Because heroin use is illegal, stigmatized, expensive and dangerous, addicts live in a world of secrecy, which in turn causes them to be uncommunicative, evasive and outright dishonest. This causes serious harm to families, as relationships need to be grounded in mutual trust. When the trust is compromised, anger and resentment are inevitable, and the addict’s loved ones find themselves fighting a battle they don’t understand and aren’t equipped for.
The most important thing family members of a heroin user can do is recognize and acknowledge the problem. This isn’t easy, as the user is dedicated to hiding the problem, or minimizing it once it’s out in the open. Also, the progression toward addiction is often slow, and family members can be oblivious to it until the addiction is entrenched. What they see is a series of symptoms: behavioral changes and changes in attitude drift relentlessly toward the unacceptable, and the addict’s loved ones find their boundaries and expectations consistently violated. Sooner or later they will see the addict radically impaired by heroin use, but even then it will be tempting to buy the addict’s explanation that it was an isolated incident, or a bad reaction to alcohol or a medication—anything to defer looking at the truth.
The next thing that is critical for an addict’s loved ones is that they stay on the same page about what the problem is and how to respond to it. It is often the case with parents, for example, that one is the enabler and the other the enforcer. The enabler wants to help but winds up doing harm by shielding the addict from the consequences of his or her heroin use. The enforcer wants to control things by setting limits on behavior and punishing violations, which the enabler will resist. This is just one example of the dynamics of dysfunction in a family where heroin use is an issue. Communication and counseling are helpful, and the addict’s loved ones would be well served by attending Al-Anon meetings.
Finally, the family’s energies should be directed toward steering the addict into treatment. Sometimes this is difficult and painful, especially if it requires intervention, which may entail clearly stating that the addict is no longer welcome in the home if he or she doesn’t seek recovery. The addict’s life is at stake here, as well as the emotional (and even physical) health of the family, and it takes courage for all the participants to make the necessary decisions.
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