Helping the Addict You Love The New Effective Program for Getting the Addict into Treatment

Introduction When I served as the director of Bellevue Hospital's detoxification ward, I often met patients whose lives had been destroyed by addiction. I particularly remember one young man who, in addition to his heavy use of alcohol, smoked more than $100 worth of crack cocaine every day and had been admitted to the hospital in a drunken stupor. Given the life-threatening nature of his addiction, and our experience with individuals with similar stories who had died, our treatment team gave him the "full-court press." In addition to medications, counseling, group therapy, and Alcoholics Anonymous meetings, several of us sat down with him and his family and tried to convince him of how much danger he was in, and how important it was for him to change his behavior. But despite our entreaties, he left after four days, telling us that he appreciated our concern and that he would try to cut down his alcohol use, but that he had no intention of stopping his crack cocaine use. In our staff meeting, we agreed that we'd failed to reach this young man, and prepared ourselves for his readmission or news of his death. Much to our surprise, however, the next we heard of him was several months later when he showed up, with several others from a local AA group, to lead a meeting on our ward. He told us that after leaving our ward and using crack cocaine a few times, he'd decided to try a few of the relapse prevention techniques we'd taught him and got his best friend to go with him to an AA meeting. From that modest beginning came full-fledged sobriety and the subsequent positive changes in his life. Ever since then, whenever I find an addict who seems similarly "hopeless," I think back on my own hopelessness in that situation and how misguided it was. It reminds me that no case is hopeless and that the techniques for getting an addict into treatment -- both those professionals use and those families and friends can use -- are more powerful than we sometimes realize and can have long-lasting effects. I wrote this book because, as a psychiatrist who treats addiction, I've had many similarly difficult and sometimes painful experiences with the friends and families of addicted people. Very early on in my practice I realized that although I could give some solid advice to my patients (such as encouraging them to join a twelve-step program), I had no such recommendations for the often frustrated family and friends of those addicts who would not even consider any kind of treatment. But over the fifteen years that I've worked in this field, I've developed a method for guiding friends and family to help get their loved ones into treatment without getting hurt themselves. That method -- which I call "Creative Engagement" -- is based on what I've learned from my teachers, what I've read in the psychiatric literature, and what I've found works best with the hundreds of patients I've treated. And I've written this book so I can share it with you. Creative Engagement means, first, being willing to use every available strategy, even those you may be uncomfortable with, to convince your loved one to go into treatment. And, second, continuing to engage with the addict -- to hang in there -- rather than leave the addict to his or her own devices. That can mean trying to push him or her toward a program, looking for ways to help the addict avoid the dangers of the substance use, or simply being there to help as he or she suffers with the addiction. Creative Engagement, then, is essentially about focusing on solving the immediate problem of getting help for your addicted loved one, doing whatever you can to resolve it, and continuing to work on it until you have. But in order for you to understand why I feel that Creative Engagement is such an effective method, I need to tell you something about how I think of addiction, some of which, frankly, goes against the conventional wisdom. TWestreich, Laurence Michael is the author of 'Helping the Addict You Love The New Effective Program for Getting the Addict into Treatment', published 2007 under ISBN 9780743292139 and ISBN 0743292138.