Understanding and supporting a loved one struggling with substance use | GUEST OP

By Milena Stott, LICSW, CDP/For the Reporter

King County’s opioid crisis shows no signs of slowing any time soon.

Last year, Seattle and King County set a new record for fatal overdoses, with 359 deaths. Whether it’s opioids, alcohol or other drugs, coping with a substance use disorder is becoming steadily more common in our region. There’s a lot of discussion about how to address this issue from a policy and funding standpoint, but not enough attention is being paid to supporting people who find themselves in the midst of a crisis with a loved one.

If someone you love is struggling with substance use, you’re no doubt experiencing a range of intense emotions – sadness, fear, anger, worry, shame, guilt. These emotions are normal. Coping with a substance use disorder is challenging for individuals and their loved ones. It’s easy to feel hopeless, but for every story of trial, there is one of recovery. To help instill hope, I’ll share some perspectives on the nature of the illness and treatment and assure you that you can make a difference when a loved one is struggling.

While each person’s experience is different, the one commonality is none of them woke up one day and decided to become dependent on a substance. Many factors lead to substance dependence. It can start with experimentation, social use, using to escape and/or prescription for a medical or behavioral condition. Additionally, social determinants of health, including economic stability, education, social support and access to health care play a role in one’s vulnerability. Personal experiences, family dynamics and genetics can predispose one to the disease. Lastly, we know that risk factors, negative experiences and protective factors or supports influence outcome.

I work in the community safety net. By the time people reach me, many have exhausted every possible resource, both social and financial. Each time access to help is not achieved, individuals and their loved ones experience increased stress, symptoms, and consequences. Substance use disorders can lead to physical and/or mental health conditions, job loss, homelessness, trauma, and isolation and each of those stressors can lead to developing a substance use disorder. When people successfully reach my door, I have the privilege of helping them feel safe to share their stories. I am constantly amazed at their resilience.

The manner in which we interact with persons struggling with substance use is a critical element in the recovery process. Individuals with substance use disorders are usually aware of the dangers and consequences of their use. They may want to stop using substances, but it serves some purpose for them that must be addressed. Professionals work to engage individuals by supporting an unmet need or appeal to a desire. Once there is safety, trust, and security of not feeling judged, the person is able to discuss their concerns and receive support.

It’s important to understand that treatment is not one size fits all and is a spectrum ranging from harm reduction to abstinence. Some individuals are not prepared to stop using, and professionals in these circumstances seek to reduce the associated harm of use and treat conditions associated with the use. Other individuals are unwilling to seek treatment due to negative treatment experiences, limited consequences, lack of access to desired care or lack of confidence in their ability to recover. The goal of treatment is to help people recognize their ambivalence and discuss how their behavior relates to the challenges in their lives. We recognize individuals as experts in their care and empower and motivate them to change the things they desire to change.

If a loved one is struggling with substance use, you can make a powerful difference. Try the following:

• Talk and listen without judgment to understand their perspective.

• Understand change is hard, and substance use fulfills a need or void.

• Communicate concerns without criticism. It’s hard to watch your loved one struggle, but we engage in change more fully when we feel supported.

Your approach to difficult conversations with loved ones can create moments of connection, which help move people on the path to recovery. They must make the journey themselves, but your loving presence is invaluable.

Milena Stott is chief of Inpatient Services at Valley Cities Behavioral Health Care. She’s a Licensed Independent Clinical Social Worker (LICSW) and Chemical Dependency Professional (CDP) with over 15 years of experience in the field. She oversees the development of Valley Cities Recovery Places Seattle and Kent. These patient-centered Residential Treatment Facilities will open late this year and early next year.