“I found out within six months that both my sons were addicts and like every other mother, I just wanted to go into bed and never get out. It’s just a very, very sad place.” https://tinyurl.com/y4gr7jq6

Enabling or supporting what’s the difference? Don’t beat yourself up about it, it’s a question that comes up very often. These are terms that are very familiar to anyone living with addiction. The terms that we use can be so important. For example, if we see our role as supportive it’s all good, but if we’re labeled an enabler it’s assumed that we’re part of the problem. How does this distinction effect treatment outcomes? How do these attitudes contribute to our bias and harmful ideas about substance use complications? If our child or friend, patient or client, was suffering from a physical illness would we have the same attitude, lay the same blame? Of course not, and we know that without support there’s no recovery.

What we can’t understand or what we haven’t experienced evokes confusion and fear when what the person desperately needs is compassion and support. People with substance disorders are usually well into the problem before they seek help. Unfortunately, treatment outcomes are so much more successful if the addiction is caught and treated early.  Feelings of shame and guilt, that accompany the substance use disorders, lead to feelings of humiliation that compel people to hide it for as long as they can.

Dr. John Kelly, an addiction researcher at Harvard and director of Massachusetts General Hospital’s Recovery Research Institute, says that the language we use plays a critical role in avoiding the stigma that keeps people from getting timely help. For Kelly, the term “abuse” implies a moral choice when we know that it’s so much more complicated. “The other thing we’ve learned in the last 25 to 30 years is that chronic exposure to drugs in the brain produces radical impairments and changes in neurocircuits of brains, in particular to do with reward and memory and motivation and impulse control and judgement. So, these different cognitive capacities are impaired so radically that it makes it very difficult for people, even when they want to, to stop.” Dr. John Kelly, the Office of National Drug Control Policy, and the International Society of Addiction Editors, among many other experts in the field, are quickly becoming aware of how much language effects our perception and our response. “What we found was that when people were exposed to certain terms, for example, when people were described as a substance abuser verses having a substance use disorder, people were more likely to view the person as needing punishment as opposed to needing treatment, and these were doctoral-level clinicians in the field.”

Bias created by the language we use may well lead to inferior care and less empathy and responsiveness toward the patient. This reality makes them more susceptible to unbearable feelings of shame and guilt, leading them to fear reaching out, and to lie about what and how much they’re using. They literally try to hide from those who can help. Sadly, statistics show that only one in ten people with substance use disorders get the help they need. There is nobody who wants to experience a substance use disorder. If you’ve never experienced the cravings induced by drugs, some literally designed to highjack our brains, you really have no idea of how horrifying and all-consuming they are. Nothing is more frustrating than watching a healthy human being destroy themselves, taking grave chances with their lives. Living and working with people who’ve become drug dependent can be extremely punishing, but for those of us who have loved ones with substance use disorders there is no choice.