GoodTherapy | How Does Addiction Affect Relationships?

by St. John’s Recovery Place

How Does Addiction Affect Relationships?

Okay, let us be blatantly honest about this: addiction to drugs or other substances has never positively impacted a relationship. There are many costs associated with substance misuse and addiction: one of the greatest costs is relationships with friends and family. There are no healthy, functioning relationships maneuvering successfully through the realms of addiction and abuse.

Addiction Affects All Kinds of Relationships

Every relationship that comes face to face with substance abuse and addiction is bound to suffer tremendously. Romantic relationships where at least one partner is dealing with addiction likely include a great deal more conflict than most. Trust issues, hurt feelings, and anxiety can be side effects of substance abuse in a relationship — for either partner or for both. These issues slowly wear away at relationships, gradually leading to the dissipation of happiness that eventually leads to relational failures, and not just the romantic kind.

Addiction does not just hurt the person who’s battling it; it affects all aspects of their life, including family, friends, and lovers. Relationships will suffer because of substance abuse and addiction. Siblings grow angry with each other, mothers cry, fathers wrestle with helplessness, friends grapple with anxiety and confusion — all of them wishing they knew how to make it better. However, these relationships and personal hurts, can be healed with time, therapy, and the proper treatment.

Family therapy is an integral part of many drug and alcohol rehabilitation programs. Often, it is friends and family working together who convince their loved one it is time to get help. The trick is knowing how to guide someone to rehab without force.

How Do I Support Someone with Addiction?

It is painful to watch someone you love and deeply care about slowly pulled deeper and deeper into addiction. Substance abuse is painful not only for the person going through addiction but also for the people around them. We see our loved ones hurting, and we wish desperately to help them, without the slightest idea on how best to provide aid.

Our first instinct is often to intervene and lecture our loved ones out of anger and/or the desire to protect them from endangering themselves and others. But in the case of substance abuse, it is often best to take a step back and look at the whole picture before trying to help.

Pause Before You Take Action

If your love for this person is making you feel urgent, take a deep breath and let it also make you thoughtful. Before you jump the gun and decide to confront your loved one, you must understand that addiction is a delicate and complex issue. No one wants to be an addict, and, certainly, no one plans to fall into addiction. But many do become addicted, and sadly, some of them have a tough time coming to terms with that fact.

Before you talk to anyone about what is going on, you should take a little time to think about the situation and circumstances you are facing. This does not mean don’t confide in a close, trusted friend, but be careful about whom you choose to share your concerns with. Struggling with an addiction can be embarrassing for your loved one to admit; fewer people knowing the intimate details about their personal life may make it easier for them to transition into recovery. If it’s something everyone knows about, they may feel like all eyes are on them, just waiting for them to screw up. You’ll also want to be careful about whom you speak with because, although most people mean well, they can give damaging and detrimental advice that can harm your chances of successfully encouraging your loved one to try rehab.

Thinking Through the Situation

It can be a lonely and complicated road to intervention, but you can do it. And if you really feel as though you need to speak to someone about what is going on but want to ensure your conversation is confidential, you can always reach out to a therapist to ease some of the weight on your shoulders. They may even be able to provide you with some solid advice and resources.

The GoodTherapy registry might be helpful to you here: we have thousands of therapists listed with us who would love to walk with you on this journey. Find the support you need today!

Before you take the plunge into planning your intervention, take some time to consider these questions:

It may sound silly, but substance abuse shares many of the same side effects of stress and of other illnesses. It is essential to understand what is happening in your loved one’s life as best you can before you decide to take definitive action. This condition likely took time to develop; you’ll want to be sure you prepare yourself to speak with your family member or friend. You should not go into such a delicate conversation about change, addiction, and recovery like a bull in a china shop. Every person responds to criticism and concern differently, so you will want to keep that in mind as well before you stage an intervention.

Of course, there are many ways to do this. Since some of them may work well for you and your loved one (and others may not), be thoughtful and wise as you consider the possible ways to approach an intervention.

Planning an Intervention

First things first: know your audience! Yes, it is true that if your loved one is suffering from substance abuse and addiction, they are bound to be different from the person that you used to know. Thus, you will need to move forward with a working knowledge of who your loved one is now, as well as who they were before substance use took over their life. Once you are certain you are witnessing an addiction issue that must be addressed, reach out to other close friends and family of your loved one to see if they have noticed similar patterns and behaviors.

Get Support with Intervention Planning

Talking to a doctor or mental health provider about the issues you are seeing in your loved one and ask for their advice on your next steps. Begin to do some research on drug and alcohol rehabs in your area or further out. You want to be ready to recommend action steps.

Recovery treatment centers (RTCs) like St. John’s Recovery Place provide drug and alcohol rehab. Use our RTC directory to start looking at the options today!

How to Approach the Intervention

In the meantime, note specific moments when you notice your loved one is struggling with something or neglecting things they used to love. You can use this information to encourage them to seek something better, rather than to shame them. More often than not, people who are confronted in interventions are defensive. You don’t want to make them feel humiliated or accused or to give them the impression you are trying to coerce them into doing a specific thing.

You want to go into an intervention with as much knowledge as you can about substance abuse and rehab. You may not know exactly you’re your family member or friend is using, but you can become familiar with the basic structures of all addictions and substance use disorders to give your “arguments” sound foundational settings.

Planning an intervention can be overwhelming. There is a lot to consider, and you’ll need to talk to a lot of trustworthy advisors. Ensure you know as much about your loved one’s situation as you can. Have examples ready for them for you to bring up and look back on if they express interest, and most of all, move slow.

But What If It’s Urgent?

It’s true that in many substance abuse cases, time is of the essence. But you want your relationship with your loved one to be a pillar of support, something they can lean into as they begin to work through the process of accepting that they need help and eventually getting it in rehab. You do not want your loved one to shun your relationship because you spoke too harshly, made accusations and demands of them, or even issued ultimatums. Even though it is possible that tough love will be effective (which probably only is true in a small subset of the population) for getting them into rehab, what you want to be supportive, persistent, and loving, and seen as a reliable, listening ear. They will need you in their path forward.

This Isn’t a TV Intervention

You may need to hold a few intervention meetings with the same people where you all gently bring up the topic of substance abuse and recovery in the proximity of your friend. Be honest and upfront, but supportive and unforceful. Let them know you see them, that you want to help them, and that you are willing to work with them through the process no matter how long it takes. Slow and steady wins the race; a steady intervention system could be the key to getting your loved one into rehab on good, hopeful terms, rather than damaging or even losing your relationship in the fight about their need for recovery.

Be prepared to meet resistance and to highlight some of your causes for concern. You may not win them over in one session, but you can open the door for them to start becoming interested in recovery and considering what their lives may look like after they have beaten addiction.

It will not be easy. But it will be worth it.

How to Support a Loved One in Rehab

Good work! You did the research and took your time convincing your loved one they may need to try addiction rehab. You didn’t watch television shows on how to do it all, but offered your case with thorough thought, compassionate understanding, gentle concern, and strong, “I’m on your side” support. That is the way it should be done.

But your job is not over yet!

Now What?

Now that your loved one has enrolled in rehab, it is time for you to work even harder at this relationship. So, what can you do to support your loved one while they are in rehab? That can be a little tricky, but there are several ways in which you can show your support.

When it comes to inpatient rehabilitation, programs often severely limit the amount of outside exposure your loved one receives. Do not panic: This is a common practice aimed at helping addicts cull their desire to contact someone who can get them drugs or alcohol and encouraging them to build a new lifestyle for themselves. Even so, you may be able to show support to your loved one in recovery and continue working on healing your relationship by doing any or all of the following:

Be sure you’re following the guidelines of the rehab center caring for your loved one — the last thing you want is to throw off the progress they’re making. If you have other ideas of how you can encourage and support your loved one, run them by the rehab. Keep in mind that during the inpatient healing process, your loved one must remain on campus grounds as much as possible in order to help them separate themselves from their old abuse habits. Addiction is scary and overwhelming, affecting everyone in its path. But recovery can also be challenging for the individual and their loved ones alike.

This Is a Temporary but Necessary Step

The recovery process may not be easy for either of you, but keep reminding yourself of how far you have already come! The effort you are putting into helping your loved one heal and working on repairing your relationships is well worth the rewards. And planning for inpatient and aftercare rehab for your loved one may keep you sane through the whole process.

After Rehab

If you’ll be continually supporting your loved one post-treatment, consider brainstorming a list of sober activities and fun ways to release stress that will help make life feel “normal again” in anticipation of discharge from rehab. Prepare for the best but have a contingency plan in place for the worst. There will be good days as well as bad days on the path to healing.

It is essential that you be ready to face whatever challenges may appear. Have a support network for yourself — to celebrate the triumphs, give you new ideas, and help you cope with the hard days. You’ll naturally want to have a long list of things you can do to help your loved one to readjust, but the best way to provide support post-rehab is simply to be there for your loved one. Listen. Show up for this relationship. Be their adventure buddy, even if your excursions are only to Walmart or a coffee shop. And always show understanding and kindness.

Rehab centers like St. John’s Recovery Place are tremendous allies in the fight to beat addiction. Be sure to reach out to therapists who specialize in addiction who can help you help your loved one and may be able to support them post-rehab.

Lawyer sits across the desk with a client, explaining a court order

When mental health conditions contribute to violent or dangerous behavior, affect the way a person treats their children, or increase the risk of recidivism, a court may order treatment. A court may also compel treatment if a person is deemed a risk to themselves or others. State laws governing court-mandated treatment vary, as do the programs a person might complete as part of court-ordered treatment.

Research on the value of court-ordered treatment is mixed. Mandated treatment offers access to mental health care that a person might not otherwise have. Some studies suggest that people pursuing court-ordered treatment may be less motivated in treatment or less likely to be honest with clinicians. Because treatment is mandatory, however, court-mandated treatments improve treatment completion rates.

The benefits and risks of court-ordered treatment depend on the type of treatment, the client’s commitment to treatment, the skill of the treating clinician, and numerous other factors.

The benefits and risks of court-ordered treatment depend on the type of treatment, the client’s commitment to treatment, the skill of the treating clinician, and numerous other factors.

What Is Mandated Treatment?

Mandated treatment is treatment ordered by a court. A person might have to undergo treatment for a set period of time, receive an evaluation from an approved mental health expert, pursue treatment at a specific facility, or agree to treatment as a condition of probation or parole. A person might also have to receive treatment before receiving visitation with or custody of their child.

Some examples of mandated treatment include:

Emergency mental health holds

When a person is a danger to themselves or to others, a therapist, doctor, or other clinician may pursue an emergency hold. These emergency holds require a person to seek evaluation at a mental health facility—usually a psychiatric hospital. In most cases, the hold lasts 72 hours. After the initial hold period, state laws vary. States generally have some form of judicial oversight, which means that a judge must approve the hold after a set period of time. A person can also fight a mental health hold, usually by filing an emergency petition with the assistance of a lawyer. A person cannot be indefinitely held against their will without a court order.

Treatment in lieu of incarceration

In some states, a person who is found not guilty by reason of mental disease or defect may be ordered to stay in a psychiatric hospital. In this scenario, the person cannot leave until they have either stayed for a period predetermined by the court or the facility has determined the person may be released.

Drug and mental health courts

Many states now offer diversion programs through drug and mental health courts. These programs require a person to complete treatment and other requirements. Those who finish the program can avoid jail or prison time. In many of these programs, jail time is used as a way to induce treatment compliance. For example, a drug court participant who doesn’t show up for a treatment session or who is accused of drinking might be forced to spend a weekend in jail before continuing the program.

Mental health treatment as a condition of some other benefit

Courts often make mental health treatment a precondition to receiving some other benefit. For example, a person being released early from prison via parole may have to seek treatment to avoid being re-incarcerated. Likewise, probation agreements that keep people out of prison sometimes require specific treatment. In these scenarios, a person typically meets with a probation or parole officer on a regular basis to show they are meeting court-ordered treatment requirements.

A person might also have to seek treatment to gain custody of their children. For example, if child protective services removes a child from a parent’s home because of the parent’s addiction, the parent may have to seek treatment and remain sober for a set period of time before regaining custody.

Legal principles of informed consent and informed refusal mean that a person cannot be forced into treatment without a court order. Some states offer a brief exception for 72 hour evaluation holds. In this scenario, however, a mental health professional must believe the person is a threat to themselves or others.

A therapist cannot force a client to stay in therapy or demand that a client undergo certain treatment. Even when a person receives court-mandated treatment, they retain basic rights such as the right to be free of physical abuse. People who have been ordered to undergo treatment may want to consult a lawyer. A lawyer can offer advice about your state’s laws as well as your specific rights.

History of Mandated Treatment for Mental Health

Mandated treatment allows clinicians, judicial systems, and treatment facilities significant control over a client’s life. Historically, mandated treatment was rife with abuse. People sent to mental health facilities might spend years in those facilities, receiving a wide range of unsupported and potentially traumatic treatments. Patients might be forced to undergo electroconvulsive therapy, be restrained for hours or days, or be subjected to violent abuse.

State licensing boards now regulate mental health facilities and prosecute abuse. Abuse can and does still happen. In 2009, a report detailed numerous abuses at Kings County Hospital Center’s psychiatric unit. New stories often feature tales of abuse in prison psychiatric facilities.

People undergoing mandated treatment should review all of their options, especially if they are permitted to choose among several therapists or facilities. When court-mandated treatment requires a person to seek treatment from a specific person or organization, advocates such as lawyers and family members can be key. Loved ones and paid advocates should educate themselves about the reputation of the treatment facility and remain in communication with the person undergoing treatment.

Common Reasons for Court-Ordered Therapy

Some of the most common reasons a court might order treatment include:

Does Court-Mandated Treatment Work?

Like any other treatment, the effectiveness of court-mandated treatment depends on several factors, including the skill of the clinician and the willingness of the client to actively engage in the treatment process. Court-mandated treatment can and does work.

Drug courts, for example, may lower recidivism. One study found that, over 2 years, drug court participation was correlated with a drop in recidivism from 40% to 12%.

Court-mandated treatment may also offer indirect mental health benefits. Researchers have repeatedly documented the harmful effects of incarceration on mental health. When court-mandated treatment helps a person avoid jail or prison time, it may prevent their mental health from deteriorating.

Mandated programs also have some shortcomings. When clients sign confidentiality waivers, they may be less likely to share openly with their providers. When a provider has the power to incarcerate a client by reporting noncompliance to the court, this can compromise the integrity of the therapeutic alliance.

Mandated treatment can feel scary and intimidating, especially if you have never sought mental health treatment before. Mental health workers offering court-mandated treatment are licensed professionals just like any other mental health worker. They have a duty to protect their clients and to offer compassionate care.

In many cases, a person compelled to undergo mental health treatment can still choose their own clinician. Find the right mental health professional near you.

References:

  1. Coviello, D. M., Zanis, D. A., Wesnoski, S. A., Palman, N., Gur, A., Lynch, K. G., & Mckay, J. R. (2013). Does mandating offenders to treatment improve completion rates? Journal of Substance Abuse Treatment, 44(4), 417-425. doi: 10.1016/j.jsat.2012.10.003
  2. Do drug courts work? Findings from drug court research. (2018, May 1). Retrieved from https://www.nij.gov/topics/courts/drug-courts/pages/work.aspx
  3. Hartocollis, A. (2009, February 06). Abuse is found at a psychiatric unit run by the city. The New York Times. Retrieved from https://www.nytimes.com/2009/02/06/nyregion/06kings.html
  4. Hedman, L. C., Petrila, J., Fisher, W. H., Swanson, J. W., Dingman, D. A., & Burris, S. (2016). State laws on emergency holds for mental health stabilization. Psychiatric Services, 67(5), 529-535. Retrieved from https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201500205
  5. Yasgur, B. (2018, May 29). Court-mandated substance abuse treatment: Exploring the ethics and efficacy. Retrieved from https://www.psychiatryadvisor.com/home/topics/addiction/court-mandated-substance-abuse-treatment-exploring-the-ethics-and-efficacy
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