Helping a Hurting Friend: Addiction
Pastor Matt Sturtevant with Dr. Tim Bonner, Licensed Clinical Psychotherapist and former Licensed Masters Addiction Counselor
Sarah sat in her car a little bit longer, waiting for the group on the sidewalk to break up. She was already a little late for the AA meeting that met in the basement of the Baptist church. That group was her lifeline. The women in that basement right now had seen Sarah through some of the most harrowing experiences. They had received her without judgement and with open arms. Three nights a week, she was there, no matter what else was happening. Her family, her friends, even some of the folks at work knew how important that group was to her survival. Monday and Friday nights were always fine, as the group came and left without much interaction from the church. But Wednesday nights were different.
There was a Bible study on Romans that met in the basement before Sarah’s AA group, and occasionally, they would still be there when she and the women showed up for their meeting. And that’s what Sarah dreaded: The sideways glances. The raised eyebrows. Last year, Sarah’s daughter was in the same class at school as a family from the church. She saw the couple on the sidewalk one Wednesday night…and more painfully, they saw her. More than once that year, when Sarah would show up to a class party, she would see the couple from church, notice them whispering to some of the other parents in the class, and her invitations to host a party, bring a dish…even play dates for her daughter…All dried up.
So, tonight, she waited a little while longer in her car. Inside that church basement was life. But she had no interest in the gauntlet that stood between her and her family of support.
This morning, we conclude our series on being a good friend to those who struggle with challenges of mental health. When many of us think about mental health, one of the first things we think of is addiction. Alcohol, drugs, pornography, or other damaging or dangerous behaviors…each of these have the potential to move into dependency or addiction. As we have each week, I want to bring in a professional to share with us elements of addiction that we may not completely understand, or feel comfortable with. Tim Bonner, longtime church member and former spiritual formation intern, and recent seminary graduate, comes today with his mental health professional hat on, to share with us how we might be good neighbors to those around us.
MS: Tim, let’s begin as we have with others, with a description of your professional background dealing with addiction behaviors….
TB: Hi, I’m Tim, I was powerless over my mother’s alcoholism. Thus, I know how difficult trying to help a family member is from experience. I also have been a licensed addiction counselor and for two years was the program manager of Alcohol/Drug Addiction Services at the Guidance Center (Leavenworth, Atchison, and Jefferson Cos.). Although my primary work has been as a clinical psychotherapist, I’m here to tell you about the serious problem of drug abuse. It may be closer to you than you think.
MS: Well said. So, let’s jump into the question of what addiction is. How would you define it for us today?….
TB: Different terminology is used to talk about these problems: substance abuse, chemical dependence, as well as addiction. The AMA defines the chronic illness of addiction as a pervasive disorder that affects all aspects of the person’s life—body, mind, spirit, and relationships (note: it is an illness, not a weakness). It involves excessive focus, time, and energy spent on obtaining and using a substance despite negative effects. It is a progressive illness, meaning that the longer it goes on the more negative effects and detriment it causes in aspects. Addiction leads to dysfunction in meeting the fundamental aspects of life responsibilities and ultimately, if unchecked, it can be fatal. The illness also includes the symptom of personal denial of the existence of the illness. Wow, that just doesn’t seem fair but it is true. Also, there is no cure for addiction. The only option is recovery through abstinence. Addiction disorders exist in at least 10% of the U.S. population (13% of males; 8% of females). Half seek treatment at some point to work on recovery, half don’t.
The recovery “V” shows the decline in functioning that is not meeting responsibilities that addiction causes. In AA they talk of the three places one ends up if the addict does not choose recovery: the jail, the hospital, or the grave. The good news is that the person can choose recovery at any time to stop the negative effects of addiction and begin the healing. With recovery they regain their functional abilities and then can take care of at any time their responsibilities. The challenge is to make sure anyone you know who has an addiction disorder chooses recovery early in the progression of the illness.
I’m going to use some real case examples to show the harm and dangers of unabated substance abuse and addiction. They are people I have known, not clients. I’ll start with alcohol because it is legal. A lot of people drink, so who has the illness? Many deny the illness by saying they do not drink all the time, so they can’t be an alcoholic. I find the acronym WARP most useful for identifying someone with chemical dependence on alcohol. They are WARPed, which stands for With Alcohol Repeated Problems. We’ll talk about how to communicate with the person you are concerned about later.
Danielle was 18 when she met our daughter and they were housemates for a few years. Danielle liked to drink and did so every day. Eventually our daughter told us about Danielle’s “love affair with vodka,” which led Danielle to death before her 37th birthday. She had been a very beautiful and talented young woman—such a tragedy.
Pills—prescribed medications are the most abused drugs in America and we’ve all heard of the many fatalities from overdoses, most of which were unintentional. Opioids are deadly medications when misused and I warn you to not keep your pain medications in your bathroom medicine cabinet. They are too tempting to others there. Any medication that has a sedative effect is very dangerous, especially if mixed with alcohol. We were friends with 19-year-old Heather’s mother and joined her at her daughter’s funeral. Heather had drunk some alcohol then took somebody’s else’s medication, laid down on a bed and never got up—another tragedy.
Yet another tragedy was Danny, my 13-year-old cousin, who huffed the cooking spray Pam and died just seconds later. Keeping it in the family, on the other side I have a cousin whose daughter spent time in prison for a drug conviction and lost parental rights to her three children. And there is my mother. She was a late-onset alcoholic as she did not begin her daily drinking until 48 years of age. She died at 68.
We all know people who use cannabis, as “weed” is the first drug used by most teens, even more than tobacco and alcohol. Although very popular, it is still illegal in Kansas overall and illegal for teens everywhere. They say marijuana is not physically addictive. However, it is psychologically addictive. I heard many clients say that it was the hardest drug to stop. Many used it as drug substitution after quitting other drugs—we call it “marijuana maintenance.” My case example is a college friend, Kerry, who was a daily pot smoker. He told me things just didn’t seem right in his day until he had smoked a joint. He continued that behavior pattern and did not live to see his 50th birthday. The side effects of cannabis use can be deadly.
Vaping—“Everybody does it at school,” said one of our granddaughters when talking about her high school, that is, everyone but her. Early research is telling us that a vape pipe is not a safe thing to use with any substance. We all know that tobacco is clearly harmful to the body but smoking it in a vape pipe adds microscopic hot metal particles that cause immediate, permanent damage to the lungs. Also, smoking cannabis oil in one can lead to lung infections that can be fatal.
The psychostimulant drugs—cocaine, crack, and methamphetamine are dangerous. Meth is what is used most because it is less expensive. It is also highly addictive as it generates 20 times more endorphins than anyone can generate naturally even in the best of times. And, it is so detrimental to the body, to holistic health. It is a pervasive problem throughout our country, even in rural areas.
MS: Thank you, Tim. Some incredibly helpful and eye-opening information.
And I wanted us to hear some of that information before I jumped into today’s passage, so that we could integrate the two. In the passage I read this morning, we find Paul in the middle of a letter to the Roman church, laying out a thoughtful, reasoned argument for the faith. He has begun this argument with a sneaky description of sin. In the first chapters, Paul covers some of the most obvious sins of his day, playing to the Romans’ stereotypes and assumptions. He understands that most of us see sin as something that other people do. So he describes these sins, and builds this momentum, and gets them into full finger-wagging mode, before he lowers the boom on them in chapter three: “there is no one righteous, not even one…all have sinned and fall short of the glory of God.” In short, to point to other people’s sins makes you look like a fool and a hypocrite, and is itself sinful.
Paul builds that argument further, making the point that sin is not just a one-time behavior or moment in time, but it is something that we become enslaved to. We lose ourselves and our personality and our personhood to this thing that demonstrates mastery over us and ruins our lives. By the time we get to chapter 7, Paul has taken this radical step of making himself Exhibit A in this argument, suggesting that he—yes, even the great Apostle that they have heard about all the way up in Rome—has become a slave to that sin that dwells within him. He calls it “fleshly,” not suggesting that physical or material things are necessarily bad, but instead offering that there is inner realm of sinful, humanly, destructive behavior. The way he uses it is almost psychological. Even though Paul wants nothing to do with this realm, he cannot help himself. “When I want to do good, evil is right there with me.” “The good I want to do I do not do.” Finally, exasperated, he cries out on the page, “Wretched man that I am!”
Perhaps this passage from Paul might be a helpful way to look at addiction. Those who struggle with dependency seem to talk with a similar language: there is this thing that happens inside of them, and while they know that they don’t want to be or stay enslaved to it, the “good they want to do they do not do.” Jay Stringer has written a new book in the last couple of years about sexual addiction titled Unwanted, talking about this disconnect between the good some of us want to do and the unwanted choices that we make instead. Stringer—and Paul—understand that this unwanted behavior leads to this experience of shame, and embarrassment, and guilt, and even public ridicule. And unfortunately, like in Sarah’s story at the beginning, it is often church finger-waggers who are the worst. The very people who have just read that “there is no one righteous” in their Wednesday night Bible study tend to feel the most self-righteous. And you can almost hear Paul’s face palm from here.
But, look at what Paul does next. Not only does he roll his eyes at the finger-waggers, putting them and himself in the same boat and those who struggle with addiction or any destructive behavior. But then he suggests that there is a way to bring that boat safely to shore. He suggests that the Holy Spirit in our midst is guiding us, loving us, empowering us to move beyond the finger-wagging. Paul suggests that it is the Spirit that we should let have mastery over us. It is the Spirit that knows our pain and our wretchedness. It is the Spirit that guides us past the shame and the guilt and embarrassment. It is because of the Spirit that we can proclaim along with Paul, as his argument spills into chapter 8, “there is therefore now no condemnation for those who are in Christ Jesus. For the law of the Spirit of life in Christ Jesus has set you free from the law of sin and death.”
So, Tim, let’s turn toward that work of the Spirit, toward the work of healing, toward the work of freedom from that slavery, in order to understand what a “no condemnation” life of faith might look like. How might we be a good neighbor to those who are struggling with addiction, even while we meanwhile understand that we are in the boat next to them?….
TB: How to begin helping the process of recovery is a challenging question. The main mantra of recovery is “One day at a time,” as it is a never-ending journey. First, I will caution you to never attempt to do the beginning communication by letter, text, or telephone. Instead, meet face to face and say, “We have a concern that involves you. Are you willing to discuss it now?” If they decline, then say, “Then when can we discuss it?” and try to make an appointment to do so. At the discussion try to avoid critical “you-statements” and focus it on your own experience by saying, “We are feeling (worried, etc.) because of our observations of your behavior pattern that appears unsafe and unhealthy. We are concerned that you are in danger of (suffering from failing to meet necessary responsibilities, etc.).” After they respond to that you say, “We want to help you. Let’s focus on next steps in problem solving using the S.O.D.A.S. steps (Situation, Options, Disadvantages, Advantages, Solution).” Then collaborate to come up with a behavioral change focusing on them doing something new to replace the problematic (dysfunctional) behaviors.” [More specifics on this at end of manuscript below*.]
There is help available for you locally. First, the free one—mutual support groups: AA, NA, ALANON, ALATEEN. They are free and anyone can go to an open meeting where they usually have a “speaker.” They use the spiritually-based 12-Step model for recovery: Step 1, “I can’t (stop on my own).” Step 2, “God can (manage my addiction disorder to get my life in back in order).” Step 3, “I am going to let God (my Higher Power) take control of my life.”
All addiction treatment in Kansas requires an “Addiction/Recovery Screening (commonly referred to as a RADAC screen)” according to Ks. SB 123, which also puts it on a sliding scale (that I think goes to $0). It also puts treatment on a sliding scale at qualifying facilities like: DCCCA (pronounced “Decka”) in Lawrence (includes the Women’s Recovery Center at Lake View on 31st St.), Valeo Behavioral Healthcare & Recovery Center in Topeka and others in the Kansas City area (e.g. Mirror, Inc.). Another area resource is Valley Hope Recovery Center in Atchison where they provide excellent treatment (it is private, not subsidized and thus will cost more).
There are three basic ways you can help others: Prayers, Presence, and Limits—You don’t tell them what to do. You tell them what you are going to do in response to their unacceptable behavior choices. You can also talk with your pastor and/or call me (785-312-7273) or send me an email (firstname.lastname@example.org). I will send you a copy of my communication guide, Synergistic Family Agreement, and S.O.D.A.S. Problem Solving Steps.*
MS: Thank you, Tim. For the work that you have done for your clients, and the time that you took to share with us today.
“There is therefore no condemnation.” Paul makes the point, and then spends the rest of chapter 8 defending that point, extrapolating the argument out farther and farther. Until the end of the chapter, when our shared boat pulls up to the shore together. Battered and nearly broken by the waves, Paul reminds us that the Spirit of God in Christ Jesus has been there the whole time:
…in all these things we are more than conquerors through him who loved us. 38 For I am convinced that neither death, nor life, nor angels, nor rulers, nor things present, nor things to come, nor powers, 39 nor height, nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.
* Below is some more helpful information from Tim, especially some next steps for those wanting to help someone struggling with an addiction. If you, or a family member, needs help with a mental or substance use disorder, call SAMHSA’s National Helpline at 1-800-662-HELP (4357) or TTY: 1-800-487-4889, or use SAMHSA’s Behavioral Health Treatment Services Locator to get help. For more information, go to https://www.samhsa.gov/families.
SODAS: Must complete each step in order before going to the next one.
Situation—agree on what problem you are trying to solve; only one at a time
Options—generate as many possibilities as you can without judging them at all (I strongly recommend writing them down).
Disadvantages—depend on the person who owns the problem to be active in this (also write these down)
Advantages—again from the person’s perspective who is needing the problem solved
Solution—now you can judge/choose, as options are crossed off as “not acceptable” then the final one remaining is the solution. Now work on action steps.
ACTION: Set a short-term action plan of steps to accomplish the solution with a time frame for completion (write them down).
FOLLOW-UP: How well did it work? If not very well, then the SODAS process can be started over in the same order. Did we define the problem clearly? What was missed or not known in the earlier attempt? Other options, what else can be done?