In my book, “Knowledge to Power: Understanding and Overcoming Addiction” I devote an entire chapter on how to help an addicted person get help when they really, really don’t want help.
There are many voices that would proclaim that you can’t help an addict until they want help. There are also folks that say that you can’t help an addict until they “hit bottom”. The problem with this belief is that hitting bottom for a huge percentage of addicted persons means that they are dead. For another large percentage of addicts hitting bottom means that they have lost everything just short of their very lives, including: health, relationships, home and job.
Fortunately, this is not the way things have to be in dealing with the addictive illness. The concept of intervention is to not wait until the person hits bottom, but to bring bottom up until it hits the addict! In other words, those of us who live with and care about addicted persons can actually help them by making things worse.
The rationale behind this is the recognition that none of us change anything in our lives until it gets bad and addicted persons oftentimes don’t even change things when they do get bad so we have to help by making it seem worse. Nobody makes changes in life when things are going swimmingly well, but only when it is too painful to go on like we are. I have never seen an addict say, “Well, my life is going swell, so I just thought I’d drop in for a little treatment”. That never happens. That is why we must help them by taking advantage of the crises that inevitably happen to an addict or even by helping to create a crisis.
There are several different ways to intervene. Legal interventions can be very effective. For example, if an alcoholic gets a DUI we might be able to speak to the judge before sentencing and persuade him to order treatment and follow-up outpatient counseling after treatment. Most judges are quite enlightened now about treatment for addicts and will be agreeable to this. Or if an opioid addict gets arrested for possession or distribution, the judge might be willing to make drug treatment at least part of the sentence.
I have known several family members of addicts who actually call the police and tell them where their loved on is driving drunk or is dealing drugs, so that they can be arrested and then can be ordered to treatment. Obviously, the addict will view this as betrayal, but if it can save their life, they might eventually be grateful that somebody cared enough to stop them.
Another type of intervention is the employer intervention. This may happen naturally as the result of absenteeism or poor work performance due to addiction. This type of intervention is what I call “The Godfather Offer”. It goes like this when the employer says to the addict, “Do you like your job? Well then you’re going to love treatment”! Oftentimes the addict then “volunteers” to go to treatment. Sometimes the family of the addict has to clue the employer in so that they don’t just fire the addict without using the leverage of the job.
Another very effective intervention is the medical intervention. This occurs when a concerned physician sits down with their addicted patient and tells them that they need help and they are willing to help them. I remember a time when I was the nicotine dependency counselor for the hospital that a concerned physician called me in for a conference and told the patient his concern. He said, “I have been your Doctor for many years, but I cannot keep up with your smoking addiction. You have early COPD and I can do nothing if you keep smoking. I have asked Kal, the nicotine dependency counselor to help you quit. Will you accept the help?” The patient did accept help and was able to quit smoking.
One of the funniest interventions that I remember is what I call “The beagle intervention”. An alcoholic man told the story of how his beloved beagle, Buddy, would have nothing to do with him when he was drinking. Being shunned by Buddy was so disturbing that the man decided to come to treatment for help. He lived alone and Buddy was the most important thing to him and the rejection was just too much.
One of the most effective ways to get help for an addicted person is the structured family intervention. This is when the family and other concerned friends gather together to confront an addicted loved one. It is important to have a group of people, because a one-on-one talk will almost never have any affect. One reason that this individual approach doesn’t work is that the concerned person believes that they have to use logic and make sense, but the addict is not bound by these rules. The addict will bring in something from left field that has nothing to do with the discussion and away you go down some dirt road that leads nowhere. This explains why most treatment centers favor group therapy as the preferred form of treatment, because the power of the group can break down denial that no individual alone can.
There is a particular way to do this type of intervention and it works best if you hire a trained intervention specialist to facilitate this process. The intervention specialist knows which people to include and which to leave out. He knows when is the best time and place to surprise the addict with the information they need to surrender. He knows which treatment centers would be best for each addict’s particular needs. He will anticipate objections and make provision for job, insurance, child care and other stumbling blocks. He will direct each participant to write a brief letter sharing what they have noticed about the addict’s behavior and how much they mean to them and that they would be there to support them if they agree to get help.
Family and friends can do a structured family intervention without an intervention specialist if they are financially strapped, but it goes a lot better usually when a professional who has done this many times is on board. Chapter 15 of my book has a nice summary of what folks need to do to be successful, but if one would really want an even more detailed account of what to do I would recommend a book by Deb and Jeff Jay entitled, “Love First”. This book walks you through all possibilities.
Even if the addict refuses to go to treatment after listening to all the concerned family and friends,the intervention is still a success. Part of the intervention is called the consequences. These are the actions that all are now willing to take if the person refuses treatment. This might include cutting off financial aid, refusing to allow children in their custody, making the addict find a different place to live or other consequences.
Oftentimes after suffering the consequences and finding out that people mean what they said, the addict caves in and gets help. For example, just this week I got a call from a father that I had helped with an intervention on his grown son. The son had refused treatment during the intervention, but after a couple months of living under a bridge and getting hungry, he was ready to go.
The other good thing that happens is that the family members and friends stop their enabling and get help for themselves and start to deal with their own illness of codependency. That is why all interventions are successful, even if the addict does not immediately go into treatment.
I encourage all of you who care about addicted persons to not sit around and let them hit bottom, but do whatever it takes to bring bottom up to hit them and then they get help.