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Recovering Health Care Professional Support Forum

Intervention: Tough Love That Works

"If you refuse to be evaluated and enter treatment if diagnosed with substance abuse or chemical dependency, the following actions will be taken:"

No manager, colleague, spouse, partner, parent, child, or friend hopes to have to say these words to someone they care for and respect. These are usually the final words used in a technique known as "Intervention". Denial is the major obstacle to overcome when treating someone with the disease of addiction. If the addict refuses to believe they are chemically dependent, no amount of cajoling, begging, or demanding will stop the progress of this disease.

Addiction is chronic (never goes away), progressive (will get worse if ignored), and fatal (accidental OD, accidents, domestic violence, other criminal activity, vomiting and aspiration when intoxicated, and any number of other diseases associated with chemical misuse). Waiting for it to go away, or for the addict to “get it” allows the brain to be altered more profoundly. So much so that it may never return to a “normal” state. The longer this disease goes untreated, the longer, and more difficult, treatment becomes. Believe it or not, denial can be a useful psychological defense mechanism for surviving extremely traumatic situations. It's an ingrained technique that allows us to "ignore" situations that would normally overwhelm us. Denial is the first of “The 5 Stages of Acceptance.” (Denial, Anger, Bargaining, Depression, Acceptance). It allows us to take in bits and pieces of a devastating event in order to develop a plan for dealing with the situation. Pathological denial is the same defense mechanism gone wild. It allows the addict to continue using despite extremely negative consequences as a result of their chemical misuse. It is not a conscious process! The addict doesn't think, "I love my alcohol, so I'll keep making excuses in order to drinking." A better example of an addict's thought process might be, "If these people would just leave me alone, I wouldn't have to drink so much (or use drugs, etc.) My drug use helps me deal with these horrible things happening in my life! I NEED THEM TO MAKE IT!" This is what is known as "addictive thinking". It is denial in action.

Something a non-addict can plainly see is a consequence of misusing mood altering chemicals, such as DUI's, loss of a job, and domestic violence, are seen by the addict as REASONS for using these substances.

“The cops are out to get me.”

“My boss puts too much pressure on me.”

“My wife/husband would drive anyone to drink.”

“They wouldn't shut up so I had to shut them up”

These are all manifestations of denial in action. Denial isn't just a problem for the addict. Family members, friends and even colleagues can all experience denial.

"My kid is on the honor roll, they can't be an addict."

"She's a respected surgeon and chief of staff! No way she's using drugs."

"He did the anesthesia for my wifes surgery! I would never have asked him to do that if he was an addict!"

Addiction is a brain disease that occurs when the following circumstances “come together”:

This is similar to other chronic diseases such as lung cancer or hypertension. When the right person, is exposed to the right chemical, in the right dose, for the right amount of time, a given disease will occur.

Notice, the presence or lack of intelligence is no where to be found in the risks for developing the disease of addiction. That's because it IS a disease. Comments such as “He's too smart to become an addict” make no more sense than saying, “He's too smart to get cancer (or heart disease, or diabetes, or Alzheimer's, etc.) Sadly, our society still holds on to the notion that addiction is a moral weakness or lack of willpower. This perpetuates the stigma associated with the disease, feeding the denial that prevents early recognition and treatment. If treatment isn't started at the earliest signs, it will progress through a predictable course. Without treatment, the individual will eventually die as a result of the disease. This is why addiction is been described as "unnecessarily fatal" since evidence based treatment protocols do work.

Treatment is delayed because of the denial in the addict and of those surrounding the addict. Treatment is delayed because of the myth that "an addict can stop using if they want to. They just don't want to." Treatment is delayed because of the misconception that they must "hit rock bottom before treatment will be successful."

ROCK BOTTOM IS DEATH!

Intervention is a technique used to create an ARTIFICIAL BOTTOM by allowing the negative consequences of substance misuse to apply pressure to the addict to enter treatment. When an intervention team composed of family, friends, and colleagues, confront the addict with factual information pointing to their addiction, it becomes more difficult to continue denying the obvious. Even if they DO continue in denial, allowing the full weight of the consequences of their actions to fall on them can be the final “tool” to break through their denial and get them into treatment. Unfortunately, the DENIAL of family, friends and colleagues must first be overcome before the denial of the addict can be addressed. This is where education by an interventionist or a state peer assistance advisor is crucial. If you think a colleague or family member may be suffering with substance misuse disorder, please contact a member of the peer assistance committee. We are available 24 hours a day, seven days a week.

We've been there. We know the desperation and isolation this disease causes. There is hope. No one has to continue living in the hell-on-earth called "addiction”.

Contact us. Take that first step to get you or the one you love the help they need and deserve.

Guide to a Successful Intervention