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Dr Xxxxx Dr Xxxxx : Not Committed to Stopping Drug / Substance Use

The addicted person – is not yet agreeable or committed to stop using drugs.


FASOs (family and significant others) therefore need to chip away at that person’s resolve to continue to use drugs.


The SUBSTANCE USER / ADDICT (drug addicted person= User) needs to be enlightened and taught about how the drugs are damaging their life.
Tell the person how their relationships are being damaged. Tell the person how it is likely it is that they will lose their relationship.
Tell the person how their capacity to work is being damaged. Tell the person how likely it is that they will lose their job.


Tell the person how their capacity to make financial decisions and to spend money is being damaged. Tell the person how likely it is that they will become poor, become unable to afford many basic necessities, become unable to deal with financial stresses and how poor finances affect everything – relationships, work, health and enjoyment of life.
Tell the person how their health is being damaged. Tell the person how likely it is that they will end up with significant and permanent health problems.


Tell the person how their mind is being affected: cravings, moods and ability to react to people and events around them.

 

 

BUT REMEMBER:
You can say the drugs are bad. You are not allowed to say that the person is bad. No person with any self-respect can stand in front of a tirade of abuse:  and accept the comments. It is far easier to just ignore or stop listening to the person making the comments. When this happens FASOs (family and significant others), lose the capacity to influence the user’s behaviour.


Erasmus Erasmus : Can you stand up to a tirade of comments like :
You are an idiot for taking drugs.
You are a loser for using.
You are hopeless.
You are useless.
You are a waste of time and effort to me if you use.
As I said before: “You can say the drugs are bad. You are not allowed to say that the person is bad. “

Stoned Stoned and maybe not willing to make life changes and stop drug use. This situation demands very specific strategies.


Kinkajou Kinkajou : Let’s talk about some of these issues.
Relationships.

Drugs cause ups and downs. Substance Users / Addicts (drug addicted persons) as a result of using the drug, can become: aggressive, irritable, hard to live with, obstinate, unreasonable, argumentative and/or even dangerous. Relationships suffer. Relationships break up. FASOs (family and significant others) need to look at what is happening in the life of their drug affected friend /relative and need  to work to show the user how the bad things happening in their life have been made worse by drugs.

 

Kinkajou Kinkajou : Let’s talk about some of these issues.
Work.

The erratic cycles of ups and downs that drugs cause disrupt the capacity to work. Substance Users / Addicts may only feel well enough to work a portion of their time at work. The rest of the time at work they become unproductive and a liability to the workplace. They cannot concentrate. They have troubles with their memory. They have troubles with persistence – spending their whole day waiting for the day to end, so they can leave. They have troubles working with other people and/or clients or customers. They are physically uncomfortable, so are unable to bring their capabilities to bear on the tasks at hand.

 

 

Erasmus Erasmus : Let’s talk about some of these issues.
Finances.

Substance Users / Addicts (drug addicted persons) spend all their time thinking about where they can obtain their next hit (drugs), not thinking about how they can use their financial resources to solve all the other problems in their day to day life. Consequently the problems related to finances in their daily life snowball. All spare cash is spent. Loans are not paid. Credit cards are run to the max and loans are taken out to have money to spend on drugs.


Dr AXxxxx Dr AXxxxx : The main methods by which Substance Users / Addicts (drug addicted persons) can obtain money for the drug habit are:
Trading (the buying and selling of drugs),
Stealing (either physical merchandise or by stealing money from others directly or indirectly through credit -related mechanisms)
Prostitution (selling yourself).
Work: often very inadequate to support a drug habit , unless cutting corners like paying rent or buying food occurs.

 

Dr Xxxxx Dr Xxxxx : Let’s talk about some of these issues.
Legal issues.

Substance Users / Addicts (drug addicted persons) have a behaviour pattern which inevitably drives them into conflict with police and the law. Their methods of obtaining money for drugs are illegal. The drugs themselves and the buying and selling of drugs are illegal. The possession of drugs is illegal. Once Substance Users / Addicts (drug addicted persons) come into conflict with the law – jobs and finances are then at risk.

Stoned Face A stoned Face : life feels good for a short time, but then ugly reality sets in.

 

Dr Xxxxx Dr Xxxxx : Let’s talk about some of these issues.
Health.

Substance Users / Addicts (drug addicted persons) face serious health risks in the pursuit of their obsession with drugs.
Injecting drug users are at risk of catching hepatitis C, hepatitis B and even HIV. Approximately 6% of HIV cases in Australia relate to Injecting Drug Use. The injecting of apparently clean but essentially non-sterile drugs puts bacteria into the bloodstream. Abscesses in any part of the body are common in the user community – within the spine for example. Sexually transmitted diseases are more common due to promiscuity associated with drug use. Most of the young people in wheelchairs or with amputations in my practice- are Users.


Infections of the heart valves are common, leading to the formation of what doctors call vegetations. These are a combination of bacteria and clotted blood, attached to parts of the heart especially the heart valves. Bits may break off , leading to infections scattered throughout the body but especially the brain and kidneys. Patients may often spend months in hospital having intravenous antibiotics to control the infections on the heart valves – and even when they appear to be cured of infection, the scarred up mass still resides within the heart. Surgery is often not an option for heart vegetations.


Overdoses are one of the most serious health problems facing our civilisation today. More people die from drug overdose than any other disease or illness – in the younger age groups. More people die from drug overdose than die from car accidents. (Overdose deaths are essentially about twice as common as motor vehicle related deaths).

Users stop using - - - or  - - -  they Die.

 

The FASOs who are promoting ceasing drug use, are people who care about the user. People who want the users to do better and who do not want the users to die. Tell them this.


 

 

Target Activity for FASOs whose User is not ready to cease Using:

Dr Xxxxx Dr Xxxxx : COGNITIVE DISSONANCE APPROACH
In this approach, in patients who do not wish to cease using drugs, the focus of FASOs (family and significant others) is to highlight to the affected person how much damage the drugs are doing to the person – in all the above categories.


The Technique is called “Cognitive Dissonance”. It aims to show the person who thinks that their life is running well with the drugs - that in fact their life is running very badly with the drugs. Hopefully over time this forces the person to realise how badly their life may in fact be.
This is the first step to initiating the process of change. The first step in initiating the move to a drug free life.

Criticise the drugs not the person: Drugs are bad. Drugs hurt your health. Drugs hurt your relationships. Drugs can cause you to lose your job. Drugs affect your moods. Drugs affect your relationships. Drugs can stop you being able to enjoy “normal” life.

Cognitive Dissonance Understanding "Cognitive Dissonance"


Introduce the concept that you want each of these things to be better.
Ask if the user wants these things to be better:  One issue at a time- over the day or the week. In short: keep chipping away at the user’s commitment to using by trying to get the user to accept that Harm is Occurring.

 

Dr Xxxxx Dr Xxxxx : Safety Approach:
You only get into trouble if you have the time and the money. “Free” drugs are not a realistic long term access option for most users.
If the user’s money is restricted and they are supervised or involved with FASOs time wise, they will have less opportunity in terms of Time AND Money to play up.


I have seen a mother ask her user son to come and help her at home every day. A small job keeps the user in a safe place for some time every day. It gives mum the capacity to give them lunch // a multivitamin- (resolving many nutritional issues) each day. You need a functioning brain to work your way out of drug related issues.  Malnourished people will not do well using their brain to work out a new way of behaving and a new way of living “away” from drugs.

Dr Xxxxx Dr Xxxxx : Rehab
This is an approach for alcohol or amphetamine users. Opioid users just tend to relapse.  I would suggest NOT doing this for heroin or narcotic addicts. There are better ways to keep people from using. The users got into trouble because they had trouble saying “No”. If they stop using, the drug still calls them back to using. It is almost impossible to say “no”.
Relapse rates for Opioid Users in rehab are much higher than for Opioid Users on a Programme. A Good Doctor will really help to keep you on your ORT Programme (ORT: Opioid Replacement Therapy).

Dr Xxxxx Dr Xxxxx : Mention ORT
(The addicted person – is not yet agreeable or committed to stop using drugs.)


A program is easy to enrol in. Tell the user to think about this option. They will have opioid in their system all the time. Cravings stop. Learning to live life normally without drug “need”  and drug effects ( e.g. withdrawal), colouring your every movement and thought - begins.

Dr Xxxxx Dr Xxxxx : EMPATHY
We are the ones who care about what happens to you. We want you to do well. We are worried about you. We want to help you.  Make people feel good about their life, their activities, their relationships, and their work. Make them feel bad about drugs: just remember you can criticise the drugs BUT not the person.

 

 

Dr Xxxxx Dr Xxxxx : ROUTINES APPROACH
Help to establish life/ work routines without drugs.
Get up at 6.30am.
Have breakfast, brush teeth, have a shower, get dressed.
Decide what is going to be done that day: even if unemployed. 
E.g. Exercise times; meal times; home jobs times: take bins out / Pack dishwasher / wash clothes;
entertainment times: TV, Video, Radio, Hobbies.
Encourage other interests besides drugs: any hobby, any activity.

 

Dr Xxxxx Dr Xxxxx : Relationships Maintenance
The addicted person – is not yet agreeable or committed to stop using drugs.
FASOs (family and significant others) need to maintain a relationship with the drug addicted person with the purpose of initiating behaviour change.


FASOs (family and significant others) need to maintain a relationship with the drug addicted person with the purpose of giving the person a safety net in the event of a crisis.


Crisis is often the triggering event for change. Being there and being available gives the person safe options and gives FASOs (family and significant others) a chance to influence the behaviour of the drug addicted person.

Lies Vs Truth Understanding " Cognitive Dissonance"

There are a few very important principles.
You can be hard on the “drugs”.
You cannot be hard on the “person”.

Explaining this: You can say the drugs are bad. You can say the drugs are doing you harm. You can say the drugs are damaging your health or your finances or your relationships.


You cannot say that the person is stupid or clueless. You cannot criticise the person. It is impossible for anybody to accept criticism of this magnitude and to maintain their own positive self-image in the face of this well-intentioned but damaging “abuse”.  This sort of help from FASOs(Family and Significant Others), only really helps the “abusing: FASO to big-note themselves.


Criticism of the drug affected person simply drives them away and gets them to turn off and to ignore any communication from the source of the criticism. In short, such criticism essentially removes your capacity to change and influence the behaviour of the substance user / addict.

 

As I have stated, you cannot successfully force someone to stop using drugs.

Rehab Group The Rehab Road: possible for someone not willing to change. Change is forced and the "User" gets exposure to "drug free" realities.

In Summary: FASOs (family and significant others)
Have a major role to play in helping users to live life without drugs.


Erasmus Erasmus : So Summarising: Methods to encourage Drug Use Cessation:


COGNITIVE DISSONANCE APPROACH
Safety Approach:
Rehab
Mention ORT
EMPATHY
ROUTINES APPROACH
Relationships Maintenance

There are a few very important principles.
You can be hard on the “drugs”.
You cannot be hard on the “person”.