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What to Do When Your Loved One Refuses Treatment

When someone you love says no to drug and/or alcohol treatment, feelings of hopelessness, frustration and worry are common and understandable. This type of situation can be extremely scary for friends and family of an individual suffering from a drug or alcohol problem.

It's important to comprehend why your loved one is unwilling to make a change before you let emotions get in the way.

Alcohol and drug addiction is a disease of the brain that causes chemical and physiological changes. Chronic use of drugs or alcohol changes consequential thinking or someone's ability to understand that if I do X, Y will happen. Rather, their judgment becomes clouded and they begin to miscalculate risks, believing that if I do X, there will be no consequence, which may explain some of the odd behavior you see your loved one displaying. Lying, stealing, and engaging in dangerous behavior are examples of this phenomena.

Interventions are often futile because when you forcibly push someone who isn’t ready into treatment, it will most likely be counterproductive. While there are exceptions in desperate situations where a family’s only option to save the life of their loved one is by making them go to treatment through the court system, this type of approach should only be used in dire situations. Force can be successful in a small number of cases, however, the most effective method is to allow your loved one to decide on entering treatment on their own. Remember, especially if your loved one is an adult, you can’t control them, and it's not your job to do so.

When your loved one is refusing treatment, they are experiencing the pre-contemplative stage of an individual’s readiness to change. There are five stages in the Stages of Change Model developed by Drs. Prochaska and DiClemente.

  • Pre-contemplation - Commonly characterized by denial and a belief that they don’t need help or have a problem. At this point, the individual is not motivated to change their behavior.
  • Contemplation - This stage occurs when the individual begins to think about the possibility of treatment, however, they are most likely still ambivalent about whether or not they want to pursue this option.
  • Preparation - The individual is intent on taking action to address his/her problem and believes he/she can make the changes needed.
  • Action - In this stage, the individual chooses to seek treatment and obtain help. It requires the most amount of time and energy. While this is a very rewarding step in the right direction, it’s important to keep in mind that it’s not the only change your loved one will need to make towards recovery.
  • Maintenance - The last stage requires the individual to use the skills and coping methods they learned during treatment to prevent relapse moving forward.

What effective methods can you be doing now to help your loved one get to the stages of contemplation and then preparation?

  1. Educate - The first, and most important course of action is to try to help educate your loved one about their disease and the possible outcomes that can occur should they not get help. Information can be gathered on-line, over-the-phone, or via a treatment facility.
  2. Confront - Mild confrontation may also be necessary at this point to help show your loved one how their addiction is impacting you and those around them. It's easy in this type of situation to let emotions get the better of you, and when this happens, the conversation will not be worthwhile. Therefore, it’s important to keep your emotions in check.
  3. Explain - Clearly explain how their behavior is affecting you and be ready to provide specific examples.
  4. Research - Do some research prior to your conversation on treatment facilities and the type of treatment your loved one will need to undergo in order to get on a path to recovery. Depending on what type of drug your loved one is using they may or may not need detox. For example, many are surprised to learn there is no detox protocol for those who use Cocaine. Calling a treatment facility to ask about next steps will help to determine the course of treatment best suited for your loved one. If possible, looking into the individual’s insurance and coverage may also help to alleviate financial concerns regarding treatment. Having clear and simple steps for them, can help to eliminate barriers and educate them about available options.
  5. Seek Support - Programs like Learn to Cope, are designed as a support group for families, parents, and loved ones of those with a heroin, OxyContin, or other drug addictions. It helps to show loved ones that you are not alone. These types of programs are offered in most large areas.

Addiction is a difficult disease to overcome. Some of these steps may need to be repeated several times before there is any progress toward the next stage in making a change. Patience and understanding are key to supporting your loved one in treatment and recovery, however, making a choice for a better life is most lasting when the decision is left to them.

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