Representatives from VALEO, Center on Halsted, Directions Psychological Services, and Howard Brown Health Center ( HBHC ) presented 'When You Care,' a substance abuse forum at HBHC, 4025 N. Sheridan, April 20.
Kevin Osten, primary therapist at VALEO ( a psychiatric/substance abuse treatment program for LGBT individuals located at Chicago Lakeshore Hospital ) began his talk by discussing aspects of addiction. Regarding why people use drugs, Osten commented that the reasons can involve mental health issues such as depression and low self-esteem.
' [ To some, ] drugs and alcohol are a way of fitting in, especially in the gay community,' he noted. In discussing the concept of self-medication, Osten said that 'drugs and alcohol appear—and I mean 'appear'—to take away from depression, anxiety, and stress to allow you to function when it is just covering up and making things [ worse ] .' Osten also said that signs and symptoms of drug abuse include changes in attitude ( especially irritability, which is usually indicative of withdrawal ) ; abandonment of responsibility; associations with different people; changes in work/school attendance; lack of attention to personal hygiene; alterations in attire ( e.g., wearing long sleeves to conceal track marks ) ; loss of money management skills; secretive behaviors; psychological problems ( such as anxiety, hallucinations, and paranoia ) ; sleep disturbance patterns; mental problems ( including a lack of focus ) ; and even inexplicably frequent trips to the restroom.
Osten also discussed the concept of addiction as a disease. 'Recently a gene for alcoholism was identified, so there is a real genetic component when we talk about alcoholism.'
Panelist Robert Switzer, a psychologist at Directions, added that there are two factors that can put an individual at risk for substance abuse: family history and genetic markers. 'People who develop addictions often start to feed their own psychological needs. As the abuse moves along, [ things change ] from using drugs to get over something to addiction. What's driving them at this point ... is biology. At this point, they don't feel so good and things are out of control,' he stated.
Vanessa Ford, a psychotherapist at HBHC, said that ' [ w ] hen I think of a disease, I think of something that's progressive and something that's chronic. That means that, even when you stop using, you'll never be able to use that drug again once you've crossed that line into addiction. So I liken it to having something like diabetes, where you need ongoing treatment. You have this problem in the background and you always need to manage it, whether it's through a 12-step program [ or some other means ] . Once you're an alcoholic, you can't go back to having wine with dinner.' She also noted that the reasons addiction occurs are mysterious: 'It's tough to say why some people become addicted to some things and others don't. There could be a biological component, there could be psychological vulnerabilities, or other things.'
In addition, Ford mentioned that the difference between abuse and addiction is a relevant one—one that would require the services of a substance abuse professional. However, for her, addiction would require the total subsequent abstinence from that drug while abuse 'is characterized by some negative consequences that may or may not lead to abstinence.' Osten added that relapse is sometimes a trait of a disease and that a change in treatment may be added.
Narcisso Flores-Bassinger, a therapist and client services coordinator with Center on Halsted, discussed how addiction can actually start from a physical disease. 'People who suffer from chronic pain may start using recreational drugs [ to battle it ] . This starts a vicious cycle because then they become dependent on drugs to feel better. It's [ similar to ] the chicken-egg [ concept ] .'
Ford then talked about enabling versus caring. 'Enabling refers to behaviors and actions that end up actually supporting the addiction model,' she said. 'What loved ones often engage in is [ actions ] that they feel is helping, such as calling in sick on behalf of someone who's hung over. What can be confusing to the loved one is that you're worried and want to help [ the addict ] , but what happens is that you're supporting the disease instead of the person. Any time you prevent the person from feeling the full consequences, you're moving that person farther away from treatment. As painful as it is for the family members, it's better for the person to feel the full weight of what they're doing.' She also recommended resources such as Al-Anon and Narc-Anon for loved ones: 'You're really taking care of yourself. Sometimes you can be so intertwined with someone who has the disease that you can lose yourself. It's a way to get support and feedback about what you're doing. Also, you get a lot of information about 12-step programs.'
Switzer focused his portion of the talk on interventions. He presented a list of factors to consider before embarking on this potentially frightening course. Preparation is key: 'Often the most successful interventions are ones that are planned out. Getting your head straight on what you want to say and how to say it can be really important. You can do that by talking to a friend or mental health professional. Also, you need to be prepared if the person is ready to go to, say, Al-Anon or a hospital program.' Switzer mentioned that loved ones should not either rescue or enable the addict: 'Don't do things like [ loan ] them money; you might as well walk up to the bar and buy them a drink.' Picking the right time is also important—and he added that a good time is when the person is hung over; he or she is usually filled with guilt at that time. He also said that having a crowd of people confront the addict is not really recommended; what is important, Switzer said, is having people who are close and having people who think the addict truly has a problem.
In addition, Switzer mentioned that being specific and brutally honest can be effective. 'Saying things like 'When you come in late, I'm ... hurt' can be really, really useful,' he said. However, once the loved one is done talking, he or she must listen, Switzer noted. 'Often, people will respond to what's been said. If you're being open and honest, an emotional dialogue will begin at that point. It's helpful to sit and listen; the more likely they think you're on their side, the more likely it is to be effective,' he commented. Also, it is important to also realize that recovery is usually slow: 'The numbers on successful recovery are pretty low; for someone who's truly substance-dependent, it's a multi-year process. Some people get it right the first time, but that's a very small number. Most people have to trip a few times ... .'
Lastly, Switzer talked about the difficulty of watching an addict 'fall apart' while not enabling or rescuing that person. Ford then talked about the possibility of taking the 'tough love' approach a step further: 'Sometimes you have to walk away from the relationship. That can be painful and [ guilt-inducing ] , but sometimes losing you is just the consequence to make someone think that he has a problem. It's up to you if you want to remain engaged or if you want to walk away. You may want to talk to a counselor about it—but you have to remember that you're not responsible for that person; ultimately, he's responsible for himself.'
Lastly, Flores-Bassinger talked about starting and maintaining open dialogues with loved ones who are abusers, focusing on a recent study conducted at New York City's Coler-Goldwater Specialty Hospital. Keeping in line with the approach to 'non-violent communication,' the study centered on inviting addicts to watch films that may resemble or mirror their own experiences; films included Circuit, Leaving Las Vegas, and Requiem for a Dream. Audience members were then encouraged to express their thoughts throughout the showings. At the end of the 12-15 week cycle, group members discussed how the movies impacted their lives. The researchers discovered that the patients were able to connect to the films' character and could even see how their views affected loved ones; in return, family members were able to convey compassion and empathy regarding issues that led to the dependency. The point was that family members could use this approach to get addicts to talk about their situations and, possibly, reach the point of realization.
The workshop concluded with a question-and-answer session that consisted of a few attendees discussing their experiences with loved ones who are addicts. It was an emotional segment that revealed the lengths that one must sometimes go to in order to help another claim responsibility for his or her own life.
Substance Abuse Numbers
Hot Line and 12-Step Numbers:
— Al-Anon/Al-A-Teen: ( 800 ) 356-9996
— Alcoholics Anonymous: ( 312 ) 346-1475
— Rational Recovery Systems: ( 800 ) 303-2873
— Cocaine Anonymous: ( 800 ) 347-8998
— Sexual Compulsives Anonymous: ( 773 ) 935-3573
— New Town Alano Club: ( 773 ) 529-0321
— Adult Children of Alcoholics: ( 708 ) 206-1156
— Center on Halsted: ( 773 ) 472-6469
— VALEO: ( 800 ) 888-0560
— Haymarket Center: ( 312 ) 226-7984
— Howard Brown Health Center: ( 773 ) 388-8905
— West Side Central Intake: ( 312 ) 850-9411
— Directions Psychological Services: ( 312 ) 332-7000
