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Whether you are suffering with alcoholism or drug addiction, or it is someone you love who is suffering, you need to know first and foremost that help is available and that treatement works.  People who seek treatment can recover and lead full and healthy lives.  If you think you need treatment, you need treatment.  Don't wait.  If you love someone who is struggling and is resistent to treatment, seek treatment for yourself and learn more about the disease and what you can do - for yourself and for them. 

Below I've written a brief tutorial on what alcoholism and drug addiction is, i.e., how it is viewed by the medical community at large, how it develops, the signs and symptoms that often occur as the illness progresses, the types of treatement available today, and a list of resources to further your knowledge about the disease and tools to help you as you seek recovery.

What is Chemical Dependency?

Chemical dependency is a progressively debilitating disorder stemming from the abuse of alcohol or other drugs; it is a way we refer today to alcoholism or drug addiction. Also, it is synonymous with the term "substance dependency." In fact, these terms are interchangeable, so if you hear someone talking about alcoholism, drug addiction, substance dependency, or chemical dependency, know that these terms infer the same thing: serious life problems occurring from the abuse of alcohol or other drugs.

What are the Signs and Symptoms of Chemical Dependency?

The signs and symptoms of chemical dependency are many. While dependency upon some drugs of abuse can develop very quickly - such as with stimulants, crack cocaine, and heroin, chemical dependency is generally viewed as developing more slowly over time and in stages from recreational use, to abuse, to dependency. Because each person is different, it can be difficult to clearly delineate where one stage ends and another begins. There are, however, certain signs that clearly indicate a problem is at hand. These early warning signs, if acknowledged, could prevent the more serious symptoms that will surface if use continues without modification.

These early warning signs include: a marked increase in the frequency, duration, or amount used, feelings of guilt that initiate promises to the self that "that won't happen, again," feelings of depression, anxiety, or the onset of mood swings, occurrence of negative consequences that affect interpersonal relationships (arguments and upsets at home, work, or school), or those that involve the law (a DIU, for example), and discounting or placing the blame for these negative consequences elsewhere.

While all of these early warning signs are significant, discounting the negative consequences is the hallmark that more serious problems lie ahead. Examples of this behavior include the often heard statements: "So, I made a mistake, one time", "it isn't that bad, you're making too much of it," "that cop was a real jerk," "the laws are stupid and too strict." These last two statements reflect what clinicians call externalizing the behavior - not only does the person not link the negative consequence to their drinking or drugging behavior, they place the blame outside of themselves, which releases them from being responsible and taking corrective action. Until these deceptive and irrational thought processes change, their drinking or drug use will continue. Continuing to use despite negative consequences is a primary symptom of substance abuse.

As abuse grows, signs and symptoms grow. New warning signs include: a growing preoccupation with the drug of choice, increased tolerance to the drug of choice (requiring more of the substance to get that 'initial' high), blackouts, onset of withdrawal symptoms, recurrent interpersonal problems and/or legal problems, attempts to modify use are made, but fail, "switching" the drug of choice for another, and physical ailments - stomach ulcers, heart arrhythmia, fatty liver - to name a few, may be present. Psychologically the person may report an increase in depression or anxiety, self-esteem plummets and their outlook on life in general is negative, they may talk about suicide. At this point, treatment is critical. With appropriate treatment and a continuing care plan, a full return to physical and psychological health is possible, and interpersonal relationships can begin healing, too.

If abuse continues, preoccupation with their drug of choice continues to grow. In effect, the individual begins spending more and more of their waking hours in relationship with their drug of choice versus in relationship with previously important people - family, friends, school or work mates. Their lifestyle revolves more and more around drinking or drugging. Important personal relationships shift and many fall away, social contacts largely include only others who will tolerate their drinking or drugging behaviors, or, they become isolative and withdraw. We often see, too, a decrease in tolerance. Whereas before the body worked diligently to adapt to the toxins ingested, it has reached a threshold and now a state of intoxication occurs with only small amounts ingested. A host of physical ailments of the heart, liver, respiratory system, and digestive tract, among others, may be present. Psychological disturbances and disorders often include substance induced depression and anxiety, hallucinations, or psychosis. Suicide attempts among chemically dependent persons are high. For survival, treatment is urgent. Despite the incredible amount of harm done to the body and brain, with appropriate treatment and abstinence, enormous healing can occur. A thorough physical and a safe medical detox is necessary to accurately assess prognosis.

How Does Chemical Dependency Happen?

Most chemical dependencies begin with recreational alcohol or drug use starting in childhood or adolescence, or, it can begin in adulthood in response to a personal tragedy, unrelenting stress, or a physical or psychological illness. For most, chemical dependency develops slowly over time and the crux of the problem is that the individual does not see that their drinking or using is increasing in dangerous ways. To understand this better, you need to understand how alcohol and other drugs affect a person's body, mind, and behaviors.

Whether one drinks, inhales, snorts, or injects their 'drug of choice,' these substances, quickly gain access to the central nervous system bringing about an altered mood and an altered state of consciousness. In short, people often report that alcohol and other drugs make them feel good. Anyone who experiences the effects of these substances as pleasant, is said to have experienced a positive payoff linked to the behavior of drinking or drugging. And, when a human being experiences any behavior that brings about pleasure, the likelihood of repeating that behavior is high. This mechanism of human behavior is known as the pleasure principle, and it is this principle that, to a large degree, leads an individual to take the next drink, the next line, the next hit, the next 'whatever.' Add to this that when a behavior registers in the body and mind as 'good' it becomes very difficult to see or acknowledge negative aspects of the behavior. Some people will acknowledge the risk, but not accurately enough to override the feel good part, so the behavior continues.

As using continues, some people will experience negative consequences. Negative consequences include withdrawal symptoms, relationship problems, work problems, legal problems (a DUI for example), or physical or psychological problems. When negative consequences occur and they are acknowledged accurately as stemming from drinking or using drugs, there is a higher likelihood that the behavior will be modified by cutting back and moderating use, or stopping altogether. In such a case, we know that the person is learning from their experiences. For some others, however, the connection between negative consequences and drinking and drugging behaviors is not made. Not only does learning not take place, the individual may defend their drinking or drugging behavior, or they may place the blame for the negative consequences elsewhere. In this case, such an individual is at high risk for becoming chemically dependent. Here's why:

From a psychological standpoint, a person who is unable to see the link between their behavior and the consequence of that behavior is exhibiting denial. Denial is a psychological process that effectively keeps a person blind to the truth. For a person to get well, to begin recovering from chemical dependency, their denial needs to be worked through - they need to see, to make the connection between the negative consequences occurring in their lives and their drinking or drugging behaviors.

While other aspects contribute to the development of chemical dependency, denial is the core of this debilitating disorder. A person will not make changes in their behavior unless they are aware and convinced that such a change is needed. In effect, denial says no problem exists, therefore, no change is needed. Sometimes, a person will admit a problem exists, but they will minimize it by saying, "it's not that bad," or "you're making too much of this." As long as this mindset continues, their drinking or drugging will continue, and their negative consequences will grow. Without intervention prognosis is poor and sudden, accidental, or early death is possible.

While many people drink socially, and - despite acknowledging that all drugs other than alcohol, caffeine and tobacco, are illegal - some people think of their drug use as social drug use, statistics say that about 10% of persons who use drugs in any form, will become chemically dependent. That means that approximately 10% of all persons who begin using drugs will go beyond the stage of alcohol or drug use, alcohol or drug abuse, to alcohol or drug dependency.

Why Do Some People Become Dependent and Others Don't?

People use to think that if a person became addicted to chemicals - an alcoholic or an addict - that that person was a bad person. That in some way they were morally deficient, lacked character, or lacked the willpower to make good decisions for him or herself. Today, we know better. Today, we better understand how powerful these chemicals are on our mind and body. And, we have identified other high risk factors that help explain why this debilitating disorder happens to some, and not to others. So, let's find out what these high risk factors are.

More often than not, a person who becomes chemically dependent will have a family medical history positive for alcoholism or addiction. In other words, in the same way that heart disease, cancer, and other medical problems run in families, so can chemical dependency. Having a positive family history for chemical dependency does not mean that all family members who chose to drink or use drugs will become chemically dependent - it means that family members may be predisposed to chemical dependency because they may carry the genetic marker for this disorder. We know, too, that as important an indicator as genetics is to developing chemical dependency, the individual's social environments play a crucial role. We examine these, next.

The first social environment any human being encounters is their family. Human beings have a strong need to be "a part of," and when we are very little we watch the bigger people in our family to learn what is expected and accepted behavior by this group. If people in the family abuse alcohol or use drugs, this sends a strong message that using these substances is acceptable behavior. A family message that OK's drug use or excessive alcohol use greatly increases one's risk of becoming chemically dependent later in life.

The next social environment we encounter is the peer group. As we grow older, we expand our social interactions to include people outside the family. Developmentally, this is healthy human behavior. While our need to be 'a part of' is still strong, we now look to persons outside the family to further fulfill this need. If drinking or drugging is a strong presence in your social group or gatherings, or, if it is an expected behavior in order to remain a part of the gang, the pressure to use will be extremely high. If the decision is made to remain part of such a group, risk for abusing or becoming dependent upon chemicals increases greatly.

The next social environment we encounter is the work environment. While drinking or drugging on the job is grounds for immediate termination of employment, many men and women report that job related social events - business lunches, dinners, conventions, etc., contain metamessages that encourage them to drink. Some jobs, requiring long hours or double shifts prompt the use of stimulants to remain awake and alert. While each person is responsible for their own decisions, such work environments can increase one's risk of chemical dependency.

So, is the environment to blame for chemical dependency? No. It is a part of the problem for many, but the environment alone, just as genetics alone, is not responsible for the development of chemical dependency. Clearly the more high risk markers a person has in their personal history the higher the risk chemical dependency will develop if they choose to drink or do other drugs.

Why Can't They Just Stop?

There are a number of answers to this. One is denial. As mentioned above, denial is a psychological process that effectively keeps a person blind to the truth. To assist in this process of lying to oneself, denial has some buddies: one is euphoric recall. Euphoric recall is another psychological process whereby the person recalls only the 'good feeling' experiences they had associated with alcohol or drugs. Euphoric recall cancels out all memory of the bad times, the sad times, the ugly times. Other buddies of denial include minimizing, rationalizing, intellectualizing, or blaming. These are ways in which the person discounts or explains away the negative consequences that are building in their life related to their drinking or drugging behavior. There may be moments of clarity that the person experiences that allows them to see what is happening to them and how their life, and the lives of those around them, are suffering from their alcohol or drug use, but these moments are often short lived. Unless such a moment is acted upon quickly by getting into a treatment program pronto, euphoric recall and denial returns and drinking or drugging continues.

Another reason they don't 'just stop' may be that they have a dual diagnosis. Research indicates that more than 50% of all chemically dependent persons suffer from another psychological disorder such as depression or anxiety, post traumatic stress disorder, or attention deficit disorder, among others. For some, the other disorder was present before they first used alcohol or drugs and when they did use these substances they found that their symptoms were relieved. Most are not consciously aware of this connection. Most simply register that when they first drank or used, their depression or anxiety ceased, their spirits lifted, and they felt self-confident. Clinically we refer to this process as self-medicating. The sad thing, here, is that the other disorder remains masked by the ongoing use of alcohol or drugs and, therefore, undetected. Until, that is, they get sober. Then, the symptoms of the masked disorder show up and these can seriously threaten the newly won sobriety. (Dual diagnoses can be treated successfully. The best treatment protocol includes primary care in a hospital or residential facility, medication (if appropriate), individual counseling, family counseling, and a strong support group for aftercare.)

Another reason they don't 'just stop' may be that they can't. Here's why: As noted above, the initial 'feel good' experience from alcohol and other drugs leads the individual to want more. As the individual's use increases in frequency and amount, the body adapts to the substance and builds tolerance. Tolerance means that larger quantities of the drug of choice is needed to get that 'feel good' experience again. The body, the magnificent machine that it is, strives to adapt to these toxins. These processes can lead to physical addiction. Withdrawal symptoms can be painful, so painful that the person feels compelled to have...well, more. This leads to a vicious cycle where the person needs to use just to feel physically ok. When this occurs, the person is physically addicted to their drug of choice. (I need to point out that when I use the word drug I am referring to all drugs, including alcohol. In many circles in our society, we are not accustomed to thinking of alcohol as a drug, but a drug it is. A person can become physically addicted to alcohol the same way people become addicted to cocaine, speed, marijuana, heroine, even prescription medications).

When physical addiction is present it is not safe for a person to 'just stop'. A chemically dependent person needs to be assessed and diagnosed by a physician or licensed chemical dependency counselor to determined if they need a safe medical detox. Withdrawal symptoms can be severe (withdrawal from alcohol is among the worse) and range from tremors and flu like symptoms, to hallucinations, seizures, delirium, and other life threatening states. If a chemically dependent person wants to stop, they need to see a physician to obtain a physical examination and a plan for treatment.

What Types of Treatment Exist?

There are different levels of care and chemical dependency (CD) treatment available depending upon one's use, abuse, or dependency upon alcohol and/or drugs. It is important that these differences are acknowledged and accurately assessed to insure that appropriate care and services are engaged. The services listed below are listed in the order of most to least intensive forms of treatment.

In-Patient Hospitalization (IP)
Primarily used for those who have a dependency upon alcohol or drugs, have experienced a substance induced psychosis, or other physical, mental or behavioral complications stemming from their alcohol or drug use. Primary purpose of this care is to provide a safe medical detox, medical and/or psychiatric services, and to secure a clean and sober environment while in the care of medical professionals.

Length of hospital stay varies. Detox generally takes 2-5 days, depending upon the substance(s) ingested, but can be longer if other complications, as noted above, are observed. Care includes family consultation and/or participation. On average, an uncomplicated IP stay lasts 5-7 days. Upon discharge, a continuing care plan will be suggested - in large part, this will include the use of community based 12-step groups, or other primary support groups.

Partial Hospitalization Programs (PHP) or
Day Out-Patient Programs (DOP)
Primarily used for those who have used or abused alcohol and drugs, have completed detox, and need strong structure to assist them in early recovery. Programs vary - in general, participants attend program 5 days per week, Monday - Friday, 3-6 hours per day.

Depending upon the program, treatment may focus wholly on CD issues or in combination with other mental health issues. Care includes family consultation and/or participation. On average, treatment last 2-4 weeks, and a continuing care plan will be suggested - in large part, this will include the use of community based 12-step groups, or other primary support groups.

Residential Treatment Centers (RTC's)
Primarily used for all forms of alcohol and drug problems, and most often utilized when other forms of treatment have not been successful. The focus is on chemical dependency education, introduction to the 12-step groups, and relapse prevention, in a clean and sober environment. RTC stays vary in length - some provide for 45 day programs - other RTC's offer 3-18 month programs.

Clean & Sober Houses
Clean & Sober Houses are available to newly recovering persons who do not have a clean and sober residence in which to live. There are many possibilities to such a scenario - other family members drink or use, other family members are not ready to have the newly recovering person come home, perhaps, the newly recovering person lives alone, the person is homeless, etc.

A Clean & Sober House secures a clean and sober environment from which they work their program. These residences generally house between 6-12 recovering persons, and a house manager is in residence. Length of stay varies widely from one month to several. Residents are required to attend local 12-step groups, or other primary support groups.

12-Step Groups
12-step groups are based upon the original works of Dr. Bob and Bill W., co-founders of Alcoholics Anonymous (AA). There are more AA groups in the community than other 12-step groups for the simple reason that AA has been around since the 1930's and it is more established than other 12-step groups. Nonetheless, there is an abundance of 12-step groups from which to choose in devising a 12-step group program and support for remaining clean and sober. These groups are:

AA - Alcoholics Anonymous
NA - Narcotics Anonymous
CA - Cocaine Anonymous
MA - Marijuana Anonymous

While family and significant others may attend "open" 12-step meetings, there are specific 12-step groups for family and significant others to attend. These are:

Nar-Anon Family Groups
Co-Dependents Anonymous

These groups seek to help family members and significant others of chemically dependent persons. In this way, support is available to every person affected by chemical dependency.

Counseling - Individual, Family or Group
Counseling can assist with recovery efforts in a number of ways - working with a licensed therapist or counselor certified in alcohol and drug services can provide accurate assessment, education and prevention, out-patient services, and individual, family, or group counseling.

Understanding chemical dependency, its origins, the phaseology of addiction, and the healing properties and benefits of recovery, is a crucial component of sobriety. Education for all family members and significant others can be of great help, too. Counseling may also be a gateway to participating in a 12-Step, or other primary support group that, for some, will be the foundation upon which they rebuild clean and sober lives.

What are 12-Step Groups?

12-Step groups are based upon the original works of Bill W., and Dr. Bob, co-founders of Alcoholics Anonymous ™ (AA). These originals works, first published in the mid-1930's are still used by treatment facilities worldwide and remain highly effective. The basic intent of these groups is to help men and women stay sober, one day at a time, through the strength of the fellowship. The primary vehicle by which this is accomplished is by attending and participating at meetings, obtaining a 12-Step sponsor, and working the 12 Steps.

Most 12-Step meetings begin with a moment of silence followed by the Serenity Prayer, and a reading of the 12-Step Group's Preamble. The preamble describes the intent, rationale, and hope of the 12-Step group. Appearing below is the Alcoholics Anonymous Preamble, as an example.

Alcoholics Anonymous Preamble

"Alcoholics Anonymous is a fellowship of men and women who share their experience, strength, and hope with each other that they may solve their common problem and help others to recover from alcoholism.

The only requirement for membership is the desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not organized with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety."
Reprinted with permission of The A.A. Grapevine.

As the A.A. 12-Step method proved to be successful treatment for alcoholism, a wellspring of 12-step groups for other drug dependencies sprouted. AA is the granddaddy to the 12-Step Programs we know today. AA also recognized that the debilitating effects of alcoholism reached beyond the alcoholic. In response to this, the Al-Anon and Al-Ateen groups were formed in the 1950's. In this way, there is help for all family members and significant others affected by alcoholism. Similar group supports are available to those whose loved one uses other drugs through the Nar-Anon Family Groups.

AA - Alcoholics Anonymous
NA - Narcotics Anonymous
CA - Cocaine Anonymous
MA - Marijuana Anonymous

These groups are attended by the chemically dependent person. Significant others may attend "open" meetings, but there are other 12-Step groups specifically for family members or significant others to attend.
Nar-Anon Family Groups
CoDependents Anonymous
ACA - Adult Children of Alcoholics

These groups provide support to family members and others who have been affected by a loved ones' drinking or drugging behaviors.

What Does Working a "12-Step Program" Mean?

While attending and talking at meetings is certainly helpful, working a 12-Step program entails a good deal more. When a person is working a 12-Step program, they are attending at least 2 meetings per week, they have a 12-Step sponsor, and they are working the 12-Steps with their sponsor. If a person is going to meetings only and is happy with their sobriety, that is very good. But, the 12-Steps represent the heart of the AA program, and to skip these, is to miss out on a great deal of personal discovery, learning, and healing. Some people attend 12-Step meetings only and then say the program didn't work for them. There is a saying among 12-Step groups, "It works if you work it." That means the whole program. So, if you know someone who has attended meetings and they continue to struggle with sobriety, encourage them to give the whole program a try by getting a sponsor and working the 12-Steps.

What are the 12-Steps of AA?

As noted above, the 12-Steps of AA represent the heart of the Alcoholics Anonymous Program. These steps represent the experiences of the earliest members of AA and what worked for them. For a fuller understanding of what these steps mean, and how they work to help keep a person sober, I strongly encourage reading the first 164 pages of the book, Alcoholics Anonymous.

The 12 Steps of Alcoholics Anonymous

1. We admitted we were powerless over alcohol - that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed, and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

10. Continued to take personal inventory and when we were wrong promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

Because these steps reference God, many people take offense. I would encourage further examination. The 12-Step Program of AA is indeed a spiritual-based program; it does not, however, dictate what that spiritual entity is, or should be. I have observed, too, that many persons in recovery have experienced trauma or a life tragedy that has left them closed off from any sense of a 'good' god. Some experience this emotional cut-off as a great void, a terrible loneliness, even abandonment. For these persons, 12-Step Programs actually prompt the opportunity to work through their hurt and pain. If you recognize yourself as being among this group of persons, a 12-Step Program may be the right recovery program for you.

What if there isn't any trauma to work through? What if the person is just not going to have any of that spiritual stuff? We are fortunate today to have additional recovery support groups available. This is addressed more fully in the next two questions.

Are Support Groups Really Necessary?

Yes. Making a lifestyle change of this magnitude - from drinking or using - to sobriety - is a tremendous undertaking. Until the person has had time to learn the extent to which their drinking or drugging behaviors have affected their lives, they will remain vulnerable to relapse. Clinical research also tells us that sobriety is enhanced and relapse is prevented by participation in a support group. This is not to say that a person cannot stay sober without a support group, there are always exceptions. But, a person who is learning to live sober is going to have some difficult times, especially in early sobriety. Having a place to go to express their thoughts and feelings about sobriety, drinking, using, their fears, and the like, without the added fear of being stigmatized, judged, or rejected by others often makes a huge difference in the quality of sobriety experienced.

Are There Support Groups Other Than 12-Step?

Yes, today we have a number of support groups from which to choose. While the 12-Step program is excellent, it is not 'the' program for everyone. People often balk at the AA Program because they say it smacks of religion. It certainly does contain a strong spiritual principal, but it is not a religious organization in any sense. Regardless, there are other support groups to choose from today. These programs are non-spiritual based programs.

S.O.S. - Secular Organization for Sobriety (also known as Save-OurSelves)
Women for Sobriety
SMART Recovery

The groups noted here focus strongly on one's thoughts and how to keep the mind free from irrational thoughts of drinking or using that could then lead to relapse. Click to the Related Links section of this site for contact information. Check 'em out!

How Can the Family Help?

Take action. If you think a family member has a problem, get professional help, now. It's important to sit down with a professional and sort though how alcohol or other drugs is affecting your family to know what help is needed. Different approaches and treatment modalities exist depending upon diagnosis and whether the abusing person is a child or an adult. You have many contacts to choose from:

Contact your family physician - your family physician may offer direct help or can provide appropriate local referrals If employed, contact Human Resources. As part of your medical benefits package, your company may include Employee Assistance Professionals (known as EAPs), available to you at no cost. Most EAPs can assess chemical dependency problems and offer suggestions for obtaining help or treatment, locally. If employed, contact your insurance company - most medical plans have a separate contact number for chemical dependency issues - your insurance company will provide you with names of professionals who work under your specific plan. Contact your local hospital and inquire about the types of services they have for chemical dependency problems Contact your community mental health agency - call your city's offices and they will direct you. If at any time an emergency arises, call 911.

By taking action you will be confronting the issue directly. In many cases this is the appropriate action to take and it can begin the healing process. However, if domestic violence occurs in your family, every precaution must be taken. Be sure to tell the professional you contact about any safety issues you fear. If domestic violence is an issue in your family and you need help now, you can contact the domestic violence hotline at 1-800-799-7233.

What Help Exists for Family Members and Significant Others?

Help is available for everyone. If you find that you are often worried or fearful about a loved one's drinking or drugging, or, you find yourself obsessing over how to stop the negative consequences of these behaviors, you need help. First and foremost you need to know that:

A) You didn't Cause it
B) You can't Control it
C) You won't Cure it

Al-Anon refers to this bit of wisdom as the 3C's. It can be difficult to take this information in because many family members, or friends, think that they have played a role in the development of the chemical dependency, or, that they can play a pivotal role in getting the alcoholic or drug addict fixed! And, by gum, they're going to figure this out and do just that! If you agree with the sentiment contained in the last two sentences, I can only say that you have much to learn about chemical dependency and co-dependency. You could check with the same sources outlined above and get professional help for yourself. Also as noted above, the community support groups - Al-Anon, Al-Ateen, Nar-Anon, Co-Dependents Anonymous, and Adult Children of Alcoholics, can be of great help. Phone numbers for these groups are located at the Related Links Section of this site and will help you know where meetings are in your local. For those of you who need to know more before becoming action oriented, reading is an excellent way to begin your education. Check out the Recommended Reading Section of this site for some suggestions. Co-dependency is defined and briefly described in the next question.

What is Co-dependency?

The term co-dependency came into vogue with the "recovery movement" of the late 1960's and it was strongly linked to a pattern of behavior observed in the family members or significant others of the alcoholic. In attempts to lessen or stop the negative consequences of their alcoholic's behaviors, it was observed that family members would step in and take up the slack for the alcoholic. An example of co-dependent behavior is the wife calling the husband's boss to tell the boss that "John" is sick with the flu and he can't come to work. Meanwhile, "John" is out cold from drinking all night long. In this example, the wife is exhibiting classic "enabling" behavior. While it's understandable that the wife is fearful that her husband may lose his job and that the whole family will suffer if she doesn't take action and step in, a new behavior pattern is set: "John" doesn't have to take responsibility for his actions because someone else (in this case, his wife), will. "John" learns that someone else will clean up after his messes, so why should he?

Many co-dependents blame themselves for the chemical dependency. Their thought processes are littered with messages of self-blame such as, "If I didn't pressure him, so much," "If I had just taken better care of her," If I hadn't upset him, so." Their mindset is, "I must not be doing a good enough job, because if I was, this wouldn't be happening." In such a case, the co-dependent literally accepts the responsibility for their loved one's chemical dependency. This dance of irrational beliefs, misguided guilt and blame, can become a vortex pulling the co-dependent and the chemical dependent down into deeper and deeper levels of dysfunction. These dysfunctional relationship patterns can go on for years and, without intervention, a lifetime.

Co-dependent behaviors are generally viewed in stages that move along a continuum from mild to severe. These behaviors range from caregiving, to excuse making, to rescuing, to controlling. Many books have been written on co-dependency. Begin educating yourself by reading. Go to your local library or bookstore and scan the bookshelves until you find a book you feel speaks to you. Untreated chronic co-dependency leads to physical and psychological illnesses. This, absolutely, does not need to happen. If you feel that you, or your family, are represented on these pages, please get professional help. In the years I 've worked in chemical dependency I have seen a great deal of recovery - people do get help - treatment does work. The healing process begins by acknowledging the problem. The next step requires action.

Especially for Parents

No parent wants to think that their child is using alcohol or drugs. No parent wants to think that their child is at risk for becoming addicted to alcohol or drugs. Some parents choose to avoid talking about this topic with their child, out of fear that addressing it will only make their child more curious and, therefore, more likely to try alcohol and drugs. Some parents believe that only kids from 'bad families' get into trouble with alcohol or drugs. Or only 'bad' kids, or 'other' kids. So, their child isn't at risk. What these types of thought processes have in common is that they keep parents blind to the truth about alcohol and drugs and kids. You need to know that the likelihood of your child using alcohol or other drugs before they leave high school exceeds 80%. Eighty percent! Considering this data, the question that parents need to answer is this:

"If your knew that your child had an 80% chance of coming in contact with a life-threatening situation, what would you do about it?"

The question carries a strong punch and that punch is intended. After reviewing the literature, I realized I could list a host of statistical data that would be 'really impressive,' but, I questioned, to what end? Most parents will look at a statistic and then go about convincing themselves, or others, how their child does not fit the 'profile' and, therefore, is not at risk. While it is true that high risk markers exist, the statistic above says something else altogether. It says that before your child leaves high school, he or she stands an 80% chance that they will use alcohol or drugs. Not "be offered" alcohol or drugs, but "use" them.

So, what can you do? How can you best prepare your child for this potentially life-threatening situation? I've listed below some guidelines to help you in your approach.

* As difficult as you feel it may be, it is vitally important that you talk to your child about alcohol and drugs. Do not leave this responsibility up to your child's school. The messages you give your child will have far greater impact than those he or she receives from a teacher while sitting in a roomful of students.

* Stymied for ways to begin the dialogue? Visit your local library and look for age-appropriate books, or videos, that can aid your discussion - there are many.

* Do contact your child's school and ask what type of program they are using to address the issue. Ask how you can reinforce this message at home.

* Be honest - acknowledge the conflicting messages our society puts out surrounding alcohol and drugs. Acknowledge how confusing it must be to hear about the dangers of using alcohol and other drugs, and to see so many people doing them anyway. Then, present your position, tell them your rationale.

* Ask your child what questions they have about cigarettes, alcohol and other drugs. Don't be afraid of not knowing the answer. You can search for the answer together. This can strengthen the bond between you and your child and emphasize not only the importance of the topic, but how important they are to you.

* Ask your child if they have ever been pressured to use cigarettes, alcohol, or other drugs. Also ask them if they worry about drugs and alcohol. Then, listen. You need to know what your child is experiencing to best know how to help him or her cope effectively. Role play refusal skills. Children who are prepared for the inevitability of being offered a cigarette, alcohol, or drugs, are much less likely to give in to peer pressure.

* Set limits for your children about smoking, alcohol, and other drugs. Encourage them to remain free from smoking, drinking, and other drugs. Then, set a family policy on these behaviors and be clear about what the consequences will be if the policy is broken. Set appropriate consequences and be prepared to enforce them.

* Be a positive role-model. As they say in recovery circles, "walk your talk." This goes a long way with children of various ages. Are your behaviors around alcohol and other drugs consistent with the message you're giving your child? If not, why not? You need to tell your child more than, "do as I say, not as I do." This statement can cause a wide divide between parents and children, especially parents and teens. If you're a smoker, quit. If you need help to quit, get it. If you've tried before, try again. If you drink responsibly, tell them why it's important to set limits around alcohol.

* Depending upon your child's ability to understand heredity, about age 10, share the family's medical history regarding cancer, alcoholism, and drug addiction. Many families try to hide such histories. By being open and honest you will be modeling responsible parenting and educating your child so he or she can make informed decisions about smoking, drinking, or using drugs, later in life.

A special concern...

If you are a parent who is smoking marijuana, or doing other drugs, and you think that your children don't know - think again. Kids are extremely sensitive to their surroundings, and intensely curious about the behaviors of their parents. Please be mindful that young children have the uncanny ability to 'find' things. What could happen to your child if he or she found your stash? Under the influence, safeguards quickly vanish. What would happen if the police found your stash? Are you willing to have your children taken away from you over drugs? Is it worth the risk? These are serious questions and they deserve serious attention. Please think them through, thoroughly. Help is available and only a phone call away.

Resourceful Skills for Every Age


Center for Substance Abuse Treatment - this is a national treatment Hotline that aids consumers in finding treatment within their local.

National Council on Alcoholism and Drug Dependence (NCADD)

National Clearinghouse for Alcohol and Drug Information (NCADI)

Alcoholics Anonymous (AA) World Services, Inc.

Cocaine Anonymous (CA)

Narcotics Anonymous (NA)

Marijuana Anonymous (MA)

Dual Recovery Anonymous

Gamblers Anonymous International Services

Return to Top Related Links

Alcoholics Anonymous
Narcotics Anonymous
Cocaine Anonymous
Marijuana Anonymous
Women for Sobriety
Smart Recovery
Adult Children of Alcoholics
Co-Dependents Anonymous

Reading List

referred to by those in the field as "The Big Book"

- Dr. James Milam and Katherine Ketcham

- Vernon E. Johnson

- Claudia Black

- Melody Beattie

- Melody Beattie

- Richard Meryman (1984)