Having a loved one with a substance use disorder can be worrying, frustrating, and baffling. Addiction upends your priorities and distorts your reasoning. It’s hard to understand why someone with a substance use disorder does the things they do. It might be perfectly obvious to family and friends that they need help and they may constantly try to encourage their loved one to enter treatment, go to a 12-Step meeting, talk to a therapist, anything to get their substance use under control, and yet nothing seems to change. The fact is that things look very different from the perspective of addiction. The following are some common reasons people who need help for substance use don’t seek it.
For the vast majority of people who need help but don’t seek it—about 96 percent, according to the National Survey on Drug Use and Health, they just don’t think they need it. They don’t believe their drinking or drug use is a problem. This is denial and it can take many forms. One is that they really don’t think they drink or use drugs excessively. This is an easy mistake to make since people with substance use issues tend to congregate. There’s always one person in your group you can point to and say, “I’m not nearly as bad as him.” Since most of their friends drink or use drugs excessively, they have a high baseline and they don’t realize their own substance use is far above average.
Another common issue is that they don’t connect their substance use to problems in their lives. They may even insist that drinking or drug use is a solution to their problems. For example, they may see their drinking, drug use, or cannabis use as a way to help them cope with anxiety, essentially self-medicating. However, they don’t acknowledge the obvious drawbacks to this coping strategy.
Often, people with substance use issues attribute their substance use to temporary considerations. They may say things like, “I know I’ve been drinking a bit too much lately, but it’s only because work has been so stressful,” or they’ve been having a hard time at home, or their anxiety has been flaring up and so on. At this point, they’re scooching toward self-awareness but they haven’t quite grasped the extent of the problem.
Eventually, someone may get past denying there is a problem and instead deny they need help for it. They may say things like, “Yes, you’re right; I have been drinking too much. I’m going to cut down but you have to let me do it my way.” If someone says this, you need to, at the very least, ask for a concrete plan that includes some method of accountability. So if someone tells you they are going to quit on their own, you should ask for specifics like, “What’s your plan? When are you going to start? How will you know if it’s working? What are the consequences of not following through?” In other words, if someone wants to quit on their own, make sure they are really going to try and it’s not just a dodge.
The next stage in self-awareness is when they realize their substance use is causing them problems and they can’t quit on their own, but they just aren’t ready to get sober. This is perhaps the hardest thing for family and friends to understand. If drinking or drug use is causing you serious problems, why wouldn’t you want to quit as soon as possible? The answers are complicated by them typically coming down to the fact that substance use serves some purpose in their lives and they don’t feel like they can live without it. It might help them cope with challenging emotions or traumatic memories. Even if the consequences of drinking and drug use are bad, they may feel like they are worth it just to get through the day.
When many people think of addiction treatment, they think of posh rehabs where the rich and famous go after a public incident. While there are plenty of treatment programs that cater to the upper crust, there are many different treatment options available, ranging from free mutual aid programs to addiction and mental health counseling on a sliding scale, to outpatient programs, to intensive residential programs. What’s more, there are now more ways than ever to pay for treatment. Most programs take several kinds of insurance and recent changes in the law have made more federal funds available for addiction treatment. Addiction treatment centers typically have staff whose job is specifically to help people find ways to pay for treatment or to refer them to treatment programs they can afford. Don’t assume you can’t afford treatment. At least call a few programs and discuss your options.
Although we’ve come a long way in our attitudes toward addiction in recent years, we still have a long way to go. For example, a 2018 poll by AP-NORC found that a slim majority of Americans now see addiction as a medical condition that needs treatment. Unfortunately, that same poll also found that fewer than 20 percent of respondents were willing to associate with someone with a substance use disorder. It’s easy to understand why someone might want to keep their addiction secret. However, addiction is progressive and the longer you go without treatment, the greater the chances that it will get out. Addiction, by definition, is beyond your control. Also, it’s important to remember that addiction treatment programs are bound by the same code of confidentiality as other healthcare providers. No one has to know that you are getting help for a substance use disorder.
Finally, change is always scary. Someone with a substance use disorder may not feel especially good about their life but they at least know what to expect. Getting sober raises the prospect of having to live without their primary coping mechanism. And even if they believe life can be better without drugs and alcohol, they may feel the pressure of expectations. That’s a lot to deal with. However, change is inevitable. You can either do what you can to make life better or let it continue to get worse.
When you have a family member who is struggling with a substance use disorder, it can be really hard to understand why they don’t just get help. It seems so simple from the outside, but from their perspective, it’s a maze of conflicting motivations and fears. It’s important to understand where they’re coming from and help them navigate these doubts. At Steps Recovery Centers, we can help organize an intervention and get your loved one into treatment. We offer many treatment options across the spectrum of care. To learn more about our programs, call us today at 385-236-0931 or explore our website.