A Guide for Parents of Addicted Children Waiting For The Other Shoe To Drop

A Guide for Parents of Addicted Children Waiting For The Other Shoe To Drop

What is the best advice for parents of addicts?

Being the parent of an addicted child does not necessarily mean that you have a young teenage boy or girl hiding in their room using drugs. Unfortunately, you may find yourself dealing with this issue much later in life. It is not unusual for a parent to find themselves dealing with an addicted child who is in their 30s, 40s, or even older. The relationship between parents and an adult child who has struggled with addiction for a lifetime can be complex, with its ups and downs. And, it will vary from family to family, depending on the overall family dynamic. In some cases, if you are challenged with a recurring drug addiction problem over a period of many years, you will find yourself getting the “black sheep” treatment from your family. Tough love, anger, and blame will be a part of many family interactions. This treatment can last many years into recovery, even after active addiction and drug use have ended long ago. On the other hand, some adult addicted children’s parents are at the other end of the spectrum, giving their addicted offspring the “golden child” treatment. This means that no matter what happens, the parents shower their child with assistance, including help to get out of addiction-related binds. While tough love is often not the best way to go, cutting off and alienating your own child who needs to have a connection with you, always being there to clean up your child’s mess is not a good idea either. Full enabling behavior, giving in to every need of your child caught in active addiction, can be just as dangerous.

The other shoe has dropped, what do I do now?

I don’t know what the origin of “waiting for the other shoe to drop” is, but I can give you some idea of the meaning of this phrase. Imagine that you have struggled with addiction for a long time and you have just recently found hope in getting treatment. For example, if you are addicted to opioids, such as heroin or fentanyl, you may discover that medication-assisted treatment with Suboxone works very well for you. Imagine after a few months of treatment, you are feeling great, going through the daily activities of life without the mental cloudiness and constant obsessions that come with active addiction. You no longer have to fight the overwhelming compulsion to keep using opioids over and over, knowing that you are harming yourself and your loved ones. At a family gathering, you are approached by your parents who have a look of concern on their faces. Possibly, they are involved in a group support meeting, such as Al-Anon or Nar-Anon.

Why do parents have to keep worrying that you are going to use drugs again?

Before you have a chance to open your mouth to tell them how great life is now that you are in recovery, they start to tell you about their concerns of the other shoe dropping. Your parents are living with the stress, maybe a form of post-traumatic stress disorder, that you are going to go back out and use drugs again. Imagine a pair of shoes hanging by the laces from a tree or power line overhead. Then, one day, as you walk or drive by, you notice that one of the two shoes has fallen to the ground. The next time you pass by, you will wonder to yourself about that other shoe and when it too will fall down. It seems inevitable that if one shoe dropped, the other will follow eventually. If your years of drug use are compared to that first shoe, what your parents are worried about is the inevitability of the second shoe falling to the ground. They are waiting in dreaded anticipation of that final drug run that could last for years, bringing with it destruction and possibly death. So, while you may have found hope in addiction treatment, your parents may believe that they are only in the eye of the storm and the worst is yet to come. While this attitude can be frustrating to deal with, it is also understandable.

Drug addiction is a neurobiologic condition that affects brain structure and brain chemistry.

On the other hand, it is important that parents understand that their addicted children are struggling with a mental illness. Drug addiction is the result of real changes in neuroanatomy and neurochemistry. The brain is altered by drug use and addiction. And, drug use occurs for a reason. People who get addicted often have risk factors and reasons why they relied on drugs to help them get through difficulties in life. In the Narcotics Anonymous program, the basic text states, “Most of us realized that in our addiction we were slowly committing suicide, but addiction is such a cunning enemy of life that we had lost the power to do anything about it.”

Interestingly, there are connections between addiction and suicide.

Drug use and suicide attempts are deadly ways of dealing with intolerable pain in life. Yet, while addiction is a terrible and debilitating disease, and it often leads to death, it also carries with it an element of hope. Suicide is a tragic event with no hope for recovery. On the other hand, recovery from addiction is possible. Parents of addicted children should keep this in mind, that while there is life, there is always hope. If you are a parent with an addicted child, you may have heard about harm reduction. Harm reduction is a trend in addiction treatment that involves meeting the addicted person where they are and helping them to safely get through their struggle. Many people who are addicted are in a stage where they are not ready to stop, and, short of locking them away in rehab for months at a time, the best thing to do is to maintain a close relationship and provide life saving resources.

How can harm reduction help to keep your addicted child safe?

For example, imagine that you have an adult child still living with you at home. Your child goes to work each day and comes home to spend time with the family. Everything seems fine, except for the fact that you know your adult child is addicted to heroin and uses it every day. What should you do? Should you change the locks on the doors while they are away at work? Call their work place to report them for illegal drug use? Call the police and ask them to search your child’s room for drugs? You may be very angry and feel that your child has taken advantage of a good situation, being able to live at home, rent-free, working to get back on their feet financially, and now you discover that they are squandering their money and partying every day on illegal drugs. After taking some time to cool down, you then realize that your child is struggling with a difficult and scary problem that started out with self-medicating emotional and psychological pain.

Narcan is one of the most important harm reduction tools available to us in the U.S.

Harm reduction in this case can be as simple as going to the local pharmacy and buying a Narcan nasal spray kit. Narcan is a brand name product that contains the drug, naloxone. If you witness someone overdosed on opioids, you can spray Narcan in their nose to reverse the overdose. Another possibility is to provide fentanyl test strips to your child. If they are using heroin, they should be aware of the fact that much of the heroin on the streets is contaminated with the potent synthetic opioid, fentanyl. Being able to test their drug supply may help them to make a decision not to use potentially deadly, contaminated drugs. Additionally, you might want to consider offering to take your child to the doctor to start medication-assisted treatment. While there is a stigma associated with treatment drugs such as methadone and buprenorphine, they are proven to work in keeping people addicted to opioids alive and safe. The success rate of MAT far exceeds the success rate of abstinence-based treatment for opioid addiction.

Who should pay for addiction treatment?

After being a witness to the behavior caused by addiction, you may, at some point, have little sympathy for your addicted child. You might give them an ultimatum that it is up to them to go and find help. Unfortunately, the best and most successful treatments are rarely free and easily available. Still, it is possible to find programs that accept health insurance or offer government funded spaces at little or no cost. Often, these programs are strict in their practices, requiring daily attendance and compliance. If you are hesitant to contribute financially to your child’s addiction treatment, consider the alternative. Treatments such as Suboxone therapy are highly effective. The most common reason for Suboxone treatment failure is stopping the treatment too soon. Helping out your child, if you have the resources, with Medication-assisted treatment is not enabling behavior. You will be helping them along on the road to recovery and you will be able to maintain a strong relationship with your child. There is nothing wrong with supporting your child in getting appropriate medical treatment for addiction. You do not have to take the word of your local Suboxone doctor or clinic for why MAT is the best option for treating opioid addiction. Ask the experts in the field of addiction treatment. The top medical doctors in psychiatry and addiction medicine agree. Treatment with buprenorphine, the active ingredient in Suboxone, is the best solution to treating most cases of opioid addiction.

Can support groups provide help for parents of addicts?

When a parent brings their adult child into the office for addiction treatment, they sometimes ask me, “do you know of any Al-Anon meetings near me?” Or, in recent months, due to COVID-19, they are more likely to ask about convenient Al-Anon meetings online. Al-Anon meetings and Nar-Anon meetings are group gatherings for family members and loved ones of people with addiction issues. They are associated with Alcoholics Anonymous and Narcotics Anonymous respectively. One issue with these meetings is the language used to discuss people with substance use disorders. Calling someone an “addict” may be harmful to their self-esteem and self-image as they move forward in recovery. If you have been to a Narcotics Anonymous meeting, then you aware that people identify themselves as “addict.” For example, a man named Tom will say, “My name is Tom and I’m an addict.” Sometimes, you hear it switched around, “I’m an addict named Tom.” The second way of saying it is done purposely, to emphasize that being an addict is more important than your own name. In Alcoholics Anonymous, the tradition is similar. Everyone is expected to identify as an alcoholic. While there are people with other addictions who prefer to attend AA meetings, they will typically go with the philosophy of “when in Rome, do as the Romans do,” and call themselves an alcoholic even if they have little to no interest in alcohol.

How harmful is a name when you are trying to recover from drug addiction?

In my opinion, it may be harmful for some people to repeatedly call themselves an addict. It is a word loaded with stigma that can hold a person back in pursuing their dreams in life. Imagine, when taking on a new challenge or faced with an opportunity, always having that voice in your head, saying, “but your an addict.” However, if you enjoy Narcotics Anonymous meetings and you feel a sense of connectedness with the group and your higher power when you say the words, “I am an addict,” then, of course, you should ignore my opinion on the topic. For you, calling yourself an addict might be empowering. Everyone is different. Yet, I do believe that no one else has a right to call you an addict, whether you choose to or not. Especially the people in your life who want to, consciously or unconsciously, hold you back and prevent you from thriving and succeeding at achieving your goals. Maybe, you are a high functioning individual who, when abstinent for long periods of time, is highly successful. And, you might have siblings who do not have the same innate potential, but they do not use drugs, and they tend to do better in life compared to you when you are using drugs.

How can your family dynamics affect your ability to recover successfully from addiction?

Do you have a parent who likes to see all of their children doing well, not one child too far behind and not one child too far ahead either? What happens when you stop using drugs? If, after some time, you start to pull way ahead, excelling in everything you do and achieving great success, that parent will want to step in and even things out. Very likely, the parent will not be aware that they are causing any trouble. “Are you going to your meetings?” “Some people don’t need meetings, but some people do.” “Have you done your ninth step yet? I’ve been waiting for my apology.” “I have an addict in the family.” If you are a parent and your adult child is struggling with a drug problem, or if they are recovering from a drug problem, remember that words are important. It may help to reframe your perspective completely. Imagine that your child is a superhero with super powers. Their super power is the ability to succeed at anything the set their mind to. They have no limits to how far they can go in exceeding all expectations, and ultimately helping others. Yet, their power only works with they are drug-free, and it continues to grow as they remain drug-free for long periods of time. Instead of saying to your friends, “my son is an addict” or “my daughter is an addict”, what if you said, “my child is a super hero.”

What are you capable of when you finally leave active addiction behind?

Just like in the movies, or in comic books, it can be scary when someone close to you develops super powers, but it can also be exciting to see the good that they can do in the world. Instead of starting out every conversation with your child with a tone of concern and asking what they are going to do about their problem, you may want to simply keep the lines of communication open and let your child know that you believe in them. Let them know that you are there and ready to help when they are ready to ask for help. And, that you will do what you can to protect them from harm until they are ready to emerge from the darkness of active addiction.