Updated: Jun 16
Written by: Stephen Pfleiderer, MA, CADC, CAI, CIP
San Francisco Intervention
Nineteen-year-old Anna stumbled home drunk again for the umpteenth time. She pinballed off the walls as she tried to sneak to her room without waking her parents. Of course, they woke up. Of course, they were angry and worried. But they couldn’t seem to come up with any consequence that effectively deterred Anna from going out and getting drunk with her friends. And she was technically an adult, so what could they realistically do anyway? They weren’t ready to kick her out of the house, fearful for what darker paths that might lead her down, and then there was the stigma that publicly acknowledging their daughter had an addiction would place on her and their family. Like most families, Anna’s parents had put on a good face to their friends and neighbors because they knew the talk that would circulate behind their backs if anyone knew the truth. They grappled with all these worries, yet they knew this simply couldn’t continue.
A Few Facts About Addiction
We know that Anna’s family is not alone. An estimated 22.2 million Americans older than age 12 abuse or have a dependence on drugs and alcohol. Approximately 15.4 million of them abuse alcohol alone, which leads to nearly 88,000 deaths a year, according to the Centers for Disease Control and Prevention.
Additionally, substance abuse–related problems are among the most under-detected and under-treated health problems in American workplaces. But the impact of those addictions is exceptionally costly. The National Institute on Drug Abuse reports that every year, drug and alcohol abuse cost the country more than $740 billion in lost work productivity, health care costs, and crime.
And the stigma surrounding mental health and substance abuse problems remains a primary reason people do not feel comfortable coming forward and getting the help they desperately need. Certain legitimate concerns prevent those with addictions and their families from seeking treatment, such as the potential of losing a job, a scholarship, or a position of standing in the community. Our culture has set in place these rules that say if you reveal a struggle with drugs or alcohol, you can say goodbye to everything you’ve worked for. Is it a surprise, then, that so many people push their addiction deeper into the darkness and avoid treatment at all costs?
Further compounding the stress around a substance use disorder is the trauma that accompanies it, more often than not. A major contributing factor in many drug and alcohol addictions is a physical, sexual, or psychological trauma—or some combination of all of these. Substance abuse sometimes emerges as a way to numb the overwhelmingly difficult thoughts and emotions that result from trauma. And in the end, the combination of the two often feels like an insurmountable problem to solve.
But drugs and alcohol are not the only ways some people try to deal with a trauma or underlying mental illness. Behavioral (or process) addictions, such as compulsive shopping, eating, gambling, internet use, or sex, are also added to the dysfunctional toolbox used to “fix” distressing emotional states and trauma. In fact, it’s very common for someone to have experienced a trauma, live with the effects of PTSD, and abuse alcohol or drugs while also engaging in compulsive, destructive behavioral patterns like a sex addiction.
By now, you’re probably getting a better picture of the immense complexity that accompanies most substance use disorders. And you may feel a small sense of hopelessness many people living this kind of life feel to be able to ever get out from under multiple addictions and live a life free, healthy, and happy.
However, the truly wonderful news is that drug and alcohol addiction can be successfully treated at the same time as mental illness and behavioral disorders. Millions of people have received help and gone on to live full lives without the chains of addiction—even if they’ve lived with the disease for decades. Treatment is always available and can actually help even the most complex and difficult addictions.
And, contrary to popular-though-outdated schools of thought on the subject, it is not a moral failure, but a chronic disease akin to asthma or diabetes. Experts on addiction treatment have found effective and compassionate approaches that are allowing people to live full lives, free from the grip of addiction.
Still, many myths live on in our culture about what it takes to for a person to get clean and sober. Let’s debunk a few of the most common ones here and counter them with what we know to be true about interventions and drug and alcohol treatment.
Myth: Interventions Have to Be an Ambush
This myth has particular staying power, possibly because of the television versions we’ve seen. The general belief is that you have to surprise the person you’re trying to persuade to go to treatment and confront with them with all the ways their behavior has hurt you. However, while this may have been the approach used by some in the past, we now know that it is not effective as a compassionate means to help your loved one. And, sometimes it even backfires, creating heightened resistance to change and diminishing the self-esteem and self-confidence of the person being confronted.
Today, the intervention model favored by the leading experts in the field is invitational, where the addicted loved one is asked to meet with their closest friends and family to discuss the impact of the substance abuse on everyone’s lives. This preserves the dignity and respect of the person and leaves them in a more open frame of mind to attending a treatment program.
Fact: An Intervention Is a Form of Pre-Treatment
The current Surgeon General’s definition of an intervention is a professionally delivered program or service designed to prevent substance misuse or to treat a person’s substance use disorder. It is also a formalized process of action taken by concerned family, friends, employers, and coworkers to actively help someone change their behavior to improve their physical and mental health.
Though an intervention is not a form of treatment itself, it can be considered a pre-treatment engagement that provides the structure families or organizations impacted by addiction need to facilitate a person entering rehab and accessing recovery resources.
The overarching goal is to create effective and healthy change for everyone involved—not just the person abusing drugs or alcohol. It is a way in which a stuck system learns to become unstuck and move down the road toward healing and recovery. It also provides a framework for accountability through which everyone impacted by the addiction can find the most appropriate resources for them to learn healthier ways to handle the complexities surrounding the disease.
One major truth about intervention that many people do not realize is that it is more about family than it is about one person. One primary goal, then, is to take intentional steps toward restoring family relationships and friendships that have been damaged by addiction. Every family deserves a treatment plan tailored to their personal circumstance and any substance or mental health disorders that exist.
Myth: I Can Just Talk to Them About Their Addiction and Convince Them to Get Help
Many family members, friends, and (sometimes) even concerned professionals may fall into a pattern of interacting one-on-one with the person abusing substances. However, this rarely proves helpful or successful in getting them to stop using.
And, because a substance use disorder is a chronic physical disease, it is not a matter of simply enlightening the person who abuses drugs or alcohol, helping them “see the light” after which they say, “Well, of course I’ll go to treatment!” It just doesn’t work that way.
First, they probably know they need help, but, because of the nature of their disease, they can’t just decide to quit. There are a host of often-painful and sometimes dangerous withdrawal symptoms that result when a person stops using, so avoiding these is actually a big motivator for many people to resist getting help. They may also have a strong psychological addiction to their substances, which causes them to see their addiction as a sort of lifeline that shields them from overwhelmingly painful emotions or life circumstances. Asking them to give it up, then, can be met with fierce resistance fueled by fear.
Mobilizing a group of family members and concerned others is a far more powerful method to break the destructive influence of addiction. There is strength in numbers, and this strength brings with it new hope.
Myth: You Have to Hit “Rock Bottom” Before You Can Get Clean
This is just flat-out false. Substance use disorders exist on a spectrum, from mild to severe, and can benefit from treatment at any point. Waiting for someone to hit the bottom of their addiction (which, by the way, looks very different for everyone) is like waiting for a car to break before taking it in to have a problem diagnosed and repaired.
Many people have entered treatment before their addiction had completely ruined their life, were effectively treated, and live happily in recovery today. Any time is a good time to get help for a problem with substances.
Myth: There’s No Rush to Go to Rehab—I’ll Get There Eventually
Many people stay on the fence about getting help for years—decades, even—during which time they minimize the effects their addiction has on their lives. But the reality is that a substance use disorder left untreated tends to generate increasingly more negative consequences in the person’s life, and the lives of their loved ones. Some of the common results of a long-term addiction are:
Exacerbated co-occurring mental health disorders (e.g., depression, anxiety).
Accidents (vehicular and personal).
The fact is, recovery is easier when there is more to live for—before you’ve lost a spouse, a job, or have a criminal record. And research shows that the earlier you get help for an addiction, the better your long-term outcomes are for you and for your family.
Fact: What Interventions Are Really Like
A good intervention unites a family through education and open communication. Everyone’s voice is heard and respected, and their feelings are validated.
In the invitational setting, the person with an addiction listens to their family, friends, and coworkers share how the substance abuse has affected them, and also how much they care about them. The person of concern learns that their loved ones will support their treatment and recovery but will not allow destructive or unhealthy behavior to continue. In this way, intervention attempts to raise the bottom, interrupting a destructive cycle before severe and devasting consequences unfold.
The professional interventionist can recommend appropriate treatment solutions and facilitate the person abusing substances getting into a program, often that day, if arrangements have been coordinated in advance. They can also put family and friends in contact with treatment professionals and groups that can serve to support them through the recovery process.
One major benefit of an intervention for the concerned others—family, friends—is that they don’t have to look back and wonder if things would have been different if they had taken action to help their loved one. There are no regrets: just a clear path forward to healing and health.
How Do I Know If My Loved One Has an Addiction?
This is a common question for many concerned family and friends who aren’t sure if their loved one’s substance use is problematic. Read the following list and note how many apply to your loved one:
Do they continue to use despite experiencing negative consequences as a result of that use?
Do they have trouble controlling their use, including when they start or stop using and how much they ingest?
Have they developed a higher tolerance to their substance of choice (e.g., they need more of it to get the same buzz or high they once got with less)?
Do they find themselves preoccupied with using?
Do they give up other activities to drink or use drugs?
Has their substance use created problems in their relationships with family, friends, co-workers, teachers, or coaches?
Have you noticed any personality changes in them since they began using?
Have they started having problems at work or school?
Have they had any legal troubles as a result of their substance use?
Have you observed in them physical symptoms caused by drugs or alcohol?
Do they sometimes black out while using?
Are they showing signs of continuous intoxication or severe misuse (e.g., binge drinking)?
Are there changes in their sleep patterns (sleeping a lot more or a lot less)?
Are there changes in their in their appetite (increase or decrease)?
Are they not tending to their hygiene on a regular basis?
Do they frequently seem irritated?
Have they been more aggressive?
Have they had suicidal thoughts or behaviors?
Has their social activity involvement decreased?
Do they associate more frequently with a peer group who encourages substance abuse?
Are the consequences of their use worsening over time?
If you were able to answer yes to some or most of these questions, your loved one may have a substance use disorder. You should never try to diagnose them yourself, though, so seek out professional help through your family physician, therapist, or an addictions specialist.
If you are considering an intervention, it is important to understand that substance use disorders do not occur immediately, but slowly over time through repeated misuse and the development of more symptoms. This means that it is both possible and highly advisable to identify emerging substance use disorders and to use evidence-based early interventions to stop the addiction process.
It is also important to remember that any action toward healing and sobriety is a good one. Small steps are still good steps, and they make a big difference. So, gather information, reach out to someone who can answer your questions—just don’t ignore the problem. Trained addiction treatment professionals can ensure you find the right level and setting of care for your loved one’s unique needs. They will carefully consider every aspect of their life when placing them in treatment so that they are best positioned to succeed.
There is hope for your loved one, no matter how far gone you think they are. Yes, considering life without the familiarity of an addiction is scary to them, but life without one is so much better than they can even imagine right now. They are capable of getting sober with the right help—and that help is waiting for them and your family now.
San Francisco Intervention is one such resource that provides treatment consultations and assessments and facilitates getting people the appropriate solution for them. Substance abuse treatment is not one-size-fits-all—everyone has a unique path and specific life circumstances that must be considered—and San Francisco Intervention can help you sort through the appropriate options and accompany you every step of the way, from entering treatment to continuing care. Reach out to them today at www.sfintervention.com—the life you deserve is waiting.