An Allies member has her daughter living with her, which felt like a relief, at least at first. She had kicked her methamphetamine habit and completed detox and treatment. Now, they’ve slipped into a dance that doesn’t feel so great. She’s using less, but is substituting fentanyl for the methamphetamine. Mom sees that there’s a cycle that needs to be broken, but she wants to keep building on the positive aspects of their relationship. She’s also not sure if having her daughter at home is too enabling, but she promised to let her stay.
with Louise Stillman, MSc, Editor
Dr. Dominique Simon-Levine offers 9 important guidelines for our member, as well as guidance specific to her situation with her daughter. Dominique’s suggestions range from CRAFT-based communication, boundaries, and rewards approaches, to questions around Medication Assisted Treatment (MAT).
This question originally appeared on the Allies in Recovery Member Discussion Blog, where experts respond to members’ real-life questions and concerns.
Member: “Thank you so much for all you’ve taught me. Prior to this, I told my 22yo daughter to leave my home. She lived in her car for a month, lost 30 lbs. and was out of control. Finally agreed to detox and treatment. Finished detox and she refused further help. I promised I’d never kick her out again and adopted CRAFT and I work an alternate strategy. She has been home for 2 months now. Our communication and relationship are amazing; however, we have a dance we do that I need to break the cycle of.
She always comes home, or calls, and there seems to be a reduction in her use; however, in the past month she has switched from smoking methamphetamine back to smoking fentanyl. She does it in her room while I’m asleep or at work. I find foil and other paraphernalia.
She holds a full-time job and pays for her own car, so the CRAFT approach of “allowing natural consequences” is confusing for me. I speak to her, and she apologizes; or if she is triggered tells me I love searching her room and I’ve made a hobby of it — and yes, I do it daily and throw everything away. What is the next step? I’m at such a loss… I can remove my hugs and positive support as a consequence; however what else can I do?
I’m petrified about her OD’ing, I have Narcan Handy, but something has to move along here. Please help.”
*Since this article was originally published, fentanyl has become so widespread that it can take up to 4 doses of Narcan to revive someone. Learn more here.
You pledged to never kick her out again: not particularly CRAFT-y
Welcome! We’re glad you wrote in, and we see that you’re asking yourself the right questions and are seeking to shift this new pattern you’re a part of. Your main goal is to support your daughter’s recovery, yet the dance you’ve slipped into with her is no longer helping.
I know you don’t necessarily want to hear this, but you may have to consider reinstating to your arsenal the possibility of kicking her out again. I’m afraid this has to remain an option for any family member, when an adult child has set up in your house and is using fentanyl daily.
It would be great to review our blog posts on this topic under “Blog Categories-Asking a Loved One to Leave Your Home.” There are over 20 articles that provide tailored solutions for when a Loved One is back to active use in your home.
CRAFT is about adding rewards for non-use and discouraging use by removing those rewards (including yourself) and allowing natural consequences to occur. So let’s apply CRAFT to when your Loved One is actively using in your home. CRAFT encourages us to “actively enable non-use.” Try making your own list of possible rewards for non-use including only those rewards that are meaningful to your daughter. Module 6 on the Allies site (see snippet below) provides a brief tutorial on
Your home is your sanctuary
You’ve invited your daughter into your sanctuary, hoping this would help her stop using methamphetamine. It has, but now she’s turned to smoking fentanyl as a substitute. When you call her on it, she pushes back. The dance continues.
Your home is no longer a healing, drug-free zone for you or for your daughter, as you originally intended. It has become a haven for your daughter. She uses in her room, daily – a different drug, one that is also very dangerous. She pushes you away when you raise the question.
Is living with you enabling their substance use?
I’m afraid that right now, offering your house can be seen – through a CRAFT lens – as making it easier for her to use.
- she’s saving rent/food/utilities money, therefore can buy drugs more easily;
- she’s warm, dry and comfortable and doesn’t have to do much in exchange for these comforts;
- and then there are the inadvertent rewards of your company, and your presence.
Your house and you are huge rewards, and having her stay (unconditionally) as you have promised takes away large parts of your CRAFT tools, right? This could be seen as encouraging/enabling your daughter’s use.
Now what? When you’re stuck in a dance with your Loved One using at home, how do you get out of it?
We always come back to the tenets of CRAFT, which help us see through the smokescreens created by baked-in patterns and difficult and complex emotions. CRAFT would say, if your Loved One is using:
- Remove rewards;
- Remove yourself;
- Allow natural consequences to occur.
I understand the hope and relief that comes from ANYTHING substituting for Methamphetamine. Dang though, fentanyl!
I worry that this situation requires you to be on high alert in your own home. Fentanyl is the leading cause of overdose deaths! Before your heart sinks at the thought of needing to ask your daughter to leave, which goes contrary to what you promised yourself you would never do, here are some basic points about cohabitating with someone experiencing addiction.
9 guidelines to follow when your Loved One is under your roof
No matter what your reasons may be for having them at home right now (Covid-19, etc.) here are 9 guidelines that we encourage you to follow as closely as you’re able.
Write these down somewhere private, talk to a friend about them, or even read them out loud — whatever helps you commit them to memory and really integrate them into your approach.
- Rewards are reversible
A reward has to be quickly reversible; “home” is no exception, but very difficult (learn about the day bed and locker setup).
2) Research alternative housing options
Make a list for your Loved One. If you ask them to leave, where will they go? Start today and think through the options. A backup plan for housing should include as many options as you come up with including:
– all treatment options,
– temporary housing options (I’ll help you pay rent for a month or two…), and finally,
– shelters. Write down all the details – where, when, who to contact, etc.
3) Additional recovery supports are non-negotiable from the get-go
The decision to let them stay (again, define the probationary period) can only happen if they design and start showing up for a recovery plan. Have your Loved One design the plan from the community treatments you have listed in #2. Perhaps they come up with additional ideas on their own. You’ll know when the energy for recovery work is maintaining or waning. Don’t ask questions, don’t get any details, just leave it to them.
4) Your home is drug-free
It’s your home, you get to decide what you want, or don’t want, going on under your roof. You decide that your home is drug-free (keeping in mind that with moderation or harm reduction strategies, the line between “use” and “non-use” can shift.)
5) Come home once you’ve come down
If they’re high, they wait until they’ve come down before returning home.
6) Establish basic rules
Establish basic house rules as adults sharing a communal space. This includes showing respect for family members by checking in (for example by phone or text) when you are due home, etc.
7) A Family member administers MAT
If your Loved One is taking a medication, consider moving towards a family member doing the dosing each morning. The studies found that sharing the responsibility for taking the medication works. It’s a ritualized daily exchange. Perhaps there’s a scripted line or two that is repeated each morning: “Thank you for being here this morning and taking this medication to help with your drinking. I hope you have a good day.”
8) Remove all substances that could be problematic or tempting
Even if this isn’t currently a problem, be proactive and go the preventative route. Your house is free of alcohol and any substances that can be misused. This includes cold medicine, computer cleaner, hand sanitizer, and isopropyl alcohol, yes — things you can’t imagine ever wanting to swallow.
9) A loose social contract: a verbal or written agreement
Agree from the start what will happen if your housing (following the above framework) becomes enabling of your Loved One’s substance use, as it has in your case. The goal of “providing housing in order to support recovery” is made clear, but you both acknowledge that situations can flip (often a 180° about-face), and you will have a plan in place in case your home starts to look like “enabling your Loved One’s use”.
You are going to be looking carefully for these signs. Practicing CRAFT daily will help you be clued into signs and symptoms. If there’s a “flip,” you’re the one who’ll need to see it and move to plan B (ref: see #1 and #2 on this list). Plan B is about other housing options. Treatment, shelters, some other place than your home. You will consider providing room & board as long as they’re holding up their part of the deal.
Remember, this is a “loose social contract” – it’s not binding, it’s not a legal agreement. It’s about communicating with each other openly and laying down your plan in case the tide shifts. You can give them a heads up with a simple statement like this:
“If I see that being here has become a problem, will you at that point agree to accept further/more intensive treatment?”
And if this does become reality, you may say something like this:
“You are always welcome here when you aren’t using drugs. This is not the case right now, and I can’t continue to help you use, which I am doing by allowing you to live here. I am enabling your use. I must stop. I’m sorry. This is my part in all this.”
As far as your specific situation, here are some thoughts for your daughter:
- Daily self-help meeting – ideally before going to work (see our extensive list of online meetings)
- SUD therapist, look for training in trauma
- Psychiatrist for mental health assessment
- Medication Assisted Treatment – buprenorphine (Suboxone) or methadone; perhaps start with Suboxone and let the psychiatrist assess if methadone is needed.
- Nutritionist, exercise, mindfulness supports, yoga…
- House of worship??
And for you (let’s not forget that you will need to be super centered and solid if you’re going to be her rock in recovery):
- The eLearning program on this site: go through all modules again, and again. Get really good at every day interacting with your daughter using CRAFT behaviors.
- Attend a virtual Allies’ meeting with Laurie or Kayla’s online group for Allies in Recovery members.
We’re glad you wrote in, and we wish you all the best with this situation. Don’t hesitate to let us know how it’s going.
Allies in Recovery provides support and guidance on how to identify and cope with the flood of emotions you are feeling. The CRAFT method teaches you the strategies and skills to engage your loved one on a path to recovery. At Allies we provide you with information critical to understanding your loved one’s alcohol/drug addiction, and train you in the important role you can play in guiding them to recovery.
A membership at Allies in Recovery.net brings you into contact with experts in CRAFT and the field of recovery and treatment for substance use. Our unique, award-winning learning platform introduces you to CRAFT and guides you through the latest in evidence-based techniques for unblocking the situation. Together we will move your loved one towards recovery.
To sign up for our 7-day trial free offer to become a member of Allies in Recovery.net eLearning program, click here. If after your 7-day trial, you decide at any time it’s not for you, the membership fee of $59 is fully refundable.