Greetings to the community. I'm looking for advice on a situation.

Before I met my wife, she was a heroin user. Based on her history and behavior of use, neither of us really categorized her as an "addict," but she was a user. She kicked it right before we met and stayed off it for years, promising it would never again be an issue (which I trusted).

However... She recently relapsed.

Owing to a number of factors, chief among them surviving cancer and (likely, though as yet un-diagnosed) RA, along with a number of other influences like family history and (probably) poor diet and exercise habits, she is in a great deal of chronic pain. We have spent years trying a great deal of medical (professional and otherwise) treatments to no avail. The pain was affecting everything; her mood, her ability to be productive, her ability to concentrate and achieve her goals, everything.

So, without my knowledge and (as was claimed) to her own shame, she started using again. Small but regular quantities to (as was claimed) manage the pain but not "get high." When I found out what was happening, I confronted her about it and insisted I be allowed to help rather than kept in the dark. She admitted I'd handled the situation in the most supportive way she'd imagined and agreed to cease use and seek treatment, attending a Methadone clinic within the next few days.

She has been a model patient; attending daily and regularly, passing all UAs designed to find usage of substances not prescribed, and completing her assigned therapy appointments. (Though, she does not take her take-home doses as prescribed, preferring to mete them out differently to deal with the pain in a more targeted way.)

However, despite constant dosage increases, she has not reached what she considers to be a "therapeutic dose" (described, by her, as "enough to remove the pain and not be jonesing for another fix").

This is all backstory. Where I need guidance is in how to deal with the current situation: She has become mean. She is grossly intolerant of most things, responds harshly and with malice to the needs of others, and has a generally sour disposition. She can't stand criticism, is unable to complete most tasks that require focus, and has lost all compassion within her. She sleeps most of the day (upwards of 15-18 hours), is incapable of bringing herself to complete chores (even the most basic, like washing a dish or changing a diaper on our child), and appears to have no interest in anything.

I have dealt with depression my whole life and I recognize and empathize with many of these struggles. However, I try to believe that most of this can be attributed to the amount of pain she must be experiencing, and I have no experience with that myself. I also have no experience with Methadone treatments, though I have a pretty expansive knowledge of addiction (and many expert resources available to me).

I bear no ill will towards her and feel nothing but a desire to be supportive. I just (apparently, by the lack of progress) don't know how to do that properly. I need help understanding what she is going through and how I can do more or less of something to make her more successful. I'm sure there are many schools of thought around these issues, and I've been purposefully general so as to cast a wide net at the range of possible solutions. I reach out to the community to help me learn about her/my options in the hopes I'll get some good ideas of what I might try.

Thanks for reading this rather long description.

The book I’m not sick, I don’t need help by Xavier Armado came up quite a few times when I attended support groups. It’s apparently pretty helpful in working with a friend or family member with addiction that is denying treatment. I have not had the chance to read this; have any of you read this? What did you think? Were there other books you’d recommend?

Here is the Piped link for added anonymity.

I came across this video about the 5 Stages of Change, and what those stages usually look like. Dr. Prochaska relates some of the examples directly to addiction and mental health, but many of the concepts can also be applied to broader changes in your own or someone else's life.

I thought many of the points were pretty spot on, such as the myth that a person with addiction needs to hit a certain "rock bottom" to initiate a change in the addictive behavior. The lecture is through the lens of a healthcare provider but delivers the speech without a lot of medical jargon. Here are some notes I took while watching it:

Stages of Change

1. Pre-contemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance

Pre-contemplation

• lack of recognition
• resistant

Contemplation

• Person recognizes need for change but is ambivalent (conflicting feelings)

• not like child development (i.e., intrinsically motivated)

• Two Forces:

• Developmental Events - e.g., smokers usually experience this at age 39, to live on the track the person is on or change the quality of projected life
• Environmental Events - e.g., dog dies from lung cancer

• myth that addiction needs to “hit rock bottom”
• Importance of identifying the pros and cons: patient practices taking part in their own care and feel more in control
• more likely to follow through makes it more approachable

Preparation

• make people as prepared as possible

Action

• people have to work the hardest / most demanding
• about 6 months

Maintenance

• still have to work, just not as hard
• period: less clear how long in recovery: you are always “in recovery”
• about 40% of smokers relapse within 5 years
• Reasons for relapse: distress (weakest points): depression, anxiety, boredom, hostility, stress, loneliness
• planned strategies is best

• talking/therapy
• exercise/physical activity
• meditation/prayer (some way to let go)

Defining termination (not going back): “total confidence across all high-risk situations, that I will not go back to my self-defeating, self-destructive, unhealthy pattern of behavior.”

• one indication: the person stops dreaming of their substance of choice

Consciousness Raising and Education

• does not lead to immediate action, they lead to contemplation (during pre-contemplation)
• also, fear. Evoke emotions.
• changes in behavior usually involve changes in self image / self identity

Self Liberation

• the belief that “I have the power to change my behavior”
• people tend to mistakenly think of this as a trait (e.g., “I didn’t have enough will-power”)
• giving people 2-3 choices make them more likely to follow-through

Giving Support

• people tend to think there will be more praise than they actually get
• “Depression is the stress equivalent to smoking a pack of cigarettes per day.”
• People with depression who randomly received follow-up home visits within one year (social relationships) had 50% fewer deaths
• Replace / find alternatives for behavior we tend to think of depression as a passive problem

The web link is from the Substance Abuse and Mental Health Service Administration (SAMHSA) and has some good discussions about addiction. The most helpful section for me was “Recovery-Oriented Systems and Services.” Most of the videos are around and hour long.

Here are Piped links to the YouTube videos, in case you want the option to view them with some anonymity.

https://piped.video/watch?v=CaIyaYAEu_c&list=54376afa-95d3-4508-b217-6de0bce9d794&index=2

https://piped.video/watch?v=MGAyU7ncD4M&list=54376afa-95d3-4508-b217-6de0bce9d794&index=3

https://piped.video/watch?v=RTbatWxWpCI&list=54376afa-95d3-4508-b217-6de0bce9d794&index=4

https://piped.video/watch?v=JWxcbaVyeqM&list=54376afa-95d3-4508-b217-6de0bce9d794&index=5

https://piped.video/watch?v=a2_rfx9QbtU&list=54376afa-95d3-4508-b217-6de0bce9d794&index=6

I have mentioned it before, but the book Addict in the House has been one of the more helpful resources for how to approach a friend or family member with addiction. The link is a version of the main points. Here is an excerpt:

“When addiction enters your home, it can be very disorienting as questions flood your mind.

Should I say something to my loved one? Do we have an intervention? What is rehab, anyway?

If this sounds all too familiar, know you are not alone. These are the same questions everyone living with an addict must eventually answer.

And there are certain things to do—and not to do—if you think you are living with an addict.

1) Talk to your loved one—in a very specific way.

If you’ve lived with the effects of a loved one’s addiction for any amount of time, you are likely confused, scared, and possibly even angry. These are all normal emotions to feel when the person you once knew and loved is no longer himself, and those feelings often spill over into how you speak to him. However, as addiction grips your loved one’s mind, concern often translates into a perceived attack on the one thing he believes is keeping him alive: his substance of choice.

So how do you talk to him truthfully and effectively? These guidelines are a good start.

• Do be truthful, but don’t vent. Speak honestly about your personal experience of his addiction, but stick to the facts versus unloading your emotions on your loved one.

• Do ask your loved one to consider getting help, but don’t ask him to quit using. It is far easier for your loved one to consider talking to a counselor than to be asked to abandon the thing his mind, body, and emotions have come to completely depend upon to feel ‘normal.’

• Do identify specific forms of help, but don’t hound them about it. If you’ve offered your loved one a therapist’s phone number and he has it, do not pester him every day to find out if he’s called. This feeds into the idea that you are trying to manage his addiction, and that responsibility lies squarely with your loved one.

• Do listen, but don’t advise. While you don’t want to engage in futile debates with the addict in your house, actively listening to him can be very helpful when he hears his words out in the wide open space between you. However, resist the urge to hand out advice no matter how obvious or logical it may seem. Instead, actively listen by repeating back what you heard him say: “I hear that you feel overwhelmed by school right now. That must be difficult.”

• Do acknowledge positive signs, but be careful with praise. Any sign that your loved one is beginning to understand the seriousness of his addiction is reason for celebration—that is a significant step. But be careful not to praise in such a way that communicates your loved one is responsible for your feelings, such as, “You made me so happy!” A better response would be, “I can see a bit of hope in your eyes when you just told me that. I share your hope too.”

2) Set strong, healthy boundaries. “

…

I found their experiences very relatable. The tips the authors provide are many of those “easy said than done” options, but do provide specific examples on how they approached those situations with their family member’s addiction.

I think that is one of the hardest things with having a loved one with addiction. We want to help, but end up enabling. Learning the support while also maintaining boundaries is quite the balancing act.

The video is a Piped link for YouTube, so it won’t have ads or track information. The actual YouTube link is here: https://www.youtube.com/live/VAvAs0Uc5UU?feature=share It is about 56 minutes long.

Cross post from !mentalhealth@lemmy.world

Multiple countries included.

I am personally experiencing some pretty tough times with my family member making more empty promises and manipulation. I think one of the most difficult parts is when the person is in denial and defensive. If they don’t agree that reality is not their reality, it becomes next to impossible to talk and be around them. It’s like we’re speaking different languages. I guess what is getting me through the times denial right now is paying only attention to behavior, not the words being said.

And I have found a couple of friends that have dealt with something almost identical, and I cannot emphasize enough how much of a relief it is to have someone else in the loop. It feels wrong to talk about it in the open, because addiction seems to still be a fairly taboo subject. But there’s nothing to be ashamed of. To deny what is happening belittles the struggle everyone is facing. I recommend doing everything possible to find people to talk with about it. And not just about their struggle; find support for you.

Anyone else have things that helped kept you anchored in tough times?

(It looks like the vLemmy instance is no longer working, so I recreated the community here. I posted this once before Lemmy.World was apparently fully connected to this Lemm.ee instance, so this is a copy)

Hi everyone, my name is loopy and I created this lemmy community to make a space for people to share and support each other through the challenges of having a friend or family member struggling with addiction. As the sidebar says, this is not to replace therapy; think of it like an online support group. I’ll get the ball rolling a little bit by sharing that my BIL has been struggling with addiction. First to opioids, then to his Adderall prescription. The mood swings are an understatement. I get glimpses of sobriety but then the cycles continue. It honestly gets pretty exhausting to keep trying to have empathy only to be let down again. My wife and my focus lately has been setting boundaries. He knows how to manipulate my wife, so I said that we all need to be present when deciding something (eg if he is staying at our house for the weekend). It feels uncomfortable for her, but it has been minimizing the stress. I have learned the valuable lesson of keeping yourself safe and well first. This is basically not possible for my wife to set this boundary with him, so my role has been a lot of reassurance and being consistent. Another essential lesson we have discovered is to distinctly define roles. We are not therapists and cannot be a detox center. We have literally tried because he talked us into it. The last recent thing we concluded is that the whole process has to be their decision. No matter how badly we want for him to succeed and how many ways we facilitate that success, if he doesn’t want to do it, he will find any excuse not to follow through. Actions are the only way to measure progress (words and promises aren’t worth much), and he must follow through first. We love him and truly wish for him to thrive in life. It is heartbreaking to see the lows, but as long as we don’t compromise on our own well-being, we will continue supporting him on his journey to recovery. How have you all managed? How has addiction affected your life? Personally, I would love nothing more than to see some success stories to encourage others, but I know those are sometimes rare.

cross-posted from: https://lemmy.world/post/396561

> Last update: July 7; Count: 90 > > Here is a continuously updated list of communities dedicated to health, or specific diagnoses, from all around the Lemmy network. > > There are some disclaimers and notes below the list. Check them too. > > ========== > > How to use links? > > If you're having problems with some links (such as a "community not found" message), see the FAQ on this post. I had to remove the dual links due to the character limit. > > ========== > > > General Health & Medicine: > > !medicine@mander.xyz > > !health@lemmy.ml > > !medicine@kbin.social (1) > > !health@exploding-heads.com (2) > > !health@midwest.social > > !medicare@sh.itjust.works > > > Disability & Accessibility > > !disabled@lemm.ee > > !disability@feddit.uk > > !disability@beehaw.org (2) > > > Mental Health & Support > > !mentalhealth@lemmy.world > > !mentalhealth@lemmy.ml > > !mentalhealth@lemmygrad.ml > > !mentalhealthsupport@midwest.social > > !antidepressants@slrpnk.net > > !appliedpsychology@mander.xyz > > > Neurodivergence > > !neurodivergent@discuss.online > > !neurodivergent@sh.itjust.works > > !neurodiversity@lemmygrad.ml > > !neurodivergence@beehaw.org (2) > > !neurodivergente@bolha.social > > > Womens Health: > > !menopause@lemmy.world > > > Vision, Blind, Visual impairments > > !main@rblind.com > > !blind@lemmy.world > > !eyetriage@lemmy.world > > > Hearing, Deaf, Hearing loss > > !deaf@lemmy.world > > !deaf@kbin.social (1) > > > Addiction, Drugs, Smoking > > !sobriety@lemmy.ca > > !stopdrinking@lemmy.world > > !stopdrinking@discuss.tchncs.de > > !stopsmoking@lemmy.world > > !quittingsmoking@lemmy.world > > !drugs@lemmy.world > > !drugs@sh.itjust.works > > !drugs@exploding-heads.com (2) > > !drugs@lemmy.ml > > !drugs@lemmygrad.ml > > !opiates@lemmy.world > > !recovery@lemmy.world > > !fafopwa@vlemmy.net (Friends and Family of Persons with Addiction) > > > Healthcare Professionals > > !healthcareworkers@lemmy.ml > > !ems@lemmy.world > > !medicine@lemmy.world > > !pharma@lemmy.world > > !radiology@lemmy.world > > > Healthy Eating: > > !healthyfood@lemmy.world > > !cheaphealthyfood@lemmy.world > > !cico@lemmy.world (Calories In, Calories Out) > > !EatCheapAndHealthy@kbin.social (1) > > !nutrition@mander.xyz > > > Healthy Lifestyle: > > !bodyweightfitness@lemmy.ml > > !sauna@exploding-heads.com (2) > > !soakingtub@exploding-heads.com (Ofuro Japanese Soaking Tub) (2) > > !longevity@mander.xyz > > !sports_science@mander.xyz > > > Satire and Memes > > !adhd@lemmy.dbzer0.com > > !aspiememes@kbin.social (1) > > !depression_now@lemmy.world > > !Evil_autism@kbin.social (1) > > !neurodiversimemes@lemmygrad.ml > > ========== > > > ~Mental Health Diagnoses: > > > ADHD > > !adhd@lemmy.world > > !ADHD@kbin.social (1) > > !adhdtalk@lemmy.world > > !adhdwomen@lemmy.world > > > Anxiety > > !anxiety@lemmy.world > > > Autism > > !autism@lemmy.world > > !autism@lemmy.ml > > !Autism@kbin.social (1) > > !autismexperiences@lemmy.ml > > !autisticpride@infosec.pub > > !autism_uk@feddit.uk > > !womenwithautism@lemmy.world > > > Bipolar Disorder > > !bipolardisorder@lemmy.world > > > Borderline Personality Disorder > > !bpd@sh.itjust.works > > > CPTSD/PTSD > > !cptsd@lemmy.ml > > > ========== > > > ~Physical Health Diagnoses: > > > Chronic Pain etc. > > !chronicpain@lemmy.world > > !fibromyalgia@lemmy.world > > !migraine@lemmy.world > > !pain@lemmy.world > > > COVID-19 > > !coronavirus@lemmy.ml > > > Diabetes > > !diabetes@lemmy.world > > !diabetes@lemmy.frozeninferno.xyz > > !t1diabetes@lemmy.world > > > Hyperhidrosis > > !hyperhidrosis@lemmy.world > > > Kidneys, Dialysis > > !kidneydisease@lemmy.world > > !kidneydisease@kbin.social (1) > > !dialysis@lemmy.world > > !dialysis@kbin.social (1) > > > Neurodegenerative diseases > > !neurodegdissupport@lemmy.world > > > Transplants > > !transplant@lemmy.world > > !transplant@kbin.social (1) > > > ========== > > > Notes: > > - I'm not vouching for any of these communities, check at your own discretion. Some of them are abandoned or inactive, so if you see one without activity that might be interesting, consider bringing it back to life and crosspost here. Communities with no content whatsoever aren't included. > > - Work in progress - let me know if you know of new communities that aren't in the list, or if you have other feedback. > > (1) Kbin is a different network from Lemmy. Interactivity may be limited or delayed. > > (2) These instances aren't federated with lemmy.world. To interact, you need to have an account on an instance that federates with them. > > Important: Some instances may gravitate towards politics or philosophies different from your own. Inclusion of a health community of any instance does not mean endorsement of that philosophy. >

(It looks like the vLemmy instance is no longer working, so I recreated the community here)

Hi everyone, my name is loopy and I created this lemmy community to make a space for people to share and support each other through the challenges of having a friend or family member struggling with addiction. As the sidebar says, this is not to replace therapy; think of it like an online support group. I’ll get the ball rolling a little bit by sharing that my BIL has been struggling with addiction. First to opioids, then to his Adderall prescription. The mood swings are an understatement. I get glimpses of sobriety but then the cycles continue. It honestly gets pretty exhausting to keep trying to have empathy only to be let down again.

My wife and my focus lately has been setting boundaries. He knows how to manipulate my wife, so I said that we all need to be present when deciding something (eg if he is staying at our house for the weekend). It feels uncomfortable for her, but it has been minimizing the stress. I have learned the valuable lesson of keeping yourself safe and well first. This is basically not possible for my wife to set this boundary with him, so my role has been a lot of reassurance and being consistent.

Another essential lesson we have discovered is to distinctly define roles. We are not therapists and cannot be a detox center. We have literally tried because he talked us into it.

The last recent thing we concluded is that the whole process has to be their decision. No matter how badly we want for him to succeed and how many ways we facilitate that success, if he doesn’t want to do it, he will find any excuse not to follow through. Actions are the only way to measure progress (words and promises aren’t worth much), and he must follow through first.We love him and truly wish for him to thrive in life. It is heartbreaking to see the lows, but as long as we don’t compromise on our own well-being, we will continue supporting him on his journey to recovery.

How have you all managed? How has addiction affected your life? Personally, I would love nothing more than to see some success stories to encourage others, but I know those are sometimes rare.