Tag Archives: enabling

Learning to Sit Still

“On the plane from Albany, New York to Portland, Oregon, I deleted my heroin dealer’s phone number. It wasn’t the first time I’d done that—more like the 15th—and each time I’d felt a strange resistance. I knew that I would miss my heroin dealer that had been oh so accommodating in terms of helping me to ruin myself. I loved people that enabled my irresponsibility. In hindsight, he was my doctor. And I was a happy patient.” Read the full article from TheFix.com.

DBT is a core part of  Behavioral Health Hawaii’s  Intensive Outpatient Program.


Most of us have seen at least one episode of the TV hit show Intervention. They show graphic images of the addict using, the families talk about the pain cause by the person’s drinking or drug use, then the big drama filled secret meeting showing the person hopefully going off to treatment. A family contacted me recently wanting an intervention. I asked the Mother who appeared to be the enabler to come to my office to discuss the situation. In our session we discussed the issue at hand devised our next steps, she went home to speak with the other family members. We set up a meeting with siblings and close relatives, invited the addicted individual, making sure no one was being secretive. The addicted individual knew they were coming to discuss the issue at hand. I tell family member to say to the addict, “I would like you to come to help me deal with this issue.” Nine times out of ten the person will come to the meeting. Everyone showed up to the appointment with the addicted individual in tow. We met for about an hour and a half, the addict family member left agreeing to go to treatment. My services were about $300.00 for the intervention. Not everyone can do an intervention this way. They had the resources to set up a treatment facility on the Mainland. They had plenty of family members to stay with the person and keep the momentum going. I was told it took 2 hours to get the person in the car to go to the airport. They had someone stay with him in California for a few day during detox so they were the exception rather then the rule. The addict is in long term treatment and hopefully they will stay. The family will need to do their own work because they become as sick if not sicker then addict. Interventions come in all different sizes and shapes. Interventions work but it takes a lot of effort on the part of everyone involved to make it sucessful long term.

Treatment Does Work

I can’t tell you how many times I hear addicts and their family members say “he/she/I have been to treatment already it doesn’t work.” This is a common misconception, the idea that if someone has been through treatment once or twice that the option of residential treatment is off the table.

To first address the misconception that “treatment doesn’t work”:

There are treatment facilities that do a better job then others, but overall most people are able to maintain abstinence while they are in treatment, therefore treatment, if the goal is abstinence, works. What doesn’t work is not following through with the aftercare plan. The other thing that can cause a person to fail is if the treatment isn’t long enough. Most insurance will only pay for 30 days at the most. It has been proven time and time again that 90 days for many addicted individuals is the minimum stay for the desired outcome.

If you suffer a heart attack and don’t follow the recommendations of you MD, you will have a higher chance of having another heart attack. Addiction, like heart disease, is a serious illness and if you want to recover you must make lifestyle changes.

Most aftercare plans recommend 12-step meeting attendance, get a sponsor, meet with a therapist, don’t hang out with using friends. Intensive Outpatient Treatment that we offer at BHH is also an important part of the recovery process. Intensive Outpatient treatment gives the addict/alcohol dependent the structure and accountablity they need to maintain abstinence. Addiction like any other disease is prone to relapse. If a person is in treatment, getting regular urine drug screening, attending 12-step or some kind of clean and sober support group, family counseling, and medication management, their chances of recovery increase significantly.

The treatment professionals do families a disservice by not informing them of the importance of aftercare. The addict gets out of treatment and they feel great the, family has their loved one back, everyone is elated. The addict has a sincere desire to stay clean and sober but without help, the stress of staying clean and starting a new life gets to them, they don’t follow through with building a sober support network, or a treatment program to help them through the first few months of sobriety and boom, they relapse.

My point is this, the addict/alcoholic needs to be in treatment and involved in some sort of sober support network for at least a year to begin to have a good chance at long term recovery. Treatment Does Work, but you have to work it if your goal is long term recovery.