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Guide For Caregivers
STEP 1: Understanding the Problem
I. UNDERSTAND THE DESTRUCTIVE NATURE OF ALCOHOL,
TOBACCO AND OTHER DRUGS
Meet
with the user in a formal setting away from others. An office
setting is ideal, however be flexible enough to meet a person’s
need. Teach the user about the destructive nature of alcohol and
drugs.
Alcohol, tobacco and other drug
abuse assault the integrity, health and spirituality of an
individual. Alcohol and drugs can destroy individuals, families and
other relationships. Commonly abused drugs include: tobacco,
marijuana, amphetamines/methamphetamines, cocaine, inhalants,
heroin, misuse of over-the-counter drugs, and misuse of prescription
medications. Prescription medications most often abused include
tranquilizers and narcotics/pain medications. Some substances found
in a typical home such as gasoline, paint thinner, or magic markers,
can also be used to "get high". Those who use alcohol or drugs come
from all walks of life, any age or from any level of church
activity.
Alcohol and all drugs are
potentially harmful and may have life-threatening consequences
associated with their use. There are also vast differences among
individuals in sensitivity to alcohol and various drugs. While one
person may use alcohol or a drug several times and suffer no
apparent ill effects, another person may be more vulnerable and
overdose with first use. There is no way of knowing in advance how
someone may react.
UNDERSTANDING THE ADDICTION
PATTERN
Anyone can become addicted to
alcohol or drugs. The powerful nature of alcohol and drugs creates a
pleasurable physiological response that affects the body and the
mind. Because of this dual effect it is possible to become
physically and/or psychologically addicted to alcohol or drugs. The
characteristics of addiction may include three phases: Initial
pleasure, Tolerance, and Addiction. (See Understanding the
Addiction Pattern handout on page 23.)
But I raise my voice with others
throughout the world who warn against abuse of drugs beyond
prescribed limits, and the recreational or social use of chemical
substances so often begun naively by the ill-informed. From an
initial experiment thought to be trivial, a vicious cycle may
follow. From trial comes a habit. From habit comes dependence.
From dependence comes addiction. Its grasp is so gradual.
Enslaving shackles of habit are too small to be sensed until they
are too strong to be broken. Indeed, drugs are the modern "mess of
pottage" for which souls are sold. No families are free from risk.
But this problem is broader than hard drugs. Their use most often
begins with cigarette smoking. Tobacco and alcoholic beverages
contain addicting drugs…Often, however, agency is misunderstood.
While we are free to choose, once we have made those choices, we
are tied to the consequences of those choices. We are free to take
drugs or not. But once we choose to use a habit-forming drug, we
are bound to the consequences of that choice. Addiction surrenders
later freedom to choose. Through chemical means, one can literally
become disconnected from his or her own will! (Russell M. Nelson,
"Addiction or Freedom," Ensign, Nov. 1988, 6)
Initial pleasure.
Generally speaking the use of alcohol and drugs
causes pleasurable physical and psychological sensations. The
repetitive use of drugs begins the addiction process. During this
early phase users may experience guilt. If they act on their
feelings of remorse and change their behavior, then the use of
alcohol or drugs can end. However, if they continue using, the habit
becomes stronger and the spiritual aspects of their life decline.
Progressively users become unsatisfied with the affect they are
experiencing, so they seek more or different substances.
Tolerance.
Repetitive use of alcohol or drugs dulls the conscience and weakens
resistance. The body actually adapts to the alcohol or drug being
used and requires more to reach the "high." Progressively users
become unsatisfied with the level of pleasure they are experiencing,
so they begin to use more frequently, to seek a stronger drug, or to
try a different way of getting the drug into their body. Another
symptom of tolerance is the justification of their involvement. The
users may think "everyone does it" and "it doesn’t hurt anyone."
They lie and minimize their problem to those they love and even to
those persons trying to help.
Addiction.
A third element that can occur in addiction is the increased
tendency to use the alcohol or drugs despite negative consequences.
With alcohol and some drugs, the body develops a dependency on the
substance and withdrawal can be painful and at times deadly. In the
last phase of addiction most users loose spirituality, recognize a
serious problem, and feel helpless to control it. It is at this
stage that some refer to as a "disease" or "illness."
How quickly can someone become
addicted to alcohol or drugs?
When and how quickly someone
becomes addicted to alcohol or drugs depends on many factors
including: their genetic inheritance, their mental and emotional
state, and the type and amount of alcohol or drugs being used.
Alcohol and drug use falls on a continuum. There are beginning users
who are experimenting because of curiosity or peer pressure. They
experience the pleasure or "high" found in the first stage. Next,
there are users who use more frequently and develop the escalation
and justification of use associated with the tolerance stage.
Finally, there are users who develop a dependency and feel hopeless.
These users are addicted. Not everyone who uses alcohol or drugs
progresses through all three stages of addiction.
SUMMARY
The pace at which a user proceeds
through these phases varies. Not everyone who uses alcohol or drugs
will go through all phases of the addiction pattern. Some progress
rapidly and others more slowly through the phases of addiction. The
tables entitled Information About Alcohol and Other Drugs and
Information About Tobacco list resources to identify and understand
the problem of alcohol and drugs. These resources may be beneficial
to the caregiver, the user and the family. Assign the user a reading
assignment from the appropriate table. Review the assignment.
INFORMATION ABOUT ALCOHOL AND
OTHER DRUGS004
INFORMATION ABOUT TOBACCO
After you have developed an understanding of the seriousness of the
problem and the users’ motivation you can begin to help them stop.
II. DETERMINE THE LEVEL OF INVOLVEMENT
Caregivers need to spend enough time asking the user and his/her
family searching questions to develop a clear understanding of the
problem. Consider asking the following questions about his/her
alcohol, tobacco and other drugs use:
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When did the problem begin? |
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How frequent is the use? |
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How are alcohol and drugs accessed? |
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Is the user isolating from the family? |
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What problems have the alcohol and drug use caused? |
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Is the user lying about and hiding alcohol and drug use? |
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Is the user progressively using more alcohol or drugs? |
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Is the user involved with stealing or other illegal behavior?
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Is the user’s conscience dulled and resistance weak? |
Signs indicating a problem with alcohol or other drugs
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If a person continues using alcohol or drugs
despite negative consequences, then the user probably has a
serious problem. Consequences include: loss of job, debt, mental
problems, decline in spirituality, health concerns or family
problems. Caregivers can obtain some idea of the severity of the
problem by reviewing the list below. |
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Evidence of alcohol and drug use such as beer cans or paraphernalia like
pipes, rolling papers, etc. An additional sign may include:
missing prescription drugs—especially narcotics and
tranquilizers. |
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Signs of covering alcohol and drug use with the use of incense,
room deodorant, or perfume to hide smoke or chemical odors.
Additional signs may include: bottles of eye drops or new use of
mouthwash or breath mints. |
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Increased secrecy
about possessions or activities. |
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Dishonesty, lying, and stealing. |
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Irresponsible behavior
with schoolwork, employment, finances and family. |
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Changes in eating and sleeping patterns. |
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Changes in friends.
Associating with individuals who appear to be irresponsible or
secretive. |
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Not remembering
sometimes referred to as “blacking out.” |
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Tolerance. The need to use greater amounts of alcohol or drugs to
get “high.” |
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Loss of Control. Not being able to stop drinking or using once
started. |
III. DETERMINE THE
LEVEL OF RESPONSIBILITY OR DENIAL
Learn about the users’ level of
responsibility or denial by asking questions and seeking inspiration
about the following:
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Do they believe they have a
problem? |
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Are they remorseful? |
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Do they want help? |
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Are they committed to stop? |
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Do they have a plan to stop using? |
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Do they minimize or justify the
problem? |
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Are they defensive about the
problem? |
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Are they willing to tell the truth
to those who need to know? |
If the users express motivation to
stop using alcohol or drugs, proceed through the steps that follow.
Reassure users that they can overcome their problem if they are
sincere and willing to work diligently.
Most users will initially
minimize, rationalize or deny their actions. If this occurs, be
confident and search for the truth. Teach users the necessity of
being honest with themselves, their family, and others who need to
know.
IV. EVALUATE THE INDIVIDUAL’S
SPIRITUAL STRENGTH
Ask the user about
his/her personal relationship with God and his/her spirituality. It
is important for a caregiver to discern if the user has the
spiritual strength to stop using alcohol or drugs. If there is no
desire to follow spiritual direction the individual’s spirituality
and motivation to change will need to be strengthened. For
additional ideas see page 13, Increase Spirituality and
Motivation in Step 2 Develop a Personal Recovery Plan.
V. WATCH FOR ASSOCIATED CONCERNS
The use of alcohol
and drugs may be related to other factors such as being the victim
of sexual or physical abuse, mental illness or personality problems.
Carefully ask questions to determine if these conditions exist.
Mental illness may increase an
alcohol or drug abuse problem and make solving it more difficult.
Caregivers should watch for the following signs listed in the table
below Indicators of Mental Illness.
INDICATORS OF MENTAL ILLNESS
Evaluate the possibility of a
mental illness by watching for the following.
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Prior History |
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Self-harm acts, like cutting
oneself |
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Talk of suicide or suicide
attempts |
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Prolonged or severe
depression |
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Tension-caused physical
problems |
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Undue, continuing anxiety and
worry |
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Withdrawal from society |
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Alcohol and drug abuse |
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Confused or disordered
thinking |
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Hallucinations or delusions |
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Unjustified fears |
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Obsessions or compulsions |
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Inappropriate emotions |
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Substantial, rapid weight
gain or loss |
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Too much or too little sleep |
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Excessive self-centeredness |
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Loss of touch with reality |
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Persistent negative
self-image and outlook |
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Inability to maintain good
interpersonal relationships |
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Bizarre religious beliefs and
behaviors |
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Excessive feelings of remorse
and guilt |
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Extreme high and low
feelings/moods |
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Inability to feel love |
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Strong feelings of anger |
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Inability to take care of
one’s personal needs |
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Inability to manage
responsibilities or solve problems at school, at church, at
work, or at home. |
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Also see the Mental
Health Resource Foundation’s Guidebook entitled
Helping Individuals Cope With
Mental Illness.
Referring to a
professional therapist is recommended if you believe there is a
serious associated problem. Even when users are referred for
professional therapy, continue to assist them to stop using. Follow
the tasks in Step 2 and adapt them to the circumstances you are
dealing with.
VI. RESOLVE CONCERNS AND DEVELOP A PERSONAL
RECOVERY PLAN
If users are resistant or in denial,
remain confident, help them to become honest and accept the
responsibility to stop using alcohol or drugs. When users express
motivation to change, help them understand the need to develop a
plan to stop using alcohol or drugs. Gain agreement to develop a
personal recovery plan. See Step 2 Develop a Personal Recovery Plan. |
