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Family Intervention: Myths About Substance Use

I want to take a moment to address some of the challenges families may have when they are concerned about a loved one's substance use.

This topic is pretty huge, but just briefly, I would like to address some issues that come up when family members try to support someone they are concerned may be using substances.

When I am contacted by a family member, most notably, a parent concerned about their (adult) child I am struck by the sense of urgency in the request. I note that the person who is the center of the concern, is not the individual who has contacted me. I recognize that the family member reaching out is obviously in distress. I also recognize that the family member who is asking for support may also need some information in their attempt to provide their loved one with suitable support.

Here are some MYTHS I would like to dispel about substance use in general:

- any use of substances is problematic

- using 'softer' substances like marijuana leads to using 'harder' substances like crack or heroin

- the person using will lose their job, their life will fall apart

- if they quit using, their issues will be resolved

- it is impossible to socially or casually use substances without harm

- substance use will necessarily cause psychosis

- substance use will cause permanent damage and loss of functioning

- the person using is lazy, immoral, stupid (insert judgment here)

- the person using does not receive any benefit from their use

- if a person uses they have an addiction

- if we stage an 'intervention' the person will quit using...immediately

Now, this is surely an incomplete list of assumptions that some family members will make with regard to their loved one's substance use. I speak as someone who has extensive experience supporting individuals who have used heavy amounts of substances such as heroin, crack, and crystal meth for years, sometimes decades. I speak as someone who has witnessed individuals managing their substance use while having lived on the street for decades. I've supported folks who may engage in survival sex work and various methods of accruing finances to support their substance use. I work as someone who has witnessed the severe toll of inadequate systemic supports and strategies to address chronic and severe mental health issues which may coexist with heavy substance use. I've also worked with many folks who have maintained their employment, housing, and relationships while regularly using.

Here are some things I know to be true about addiction and/or substance mis/use:

- Substance use is often a coping strategy

- People invariably use substances for a reason

- Some of these reasons include, but are not limited to: joy, pleasure, fun, excitement, boredom, anxiety, depression, trauma, social connection, numbing out, dulling pain, energy, motivation and focus....

- Some substances are socially more acceptable than others that carry severe stigma

- Stigma around substance use is affected by classism, racism, ableism

- People at all levels of society and in all professions use substances such as cocaine, narcotics, painkillers, hallucinogens etc.

- People are capable of using substances in a manner which does not disrupt their lives

- People can socially and casually use substances such as crack and crystal meth

- The most damaging, harmful, and common substance misuse comes in the form of alcohol abuse (statistically proven: car accidents, death, illness, interpersonal violence, job loss)

- People will quit or reduce their using when they feel compelled that their use is causing harm they can no longer manage

- Reducing or quitting substance use can happen quickly, but most often over an extended period of time with ongoing support

Some suggestions for family members:

Approaching your family member with shame and derision will likely alienate them from you and increase their desire to use. Approaching them with inflammatory 'facts' about the potential consequences of their use (worst case scenarios) will show that person your biases and likely not affect their desire to change. You may very well see harm and consequences that your family member does not. You have every right to communicate this with them, however your approach is of the utmost importance. Approaching with curiosity, concern, and a lack of judgment will increase the chances your family member will stay connected and engaged with you. Offering to discuss ways that you can be supportive can be helpful. Setting your own boundaries around some of the harms or consequences you directly experience must also happen in a transparent and gentle manner.

Family members who are concerned often focus on the individual who is using as The Problem. However, they rarely engage in a reflective process themselves about their role in creating stress or distress, their expectations of the person, or how they participate in conflict in the family unit or relationship that may exacerbate the person's desire to use substances as a coping strategy.

Getting support for yourself by way of safe space to talk and process your feelings, concerns, fears, impacts on you, lack of knowledge and education are equally important and will improve your ability to offer support in a manner that is most constructive for everyone involved.

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