Question: I am currently in a situation where I am employed by a few of my friends who started a business together. One the partners has exhibited severe issues with drug and alcohol abuse over the past years that has led his work, health, and personal relationships to deteriorate. His partners have sat him down many times to try an intervene with the recourse of being terminated from the business. This has all happened with varying degrees of success. In the last few months, his behavior has greatly improved. He has taken month stints of not drinking at all, he is eating better, he is consistently on time to work and behaving in normal manners. Last week, one of the partners was struck with information that accused this individual of sexually assaulting two different people a year ago, during the time he was drinking heavily. I have now been asked to join an intervention for this individual to be performed asap. I am feeling uncomfortable with this request: 1. I am being asked by my employers to be a part of an intervention for my coworker and soon to be defunct boss. 2. They are asking to keep the sexual assault allegations out of the intervention, but he is not currently displaying signs of alcohol or drug abuse. It feels forced and I feel I would have to lie to go along with this. Can you offer any direction? With this brief overview of history, does it sound like an intervention is the correct thing to do? Should I put aside my underlying feelings of discomfort to offer this friend help? It all feels rushed, not clearly thought out and is making me feel uneasy.

Jim LaPierre Says...:

Greetings and thank you for your question. I agree that your employers have a very poorly conceived plan and frankly, it feels like their primary concern is limiting their liability. Few problems with that, obviously many harms have been done - some allegedly and some known. Performing an intervention when someone is sober seems misguided and confusing at best. I would urge you to consider challenging your employer by simply asking, "What is the desired outcome?"

If you are forced to intervene, I would suggest doing so from a very positive direction (not what we normally associate with intervention) You could simply praise the coworker for his progress, inquire as to how you might support his efforts, and encourage him to continue on the path he's on.

You might also consider looking for healthier people to work for. If I can be helpful or answer more questions, feel free to contact me

Best,

Jim LaPierre

Question: Who can I call for help with my 33 year old son?. He is an alcoholic, He was attending AA but has relapsed. He has been on a binge in his room for 7 straight days. He drinks and passes out. Both his sister and I told him that he either needs to call rehabs or leave. He has done nothing. He knows we can't physically pick him up and throw him out. It's as if he has given up. won't do anything. Knows that we can't. I am disabled and receive Medicare. We do not have funds for private insurance, he does have medi-cal. I have no other family members or anyone who can help me with him. What do I do? just let him drink himself to death?! Can I call the police and get them to take him to detox?. I need assistance please??! Thank you.

Jim LaPierre Says...:

Hello and thank you for your question. I'm sorry to say that it is nearly impossible to force an adult into treatment for alcoholism or drug abuse. I urge you to have him removed from your home by any means necessary. The police would be my first stop, contact them locally through a non emergency line and ask about how to proceed. Be clear that he is a family member who has been staying with you and that he does not have a lease nor any legal claim to continue residing there.

It's obvious that your intentions are very positive - if you allow him to continue living in your home, you are enabling him to continue drinking. It's counter intuitive and sad, but removing him from your home is the best possible outcome at this time. Please contact me if I can answer other questions or concerns. Blessed be, Jim

Question: Have a 16 yr old that cuts and smokes weed/ cigs not doing well in school. We have her in therapy already, does not seem to be helping. Next step should be?

Cali Estes Says...:

Hi

How long has she been in therapy AND is the therapist trained I addiction. Also what is causing it?  Trauma, peer pressure, learning disability?  Something kicks it off,   you need to get to the why and the what and solve it and the addictive behaviors go down. Where are you located?

My suggestions would be to find an addiction therapist or coach that specializes in teen addiction. This can be done in person or by Skype and get to the bottom of the why. Is there any other drugs involved or just weed?  and is weed legal where you are?  I need a tad more info....

Question: My sister is addicted to pain drugs. This morning her boyfriend found her on the floor not breathing with blue lips (actually she was still breathing but just barely and it looked like she wasn’t). He called 911 and they were able to resuscitate her. This is the 3rd time she has accidentally overdosed. If someone was going to keep trying to jump off a bridge we’d out them in a hospital until they weren’t a danger to themselves, even if they didn’t want to be there. My sister doesn’t want treatment right now but she is going to die soon without it – so what’s the difference? How is one form of suicide different from another? The hospital says they can’t take her on unless she agrees to the treatment. Is there anything I can do to get her forced into this?

Evan Jarschauer Says...:

Thank you for the courage to reach out to help save your sister’s life! The simple answer to your question is that there are definitely a variety of measures that can be taken to help move the recovery process along without waiting for a person to actually agree to enter into treatment on their own accord.

The reality is that by the time someone has accidentally overdosed for the 3rd time, they may have lost the capacity to reason and make rational decisions on their own! Similar to a professional boxer who is obviously outmatched, barely able to see straight, and unable to stand up, your sister now appears to be dependent upon you, and perhaps other concerned family members and friends, to throw in the proverbial towel and intervene on her behalf.

Most states have specific statutes in place that provide for involuntary assessment and treatment for both substance abuse and psychiatric disorders. Your local county clerk of the court should be able help you with all of the paperwork required to initiate the process. However, as with any legal matter, you may also want to consider reviewing the case with a good family attorney if possible.

Nevertheless, beyond filing a petition for involuntary treatment, perhaps the most powerful action that you can take to “get her forced into treatment,” is to help her understand that you and other concerned family members and friends, including her boyfriend, are unified in supporting the recovery process by establishing and then implementing healthy boundaries designed to bypass the denial and dismantle the resistance. Tough love does not mean turning your back on a loved one, but rather supporting a firm approach. The reality is that the success of any intervention lies almost exclusively within the collective loving power of family and friends to actually uphold healthy boundaries.

Understanding the inequities of the healthcare system, and given the life and death nature of your case, proceed with caution and vigilance. Be prepared to act a moments’ notice with a solid plan for her care once she finally agrees to accept treatment. Based on the detail that you provided, it appears obvious that if nothing is done, the situation may get progressively worse. Although you may not be able to actually force your sister or anyone else for that matter into treatment, you may be able to move her in the right direction by creating just enough strategically managed loving discomfort to motivate her to have to stand up and join in the fight for her recovery. Please feel free to reach out to explore some of the potential healthy boundaries that may apply to your specific case.

Question: My 34 year old brother is now living in his car. He is chronically unemployable from his drinking and drug use and he hangs out with people that are 10 or 15 years younger than ne is because everyone his own age has grown out of his party lifestyle. He just got evicted so this is a new low for him but he still doesn’t see that he has a problem with substance abuse. What is it going to take for him to wake up? He just laughs it off when I say anything. This is his problem. He is really likeable and a happy go lucky person so everyone just laughs off his behaviors but if you just look at what he does it is crazy and so unhealthy. I am letting him stay in my driveway. I feel like a jerk that I won’t let him stay in the house. Am I doing the right thing? It makes me feel terrible that he is so understanding of my decision and still tries to make me feel good or laugh all the time.

Jim LaPierre Says...:

Hey there - thanks for your excellent question. My heart goes out to you - I know how hard it is to not enable someone you love. I want to affirm that you are doing the RIGHT thing by offering only the driveway. Enabling an addict/alcoholic happens when we protect them fro the natural consequences of their behavior. Your brother has arrived exactly where his addiction has taken him. It's hard to tell sometimes how close a person is to hitting bottom. It's unique to each individual. It seems your brother has a ways to go. Just remind him that you're there, you're concerned, and you're prepared to be supportive when he decides to make changes.

The title above is the name of a Smokey Robinson song - it explains your brother's behavior well.

"now if I appear to be carefree

It's only to camouflage my sadness

In order to shield my pride I try

To cover this hurt with a show of gladness."

You're doing the right thing. I hope and pray he decides to choose a better life soon. Please let me know if I can answer more questions or be helpful - Best, Jim

Question: I am considering an intervention for an alcoholic family member. Things are very touchy with her. Do interventions ever backfire and make things worse?

Evan Jarschauer Says...:

That is a great question and one that requires careful
consideration before moving forward with any intervention. The primary goal of
an intervention should be to help someone who is in need of immediate care for
an addiction or an underlying mental health issue. In most cases, it is planned
only after multiple attempts by friends and family to help the individual have
failed, or appear to have been unsuccessful. From my perspective, the true
power of the intervention experience is found deep within the collective core
of all those involved in the process. The key to harness all of that concerned energy
is having a comprehensive and caring plan that can be implemented with a
unified approach.  Similar to a paramedic
breaking a few ribs when performing CPR, there may be some collateral damage as
a result of the intervention. Therefore, before you move forward with the
intervention, you have to be able to accept all the potential outcomes
associated with the process, even if that means that you may potentially damage
or strain your relationship with the person in need of help.

Now, if you feel as though you are ready to move forward
with an intervention and your question is regarding potentially pushing your
loved over the edge, then you have to
make sure that your intervention plan carefully outlines predetermined
strategies and solutions to manage each possible scenario along with the
potential fallout. At the same time,
keep in mind that addiction thrives within the fear of those that if affects.
It holds families and friends emotionally hostage, scared to make a move one
way or another. Therefore, making the situation worse, or going over the edge may actually be one of the only ways to help
someone suffering with severe symptoms of addiction hit a bottom, thereby
helping them experience enough carefully managed discomfort to feel the need to
reach out for help and commit to the process of recovery.  

Question: My brother and his wife had their first child born two weeks ago. My brother is a big partier and a fun guy who makes a lot of money doing sound and light for clubs and shows. Because of his job it is normal to have drinks around so I did not realize that things were so bad even though he usually had a beer around whenever I saw him at work. What was eye opening was that when his wife was in labor I know he was sneaking out into the bathroom and drinking. When I called him on this he said he was celebrating and that I shouldn’t get weird about it. I had not spent time a lot of time with him in the last couple of years and even though he was really hiding his drinking from me after I brought it up I could smell it on him all the time. He is an alcoholic I can see this plainly. The question is, with an infant baby in the house and he is the family bread winner should he go to rehab now? I want him to get help but I do not know what to suggest.

Rebecca Ashton Says...:

Thank you for your question. I am sorry to hear of the current difficulties within your family.

Upon reading what you have written, I can see a clear sentiment in that you say; 'I want him to get help' but I am just wondering, what does he want? How would it feel to ask him what he wants you to do (if anything) and what kind of help he might want or need from you?

It sounds as though it might be helpful to try to set some time aside-when you are both feeling calm-in order to talk to him about your concerns and ask him for his thoughts before doing anything else.

It is important to support, not judge your brother and to respect his autonomy as much as possible; if he perceives you to be 'interfering' it could drive a wedge between you. This can be achieved by making your intention to work *with* him very clear. For example, you might suggest that you research local support groups/programmes together instead of doing it on his behalf.

Overall though, I would say that it is very important to put aside thoughts about what *you* want to happen, so that you can really listen to your brother and find out where he is coming from-that can go a long way to helping someone feel supported, rather than hijacked and it can create a much needed stable foundation for the work that lies ahead.

I wish you and your family the best of luck for the future.

Question: How do you do an intervention when the person you want to do an intervention on is high all of the time. If they are not high on some rare occasions it is only because they could not score drugs and during these brief periods they are sick and very irritable and it is hard to imagine an intervention having much chance of a good end result. But on the other hand, is an intervention going to work when the intervnetionee is sitting on the couch nodding off? How do we overcome this very basic roadblock?

Dyan Kolb Says...:

Hello. Yes, tough situation indeed. Try to keep in mind that although your intentions are caring, sometimes the addict needs to really hit their rock bottom. Sounds like the person that you are referring to has trouble with opiate addiction. At the worst of the addiction, the individual is only using at this point to avoid withdrawals from the drug, which is an incredibly painful experience, both physically and emotionally. Also keep in mind that the suffering addict is consumed with their drug of choice, and its likely that any conversation you have with that person is a conversation with the drug. The person you know and love can't really hear you so to speak. 

Some people approach situations like this by evaluating the ways in which loved ones are enabling or supporting the addict in ways that they aren't realizing. For example, sometimes family members allow addicts to live with them, fearing that their family member will be in danger on the streets. Loved ones don't often realize that housing that person is often harmful as well in the context of supporting their use. Tough decisions are hard to make, but setting firm limits and boundaries with the addict is often a wise move. 

Also providing that this person is an adult, remember that you can't force someone into treatment unless they present as gravely disabled (unable to provide for his basic needs i.e., food, clothing, shelter) or a threat to themselves (suicidal) or others (homicidal). If they are able to keep it together enough, so to speak, they have the right to use drugs. That is called self determination.  

Sometimes, the best thing to do is to enforce limits and boundaries around how the addict is effecting your life  both emotionally and financially (if they are dependent on or asking you or others for things) and what you and others will and won't stand for in terms of having this person involved in your lives. It may sound harsh or as if you are turning your back but it's more about not being held emotionally hostage by this person who is making an active choice to continue to use substances and burn his bridges, rather than be open to hearing about treatment options. 

Also, please consider attending al-anon support groups - these are nationwide groups that offer support for family and friends of addicts and alcoholics. You may also want to look into safe needle exchange programs in your area if your loved one is an IV heroin user. If the addict is unwilling to quit at this time, at least provide him or her with information to help reduce risk of IV transmittable diseases. 

I hope that this has at least provoked some thought and possibly answered your questions.

Best of luck,

Dyan

Question: can a drug rehab center make you give consent to speak to your medical doctor or the will dismiss you from the program

Jim LaPierre Says...:

Hi - yes, a rehab center can require this as a matter of policy. This can be a vital part of ensuring safety - especially for a person who is newly sober. Known medical conditions give us an idea of what could be happening for a person whose health is faltering or failing. I'm not sure what you're concerned about but I would encourage you to discuss it with the employees of the rehab - if there is very specific information that you don't want shared that's ok - as you look at the release that you're asked to sign, there will be space/boxes to check on the form that allow you to specify what you're willing to have shared and what you're not. You have a right to your privacy and if you're willing to have a very candid conversation with the rehab this should be easily resolved Good luck!

Question: I am 17 and my friend is 21. We are in the same summer class. She is doing a lot of meth and now she is selling it. She used to be pretty normal but now she is hard to understand when she talks to you. She stays awake for 3 or 4 days in a row and then sleeps for 24 hours. She supports herself by selling. She just had to sell her laptop to get new ‘product’ to sell. She says the money is so good but she keeps having to sell her belongings so obviously there is a flaw in the economics of it all. She is so skinny and she looks terrible. Oh, and her mom is one of her customers – so that is weird too. Everyone knows she is using and selling so I don’t think she is going to get away with this for long. I want to help her but she doesn’t seem to even understand what I am saying to her so what can I do? She comes to school every day but she is going to completely fail and I don’t think she is coming back next semester. My friends and I want to help her before she is gone for good but we don’t know how to start..

Dr. Mark Abrahams Says...:

Dear Anonymous:

I am sorry to hear of your friend's involvement with 'meth.' This substance has had the reputation that "Speed Kills" since the 1960s, and even the occasional 'tweaker' is at high risk for sudden death. I do not want to come off like a 'narc,' because that is not my intention, but without a support system (like a clean parent), the prognosis for change and recovery is not good. While I don't want to get users arrested, the word arrest actually means stopped, and despite your friend's predictable denial that everything is OK, you know things are NOT OK.

She will feel betrayed if you act to stop her, but it sounds like her sleeplessness and irrationality is moving her towards a psychotic break. If you witness her 'wigging out,' or if she calls you in a paranoid crisis, you would do well to call 911. It may save her life. Police are the standard for involuntarily committing a person in such a crisis to the nearest psychiatric stabilization unit for 72 hours of observation and treatment. Meanwhile, be supportive but do not enable her in any way (don't get involved with accompanying her to buy, sell or use).

Don't get caught up in her bad trip, but be available to help. At 21, she is supposed to be responsible for herself. If she refuses to take responsibility for her health and safety, do not allow yourself to be put in harm's way by your association with her. Your attachment will need to be balanced by a healthy detachment. She is not your responsibility, and you may need to let her go, while doing what you can to preserve the safety of whomever you can - including yourself.