Howard J. Shaffer, Ph.D.

Since I began working with addictive behaviors several decades ago, the question people ask me most often concerns the drug and/or alcohol use of a loved one. Some of the worried relatives ask what they can do to stop another family member from drinking, gambling or using drugs. Often they want to stop a relative from doing some combination of these activities. Others want to share the hopelessness and despair they experience when a family member acts out of control. These questions reveal that the people most severely affected by drug abuse and addictive behavior may not be the people who behave excessively. The real victims of addiction are the people who live with someone else's loss of control. This column will focus on the people who surround someone struggling with addiction.

If you live with an adult who is having difficulties with excessive behaviors, there three very important and straightforward things you can do to help yourself. Unfortunately, these things do not guarantee an immediate stop to the addictive behaviors, but nothing can do that. First, don't worry about whether the person you love is really an “alcoholic” or actually has “addiction.” This concern will not help either of you. It will tend to intellectualize the problem and keep both of you from taking action. Instead, identify the behaviors that bother you. Recognize the things that the person does that could be harmful to you and take action to protect yourself. For example, remember that you don't have to ride in a car when the person driving is under the influence of drugs or alcohol. Second, try to make new friends and expand your circle of activities. Living with someone whose main goal in life is to find and use drugs and alcohol can be very lonely. Even when they're physically present, intoxicated people are not usually present emotionally. It is very helpful to talk with others about your situation.

Finally, social support groups break the silence and isolation that accompany the addictive behavior of a loved one. There are self-help groups available for you to help yourself. You have little power to change the addictive behavior of the one you love unless you help yourself first. When you seek help, loved ones usually follow. Don’t force them to participate in self-help groups or professional treatment. Take care of yourself. When your loved one asks about what happened at a meeting or treatment session or who said what to whom, invite them to come to the next meeting or session so they can see for themselves. Curiosity and self-interest usually seduces loved ones to participate in the change process more often than coercion does. Coercion will help some people and hurt others; we cannot distinguish those that coercion will help from people it will hurt. Therefore, as a method of engaging resistant people into treatment, I prefer seduction to coercion. Al-Anon, Alateen, and Gam-Anon are organizations for the relatives and friends of alcoholics, teenage drinkers and gamblers respectively. In most parts of the United States, these group meetings occur every night of the week. These organizations are ready to help and easy to access. Professional care also is available for help with the consequences of a loved one’s addictive behavior. Many relatives and friends of problem drinkers, gamblers and drug abusers have been able to lead more happy and peaceful lives by adopting ideas they got at support group meetings. These principles can improve family life even when the problem drinker doesn't stop. If you believe that you can make a person struggling with addiction start or stop their excessive behavior, disappointment likely is in your future. This is an unreasonable expectation. You simply don't have that kind of power. When a person with addiction begins to feel out of control about their own behavior, they often blame the people who are most close to them for their problems. Technically, this is a form of projection. This usually leads to friends or relatives feeling responsible either to save or cure them. Sometimes family members and loved ones feel guilty because they think they caused the addiction.

It is a very difficult and lifelong lesson to learn, but with few exceptions, people ultimately are responsible for their own behavior. This is particularly true about getting help. No one person can cause or cure another's addiction. Similarly, another family member's addiction is not the cause of your problems. It may often seem that they are causing your suffering—but it just isn't so. The key to helping the person you love is to help yourself. As you begin to find peace and order in your life, the person who is struggling against their impulses and suffering with addiction will learn to adapt to you. They will learn from your example. Drug abuse, compulsive gambling, and eating disorders are baffling predicaments. They cause immeasurable pain and suffering for those who engage in the behavior as well as their family members. Research reveals that a significant number of smokers, drinkers, heroin and cocaine abusers stop their addiction as they mature. Unfortunately, maturity in these cases often can mean that a person struggling with addictive behaviors must reach their thirties or forties before they begin to gain control. Relatives and friends can be most helpful in this process if they can remain supportive and detached—detached from the person’s destructive behaviors and supportive of the person they love. Sadly, people do not always overcome their addictive behavior patterns. Sometimes people die prematurely from excessive behaviors. This is an unhappy, tragic and difficult fact to accept, especially when addiction has adversely influenced a close friend or relative. It is essential to remember that one person's addiction need not ruin the lives of the people who love them. You determine the quality of your life—not anyone else.

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Dr. Howard Shaffer is an Associate Professor at Harvard Medical School and is the Director of the Division on Addictions at Harvard Medical School. Dr. Shaffer is licensed as a clinical psychologist in the Commonwealth of Massachusetts and is certified by the National Register of Health Care Providers in Psychology.