Is Addiction a Mental Illness or Disease?

Is addiction considered a mental illness?

Drug addiction and alcoholism are listed as “substance use disorder” in the Diagnostical Statistical Manual, also known as the DSM V, published by the American Psychiatric Association (APA). There were nine substances included in the DSM V. 

With caffeine no longer listed, the eight substances are:

• Alcohol Use Disorder – All alcohol
  
• Cannabis Use Disorder – Marijuana, THC, and CBD products
  
• Hallucinogen Use Disorder – LSD, Mushrooms, Ketamine
  
• Inhalants Use Disorder – Glue, Duster Cans, Paint, Gas, Whip It’s, etc.
  
• Opioid Use Disorder – Heroin, Fentanyl, Oxycodone, Hydrocodone, etc.
  
• Sedatives, Hypnotics, and Anxiolytics Use Disorder – Benzodiazepines, Barbiturates, and Sleep Drugs
  
• Stimulant Use Disorder – Methamphetamine, Cocaine, Crack Cocaine, Adderall, Vyvanse, etc.
  
• Tobacco Use Disorder – Cigarettes, Chewing Tobacco, Vapes, etc.

Sources:

• NIH (National Library of Medicine)
• APA (American Psychiatric Association)
• Los Angeles County Department of Public Health

The theory of addiction being a mental illness and treating with this theory falls under the psychological model. The psychological model is one of many models, and unfortunately, there are several models to choose from, which we will discuss in the next section. All the models make good points. Whether or not drug addiction or alcoholism is a disease or a mental disorder, it is a problem of behavior that can be treated. 

The entire point of this article when asking about addiction being a disease or a mental illness is not about answering the question with absolute certainty because nobody knows the answer, and professionals are split down the middle on the subject, as is our legal system. It seems we call addiction a disease or a mental illness based on what the other side is trying to accomplish by way of profit and outcome. The article seeks to inform you that regardless of what it is, your loved one has it, there is a solution for it, and you do not have to sit back and wait for them to address it while you, your family, and your loved one fall apart.

One of the more significant challenges our family recovery coaching team and interventionists face is when families see their loved one as a victim of a disease, mental illness, drug addiction, or alcoholism rather than see them as someone who would benefit from taking accountability for their behavior. When the intended patient is believed to be a victim, this can lead to enabling and codependency, which often disables the intended patient from advocating for themselves and their care. As interventionists, we try to stay out of the debate as to whether or not addiction is a mental illness or a disease. The interventionists’ duties address the behaviors and the resistance to treatment, along with helping the intended patient’s family—the intended patient and the family struggle with the fear of change. The interventionist helps move the patient and their family through their fears and into recovery.

The patient is afraid of what life will look like without alcohol and drugs, and families hold onto their unhealthy family roles in fear of what it will look like any other way. The family and the intended patient fear the unknown outcome and choose the current path because it is familiar. The challenge most families face is the entire process of their loved one accepting help or not. Families are afraid of what will happen if they refuse help and are equally scared of what will happen if they do. When a family makes it all about their loved one accepting help, they miss the problem. The focus should not just be getting them help; the primary focus should be why they won’t take it or seek it out alone. 

Whether or not addiction is a disease or mental illness, the patient is not a victim, and there are treatment options that produce successful outcomes. Whether or not you choose to believe it is a disease or a mental illness, or whether or not doctors and psychiatrists decide to do the same, the patient still produces a wake of destruction upon those closest to them and who love them the most. A family has to ask themselves, at what point is it not okay to let your loved one treat you and themselves the way they do? Families often believe their loved one has a disease or a mental illness; therefore, this frequently leads to thinking they are a victim, and the family must accept not addressing the problem while those connected to the intended patient deteriorate, waiting for them to hit bottom or seek help. 

What is the disease theory of addiction?

As stated in the section above, the chosen model is often determined by what the person on the other side tries to accomplish. The world finds addiction and mental disorders profitable and has several models to choose from when deciding what is best at the time. A psychiatrist may profit from the medical model to bill insurance, and a judge may benefit from the moral model (you caused it, you fix it) in determining sentencing. The point to consider is nobody has the answer with absolute certainty.

Please keep in mind that:

The most significant difference between these models is what they imply and what message they send to the patient and their family. The law of unintended consequences applies to everything, including these models.

There are several models of alcoholism and drug addiction; these models are:

Biological/Genetic Medical Model

The biological/genetic medical model of addiction believes that addiction is a biological disease with a predisposition that can be diagnosed and treated. The model assumes that a lifetime of total abstinence is required and that resuming substances at any time will result in a full-blown relapse. The medical model believes alcoholism and drug addiction are chronic and progressive (Jellinek Curve). Addiction can also be fatal. The medical model believes you did not cause the problem, and you cannot fix the problem; there is no cure.   

Dr. Jellinek’s “You did not cause it, and you cannot fix it” supported the medical disease model by identifying five types of alcoholics. The AMA (American Medical Association) supports Jellinek’s Gamma type of alcoholic. Gamma has an increased tolerance and loss of control, is unable to stop on their own, and experiences withdrawal symptoms. Jellinek also identified the Delta type of alcoholic, which he feels also has the disease. The disease model of addiction allows the problem to be treated and billed through insurance by doctors, psychiatrists, and all other licensed addictions and mental health professionals. Not all agree with this model; it is the industry standard today.

Since the medical model is the industry standard, we will focus most of our attention on this model as it is responsible for most of today’s treatment of addiction. Success rates before this model were roughly 50%. Today’s success rates of lifetime abstinence under this model are about 3%. One of the unintended consequences of this model is that it keeps the patient in a perpetual state of victimhood, it keeps the patient coming back for more treatment, which is highly profitable, and it directs families to accept the problem, which turns to enabling, codependency, unhealthy family roles, and the inability to believe that any other model, treatment, or intervention can be successful. The model assumes the patient suffers from a genetic predisposition to alcoholism and drug addiction. The model believes addiction can be treated with relapses being part of recovery and cannot be cured. The greatest challenge with this model is not only that drug addiction and alcoholism are treated as a disease; it is that the model allows the patients and their families to believe they are victims, relapses will happen, the patient will never be cured, they stay in a medical system of constant mental disorder diagnoses, and they have to accept the destruction of the disease as it plays out until the intended patient wants help or hits bottom. We do not believe Dr. Jellinek intended this to happen. Like everything else in life, there are unintended consequences. 

What Jellinek did not factor in is that addicts and alcoholics will look for any chance to flip the script and point the finger before they take ownership of the problems that exist. Even if every aspect of the disease model were accurate, it backfires and is used as a weapon by the addict or alcoholic. People don’t take accountability when convinced it is not their fault. As soon as someone thinks they are a victim, many others close to the victim do, too. When someone believes they have a disease with no cure, that affects their thought process. The non-addict or alcoholic may fight harder when presented with that, such as when someone is told they will never walk again and then put all their energy into walking again. The person with an addiction and the alcoholic do not do that; they run with the validation that there is no hope, treatment will never work, and they are victims, and it is everyone else’s fault, so what’s the point?

The problem is not the model itself; it is the law of unintended consequences and what it has done to addiction and alcoholism treatment today. 

The following section, “Is Alcoholism and Drug Addiction a Disease?” summarizes the law of this model’s unintended consequences. 

First, we must continue with the other models.  

Moral Model

Most dads suggest their belief in this model without realizing it. The model believes you’re making bad choices and must stop and figure out your life. This model assumes the person is weak and requires a spiritual solution. It believes in total abstinence, like the medical disease model. The moral model suggests you caused the addiction, and you must fix it.

Psychological Model

The model suggests the cause of addiction is the self-medication of a mental illness. The patient caused the problem by self-medicating mental disorder systems and also states you cannot fix the problem. The psychological model says if you fix the mental illness, the addiction goes away. For the record, we have never experienced that victory for a client; address the mental disorder, and the addiction disappears. 

Sociocultural Model

States that it does not matter what caused it and that there is a solution to address and fix it. For the record, this model makes the most sense regarding the message that would be most effective to a substance user. It takes away the debate, the victimhood, and the finger-pointing. It sends the message you are addicted to drugs or alcohol, and there is a solution, so take accountability, stop destroying yourself and your family, and stop blaming everyone else for your problems. The model does not believe in labels and believes that behaviors are learned and that family, family of origin, other people, access to substances, culture, and the environment are driving forces of addiction.

Biopsychosocial Model

Believes addiction is the result of a genetic predisposition, repeated use until you are physically dependent, poor coping skills, trauma, emotions, environment, and influence by others. The biopsychosocial model took a bit from each model and put it in one place to call it its model. 

Dr. Gabor Mate’s Trauma Model

Believes trauma can contribute to mental and physical illness and can be passed generationally (family of origin). It states that traumas can be healed; it is not the trauma itself but the scar it leaves. The model believes that families pass unresolved trauma onto their children. Believes brain development is a significant factor. The trauma contradicts the medical, genetic, predisposition model. Says addiction is not a disease

In defense of this model, we believe that the person with trauma has two choices. One is to address the trauma and the scar left behind. The other choice is to become a victim and weaponize the experience(s) to hurt others and justify your behavior and alcohol and drug use while blaming others for what has and continues to go wrong. Regardless of how the intended patient got to this point, you can address the problem and live a better life. People with other fatal illnesses do not spend as much time wondering how they acquired the life-threatening problem as much as they spend time addressing the life-threatening situation. People with substance use and mental disorders do not approach things that way. Addiction and mental disorders are the only medical problems the patient fights to stay sick and convince others it is their fault for their sickness. Hurting people hurt other people, and alcohol and drugs are not viable or sustainable solutions for addressing trauma and past experiences. Believing addiction is a disease and that it can’t be fixed takes away ownership of having to address the actual underlying problem. We also know that trauma can cause mental disorders and the symptoms of. Until a person is abstinent, no accurate diagnosis of mental disorders can be made, nor can the trauma be addressed. As addiction and mental health professionals, we are taught that:

 “When active substance use coexists with a range of other psychosocial impairments, the clinician should assume that these impairments are related to the client’s substance use until proven otherwise.”

Integrated Treatment for Dual Disorders, A Guide to Effective Practice,
Mueser, K.T., Noordsy, D.L, Drake, R.E, & Fox, L. 2003

Is Alcoholism and Drug Addiction a Disease?

Since nobody knows for sure, and as you just read, some of the models make a pretty good argument, and there is no exact answer. What we know is that victimhood and believing you are incurable with a label absolutely without a doubt decreases positive outcomes. As we stated, the problem is not the disease model but the message it sends. We also know that since the medical disease model started, addiction and mental health have become highly profitable, and the DSM (Diagnostic Statistical Manual) published by the American Psychiatric Association (APA) has every behavior and quirk a person can have to fit into a diagnosable disorder. Since the disease model, we have seen mental disorder diagnoses skyrocket, and we have seen successful outcomes of substance use disorders plummet. Treatment centers today believe everyone who enters their facility has a pre-existing mental disorder that needs diagnosis and medication. The way addiction and mental disorder treatment has gone is not producing success, and people in authority, insurance companies, and those writing the checks are taking notice. Most families reading this article agree with us because their loved one has been through the system many times with little to no results. 

The success rates of treatment today are why Dr. Gabor Mate’s trauma and sociocultural models make sense. Since we started offering our intervention services in 2005, we have never taken a position on the disease model and have always treated it through the sociocultural and trauma models. We are not saying we have reinvented the wheel because we have not. Our clients and their families do much better under these models than when they cycle through the medical disease model. The medical model has significantly impacted Twelve Step groups, such as Alcoholics Anonymous and Narcotics Anonymous. What once was a very successful program in Alcoholics Anonymous has seen its successful outcomes decrease since the medical-disease model started. Alcoholics Anonymous is not what it used to be, and the members at many meetings today do not follow the format and bring in things that would have never otherwise been brought in. The biggest downfall of Alcoholics Anonymous is the members have gotten away from the content of the book and the steps.  

Nowhere in the book of Alcoholics Anonymous does it say addiction is a disease, nor does it state that relapses are a part of your program; the book of Narcotics Anonymous does. The book Alcoholics Anonymous uses the word Recovering and Recover most of the time with very few references to the word Recovering. Narcotics Anonymous states that relapse is a part of your program. The comment not only encourages relapse but also feeds into the disease model that it cannot be fixed and that it is understandable to do so. Many believe that drug addiction has a higher rate of relapse than alcohol because drugs are drugs and alcohol is alcohol. We think it is because one model assumes it can be fixed, and the other says it can’t; it implies it is okay if you relapse, which is expected. The book Narcotics Anonymous states in “Why We Are Here,” which is read thousands of times a day at the start of each meeting, that “We suffered from a disease from which there is no known cure.” Labeling people this way and insinuating they have a disease and will never get better is not their intention, and it does have a profound effect on someone who is already looking to manipulate and point fingers at others for everything wrong. We are not here to knock on Narcotics Anonymous as it is a beneficial program in which thousands of people with an addiction have maintained long-term sobriety because of attending. We intend to highlight how treatment has shifted and the views of twelve-step groups resulting from the disease medical model. The law of unintended consequences applies everywhere.

Can addiction be treated as a mental health disorder?

The DSM (Diagnostic Statistical Manual) classifies a substance use disorder as a mental disorder. Substance use disorders are classified in the DSM by category, severity level, and criteria. As a result, alcohol and drug use being classified as a disorder and not a moral dilemma has allowed insurance companies and states to pay for the treatment of drug addiction and alcoholism. When treating addiction or mental health, there should always be a focus on addressing behaviors and traumas rather than going straight for medications, which, at times, is necessary. There are pros and cons of treating addiction as a mental health disorder because you go back to labels, victimhood, and disease. As we said about the disease model, treating addiction as a mental disorder is not the problem; it is what it implies to the patient.

One of the most significant setbacks we witness, this is not an opinion, it is what we see and hear from families, is their loved one going to treatment and coming out with more mental disorders and on more medications than they went in with. Why is this? Unfortunately, the more diagnoses you have, the more codes you can bill for. We understand that statement sounds opinionated and controversial, but it is true. We quoted what clinicians are taught above; some have forgotten to follow.

To remind you of what was quoted above, no professional can diagnose a mental disorder while someone is under the influence of substances, in detox, or during the first thirty days of treatment. The clinician, doctor, or psychiatrist argues they often go off history. Who is to say the history is correct? Now that we have learned about Dr. Gabor Mates’s trauma model, who is saying the mental disorders were not misdiagnosed or previously diagnosed during active addiction, unresolved trauma, or during times of crisis or duress?

Our point is the trigger-happy doctors and psychiatrists quick to diagnose mental disorders with little to no therapy or trauma resolution is why our success rates are low and why people much higher than our pay grades are taking notice; the success rates are low, and people are not improving under this treatment model. We are not saying people do not have mental disorders or that addiction should not be treated as a mental disorder, so insurance and states can help with the cost. What we are saying is there is much more profit in diagnosis and medication than there is in therapy and trauma resolution. It is a lazy approach and an ingrained norm that has taken over treatment centers today. Private equity firms are buying treatment centers, and the length of stay is slimming down. The money is in the first thirty days and the diagnosis, not days 31 – 90 with a behavioral and trauma focus. Alcoholics Anonymous used to be the gold standard. Alcoholics Anonymous is an evidence-based treatment that outperformed Cognitive Behavioral Therapy (CBT) and Motivational Enhancement Therapy (MET) in a study called Project Match. So why do so many social workers, therapists, and clinicians speak ill will of twelve-step programs today? We believe it because it is free and more effective than what they do alone. We are not saying we do not need therapists, as they are a significant part of a patient’s recovery. Even in the studies where twelve-step facilitation outperformed other forms, successful outcomes were higher when multiple evidence-based treatments were applied simultaneously. Our intervention clients frequently state their dislike for twelve-step facilitation. Most of them disclose they heard that from their counselor, therapist, or treatment team. It is not the program they dislike. It is the message and the change that scare them off.

It is not just what we see; insurance companies, employee assistance programs (EAPs), managed care organizations (MCOs), states, and the government are taking notice of the millions and billions they are spending on substance use and mental health. The successful outcomes have never been lower. 

What are the symptoms of addiction as a mental illness?

There are so many symptoms of mental disorders that parallel substance use disorders. I do not believe I have ever received a phone call from a family member that did not include them stating that they think their loved one has a mental illness and that it is the cause of the problem or at least part of the problem. Occasionally, this is true; often, it is false. Take a person addicted to crack cocaine, crystal meth amphetamines, or ADHD medications such as Adderall or Vyvanse. The symptoms parallel mental disorders such as Schizophrenia, paranoia, anxiety, and Mania. Take an alcoholic; the number one thing I hear is they are severe, if not clinically, depressed. Did anyone know that alcohol is a central nervous system depressant? Opiate users are often not the typical sleepy person you would assume to see. Opiate users who are highly addicted have a reverse effect on opiates and frequently act neurotic, angry, and manic. All these examples could be experiencing SIPD (Substance or Medication Induced Psychosis), also listed in the DSM.

Look up Anti-social Personality Disorder (ASPD), Narcissistic Personality Disorder (NPD), and, when they were younger, Oppositional Defiant Disorder (ODD); you will see many symptoms of your loved one using alcohol or drugs. Does this mean they have these disorders? People using substances are textbooks in their behaviors and are highly predictable. 

The most common behaviors we see are:

• Dishonesty
• Resentment
• Gaslighting
• Flipping the script
• Instilling guilt and shame in others
• Everyone else fault
• Their way or the highway
• Disregard for others’ feelings and needs
• Selfishness
• Denial
• Exploding, using anger and fear tactics when confronted  
• Denial
• Minimizing
• You are the one with the problem, and had you not done this, that, or the other, I wouldn’t be this way or in this mess.

These are only a few common behaviors, and you get the picture. At Family First Intervention, we have a manual that we bring to families for the intervention. Although it has been edited, modified, and added over the years, when a family reads it, they believe we brought a book specific to their unique situation. They also find it difficult to understand that many of these behaviors exist before the substance use and do so for a while, even after the substance use stopped. It does not mean the person has a disorder. The patient could be suffering from unresolved trauma, mental blocks, lack of coping skills, false perception, etc. One of the most incredible things a person with substance use disorder can do in recovery is take accountability and look at their role in the problem they believe someone else caused. The other thing they can do is stop being selfish and stop believing the world revolves around them. People with substance use disorder check many boxes of mental disorder symptoms; it doesn’t mean they have them, and it doesn’t mean they always need medications to treat them. What we are saying is that there is no replacement for trauma therapy and addressing maladaptive coping skills and behaviors. 

The point is no psychiatrist, doctor, or clinician can determine what it is until the person is detoxed and off substances for some time. The trigger-happy diagnoses have to stop, and agencies have to find other ways to make money rather than labels and disorders too early in the process.  

How does addiction affect mental health?

Alcohol and drug use, even at minimal levels, can exacerbate mental health symptoms. Someone with bipolar I disorder can have their symptoms appear as bipolar II with additional diagnoses as the result of substance use. The psychological model you read about above believes addiction is a self-medication of mental disorders. Substance use disorder is the self-medication of all problems, whether it is mental health, trauma, or both. When the intended patient self-medicates, they are not only making underlying symptoms worse; they are not fixing the problem. 

“A family’s biggest mistake is believing their loved one does not want help. The fact their loved one is using alcohol or drugs to change the way they feel says they do. Using alcohol and drugs is a form of help. It is not a viable or sustainable solution, and it is destructive, but it is a solution the intended patient sees at the time.”

Alcohol and drugs bring on symptoms of mental disorders. Traumas experienced early on can be diagnosed as mental disorders as the result of the person not having the ability to cope with the trauma properly. People act out trauma in different ways, and many doctors, psychiatrists, and clinicians don’t ask many questions outside of symptoms and then medicate the symptoms. There is not a lot of therapy in the treatment of mental health, and that is a problem and why success rates of mental health are most likely so low. We know this because of the low successful outcome results; as we said earlier in the article, others are starting to see the same thing, such as insurance companies, states, Medicaid, and Medicare providers. If a mental health professional misdiagnoses someone with a mental disorder because they addressed the symptoms and not the underlying, then the patient is not going to improve on their medication. Many families that call our office have a loved one getting worse in their addiction while on mental disorder medications, and they think it’s only because they are taking the medication with alcohol or drugs. The belief is confirmed that alcohol and drugs will affect the efficacy of medicines, and it could be that they are on the wrong medication and have been misdiagnosed. After the intervention and stabilization of the patient, what we see often is the patients were misdiagnosed, even before substance use, and did not address their trauma, feelings, beliefs, behavior, and perceptions correctly or at all.

One of the most challenging aspects of what we do is families tell us their loved ones were diagnosed with mental disorders before drug or alcohol use, and now they are worse than ever. Families hang onto that early diagnosis as the primary cause, which could be true, and often, it isn’t. When something happens to someone, no matter how little or big it is, there is the potential for maladaptive behaviors and coping mechanisms to address the experience(s). Most people do not seek professional help with their problems when it happens. Later in life, they seek professional help, and the doctor, psychologist, psychiatrist, or clinician listens in the session for diagnosable disorders, not necessarily unresolved issues. The approach has become a standard operating procedure.

Up until about five years ago, we had never done or received a call from someone who uses marijuana. To date, many of our calls are for mental disorders with marijuana use. Most of these clients do not have mental disorders after they arrive at treatment or not as many or as severe as the client was told by their provider. The marijuana that is being sold today in dispensaries has astonishingly high levels of THC. The amount of THC in legal marijuana and gummies is causing some of the worst psychosis and mental disorder cases we have seen. Today’s THC use often causes mental disorder symptoms greater than crystal methamphetamine use. The parents of the intended patient don’t understand because the marijuana they smoked or tried as a young adult wasn’t legal and was low-level THC. Before you jump to mental disorders as the primary, we have to address substance use. Before we even do that, we have to remind you that your family called about their loved one’s behaviors and not the drug of choice or the diagnosis. Your loved one needs help regardless of the drug of choice or diagnosis, and that is what the intervention and the treatment center are for. 

What is the difference between addiction and dependence?

To explain the difference between physical and psychological dependence, we will go back to Dr. Jellinek’s study and the medical disease model. Dr. Jellinek identified five groups of alcoholics, with only the Gamma representing someone with a disease. Dr. Jellinek believed the Delta had the disease, too; The American Medical Association only recognized the Gamma then. Before we break down the five, the easiest way to explain the difference is that people with an addiction can not stop on their own, and someone with a dependence may be able to. 

• Alpha – People in the study had psychological and emotional dependency and no physical dependency, no withdrawal symptoms. Don’t jump to conclusions and say your loved one is alpha and addiction-free because they do not go through withdrawal symptoms. Some drugs do not have withdrawal symptoms that you would notice.
  
• Beta – A person who had health issues caused by substance use with no physical or psychological dependence and could stop on their own when matters got out of hand.
  
• Gamma – Most people in the study were Gamma. A person has physical and psychological dependence, higher tolerance, inability to control use and abstain from use, and withdrawal symptoms. Gamma has a disease.
  
• Delta – Like Gamma, they have the same symptoms and cannot stop independently. They can set limits and somewhat control their use. Jellinek believed they also had the disease.
  
• Epsilon – This type of alcoholic is the binge drinker. The binge drinker is just like the Gamma when they drink. Many Epsilons end up in treatment. It is not how often they use alcohol or drugs, but it is what they do when they use alcohol or drugs.

Alcohol and most drugs can cause physical dependency. The easiest way to summarize this section and differentiate addiction from dependence is with an example. A cancer patient going through chemotherapy and radiation taking opioids for pain will be physically dependent on opioids. After treatment, they can be detoxed or tapered off and not seek out more opioids. That is dependence versus addiction. Your child on ADHD medications is physically dependent on pharmaceutical amphetamine salts. It does not mean they have an addiction and there will be withdrawal from physical dependence. Not all people physically dependent have an addiction, and all with an addiction are physically dependent. The only time this would not apply is when a drug does not cause physical dependency, such as LSD.

Professional Intervention for Your Loved One Struggling with Addiction

Family First Intervention is a family intervention program about change. Most families and their loved ones are stuck in fear of addressing the problem and experiencing any positive or negative change. The S.A.F.E. Intervention Services and Family Recovery Coaching Program helps families with what they have gone through and how to pull them from the bottom and forge ahead even when their loved ones will not. The intended patient and their families cycle around and stay stuck in the second stage of addiction recovery, called the contemplation phase. What is required to move out of this stage and into recovery is that the consequences of staying where you are must be more significant than the benefits of staying where you are. Families hold onto their maladaptive family roles, and any progress is short-lived. Families almost instinctively get pulled back into what they perceive as their safe place. That safe place is an illusion surrounded by false perceptions and dysfunction. The intended patient does the same thing, as they believe the benefits of continuing have been greater than the consequences and don’t feel they need help. It is not whether they want help but whether they have to receive it. 

Regardless of the diagnosis, families do not have to wait for their loved one to address the problem or ask for help. Often, the family’s actions prevent their loved one from seeing the need to change and create an environment that keeps their loved one stuck in the second stage of change. We call ourselves Family First for a reason. If the family does not address their dysfunctional perceptions and acquired family roles, their loved ones will likely not. What you are waiting for them to do is what you must do first. Addiction and mental health are the only fatal problems in the world where families and patients act and think this way. It is also the only fatal problem in the world where the patient fights to stay sick, and the family, either directly or indirectly, helps them do that. If you were to replace their current problem with any other health problem, you would not need this much information and insight to help you see the need to address the issue. If it were anything other than addiction or mental health, your loved one would not need convincing to stop or quit.

Families can take the first step, and we know how difficult it is when you constantly fall backward into your default operating system. The only difference between a family that acts and a family that does not is that one stays stuck in fear, and the other realizes it can’t get any better without taking action. The fear of the unknown, letting go of your illusion of control, and meeting with your loved one are some of the greatest fears that keep families stuck. If a family allows us, we can help them through that. Our organization aims to help every family realize they did everything possible to help themselves and their loved ones.