Addiction Is Confounding, but with CRAFT There Are No Gray Areas

Allies in Recovery, AiR, Dominique Simon-Levine, dominique simon levine, addiction, addiction recovery, recovery, Craft, treatment, sobriety, family, detox, detoxification, treatment, overdose, community, distress, relationship, danger, suboxone, boundary, narcan, methadone, gray

An Allies member and mother is in distress  — the “Gray area” of not knowing how to respond to her son’s addiction has her overwhelmed, worn down and mad.

This post originally appeared on our Member Site blog, where experts respond to members’ questions and concerns. To take advantage of our current special offer and get full access to the Allies in Recovery eLearning program for families, click here.

 “My son is 23 and was addicted to heroin or fetanyl. He OD’d twice but that didn’t scare him, then went on suboxone. Eventually before going back to the clinic for his script he would use again. He was selling the suboxone to make a few bucks even though he has a job. Every paycheck only lasts one day and then is borrowing money from me. He lies about everything. I take him to work everyday and he lives with me and my boyfriend of 4 yrs. My life isn’t my own anymore and I wish everyday for my death. The pressure and unhappiness he brings here is too much.

I’ve had him sectioned before and he said it was horrible and dirty and he was cold and hungry all the time. People tell me to throw him out but I love him and he has no one else. He says he hates me, tells me to go f* myself and a whole lot more. Now he has no suboxone because he missed his Dr’s appointment and she won’t be in for another week. I called to see if they could give him some until she comes back and they said no. He is DOPE sick cause he can’t sleep and his legs bother him.

I am running out of money and have given up caring about myself. My relationship with my boyfriend has deteriorated. I need him to go but the question is WHERE???? I hate and love him at the same time. Any advice would help.  To be honest I see myself in hospital soon because all this is taking its toll.”

Allies in Recovery, AiR, Dominique Simon-Levine, dominique simon levine, addiction, addiction recovery, recovery, Craft, treatment, sobriety, family, detox, detoxification, treatment, overdose, community, distress, relationship, danger, suboxone, boundary, narcan, methadone, gray

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Dominique Simon-Levine responds to this troubling and dangerous situation: “Learn to come out of the gray area…”

What you describe is a terrible, terrible situation. Your son is in real danger and so are you. There is the fact that the suboxone isn’t working and that he is diverting it, selling it to buy other drugs; the real possibility of another overdose; that he is active in his addiction in your home, lying and being completely disrespectful; and, that you feel your own life and relationship with your significant other is being destroyed by your son’s actions.

CRAFT talks about the world dividing in two, no gray areas

When your loved one is using, you disengage, allow natural consequences and remove rewards, when your loved one isn’t using, you reward.

In several earlier posts (see this link) we apply this core concept to a loved one living in your home. When the world divides in two, we seek to avoid gray area as much as humanly possible. Housing our loved one can either be:

–  an inadvertent support for using drugs or alcohol, or
–  a reward for making efforts to reduce or not use.

Period. Landing somewhere in the middle sends mixed, weak messages.

Where is your son today?

In those earlier posts, we suggest ways of talking to your son, and that you set up a temporary place in your home where your son can come for the night when he is not high. In other words, the suggestion is to move to a day-by-day basis rather than an open ticket. This is not easy, but it is the (non-gray) way to think about opening your home to a loved one.

Someone in active addiction pulls in all resources to keep going. Parents love their children and are often pulled in beyond any reasonable boundary. The child makes the parent feel responsible for their “well” being—after all that is a parent’s role. When drugs and alcohol have taken over, the parent is drawn into the needs of the addiction, blamed when resources come up short, attacked when they refuse to provide the “help” requested.

If addiction weren’t present, your efforts to help your son could succeed; but with addiction, your efforts are co-opted towards the needs of the addiction, and the loved one continues to sink.

Your own well-being is vital

The next thing to consider is your own mental health (see an exerpt from our Module on self-care). It is disturbing, very disturbing, to be living life with the fear and disruptions, the conflict, and the constant need to address the wishes of addiction.

CRAFT suggests disengaging where there is active use. Module 7 (available to members) describes some basics of how our thinking can be made worse as we get worn down. A support group can provide suggestions and a critically needed community in this time. It is not an exaggeration when I suggest that you are living through trauma—at times acute trauma. Your love for your son keeps you trying, he takes advantage, and your own life gets chiseled away.

Your son is not adhering to the suboxone treatment. He is in danger of another overdose. Make sure you have narcan, the opiate antidote, and that you know how to use it.

Time for a game plan

If you haven’t done so, both you and your significant other should view the Learning Modules, available on our member site (view our introductory Module) to learn how to get your son into further treatment. He may be a candidate for methadone, which entails daily visits for dosing and is much harder to divert. The doctor who prescribes the suboxone surely knows that he is using drugs (through urine tests or missed urine tests), and that your son is in trouble. The doctor should be orchestrating a more intensive level of treatment that may include methadone.

If this isn’t the case, advocating for the next level of treatment will be up to you, if you can manage it. Your public profile doesn’t tell me if you’re in Massachusetts. Other states will have their own system. Here is what could happen in Massachusetts. Every region in Massachusetts has one or more Crisis Stabilization Services, or CSS. These provide a couple weeks of inpatient treatment and can be followed with a Transitional Support Service, TSS, which continues inpatient until a bed opens up in the residential system.

Contact the helpline for Massachusetts (Substance Abuse Information and HELPLINE:  800.327.5050  (M – F 8 AM – 10 PM; SAT/SUN 9 AM – 5 PM)). A real person answers the phone and they have a database with bed availability in real time. Your son may require a medical detoxification which can assist in accessing CSS.

It may include a civil commitment

If your son doesn’t sign a release, you can still try to talk to the clinician. Let them know your son is homeless, no longer welcome in your home.

(By the way), the treatment program to which people are sent when sectioned (a civil commitment) isn’t the Ritz, I grant you, but it is a safe place and is treatment. Don’t rule out sectioning because your son wasn’t comfortable enough. I have known parents who pulled their children out of treatment because the child complained endlessly about the conditions. It pulls at a parent’s heartstrings. Yet it also pulls at mine to see a treatment interrupted, especially when you consider how hard it is to get them there.

Like the lotus flower, hope can blossom even in dark — or gray — situations

The weather is very bad throughout the northeast, which can overload the public system even more. So what I am suggesting is a game plan – it may not happen today. It is difficult and will need your focus and energy. It is, however, the way through.

Your son is hurting. I can assure you a large part of him wants this to end. Look for that small amount of motivation, calm and disengage yourself, try not to take his actions personally, and try to figure out the system in a way that the door of treatment is open to him in the moment he agrees to help. For a mom I spoke to yesterday, she learned that her son had to get to the intake for detox by 8AM to be assessed. Once assessed, he would be eligible for a detox or CSS bed. A bed wasn’t guaranteed that day, which is tough, but both she and her son were learning where to go and what to do.

We are here with you to suggest a game plan, a strategy to follow that can move your son to treatment. The Learning Modules are full of detailed examples, and lots of concrete actions to take. Taken as a whole, the CRAFT framework is both well-tested and able to unblock the situation you are in. My very best hope for you. May you find some energy to try this and some peace in your day.

A membership at Allies in Recovery brings you into contact with experts in the fields of recovery and treatment for drug and alcohol issues. Our learning platform introduces you to CRAFT and guides you through the best techniques for unblocking the situation. Together we will move your loved one towards recovery. Learn more here.