Introducing “FSDP Presents”: A Podcast Brought to You By Our New Partners at The Social Exchange!

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FSPD is excited to announce our partnership with The Social Exchange, a brainchild of the brilliant Zach Rhoads and Aaron Ferguson.

26233524_10103289292747830_6908264666812993265_oThe Social Exchange interviews the world’s leading intellectuals about a variety of social topics: addiction, social science, philosophy, and many more.  Zach is a masterful interviewer and through their podcasts they offer listeners cutting-edge information about each topic.

What’s refreshing and unique is that there is no rule that the conversations are agreeable or comfortable. However, each conversation is guided by an honest, information-seeking style of dialectic. On The Social Exchange, ideas are challenged, people are respected.

As part of the partnership, FSDP will have the opportunity each month to select an FSDP community member to be interviewed on the podcast on a segment called” FSDP Presents”. We’re proud to have Glen Carner, Licensed Mental Health Counselor  from Hawaii as the inaugural podcast guest. Glen has a paradigm-shifting outpatient addiction counseling program, Family and Addiction Counseling LLC  that uses a collaborative harm reduction approach that coordinates care for his clients with relevant community supports whenever possible. As you’ll hear in the podcast, he blends his expertise with unbounding enthusiasm and a passion to work with individuals and families impacted by substance use.

You can hear the podcast here and learn more about Zach’s work with The Social Exchange on their Patreon page here.

NEXT UP ON “FSDP PRESENTS”: Kenneth Anderson, a pioneer of alcohol harm reduction and Founder of the HAMS Network: Harm Reduction, Abstinence, and Moderation Support.

Harm Reduction for Families: Communicating With Love

Adding to our Fall series, welcome to the November 2018 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout.

This month, Dee Dee shares her unique perspectives on harm reduction’s influence on family communication

To learn more about how your family can join our growing community of enlightened friends and advocates sign up here now.

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Communication.

This is a huge topic which I can only hope to touch on here. But I hope that I can offer some suggestions, look for some possible answers from you all (families) and see what we know in science now.

For more than fifty years, we professionals have made (still make??) terrible mistakes in our advice about communicating with loved ones who use drugs: DON’T BOTHER! We said things like, “All addicts are liars” and “They must hit bottom” and “You need to use tough love with addicts”. We called you all names: codependent, enabler, co-addict/alcoholic. Now don’t misread me here: we’re discussing a family which is a system.

To use the favored metaphor from famed American educator and author, John Bradshaw[1], “families are like mobiles: touch one side of a mobile and the entire piece shifts.” This means all family members must participate in changing in order for change(s) to actually happen. Bradshaw, [2] (who also coined the terms “dysfunctional family” and “inner child”, and some believe ushered in the self-help movement of the 1980’s) used to call the problem a “dis-EASE” with the world. I think that is still one of the best definitions of addiction we have. And it speaks to the trauma that all too often accompanies addiction/drug use. More on that in the future.

So, what does communication in a harm reduction world look like? Here’s an example from Patt Denning and Jeannie Little’s book, Over the Influence[3]:

“You can love your child and kick her out of the house. You can kick her out of the house and pay her rent somewhere else. In these ways you can continue to love and support her and limit the damage she can do to your marriage, your house, and your other kids. In other words, you can make changes in your relationship with your loved one way before you are completely worn out. In fact you should.”

A second example is from the Center for Motivation and Change’s (CMC) booklet, “The Parent’s 20 Minute Guide”[4] (they use the term “parent” to mean any caregiver). In the section titled “Helping with Understanding”, CMC makes the point that the behaviors your child is engaged in (i.e., using drugs) make sense and we parents need to appreciate that relationship that our loved ones have with substances even as we struggle to understand it. Wow, huh? This can be a tough request but here’s why it’s crucial to Communicating with Love:

“Feeling relaxed, exhilarated, less anxious, braver, funnier, and part of the group, are all potential benefits of using substances. If there were no benefits, there would be no use.” (emphasis mine)

This is enormously important for families to understand. Without this acknowledgement, little communication with love can happen. We need to remember that our loved ones’ actions have more to do with their personal reasons for using (the reinforcers) than us. This knowledge can help us to not take our loved ones’ actions so personally and to start to see the reasons for the substance use: loneliness, boredom, social/fitting in, anxiety, trauma, and more. The CMC 20 Minute Guide goes on to say,

“Understanding what your child gets from using can also lower your fear and anxiety, as it makes the behavior less random and more predictable. If he uses to fit in with other kids, then you know he’s more at risk when he’s out socializing than home with the family.”[5]

With this information in hand, strategies can be launched with your loved one and everyone can be invited to brainstorm options when your loved one is faced with potentially triggering social situations.

The Guide also has worksheets, such as the one titled, “Behaviors Make Sense”[6] which is designed for the parents to complete based on their understanding of their loved ones’ reasons for using drugs. I would suggest that these worksheets might be even more effective if completed with your loved one. That way you’re not left guessing about the relationship your loved one has with substances. It also allows for further exploratory conversations to better understand your loved ones substance use (it’s also possible that your loved one isn’t sure of all the reasons they use drugs; this openness to conversation could allow them time to consider why they use a substance(s)).

Denning and Little also provide some excellent guiding concepts for families to use, calling them “Harm Reduction Principles for Family and Friends:”[7]

  1. Promises only cause problems
  2. There are no rules except the ones you make
  3. You cannot enable drug use (unless you are supplying them)
  4. Base your actions on your values
  5. Base your actions on what you can manage
  6. You have triggers too
  7. Any limits you set are about you

I would add a couple of others:

8) Everyone’s doing the best they can so be kind/gentle with yourselves – and with your loved one (it may seem like your loved one cares more for drugs than for you right now but I doubt that’s really true)

9) You probably can’t solve this problem, but you can make it better or worse

10) For change to be successful for your loved one, you must also change

So perhaps now you’re thinking, “OK Dee-Dee, this is all great but is there some research to tell us how to communicate with love?” Yes there is!

CRAFT. Community Reinforcement Approach and Family Training[8], developed by Robert Meyers, PhD (Research Associate Professor Emeritus in Psychology at the University of New Mexico’s Center on Alcoholism, Substance Abuse and Addiction) is an answer. Bob Meyers (full disclosure: I have been trained by Dr. Meyers in CRAFT) came to the field of addiction through his own family’s problems with substance use. He became convinced that there could be a better way to interact with loved ones using substances and focused his research on finding some answers to this lifelong idea. Taking Dr. Nathan Azrin’s Community Reinforcement Approach (CRA) and combining it with his own brand of Family Training, Dr. Meyers developed CRAFT, now an evidence-based therapy.

CRAFT is unique in addiction counseling in many ways. One of the most important, in my opinion, is its focus on “catching people who use drugs doing something ‘right’”. In other words, instead of the main focus being on punishment for misbehavior, CRAFT encourages us to focus on the times when your loved one isn’t engaging in the ‘misbehavior.’ It also supports the idea that drug use (especially problem drug use) doesn’t happen in a vacuum: it happens within a system and all parts of the system must change.

Too often the drug user is seen as the Identified Patient (or Problem aka the IP) and taken off to treatment to make changes which we’re often led to believe will solve all the family problems. However, if the system she is in doesn’t also make changes, how do we expect her changes to be maintained? This is what’s called “magical thinking” (which has sadly been perpetuated too often in my profession); it’s also a set up for failure. All too often treatment does fail[9] too regardless of how much she wants to make a change(s).

Down under, Tony Trimingham, founder of Family Drug Support (FDS Australia), shares some similar ideas in his “Letter to Family and Friends.”:

“When we expect immediate changes and refuse to be with the person during the process we undermine the very goal we seek to accomplish.” [10]

I want to stop here for a moment to reflect on things that I’m suggesting families can do differently – I want to emphasize that I am NOT pointing these things out in order to lay blame. Never. Are there things we could’ve/should’ve done differently as families with loved ones who love drugs? Absolutely. Does that mean we are to blame/responsible for the drug use? Not likely. But we are part of the overall system – and therefore we must be willing to look at our part in the creation of that system of dis-ease we are all in squarely in the face.

After all, isn’t that what we ask people who use drugs to do in treatment? What I’m saying is that when there’s a complicated, possibly chronic condition in the family, it affects everyone, therefore, the solution(s) has to involve everyone. Gratefully we now have more options & suggestions for families than the old “let them hit bottom” and “stop enabling/being codependent.” We can now say, “don’t stop loving your family member!” and “when our loved ones are ill we need to hold them closer.” Learning how and when to “hold them closer” so change can be possible is the challenge. One way of helping us may be to learn more about change in general. How does it happen? How can we help or hinder change? Is it ever successful?image004

We’ve learned a great deal about how people make change(s) in their lives. The researchers James Prochaska, Carlo DiClemente, and John Norcross discovered how change happens back in the late 1970’s which they called the Transtheoretical Model (TTM) or Stages of Change for short.[11] We’ve learned that instead of looking at abstinence as the best or only way to recover or change, incremental positive change may be the best route: “Any positive change” is the slogan the late harm reductionist, Chicago Recovery Alliance founder Dan Bigg[12] who has used this slogan to describe how to view the small steps typically needed to move toward change.

Harm reduction for families at its core is about providing support to help families make decisions that fit their individuality: their values, their needs, their loved ones. It’s about helping families to see that abstinence is one possible outcome but doesn’t need to be the only one – nor is it always the best option for everyone.

For many people, the best way to make change is to go mindfully and slowly, small step by small step, moving closer and closer – with some setbacks – toward the big change you plan to make. Think of how many people quit smoking (side note: The Stages of Change were discovered when the developers/researchers looked at some 1500 smokers). Usually smokers quit on their own, either with or without the help of aids as nicotine replacement (Nicorette gum, inhalers, lozenges; anti-craving medications). Others just stop, cold turkey. But most professionals now will suggest – for those not wanting that “cold turkey” method – a “warm turkey”[13] approach is a good option especially for those who have a difficult achieving their goals with “cold turkey” methods.

The same can be true for abstinence or moderation goals in drug/alcohol use. Families can now Google terms such as “harm reduction for families” and find options that may be more in line with their values/goals and those of our loved ones using drugs. With cannabis legal in more and more states every day, many of us have found that we are looking to this substance to prove helpful in treating addictions (we already know about its usefulness – alone or in conjunction with cannabidiol CBD[14] – in treating anxiety, pain, depression and more for many people). Most families I work with now are more than delighted to have their former problematic drug-using loved one find relief and assistance in some form of cannabis.

Harm reduction for families at its core is about providing support to help families make decisions that fit their individuality: their values, their needs, their loved ones. It’s about helping families to see that abstinence is one possible outcome but doesn’t need to be the only one – nor is it always the best option for everyone. And by the way, one can definitely not be abstinent (defined as not taking any medication/drug) and still be “in recovery.[15]” More and more families are coming to see harm reduction as a better fit for them than the old “hit bottom/throw them out” model as they see the harm that is caused to them and their loved ones by such traditional, zero tolerance policies.

Families have also had enough of the old ways of thinking from my profession – the misinformation/scare tactics, the lack of nuance in treating them and their loved ones who use drugs, the one-size-fits-all approach – even the beloved American disease model of addiction has been challenged by many of the families I see![16] Family work in addictions is at a crossroads: in my opinion, it is the outcry from families that will be the reason new harm reduction policies will be adopted. It is your voices that are the loudest, strongest, and which will be best received since frankly, families are seen as victims of addiction unlike “addicts” (I’m not suggesting this view is accurate or not, simply that it is a reality in our culture). Bottom line: once again it’s about LOVE. LOVE which is the center of positive and healthy communication – and something we can all improve on demonstrating within our families this minute.

So grab one of these books – or perhaps you know of another one that fits your needs best – and start reading and practicing. It’s time for our Family Recovery movement. We must demand better, more from the professionals and other healthcare practitioners. And we must learn to improve our own communication with love.[17]image008

(Note: all photos are from unsplash.com)

Don’t miss next month’s edition:  “Holy Holidays, Batman!!  12 Tips for Enjoying the Holidays in Spite of Everything.”  

 

REFERENCES

[1] www.johnbradshaw.com.

[2] Ibid. Accessed on 9.26.18.

[3] Denning, P & Little, J. (2017). Over the Influence, 2nd Edition. Guilford Press. NY:NY. p221.

[4]https://the20minuteguide.com/. Accessed on 9.26.18. p11-12.

[5] Ibid

[6] Ibid. p13-14.

[7] Denning, P & Little, J. (2017). Over the Influence, 2nd Edition. Guilford Press. NY:NY. p221.

[8] www.robertjmeyersphd.com. Accessed on 9.26.18.

[9] Statistics for success re: professional treatment is difficult. 30% is the highest publicized rate yet this number generally reflects only those who completed treatment, not who improved longterm. AA’s rates are about 5%.

[10] https://www.fds.org.au/newsletters/letter-to-family-and-friends (accessed 10.22.2018)

[11] https://en.wikipedia.org/wiki/Transtheoretical_model (accessed 10.22.2018)

[12] Chicago Recovery Alliance (CRA): www.anypositivechange.org

[13] https://www.ncbi.nlm.nih.gov/pubmed/1787547

[14] https://www.projectcbd.org/about/what-cbd. Accessed on 10.25.2018.

[15] https://www.aa.org/assets/en_US/p-11_aamembersMedDrug.pdf

[16] See works by Marc Lewis, Maia Szalavitz, Stanton Peele, Jeff Foote, Denning & Little, Andrew Tatarsky, to name a few professionals in the field who do not ascribe to the traditional disease concept of addiction. Dr. Marc Lewis is a neuroscientist, researcher and former drug addict who has authored several books on this subject: http://www.memoirsofanaddictedbrain.com/authors-bio/

[17] Another book I suggest & use with families: William Miller’s (Motivational Interviewing) 2018 book titled, “Listening Well: The Art of Empathic Understanding.” It’s available at Amazon and beyond.

 

FSDP at The 12th National Harm Reduction Conference in New Orleans, LA

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Thanks to the generosity and support of our friends and stakeholders Team FSDP attended the 12th National Harm Reduction Conference #harmred18 in New Orleans, LA, October 18-21, representing a growing number of families who are adversely impacted by the unprecedented public health crisis surrounding substance use.

This biennial event brought together some of the most creative minds from the US and abroad to address a myriad of complex issues facing the harm reduction movement. A diverse community of people who use drugs, social justice activists, service providers, healthcare workers, researchers, policymakers, public health officials, and law enforcement gathering together determined to put an end to the harms and injustices caused by the War on Drugs.

FSDP is dedicated to serving the needs of our families and our participation in this conference is a heartfelt expression to honor our loved ones who have been lost to overdose and to save the lives of those who remain at risk.

 

FSDP co-founders Carol Katz Beyer and Barry Lessin were privileged to be invited to join harm reduction pioneer and visionary Patt Denning, Ph.D. on her panel: “Loving Someone Who Loves Drugs and Alcohol.”

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Patt outlined specific strategies for family members and friends based on guiding principles of harm reduction including “there are no rules except the ones you make”, “establish your absolute limits”, affirm your values, “identify what’s most important for you” and “tough love is neither, and it feels bad to all”.

The packed meeting room was inspired by Carol sharing how her lived experience inspired her to advocate for impacted families by creating a space to powerfully speak the truth to the powers that be in the broken treatment-industrial complex.

Barry gave an overview of the work of FSDP and shared how family and friends can become empowered by being open to reality-based harm reduction information and sharing it with peers, planting seeds of hope in their communities.

Our dedicated team was on hand to welcome attendees at our exhibit table continuing the conversation, networking and providing conference attendees with educational materials, tutorials and resources.

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Thank you Juan Fernandez Ochoa for sending us the Support Don’t Punish t-shirts. They were a big hit!

The 2018 Harm Reduction Conference comes at a time when harm reduction, health care, and drug policy reform have entered a dynamic and critical phase. The prescription opioid and heroin overdose epidemic has captured national attention, with renewed focus on transmission of HIV and Hep C among people who use drugs. These trends are reshaping the policy and public health landscapes, making harm reduction more urgent and relevant than ever before.

Because of your ongoing support, we are bringing our communities together, empowering families, restoring health and saving lives!HandDonate

Welcome Family Drug Support USA This Giving Tuesday!


GT Tony
GivingTuesday is a global day of giving fueled by the power of social media and collaboration.

Celebrated on the Tuesday following Thanksgiving, (November 27 in the U.S.) and the widely recognized shopping events Black Friday and Cyber Monday,

FSDP is excited to announce that starting at 5am PST on November 27, Facebook and PayPal will contribute a total of $7M to partner with our stakeholders and match any donation to your designated nonprofit of choice! Giving Tuesday is a not to be missed opportunity to help us support more families by bringing Family Drug Support USA to communities across the nation. Our Facebook friends can also have their gifts matched by using the fundraising for nonprofits option on Facebook for which includes birthday fundraisers and the donate button feature

As a mother, Carol Katz Beyer, who has been personally impacted by the devastating loss of her two children Bryan and Alex, was inspired to co-found Families for Sensible Drug Policy with Barry Lessin to regain control of our families’ health by collaborating with our stakeholders to implement a new paradigm of care and support based on compassion, science, public health and human rights.

Please read this heartfelt message from Tony Trimingham to learn more about Family Drug Support:


“When someone dies as a result of illicit drugs, it is estimated that on average they lose 35 years of their lives (compared to 5 years for nicotine and 15 years for alcohol). Not only does this rob the person of a chunk of their life, it has a massive impact on their family. When my 23-year-old son died from a heroin overdose, not only did I experience profound grief and shock, there was excruciating pain and a massive impact on me, and all my family. If I could get to sleep (which was rare) I would dream of him being alive, then I would wake up to the nightmare. I found myself breaking down on an almost daily basis, and simple everyday tasks became difficult.

 My wife and friends who were suffering their own grief had to cope with my not coping. I would hear his voice in public places and thought I saw him walking along the street. For the first 6 years after he died this level of pain continued and it took a long time before I was able to smile again and enjoy the normal things in life. It is now 21 years and while the pain has subsided and is not as acute, there isn’t a day go by where I don’t feel sad, and miss my son. I have missed out on conversation with him, possible grandchildren, and seeing him progress through life. I have had similar conversation and reflections with hundreds of other families who have lost people, and suffer the same anguish. For this reason, Family Drug Support believes that keeping people alive and safe is the first priority when it comes to dealing with problematic drug use.

In my work with Family Drug Support, I have spoken to more bereaved families in the last six months than I have in the last six years. This is because of the increase in the use of legal opiates, and also because street heroin is back on the radar. The truly sad fact is that these deaths, along with those at music festivals from taking pills, are completely preventable.”

Family Drug Support Training is an opportunity to work directly with Tony Trimingham in an experiential workshop learning specific skills using harm reduction principles and the psychological approach of motivational interviewing to deliver support to those in need. People that successfully complete the training will be able to bring this peer to peer support to their communities.

Please click here for more information about Family Drug Support USA

Meet Tony Trimingham in this video describing the workshop.

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Our families desperately need your help and we urge you to join us as part of a long term solution that will keep our loved ones safe, connected and plugged in to the services that will keep them alive. A watershed moment reflecting our nation’s most significant public health disaster, requires that we as a nation embrace a multi-tiered and realistic approach towards prevention, education and access to healthcare services.

Your donation no matter how big or small helps save lives by forwarding our mission to deliver the message of harm reduction to communities around the world. Please help us reduce overdoses and empower families by educating and advocating for progressive solutions for family support based on science, compassion, public health and human rights.HandDonate

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Sign up HERE to receive our newsletter stay informed on the latest news and events.

Thanks so much being a valued friend to our community. Your generosity and support is  really appreciated and will help make our family voice be heard.

“Love Has No Labels: The Rise and (hopeful) Fall of Tough Love in America?” — Part 2

Welcome to the August 2018 edition of Family Matters – Families Matter, our new blog authored and curated by FSDP’s Guest Blogger–pioneering harm reduction therapist, educator, advocate and author Dee-Dee Stout. To learn more about how your family can join our growing community of enlightened friends and advocates sign up here now.tyler-nix-525388-unsplash

Last month we started our discussion of “tough love” and its origins. This month we’ll continue this look at this well-known and used concept to see if it really works and is the most effective strategy for families who love someone who misuses drugs.

We’ve discussed Synanon and its use of harsh confrontation and “tough love” in treating drug use problems. We’ve looked at Al-Anon and its concept of “letting go with love” and seen that what that often looks like is anything but love – though setting limits is important, too. Also, we’ve discussed how this concept of “tough love” isn’t just bad for helping drug users make changes but also bad for loving family members. We also talked about the difference between gaining or giving approval versus love. Finally, we looked at what more pain does for drug users: encourages them to use more, not less. So, let’s pick up the conversation here, starting with more on harsh confrontation.

You may have questions by now and I’m going to try to guess what some of them are and provide answers here. 1) Is tough love the same as harsh confrontation? The answer is yes! 2) I thought treatment is supposed to break through the denial of a person addicted to substances? The answer is no, that’s actually more likely to harm clients especially those with other underlying mental illnesses including trauma. 3) Don’t people who use drugs problematically need to be shown what a mess their lives are and how they’ve hurt others, such as their families? Again, the answer is no, they’re fully aware already and are usually extremely ashamed of their lives and behaviors even though families may not see this.

By the way, these are all reasonable questions to ask. Let me suggest, as many experts in the field do, that we look at how we treat other chronic medical conditions. Let’s take diabetes for example: when one has diabetes and is reliant on medication, do we complain that they are “addicted” to insulin? Of course not. We’re happy that there is a medication that can help them live a more full and healthy life. But with medication-assisted treatments (MAT) we hear negative comments (Narcotics Anonymous (NA) has made their views clear in their official pamphlet on MAT) such as how folks are just trading one drug for another; that they aren’t really “clean”. Here in California, our Department of Health Care Services has informed treatment providers that they expect us not to ask clients to engage in activities that we wouldn’t ask of those with other chronic health conditions such as diabetes. So, for instance, would we ask someone with diabetes to list their character defects that may have led to their illness? Of course not. Would we ask them to hold hands in prayer around a circle? No again (while any individual may find this helpful, we wouldn’t consider this professional treatment). We certainly wouldn’t put a toilet seat around their necks and tell loved ones to throw them out of the house for eating less healthy foods! But these are all deemed reasonable treatment approaches to addiction to many in our profession even today. (This calls for a lengthier discussion on addiction that I’ll do in another installment)

As I often do, I got out the dictionary to view some definitions of these 2 words as I prepared to write. Using the online version of Merriam-Webster’s (M-W) dictionary, I found “tough” means durable, strong, resilient, sturdy, rugged, solid, stout (I couldn’t resist!), long-lasting, heavy-duty, industrial-strength, well built, made to last. And what of love? “Love” is defined by M-W as “unselfish, loyal and benevolent; concern for the good of another.” Love is further defined as “an assurance of affection.” An assurance of affection. Wow. In my experience with “tough love”, there was absolutely none of that. In fact, withholding affection/love is at the crux of “tough love.”

So if these 2 words are polar opposites, how did they come to occupy the same space in our heads and in our common lexicon? As stated previously,    the phrase “tough love” was originally used by therapeutic community programs such as the former Walden House in San Francisco and DayTop Village and Phoenix House in NYC and continues to be used frequently today (just Google it to see for yourself). Using this concept of tough love, parents were encouraged to check their troubled teens into wilderness camps and behavior modification programs to deal with their kids increasingly frustrating and sometimes dangerous behaviors. And parents absolutely mean/t well; they were at a loss as to how to control their “out of control” teens. Plus they were listening to the so-called experts tell them, “you have to stop coddling your kids; you need to get tough with them – show them who’s boss.”

My own parents tried to do this with me when I was 15 or 16 (It backfired. I filed for legal emancipation and won. However, my relationship with my parents and siblings was forever damaged, as was I). It would seem that the concept of tough love is really about control. And when did control become synonymous with loving?

“Tough love” is also often associated with criminal activity or with children. In other words, if you’re a person who uses drugs problematically – or a criminal or a child – our society says using tough love is acceptable. The thinking is that in any of these three instances the person you’re using “tough love” with is incapable of learning any other way; their behavior must be controlled for their own good. In fact, the definition according to an old book we used to use in addiction treatment and studies called “Addictionary” (by Judy and Jan Wilson, 1992; Hazelden) “tough love is a phrase that describes behavior to stop enabling addiction. When you refuse to cover up for an addict, to rescue them, or to prevent them from experiencing consequences of their addiction, that is tough love. It is loving of the person but tough on the disease.” But is this true? And is this the most effective treatment modality? Perhaps the best question is who does the concept of tough love harm? I’d argue that tough love harms everyone involved – and that often once used, it damages relationships beyond repair.

But it works sometimes, right? I guess that depends on your definition of “works.” Can you get your loved one to behave or not behave in a way that’s acceptable to you? Probably, with enough threatening and coercion. But again, that’s not love. And it usually isn’t helpful for those of us diagnosed with a mental illness or substance use disorder (or chronic pain condition). In fact, Johann Hari, in his book “Lost Connections” argues that disconnecting from loved ones (as parents and partners are often told to do) who are “misbehaving” is typically the worst thing a parent or partner can do; losing connections to love – friendships, enjoyable activities such as sports, pets, and more — is often the exact scenario that is ripe for addictive behavior and other mental illnesses to thrive in, to fill the void left by the withholding of love and affectional bonds. I know I can definitely relate to this.

Now let’s be clear here: I’m not saying that limit setting is unnecessary. Of course, it’s necessary. Limit setting is part of being a responsible parent and, sometimes, a loving partner. But the most important piece is that when you set limits with someone, you do so with unconditional love and appreciation for the other person.

You listen to their ideas, negotiate, and you have this conversation–this is crucial–when you’re not emotional. Once again, the time for limit setting is BEFORE the undesired behavior occurs, not afterwards (when limit setting is done after the behavior occurs, it’s called ‘punishment’). There are exceptions, which again each family must work out for themselves (this is the work of family or couples treatment/therapy). Bottom line, when dealing with the problematic drug-use of a loved one, yelling, screaming, throwing out their alcohol or other drugs, etc, isn’t helpful to anyone.   And it certainly isn’t loving behavior.

Now let’s be clear here: I’m not saying that limit setting is unnecessary. Of course, it’s necessary. Limit setting is part of being a responsible parent and, sometimes, a loving partner. But the most important piece is that when you set limits with someone, you do so with unconditional love and appreciation for the other person.

OK so what about the idea that “addicts” must be shown what a mess their lives are and take responsibility? Well, I can tell you that I was aware every moment that my life was a mess when I had a substance use disorder as we now term the condition. There was no need to show me how bad things were. In fact, whenever I got a glimpse of the mess that was my life, I wound up using more to cover the pain and the shame. This is a typical response we see in many problem drug users. Lastly, let’s look at how tough love confronts personal responsibility. The tough love that my family of origin gave me did two things: 1) made me more ashamed and reluctant to try to change (if it’s my fault and I’m such a fuck up, why bother trying to change?); and 2) ruined any chance of a healthy family system because my family couldn’t look at what they may have contributed to my life of addiction (no I don’t blame them). Most of the “mess” or “unmanageability” as 12-Step would describe it, are problem behaviors of illicit drug users due to the illegality of most drugs of misuse. When drugs are illegal, drug users must go to places to get drugs where they are likely to be put in danger, risking rape and other physical harms, as well as jeopardizing their freedom by being caught by police with the results often being arrest/jail/prison, especially if you happen to be black or brown. Plus, drug users tend to use more in these circumstances than they would in safer locations, and they overdose more often. More on this in future segments.

So here we are at the end of this discussion on “tough love”. And I hope I’ve shown that tough love doesn’t look much like love at all. Instead the concept appears to be all “tough” with “control” at its core. Think of it this way: with positive reinforcement (think B.F. Skinner and others), I reward you for positive behavior (coming home on time) by giving you something you want (perhaps an extended curfew on one night) and set limits regarding less positive behaviors (think staying out after curfew) but I do this BEFORE you are late. And I do this when I’m not emotionally raw. If I wait and give you “consequences” for your undesired behavior, then I’ve punished you. That does not lead to positive behavior change. It leads to controlling with fear. Also, too often we fail to couple “consequences” with any kind of reward for the positive behavior. And when that consequence is withholding love and affection, well, can you see where this could lead to increased drug use? Not what anyone wants. But now we’re “woke” and can see while it isn’t what I wanted, it is expected. This denial of love and affection leads more people to have a (another?) traumatic experience and we know trauma and addiction – and other mental illnesses – tend to feed off each other. I am sure that this is not the outcome that any parent – or partner or loved one – wants for their child/partner/loved one.

So what have I learned – and what do I hope I’ve shared with you all here on this topic of “tough love?” Here are my Top Four “Take Aways” from this discussion:

1) Perhaps the most important take away is this: I hope I’ve made the case that we as a culture need to stop treating the concept of “tough love” as something positive and healthy. I’m optimistic that I’ve shown how inaccurate and horribly damaging to individuals and families tough love actually is, too;

2) That the concept of tough love really means that this concept is tough on all of us: drug users and loved ones/families alike. Like my own unrepaired family of origin, I have seen so many that will never recover from this so called “treatment intervention/sign of love.” Nothing could be further from the truth;

3) That what we really need instead is a concept let’s call “love AND limits,” meaning there is no limit on our love – ever – and (not “but”) we human beings have limits, too: on our time, our resources, our finances, and more. That’s called life and should always be negotiable and honest.

4) We can no longer afford to use a tired, inaccurate, corrosive concept such as “tough love” to (hang in here with me ok?) “excuse” us from the task having difficult conversations about hard topics with people that we love, what I’m calling “Compassionate Conversations.” What do I mean by this? I mean we must begin the work of having conversations that are about deep, profound, empathetic listening to one another, conversations that seek to really understand.

Today it seems that the conversations we typically have with loved ones – especially with drug users – are ones with agendas to get them to stop using. So, what’s the worst that could happen if we could truly let go of our old agendas and just listened? And just for the record, I’m not suggesting that we should agree with how our loved ones view something or how they behave right now, but rather I’m suggesting that our conversational goals change from getting-them-to-do-something-I/we-want to one of astonishing appreciation: of their views, their perspectives, their reasons for using/behaving in less than healthy ways. Let us decide that gaining compassion will be our attending agendas in these conversations.

Our world today is filled with rhetoric (with few real conversations) that is siloed and dishonest, cut off from reality, and full of prejudgments and predetermined agendas. Sadly, when we act from these values, we do so from fear–fear of losing power, fear of not being accepted, fear of losing our place in the world, fear of losing our loved ones to drug use and more. But when we push forward incorporating these fears rather than fighting them and force ourselves to see what is and become “woke” as the modern vernacular states, we have opportunities galore to change our relationships to ourselves, to our loved ones, and to the world. We learn how to say things like, “I love you more than anything AND I’m uncomfortable/unhappy/it’s difficult being around you when you’re loaded/high/under the influence. But when you’ve come down/sobered up/are able to moderate, let’s have lunch/dinner/go to that movie we’ve talked about.” Or how about, “I really love spending time with you when you’re emotionally available to me/us/the family/yourself.” I realize these “compassionate conversations” aren’t dramatic so they won’t make for good “reality” television, however they do make for good, healthy, strong relationships in real life. Plus research shows us these types of conversations are also more likely to help encourage positive changes toward healthier behaviors for everyone.

So, let’s tip “tough love” into the collective trashcan and from our collective vocabulary. Instead let’s work towards an agenda/belief of “love and limits” through “compassionate conversations.” Frankly, after all the pain caused to us all from using “tough love”, just how much harder can this new way of being really be?

#stopthestigma #recoverywithoutabstinence

In honor of September being Recovery Month, don’t miss next month’s edition: Reinventing Recovery

 

Join Us for International Family Drug Support Day 2018

Please join us with friends, families and coworkers in commemorating International Family Drug Support Day (IFDSD) 2018 with our global partners across the miles.

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The 1st National Family Drug Support Day (IFDSD) was held on February 24, 2016–the anniversary of the passing of our good friend Tony Trimingham’s beloved son Damien from a drug related overdose. Tony, the founder of Australia’s Family Drug Support, partnered with FSDP to bring IFDSD to the United States in 2017 and the day has now become an annual international event to highlight the need for families like ours to not only be recognized and heard but to be supported and encouraged to speak about their concerns and their needs.

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Thanks to all of the amazing participants who came out strong to make last years event a huge success! We are excited to unite old friends and welcome new ones, as we invite everyone to host a gathering—large or small–and raise awareness in your communities. Watch and share this important video about IFDSD with a heartfelt message by Tony.

THIS YEAR’S THEME IS #SUPPORTTHEFAMILYIMPROVETHE OUTCOME

The objectives of IFDSD are to:

  • Reduce stigma and discrimination for families and drug users
  • Promote family drug support services for families and friends
  • Promote harm reduction strategies for families and friends

In addition, the following issues will be highlighted:

  • The important role of FDS and FSDP volunteers in providing family support in the US, Australia, and the world
  • Reducing fatal and non­fatal overdoses from drugs including pharmaceuticals
  • Promoting the widespread availability of naloxone
  • Promote greater inclusion of family members in the decision making process for families experiencing problematic drug use
  • Promoting greater support and resources for treatment services for those who want it and need it

HERE’S WHAT YOU CAN DO FOR YOUR EVENT:

  • Be an ambassador for change in your neighborhood by raising awareness within your community
  • Request to meet with your local schools, doctors, political representatives, law enforcement and clergy and we will provide you with a tool kit and promotional materials to support you in your advocacy. Talking points for communicating with the public are here.
  • Invite friends, family or coworkers to share an informal gathering over food or coffee to share discussion and voice the issues.
  • Call your local state and federal legislators. To locate your US representative click here. Talking points for communicating with the legislators are here.
  • Host a harm reduction workshop
  • Invite stakeholders to participate in a naloxone training
  • Promote IFDSD on social media: #SupportTheFamilyImproveTheOutcome

All participants will receive a personal event page that will showcase your organization and identify you as a supporter of this important event.

We welcome your ideas so please feel to be as creative as you like. For more information of to forward your ideas please contact Barry Lessin barry@fsdp.org or Carol Katz Beyer carol@fsdp.org

Your tax-deductible gift will directly help fund our community-based events and reach more people to reduce stigma and discrimination for impacted families, promote better access to treatment and drug support services and encourage wider distribution of naloxone that will reduce fatal and non fatal drug overdoses.

We need your help to make sure that the voices of families continue to be heard. We invite you to stand with FSDP in our battle to empower families, restore health, and save lives.HandDonate

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 Your tax-deductible gift no matter how big or small will help us to forge ahead and change the way our policies and society interact with our families.

FSDP Celebrating Life: A Town Hall with New Solutions for the Opioid Crisis

Please join FSDP co-founders Carol Katz Beyer and Barry Lessin, Team FSDP and our partners–The Center for Optimal Living, Harm Reduction Coalition, The New School, International Network of People Who Use Drugs (INPUD), New York City Department of Health and Mental Hygiene, New York State Psychological Association’s Division on Addictions, and VOCAL-NY—who are representing our families to demand solutions based on a new paradigm of healthcare that provides a comprehensive continuum of care with multi-tiered strategies that empower families with reality-based solutions.

celebratelife_townhall (FINAL)We are privileged to be represented on the panel of representatives from the fields of public health, psychotherapy, community engagement, public policy, and The New School’s Student Health Services who will present their perspectives on the impact of opioid use, the opioid crisis, and how to reduce the number of overdoses.

We will also be training attendees in overdose prevention strategies and naloxone kits will be provided to those who wish to receive them.

Following an overview of the current opioid use patterns and overdose rates in New York, we’ll discuss the programmatic work that is being done to address the multiple challenges associated with this issue. We’ll hear from people who work with active drug users as well as current and former people using drugs contributing to the panel discussion. In addition, treatment professionals will describe an integrative harm reduction approach to working with people using drugs.

Overdose deaths are preventable and we shouldn’t be punished for making progress in our in our path to optimal health and well-being! Lives will be saved when we shift our thinking about treatment to complement and support public health overdose prevention strategies. A harm reduction-informed continuum of care linking harm reduction strategies to the full array of effective substance use disorder treatments needs to be integrated with overdose prevention efforts.

Families impacted by substance use deserve the best care available. Every other medical condition is guided by best practices and we expect nothing less. We are in the best position to help our loved ones and we demand the information and services required to give us the best chance for successful outcomes.

This event is open to the public and is free of charge.

FSDP and Our Global Partners Bring a New Paradigm of Family Drug Support to the United States

Our heartfelt presence at The International Harm Reduction Conference #HR17 in May 2017 was a springboard for a dynamic and thought provoking weekend: A celebration of family empowerment that filled attendees with enthusiasm and hope, while offering enlightened strategies, tools, and opportunities for advocacy.

Day 1: Workshop on Peer-Led Family Support Model18664623_1720713967945235_3219150813966158127_n

The two-part weekend that followed was an expansion of our global partnership including Liz Evans and Mark Townsend (not pictured) of New York Harm Reduction Educators (NYHRE) and Washington Heights Corner Project which featured a workshop introducing Tony Trimingham’s Family Drug Support (FDS) model (in center at right with Barry Lessin and me) and an international panel discussing the life-saving value of Supervised Injecting Facilities (SIFs).

Our families have a vital role in the development and resolution of how substance use impacts their home—for far too long our families have not been afforded the opportunity to engage as active participants and problem-solvers. The weekend offered a new paradigm of support for families impacted by substance use.

18581706_10102491791666402_8890817018380267324_n-3The weekend events, highly lauded by a passionate gathering of family members and clinicians, were a milestone for FSDP, allowing us to offer our vision of tangible support for families, based on what families need, expect and experience. This model of support helps families better understand and strengthen the connection between ourselves and loved ones who use substances. The peer-led support groups present viable alternatives for families to explore potential solutions and coping strategies.

Day 2: International Panel about a Public Health Response Proven to Save Lives: Supervised Injection Sites (SIFs)

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We were delighted to have CNN political commentator Symone Sanders (at right, between Liz and Tony) emcee the gathering at the Malcom X and Dr. Betty Shabazz Memorial and Education Center in Harlem. It was a moving interactive presentation before a diverse and engaged audience. The featured presentations were delivered by harm reduction pioneers Tony and Liz, who poignantly shared their own personal stories reflecting the inspiration that led them to do their groundbreaking work that included establishing successful SIFS in Sydney and Vancouver, respectively.

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Evidence from years of research is conclusive that SIFs reduce HIV and hepatitis transmission risks, prevent overdose deaths, reduce public injections, reduce discarded syringes, and increase the number of people who enter drug treatment. Across the globe, there have been no reported fatalities from an overdose in an SIF.

Personal Relevance

My own personal journey as a parent and healthcare advocate was inspired by the compelling and relatable perspectives shared during the presentations, as I too am a mother who is devastated by the recent loss of my precious son and student of the world, Bryan.

Bryan’s life parallels many young lives who, despite a loving relationship with a beautiful new wife, a supportive family in his corner and an amazing circle of friends who believed that laughter was the best medicine, his valiant attempts with sustainable periods of time in and around “recovery” were ultimately circumvented by much of what does not work about a ‘one size fits all’ model. Far too many young lives are tragically being lost to an accidental and fatal overdose that is preventable!  

My own perspectives and belief system came full circle from the early days when our families were first indoctrinated to the mantra of the addiction professionals champing for ‘hitting bottom’ and ‘detaching with love’ as the remedy. Despite a decade-plus of extensive and ongoing attempts by my own family to embrace the recommendations of the traditional treatment industry, our personal situation continued to implode on a downward spiral of pricey interventions, therapeutic wilderness programs, and exorbitant rehabs that over promised and under delivered.

Myths like encouraging us to use the criminal justice system, or advising us that advocating for our child’s well-being essentially reduces us to ‘enablers’ and ‘codependents’, only exacerbated the family issues and compromised health rather than supported it. If only we had the opportunity to turn our focus to empowerment and safeguard our loved ones with viable medical models during those times that they were in active addiction. Many people with problematic substance use have little or no access to evidenced-based care, or simply were not ready or able to embrace a path that was limited to abstinence-based recovery.

Our families deserve person-centered screenings and alternative solutions that meet them where they are with the goal of optimal health and wellness based on individual needs and unique circumstance.

Stay tuned to learn about more of our upcoming events as our momentum moves forward towards the Fall, where we will be representing the voice of the family at the 2017 Drug Policy Alliance Reform Conference.

 

Representing the Voice of the Family at the 2017 International Harm Reduction Conference #HR17

C_DNaZxXgAAUhpMRepresenting our family voices in the global harm reduction community, FSDP Co-Founder Barry Lessin and I enthusiastically attended the 2017 International Harm Reduction Conference #HR17 in Montreal, Canada, May 14-17, 2017.

The theme of this year’s conference was ‘At the Heart of the Response’ and addressed “innovative harm reduction services, new or groundbreaking research, effective or successful advocacy campaigns and key policy discussions or debates. With delegates from more than 70 countries the programme not only reflects the truly global nature of our movement but also addresses key international issues”

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We had the opportunity to meet with our global partners Australian Family Drug Support (FDS) powerhouse Tony Trimingham (right) and Shaun Shelly (below) to identify the issues that are unique to families and bringing the family voice into our home communities. The inspirational and motivational moments were continued with a dynamic and thought provoking celebration of family empowerment that culminated in New York City May 20-21, 2017 with an extraordinary weekend filled with enlightenment and hope. Barry and I are energized and privileged to bring the FDS model of family support to our cherished friends here in the United States. We remain humbled and honored to serve our growing network of families who are asking for non judgmental alternatives to support optimal health and well being for their loved ones impacted by substance use while managing their own needs and self care in the process.

FSDP AC_9Zk_UUwAAB1qWdvisory Board member Shaun Shelly (whom we got to meet in person for the first time!) explaining the challenges and successes in his groundbreaking work in harm reduction service delivery to his native South Africa.

One of the highlights of #HR17 for many of the attendees was the dynamic presentation given by Andrew Tatarsky (right) on “The Scientific Revolution of Addiction Treatment”, exploring how his model os Integrative Harm Reduction Psychotherapy 18558570_1716762775007021_2210259828598535816_o(IHRP) can enhance harm reduction services and make addiction/substance misuse treatment relevant to the majority of problematic drug users who have been turned off or hurt by traditional abstinence-only treatment.

18527769_1714581398558492_4107739766811187219_nPausing to honor the dedication and commitment of our global partners, appreciating the connection and spirit of compassion shared among cherished friends like Zeeshan Ayyaz Shani, who sadly could not attend because of visa related obstacles. Paying tribute to his courageous advocacy and extraordinary efforts on behalf of drug users in Pakistan through his exemplary work with Middle East and North Africa Harm Reduction Association (MENAHRA).

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Barry and Tony discussed the new collaboration of Tony’s Family Drug Support model of family support and FDSP’s commitment to bring strategies and solutions into the homes of our families!. Below, Tony joins me, Deborah Peterson Small, who spoke at a morning plenary on the global priorities of drug policy, and Ernie Drucker, valued mentor to FSDP and author of “A Plague of Prisons”. 
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Stay tuned for more about FSDP’s next steps in our collaboration with Tony’s Family Drug Support to empower families, restore health and save lives…

FSPD brings a Weekend of Family Empowerment to the United States

TFDS NYC Workshphe inspirational and motivational moments shared with internationally acclaimed Family Drug Support founder, Tony Trimingham at the International Harm Reduction Conference in Montreal, Canada #HR17 will continue with a dynamic and thought provoking celebration of family empowerment next week in New York City with an extraordinary weekend filled with enlightenment and hope. 

When: May 20, 2017, 10am to 4pm

Where: Center for Optimal Living, 370 Lexington Ave, Suite 500, New York, NY.

FREE Sign up herehttp://support.bpt.me/

Our families have a vital role in the development and resolution of how substance use impacts their home—for far too long our families have not been afforded the opportunity to engage as active participants and problem-solvers.

We remain humbled and honored to serve our growing network of families who are asking for non judgmental alternatives to support optimal health and well-being for their loved ones impacted by substance use while managing their own needs and self care in the process. Attendees will learn how to become ambassadors for your community by implementing a new paradigm of support for families impacted by substance use by becoming a Family Drug Support meeting facilitator.

The FDS model has enjoyed much success over the last 20 years because it presents viable alternatives for families to explore potential solutions and coping strategies. It introduces reality-based concepts and tools based on what families need, expect and experience.

The concepts are based in harm reduction approaches of meeting families where they are, listening and understanding, changing language, dropping labels, stages of change for drug users and their families. coping with positive changes and challenges, while challenging your triggers and assumptions.

This workshop, co-hosted by FSDP, Family Drug Support, Center for Optimal Living, New York Harm Reduction Educators (NYHRE), and Washington Heights CORNER Project.

We are energized and privileged to bring the FDS model of family support to our cherished friends here in the United States and are busy working behind the scenes in preparation to launch our inaugural family support meeting!

Weekend Part 2

FDS SIF event rev

Last year almost 54,000 lives were lost as a consequence of accidental overdose. Many of these deaths could have been prevented by ensuring that our loved ones had access to a full continuum of care that is rooted in science and compassion. Our families deserve person-centered screenings and alternative solutions that meet them where they are with the goal of optimal health and wellness based on individual needs and unique circumstance

Co-sponsored by FSDP, Family Drug Support, Center for Optimal Living, New York Harm Reduction Educators (NYHRE), Washington Heights CORNER Project, Students for Sensible Drug Policy and Community Insite, join us at a FREE panel including International harm reduction pioneers Tony Trimingham and Liz Evans and others, presenting life-saving alternatives to public injection and overdose from other countries

When: Sunday, May 21, 2017, 11:30am

Where: Malcom X and Dr. Betty Shabazz Center, 3940 Broadway, at 165th St, NYC

FREE Sign up here: http://opioidresponse.bpt.me

Evidence from years of research is conclusive that Supervised Injection Facilities (#SIFs) reduce HIV and hepatitis transmission risks, prevent overdose deaths, reduce public injections, reduce discarded syringes, and increase the number of people who enter drug treatment. Across the globe, there have been no reported fatalities from an overdose in an SIF.

A preponderance of evidence also shows that clients of SIFs are more likely to go to detox and quit injection drug use over time. SIFs increase access to lifesaving services and restore some of the humanity and dignity that drug users deserve by offering them a safe place to access medically supervised care and other related services.

“If synthetic opioids are in fact becoming the new norm in terms of distribution and consumption, then drug checking and supervised injection sites ought to become the new public health norms too.” — Rick Lines, Executive Director of Harm Reduction International #HR17.

FSDP embraces enlightened drug policies to empower families, restore health, and save lives..

#FSDPSaysOurFamiliesDeserveSIF’s