Family Dynamics: Multi-Generational Addiction

Desperate Aunt has experienced great success through the CRAFT method—both of her nephews struggling with substance use are currently in recovery. But other family members are still struggling gravely and she's afraid the new developments may destabilize them…

Thank you Dominque, Yes, one of my nephews went to inpatient, but they don't offer a full comprehensive care program with her circumstances. The only one I have found is Adcare, but availability is low. My brother has come farther and acknowledging somewhat that he has no control but regretfully won't attend a meeting for himself. Last week his wife OD'd twice within 24 hours and the first time, they sent her home in a cab, alone, without his knowledge. The second time, he and his wife's sister convinced the hospital she is currently in, to keep her and she is now in the psych ward, where she is scared, angry and still in denial that she needs in patient care. Just this morning, cried to me on the phone that "she would never do this to her husband if the roles were reversed". I am not a professional and logically understand I can't control this, and am doing my best to keep it together for myself. My brother (her husband) can't bring himself to section her and won't throw her out on the street, as some have suggested. I don't have all the answers and am trying to stay positive and focus on the fact that her two sons are still sober and we as a family are supportive to them to continue their road in sobriety. I can only imagine how hard it is for 2 sons to deal with this and stay sober. I am grateful that they are still sober. I pray every minute of everyday that, yup, back to feeling fearful of her dying. From what I've learned I need to leave it up to the professionals, but how can professionals send her home in a cab, alone and in a wheelchair?

Your sister-in-law overdosed twice in 24 hours. This is terribly frightening for everyone, and yet the emergency department chose to send her home in a cab alone the first time. She is now in a psychiatric hospital unit after relapsing a second time, very upset at everyone that she is being held against her wishes. Your brother and his wife’s sister convinced the hospital to admit her.

We have followed your story for well over a year. You have been instrumental in helping your two nephews engage into treatment. Their recovery remains strong yet you are worried this crisis with their mother may destabilize them.

Relapse can happen in response to a crisis such as a mother overdosing. Yet, in our experience it can equally happen over small, inconsequential factors, like boredom, frustration, or bumping into an acquaintance with drugs. The key is to protect yourself from relapse, everyday. What are your nephews doing to support their recovery? Crises, frustrations, hard feelings happen and will continue to happen. Well-honed coping skills, social support, healthy substitute behaviors all matter greatly in maintaining one’s recovery.

Your brother has resisted learning what more he could do to help his wife. This may be finally shifting some because of the two overdoses in quick succession.

The psychiatric ward will likely keep your sister-in-law for only a couple days. Their mandate is to stabilize and discharge. Aftercare planning is too often limited with inpatient psychiatry. Can you step in? Will your brother let you? Can you call Adcare to see what they offer, what their waitlists look like? I know your sister-in-law is already medically unwell from past drug-related crises, hence the wheel chair. Finding an inpatient dual diagnosis unit that takes someone with serious medical needs will be a challenge. Section 35 needs to be investigated to learn whether the program can handle her medical needs, and your brother must become convinced that it is necessary. Your sister-in-law is in danger of losing her life.

Have him read this post.

If she is unwilling to get further treatment after her discharge from the psychiatric unit (Adcare or at the least a medication-assisted treatment for the opiates), a civil commitment can save her life.

Her reaction to family members who are seeking to help her is chump change compared to the gravity of the situation. Your sister-in-law is under the grips of a fatal disease. She has remained home, using drugs, with your brother, her husband, doing the heavy lifting of maintaining this lifestyle.

It is time to keep all the professionals you can in play. Her overdoses may be the opening she needs to consider more help. It may also be the opening your brother needs to consider how he needs to change.