By: Travis S. Miller

You are not alone. I want to say that right at the start, because if you're anything like me, finding yourself in the position of having a loved one destroying themselves before your eyes, a large part of your thinking is going to be saying "I can't talk to anyone about this."

Not true. I'll get to that.

First, though, I want to talk a little bit about the disease of addiction, to give you a grounding in what's going on in the mind of your addicted friend or family member. There are dozens of myths, moral platitudes, well-intentioned half-truths and flat-out fabrications out there, so I think it'll be helpful to cut through the crap first. We're dealing with a disease that, directly and indirectly, kills more North Americans than any other single cause. The only difference between a bottle of booze/crack pipe/heroin syringe and a loaded pistol in the mouth is the speed with which the addict gets dead. When you get done reading this, you're going to go out into the world and help save the life of a fellow human being. So here are some things you'll need to know.

Being addicted to something is not about the pleasure that the drugs bring (and by drugs, I mean ALL drugs -- alcohol and nicotine are both powerful psychoactive drugs. Just because the government says it's all right to buy them doesn't make them any different or less harmful than crack or heroin). Drug use is a symptom of addiction -- not a cause. Let me say that again, because in most of the popular literature, cause and effect are reversed. Drug use is a symptom of addiction, just as, for example, excruciating pain is a symptom of a broken leg. Instead of a broken leg, an addict has a broken thought process. That broken thought process causes the addict to seek something that numbs the pain of the broken thoughts, exactly like a broken leg will cause you to seek something to numb the pain of your splintered tibia. Now, when you break your leg and get rushed to the hospital, the ER doctor doesn't just give you a shot of demerol and say, "Okay, the pain's gone -- you're cured. Go home." Patently, if they pulled something like that, your first stop after being properly treated would be a malpractice lawyer's office. Yet in too many cases, when we think about addicts, we think, "Just stop doing the dope and things'll be fine."

"Okay," I hear you ask, "so why can't they just quit? I have a few drinks after dinner sometimes and it doesn't ruin my life!" This leads directly to point number two: Addiction is a disease of self-esteem. Now, that looks a little odd just standing there by itself, I'll admit. You can go out and read any number of textbooks to explain in a lot more words the same thing, but here it is in a nutshell: An addict has at his or her core an absolutely inviolable belief that he or she is not worthy of your love (and with that, I'm going to stop saying "he or she" because it's awkward and takes longer to type. From here on, if you see "he" or "she" or "they," it means both, because addiction doesn't discriminate). In every single case of addiction I've run across -- which is, quite literally, thousands of cases -- the addict has known, without question and usually since her earliest memories, that she is somehow less of a person, less of a human being, less worthy, less attractive and less lovable than everyone else around her. Remember this. It's important.

Addiction is not a lack of willpower, or lack of moral integrity. In fact, when addicts get into recovery, the same personality traits that led to their downfall make them some of the most scrupulously honest, diligent and compassionate human beings I've met. Like everyone else, addicts want to be loved and appreciated by their family, friends and coworkers, but being saddled with the knowledge that they're inferior and unlovable (the disease of self-esteem) has placed them in such a world of devastating emotional pain that they quite literally have no choice but to blunt their anguish with drugs -- or behaviors like compulsive sex, gambling and work.

Only the addict can make the decision to seek help...but you can help create the conditions to make that decision more attractive. Narcotics Anonymous, a 12-Step program of recovery from addiction, says this about the decision to quit: An addict will only accept the need to change "when the pain of changing becomes less than the pain of remaining the same." So what does that mean in real life? The answer is different for every addict. You've probably run across the term "hitting bottom" at some point. The "bottom" referred to is not necessarily a physical location -- a skid-row hotel room, for example -- but an emotional state, where the spiral of drug use, consequences, shame and then more drug use has reached a point where the addict wants only either to die or to change. Most of the literature regarding addiction agrees that "hitting bottom" is a more-or-less essential starting place on the road to recovery. The really tragic part is, for the vast majority of addicts, the bottom they reach is the bottom of a grave. So with that sobering thought in mind, let's start painting a picture of recovery.

Raise the bottom. I've been to too many funerals. Now, I want to start filling in the grave before someone drops into it. How do I do that? Well, if the person I want to save from that cold fate is an addict, I have to stop helping him kill himself. Say these words (really. say them out loud, right now): "I love you too much to help you die." Think about what they mean. The first five hundred times an addict hears the words "I love you," she thinks to herself (because of that broken thought pattern I spoke of earlier), "You're just saying that. You're just saying that because you want something from me; you're just saying that to make me feel good; you're just saying that to make yourself look good..." Eventually, though, if you mean it and she hears it enough, sees it demonstrated enough, a crack opens in the armor of the negative self-esteem. "Maybe....just...just...maybe, someone does love me." And "I love you too much to help you die" means that because I love you, I'm going to start doing (or not doing) things that you won't like, because those things have been making it easier for you to continue getting loaded. It means "I love you too much to:

phone your boss for you
        ("You chose to get loaded last night -- it's up to you to deal with the consequences.")

buy your groceries
        ("I guess you'll have to try the food bank if you spent the grocery money on crack.")

buy your cigarettes
        ("If you can't afford cigarettes, I guess you'll have to quit.")

pay your rent
        ("Better tell the landlord you spent the rent and see if you can make some arrangement with him.")

make excuses for you
        ("I can't lie for you anymore.")

believe your lies
        ("You know that's not true. Please don't lie to me.")

buy your dope for you
        ("No.")

loan you money
        ("No.")

let you blame others for your situation
        ("It's time for you to take responsibility for your situation.")

talk to you when you're loaded
("We can talk about this when you're sober.")

let you care for children when you're loaded
        (This is a big one. "I don't feel safe leaving the kids with you like this.")

spend time with you when you're loaded

let you drive loaded...
...and generally, I love you too much to do anything at all that makes it easy, or okay, for you to keep on using.

(I didn't say this was going to be easy. In fact, it will be one of the hardest things you've ever done). In short, what you need to say to your addict is, "I love you so much that until you decide to get help, I'm not able to see you or deal with you at all, because you're killing yourself with your addiction and I can't bear to see it."

Then, on the flip side of the equation, when your addict does decide to ask for help, you're going to do everything in your power to help her stick to it. Here's how.

Quitting is easy. Staying clean takes work. I am not a doctor, and I do not pretend to provide or imply medical diagnosis or advice. The following are general suggestions based on my personal experience only.
There are a lot of factors involved in getting off drugs, but primarily let's look at a few details: Regardless of what drug your addict seeks to stop, it never hurts to seek a qualified doctor's advice and assistance, but if your addict's "drug of choice" is alcohol or  "benzos" (valium and its chemical cousins), medical supervision during the detoxification period is strongly encouraged. Withdrawal symptoms from these drugs can be fatal. In addition, opiates (heroin, methadone, opium, morphine) can be excruciatingly painful to get clean from. Other drugs, like marijuana, cocaine, crack, speed, crystal meth and ecstasy, do not cause the intense physical dependence that characterize booze, benzos and opiates, but that does not mean that kicking them is any easier! Check with your local health providers -- they will be happy to steer you toward recognized detox and addiction-treatment facilities.

Once the addict makes the decision to seek recovery, he needs your help. It's critical, though, to distinguish between real support and enabling. If by helping you provide love and emotional support, understand that addiction is a mental illness and not a lack of will-power or a moral deficiency, encourage them to get to and from counseling appointments, Narcotics Anonymous, Alcoholics Anonymous or other meetings, and making sure he has the physical necessities of life, then by all means, get on it. On the other hand, being an occasional crying towel, loaning money and believing the inevitable bullshit when someone is making an insincere act of quitting rates slightly less than zero on the actual help scale.

Other valuable help (especially if the addict is living with you during the detox and early-recovery phase) is locking up or removing any booze or prescription medication (getting clean means getting clean, not substituting one drug for another) blank checks and cash that might be laying around your place . If I was the addict trying to quit at your place, I'd consider it a favor that you had done so, because any temptation might be enough to send me off again. If she has any current prescription medications, strongly suggest that you keep them and dispense them to her according to doctor's directions, period.

The question virtually all treatment schemes ask the addict right at the get-go is, "What are you willing to do to get clean?" Ideally, the person in question has reached such a place of physical, emotional and spiritual bankruptcy that their answer is an unqualified "Anything!" Then, once they've bitten the bullet, the first few weeks of recovery are critical. The cravings an addict  experiences for their drug can be unbelievably intense, and can take a long time to diminish (what clinicians refer to as "post-acute withdrawal" can take as long as two years to subside). The reason a lot of people go into detox centers or treatment facilities is to keep themselves safe from the cravings through the first days/weeks. There's a lot to be said for such places, but they are not essential to recovery. What is essential is peer support, and a close second behind that (some might put it first) is individual therapy from a qualified addictions counselor.

REALLY IMPORTANT: Relapse is NOT failure! Recovery is not always a straight-forward path. If your loved one goes back to using after getting clean, don't despair. Put back into place all the tools mentioned above, but make clear to them that you still love them and want the best for them. Encourage them with all the strength in your power to get back on the path of recovery. When a cancer survivor experiences a relapse, we don't give up on them -- don't give up on an addict just because she isn't completely cured after the first shot at treatment.

Finally, don't neglect yourself! Two organizations that are enormously valuable to friends and family of addicts are Al-Anon and Nar-Anon. Both (along with AA and NA) can usually be found in your local phone book.