Are you wondering if a family member, a friend, a significant other or the person in the mirror is addicted to something? How do you tell?
In addiction there are patterns. There are patterns for both the addicted person and for the spouse and for the children.
Claudia Black's book It Will Never Happen to Me is an excellent introduction to the patterns children in addiction households fall in to. They are trying to cope and they are doing their best.
But what if you have a friend or family member and you are wondering if they have a problem?
I take care of opiate overuse patients and alcoholics and methamphetamine addicts and tobacco addicts. And I see patterns.
One pattern is excuses. For the opiate and meth folks, when we call them the mailbox is not set up on the phone and/or the phone doesn't work. "I was out of minutes. My phone was not charged. My phone is not working right. I missed my appointment because I didn't get the reminder call. Call my medicine in."
No. There are very few excuses of this kind that we will accept in clinic. This is a DNKA: Did Not Keep Appointment. Once there are three DNKAs in a one year period, a letter is sent telling the person they have 30 days of emergency care only, that they need to find another doctor, that they are discharged from the practice. New patients get two chances: if they fail to show up twice for the one hour initial visit, we won't take them.
"I had to be in court. My mother took the reminder call and didn't tell me." Ok, this is not from a teen. It is from a person in their 30s. Grow up.
Another pattern is distraction by blaming. I told one person that they needed inpatient treatment. "You are FORCING me to use heroin," they said. "Um, but you already are. And meth too. You have failed outpatient treatment." The person has the choice to find another doctor, return to the streets or go inpatient. Sadly they usually go back to the streets. Each time I say a prayer that they will awaken and return to treatment. Some don't. I hear of a death at least once a year.
The distraction by blaming can be very much more subtle. One person confronted by a substance that was in their urine told me that they HAD told me they were on that PRESCRIBED, and it was my fault because I had not written it down.
I was taken aback for a moment, wondering if that could be true, but... "You have been here for four visits. Each time I gave you my note, asked you to read it, and asked you to correct anything wrong. No, it is not my fault."
"Oh, yeah, you did do that, didn't you." This person went from a hurt/hostile/defensive emotional stance to surprised and thoughtful. I was amazed by how quickly they dropped the attacking stance. It is the drug addicted brain lying to me, doing anything it can to stay on the drug.
If your loved one is blaming you for something that seems entirely unreasonable and saying they are terribly hurt and shocked by your accusations: trust yourself. Start a diary. Start watching for patterns. Don't be apologetic. Listen and watch.
Charm is a pattern. I had a receptionist for five years and she would say, "A beautiful charming male voice. I can tell now. Watch this one." Any person who comes to clinic and tells me that other doctors have done horrible things to them, they have been hurt over and over, but they know that I am different.... watch out. They will be telling the next doctor how horrible I am. And so the addicted person divides and conquers. A friend is told secrets about another friend, "You are the only person I dare tell what he's really like, you won't believe what he has done." You become the special person, don't tell anyone else, this is secret, private, no one else but you would believe me.... again, beware. If they are telling you evil of everyone else in their life, what are they saying about you? And if you become isolated and stop talking to the other people in the circle of family/friends you are a set up. When the gossip turns against you, people will believe it because you stopped talking to them.
People who are genuinely ill are polite but do not try to charm me. Sometimes they are too sick to be polite. And no one coming in for an annual physical is charming. The minute the charm is turned on, my defenses rise: what is this person trying to charm me out of..... or distract me from....
Another pattern is confusion. The addicted person will just act so weirdly that the family member will go into denial. This is not happening, they must be sick, I must be confused, they aren't like that, it only happened once, I must not be remembering it correctly....Um, sorry, but you are remembering it correctly. Go to Al-anon and listen. Listen to the stories and recognize the patterns and recognize denial in others so that then you can catch it in yourself.
Good luck and blessings.