Addiction and the Family

Prescription Drug Abuse Statistics

Addiction and the Family

WebMD Live Events Transcript

As the daughter of former First Lady Betty Ford, Susan Ford Bales knows firsthand how addiction can affect a family. Now a spokesperson for the Betty Ford Center, Bales and Nancy Waite-O'Brien, PhD, vice president of Clinical Services at the Betty Ford Center, joined us on March 16.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome to WebMD Live, ladies. Thank you for joining us today. What is the first step you should take if you feel that a family member is abusing or is addicted to a substance?

WAITE-O'BRIEN:
My suggestion is to start gathering information, and that might be from a local council on alcoholism and other drug abuse, or a treatment center. I suggest that the person also goes to Al-Anon because it's easy to get confused about what's likely to happen with the increased confusion and chaos around somebody else's addiction.

FORD BALES:
Al-Anon is also a support system while trying to figure out what they are going to do and how to go about it.

MODERATOR:
The Betty Ford Center offers programs not only for the patients, but for children and families that are touched by alcoholism or drug addiction. Can you tell us a little bit about why these programs are so important for family members?

FORD BALES:
One of the reasons we have all the programs is that the entire family needs to be treated; it doesn't affect just the patient but all of the family members. The important part of the children's program is that it treats children from ages 7 to 12 who are living in a house with an alcoholic or dependant person. That age group carries a lot of burdens: "I didn't get an A, that's why Mom drinks", etc. So, they need to be treated differently than an adult.

WAITE-O'BRIEN:
We found that when the family gets help, the likelihood the person stays sober for a long period of time increases significantly. When the disease is active, everyone is affected. So when recovery begins, it's best that everyone is involved. That includes spouse, children, and parents.

"About half of the people that come into our center have been in treatment before. So what we know is that there's a distinct possibility that a person will experience relapse. We recommend that they keep working on it, to keep seeking help, and for the family to continue to be supportive."

MODERATOR:
Are children of addicted parents at a higher risk for alcoholism and other drug abuse than are other children?

WAITE-O'BRIEN:
There's evidence that there's a genetic link, particularly between mothers who are alcoholic and their children. The likelihood that a child becomes an alcoholic or addicted increases also because of what they observe. If they see their parents drinking or using, and that's how they problem solve, that's what the child will learn to do.

MEMBER QUESTION:
My brother in law is an alcoholic and continues to fall off the wagon; it's discouraging for us and I'm sure for him as well. Do most people recover on the first or second try? Should we all be saying something to him when we know he's been drinking?

FORD BALES:
Recently I've read in IDA [Information on Drug and Alcohol] that with most people, it takes four times of treatment before they get it. Relapse is a part of the disease, but don't give up. Keep trying.

WAITE-O'BRIEN:
About half of the people that come into our center have been in treatment before. So what we know is that there's a distinct possibility that a person will experience relapse. We recommend that they keep working on it, to keep seeking help, and for the family to continue to be supportive. The second part of the person's question -- maybe don't talk to him when he's drunk, but certainly right afterwards.

MEMBER QUESTION:
I've watched my four adult children deal with the effects of my alcoholism. It's not been easy for them, but I am very proud of how they're managing to lead productive lives. As the adult daughter of an addict, what specifically have you done to keep yourself clean and maintain a healthy perspective?

FORD BALES:
One would be continue to go to Al-Anon or therapy or whatever to deal with issues that continue to come up. Also, knowing that I am not in charge of my mother's sobriety, that is her responsibility. My mother and I are both micromanagers, so part of it is separating that. I think education plays a major role in healthy living in every aspect of your life.

MEMBER QUESTION:
Could you tell us more about how family involvement helps ensure long-term recovery?

WAITE-O'BRIEN:
What is likely to have happened is that the family has become overinvolved in the person's life. When they get treatment, they then begin to understand that they need help themselves, and it shifts the focus away from the alcoholic so that person can get help, too. Without that kind of treatment, there tends to be people blaming one another, telling one another what to do, and that leads to a lot of unhappiness. In short, it teaches the family member not to enable the alcoholic.

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FORD BALES:
I would agree with everything Nancy said. When I went to family myself, it was an incredible learning experience about what alcohol and drugs do, and why the person behaves the way they do. Also, the family usually is in major denial -- we need to get our own heads clear about what is really going on.

MEMBER QUESTION:
I am the mother of three daughters ages 21, 18, and 11 and the ex-wife to their father who has a cocaine addiction. He is now incarcerated and is facing time in prison. What can I do to help my children with this painful struggle and the continuing disappointments from their father? The emotional damage that they are going through seems unbearable.

WAITE-O'BRIEN:
Again, I'd recommend Al-Anon.

FORD BALES:
Alateen, also. The piece of information you could share with your daughters is that if he could do it differently, he would. But this disease is so powerful everything he does is driven by his need to find more cocaine. So he can't do anything else. His true love is the drug. If they can be sympathetic towards him, they'd probably feel less pain.

"Genetics is a predictor, but it doesn't determine the outcome. That means that having a parent that's alcoholic increases the likelihood that the child is an alcoholic, but it doesn't mean that they will be."

MEMBER QUESTION:
I am an only child and almost 41. My parents divorced when I was 18. My mom is a severe alcoholic. I married an alcoholic and drug addict and was with him for almost 20 years. I do not understand why so many people say that "I am this way because my mom was." Everyone tells me that I will be an alcoholic because my mom is. I believe in my heart that we all have choices to make and I do not like to drink. I do not like the way it makes me feel. My mom says she is this way because her father and grandfather were alcoholics. How do I respond to people always telling me if I have a drink I will end up like my mom?

WAITE-O'BRIEN:
Genetics is a predictor, but it doesn't determine the outcome. That means that having a parent that's alcoholic increases the likelihood that the child is an alcoholic, but it doesn't mean that they will be.

It sounds like what happened instead is that you are more comfortable in a relationship with an alcoholic, and that's what you learned from your mom. It is the mirror image -- still being impacted by addiction, still being impacted by the family side of it.

MEMBER QUESTION:
Do children of alcoholics stay completely away from alcohol as they grow? Or do they tend to go down the same road? Is it important that they get more help themselves as they reach the legal drinking age? What can we do to assure they don't "get" the disease?

WAITE-O'BRIEN:
Some children of alcoholics don't drink at all, and some will drink and become alcoholics. In a third group, they are able to drink socially. So it's hard to predict.

It is helpful as the child grows that they get help and support if they have grown up with alcoholism so they can understand how much they were impacted by the disease. There is no way to keep someone from being an alcoholic. The best thing is to provide a lot of information and support, and a general understanding that if the disease emerges, to get help.

The best prevention for children of alcoholics is to see their parent get sober.

FORD BALES:
From my own experience, I have talked to my girls and stepsons constantly about the disease. It's not something we've hidden. We've educated them that there is the genetic link but that's not always the determining factor.

Also, having watched college kids in today's society, there is a whole lot more education out there, but I think sometimes you're talking to a deaf ear, and I don't know the solution to that.

"For women, there's a great amount of secrecy involved in their addiction. That occurs because our culture is less accepting of a woman's drinking or drug use."

MODERATOR:
The Betty Ford Center offers gender-specific treatment. Why is this so important in the recovery process and how does treatment differ for men and women?

WAITE-O'BRIEN:
It's important to do this because men and women's experience in addiction is so different.

For women, there's a great amount of secrecy involved in their addiction. That occurs because our culture is less accepting of a woman's drinking or drug use. So, because of that, a woman will try to keep it hidden from family and friends, and has a great deal more shame about being alcoholic.

For men, there's often a cultural admiration for the capacity to drink a lot. The beginning of a man's alcoholism is not shrouded in secrecy, but more often in the company of friends, where a woman's drinking is likely to be alone.

There is a great likelihood that woman alcoholics have been sexually assaulted at sometime in their life. Many in childhood, and an equal number as adults, most often when they've been drinking. That also predicts a higher level of shame about being alcoholic. When these two groups are treated separately, then the secrets get talked about. In mixed groups, women are less likely to share those painful life experiences. They also tend to talk less when men are there.

In group therapy for men, they also talk about the secrets in their life, and they are often different. Many men have a history of childhood abuse, physical or sexual, and a great number talk about the loneliness they experienced because their fathers weren't around.

FORD BALES:
When we opened the Betty Ford Center, more than 22 years ago, we didn't have gender specific treatment and we saw that women were doing better in women's halls and men were doing better in men's halls. That's why we made the change, and we are one of the leaders in the business having done that.

MEMBER QUESTION:
What is the difference between abuse and addiction?

WAITE-O'BRIEN:
People who abuse alcohol or any other drug, have a problem that they drink too much then get arrested or drink too much and lose their car. When a person does that repeatedly then goes on to make excuses about that behavior, "It wasn't really me", "The police officer was being picky" or something like that, when it's persistent and the person continues to drink or use and then shape their life around accessing the drug, and may even try and stop and fail, or try and control it and fail, then it's dependence.

MEMBER QUESTION:
I am seven weeks pregnant and my fiance is addicted to crack and we are trying to get help but Narcotic Anonymous is not enough.

WAITE-O'BRIEN:
He may need a treatment center that gets him out of the environment where he keeps getting the drug. That would be my best recommendation, that he get into a treatment center and get away physically from his dealer and the crack house. Go to NA (Narcotic Anonymous), AA (Alcoholics Anonymous) and CA (Cocaine Anonymous).

MEMBER QUESTION:
How does one approach someone with a drinking problem? Should it come from a friend or better yet a family member?

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WAITE-O'BRIEN:
It should come from everyone.

FORD BALES:
I agree. One of the things we use is called intervention. There are interventionists out there who do this as a profession to get a group together to confront the individual. Usually one-on-one confrontations don't work as successfully as a group intervention.

WAITE-O'BRIEN:
I agree that the more people who can be present and talk in a way that's loving but direct to the person who is using, and usually under the direction of an interventionist, the more likely that person is to get help.

"Our spirit is where our hope is. When we help people access a source of hope, the possibility for change emerges."

MEMBER QUESTION:
What percentage of alcoholics die from the disease, either directly or indirectly (i.e. accidents, suicide)?

WAITE-O'BRIEN:
Without treatment, nearly all die of their disease. This person included what makes sense; the accidents, suicide -- things that are not directly related to the physical part of addiction but are part of the whole disease. When you put all of that together without treatment, the person will most likely die of their disease.

MEMBER QUESTION:
Is it true that an alcoholic has to hit bottom before he has the ability to truly break the cycle?

WAITE-O'BRIEN:
No. What happens is that the bottom hits them. By that I mean that when friends and family confront the person, that essentially brings the bottom up. When friends and family express their concern and then refuse to enable the person, the likelihood is that the person is going to get help, and they don't have to hit bottom.

MEMBER QUESTION:
How do you handle it when someone you love refuses to get meaningful treatment?

WAITE-O'BRIEN:
I would get help for myself. That might mean going to a family program in a treatment center, and it certainly means going to Al-Anon. Out of that, what's likely to happen is that the person can make a plan to how to stay in the relationship or how to leave it.

MODERATOR:
The Betty Ford Center considers spirituality vital for recovery. Why is this so important?

WAITE-O'BRIEN:
Our spirit is where our hope is. When we help people access a source of hope, the possibility for change emerges. So, without attending to the spirit, there is no hope.

FORD BALES:
The other point to all of that is what the family members and patients are holding onto desperately is hope. There is help and there is hope.

MODERATOR:
Could you please tell us more about how addiction affects family dynamics?

WAITE-O'BRIEN:
Addiction, like any other life-threatening illness, changes the dynamics of a family. The attention shifts toward the person with the illness. The energy shifts toward the person with the illness. Individual needs of family members don't get attended to because the demands of the illness are bigger than any one person. Think of what treatment is -- it is, in part, a rebalancing of family dynamics so people can take a breath and have a life that is separate from this disease.

FORD BALES:
To follow up on what Nancy said; that's why every member needs to be treated, because it does affect the entire family. The family members get lost in the disease and forget about themselves.

MODERATOR:
How are these very adult issues handled with young children in the children's programs?

WAITE-O'BRIEN:
The children's program is for kids ages 7 to 12. The focus of that treatment is to help the child understand that this is a disease that they are not responsible for. They didn't cause it, they can't control it and they can't cure it. They also get the opportunity to tell their parent how they feel about what's been going on. And it's a wonderfully freeing experience for a child.

FORD BALES:
Some children do go back to a home where the parent is still using or drinking. What we've seen at the Betty Ford Center is that children who have gone through the program may have gone onto adulthood to do drugs or alcohol, but they know where to come to get help. It's almost an early intervention for the child.

"Don't give up on hope. If you can't get that alcoholic or addict to change, you can change and make a difference."

MODERATOR:
We are almost out of time. Before we wrap things up for today, do you have any final words for us?

WAITE-O'BRIEN:
What I'd like to say in closing is that addiction does not have to be a fatal or family-wrecking illness. Any part of the family who reaches out and gets help changes that family dynamic. It can begin with the person who is not alcoholic. They get help, that changes things, and then it's likely down the road that the addict or alcoholic will get help.

If people have more questions, they can access our web site at www.bettyfordcenter.org or call our admissions department. We're happy to give them information about the Betty Ford Center or treatment centers in their home area. We want most of all for people to get help.

FORD BALES:
Our admissions staff takes phone calls and helps people find other treatment in their community; not everybody is the perfect patient for the Betty Ford Center. We are constantly sending people in other directions or the direction they should go. So I want to encourage people to call for help and information. Don't give up on hope. If you can't get that alcoholic or addict to change, you can change and make a difference.

MODERATOR:
Our thanks to Susan Ford Bales and Nancy Waite-O'Brien, PhD for joining us today. And thanks to you, members, for your great questions. I'm sorry we couldn't get to all of them. For more discussion on this topic, be sure to visit the WebMD message boards to ask questions of our online health professionals and to share questions, comments, and support with other WebMD members.



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Reviewed on 3/29/2005 11:46:59 PM

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