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DepreMelanie Cole (Host):  Are you concerned with someone’s alcohol or drug use? Addiction can wreak havoc in families but there is help. My guest today is Jerome Barry. He is the Director of the Independent Center at Bryan Health. Welcome to the show, Jerome. Tell us a little bit about addiction. How do you recognize the signs?  

Jerome Barry (Guest):   The easiest way to recognize addictions is with the following definition. Does the use appear compulsive? Does it appear out of control? The third one is the most important:  does the use persist despite negative consequences? In other words, if something bad happens connected to my use of whatever the product is – whether it is alcohol, marijuana, prescription drugs – if a negative thing is connected to that use and yet the user continues to use and justify the use despite the negative consequences, that’s when you begin to think about this might be an addiction.   

Melanie:  So then, what do you do? If there is the yelling and the screaming and the not talking and trying to get this person to recognize what they are doing, what do you do?  

Jerome: I love that topic because historically I think we’ve made a mistake in the way we have taught loved ones and the public how to intervene on someone that they care about that may or may not have a drug or alcohol problem. I think we’ve made a mistake because, basically, we’ve taught non-licensed people that don’t have the credentials to diagnose a substance use disorder. We’ve taught them to gather around their loved one and refer to them as alcoholic – “I think you have an alcohol problem.” They are diagnosing the problem, plus they are recommending treatment. In days gone by, substance abuse programs and providers would teach families to intervene on their loved one in that fashion. It caused a lot of resentment, a lot of kicking and screaming and denial, and the individual would be resentful of their spouse or their children that were intervening upon them. Today, we are taking a little different approach here at the Independence Center we are encouraging family members and loved ones to tell the person the honest truth which is “I don’t know what is going on. I don’t know whether you have an alcohol problem. I don’t know if you have a drug problem. I don’t know whether you have a mental health problem. I don’t know whether you just have an attitude problem but would you be willing to go to a professional and let them help us figure out what is going on?” By doing that tactic – and I know that doesn’t sound like a huge “wow”-er of a tactic--but it really changes the whole dynamics of the conversation. Now, you can express your love, you can express your concern, and you can stay out of the category of diagnosing and telling them they are an alcoholic and telling them they need treatment. You can just say, “I don’t know what’s going on but let’s go to a professional.” Then, what happens is that family and loved one lets us – the substance abuse professional – be the bearer of the news that you have a diagnosis of alcoholism and you have a need for treatment on some level. It just tends to be more effective. We tend to get more people in the door for a drug and alcohol evaluation – which is the first step in the process anyway. The new intervention - that sort of softer, loving approach seems to be more effective.

Melanie:  That’s brilliant of you to come at it from that angle because it is true the families gang up on the person; then, they deny it. It causes all kinds of problems and everybody is acting like a mental health professional in the situation.  

Jerome:  Correct.  It would be like my family gathering around me and saying, “Jerome, I think you have a slipped disc and you need a back fusion and we think you need to go get it treated today.” They are not qualified to diagnose that. What they want to do is, they want to get me in for an MRI or get me in for an x-ray so we can diagnose the problem and let the professional tell me what treatment I need. It is sort of following that same tactic of a softer, gentler and, actually, a more honest approach. Because we really don’t know what is going on with a loved one. We assume we know because we see them drinking, we see them using, so we put two and two together and we think there is a connection there. Lots of times, quite frankly, we’re right but I’d rather let you love them and let us be the bad guy. 

Melanie:  What if you say to that person, “Will you see a counselor? Will you get some help?” I’ve always heard down the line that them admitting a problem is the first biggest step. Is that still the case? What if the person says, “I don’t need any help? I’m just fine.”

Jerome:  Once you get a person into treatment that is the goal – to get problem ownership, problem awareness, problem understanding. But, what we’re trying to do with the tactic I shared is we’re not trying to get them into counseling. We’re trying to get them evaluated and assessed. It’s harder for an individual to refuse being assessed and evaluated. That’s a harder one for them to say, “No, I don’t need that.” It’s a little easier for them to say, “No, I don’t need counseling. I don’t have a problem and I don’t need counseling.” We can back off and say, “No, I’m not saying you need counseling. I’m saying let’s go find out what you do need and let’s see what a professional says.”    

Melanie:  What a wonderful way to put it. Tell us about some resources that are available at the Independence Center at Bryan Health.  

Jerome:  We have a variety of levels of care depending on the need. We’ll use that drug and alcohol evaluation once we get the individual in for that assessment. We use that assessment to try to determine, number one, is there a substance use issue, is there an active diagnosis? If there is, do they need detox? Do they need in-patient? Do they need an intensive level of out-patient where they come all day long? Do they need a lesser level of out-patient where they come three hours, three times a week? Do they need just individual counseling sessions? We’ll take each individual and look at that clinical picture that they present with and try to make our best guess. Where do we start? Do we start with out-patient and then, if they struggle we bump it up to something more intensive? Lots of times that’s real effective, too, because a lot of addicts or people with drug and alcohol problems deny that they need treatment. They want to just try it on their own. They like to convince themselves that they don’t need much help to quit. We can put them in a less intensive level of care and say, “Okay. Great. If you are able to quit with this less intensive level of help more power to you. That’s awesome. That’s going to cost you less.” But then, the agreement is established that “George, if you struggle at that level of care and if you are not able to stay, will you agree then to bump up to a higher level of care?” Now, you are actually gaining some problem awareness as you go through that process. But, you are absolutely correct, Melanie, problem ownership is our first and number one goal because if they come in the door and everybody else is telling them they have a problem and they are not yet seeing it, we’re not going to get very far until they start checking it out themselves.

Melanie:  Where do the friends and family and loved ones come in? You love somebody that’s got an addiction issue. At Bryan Health in the Independence Center, what are you doing to get the family and friends involved or are they not involved until this person has taken ownership and is doing something about it?

Jerome:   First of all, they are always involved in the problem because it’s hard to be in a love relationship with a person with an alcohol or drug problem and not have been impacted. They are being impacted by the person’s use. They learn to work around it. They learn to make excuses for it. So, they are already involved. What we do is we try to take some family members that are tired – they are sick and tired of being involved. They just want the person to stop. We’re trying to re-connect with these families, with these loved ones. Sit down and have individual sessions with them. We have a family workshop with them to try to help them understand what’s going on with their loved one. That’s really important because if you’re not an addict, if you’ve never been a smoker, if you’ve never had a food addiction, if you’ve never had an alcohol addiction, it is very difficult to understand an addict’s behavior because in your mind they should just quit. They should just love me enough to quit. If they cared for me more they’d stop. The perception from the general public towards an addict is very different than what it feels like inside the addict. We try to help that family come to some new empathy and new understanding of what it’s like being an addict. Then, we also empathize with their situation because they are definitely being impacted by it.

Melanie:   In just the last few minutes – it’s great information, Jerome, and I applaud all of the great work that you do – give your best advice for someone who loves someone who may suffering from addiction of one substance or another and why they should come to Bryan Independence Center for their care.

Jerome:   I would simply do this:  I would walk up to them in an intimate moment and just say, “I love you. I care about you. But, I am worried that something is going on. I can’t put my finger on it. I don’t know what it is but I would love if you would be willing to go with me and see a professional and have them help us figure out what’s going on so we can rebuild our relationship again and so I can stop worrying about you again. Would you be willing to do that with me?” That is harder for the individual to say “no” to and walk away mad then the old technique of intervening. My suggestion is love them up. Don’t diagnose them. Don’t tell them they need treatment. Don’t tell them they have an alcohol problem. Just love them up.  

Melanie:  What great information. Thank you so much. You’re listening to Bryan Health Radio and for more information you can go to BryanHealth.org.  That’s BryanHealth.org. This is Melanie Cole. Thanks so much for listening.