Article Contributed By: Paul Pound, MS Mphil LPC LCADC ACS
Family units play a significant role in the success of a family member who is intent on remaining in recovery from substance abuse. AGREE is an acronym representing five important actions family members can express when interacting with their loved ones motivated to begin a life that is a new normal.
Despite tremendous effort on behalf of the well intentioned family member recovery is a difficult road to follow and relapses often occur. Early research reported that 56% to 77% of opioid addicts in different treatment groups resumed opioid use within one year after completion of treatment (Simpson and Sells, 1982).
Recent information highlights the complicated nature of predicting relapse within an individual due to varying environmental and hereditary factors. The highly positive support of family has demonstrated higher levels of success for the recovering family member (Gifford, 2011).
AGREE seeks to provide an outline for families when looking to help their loved one through the trials and tribulations of addiction recovery.
The first step is often the most difficult with acceptance for a family member in recovery requires both understanding and tolerance. The family that is educated about the neurological changes that have occurred in the recovering family member will have a greater understanding of the behaviors that often occur.
Examples of seemingly impulsive behaviors are
- Intense cravings
- Agitated behavior
- Grandiose discussions about the substance of choice
Post-Acute Withdrawal Syndrome (PAWS) can occur at any time and be expressed through a variety of behaviors that include intense cravings, mood swings and impulsive actions. The understanding and tolerant family can accept the thoughts, feelings and behavior of the recovering individual with thoughtful dialogue and encouragement for involvement in healthy activities. Acceptance moves beyond denial and helps to prevent the family from enabling behavior.
The ability to guide often requires patience and knowledge. Patience allows the guide to receive information despite being aware of the inaccuracies being reported. The knowledge of the guide permits an informed discussion that minimizes emotional content.
Rather than opening comments that begin “I think you need to…,” bridging openings can start with “it’s interesting you mentioned about your friends using marijuana – are you aware that a big research study found IQ can drop 8 points when you keep using the marijuana (Meier et al, 2012).”
Guidance can lead to discussion while rules often lead to enforcement. Rules require limited knowledge while the family that guides has a depth of understanding that is useful to the family member in recovery.
The family can provide tremendous self–esteem building support through encouraging communication for the effort that is being put forth by the family member in recovery. This requires present orientated thinking often due to past behaviors that may have damaged trust between the family unit and family member in recovery.
Respect is also required from the recovering family member for the organizational rules of the family. Healthy functioning families have defined behavioral rules that are designed to keep the integrity of the family and the family members safe.
Information that can be used to dialogue and provide fertile ground for discussion is an important part of the education of the family unit. Recovering family members are responsible for constantly learning to improve their chances of remaining in recovery.
This can be found in individual and group counseling sessions as well as the rooms of AA/NA. Education is often the difference between moving forward and returning to behaviors that are only known from the past. Family roles may change and educated changes help to improve the functioning of the family.
The final area for consideration is that of evaluating the behavior, progress and impact of the family on the recovering member and the recovering member on the family. Specific family rules may require enforcement to secure the healthy functioning of the family as well as compliance with state and federal laws.
Weekly family meetings may provide an opportunity to openly discuss thoughts concerning areas of success and improvement. Planned consequences that are agreed upon by all parties can help to eliminate the emotional content that is often infused into the reaction of inappropriate behavior by the recovering family member.
AGREE provides a framework for family’s that are involved in supporting those in recovery. The family is an important link in the chain that helps to strengthen the recovering family member. Recovery for the family member can be a difficult journey that is made easier with the support of families that utilize AGREE.
- Gifford, S. (2011). Family Involvement is Important in Substance Abuse Treatment. Psych Central. Retrieved on September 2, 2014, from http://psychcentral.com/lib/family-involvement-is-important-in-substance-abuse-treatment/0006631
- Meier, M.H.; Caspi, A.; Ambler, A.; Harrington, H.; Houts, R.; Keefe, R.S.E.; McDonald, K.; Ward, A.; Poulton, R.; and Moffitt, T (2012). Persistent cannabis users show neuropsychological decline from childhood to midlife. Proceedings of the National Academy of Sciences 109(40):E2657–E2664,
- Simpson, D.D., and Sells (1982), S.B. Effectiveness of treatment for drug abuse: An overview of the DARP Research Program. Advanc Alc Sub Abuse 27-29.
- Vik PW; Cellucci T; Jarchow A; Hedt J (March, 2004). “Cognitive impairment in substance abuse”. Psychiatr Clin North Am 27 (1): 97–109