Get answers to your questions about topics covered in the latest Addiction In the Home: Healing Lives, Families, and Communities. Simply submit questions using this anonymous form, and watch for the next Road to Recovery Update to learn when the answers are posted on the Web site.

To view the Webcast, visit http://www.recoverymonth.gov/2005/multimedia/w.aspx?ID=412.

Ask the Expert Transcript

Question:What is the best and most reliable form of treatment for opioid dependence?

Dr. Ackerman: The best treatment for addiction is obviously one that works. Treatment for opiate addiction has always proved to be difficult. This is in part due to the fact that opiate addiction is both physical and psychological. Often before treatment can begin, an addict must be detoxified from the physical dependence on the opiate drug. This should be done under medical supervision. Most treatment programs for opiate addiction understand this and often have their own medical staff or refer the client to medical care before individual or group treatment can begin. I think the best intervention for an opiate addict is an intensive in-patient program followed by an intensive out-patient program, plus involvement in a 12-step program such as Narcotics Anonymous. Many studies on opiate addiction often mention that the craving for the drug can occur for years, and thus I believe that mutual group support is very import for the addict. The goals for a recovering person should be 1) learning how to make healthy choices and decisions, 2) developing the healthy skills to interact in with others, 3) creating and re-creating healthy relationships with family, friends and others, 4) following a proven recovery plan, and 5) learning to live as a healthy recovering person. The best treatment can be in programs that can help the addict to accomplish these goals.

Question: If an alcoholic has been in and out of treatment centers/programs, and say he wants to be sober, but has reoccurring relapses, when is it time for the family to say enough is enough? Questionable and unacceptable behaviors occur when the alcoholic is actively drinking and I don't want to expose the children to this. Thank you.

Dr. Ackerman: Living with an alcoholic is not a spectator sport. Everyone in the family is affected including the children. Everyone living with an alcoholic is faced with the same question that you have asked. When is enough? If the alcoholic is making progress in treatment we find hope even though there might be relapses. What you are probably looking for is either an indicator that progress is being made and the situation will get better, or you are looking for signs that indicate that changes are not occurring. I cannot tell you what your "bottom line" is and thus you will need to learn more about yourself. I suggest that you not wait for the alcoholic to recover before considering any of your own needs. You and your children have a right to recovery and you don't have to wait anymore. I think you will find your answer better by involving yourself and the children in such programs as Al-Anon where you will find those with similar experiences and I am sure more insight into yourself and certainly more options on how to react in a healthy manner for yourself and the children. Finally, if questionable and unacceptable behaviors by the alcoholic involve any kind of family violence, then you need to act immediately for your safety and the children's.

Question: Dr. Ackerman, I'm from Bulgaria, the mother of two addicted sons. After several treatments they both are recovering well now, one is sober almost a year, the other since December last year. They live and work in another city, have plans about keeping on with their education, things are going well. In my city, I created an organization called Mothers Against Drugs, and it's a very viable one: we meet in groups every week, help each other. There is one big question the most parents have: how to motivate the son or daughter to admit he or she has a problem and how to force them into treatment. In Bulgaria it's very hard, almost impossible to get somebody to treatment, it's all up to the family. With my sons I didn't have this problem-they wanted to quit and went voluntarily to treatment. But about 40 percent of the parents have this trouble. How can I help them build an effective strategy to motivate the child? I support a Web site for the parents of drug addicted children. If you give me some advice, I'll publish it on the Web site, too. Thank you very much.

Dr. Ackerman: Finding some motivation for alcoholic and drug addicted individuals has been very difficult, and especially if it is a family member. However, parents don't have to wait for the person to make a rational decision about his or her addiction. Rather, parents can create a situation to confront the addicted person and at the same time offer treatment. I think the best strategy for parents is to arrange for an intervention with the addicted family member. If you can educate parents about the procedures and the benefits for healthy interventions, I believe you will make a significant contribution to the parents in Bulgaria. There are many approaches to a good intervention. These should include getting help from a professional to advise and direct the intervention. Bring together the people that have the most influence on the addict. Decide who is going to say what to the addict and rehearse the intervention with all involved before you confront the addict. Parents will need to decide consequences it the addict will not respond or seek treatment. Finally, the intervention should not be just a vehicle to confront the addict, but also to offer help, and thus treatment needs to be arranged ahead of time. The secret to successful interventions is rehearse, rehearse, rehearse.

Question: Are there any videos on drug abuse among teens and youth I can present to my 18-year-old son? I think this would be helpful for us to view people and testimonies on this topic together....I can't seem to find any. Thank you, concerned Mom.

Dr. Ackerman: SAMHSA's National Clearinghouse for Alcohol and Drug Information has VHS and DVDs of videos that would be appropriate to show to your son. Most of the videos cost $12.50/$13.00, and can be previewed online. Here is the link to the videos:
https://ncadistore.samhsa.gov/catalog/results.aspx?h=publications&topic=128

Here is a more detailed search of videos dealing specifically with substance use among youth:
https://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=15066
https://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=17064
https://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=16038
https://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=15424
https://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=16045
https://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=16046
https://ncadistore.samhsa.gov/catalog/ProductDetails.aspx?ProductID=16419
https://ncadistore.samhsa.gov/catalog/ProductDetails.aspx?ProductID=16631
https://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=16047

You can also check out the following publications that you can order through NCADI, free of charge:
https://ncadistore.samhsa.gov/catalog/results.aspx?h=publications&topic=100
http://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=16748
http://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=14608
http://ncadistore.samhsa.gov/catalog/results.aspx?h=audiences&topic=14

Question: Why do children of alcoholics often marry or enter into relationships that are abusive to them?

Dr. Ackerman: Although I cannot cite empirical evidence to support your ideas about relationships for children of alcoholics, your question certainly has been asked many times before. In my work on studying adult children of alcoholics (ACOAs) and especially with the ACOA women that I interviewed to write the book, Perfect Daughters, this issue came up again and again. However, it seems that daughters of alcoholics do not marry alcoholics any more than do women in general. What they seem to do disproportionately is to marry males who later develop alcoholism. This makes it even more intriguing! Thus some ACOAs seem to be attracted to high risk partners. Many of the ACOA women that I interviewed believed that there must be something wrong with them because they kept picking the wrong person. However, maybe the wrong partner picked them! This never occurred to the women. One of the most common things for these ACOA women was that they wound up in relationships with a very controlling partner, but they still believed it was their fault. Many of these women may have been attracted to high risk partners because they themselves were high risk women. This occurs when one has a very poor understanding of healthy relationships and when being needed inappropriately is confused with being loved.

Question: Hi, Dr. Robert Ackerman, I am 30 years old and married. I have three beautiful children. My question is can a person that has been addicted to meth for 12 years straight without stopping (maybe a couple of months, but that is all) ever stop and be normal?

Dr. Ackerman: With the right treatment and support, the answer is yes. There are millions of recovering people out there who are living proof of the power of recovery. Recovery is not just about stopping the intake of a drug. Recovery means physical, emotional, and spiritual well being. Recovery is a process that allows the addict to begin to lead a healthy life and support for maintaining it. The addict needs to learn many new things and different ways to live. Often addicts think the world is "normal" when they are high and have difficulty handling every day life with out their drugs. Thus becoming "normal" will take on an entirely different meaning in recovery for addicts. This will include being around as many healthy people as possible. Recovery offers life changes and hope.

Question: What can a group like ours, International Union of Elevator Constructors Local 20 (Louisville, KY office, covering most of Kentucky), do now in order to take advantage of Recovery Month? The alcohol and drug addiction problems in this trade are a constant problem (maybe not unlike other working trades). How do you suggest we approach this with our membership?

Dr. Ackerman: Some of the best models for supporting fellow workers are found in developing an Employee Assistance Program (EAP). This type of program offers education, training, and assistance to employees who are struggling with a variety of problems including alcohol and drug abuse. You might consider starting such a program for your organization. I would suggest you approach your membership from the position of offering a new benefit, namely an EAP. During Recovery Month, you could offer educational classes on the new program and use education about alcohol and drug problems as an example of what the new program can address. In order to get you started, I suggest that you contact the folks at Performance Resource Press who publish numerous articles and educational material for employee assistance programs (1-800-453-7733).

Question: Because of my husband's behavior, I have been rejected by his family through a misunderstanding. I am sure this is very common. How do you avoid it and if I am the only one fighting for the marriage, when do I just give up? Any help would be great. What can I do? I have never used drugs and it has ruined my life.

Dr. Ackerman: Unfortunately, people who do not abuse alcohol or drugs can still have their lives ruined by these substances. As with anyone who lives with an alcoholic or drug addict, the first important thing to do is to start taking better care of you. This includes learning as much as possible about the disease of addiction, finding support groups for you, and supporting and confronting the alcoholic or drug addict with suggestions for treatment and intervention. Additionally, not all of the solutions for many of the associated behaviors due to addiction can be resolved in addiction treatment only. Thus, as you mentioned, it might be necessary to find couple/relationship/marriage counseling. It is important to educate yourself about what addiction is doing to your relationship and to become aware of your options. As you begin to learn about addiction and to take better care of yourself physically, emotionally, and spiritually, you might become more aware of the choices that lie before you. You cannot recover for another person, but you can do healthy things for yourself.

Question: It has been little over a year since my husband started his recovery. Is it common for someone to go through four sponsors? He has also had multiple relapses. However, he continues to go to meetings. And he is seeing his counselor. I guess I am puzzled. Sometimes I feel I am enabling him by not giving him the boot. I continue to go to Alanon I feel confused! How should I handle his continuous slips?

Dr. Ackerman: It is not uncommon for someone recovering from alcoholism to have a "slip" or relapse. It is, however, very important that the person get back to his/her recovery program just as soon as possible. It is hoped that the time between relapses gets longer and longer and the time between relapse and getting back on a program gets shorter and shorter. The positive thing in your questions is that you state he is still trying and going to meetings. Obviously, he has created some frustration with his sponsors who are probably telling him what he does not want to hear. There is a slogan in A.A. that says keep coming back-it works.

I am very pleased that you continue to go to Al-Anon for your own support. I am sure that there are others at your meetings who have experienced the same dilemma and that you can learn much from them about how to handle the relapses. It is important to make your position known to your husband and at the same time let him know that you support his continuing efforts at sobriety, but not his excuses for relapse and any associated negative behaviors. We cannot recover for another person, but we can offer support through our own healthy behaviors. It is important, therefore, that we learn the difference between unhealthy enabling behaviors and healthy supporting behaviors.