She’s made all the mistakes, so you don’t have to… Ask Erin is a weekly advice column, in which Erin answers your burning questions about anything at all.
Q.
Dear Erin,
I used to think I knew a decent amount about addiction. I was partnered with an alcoholic for nearly three years. I'm the child of two alcoholics. I've sat in many recovery meetings. For a time, I thought I was an alcoholic but realized that for me, I wasn't an alcoholic but definitely in dangerous territory the way I was abusing food and drink.
The common thread with all of these situations is that the person who had the issue was aware and open about their problem. Now I'm in a different situation, and I don't know what to do.
My very best friend of 15 years is addicted to opioids.
They've been to rehab once because their family sent them, but that was five years ago, and now they're using again. When we last spoke about it, they told me they were clean and didn't have a problem anymore, and I believed them. I offered to go to meetings with them since I know how valuable they are for staying clean and having a community of other people who want to stay or get clean. I was giving them money when they asked for it for random requests, but they stopped asking.
They don't owe me anything, but it breaks my heart because I don't think they are clean. Their family doesn't think they are clean. They have now lost their spouse, their children, and their house. They have withdrawn so much that they don't respond to my calls or texts.
It's been more than a year since we've spoken, and I worry all the time that they're going to move on to heroin—if they haven't already—and overdose.
I suspect that there's nothing I can do until they’re ready to stop. I feel like all I can do is love them from afar. I don't reach out much anymore to them because I wasn't getting responses, and I don't want to be annoying or presumptive that I know what's happening in their life. But based on regular conversations with their ex, who now has full custody of their children, they’re teetering on the brink of permanent self-destruction.
This is not the person I know and love. They'd never let their children go willingly.
Addiction has a hold over them, and it's breaking my heart.
I know that they aren’t going to seek help until they want it for themself, but I miss my friend, and I'm concerned about their life. What can I do?
Thank you,
A concerned friend
A.
Dear Concerned Friend,
I know the position you are in all too well. I have been the one drowning in addiction, as your friend, and I’ve been like you are now, watching someone drown and feeling helpless to save them.
The feelings of helplessness are understandable because you don’t have control over your friend or their addiction; you only have control over your own words and actions.
What you said is true, that on some level, they won’t seek help until they want it for themself, but there are things you can do to highlight that path. You have been doing that to a large extent. Don’t stop with the calls and texts, even if they continue to go unanswered. And the calls and texts don’t need to be solely focused on your concerns about your friend. People struggling with addiction need those reminders that they are human beings deserving of friendship and love. Send some texts or leave some messages that have nothing to do with their struggles. Tell them what you’ve been up to, that you miss them, relate a funny story from your daily life, or recall a warm memory the two of you share.
For so many people who struggle with addiction, the lack of connection to their family and friends reinforces the accumulation of shame, which is a barrier to getting help.
As Johann Hari so eloquently explains in his Ted Talk, the opposite of addiction is connection. This was certainly true for me.
I get asked a lot about what to do when a loved one is in the throes of addiction, and my baseline answer is to meet them where they are at. Open those lines of communication and connection. I don’t know the whole scope of your friend’s treatment history, but maybe rehab and/or 12 step programs aren’t the right path. Maybe they need MAT (medication-assisted treatment). Maybe they need a deeper level of psychiatric care. Maybe they need one of the newer treatment models like SMART recovery or Buddhism-based recovery programs.
There is no one-size-fits-all solution to addiction.
I often use the analogy of how a medical team would approach treating a cancer patient. They would decide on a treatment protocol based on many factors. If that treatment didn’t work, the team would readjust and apply a new treatment protocol. I believe this is the attitude we need to have when facing the issue of addiction.
In your email, you said, “This is not the person I know and love. They'd never let their children go willingly. Addiction has a hold over them, and it's breaking my heart.” You’re right; they are not the person you know and love. Because what you are looking at is their addiction. But, the person you know and love is there, underneath the addiction and all the subsequent behaviors around addiction. I firmly believe that.
I appreciate that you have given your support without the judgment that many do. It can be so challenging to stay nonjudgmental. The old model of “tough love” does not work for most people with substance abuse disorders. People confuse personal boundaries with tough love. They are not the same thing.
We can only help people recover who stay alive.
In addition to the messages and calls that reinforce the connection, if you’re able to open up communication with them again, I would encourage your friend to look at medication-assisted treatment and other harm reduction services, like Narcan access/training and fentanyl testing strips. We want your friend to stay alive, and accessing harm reduction services improves those odds significantly.
Lastly, please remember to take care of your mental health during this process. As I am sure you know from your experiences, Al-Anon has helped so many loved ones of those struggling with addiction. Talk therapy and leaning on your support system of friends and family will be so valuable as you walk through this, no matter what the outcome is.
I hope with all my heart that your friend makes it out. I have seen so many people recover who people believed would never recover. I struggled with heroin addiction for 15 years. I didn't believe I'd ever get out. I didn't think I could let go of the shame. I felt incapable of telling the truth. I thought I was a monster. I was sure I'd meet my end in overdose or by suicide. But here I am. I hope they make it here, too.
The information within Ask Erin should in no way be interpreted as medical advice because I’m not a medical professional. But I am here to help — to share the wisdom I’ve gained after years of making mistakes. If you have a question for me about relationships, addiction, dating, friendships, depression, parenting, sex, consent, what I’m watching, what I’m reading, what I’m listening to, Albite, or anything at all, use the contact form HERE or email me: askerin@erinkhar.com. As always, your anonymity is golden.
Did you know I wrote a book about my 15-year struggle with heroin addiction? It’s called STRUNG OUT: One Last Hit and Other Lies that Nearly Killed Me, and it’s on sale now!
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*Artwork: Tess Emily Rodriguez