The unfortunate truth is that by the time you are heavily into substance abuse, nothing else will matter. Addicts and alcoholics will continue using until the age-old AA warning comes into effect; jails, institutions, and death. By the time the consequences get bad enough, you simply won’t care, nor will you have the where-with-all to recognize danger.

Initially, the choice to use alcohol or drugs is just that, a choice. It remains a choice until tolerance builds up, dependence occurs, compulsions drive use, and withdrawal symptoms appear. The end result is not pretty.

Common effects of regular substance use are mood dysregulation and the inability to make good decisions. There are changes in the brain that target and alter the reward system. The substance becomes the only thing that triggers feelings of wellbeing or normalcy.

Common sense is replaced with drug-seeking behaviors that often place you in dangerous situations. A typical day of an addict will be the laser-like focus on obtaining and using your substance of choice.

Sooner or later negative consequences occur. Relationships will be affected, employment and other responsibilities will be blown off, financial means will become dire, and basic self-care will be out the window. Material wealth and financial sufficiency evaporate in short order.

Prevalence of accidents, DUI’s, hospitalizations, court dates, dual-disorders and worsening of pre-existing mental health conditions will increase. General living conditions will suffer and isolation will occur. Repercussions will pile up.

ARGUE FOR LIMITATIONS

None of this is going to matter to you when you are deep into addiction. There is almost nothing anyone can do to convince you that you need to stop using.

Denial, resentment, lies, excuses, promises, and extreme ability to manipulate are the calling card of the addict.

For every argument and plea that loved ones have will be cleverly deflected, justified, excused, or ignored. There is no convincing an addict that they have a problem and they need help.

That is the insanity of addiction. It will take everything from a person, turn them into an empty shell, and you will still argue that you have not changed.

There is the straight-up insanity of thinking you have any control over your substance abuse once you have fallen below the bar of acceptability.

INCREASED SUBSTANCE USE

Almost no consequence is going to stop you from using substances. This is your of coping with difficult, emotional or uncomfortable feelings.

The worse it gets, the more you will use to shut off the thought, feelings, emotions and physical and emotional pain.

Addicts and alcoholics are very clever people. You will always find a way to get what you want. The guilt, shame, and anger you may feel about alienating everyone and everything are covered up with more drugs and alcohol.

Self-loathing and despair will drive the need to numb everything.

Addicts and alcoholics will display behavior that is dishonest, criminal, hazardous, and without regard for their safety or the safety of others.

You are a walking time bomb.

When do the consequences get bad enough?

TRAIN WRECK – CONSEQUENCES GET BAD

No-one can change you, but you. Loved ones can beg and plead, the judge can order, or you finally get involuntarily committed, but no-one can change you.

A lot of the time there is nothing to be done but wait for the consequences to pile up and hope that the courts will get involved.

It is literally like watching a train wreck. You know the outcome but are powerless to stop it.

Loved ones need to stop being codependent enablers or acting as a buffer between the negative consequences. The negative consequences have to stack up; they have to be experienced in their entirety

You are not helping, you are contributing to an already deadly situation by allowing the substance abuse and consequences to go on much longer than it might.

You need to set boundaries and step back.

Don’t enable and get yourself some help. Addiction is affecting you and you need to learn coping skills before the stress and worry make you sick.

WHAT FRIENDS AND FAMILY CAN DO

You can try talking to them. Maybe they are ready to stop and just need a push in the right direction and a good inpatient or outpatient program.

If they are in violation of the court, they will be going to jail. There are substance abuse programs and 12-step meetings in jail if you are there long enough. If not, they will have to do the time, and then you ferry them to an inpatient program.

If they have been hospitalized, speak to the doctors. Find out what can be done. If there is a mental health diagnosis as well as substance abuse, there may be a partial hospitalization program they can enter.

Most health plans now have mental health and substance abuse rehabilitation programs. The hospital or clinic will be able to refer you to an inpatient or intensive outpatient program, or resources in the community.

If the individual has been placed on a 5150 hold (CA) you should arrange for transitions straight into an inpatient program after release. If courts are involved, a program may be mandatory. The courts will give you a list of approved programs.

You could stage an intervention, led by a professional and planned over a few meetings. This is not really something you should do yourself. Find someone to help you. Interventions take a lot of planning.

There is also the good old 12-Step call. Members of a 12-step program come and talk to the individual about their experience, strength, and hope in the program in the hopes that the addict will agree to check it out.

BECOME FORCEFUL

In some instances, you can force someone into treatment. Legal systems or ultimatums will often be enough. But, whether they stay in treatment, find ways to contraband substances in, or walk out the gates at the end and relapse, or display other unacceptable behaviors in on them.

Hopefully, along the way, treatment and recovery will begin to rub off.

LONG-TERM SOLUTION

Given relapse rates of 50-70% within a short period of time after treatment, long-term plans should be made.

Aftercare, a step-down outpatient, sober living, meetings, therapy, alumni events, or volunteer work should be scheduled as far out as possible.

Success requires daily vigilance and practice. The longer this is done in a semi-restrictive environment the stronger a person new to recovery is. This allows sufficient practice of new coping skills before the training wheels come off and their life is again completely in their hands (and mind).

Bottom line is, negative consequences alone will often not be enough to get someone into treatment. Additional leverage is necessary to corral an addict into treatment.

Look for community resources and reach out to medical professionals to gain insight and information about concrete actions you can take to ensure your wellbeing.

DON’T BE FOOLED

Don’t be fooled by the recovery myth that when the consequences get bad enough, an addict will stop using.

An addict will continue to use no matter what.

Addiction is complicated. Even if an addict goes to treatment, recovery may not stick.

RESOURCES

For more recovery myths click on the links below.

• The more you spend on rehab, the better the treatment.
• You have to hit rock bottom before getting treatment.
• You only drink or use on weekends, so you don’t have a problem.
• You have one week clean and sober, you are cured!
• You can’t force someone into treatment.