When someone we love is in trouble, we are in trouble. 

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Today, we explore the blast radius of each case of addiction—the proximal suffering resulting from loving or being around someone with addiction. This picture above paints a thousand words, and leaves ten thousand words out. Our image makes a good point, yet it's a cliché—a white male with substance use disorder and their white cisgender female partner—this blog is an overview, with a lot of nuance and untold story. I hope it is a conversation starter; this is a blog and not a comprehensive overview. Rebellion Dogs would love to hear from you.

Sometimes, in my own story, I share about my family legacy, “Shake any family tree and one or two drunks fall from the branches to the ground. My family is no different. And I was not the first family member to enter the recovery rooms. Our family tartan is stained by generations of spillage, rips, stains and chaos.” My story includes those who attempted to help me and others from the clan whom I have also tried to help. 

So let us start here… I have been that person: the loved one, who, in my own self-destructive addiction spiral, caused collateral damage to those who cared about me. At the time, I needed you to understand something—In keeping with my rationalizing, addiction-protecting posture. “I am not the bad guy, here.” I would say. “I am the victim, don’t you see? I’m plagued by a series of bad breaks and serious misunderstandings!” 

Later, from self-examination in recovery, I learned that I was confused (misunderstandings). My consequences from addiction were increasing in frequency and severity (bad breaks), and I was in denial that these were the symptoms of addiction. Alcohol and other substances, in my mind, were the solution, not the problem. Add to that, I can read a room; I see the contempt and the stigma for the way I use drugs. I was forced underground, hiding my consequences and my increasing usage. So I was in denial. But instead of welcoming your help, I was asking, as a person in addiction, for your sympathy and agreement. I desperately wanted you to align with me by, as the crude and poetic expression goes, in the rooms, “Could you please co-sign my bullshit?” 

A sickness of selfishness: 

There is something self-ish about addiction: self-destructive, self-absorbed, needy, and desperate. 

I could not see how hurt people will always hurt people through violence, manipulation, deception, neglect, gaslighting, and/or chaos. I was hurting myself, and these symptoms of suffering and addiction were affecting others. Today, it is not lost on me how hard it is to love a person who will not own personal responsibility, who clings to rationalization instead of reason, and who drives people away who threaten the addiction, now prioritized over nurturing human connection. My antisocial actions were damaging to those I depended on and cared for most. 

As the Chinese curse promises, in a life lived “in interesting times,” the shoe has been on the other foot; I have loved someone with addiction, too. 

Love hurts: 

In a helpless wanting to rescue someone with substance use disorder (or other addictions), my own addiction and recovery offered limited skills to help me help them. Rightfully, in a person-first approach to mental health and addiction, people in addiction are regarded as suffering, not as villains. Also true, those closest to the loved one are within the blast radius of the toxic impact of addiction, sickness, and injury also. This secondary impact also requires love, community, and the treatment of wounds. 

From the National Institutes of Health (NIH) Statistics:

"For each person suffering from addiction, on average, 4 to 10 others are adversely affected. One case of substance use disorder brings adverse emotional, physical, and financial consequences to an average of seven others. Multiply this by the approximately 46.3 million Americans aged twelve and older battling substance use disorder, and now, 2 out of 3 Americans have a family member, colleague, or friend with addiction."[i]

This is a pandemic-level impact on our community. Two-thirds of us are emotionally, physically, and financially compromised due to addiction’s “blast zone.” 

The dorsal Anterior Cingulate Cortex is a critical hub in the frontal lobe that serves as the command center for cognitive control, behavioural adaptation, and emotional regulation. Empathetic brain chemistry is activated when loving someone with addiction. A stranger's pain can cause you or me to wince. Consider the brain energy drain of witnessing someone close to us suffering over and over, bearing witness to a near-death experience… or many such traumatizing experiences, compounding over time. 

Responding to addiction, the autonomic nervous system defends us. By controlling involuntary functions like heart rate and respiration, we may respond with fight, flight, freeze, or fawn responses. [ii]

Our loved one struggles but is also a threat. Involuntary programming, trying to alleviate threats, kicks in. Our senses may become heightened, exhausted, anxious, and overwhelmed. Dissociation, self-blame, becoming reactive, or any number of natural responses under the circumstances are warning signals that we are infected by someone else’s addiction. Nonetheless, if we are looking to help our loved one, unchecked, these involuntary reactions are counterproductive. Awareness, response, and self-regulation are keys to being effective. 

If we are adults, reading this blog, this may not be your first chaos-of-addiction rodeo. If two-thirds of people are being impacted at any given time, consider that some of us grew up with alcohol use disorder or other addictions. Imagine how prolonged influences, during our developmental years, can leave their mark and/or a pattern? We may be developmentally impaired from exposure to addiction in our formative years. Our sense of “normal” is corrupted. Our own trauma may have been overlooked in our youth, due to attention paid to the person with addiction or another suffering caregiver. 

Healthy attachment settings may have been reprogrammed to avoidant or anxious attachment settings. As adults, we may be prone to a negative feedback loop of pursue/withdraw, caused in part due to the untreated impacts of the blast radius of family addiction. Some will obsess with a rescue plan, and our self-concept may be inextricably tied to the other’s fate. Others fall prey to Claudia Black 101: Don’t talk, don’t trust, don’t feel.[iii]

 From The Art of Forgiveness, Loving-kindness, and Peace, Jack Kornfield… 

"Peace requires us to surrender our illusions of control. We can love and care for others, but we cannot possess our children, lovers, family, or friends. We can assist them, and wish them well, yet in the end their happiness and suffering depend on their thoughts and actions, not on our wishes."

Just as the dilemma of addiction—for the addict—is a treatable condition, the impact on those who love someone with addiction is not helpless either. There are things that can be done to manage the chaos of addiction impacting your life. 

Let’s look at some things to do and avoid. 

Avoid: 

Be aware if you are blaming yourself. Loving an addict can be like holding an alligator by the tail: you don’t want to be holding onto an alligator, but if you let go, it may eat you. You want your loved one back; you want them to be well; you certainly don’t want to watch them die. You may feel certain that if you’re not in their face, something terrible will happen, and you won’t be able to live with yourself. Here’s the punchline. If I’m your loved one with addiction, you can’t coax me, threaten me, shame me, or love me into recovery. I am out of control, and sadly, so are you. 

Self-blame has a seductive psychological benefit: the illusion of control. If it’s my fault, I can fix it, right? That false sense of agency is an attempt to shield ourselves against a terrorizing reality. Life is unpredictable. 

This cognitive distortion, called “personalization,” makes you feel in control. If you come from trauma, including facing someone else’s addiction, your survival response may be fawning. Of the “Four Fs” mentioned already (Fight, Flight, Freeze, Fawn), the best-known coping mechanisms are fight or flight, they hyperactive responses to stimuli. There is freeze, a hypoactive response, which means dissociating (playing possum) to avoid pain and panic. There is the fawn response: “You’re right; I need to be more supportive. You’re the one suffering, let me help, I’m so sorry, this is all my fault.” 

Do not make excuses. Making excuses for your loved one to employers, family members, or the community isn’t love. The jargon for stooping to rationalizations and enabling is called codependency. This is the very “affected by addiction” that NIH reports, above. 

The enabling trap: when “helping” crosses the line to enabling your loved one’s problematic behaviour to continue, it can be detrimental to your well-being — physically, mentally, socially, and even financially. And it’s counterproductive to the person you’re trying to help.[iv]

“I would rather step on your toes than walk on your grave.” Beyond Belief: Agnostic Musings for 12 Step Life, April 29th

Avoid losing yourself. Be safe. If your loved one is in danger, both of you being in danger isn’t helpful. You need someone to talk to. Prioritize your self-care. This could be a long journey; hopefully, it won’t be. 

Let’s Be Positive: 

Remember that your loved one does not have incurable cancer. Addictions of all kinds are treatable. There is help for people with addiction and for loved ones who suffer collateral damage. There is professional help and community help (mutual aid). While they overlap, it is rarely one or the other. What we know about people who are thriving in recovery is that multiple services and strategies are employed throughout the recovery process. 

Speak up. This is a countermeasure to fawning. Express your concern about how their behaviour affects you, and explain how and why you care. 

Love is a balancing act: Respond—don’t react; manage your energy, be aware but look out for your own preoccupation; understand boundaries—how they protect you, not punish the other; caring is good, controlling is symptomatic of being part of the chaos. 

Control what you can. Be informed, do not cower in silence and shame. Act in your interests first. This is not at the expense of your loved one. By controlling what you can, you are in better shape to help where and when you can. We have seen Intervention on TV, when friends and family conspire to confront the loved one with the aid of a counsellor who specializes in addiction. At least explore this; in this way, you are not helpless. 

Exercising discernment. Separate the signal from the noise; weigh options, motives, nuances, and intentions. 

The Harvard Medical School’s Overcoming Addiction: Finding an effective path towards recovery, draws on etymology—not the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

“Addiction comes from the Latin word addicere, which means enslaved by or bound to. Anyone who has grappled with addiction understands why. Addiction is a serious, chronic condition that changes your brain chemistry. It is characterized by craving of varying intensity for a substance (such as alcohol) or behaviour (such as gambling), impaired control over the use and continued involvement with it despite unhappy consequences.”[v]

In my case, the benefits of alcohol and other drugs kept diminishing, and the consequences became more severe. Mind-altering substances were a solution that almost worked. I never really got lasting relief, but I felt the benefits without consequences were right around the corner. I was “enslaved by” and “bound to” my drug of choice. Sobriety seemed like a punishment for being bad, or a provisional life, an end, not a beginning. 

If you love someone like me, struggling with addiction, I can tell you that the love and guidance of others were essential to finding and maintaining sobriety. I miscalculated the impact of addiction on me, my life, and the people I loved. 

As a loved one, resist becoming enslaved by another’s addiction. In this way, addiction can be contagious. Those who are close are also suffering and stuck in a cycle. And, like any other challenge, it is not a sign of weakness to accept help from those with experience and expertise. 

Yes/And thinking vs. this-or-that: The keys to abundance and innovation in recovery.

Here is a cautionary tale. 

I was driving home from a Toronto treatment centre where I volunteered as a peer-support worker. With a counsellor, our weekly aftercare group had just wrapped up. In the car ride home, I was listening to a talk show on CBC Radio. A family was sharing their story of addiction with the radio host. The daughter, an Olympic hopeful, had an accident; her medical care included Oxycodone.

Oxycodone blocks pain signals to aid healing and reduce suffering by hijacking the brain’s natural chemistry, rewiring the reward pathways. This manages pain. Physical and psychological dependency are possible side effects. This was the case on CBC Radio. Under close scrutiny, the patient was weaned off. Sadly, the rest of the story reveals that it was too little and too late. 

Addicted, the patient found black market access to oxy to feed her need. She kept her addiction a secret. The cost of the drug became problematic. She turned to heroin, which was available more cheaply from the same source. Despite efforts to keep the continued drug use secret, symptoms became obvious. Her family confronted the sports star. Resisting at first, finally, the storyteller's daughter admitted she had a problem and asked for help.

The family called the doctor. Detox and treatment were recommended. She was ready now, but there wasn’t a bed available in the 28-day in-patient treatment centre for six weeks. The daughter underwent intake and was put on the waiting list. Tragically, while awaiting treatment, our star secretly called her dealer and was given fentanyl. She died of an overdose. 

Empathy and anger were expressed across the airwaves, an expert was interviewed, and the phone lines lit up with listeners' stories and views. What a tragedy; what went wrong with this broken health system! Who is to blame?!?

The system—this is not the right word, and holding onto this one system or best system may hinder outcomes. Inpatient treatment is part of a system. The whole radio show focused on one arrow in a quiver, implying that inpatient treatment was the only arrow in the substance use quiver. 

Treatment is fundamental for many, helpful to others, and unnecessary for some. I wish she could have gotten a bed right away and the help she craved. So did everyone else who called into the show. 

I also wished that other parts of the system had been discussed—not just on air, but with the family at the time of early intervention. At the time, community services, beyond a high-demand treatment center, were ready to help immediately. There is no waiting list for She Recovers, Narcotics Anonymous, LifeRing and other peer-to-peer support, with a seat at the table beside people who know, today. There are transition houses for people waiting for or transitioning into inpatient care. There are life/recovery coaches.

People in Recovery surveys were conducted in the UK, USA, Australia, and Canada between 2015 and 2017. In North America, the report revealed that respondents utilized an average of 3 or 4 different services/supports, simultaneously or sequentially, to sustain their long-term recovery. In these surveys, respondents reported up to twenty different available services.[vi]

The dualism of this-or-that comes from its own addiction to certainty. “I want the best, forget the rest.” Alternatively, Yes/And denotes innovation, creativity, and abundance. Do what you think is best, and more.

The day our athlete was ready, she—and her whole family—could have accessed multiple pathways, while waiting on a bed for six weeks. Whether online or in person, there are peers who have been there and can help at these organizations I mentioned above. At an NA meeting or Women for Sobriety, recovery peers who have been through it are ready now, no cost, no waiting. 

I am not saying Narcotics Anonymous (or fill-in-the-blank mutual aid group) is better than treatment centres; I am saying, yes to treatment and yes to mutual aid and yes to yoga, and a good book, or podcast. 

In the Canadian Center for Substance Use and Addiction's 2017 survey, participants offered their firsthand experience. One reflects, “I recognized that drugs and alcohol had become more important to me than my family and people I loved.” Also mentioned as a barrier to recovery was, as CBC Radio reported, a long wait for inpatient treatment. Again, this speaks to a many-paths approach over a monofocus recovery plan. 

NIH research on Addiction-Affected Families’ (AAF) issues and the lack of attention given to their difficulties and treatment in interventions and clinical practices indicate that the primary focus consistently revolves around individuals with addictive disorders, even when the treatment process involves their families.

Research shows AAF experiences include severe emotional distress, financial instability, and deteriorated mental health. Children of addicted parents are particularly vulnerable, facing a much higher risk of developing anxiety, depression, and substance use disorders themselves.[vii]