Who Needs an Intervention?

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An intervention is a collective effort by those who care about a person engaged in a pattern of addictive behaviors. The ultimate goal is to get the person to begin treatment for the addiction. A part of achieving that goal is an open discussion of the addiction and its negative effects on the individual, as well as upon each member of the intervening group. According to the Mayo Clinic, a person may need an intervention if his or her behaviors have become compulsive, meaning that he or she continues to engage in the behavior despite negative consequences, often denying the relationship between the behavior and the consequences.

Distinguishing Addiction from Use and Abuse

Medical professionals outline a simple yet profound set of criteria for distinguishing addiction from use and abuse. Use of a substance typically occurs in a positive sort of emotional setting, one in which the person is already feeling happy and satisfied in general. Abuse tends to take place in a negative emotional context.

People Use Substances to Deal with Negative or Painful Emotions

Addiction takes abuse to the next level. The original reasons for using are compounded by the negative consequences of abusing the substance. For example, if dealing with negative emotions associated with a relationship problem were among the original catalysts of substance abuse, the poor behavior during bouts of substance abuse can cause further relationship problems, resulting in more negative emotions, such as guilt and anger, contributing to the increase of substance abuse, reinforcing and deepening the cycle.

When Drug Use Becomes AddictionAs abuse shifts to addiction, it takes significantly more of the substance to achieve the desired result. Abuse becomes compulsive, and negative consequences do not serve as a deterrent. For example, the loss of a job or a license to drive because of substance abuse doesn’t stop or even reduce the substance abuse. During periods when the substance is unavailable, there are signs of mental and physical withdrawal, as mind and body become dependent on the substance.

Dr. Arthur Dingley, a psychiatrist at Evergreen Behavioral Services in Farmington, Maine, points out another distinguishing element of addiction. He notes that when a person uses a substance specifically to avoid the symptoms of withdrawal, such as the alcoholic whose first drink of the day is taken specifically for the purpose of stopping the tremors and shakes of withdrawal, it is a strong marker of addiction.
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The Intervention Decision

Choosing to perform an intervention is never an easy decision. It is, at its base, a confrontational act, forcing open communication on emotionally laden subjects that are usually not spoken about, and there are risks involved. Deciding on the point at which behavior has become a serious enough issue to warrant an intervention can be difficult. While popular wisdom states that an addict must reach “rock bottom” to really be ready for help, modern medical, psychological and addiction sciences refute that.

Interrupting the cycle during the abuse phase, according to the Mayo Clinic, is an opportunity to give “your loved one a clear opportunity to make changes before things get really bad.” The National Institute on Drug Abuse describes addiction as a progressive, chronic disease and states that the sooner treatment is sought, the greater the likelihood of a positive outcome. Furthermore, the NIDA also notes that “treatment does not need to be voluntary to be effective. Sanctions or enticements from family, employment settings, and/or the criminal justice system can significantly increase treatment entry, retention rates, and the ultimate success of drug treatment interventions.”

If a loved one’s behavior demonstrates obvious patterns of substance abuse and is having a negative impact on day-to-day living for him and those who care about him, it may be time to plan an intervention.

Here are some signs to look for

  • Significantly increased tolerance for the substance of choice
  • Behavior aimed at hiding substance use frequency and/or amount
  • Seems to work all the time, but is chronically low on money
  • Mounting debt, especially when there’s nothing to show for it
  • Decline in physical appearance and hygiene
  • Emotional volatility or mood swings
  • Disruptions in sleep cycles and eating habits
  • Sharp rise in interpersonal difficulties, such as increased conflict with family, friends and coworkers
  • Legal problems related to substance abuse
  • Trying repeatedly to reduce use and failing
  • Failing to meet basic responsibilities, such as going to work or taking care of children
  • Endangering others, such as driving drunk with children in the vehicle
  • Failing to remember behavior, especially negative behavior, such as verbal or physical abuse of family members

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An Ideal Intervention is a Structured Event

Careful, specific planning should always come prior to the actual staging of an intervention, because of its confrontational nature and because of its emotionally charged elements. Often family and friends of the substance abuser or addict carry a heavy emotional burden and may feel resentment, pain, anger or fear toward the addict. The substance abuser or addict also carries emotional weight, such as guilt and shame. There may even be rage, in which the substance abuser blames others for his behavior. Denial of a problem and anger at what is perceived by the addict as an attempt to control his behavior are also common. An intervention should be a highly structured event to minimize the chance of the situation spinning out of control.

Interventions are structuredThe Mayo Clinic says that information gathering should be the first step in the intervention planning process. Information about the extent of the substance abuse should be collected, as well as information about available treatment options. In ideal circumstances, during this phase, entrance into a treatment facility is secured, with that entrance date serving as the intervention date.

Specific plans for the structure of the intervention are next on the agenda. The time and location must be chosen. There needs to be a solid agreement between participants as to what the consequences to the addict will be if he refuses to participate in treatment. All enabling behaviors should be recognized and discussed, and participants should agree on the ways that they are no longer going to shield the addict from the consequences of his behavior. The parents and friends of an addict may state clearly that they will no longer loan or give money. A non-substance using parent may remove herself and the children from the home. The group may decide to refuse shelter if the substance abuser or addict arrives under the influence.

Intervention PlanningEach intervention participant should develop a script for their part in explaining to the substance abuser or addict how his or her behavior has a negative impact on the participant. A non-using spouse may point out that she now avoids going out with him socially because she doesn’t want to deal with the public intoxication and that not being able to enjoy social functions together is damaging the relationship. A teen child may talk about how the parent’s drug abuse has resulted in the teen’s friends’ parents not allowing their children to visit him at home. A sibling might describe how being asked to lie and cover up the addict’s behavior to other family members makes him or her feel. An employer may talk about how the addict’s failure to show up at work led to problems for the employer and the addict’s coworkers.

Scripting is important because these messages need to be spoken without seeming like an attack and in a manner that does not provide an excuse to deflect energy and attention from the substance abuse. Points should be made in a caring, respectful manner, without letting emotions get out of control. Overt personal criticism should be avoided.
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Enlisting a Professional

Some people choose to involve an intervention professional in their home intervention planning and execution. In some cases, according to the Mayo Clinic, this is the best and safest way to accomplish the intervention. The Mayo Clinic advises using a reputable intervention specialist to assist with the substance abuser or addict if these factors are present:
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  • A history of violence
  • A history of mental illness
  • If the substance abuser is likely to deny, minimize or rationalize the problem and erupt in anger to defend that position
  • Has been suicidal recently or in the past
  • It is difficult to find a time when the substance abuser or addict is not using
  • If using mood-altering substance(s) to the volatility point

Understand that intervention may not work the way the participants hope it will. The substance abuser or addict may flat-out refuse treatment. Even if the addict does agree to treatment, that is just the beginning. As explained by the National Institute on Drug Abuse, this chronic, progressive disease takes time to recover from. However, even though the process is long and difficult, the NIDA cites statistics that demonstrate a favorable relapse comparison between other common chronic diseases. Type I diabetes patients experience a 30 to 50 percent relapse rate, hypertension patients have a 50 to 70 percent relapse rate, and drug addiction relapse rates fall at about 40 to 60 percent.

Entering an intervention plan with realistic expectations and a solid understanding of outcome potentials is as important as making sure the event is tightly structured. Intervention participants need to understand that they can only do their best, with love and respect for the addict. Once they have done their best, they have to recognize that the final outcome is out of their hands, and not fall prey to guilt. In the case of families with children, normalizing family life and keeping children safe must be the highest priority, despite what the substance abuser or addict may choose to do regarding his drug abuse. Family counseling can be helpful in forming strategies to achieve those essential goals.
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