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Today, an estimated 46.3 million U.S. adults or 16.5% of the population have a substance use disorder. This means that most Americans know someone with a substance use disorder and one in four of us live with an addict in close proximity. That’s traumatic enough on its own, considering you likely have to watch as someone you care about hurts themselves with an addiction and with substance use that consistently harms them and the people around them. At the same time, living with or around an addict can be significantly traumatic as well. People with addictions change priorities to focus on the substance they’re addicted to, they may manipulate you, lie, harm things you’ve worked for, and behave in ways that are callous and hurtful. Taking steps to take care of yourself and your mental health is important to being able to navigate that without hurting yourself.
Of course, that might not always be possible. It’s important to be honest with yourself, to withdraw when you can’t manage your relationship in a healthy way, and to prioritize also taking care of yourself.
Chances are high that you feel a significant amount of responsibility, including shame and guilt, for your loved ones addiction. You might constantly go out of your way to try to fix things for them, to give them opportunities to recover, or to make life a bit easier for them.
Part of setting healthy boundaries is to step back and determine where you’re actually responsible. Here, addiction can be complicated. No one chooses to be an addict. Your loved one didn’t wake up one day and go “I will bet hooked on X”. Instead, addiction normally happens as a slippery slope of decisions that result in chemical dependence and then behavioral addiction. Most importantly, that person has to take responsibility for the decisions that allow them to continue using.
What does this mean for you? It means that even if you handed them the substance they’re addicted to the first time, you aren’t responsible for their addiction. You may play a part in the decisions that got them to addiction and that part may even be significant. But, they have to take responsibility themselves. This also means that if you try to make yourself responsible for their addiction, you could be actively harming their ability to get clean and sober. Setting good boundaries is good for your loved ones as well as for you.
Saying no can be extremely difficult. However, it’s an important part of setting boundaries. Often, that will require practice, getting things wrong, and trying again. Here, good boundaries normally involve setting limits, practicing staying inside of those limits, and consistently and regularly saying no. That will mean taking an approach of saying no in a healthy way.
Practice De-escalation – People with substance abuse problems can often try to escalate things and very quickly. What you intended as a simple and quick conversation may end up as an argument every time you try. Practicing de-escalation is important for you and for them. Here, de-escalation may mean saying “I am not having a fight with you, I will withdraw from this conversation until we can have it in a calm way”. It may also mean keeping your voice level and refusing to rise to bait to escalate things. And, it may mean going, “That’s not what I want to talk about right now, can we stay on topic please”. It’s important to keep in mind that while you’re calm, you’re in a lot more control of the conversation and what you want to get out of the conversation than if you allow conversations to be escalated. Practicing keeping conversations calm and on topic will help.
Be Gentle but Firm – Being firm can be difficult, especially if someone doesn’t listen to you. That’s even more true if you’re accustomed to having to escalate to get people to acknowledge you or your point. However, you don’t need acknowledgement to know that someone has heard you. Keep your tone soft, be kind, but be firm. That means sticking to your “no” and to what you said. It also means staying level even when the other person isn’t acknowledging you.
Don’t Explain More than Once – Getting stuck in loops of over explaining yourself can actually be detrimental to your boundaries being respected. Why? If you feel you have to validate your decision every single time you say it, you create openings where your loved one only has to find loopholes or alternatives in your reasoning. If you set a boundary, be certain of it. Explain yourself once or if your loved one asks you to. Then, if you have to remind that person of your boundary, simply do so. “I told you I can’t lend you money anymore” rather than a list of reasons why you can’t lend them money. “I will not drive you to the party” rather than a list of reasons why not. Be simple, clear, and firm, and don’t feel the need to validate yourself or your boundaries after you explain them.
One of the most important aspects of setting a boundary is that once you set it, you have to stick to it. That means ensuring there are repercussions for not following your boundaries. Sometimes those repercussions should be quite harsh. For example, if you’ve told your loved one that they can’t borrow money and they steal it instead, you’d want to take significant steps. If you told them that they can’t have friends over to use drugs and they do anyway, taking steps to restrict their access to the house may be a good idea.
Set boundaries and decide on valid repercussions if those boundaries are not followed. Pick repercussions that you can and will follow through on because if you don’t follow through on boundaries, your boundaries essentially don’t exist.
You’ll also likely want to try to be mindful of where your boundaries may overlap with safety concerns. For example, you may not be comfortable with your loved one using in your home but it’s likely a lot safer for them to use in your home than on the street. If you have something that you feel is important for your mental health, emotional health, stress levels, or physical health, write it down, consider discussing it with your loved one, and come to an agreement based on everyone involved.
If you or a loved one is seeking help for alcohol or other substance abuse, contact us at Stairway Resource Center today. At Stairway Resource Center we provide a 60 to 90-day outpatient program that takes place in an engaging and supportive community setting. We offer dual diagnosis treatment and daily group and individual therapy for our clients, in addition to fun community-based events and activities.
Michael D. Stone, MD has been in practice for over 30 years. He graduated from Medical School in 1986 and attended LA County/USC Medical Center Residency in the field of Emergency Medicine. He is a practicing E.R. doctor at 2 hospitals in the Southern California area. Dr. Stone also has a Specialty in Chemical Dependency and Addiction Medicine for 22 years. He is the Medical Director of numerous Residential and Outpatient Facilities in the Los Angeles area. Dr. Stone’s interests outside of medicine include a commercial pilot, all outdoor activities including skiing, fishing and boating.