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She’s Coming Home and I Need Help

Recovery (MAT)

Fireweed3 reaches out with concerns about her Loved One’s return home. She’s coming home from residential treatment, 90+ days sober. But she’s on shaky ground right now, not taking proactive steps in her recovery. For this family member, practicing CRAFT when her Loved One was actively using was in some ways more clear-cut. How can we work CRAFT during this fragile time of transition?

My 19 year old daughter is coming home on March 7. She has been in residential treatment since November 21 (the day before Thanksgiving). She is 90-plus days clean of heroin and other substances.

While she has come an incredibly long way, she is currently experiencing a worrisome setback — just as she prepares to come home. She recently lost "mentor status" in treatment due to her not following through with "proactive steps in recovery" (job search, re=enrollment in classes, 12 step meetings, etc.). As her addictions therapist states in email: "She is settling back into old behaviors of being in contact with men who are active in their addiction and not expanding her social circle. She has not maintained contact with her sponsor and there is little evidence that she has one. She is floundering. She is also discussing having high cravings and refers to using as something she misses." Indeed, she has visited her "boyfriend" at least 2x — the 28 yo man who introduced her to IV drugs last fall. Read this member’s full comment here.

It is good to hear your daughter is completing her 90-day program, though it sounds like she is shaky in her recovery. She is headed home.

The program should be setting up a solid aftercare program for your daughter to follow. Something to help her adjust back into the community. I would also strongly suggest you both consider getting your daughter on medication assisted treatment, Sublocade is the new monthly shot of suboxone, or Vivitrol, the monthly shot of naltrexone. You can read more about both in our Resource Supplement.

Your daughter was living in the streets before entering treatment, hanging with an older boyfriend who introduced her to heroin. She has been in contact with him.

Your daughter is used to living in the detached garage and your plan is for her to return living there. You are setting up lots of guidelines for her to follow. It sounds like your daughter gets easily overwhelmed when the talk turns to earning a living.

Even if your daughter was doing a better job of talking-the-talk – “I’m well, not going to use, not contacting old using mates, going to jump right into a recovery community, therapy etc.” – I would still set up as though she was shaky, during a transition time like this. Since she is shaky, it makes sense to be cautious in the living situation that you set up for her return home.

How about leaving the detached garage as something she can graduate to, after a period of successful “transitional living” in your home. For now, it’s time to look at the daybed and locker set-up that we have talked about.

The list of activities, etc. that you are working on sounds good. Keep polishing up that list. Make sure to check about a list of treatments her current treatment provider should be linking her to. You’ll give her both of these. Really, for her to be home with you, YOU need to know she is as safe as she can be from a possible overdose. This means medication assisted treatment for the time being.

You provide her with this material. Then, how about taking it one week at a time? “We’re going to put you through your paces and see how you’re doing at the end of each week. If this home cannot provide you with enough support to work your recovery, we’ll know it very quickly. If we feel it’s not working out, we will move you to a sober living situation.”

A person can spend all day in community recovery activities: self-help meetings, therapist, MAT, a little volunteer work…? Perhaps those first few months are spent focusing on these things. This is part of recovery. The job and school get added in gradually. This is already a transition. Try to think in terms of baby steps for now, not aiming for those big goals of employment and school quite yet.

CRAFT is completely useful during this period. The hope is that your daughter does well and you get to step in and give rewards for her daily effort. The biggest reward here is going to be your home and her loving family. Certainly, if she digs in her heels and doesn’t participate in the structure you are outlining with her, you will step back with the big chill. In this sense, you’ll act as though she has just used: remove rewards, remove yourself, and allow natural consequences.

Your daughter may not like every recovery activity she tries in the community. You’ll have to give her the space to withdraw from some things, but continue to insist that she adheres to a basic structure of recovery activities of her choice. This helps foster a sense of her own independence – important for any young adult living at home – within the confines of a basic supportive structure.

You are going to have a lot of trouble trusting her. Given this, it will be a great help if you don’t give her a space to hide in right away. That will also signal to her that this is a very transitional time: nothing is as it was before. This is new territory, for both of you.

Full trust is going to take a lot of time. This next transitional period will not be easy on you. Providing her a daybed and not the garage, using MAT and recovery activities will help mark this as a transition for all of you. If you set up without the expectation of fully trusting her right away, it will go a long way in helping you manage your own emotions.

It is wise of you to recognize the need for your own “program” in order to remain calm, clear, and centered. Good for you. It is so heartening that you identify and are working on this proactively. It can’t be emphasized enough. Reach out to those you can trust. Find new ways to feel supported, to attend to your own needs. Those needs are very real. The more support systems you have, including us, the better.

One last thing. She will almost certainly reach out to the boyfriend. Ultimately it is her choice to do so. As before, it’s important to remember that the boyfriend is not the problem. He is a symptom of her addiction. She is going to have to wrestle with this. She is going to have to choose a warm home and family and recovery OR an easy return to her drug use with him. She is going to have to fight for herself.

If you choose to bring this up, add this last line to your conversation… ”I cannot stand in your way if you choose to talk to, see, or use with XXX. I am here to help you fight for yourself and for a better life. If you aren’t willing to fight for this, we need to quickly move you to a more structured program than our home.”

Thank you for sharing these updates with us. Let us know what else we can do as you prepare yourself for this transition. We are here to help.



In your comments, please show respect for each other and do not give advice. Please consider that your choice of words has the power to reduce stigma and change opinions (ie, "person struggling with substance use" vs. "addict", "use" vs. "abuse"...)

  1. I am so very sorry for the stress you are living with. As loving parents, we want to help our children solve their problems but they are no longer little kids who accept us in that role. Sure they do when they need something from us, like a Starbucks card, but we know it’s probably the addiction that’s reaching out to us for that kind of support.
    My daughter has not attended any meetings that I know of. We cannot talk about her drinking or recovery. It leaves us in a kind of limbo of the unknown. She still loves her new job and says she is exhausted at the end of every day. My runaway suspicious are she is drinking on weekends. I have no way of knowing. I will not search for evidence or ask her boyfriend. Those activities only increase my own suffering, encourage my own anxiety. So I wait and try to leave her and her problem be. We text, we email, she came for dinner last night and looked/sounded pretty good. That is where we are. By caring for myself, I am stronger should the addiction rear it’s ugly head and come back into my own life space.
    So we pull back and practice what CRAFT has taught us, and we practice self-care. I recommend you check in with the “My Progress” graphing in the “My AIR” tab. It helps me to see my mindset and I can make adjustments in my thinking as necessary. The biggest takeaway from AIR for me has been calmness and self-care. I am a emotionally needy person. I find online as well as face to face communities can help meet those needs while framing my thinking.

  2. I thought things would be okay for a few days after she came home after 90 days of treatment. I wasn’t expecting miracles, but I was anticipating a softer landing.

    My 19 yo daughter was discharged from treatment on Tuesday. She requested that she be allowed to come home, but she has only spent one night here so far. She says she’s been spending time with a couple of friends from treatment who were discharged this week as well. I’m glad she is building and connecting with a recovery community, but she seems to be avoiding all other aspects of her clinical aftercare treatment plan, as well as the “recovery contract” we created together.

    She was offered a job at a bakery on the day she discharged from treatment, but has already changed her mind about it (not taking it). She hasn’t attended any 12 step or SMART meetings, isn’t looking for other work (or exploring school) and hasn’t done any household chores, as per our agreement. She blew off breakfast plans with a dear friend this morning. She hasn’t been taking her medication as prescribed. And she isn’t keeping me informed of her whereabouts.

    Today she asked (via text) for an electronic Starbucks gift card. I told her I couldn’t subsidize all of her activities when she’s not showing an effort to follow through on her aftercare treatment plan and recovery contract. But I also told her I was here if she wanted to talk about what was getting in her way, and closed with “I love you.” She simply replied: “Okay sorry I understand.” No mention of coming home.

    I am trying to practice mindfulness and self-care, but in all honesty, her behavior is triggering a trauma response in me — it’s taking me back to October/November when she was using meth and heroin on the streets. I’m struggling. A lot.

    I am unsure how to use CRAFT to address her lack of structure and engagement in aftercare. I realize she’s adjusting to “life outside of treatment” and that she feels scared and incapable of functioning without drugs. I have a great deal of compassion, and truly understand how difficult this is for her. Maybe I’m expecting too much so early in her post-treatment phase.

    But without structure and/or purpose to her days, she does not have a chance at recovery. I realize I cannot control the outcome but maybe I can play a role in her aftercare treatment/early recovery. If so, how do I utilize CRAFT in this context, if at all? Do I acknowledge/reward when she follows through (e.g. attends a meeting), and conversely “chill” when she doesn’t (e.g. skips appointments or meds)? Or do I let go and allow this to unfold on its own?

    1. Dominique, I re-read your reply to my previous post about preparing for daughter’s return after treatment.

      I will have that discussion with her that you suggested (i.e. checking in at the end of each week…). I asked her on Thursday to choose a time to connect — she never did — but will continue to push for that this weekend. I will also try to plan how to communicate if she comes home showing signs of use, and will continue to reward any follow through w aftercare/recovery contract.

      I fear that I’m seeing all the signs of impending relapse and feel shaken by it — thought we’d at least have a brief honeymoon period before old behaviors returned. I will say, this is all the more difficult as a single parent with very few resources. I can’t just send her to sober living if family home doesn’t work. I am barely making ends meet as it is. I don’t even know how I’m going to pay for her treatment (just completed), let alone the medical bills incurred when she was in/out of emergency departments and ambulances. Was just hoping for some peace, at least a period of calm before the storm. Perhaps she’ll get back on track before something happens.

      Oh, I also listened to the most recent podcast with you and Annie last night. Thank you, it was helpful as I grapple with the fear rising up in me. (Thanks Annie for sharing your lived experience w your son. Always a salve to my vulnerability, hopelessness, fear…and “terror” — you nailed it.)

      1. Oops, the recent Coming Up for Air podcast (“I’m desperate to save my loved one”) is facilitated by Laurie (not Annie) this time. The episode is highly recommended. I’ve already forwarded it to other parents. Thanks Laurie. You have supported me in the past as well, in a reply to one of my posts — literally helped me to breathe that day.

      2. You are seeing signs of relapse already and your daughter just left a long period of residential treatment. It makes sense that you are feeling shaken. She’s home but is already spending nights out and isn’t participating in recovery activities.

        This can indeed be the cycle. As a family member you have some tools: your communication, your behavior and responses, and the resources you can provide your daughter… These resources include your home and your helping her to find and engage with treatment. Read my full response to this family member here:

  3. I’m glad you brought up MAT. My daughter was using Naltrexone (in residential treatment). But when I asked her res case manager about it last week, I was told naltrexone was discontinued. (?) He advised me to talk to a step-down treatment program about it.

    Then I learned that she hasn’t yet been linked to an IOP or outpatient program. He apparently assumed she could return to Kaiser when she discharges — but it can take weeks to make appointments in their AM program. I left a message with her previous outpatient therapist at Kaiser so she’s on his radar, but it’s still going to take a while to get her connected to the AM physician. This seems like poor aftercare treatment planning on the part of her res provider. Maybe this is how it goes. Hopefully things will fall into place.

    With regard to the daybed and locker (versus moving her back to detached garage) I hear you — it makes perfect sense. But our century- plus-old house is only 820 square feet. I don’t have room for a daybed (and the couch is too smal). Also not sure her younger brother can tolerate the stress of having her inside the main house overnight right away. She trashed his room and stole from him. (He has his first appointment with a Kaiser therapist soon to process everything.) I’m thinking maybe she can sleep in the garage space but spend family time with us during the day. I don’t know. It’s not ideal — wish I had more space for a daybed/locker in the main house.

    Just learned yesterday that her 2 close friends from residential treatment relapsed. They were living in a sober house together for a month. Makes me painfully aware that even the most thought out plans are no guarantee that a loved one will stay clean after treatment. Hard to accept — but I’m working on it. Radical acceptance is the only way I’ll get through this. Trying to find it in me.