Even After the Addiction is Resolved…You May Need to Do More

AiR member mbir is concerned about her daughter, whose recovery from opiates has been shaky, and who herself has a young child.
 

"My daughter has been in recovery, on methadone for almost 2 years – in and out of treatment for 10 years. Still not seeing much improvement. Not completely sure if she's going to the program. Along with other family members I am concerned about her behavior. Her program can't give me any information because of confidentiality. She has a child that I need to know is OK. Any ideas on how to approach this or get help?

Trying to talk to her puts her into a screaming and yelling state. Then she won't let me see my grandchild."

I just this week spoke to a father I have stayed in touch with for over three years. Year one was spent helping him apply CRAFT strategies in response to brief periods of sobriety followed by horrendous relapses. After about a year of this, the young man followed through on a program’s suggestion he go live in a three-quarter sober house, and his active substance use almost entirely stopped. But, his behavior was still concerning. It was as though the young man was frozen in place, unable to keep a job, he was sluggish in his demeanor, we wondered if he was depressed. He was clearly scared of the world while also feeling quite entitled, like no job or situation was good enough. His parents were relieved by the sobriety but still upset and worried about their son’s future.

I heard from the father this week. He told me their son was now on a much better course. He has a job that he likes and is doing recovery work. Most notable, his brother recently allowed him to take his nephew out skating. That his son had progressed to the point where his brother would entrust him with his child just felt miraculous to our client.
 

There is Often More Work to Do After the Drug Problem is Resolved

Clearing up the drug use is a first, essential piece to resolving the problem, but for the vast majority it isn’t going to be enough. I asked this father what had happened to make his son seem to finally just snap out of it. There was no decisive moment, he explained, it has been a slow bumpy march towards occasional AA, a healthy home, and, finally, a job that seemed right for him. It also helped that his family stayed the course and understood what was happening, while seeking their own support for coping with the situation.

Your daughter is now on methadone, which is probably helping her curb her use. After two years on methadone, one would hope that she is stable and drug-free. But this may not be entirely the case. Methadone providers have little recourse for clients who use other non-opioid drugs, like pot or cocaine.  I recently spoke to a large methadone provider in Eastern Massachusetts who told me that only 40% of their clients comply with the mandated once-a-week therapy. Your daughter may be using occasional opioids, but if she had stopped going to the clinic all together, you would know it. She would probably quickly regress to daily drug use and her behavior would be much, much worse.

I have written elsewhere on this blog about the limits of medication-assisted treatment, most recently in this post:
 

Your Role Now is to Help Her Get Additional Support

Accepting that methadone may only be a partial solution, your family's work now is to gently shepherd your daughter towards additional treatment. The way to do that is to redouble your efforts at better communication and responses to her as laid out in the modules on this site.

You want to partner with her, not dominate. You want to get your frustrations addressed elsewhere and not aim them at her. There is a child involved, which makes things critical. Hanging back and making a rule of approaching her gently may feel intolerable, given your need to know about and to see your grandchild.

Now that your Loved One is mostly sober, apply CRAFT to the next layer of difficulties. Additional treatment is the long-term goal. The short-term goal is for you to apply CRAFT in order to stay in your grandchild’s life.

What is the stance of someone using CRAFT?  From Module 8:
 

• You create that bridge between the two of you.
• You empathize and show respect.
• You stop the negative talk, add in positive talk, and listen to what your Loved One is saying.
• You make requests.
• You don’t dominate.
• You take care of yourself, which helps you stay calm and patient.
• And you understand that getting sober and clean is a process.

Doing even only a few of these things to the best of your ability will help your Loved One open up to you, to be more likely to say when it hurts, and to ask for help. There will be less shouting and fighting, and you are more likely to keep seeing your grandchild.