We do not live in a bubble. Our lives are intertwined with family, friends, and co-workers. There is drug use and alcohol everywhere. This makes staying abstinent very difficult, especially if the use is at home or the user is a spouse, other family member, or a girl or boyfriend.
I recently had a discussion with one of my patients who had been off alcohol and opiates for over 100 days. He had completed an intensive outpatient treatment program and was a “mentor” for others as part of his aftercare program. He told me that his girlfriend, who did not have a drug abuse problem, drank alcohol or used marijuana at least weekly and on occasion with him present. He stated that he had no cravings or desire to use, but that it was “difficult” to be around her when she drank or smoked. After we talked a while, he said that he might have wanted a drink, if anything at all. We discussed that fact that crossing any line was the beginning of the “slippery slope”. He acknowledged this. Since he had deep feelings for her and she provided a large amount of his emotional support, stopping seeing her was not an option. He had discussed this with her, but she was reluctant to give up wine or marijuana completely. He told me that he had no problem with her using if he was not present, but that if she had smoked marijuana before he saw her, it was difficult because she was “different”. In the end, we agreed that he would work on this in his group and that he would continue to discuss this with her.
During the discussion, I had some thoughts on this type of problem. There are basically three separate considerations when this occurs. The first is the temptation to start using again, the second is if someone loves you, why wouldn’t they stop using or at least keep it away from you, and the third is the resultant lack of an appropriate support system.
Someone in early recovery is fragile. Relapse is a part of the disease and is all too common. Getting away from places and situations that were associated with prior use is imperative. There is definite correlation between exposure and relapse. We find that it is very difficult for our younger patients to stay clean and really recover if there is drug or alcohol use in their homes. This usually involves drinking by a parent, but other drugs such as marijuana are also common. Drug use at home is a strong indicator of other family problems that may also contribute to poorer results.
Making sure that the home environment is free of added stress is a vital part of the recovery process. Those close to the person in treatment have to make commitments and invest in their recovery in order to maximize success. In addition, family members can take positive steps to help even more.
When a spouse or significant other fails to make the changes needed to help their partner, it should trigger an inspection of the total support system and the motives and/or level of awareness and commitment of the partner. Family or couples therapy may help and we also suggest that the partner go to Al-Anon meetings to learn more about chemical dependency. The partners may need to start treatment themselves, either for family dysfunction, but also for chemical dependency . This is critical for long lasting recovery.
Avoidance of temptation is often not an option, as in my patient’s situation, but recognition of the problem and early action, can mitigate its effects.
By Richard I. Gracer M.D.