Prevention for a Loved One

If you’re reading this, chances are you’re already concerned about a loved one – a child, spouse, parent or friend who is near and dear to your heart. You may be wondering what makes some people become addicted while others don’t. More important, you want to know how you can you help your loved one avoid becoming a statistic.

The answer to why some people become addicted while others can try a substance or behavior and never develop a problem lies in the brain. A potentially addictive substance (like alcohol, tobacco products and heroin) or behavior (like gambling, video gaming, compulsive eating, shopping and sex) stimulates the brain’s reward center. It is this area of the brain that releases a powerful brain chemical called dopamine, which helps us feel pleasure – even euphoria or a “high.” Over time, when repeatedly overstimulated in this way, the brain changes and begins producing less and less natural dopamine to compensate for the rapid (and unnatural) chemical surges it experiences from compulsive use.

Because addiction affects the brain in these ways and changes the brain’s circuitry over time, the National Institute on Drug Abuse (NIDA) considers substance addiction to be a chronic brain disease that is progressive. That means people with substance use disorders gradually get worse over time if they keep using a substance; and relapses are all too common as well with this disease. Similarly, if your loved one has a problem with a behavior such as gambling, this, too, is considered an addictive disorder similar to substance use since both activate the brain’s reward system in a comparable way, according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the guide clinicians use to diagnose mental disorders. Compulsive behaviors are often called behavioral, or process, addictions and include video gaming addiction, sex addiction, food addiction, porn addiction, work addiction, love addiction, exercise addiction and shopping addiction, among others. These, though, are not currently recognized in the DSM-5 as addictive disorders.

Because an addiction generally develops over time – not after a single use – you can help prevent a problem from starting by discouraging experimental or recreational use so that it doesn’t have a chance to develop into something more serious. How long it takes for casual use to progress into an addiction varies from person to person and also depends on the specific substance(s) or behavior(s) involved – as well as the individual, because relatively few people who use ever become addicted.

There’s no single root cause of addiction. But there are a variety of factors that can increase your loved one’s risk. These include:

  • Easy access to drugs or other substances or ways to behave compulsively
  • A family history of addiction
  • Stressful and traumatic life events
  • Personality traits such as aggression or impulsivity
  • A lack of knowledge about harmful outcomes related to drugs or other behaviors
  • A diagnosis of a co-occurring mental health issue, such as depression, ADHD or anxiety

Sometimes your loved one’s risk factors simply cannot be helped or changed. These might include experiencing trauma, such as being a victim of rape, incest or physical abuse; having a family history of addiction or being raised in a dysfunctional home. While you might not be able to prevent your loved one from developing an addiction, it is possible to intervene, especially early on, and perhaps have a powerful and meaningful impact on the life of someone you care about.

What you will be able to do to help largely depends on the strength and closeness of your relationship to this person. If you’re a parent and your child is under 18 you will, of course, have more rights and responsibilities to help your child. But regardless of the legal relationship you share with your loved one, what’s most important is that you care enough to recognize there could be an issue and that you’re arming yourself with important information about prevention.

If you are a parent or caregiver, you can:

Adjust your parenting style. Having a strong family bond can help children avoid developing an addiction down the road, according to NIDA. Researchers have conducted studies to find out which parenting style seems to be most effective at preventing substance abuse problems in children. One such study in the journal Drug and Alcohol Dependence looked at nearly 8,000 adolescents across Europe and found that both an authoritative parenting style (characterized by warmth and strictness) and an indulgent parenting style (warmth without strictness) were both protective against adolescent substance use. But parents who were authoritative (strict and not warm) and neglectful (neither warm nor strict) were less effective at preventing adolescent substance abuse in the six countries studied. NIDA suggests trying to keep the lines of communication open with your teen; not leaving him/her alone for large blocks of unmonitored time; and doing your best to handle emotional conflicts collaboratively and effectively. To brush up on these and other skills, check out NIDA’s Positive Parenting Family Checkup.

  • Bolster self-esteem. How your child feels about him/herself is critical in preventing substance abuse. Research links low self-esteem to current and past substance use. Problems such as poverty, parental marriage problems, physical abuse, bullying and poor grades can all factor into how someone values him/herself.
  • Get involved. Strong social connections help protect against a substance use problem, according to the Substance Abuse Mental Health Services Administration (SAMHSA). Go to your child’s school performances, and invite him/her to come with you to religious services, sporting events or other local activities. You might be surprised how much these experiences could affect even the most taciturn teenager, and you may find that your relationship with your child is strengthened in the process.
  • Offer support during transitions. Change can be hard under the best of circumstances, but adolescents can find transitions, like a move from middle to high school, graduation or a relationship break-up, particularly hard to navigate. These are the times when drug use can take hold, according to NIDA. Do what you can to offer extra support and attention when your teen or young adult is in a sensitive stage of life.
  • Attend anti-drug programs together. These types of early-intervention programs can help prevent risky behavior in adolescents, research shows. Even just starting the conversation about what your child learned in a school anti-drug program gives you an opportunity to encourage him/her to stay drug-free and refuse anyone who offers them a drug or alcohol.
  • Support healthy choices. NIDA research shows that when drinking or using drugs starts in the early teens, the risk for addiction dramatically rises. Therefore, preventing an addiction from starting in the first place means discouraging your child from even casual use and offering them healthier options such as participating in sports, developing hobbies and hosting drug and alcohol-free parties.

Here are some more ways to reduce the chances your loved one will develop an addiction. You can help them:

  • …learn how to deal with past hurts and trauma. Perhaps it’s time to suggest counseling to help your loved one achieve better mental health. You can suggest that he/she attend a support group, see a therapist or read a self-help book – just lending your loved one a book that you think will resonate may be enough to start the healing process. A gentle suggestion may be useful in helping your family member or friend begin to sort out the past for a healthier tomorrow.
  • …improve self-control. If you see that your loved one tends to be aggressive, impulsive, anti-social or a risk-taker who seeks out extreme experiences and sensations, therapy may also be in order. According to NIDA, each of these personality traits are common predictors of later problems with drugs and alcohol. And if you can’t get a loved one to go to a counselor, you can still go yourself. Sometimes, changing the way we interact with a family member or friend can trigger changes itself. A therapist might be able to give you strategies you can use that may encourage your loved to act out less, be more social and make fewer risky choices. Perhaps most important, therapists and 12-step groups can help you and other family members or friends how to stop enabling unhealthy behavior.
  • …feel accepted. If your loved one is lesbian, gay, bisexual, transgender or queer (LGBTQ), feeling surrounded by love and support is essential. It’s not at all uncommon for substances to be a sort of Band-Aid for dealing with difficult feelings related to self-esteem, homophobia, discrimination, trauma and violence. According to the Centers for Disease Control (CDC), people in the LGBTQ community are more likely to have substance abuse issues into later life.
  • ….choose healthy friendships and social situations. Easy access to drugs or alcohol is obviously a big contributor to substance abuse, and this is especially true for young people. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the earlier someone starts drinking, the greater the odds that he/she will develop an alcohol use disorder. So in your home and at family gatherings and parties, think about the food and beverage choices you offer and whether these support or hinder your loved one. In addition, peer pressure can be a huge factor, so you may need to talk to your loved one about choosing friends who don’t use; drug-abusing friends are a major risk factor for your loved one — and that doesn’t just mean teenagers. Working with colleagues who drink heavily or use drugs can be just as influential. In your words and in your actions, you can be a good example, too, by modeling healthy limits.
  • …get informed about the dangers of drug use. According to SAMHSA, simply believing that drugs and alcohol aren’t that harmful is another risk factor. So educate the person you love about how drugs increase the chances of losing a job, dropping out of school, participating in risky sexual behavior and even developing certain mental disorders that are substance-induced. You know best how to start the conversation. The important thing is that you care enough to have the talk, even knowing they may not want to hear what you’ve got to say.

While there’s no surefire way to keep your loved one safe and addiction-free, following this advice can help raise the odds that your loved one will not veer into addiction and all that it entails.

If you think it may be too late for prevention and it’s instead it’s time to consider treatment for the person  you love, go to SAMHSA’s Behavioral Health Treatment Services Locator, or call (800) 662-HELP. Getting help early on, before the problem becomes too serious, is the best course of action if you think your loved one’s substance use or behavior has turned the corner and might be crossing over into addiction.

Sources: American Journal on Addictions; American Journal of Drug and Alcohol Abuse; Centers for Disease Control; Diagnostic and Statistical Manual of Mental Disorders (5th ed.); Drug and Alcohol Dependence;  International Journal of Eating Disorders; Journal of Behavioral Addictions; National Institute on Drug Abuse; National Survey on Drug Use and Health (2013); Psychiatria Danubina; Substance Abuse and Mental Health Services Administration.

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