It’s true that drug and alcohol addictions are at epidemic rates in our society. These medical conditions definitely kill more people than viruses. These illnesses take away young mothers and fathers from their children and destroy lives in a ripple effect. Anyone with an open mind who learns about addiction will see that this epidemic shows us what’s wrong with our world. It shows us we need more compassion for people in pain instead of punishing them. It also shows us that mental health is neglected, and we need to do better. That’s a big reason why people talk about defunding police. More police and stricter laws do not reduce addiction and crime. If we actually allocate that money towards mental health, education, and invest in people, I guarantee you that we’d see addiction destroy less lives.