Enabling can be harmful to a person’s recovery. This blog will look at what enabling is, and how you can support a person in recovery rather than continue to aid them in their addictive behaviors.
Definition of Enabling:
According to the dictionary, to enable is to “give someone or something the authority or means to do something,” or “to make possible.” With regard to substance abuse, enabling is removing the consequences of behavior, so that the person can continue to use. Examples of enabling include: giving money to the addict, lying to their employer about why they’re missing work, completing tasks the person is responsible for, making excuses for their absence or behaviors, paying off debts, or bailing him/her out of jail. The person who enables sees their behavior as helpful, but what it can do is prolong the “rock bottom” the addict usually hits before trying to get sober. Think about it—if I have someone paying for my drugs or bailing me out of jail, why am I going to stop using? I have no consequence for my behavior, and no incentive for change, so I can continue to engage in the same things I’ve always done.
Harm to the Enabler:
In addition to the obvious harm to the addicted person, the person who enables also ends up harmed. Oftentimes, a person who enables resents the things they take on to help the addicted person, usually put others needs ahead of their own, fear retribution so they don’t often express their emotions, lie for others, and are stressed out because they’re not taking care of themselves or their needs. Al-Anon, counseling, or other groups can help provide support for people who have a loved one who has an addiction. These groups or counseling can also help people create healthy boundaries so they can support a person’s recovery rather than continue to enable a person’s addiction.
How to Help Recovery:
People who are used to enabling may find it difficult to set healthy boundaries. They may feel that saying “no” to their loved one is “mean.” The person who is used to getting what they want will likely be upset with newly created boundaries as well. This may result in fights and anger that may make you want to forget the boundaries and just give in. Honestly, this discomfort can’t be any more challenging than the daily anguish of having to watch someone slowly deteriorate due to their use of drugs/alcohol.
Some ways to stop enabling can include: not giving the person any money for any reason, not lying on their behalf, not doing tasks/errands/work for them, not driving them places, and not bailing them out of jail. It is so important that you have support during this time, because your addicted loved one is going to use every manipulation tactic in their arsenal to try to make you give them what they want. It can be difficult to stay strong with your boundaries without healthy support from others who have been through a similar situation.
What makes 12-step programs a good viable option for continuing care after treatment? Let’s look at the reasons to stay engaged.
12 Step Programs gives those in recovery a means of continuing recovery. Life is still going to happen. There are days that will be harder than others. It’s like being up at bat, hitting the ball and running the bases. Each base is a part of the day that demands work, decisions, interaction with others (“words with the boss”). Not all days are easy. So when I’m heading for “home” (my meeting place, or home group), the ball is being hurled to the catcher, I slide in, dust is everywhere, I look up, the umpire pauses and then his arms reached out to the side says… SAFE ! I’m safe and during the first minutes I can re center myself and know all is well.
I’m with people like me.
A Sponsor is someone who takes you through the steps and helps in dealing with life on life’s terms. This is one of the most important relationships I can have. My go to person in life. The experience they offer is priceless. My Sponsor wants better for me than I want for myself. Someone that is louder than my head.
The direction is like this, “Sponsors hold the flash light while you look”. I need my lights, along the way, so I can stay out of the weeds, and on the path. I was given much direction, which I needed, as my life was unmanageable by me. I had not been a person of integrity, or accountable to anything or anyone. I had to learn how to go to work and stay all day. How to be where I say I’m going to be and do what I say I’m going to do. Go with my first commitment and not back out of it because something better came up, (an old idea for me). My Sponsor showed me this through inventories, steps 4&5.
Eventually I must give it away to keep it. When sponsoring I remember that this is someone’s sister/brother, someone’s aunt/uncle, someone’s mother /father…this is someone’s someone. I share my experience and together we both grow. To whom much has been given much is expected…
‘Among them you will make life long friends’…
The fellowship in the program is what keeps me accountable as well. I needed to learn how to be a mother, sister, friend, partner the examples in the fellowship were also my teachers. I have a list of people that I call daily and find out how they are, (keeps me out of self). I had to learn to reach out to the fellowship, which is not always easy. Then in turn, I learned how to have solid relationships with others. Sponsors are not always accessible, so the friends in the fellowship are a big part of recovery. Some days I just get in the car and go to the conference, or to the out of town meeting, these road trips with others taught me how to become one of many and these actions lead to the feeling of being a part of something bigger than me. I learned how to take the actions toward a sober life, even when they felt uncomfortable.
The steps well worked will lead to a way of life that enables sobriety. Taking the steps and having a sponsor, (to take them with) insures accountable.
The 5 Things:
I hope you get to live on the sunny side of the street…
Since the 1980’s there has been a movement towards a different conceptualization of addiction, from one that required ingesting a substance, to an alternative perspective that includes a focus on behavior. Through this new behavioral model of addiction, there has been an increased amount of attention considering the diversity of behaviors that could be considered addictive, for example, sex, shopping, gambling, and most recently, addictions associated with the internet. Most recently, the DSM-5 identified Internet Gaming Disorder as a condition warranting more attention from clinicians.
In the late 1980’s, the introduction of the Nintendo home gaming system generated continued interest in video games, and industry sales figures went from $100 million in 1985 to $4 billion in 1990. Over the last decade, as interactive games have migrated computer use over the internet, much of the online game research has examined the impacts of Massively Multiplayer Online Role-Playing Games (MMORPGs). These MMORPGs are virtual three dimensional worlds that allow game players to immerse themselves in different environments and interact with others via the internet and each of them is a self-contained society where game players have characters that can grow and evolve. In the United States, more than 45% of gamers play for over 20 hours a week and over 80% of those who play MMORPGs had indicated that they had gaming sessions that lasted for over eight consecutive hours. Today, popularity of online gaming is widespread, involving nearly one out of every two internet users, totaling 87 million users in the United States alone.
Some of the impacts of internet gaming that have been identified by researchers include: negative effects on social relationships, less social competence, performance decreases in work or school, decreased satisfaction with life, lower self-esteem, and a variety of physical problems.
One important note is that internet gaming addiction has all the common characteristics of other addictions (tolerance, withdrawal, using for longer, unsuccessful attempts to limit use, decrease in other activities, continued use despite negative impacts) but also uniquely gives the ‘user’ the feeling of being connected to a community. This factor is one that is important for clinicians to take note of when treating internet gaming addiction
Other important factors to examine when treating internet gaming addiction are the motivating factors that are keeping the gamer ‘hooked’. Some of these factors are the feeling of community that the gamer gets from playing, the sense of achievement that comes from gaming that the gamer finds lacking in other areas of life, the sense of escape from their real life (RL), being able to create an avatar that has characteristics that the gamer wishes they had, the feelings of control, or an outlet for aggression. Treatment of internet gaming addiction must examine these factors to individualize the treatment for each client’s specific motivational factors.
We choose to set aside money for many pleasant events during our lives. We certainly save money to buy a house. We save to pay for college or to go on our dream European vacation. There are things we don’t save for though, because we don’t feel we should have to. More and more families today are being faced with having to send a loved one to treatment for addiction. Determining how to pay for treatment can be a daunting process to navigate during this very stressful time.
The most common method is to use government assisted programs that pay for state funded treatment facilities. With the introduction of the Mental Health Parity and Addiction Equity Act, more individuals have access to treatment through private insurance. The mental health parity act aims to ensure that medical benefits and mental health benefits are equitable. Many programs accept private insurance. Most addiction treatment programs accept insurance on an either an in or out-of- network basis. In and out-of- network facilities generally require the client (insured individual) to meet their deductible before admission to treatment. By law, facilities are required to attempt to collect the deductible. There also are individuals fortunate enough to be able to pay out of pocket for their treatment. Most facilities offer some internal financing options to help alleviate the financial burden for the family. In some instances, families are forced to take out personal loans either with a bank or family. Figuring out how to pay for addiction treatment adds to the overall stress of getting treatment help for a loved one.
When choosing a treatment program, it is important to look at specific characteristics of each program. Going with the least expensive option does not necessarily mean a lower level of care and likewise, going with the more expensive option does not necessarily mean better treatment. It is important to find programs that are licensed, accredited, and have credible staff. When considering the staff a program has on their website, it is important to make sure that the treatment professionals actually work at the facility and are not just contracted to use their name or credentials.
Due to the Affordable Care Act, there has been an increase of 20 million people that have access to health insurance benefits. Individuals up to the age of 26, can be covered by their parent’s insurance policy. There are many ways to make treatment accessible. Talk to an admissions counselor about your options in order to make an informed decision. There are many support groups that can help you to find the right program from practical experience. One group, Mother’s With a Purpose focuses on helping families navigate the process of how to pay for treatment and the right questions to ask. More information about Mother’s With a Purpose can be found at their website: http://motherswithapurpose.org.
Prescription drug abuse is becoming a big problem in the United States, and prescription painkillers like Oxycodone and Vicodin are among the medications most commonly abused. A recent government report found that abuse of prescription opioid medications increased by more than 111% between 2004 and 2008.
People engage in prescription drug abuse for a variety of reasons, but the biggest reasons for its increasing prevalence are the drugs' availability and the misperception that drugs prescribed for medical use are safer than illicit street drugs.
Drug rehab centers are helping more and more clients who arrive with a prescription drug abuse problem, many of whom are addicted to prescription painkillers. Some prescription drug addicts don't realize they have a problem, or even that the drugs they are taking can be unsafe, until they end up being treated in the emergency department of their local hospital. During the 2004-2008 period of the previously mentioned study, emergency room visits due to prescription painkiller abuse more than doubled.
In response to this massive increase in prescription drug abuse, drug rehab centers like Elm Tree Recovery are providing services that can be tailored to the specific needs of those addicted to painkillers. The drug rehab center at Elm Tree Recovery provides individualized treatment plans designed to meet the unique needs of each recovering addict, including the many who struggle with prescription drug abuse.
In order to define the pathology or etiology of a disease consists of three things; of a disease, an organ, defect, symptoms (McCauley, 2009). From the biomedical model the brain is the organ that has an abnormal neurobiological reaction pertaining to the neurotransmitters dopamine and GABA. The defect is the deficiency and overcompensation of dopamine which results in symptoms such as tolerance and withdrawal. According to the National Institute on Drug Abuse [NIDA] addiction is a brain disease because of the changes in the brain that occur as a result of substance use. This concept pertains to the neuroplasticity of the brain psychological and physical reliance occurs. The biomedical model depicts how the mesolimbic dopamine system and the stimulatory and reinforcing an individual and affect their behavior.
There are some individuals that claims addiction is not a disease. Even the leader in neuroscience Eric Kandel Nobel Prize laureaate finds those individuals to be irrelevant and incorrect. When Eric Kandel and Nora Volkow tell you you’re off base, they’re probably right.
The most interesting point is that addictions impacts the neuroplasticity about how the changes of the brain pertain to language and learning which is true. But to say that language and learning discredit the disease concept is offensive to the 5 million individuals that have Alzheimer's disease. explain the influx of high socio-economic Eurocentric heroin users? If addiction is not a disease, then one needs to address the American Medical Association and address diabetes, hypertension, cancer, Alzheimer's, stroke, schizophrenia, and Alzheimer’s being classified as diseases. Research conducted using positron emission tomography (PET) demonstrated how endogenous opioids released into the orbitofrontal cortex and nucleus accumbens provides insight to how complex the intricacies are in the human brain relating to OUDs (Mitchell et al., 2012). Opioids increase the quantity of dopamine released in the brain reward system referred to the mesolimbic reward pathway and simulate the effects of endogenous opioids. Depending on the route of administration (injection, snorting, smoking, suppository, ingestion) the opioids pass through the blood brain barrier at different rates. From there the activation of the opioid receptors in the reward pathways cause a rush of euphoria, which then is followed by relaxation and perception disturbances (Powers, 2012).
Physical dependence is a literal change in biochemistry. Which is literally identical to hypertension and diabetes in pathology. Addiction involves the nucleus accumbens and prefrontal cortex as the centers of addiction. Addiction additionally impacts the mesolymbic cortical pathways pertaining to dopamine and glutamate both of which supersede the prefrontal cortex. Specifically, D2 receptors. Anyone that has access to scholarly articles can literally prove this with science.. Experts agree that there is more to substance use disorders than just neurochemistry, but if by every definition of the word, Addiction is a disease.
Written by – Adam McLean
McCauley, K. T. (Director). (2009). Pleasure unwoven [Documentary]. USA : Institute
for Addiction Study.
Powers, J. (2012). When the servant becomes the master. Central Recovery Press: Las Vegas, NV: