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Reva, an executive at a California-based non profit, had been with her husband for six years when she found out he was very sick. Like with many serious diseases, Reva learned about it suddenly — and it impacted their relationship for years to come. However, unlike many patients, Reva’s husband had hid his illness from her for several months. He was an addict. And, while his addiction was as serious as other chronic diseases, the devastation hit on another level as well: $100,000 of debt accrued from feeding his addiction. Years later, Reva simultaneously filed for both bankruptcy and divorce.
Though addiction is extremely common (40 million Americans suffer from it, making it more common than heart disease, diabetes, or cancer) the path to recovery can be even more emotionally wrought than with other illnesses — perhaps because residual societal stigma of addiction keeps us from empathizing in the same way that we do for Alzheimer's or cancer patients. Or, maybe it’s just easy to stay pissed at the person who lied to you. Most often, an added layer of secrecy and deceit accompany addiction. Trust between loved ones is often destroyed, and deep emotional rifts are firmly in place by the time treatment is sought out.
Reva never suspected that her husband, a recovering alcoholic active in AA, was hiding a Vicodin addiction from her. While collecting sobriety chips, he also fell under the grip of opioid addiction after dental work garnered him some prescription meds. Lies and financial hardship quickly followed.
It’s no surprise that most addicts aren’t getting the help they need. The average person (be it the addict or the partner) isn’t equipped to deal with this kind of illness. And, if an addict has already burnt bridges with his or her support system, or the supporters remain totally in the dark, then the help so desperately needed can be hard to come by. The result? Just one in 10 of those who suffer from alcohol, illicit or prescription drug abuse get the help they need, according to the National Center on Addiction and Substance Abuse at Columbia University.
And, since American men develop addiction or substance abuse issues at more than twice the rate of American women, according to the 2010 National Survey on Drug Use and Health, oftentimes, it’s us ladies who are unexpectedly thrown in the role of supporter. So, how do we help the person you love (especially after being lied to and taken advantage of) without enabling their addiction? And, at what point is it best to cut your losses and end the relationship?
There’s no one-size-fits all treatment plan for addiction, and the natural instinct to nurture someone we care about may inadvertently cause more harm. For example, taking on an addict’s consequences (i.e. covering for a boyfriend when he’s too effed up to go to work) might feel like a helpful move in the short term. However, it robs the addict of their ability to see the true effects of his or her behavior.
Since most of us don’t know how to help, the first thing to understand is that supporting an addicted loved one requires educating yourself. And, that often involves talking with a psychologist or counselor, or joining a support group for family and friends. It’s an active role that requires more time and commitment than, say, that of a loving supporter who keeps the fridge stocked with fantastic virgin drink options. Which can be kind of a head scratcher: Shouldn’t the person with the addiction be the one getting help?
Well, yes and no. “Research shows that as soon as family members or significant others are engaged in and part of the treatment, the odds of success go up big time. It’s literally part of the process. If you think that sending the person to treatment will take care of all of it, it might. But the odds are a lot lower than if you’re involved. Part of that is because the partners who are more involved and have more empathy and compassion and more at stake,” says Dr. Adi Jaffe, director of research, education, and innovation at Beverly Hills-based Alternatives Addiction Treatment, and addiction educator at Cal State Long Beach.
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Jaffe adds that the level of involvement doesn’t necessarily have to be totally immersive up front, but being ready and willing to get involved in the addict’s treatment can prime a couple to unpack deeper issues, like behavioral patterns that play out in the home and trigger an addict’s compulsion to use. Treatment professionals are now careful to consider environmental causes as well.
“We’ve learned more and more over the last 50 or 60 years that it’s almost impossible to tease apart the relationship between the individual and the drugs or alcohol and their environment. More and more studies have shown us that the environment in which a person uses and lives has a massive influence as to whether they even start using drugs and/or develop a problem with drugs,” Jaffe says.
“There’s no way to ignore that [as a romantic partner], you’re a very significant part of their environment. Without placing any blame on the partner, if you’re part of the context in which there is a problem, it would make sense that you need to learn about what, in that environment, is reinforcing the drug use or making things harder, so you can help them along.”
Oftentimes, learning about that environment can reveal behavioral changes needed in both partners to help overcome the judgment, shame, eggshells, and elephants that are revealed when an addict stops using, but tension in the relationship still persists.
And, while it’s clearly helpful to take an active role in your partner’s recovery and consider how you might be contributing to a healthy or unhealthy environment, it’s important not to forget about your own needs in the process. Support groups specifically designed for loved ones of addicts, like Smart Recovery Family and Friends (a secular alternative to 12-step programs) or Al-Anon (a 12-step program created for friends and families of alcoholics) can play a particularly helpful role, as Reva discovered.
“For me, as someone who has been impacted by this disease, Al-Anon was an extraordinarily helpful program,” Reva says. “Not that I ever played the victim, but it helped me come to that place of not taking it personally. Addiction is self-motivated and self-fulfilling. It doesn’t matter how much they love you or care about you. The addiction is primary and comes first when in its full blown state. And, that’s ok. I don’t need to try to grab the neck of this dragon and control it. That was really helpful. The program helped me focus on myself instead of that other person, and think, ‘What do I need to take care of myself, to notice these things, to set boundaries and have a healthy life and still come from a place of loving this man?'”
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One technique that Al-Anon uses to help participants get out of the all-about-the-addict mindset is to put your core needs first. “The suggestion is offered that if you find yourself feeling too physically hungry, angry, lonely or tired, it’s best to drop everything else and take care of that primary need right away. Because that can give a sense of inner balance and well being that enables you to trust your own judgement as opposed to reacting out of a sense of panic,” says Pat Q., Associate Director of Public Outreach for Al-Anon.
Of course, there is a strong caveat to consider when working to support an addict’s recovery: No matter how motivated the supporter, the opportunity for recovery doesn't exist if the addict doesn't want to get better. Over the course of a year, Reva’s husband repeatedly rejected support and plans to get sober. He just wasn’t ready to make a change, which prompted Reva to leave the relationship. And, as Jaffe points out, the refusal to work on a relationship can be a dealbreaker whether addiction is involved or not.
“If one partner isn’t willing to work with the other on the relationship, there are going to be issues, whether there are drugs involved or not,” he says. “If you’re really done your best and this person is still not willing to get help, then the next question to ask yourself is, ‘What am I getting out of this, and am I taking care of myself?’”
When and how to leave a relationship with an addict who does not want to change his or her behavior is a complex question. It can be tremendously difficult to make this choice, and those who make it often benefit from support.
But, if your loved one is committed to getting better, and you both work to calibrate behaviors, environment, and lifestyle, your relationship stands to gain more than just escaping the damages of addiction. The process can see you emerging with a stronger relationship and deeper connection with one another than ever before.
As Reva says, “There are masks that addiction wears. There’s the self-medicating mask, the it-looks-good-on-the-outside mask, there’s the I-just-do-it-occasionally mask, the I’m-deep-and-dark-into-this mask. It appears many different ways, but underneath it is the same — it’s addiction.”