Understanding the nature of addiction, how sobriety may change your relationship, and what you need to do—and don't need to do—to facilitate recovery is therefore very important. Below, Rachel Russell, chief clinical officer at The Freedom Institute, an outpatient treatment center providing addiction rehabilitation programs in New York City, offers her best advice for helping a loved one through this challenging but hopeful time.
- Rachel Russell, Rachel Russell, MA, is Chief Clinical Officer at The Freedom Institute, a NYC-based outpatient treatment center providing addiction rehabilitation programs.
1. Learn about addiction
First and foremost, Russell says it's important to educate yourself. "Most people don't learn much about substance use disorder and addiction growing up," she says, adding that many of us learn inaccurate information from TV and movies. "There are a lot of misconceptions about how somebody ends up with an addiction, and a lot of misconceptions of what it takes to be sober."
For example, Russell explains, a lot of people mistakenly believe that substance use is a question of character, or that it's their fault if they end up with an addiction. However, a large part of what causes addiction is genetic. "It runs strongly in families and is also strongly associated with co-occurring mood disorders, for instance," Russell says. "There are biologic and genetic components, and it's important for people to understand that so they can have compassion." That doesn't necessarily mean putting up with poor behavior, for instance, but it does mean withholding judgment.
To understand addiction better, Russell recommends reading books on the topic or diving into the medical literature, seeking professional insight (e.g., from a therapist or someone trained in addiction), and joining Al-Anon or other like-minded support groups specifically designed for the loved ones of those suffering from addiction.
2. Don't micromanage your loved one's recovery
When one person in a relationship or family is suffering from an addiction, the entire dynamic tends to become about that addiction—trying to prevent something from happening, for example, or managing something after it's happened. "That dynamic can really carry over into recovery, so family members can take on too much responsibility in trying to manage their loved one's recovery," Russell says.
This will often involve interrogations into their behavior, such as whether or not they're going to enough meetings. It may also include some "detective" work, which involves the friend or family member watching the recovering person closely for clues as to their mood and potential to relapse. "This is not a helpful dynamic for anyone," says Russell. "It's exhausting for the family member and it sends really negative messages to the person in recovery." This doesn't mean you should avoid the topic or ignore troubling behavior, she clarifies. "Just don't try to police it and be in charge of it," says Russell.
Often, she explains, the tendency toward hypervigilance or micromanaging a person recovering from addiction is a product of anxiety. "People are so relieved when somebody stops using, and so nervous that it's going to go back to the way it was, that they manage their anxiety by trying to manage their loved one's recovery," she says. Instead, Russell recommends that people get support to manage their own feelings around their loved one's addictions. "Let the person be in charge of their own recovery," she says.
3. Help your loved one create a new sober lifestyle
"When people are newly sober, it's sort of like walking around without enough skin. Often they feel very raw, and they're having to learn how to do so many things they haven't done without substances for so long," says Russell. They've given up their go-to coping mechanism, she explains, and likely the friends and activities associated with using, too. This can leave them feeling lonely and vulnerable, so Russell says that anything friends and family members can do to help the person in recovery build their new sober life can be helpful.
For example, you can clear the house of all substances and triggers before the person returns home from treatment. (Russell recommends asking first, however.) You can also be proactive about finding sober activities to do together, joining them in any new interests, and also giving them space to make new friends who are sober. "The people who are most successful at sobriety are the people who build themselves a sober community," she says. While this need can be hard for friends or family members to understand, Russell says it's important to make space for these new relationships to develop.
4. Open a dialogue about whether your role needs to change
If you were a drinking buddy to your friend or loved one, Russell suggests having an open and honest conversation about how they feel about interacting with you now. "You could say to the person, 'We used to do a lot of drinking together. If we go to the baseball game where there is drinking, is it going to feel triggering to be around me since I used to be your party buddy?'" she advises.
Usually, she explains, the person in recovery will already have done some thinking on the matter and will be able to respond with boundaries. "But it's important to talk about it and name it," Russell says.
This can also be a critical conversation to have because sometimes, the person in recovery will withdraw because they feel like they aren't fun anymore or that their sobriety is a burden. By letting them know you're open to alternative activities, and especially by being proactive in your suggestions, you can help prevent them from feeling isolated or excluded, Russell says.
5. Don't use alcohol or other substances around your loved one
It's important not to use substances—even drinking just one beer—around someone who's in recovery, says Russell. "Once people get a good chunk of time [sober] under their belt, they find it much easier to navigate situations where other people are drinking, for example. But in the beginning, that's really difficult," she says.
Having a friend go sober may surface some uncomfortable realities about your own drinking.
Many people learned to rely on alcohol as a way to overcome social anxiety, Russell explains, so when someone is newly sober, they may have a lot more social anxiety about going to any type of gathering. "Being mindful of that and and joining them in not drinking also provides support for them so that they're not the only person turning things down," says Russell. "It [can be] a bummer to be the only person sitting at the table when everyone else is two or three drinks in."
Sometimes trying to abstain on behalf of a loved one can be an issue, says Russell, because it's not uncommon for someone who's reached an unhealthy level of drinking to have friends who are abusing alcohol use, too. "This is sometimes how people find out they have problems of their own, honestly," says Russell. In other words, having a friend go sober may surface some uncomfortable realities about your own drinking, or that of some of the others in your social circle. Friendships with the newly sober can strain as a result of resistance to this realization (that you, too, have an issue with substance use), so this is something to watch for, too.
6. Expect new passions to surface, but watch for warning signs of replacement addictions
It's not uncommon for people in recovery to replace their earlier addiction with a new one, says Russell. Someone who's given up substances, for example, might suddenly begin engaging in compulsive sexual behavior. In some cases, it's obvious that this behavior is unhealthy, but in others, it might be a gray area.
After all, Russell explains, many people in recovery throw themselves into a new passion, such as exercise or religion, and it can be tricky to discern whether it's a helpful coping mechanism or a new dependency. "We would want to approach that carefully, with the same kindness and concern that you would have had in your initial conversation [about the original addiction],'" says Russell. "It's about communicating openly and listening actively to what they say is working for them."
If you still feel concerned after that conversation, Russell recommends consulting a professional to see if your worries are justified and to get advice on how to act on them.
7. Don't air your pent-up grievances just because someone is sober, but don't tiptoe around necessary conflict, either
Active addiction can cause a lot of pain and trauma within a relationship, and it's difficult to address that when the person is using. "There's a lot of resentment, anger, hurt feelings, and all kinds of wounds that addiction has brought on the family [or friendship]," says Russell. Once the person gets sober, loved ones can sometimes feel it's time to tell them everything they've done wrong—but Russell says this isn't necessarily the right instinct, especially early in recovery.
On the flip side, others may be terrified of speaking up against the person in recovery, or doing anything to rock the boat out of fear that it may lead to relapse. "So they'll avoid dealing with issues or expressing feelings or having a conflict because they're petrified that if they upset someone a little bit it's going to cause a return to [the addiction]," she explains.
Both of these scenarios are further examples of why Russell advises that loved ones seek support and guidance for navigating their relationship with a newly sober person. "It's important for people to be doing their own work, to be communicating about what's happening, and getting support," she says.
8. If you think they're relapsing, approach with honesty and without judgment
If you suspect someone is relapsing, Russell recommends that you avoid accusing them. "But you can express concern. You can say, 'I'm kind of worried about you. I've noticed you're not going to the meetings you usually go to, and you seem kind of depressed... and I'm wondering if you're having a hard time or if you're drinking or are struggling with wanting to drink,'" she says. "Just be open and honest."
People vary in their capacity to disclose whether they’ve slipped, because it can feel like a failure and be shame-inducing.
People vary in their capacity to disclose whether they've slipped, because it can feel like a failure and be shame-inducing, she adds. But sometimes addiction isn't managed properly the first go-round, so slip-ups can happen. She compares it to the treatment of any other type of disease—the first treatment attempted might not work, at which point it might need to be adjusted. "So that conversation isn't about judging," Russell says. "It's about wondering if there's something else that needs to be in place to help them stay on track."
If there's any recurrent theme to this advice, it's that—no judgment. While it may be difficult to understand, addiction is not easy to break. Those struggling need all the compassionate support they can get.
If you or a loved one need support for substance abuse disorder, you can find help 24-7 via SAMHSA’s National Helpline at 1-800-662-HELP (4357).
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