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Jude's avatar

How do you distance yourself from a loved one who you can't help, yet, if you keep your distance, you feel as though you're abandoning them?

Asked by Jude (32112points) May 25th, 2010

The loved one in this case is my sister and she is going down the slippery slope and fast. Dependent on Oxy for pain (due to an accident) and is only getting worse. She won’t reach out to anyone else (feels ashamed), so, she turns to immediate family (namely my one brother and I) for support. The back pain is a major problem (doctors won’t do surgery and she needs to take the Oxy), but, the dependency is becoming a bigger issue. She’s falling apart. There is nothing that I can do for her. Now, she mentioned to my brother that she is a borderline alcoholic (alcohol helps with the pain, since the painkillers alone aren’t doing the trick). My brother (who also messed his back up and is disabled) said that when speaking to her, ‘it’s not really her” (it’s the addicted her). I know that she’s sick.

I’ve been under a lot of stress because of this. It’s been so stressful, that I believe it is making me sick. Other than my brother, I’m the one that she turns to. Not her husband, she’s distanced herself from her friends, she won’t open up to my Dad, my Mom passed away 3 years ago, and that was a big support for her. I know that she can’t pull out of this alone, but, I really don’t think that I can help.

Also, she’s is right in the midst of a lawsuit (because of the accident), so, she has to be awfully careful what she does.

I hate dumping on you guys, but, I don’t know what to do. Any advice?

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27 Answers

tinyfaery's avatar

Have you talked to her openly about her situation? Does she understand that she is addicted and does she know how that addiction is affecting her, and you? If not, maybe it’s time. She needs help, maybe even detox and rehab.

le_inferno's avatar

You’re right in saying that this is a problem that is way bigger than you. She should probably see a therapist, and/or enroll in a rehab facility.

WestRiverrat's avatar

Sadly, she probably won’t admit she needs help until she hits rock bottom. And if you are there to catch her when she falls, she may never hit bottom. You need to get with the rest of your family and her friends and do an intervention.

Find an in patient rehab for her, make arrangements for her to be placed, and get their staff to help you with the intervention. She will ultimately have to consent to the rehab, or it won’t work. You can not force help on people that don’t want it.

You may have to let her go down hard before you can help her. It isn’t easy to do, but it is sometimes necessary to temporarily remove our support from the ones we love.

Edit: Find a local support group. Social services, or Narcotics Anonymous should be able to hook you up with other people going through the same thing you are.

Jude's avatar

She talks about admitting herself into rehab once the lawsuit is settled. That could take a year .

Buttonstc's avatar

Have you considered doing a structured intervention? This has been the turning point for many an addict.

There are people to whom you can turn for advice on the best way to do this. It’s clear that she needs the ttype of comprehensive help that a good rehab facility can provide. This is not JUST to deal with the Oxy addiction, but to find alternatives for pain management and accurate diagnosis of precisely what is causing the pain.

A good rehab facility is a necessity because if she continues combining alcohol and painkillers, she will end up dead (either accidentally or intentionally.). That may sound harsh, but it is the unfortunate truth. It’s just a matter of time before it happens. It’s clear she can’t manage this on her own.

Until you feel prepared enough to arrange an intervention, the best thing you can do for yourself is to begin attending Al-Anon or Narc-Anon meetings.

These are for family members of those who are addicted. The focus is on you rather than the addict. It’s the best coping mechanism for you since things will not change until she gets professional help. You are no longer dealing with the sister with whom you grew up. You are dealing with the booze and drugs.

Your brother is absolutely correct with his insight.

The two of you need help for her and yourselves. Right now the drugs and booze are in control until something is done to intervene.

le_inferno's avatar

@jjmah Rehab isn’t always necessary though, at least not right now. If she needs to take care of this lawsuit, she should probably see a therapist at least in the meantime. My psych professor specializes in substance abuse patients, so I know that people can cope with addiction in other ways. There are professionals like him who can help out, at least until this lawsuit is done with. It can’t hurt!

Buttonstc's avatar

I was typing while WRR was posting. He is correct.

Just realize that the lawsuit is NOT the issue. After that there will be another excuse and another. The success of her lawsuit can only be helped by her sobriety. That’s the truth.

The other truth is that the day that she combines too much booze and drugs for her system to handle could come at any time.

She could be dead before the year is up. I’m not trying to be dramatic or alarmist. That’s just the unfortunate reality of the situation. It’s all too easy for someone to be in too much of a fog to remember how much of what they took.

Corey Feldman, Heath Ledger and countless others have died way too young for precisely this reason. It doesn’t just happen with famous people.

Cruiser's avatar

I hate to be so blunt but where is her husband in all this??

Jeruba's avatar

She sounds like she needs help now, lawsuit or no lawsuit. Rehab might be the best course for her; maybe it would be AA or private therapy. In any case you can’t save her, and you can tear yourself apart trying. You shouldn’t take on that burden.

You can and should tell her that you love her, you are concerned about her, and you want her to get help. Saying yes to help is still up to her.

evandad's avatar

I knew it had to be drugs just from the lead in sentence. It’s an old cliche, but it’s true. They have to hit bottom and see the wretch they’ve become before they will ever come back. And I’m sure you know they will take from any enabler who will give them a twenty. You’re not helping them if you buy them drugs.

susanc's avatar

This may be the most painful thing any of us can be called on to bear.
You would feel much less overwhelmed if you started going to AlAnon and maybe a therapist. People you love have been taken from you – too many, too fast. I’m worried about your sister, but I’m more worried about you. Can you try to concentrate on getting yourself steady right away? And by the way, that’s no quick fix either. BIG hug.

YARNLADY's avatar

When that happened to me, I visited a psychological counselor and received some great tips and ideas. If you have any insurance coverage, it will be a minimal cost.

If you can’t afford that (no insurance) then visit e.how

Buttonstc's avatar

The old theory was that someone has to hit the absolutely worst possible bottom before they would be ready to accept help; even if that meant death.

The entire reasoning behind an organized intervention is to “raise the bottom”.

It’s not a guarantee and some addicts refuse and continue till they bottom out.

However, there are others for whom the realization that their chief enablers are opting out and that the full consequences of their behavior choices will now fall on their own shoulders, realize that they are being thrown a lifeline. They then proceed to rehab and some are saved from years and years of further destruction or possible death.

The worst thing that can result from an organized intervention is that the addict refuses help and continues in their addiction. But, that’s what they were doing prior to the intervention anyway.

The best thing that can happen is that the help and insight they receive in rehab enables them to live a normal healthy life.

You can’t control the outcome of an intervention but you can certainly help to organize it.

I think it’s difficult to envision the downside of an intervention, because the worst scenario is taking place already. It’s worth a shot to try to effect a change.

Waiting until she hits her own bottom instead of raising that bottom for her could very well result in her own choice of bottom ending in a coffin at a much younger age than necessary.

If you are going to distance yourself from her anyway, why not include it as part of the intervention. This would be part of your bottom line if she decides to continue in her addiction.

At least then, the reason would be clear cut and reversible by her should she decide to make a healthier choice in the future.

Make it clear to her that the only contact to which you will respond is her requesting a ride to rehab. And stick to it.

If you’re going to distance yourself (and it would be perfectly understandable if you did) at least make it count for something potentially positive instead of just the anger of negativity. But if you do issue her that type of ultimatum, don’t waffle on it. Either do it or don’t.

aprilsimnel's avatar

I can’t add a thing to what @Buttonstc has said except to agree. Al-Anon for you and your brother and some sort of intervention with professional assistance for your sister.

Jude's avatar

I’m going to call my brother tomorrow. I’m thinking, at this point, an intervention is the way to go.

I’ll be seeking out help from a support group (Al-Anon or Narc-Anon).

SeventhSense's avatar

Intervention with the healthy family members. There’s often power in numbers.

Buttonstc's avatar

Keep us posted on how things go.

You’ll be very glad for Al-Anon. I’m sure that there are loads of meetings. If one doesn’t feel comfortable for you keep trying them out till you find one that feels like “home”. Or try several simultaneously. No law against that.

Try to strike up an after meeting conversation with some of those with the longest track record. There’s a calmness about them that’s contagious.

They will also be the ones most likely best aware of all the resources available in your community, therapists, interventionists, rehab facilities, etc.

Just call the AA number listed in the phone book and they can guide you to groups meeting in your area.

eden2eve's avatar

I was put in the unenviable position of organizing an intervention for a family member a number of years ago. I was warned by the trainers that the family member might cut me, and other family members, out of their peer group, and that proved to be true.

We were able to get the addict into a program, but I was immediately told that I could have no information on the progress or well being of the person, per their request.

That was ok with me, as long as she was getting help. Besides, I was able to learn from others who had not been denied access to information. The person tested positive for the drugs, but checked out of the program as soon as it was allowable (three days). We as family members were told by the addict that the tests were negative.

The person went on to kick the habit independently, going to a safe place where she could get care for her children and have the time to recover, which took nearly a year.

I believe that the big motivator for her was that she was threatened with the loss of her children by their father. I don’t think that everyone is strong enough to do that, but I am very grateful that she was unusual in that way. And she was fortunate in that she had such a place to recover.

Today, she seems to have no addiction problems. Not to say that she is free of other problems, but this situation was quite possibly dangerous to the point of fatality, due to the fact that alcohol and drugs were being used together, and the severity and scope of the usage.

MissA's avatar

I don’t understand why doctors prescribe oxy and others in a way that would make the patient dependent. What is their exit strategy? Enough of this goes on that there needs to be even a baseline for prescription pain meds. It’s way too common. I wish a doctor would post here and give their thoughts and facts.

trailsillustrated's avatar

I know you care about her, and want to help. I also know there is nothing you can do. There are wierd things that go on in the addict’s mind, which we can never really know. I say this because I was there, my family completely turned away. Yes I was reduced to living in cars and whatnot. It has to be left up to her, I am sorry to tell you this, but that’s it. Unless some one of you has a large financial resource, and then the answer is medical detox and supervised sober living for quite some time. Like, about a year and a half. That person has to be supported and not expected to work or do anything but get well. So you see, it’s very hard. I am very sorry for you, and I truly wish you and her the best.

PandoraBoxx's avatar

Is her doctor aware that she has a substance addiction? Perhaps that’s a place to start.

La_chica_gomela's avatar

@MissA: That’s the nature of pain killers. There’s no reason to assume that the situation is her doctor’s fault. I’m not a doctor, but when treating patients with chronic pain, they have balance on the often razor thin line between adequate pain management and the possibility of addiction. And the truth is that those often overlap.

MissA's avatar

@La_chica_gomela I’m not suggesting that it’s the doctor’s ‘fault’. But, he/she does have a hand in this…and, they should be monitoring this person very closely. I understand balance…that’s why careful monitoring is essential.

GrumpyGram's avatar

Here we go with the “rock bottom” myth. There are addicts who hit what Many would call rock bottom. I know one. They bounce back up Slightly, then go back down again. Oh; then they get better! For awhile. Then back down to the same level or worse. They sometimes get arrested. Think that’s rock bottom? For many, it is. For others? They get out of jail then go back to the drugs.
Second point: if someone has horrible back pain, takes painkillers (narcotics) and they try to get Off of the pills but the pain is too severe to do so, then why is rehab recommended? Do we believe that getting counseling in rehab will make their back stop hurting? The fact is, millions of people with severe pain Must take painkillers to be able to function but their doctors refuse to renew their prescription for fear “they may become addicted.” Well , they’re already addicted. They’ll probably stay that way.
I don’t get it. I’m not in pain but I understand people needing painkillers “even if they’re addictive.*

Buttonstc's avatar

The primary reason why a COMPETENT rehab facility is necessary, if you read my suggestion carefully, is NOT JUST to deal with the Oxy but to also deal with the pain issue.

This would include a comprehensive medical workup and diagnosis to pinpoint the source of the pain as well as explore alternative methodologies for treating it. She is certainly not the first addict to have real physical issues. It’s actually quite common.

I can guarantee you for certain that if a person is combining painkillers with alcohol, it is not for pain relief alone. Alcohol does not relieve physical pain, pure and simple.

There is a huge difference between the physical dependence of the body and addiction.

Otherwise steroid-dependent asthmatics and diabetics would likewise be labeled as addicts.

Addiction is a complex disease which PRIMARILY involves the mind, emotions and will (not just the physical body).

I know I’m grossly over-simplifying here, but it’s to make a point. The main thing differentiating an addict from someone needing pain relief is that the latter takes the medication as prescribed for the relief of physical pain only.

They don’t take more if they’ve had an exceptionally trying day (emotionally) or increase the amounts for relief in coping with grieving associated with a loved ones death or other difficult life circumstances.

The addict conflates the two (physical and emotional/mental) and increases the medication to cope with (actually escape from) issues other than physical.

One of the clear-cut tip-offs to addiction danger is potentiating the mind altering qualities of painkillers with alcohol.

To be perfectly blunt, alcohol doesn’t do jack-shit for physical pain. It does, however, allow one to mentally escape from whatever they are having difficulty coping with.

A good rehab facility with competent medical personnel will deal with this as well as the physical because they have regular MDs on staff as well as addiction counselors.

This is why I don’t think that, in her particular case, just going to meetings will do it because they are ONLY equipped to handle the addiction part but not the medical.

This person needs to be dealt with in a comprehensive manner which is best done in an inpatient setting so that the medical part gets taken care of as well as dealing with an addictive mindset.

If that is not done, she will just return to self medicating (and not doing such a good job of it).

As far as blaming Doctors goes, that’s not really productive. Unless one is a mind reader, there is no way for a Doctor to know which of his patients is taking this medication addictively or which are using it SOLELY for pain relief.

Unless the person tells them, they have no way to know what is happening outside the office in the rest of the patients life.

I think I can say with a fair degree of certainty that this lady is NOT telling her Doctor about the booze she is adding to the prescription. Unless she comes for an office visit reeking of alcohol, how would he expected to know ? And addicts are way too smart to come walking in smelling of booze.

Anyhow, there are multitudinous factors contributing to someone’s addiction (not the least of which might be an inherited pre-disposition) and this is what the addict gets educated about in rehab so that they can (hopefully) manage this disease both physically and otherwise.

For anyone desiring more info on this complex problem, I would highly recommend Betty Ford’s book describing her experiences.

She also had real physical problems with neck and back which necessitated her medication to begin with. And she certainly never hit total rock bottom in an obvious way.

Had she never chosen to make any of this public knowledge, none would be the wiser. And she had to overcome massive amounts of her own denial before the truth became evident to her. In that regard, her story is like that of any other addict on the planet.

The only thing preventing any recovering addict from being able to BS a Doctor in the future (especially if they have X-Rays as medical proof) is their own fearless self honesty and desire to avoid relapse. That’s a large part of what they will learn in rehab.

It’s not realistic to expect a Doctor to spot every addict. Its up to a recovering addict to resist pulling the wool over a Doctors eyes.

trailsillustrated's avatar

the deal is, that these kind of pain relievers create a very physical addiction. you get incredibly sick if you don’t take them. Lots and lots of people in pain live with low level physical addictions. They are completely functional in life, and it’s not AT ALL the same as a heroin addict or something like that. But, if something happens and they don’t take their medication, they are in WITHDRAWL and can’t function. It’s just a bad side of pain management, and lots of people take the medication for their whole lives and are fine, functional, and productive. As long as no apocolyptic type thing happens, they are fine and have very normal lives. I don’t know if she is this type, but only her doctor and her own self can determime this.

Buttonstc's avatar

But if people are using this medication responsibly, they are NOT combining it with alcohol or withdrawing from friends etc.

This is clearly addict behavior.
If it were heroin or a street drug, it would be very clear cut. Because this is a prescription item, that tends to cloud the issue for society as a whole.

But the substance itself isn’t really the issue. It’s the way in which it’s being used.

Yes, there is a physical aspect here in that one can’t just stop taking this suddenly. But that’s physical dependence. As I mentioned before, there are Asthmatics who would be in severe medical difficulty if they suddenly stopped taking their Prednisone. That is physical dependence but not typically regarded as addiction.

Same for diabetics. But neither insulin nor prednisone have the mood/mind altering effects that narcotic painkillers do.

That’s why it is relatively easy for someone to transition from physical dependence to addiction if not careful.

Potentiating with alcohol is one of the quickest ways to hasten that along. It is a very human trait, when facing painful life’s circumstances, to relieve that emotional pain as well even tho that’s not why these painkillers are prescribed.

Escaping emotional pain with them and/or alcohol only works on a short term basis and ends up creating more problems.

This is an unfortunate cycle which people get into. And that’s why it takes a comprehensive approach combining diagnostics and education to enable someone to deal with life differently.

It’s definitely not an easy task.
And as someone who has been there (as you mentioned) I’m sure that you understand this better than most. I spent my childhood growing up with addicts and many years in therapy and Al-Anon groups to learn the same thing. It’s a hard situation for all concerned.

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