What: Rally to Demand Cuomo Apologize, Sign Lifesaving Bill!
In preparation for International Overdose Awareness Day, join the Families for Sensible Drug Policy and the New Jersey Department of Health for an interactive Harm Reduction Workshop!
Date: Wednesday, August 21
Location: War Memorial 1 Memorial Drive, Trenton, NJ
As NJ DOH explains that “Harm reduction is a life-saving, evidence-based public health tool for New Jersey communities.”
FSDP President Carol Katz Beyer will be in attendance and is honored to be representing the family voice at the event. She will join national experts and local leaders about how harm reduction can prevent overdose deaths, reduce drug-related stigma, decrease transmission of HIV and Hepatitis C, and promote the dignity and health of all people with substance use disorder.
REGISTRATION IS FULL. PLEASE EMAIL: HretEducation@njha.com to be added to the waitlist.
Welcome to the Spring 2019 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.
I have been a Star Trek geek for as long as I can remember. This infatuation even rubbed off on my son who designed the current World Tour stage for the multi-award- winning mega-band Muse to be shaped like a Klingon Bird of Prey. I never quite understood my fascination with all things alien, watching the new Star Trek Discovery series week after week in tears. Really?? Crying over a TV show, and a sci-fi show no less?? Well, after some 50 years of dedication and fanaticism, I think I figured it out:
To borrow a phrase: it’s the future, stupid. The past is finished, complete, even if I do mine it reasonably often, still attempting to understand things as they unfolded oh so long ago. There is wisdom that has come from that exercise as well as some futility. But it’s the future that really does it for me, makes me weak-in-the-knees excited & emotional all at once, like the old roller coaster The Big Dipper in Santa Cruz does every time I ride her. And the relationships, the dedication, the incredible sacrifice and love emanating through every episode brings my heart into my throat with regularity. That all makes me desire to keep going – which some days is a monumental feat I will admit briefly – as I see real possibility for us all, the Human Race. And besides, if a Vulcan can ask for forgiveness (Sarek, in Part 1 of the second season’s finale) who am I to not give such a gift to myself and my families: both the one of chance and the one of choice? It appears this is the work of my future, the work of ‘Change to Come’.
And so we’re onto Change for this month’s blog. And here’s where I’ll begin…
Change is about leaving what we know behind, jumping into the abyss of the unknown just as a starship jumps into warp drive. Never knowing what’s on the other side should be exhilarating for me (Remember? Rollercoaster lover?) and yet it’s always filled me with fear & uneasiness. I’m still here though, alive – as are many others who shouldn’t be – and that’s all due to this thing called Change and those who have ridden this wave with us all.
“Most people never get a chance to learn what’s in their own hearts. If we figure it out it’s often not what we expected, or even what we would have chosen for ourselves.”
—Capt. Christopher Pike, 2019; Star Trek Discovery, episode 13
What’s in my heart? I wondered when hearing this line of dialogue. As so many others have too, I have studied several religions at various points in my life. My first exposure was as a child when I was baptized in the Congregational church of my maternal grandparents, and then as a grade school-age youngster in my family’s home (in Midland, MI) at the United Church of Christ (UCC) which they helped to build. I am proud of the heritage of the UCC as a church of social justice and inclusivity. Even at the height of my drug use, my minister refused my mother’s request that I not be allowed to attend nor teach at the church. He believed in me and the idea that Change could only happen in a place of love & inclusion. He also preached that God was not something outside of ourselves but rather inside of each and every living thing. Finally, he told us that our church was about ‘accepting the unacceptable’ of society (that belief is partly what drew me early on to helping problem drug users ironically). I also recall as a teen wishing to become Catholic as I saw many of my drug using friends able to attend confession each week which they believed absolved them of their “bad behavior” as well as allowed them to repeat it the following week. To me, it simply appeared that Change for them was easy – and I was jealous.
In the pagan Wiccan traditions, every season brings Change of a new variety. As we leave April and head into May, the Wiccan calendar moves to celebrate the festival of Beltane. This date is also known more commonly as May Day. It is a time for birth and renewal: pastel colored eggs to signify fertility; a Maypole around which songs are sung while long ribbons twirl while celebrants dance around the phallic symbol of the pole, and rituals around fertility, crop blessings, and romance abound. After a long hard Winter, Spring brought promise to our ancient people’s here; a promise from someone, somewhere, that they had not been abandoned nor forgotten.
I see Change as a promise to us too: a promise that no matter what, nothing will ever remain the same; all will be well; don’t worry, be happy! Within addiction, this is ultimately the challenge as there often seems little to be happy about when things turn bad. When I was using drugs problematically, I see now that a good part of my reasoning was to keep things the same, status quo. That provided me with ritual, some strange stability, and again ironically, a sense that I always knew what to expect. As a person with a history of trauma, I yearned for something to keep me centered, something expected. It’s also what kept me in violent/abusive relationships. I recall saying out loud finally that I understood that “to know something – even something violent – was better than leaping into the unknown.” Some people believe that those of us who remain in these violent relationships do so because they’re comfortable, that we become comfortable with the abuse. I disagree. I say we become familiar with it and that’s the point: it is better to stay with what we know v be so terrified that Change could be worse. That’s how frightened we often are of Change. IT is the enemy. It is the same with addiction: fear of Change can keep us from trying something new.
And this leads me to the topic of families and the people they love who problematically use drugs. We all resist change to some degree. To some degree we would rather stay in the status quo, in the familiar, than take a risk into the unknown – “to go where no one has gone before” – or perhaps we’d simply prefer that someone else makes the Change and not us. But this isn’t how Change works!
Recently a post from my dear friend and colleague Andrew Tatarsky (Board member at FSDP) came through my Facebook feed, which Andy had reposted from a colleague apparently having a conversation with Dr. Gabor Mate, the renowned trauma & addiction expert and author. Much like my beloved Star Trek it, too, has left me in tears each time I read it. I hesitate to repost this dialogue here for fear of offending people reading this blog. But I am going to take that chance and hope you will hear the hope and joy and see the “Way Out” – as our Brit neighbors wittily call an exit – as I unexpectedly did after reading it. Bring the hankies. Here goes:
“We weren’t quite finished yet. I wanted to know about family members who are dealing with addiction. What can they do for a loved one who’s caught in the grips of active addiction? Because when people are that deep in addiction, they’ve lost themselves—they’re gone in a way. I know I was. I know there was nothing my family could have done no matter how much they wanted to.”
Gabor didn’t agree with me. “You don’t know that. What you do know is what they tried didn’t work, but you don’t know that there’s nothing they could have done. In one sense, you are 100 percent right: There’s nothing they can directly do to change your mind. There’s nothing they can directly do to change your mental status. There’s no way that they can talk to you, advise you, control you, beg you, accuse you. That does not mean there’s nothing they could have done. Imagine if your family had come and said, ‘Chris, here’s how it is. We recognize that your addiction is not your primary problem. Your primary problem is that you’re in a lot of pain. And that pain is not yours alone. That pain has been carried in our family for generations. And we’re as much a part of that pain as you are. You’re just the one who’s soothing it with that behavior. In fact, you’re the one whose behavior shows us how much pain there is in our family. Thank you for showing that to us. So we’re going to start working on you, because we realize that we’re as much a part of it as you are. We’re going to take on the task of healing ourselves. We invite you to be there if you feel like it. And if you’re not ready, sweetheart, then just do what you need to do right now.”
“Families also have to decide, can I have this person in my life, or can I not? If I want them in my life, there must be certain rules, like they can’t steal from me and so on, but if I can have them in my life, I must accept them exactly as they are, exactly where they’re at, and 100 percent accept that right now they’re using because they feel they need to. I’m not going to nag them, cajole them, advise them. I’m not going to say a thing that they didn’t ask me about. I’m just going to accept that this is who they are and I’m just going to love them. That’s a rational decision to make. It’s equally rational to say, ‘You know what? It’s too painful for me. I can’t handle it. I can’t stand to see you do this to yourself. It’s too stressful. I can’t be with that, so I’m sorry, I love you very much, but I can’t be with you.’ That’s legitimate, too.”
“What is completely nonsensical—and unfortunately the pitfall for most families—is to try to be in the addict’s life and try to change them all the time. That’s the one thing you cannot do. So either accept or lovingly distance yourself, but don’t try to stay in there with the intent of altering the other person. To the addict, that signals only one thing: ‘They don’t love me the way I am.’ That’s my advice to families. I do believe that addiction in a person can be a healthy wake-up call for them and for everyone in their lives.” — Dr. Gabor Maté, Dead Set On Living
Change, especially when we look at addiction(s), sure isn’t linear; not even close. In fact, even the theorists behind the Stages of Change now use a spiral model rather than their traditional wheel. Me? I’ve always seen Change more like a pinball machine, and I’m no wizard: you know, one minute you’re over here, the next down there, and a moment later, ding, ding, ding! It’s unknowable, it’s exciting, and it’s scary as hell. That’s the Change I know…and I am finally just beginning to like Change rather than fear and respect it like an overbearing & abusive parent. Bottom line: it always happens whether I like it or not!
If I may, this seems like a good point to insert briefly the 7 Stages of Change (SOC) as they apply to any Change you might want to make, and of course I will provide you with references for more on them if you wish (apologies to anyone in the know here. Feel free to skip this next part): precontemplation, contemplation, preparation or determination, action, maintenance, termination & relapse/recycle. In a nutshell, here’s the definition and task of each stage (please keep in mind that these stages aren’t linear; remember – pinball!!)
Precontemplation: When my behavior is in this stage it means I can’t see it as a problem so I’m unlikely to see a need for change (think the old idea of denial). Perhaps my family, friends, or employer is seeing a problem in my behavior. So here the main task is to increase my awareness of the need to change – to help me/someone recognize that the cons of not changing are greater than the pros of change.
Contemplation: This is the stage of thinking (insert Rodin’s The Thinker). I see my behavior as being a possible problem but I’m not ready to commit to making a change. Ambivalence lives here. Think of this stage as “well, maybe I should make this change but…”
Preparation or Determination: When my behavior is in preparation, you’ll know because I’m planning out the needed resources, discussing how and maybe even why I want to make this change. I might even begin to take baby steps toward my healthier self.
Action: In action, I’ve moved forward and state my intentions to keep on that path toward healthier living. Any positive change is the key here.
Maintenance: Since I plan to maintain my change in this stage, I will need to work on recognizing obstacles and other speed bumps to my continued Change path.
Termination: For the researchers, this stage was noted by the problem behavior being eliminated for at least 6 months. This stage is often left out of behavioral health programs (including rehabs) however as many don’t believe this stage is reachable. I believe this concept deserves review, and that “termination” should be viewed personally and individually. For myself, I do believe my former addictive behaviors with alcohol and other drugs is done, finis, over with, hasta la bye bye. I have all sorts of other problem behaviors to continue to work on but not those. Others will likely feel more comfortable with termination being left out of the Spiral of Change.
Recycle/Relapse: The researchers decided that the term relapse wasn’t good enough as it isn’t accurate for most people making Change. This is because to relapse means to go back to the beginning, in this case to precontemplation. And while some people will indeed return to precontemplation, most will instead recycle back into one of the other pre-action stages.
Spring appears to have finally come to the Bay area. While we are all grateful to not have to endure yet another year of horrendous drought, we are equally grateful to get a respite from the torrents of rain that have devastated communities throughout our Golden State recently. Even as I write this, we are being warned of a touch more showers coming tomorrow, hopefully the last spurts for the wettest April I recall in my 40 years here. Spring is a natural time to think of change: flowers blossom; mice mate and dogs give birth; the seasons shift as our little Blue Marble of a planet tilts on its axis once again. Like the seasons, Change is both predictable and unpredictable at the same time: the only thing we can be sure of is that nothing will remain the same and that Change happens, constantly and without permission. I can accept that or not but like the moonrise, it will happen everyday in spite of my feelings about it. So will my Change. I will continue to change and grow because to do otherwise will be more painful. This I now know for sure. So, I will make room for the Change in the same way as the philosophical cat Garfield says so brilliantly: “Everything I’ve ever let go of has claw marks all over it!” No one said I have to Change gracefully. And I will wait to cry one more time at Part 2 of the final episode of this Star Trek series season to begin my long winter of wait for the next season to begin. And the next season, and the next Change, will come gratefully – both for my beloved Star Trek and for all of us, if we can just hang on to each other a bit longer. Let the adventure continue…http://centerforoptimalliving.com/.  The Transtheoretical Model (TTM) of Change was developed by the Drs. James Prochaska, Carlo DiClemente and John Norcross. For more, please see their academic websites: https://web.uri.edu/psychology/meet/james-prochaska/; https://psychology.umbc.edu/people/corefaculty/diclemente/; https://www.scranton.edu/faculty/norcross/  See “Changing for Good” by Prochaska, DiClemente & Norcross.  There are a lot of good sources for SOC materials. Here are a few standouts: https://www.lifehack.org/676832/stages-of-change-model; “Changeology” by John Norcross; “Changing for Good” by Prochaska, DiClemente & Norcross; “Changing to Thrive” by Drs. Prochaska.  Thanks to my friend, the late Dan Bigg, founder of the Chicago Recovery Alliance (CRA) for this simple phrase. For more on CRA, go to https://anypositivechange.org/
Welcome to the February 2019 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, with her exuberance and energy, explains why International Family Drug Support Day means so much to so many of us…
Join us in honoring International Family Support Day on February 24, 2019!! Please follow us on Facebook and check out our website at fsdp.org for more information.
Hello everyone and happy 2019!!
I’ve had a remarkably busy start to the New Year as perhaps some of you have as well, meaning there was no blog for January. My apologies! As the Lunar/Chinese New Year just passed, it seems a good time to discuss the new partnership between FSDP and Family Drug Support Australia. Having attended the engaging and insightful training in NYC with Tony Trimingham (www.fds.org.au) at Dr. Andrew Tatarsky’s Center for Optimal Living site, I want to speak about the work of both these organizations as we prepare to commemorate International Family Drug Support Day (2/24). This date is important to Tony personally as this is the date his own son, Damien, died of a drug-related overdose in 1997 (see https://vimeo.com/249347700 for more from Tony). Each year Tony and his team have chosen a topic on which to focus. This year it’s #SUPPORTTHEFAMILYIMPROVETHE OUTCOME.
31 years ago when I began my journey into traditional recovery, there was family support built into the rehab I entered. There was even a program for my young son, Jesse, though that program was an additional fee. But the Family Program, which met every Saturday during my treatment stay, was vibrant! In those days, the family was too often seen as part of the problem however (think “enabler” and “codependent”, labels I would never use today though many professionals still do). Today we know that family support is crucial to long-lasting change to happen for those with problem alcohol and other drug use.
Families have lacked support in their struggles and in daily living with those they love with problems using drugs (including alcohol). International Family Support Day is one way to highlight the need for families like outs at FSDP to not only be recognized and heard but also supported and encourage to speak out regarding their concerns and their needs, including the needs of their loved ones with problematic drug use. One saying that I love is this: “If my family member had died of cancer or heart disease or a car accident, neighbors would be bringing me a casserole. Not so with addiction.” We at FSDP say we want to see casseroles!
One of the biggest and fastest growing areas of family work in addictions is the notion that abstinence doesn’t have to be the final goal. In my world, I call this Harm Reduction Recovery™ (HRR). Recovery without abstinence is entirely possible but it does require thinking out of the norm! HRR can be a goal to itself or perhaps it’s a stepping stone on one’s path to abstinence – or something in between. Families see that the most important first goal is keeping their loved one(s) alive. That means for many families, requiring that they throw their loved one out when they exhibit the very symptoms we want them to seek treatment for is no longer an option. As my aunt (who’s taught me a ton about families, addiction, and harm reduction) said, “He’s my child. I’m not going to be able to sleep at night worried that he’s not only using drugs but now he’s alone on the streets. I don’t need more to worry about; I need less.” More and more families are speaking out against easy “solutions” like exiting their loved ones. They’ve come to the realization that my aunt did: throwing your loved one out may not be the best solution. In fact it may increase your own stress and add more trauma to all involved which doesn’t lead to a reduction of drug use. In fact, it often leads to an increase. We have learned that the opposite of recovery isn’t harm reduction but rather zero tolerance (and tough love). And we will NOT enable these concepts to rule us anymore.
Speaking of tough love, refusing to participate in this concept is another area of growth in family addictions work. We’ve learned through research that many problem drug users are using alcohol and other drugs to soothe trauma(s) they have experienced in life. Addiction is definitely enabled by, if not always directly caused by, trauma(s). We also know that having a trauma history can be a barrier to seeking help (lack of trust; fear of others’ judgments; lack of confidence; distrust of healthcare professionals, and more). Therefore again, if we want our loved ones to seek help, we must be willing to reduce/do away with as many barriers as possible. Demanding abstinence can be a huge barrier; insisting that problem drug users “hit bottom” is a re-traumatization which also increases barriers. Families are converging and demanding better for their dollars from rehab providers and other professionals. We at FSDP are behind them all the way!
Families for Sensible Drug Policy (or FSDP) was founded by Barry Lessin, a therapist working in the addictions field, and Carol Katz Beyer, a mom who lost 2 of her 3 young adult sons to drug-related overdoses. She knows a thing or two about what it’s like to change your approach to drug treatment/rehab and drug users! As we head into International Family Drug Support Day (IFDSD), here are a few things Carol and the gang at FSDP want you to know about this special day:
The objectives of IFDSD are to:
- Reduce stigma and discrimination for families and drug users (bring on the casseroles!)
- Promote family drug support services for families and friends (all treatment needs to include all players)
- Promote harm reduction strategies for families and friends (no more tough love or zero tolerance)
In addition, the following issues will be highlighted around the world by all participating in this event:
- Establishing 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
- Promoting 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 – and appropriate alternatives for those not yet ready
For more on what you can do in your area – or if you have an idea of your own – please contact Carol Katz Beyer at email@example.com.
The take-away: please join us this year on February 24 to honor International Family Drug Support Day in any way that feels right to you. I’ll be lighting my candle that night for all those using drugs problematically and their families of chance and/or choice, as well as those lost to this complicated condition we call “addiction”. I’ll also be saying a “thank you” to my son, Jesse Lee, my late former husband (Bob) and my late in-laws (Rhett & Faren) for their constant, unconditional love and support while I developed a path to recover me. I’m also lighting my candle for my friends who were with me in the beginning and those who are with me now and those who will be with me in the future. Without them all, I would not be here and for that, I will always be grateful and will continue to work for the voice of all in addiction to be heard and honored. Support the Family, Change the Outcome. It’s a recovery revolution and the time is now.
 Let me define “family” here: One type is the family you’re born into which I call your “family of chance.” The other is the one you create which I call your “family of choice.” Sometimes they are the same of course. The important point is that you need not have a “family of chance” present, but you must have a family of choice then. All humans need community in some form as we are social beings. How much and what kind is up to the individual.
A long-awaited milestone for Families for Sensible Drug Policy of bringing a new paradigm of support for families impacted by substance use occurred last month when Tony Trimingham, founder of Australia’s Family Drug Support, came to the United States and trained our first group of family members and professionals from across the United States at a sold-out workshop in Family Drug Support USA.
Family Drug Support USA, co-hosted by our friends at the Center for Optimal Living in New York City, is a program of innovative non-judgmental, peer-led support groups with solutions and strategies that encourage self-empowerment by recognizing each family as unique. It will provide our families with an opportunity to access much needed community support and connection 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.
We were humbled by the interest of the attendees in learning the model and impressed with their passion and brilliance in their shared experiences. Family members and advocates from diverse communities attended the training to bring the groups home, planting seeds of harm reduction and hope. It was a remarkable weekend, tangible evidence of our mission to bring communities together to embrace enlightened drug policy–empowering families, restoring health and saving lives.
The workshop was in two parts: On Friday night was “Support The Family Improve The Outcome”, an introduction to the Family Drug Support model providing an in-depth overview including harm reduction tools and coping strategies. Saturday and Sunday was a two-day intensive training, which afforded participants an opportunity to work directly with Tony 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.
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.
Our commitment to making the family voice heard will continue on February 24 as we bring communities together to commemorate International Family Drug Support Day, (IFDSD) a global event which aims to highlight the need for families impacted by substance use to not only be recognized and heard, but to be supported and encouraged to speak about their concerns and needs in drug policy.
To learn more about what you can do for IFDSD, please…
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.
Last weekend, January 11 to 13, 2019, presented an exciting opportunity for Families for Sensible Drug Policy and the Center for Optimal Living to embrace a new paradigm of support for families impacted by substance use when we welcomed the founder of Australia’s Family Drug Support Tony Trimingham, who led a sold-out weekend workshop training for attendees from across the US in the Family Drug Support model. Family Drug Support USA brings innovative non-judgmental, peer-led support groups with solutions and strategies that encourage self-empowerment by recognizing each family as unique.
The workshop was in two parts: On Friday night was “Support The Family Improve The Outcome”, an introduction to the Family Drug Support model providing an in-depth overview including harm reduction tools and coping strategies.Saturday and Sunday was a two-day intensive training, which afforded participants an opportunity to work directly with Tony 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.
This long awaited milestone for FSDP will provide our families with an opportunity to access much needed community support and connection 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.
Our commitment to making the family voice heard will continue on February 24 as we bring communities together to commemorate International FamilyDrug Support Day, a global event which aims to highlight the need for families impacted by substance use to not only be recognized and heard, but to be supported and encouraged to speak about their concerns and needs in drug policy.
Welcome to our Holiday Special Blog, the December 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, in her own inimitable style, shares some essential tips to navigate the holiday season in empowering ways…
To join our growing community of enlightened friends and advocates sign up here now.
Hello all! Here we are at the end of 2018 – and of my blogs for this year! Thank you all for your support and your readership! I have truly appreciated all the comments and shares over these past few months. And I’ve discovered just how much I love to do research on these topics!
In the past five months we’ve talked about the dangers and origins of Tough Love; recovering the word “recovery;” and Harm Reduction strategies for families. I know I promised 12 “Ways to Get Through the Holidays” but you know, I found myself doing only 10, perfect for counting on both hands! I hope you won’t be too disappointed. Most importantly, remember our 2018 take away for all families and their loved ones through this sometimes treacherous time:
It really is all about the love – and love is never tough!
So, who knows what the new year will bring. I know I’m eager to see 2019 and I haven’t felt that way in a long time. For the New Year, what ideas and suggestions do you have for new topics and conversations? Please write to me at firstname.lastname@example.org and let me know. See you all next year!
Holy Holidays, Batman!
Holidays. I love them and hate them.
And regardless of which camp you fall into – or perhaps you’re in the “in between” camp – the winter holidays can be a challenge to navigate, especially when there’s added drug use (yes, I mean that tasty eggnog or rum punch too) by many involved. As I sit here with all my research and ideas in front of me, it occurs to me that I can’t think of anything to add to an incredible list of “do’s and don’ts” already available all over the internet and social media.
But that said, perhaps it’s worth revisiting some ideas with a “reduction-of-harm-to-all” bent – and so here goes (OK to sing your fave holiday tune along to these 10 tips, too. Ho ho ho!).
1. Eat light
One of the best tips we can use is to save those heavy conversations for another time. Sure, there will be exceptions to this, but the holidays are already such a heavy meal in so many ways that experts suggest benching the Big Convos until after things have settled down, including our stomachs. So what’s one thing we can do to lighten the mood?
Perhaps we can simply focus on the positives this season and save the less positives for later. That’s a tip for all seasons according to CMC’s 20 Minute Guides for Parents & Partners. What do we mean by this? Think of finding positive things – called “reinforcers” – to say to your loved ones – family, friends, and those using drugs problematically. And here’s why: “The value in reinforcing positive behavior…is that it can start to compete with the reinforcing effects of drugs and alcohol. In essence, your [loved one] can learn to “feel good” in other ways rather than using drugs/alcohol.”
John Gottman, the famous couples therapist, has stated that we need a “magic ratio” of 5 positive statements for every 1 that we make to someone. Dr. Gottman and his team successfully predicted divorce with 94% accuracy in 700 couples 10 years after scoring their negative-to-positive responses in one 15-minute conversation. That’s pretty darned “magic” indeed. We see similar results in workplace conversations as well. So lighten up on the negatives and accentuate the positive statements this holiday season. You might see a greater gift than you ever expected
2. Hang out in the bathroom
This is something I suggest to those trying to reduce or eliminate their drug use as a place to be alone and use a quick meditation. (side note: I realize that for some this can also be a triggering place for both families and their loved ones using drugs so like all good suggestions, please use your discretion as to whether any of these are right for you). But this is also a terrific exercise for anyone to use for a quick fix. This exercise is known as “The Ball and Triangle.” I learned it from the developer, Terry Gorski, back in the 90’s. And it can be done anywhere, with your eyes open or closed. Here it is:
To start, take a deep breath in through your nose and out through your mouth, like a big sigh. Now imagine there’s an equal-sided triangle floating in space in front of you. In one corner of the triangle there’s a small ball, just sitting. On your next inhale, move the ball up the side of the triangle. On your exhale, allow the ball to fall back into its original place. Do this until you feel as relaxed as you desire.
There are many ways to get creative with this brief meditation too so feel free to experiment; make it your own.
3. Just like real estate: it’s all about location, location, location
One thing that I hear from families and their loved ones is that the location of the festivities is important. Some places encourage nostalgia though may also bring up tension. It may be helpful to discuss the location of events with the whole family. See how everyone feels. I have found with my own family that eating out at a local restaurant can be wonderful: a) everyone’s food intolerances can be honored; b) most folks will be on their best behavior when in public and finally c) no one has to do the dishes! Perhaps grandma’s or dad’s special chocolate pecan pie at Aunt Cristina’s house can be an alternative.
4. BYOB: Bring your own bottles
Even if you’re not the one with the drinking/other drug problem, it might be a good idea to limit your intake. The very best way to do this is to first, bring your own fave beverage. I’m a big fan of Pellegrino so typically carry a couple of bottles with me (I even bring a baggie of lime slices). That way I know what will be served. If you’re moderating your drinking especially, it’s really important not to get dehydrated which is easy to do in a heated room with booze. So experts suggest drinking water between alcoholic beverages. Again, an easy way to reduce your intake – and possible help stave off a nasty hangover too. Be sure to eat something as drinking on an empty stomach is never advised. Also food will help to absorb some of the alcohol which will keep your overall blood alcohol levels down. Finally since alcohol is known as a “social lubricant” for good reason, you might consider who you’d like to be in charge of your emotional state during this event (see # on Lizard Brain). But if you want to indulge more than usual, remember the previous tips and to call Lyft this holiday season. It’s so easy not to drive while intoxicated now – and expensive to get caught.
5. Find support where you can
Hug your pet. See old friends. Go to a meeting at a support group, or a service at your local synagogue, church, temple, or mosque. Volunteer and make new friends. Lots of ways today to stay in touch with others even if only through social media. Visit someone in a nursing home or senior housing. Take a plate of cookies to a neighbor you’ve never met because you’re working all the time (no, they don’t have to be homemade).
6. Like a good photograph, mind your exposure.
If you’re spending time with those that irritate you, do so gently. It’s OK to limit the time you’re with those you love. This is your holiday, too.
7. Rest when you can
For many of us, the holidays are an expenditure of more energy. Sometimes more than we can muster! So resting and sleeping well are crucial to having the outcomes we want. You can think of rest as our body’s need to regenerate its resources to allow us to think before we eat, act, or wind up somewhere we didn’t want to go. I’ve learned that I can’t engage my mind when it’s running on empty, which leaves me with Lizard Brain in control. Now I’m OK with old Lizard Brain having some fun once in a while but not all the time and especially not when I’m going to be in an emotionally challenging situation
8. Cravings aren’t just for drug users
Yes, you heard me right! I like to think of cravings as the body’s way to say “Holy crap, Batman, I need something – help!” The difference for families is that there aren’t any medications for your cravings (and yes I know there aren’t meds for all chemical cravings too but let’s ignore that for now). You may have physical or emotional cravings for all sorts of things from food to the latest mystery to taking a ski weekend in Banff. Whatever it is, it’s just possible that your body/mind is trying to tell you something. We want to learn from our emotions and not be afraid of them or ignore them. We all know the holidays are overfilled with stress so perhaps we can take a page from relapse prevention for drug users and learn to “urge surf”. Here’s how to do it. And you can keep your eyes open or closed them as you find most comfortable:
First, think of something in your real life that’s challenging for you, something that actually triggers some strong emotions (be gentle with yourself here though. Nothing too tender please!). As you think about this challenging behavior or event, imagine that you’re NOT reacting in the moment with that usual strong emotion (you’ll be responding to the situation soon). As you’re thinking about this event, be mindful of where you’re sitting: how does it feel? Are you comfortable? Plant your feet gently and firmly on the floor if you’re sitting. Let your breath gently come in and out of your nose and notice the rising and falling of your chest/lungs. Now once again, think about the triggering circumstance. Really see yourself there at the moment and bring yourself right up to the moment that you’d typically lose your temper, or be overcome with sadness, or even use a drug/take a drink. Here we might think it’s a good idea to push away these strong emotions or swing the opposite way and give in to the emotion/behavior. Instead, I’m going to ask you to just be curious about this emotion and event without reaction. Ask yourself these questions: 1) what does the feeling really “feel” like? Where is it located in your body? 2) what about this situation/feeling feels intolerable? Can you stay with it and relax into it rather than get overwhelmed by the situation/feeling? 3) what is it you really need right now?
Finally, imagine that the feeling your experiencing is a wave on an ocean. You’re riding this wave like a surfer, using your breath as your surfboard. All you need to do right now is focus on your breath going in and out of your lungs and imagine that surfboard riding the waves like Bethany Hamilton! You’re able to keep your balance in spite of feeling a little frightened. Up and down, in and out, you’re riding your board; you’re not allowing the wave to push you off. This is “urge surfing”.
When you begin to feel relaxed and able to respond instead of reacting to a situation or feeling, you can let the board bring you home. Notice how you were able to ride the wave and not succumb to its power but rather allow it to be what it is: just a wave…and it will end. When you’re ready, come on back to the room while you let go of the triggering situation you were thinking of. Take a few deep cleansing breaths and know that you’ve got this! Bethany would be proud!
9. Ho, ho, ho!
I always encourage humor and lots of laughter during the winter holidays (actually I encourage it all the time!). Laugh till your face hurts. Be silly as often as possible. I read a piece recently on a family holding an “Ugly Christmas Sweater” contest with the winner getting a gift card to a favorite store. Wonderful idea! We humans are a pretty funny lot all in all and this is the perfect time of year to embrace that.
Movies are another great way to bring laughter into a room and there are some terrific old and newer holiday films that will make you pee your pants (in my family, it’s “A Christmas Story” hands down!). Anything from “The Grinch” and “Charlie Brown Christmas” to “Bad Santa” and “Die Hard” are considered holiday fair game. Or perhaps you’re the sentimental type and look forward to watching your favorite heart-wrenching, tear-jerker each holiday. No problem! Those films are available as well (anyone for “It’s a Wonderful Life” or “White Christmas?”). Just be sure to temper those tears with some belly laughs
10 The holidays are a trip!
And they are literally for many of us! Traveling these days can be a trial-by-fire experience. Some quick tips: 1) Only use a carry-on bag 2) Bring something to read/watch/play and 3) slow down on imbibing early (planes really suck the moisture out of every part of us and alcohol makes it worse). For more excellent tips on everything “travel” this holiday season, check out Cheap Flights Survival Guide: www.cheapflights.com/news/holiday-season-travel-survival-guide
Bottom line for the season: Do your best, let go of the guilt/shame, and have as much fun as possible. That sounds like a pretty good recipe for 2019 to me, too. In fact, I think I’ve just found my 2019 New Year’s resolution. How about you?
 The Parent’s 20 Minute Guide by CMC: Center for Motivation & Change. (2016) Center for Motivation & Change. NY, NY. p93.
 https://www.ocde.us/PBIS/Documents/Articles/Positive+$!26+Negative+Ratio.pdf. Accessed 12.18.2018.
 https://terrygorski.com/2014/05/08/magic-triangle-relaxation-method/. Note: the Ball and Triangle exercise is now called the Magic Triangle Relaxation Method. Accessed 12.18.2018.
 The limbic system aka Lizard Brain is the seat of our emotions and the oldest known part of our brains.
 Bowen, S, Chawla, N. & Marlatt, G. (2011) Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician’s Guide. Guilford Press. NY, NY.
FSPD is excited to announce our partnership with The Social Exchange, a brainchild of the brilliant Zach Rhoads and Aaron Ferguson.
The 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.
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.
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.
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, “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,  (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:
“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” (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.”
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” 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:”
- Promises only cause problems
- There are no rules except the ones you make
- You cannot enable drug use (unless you are supplying them)
- Base your actions on your values
- Base your actions on what you can manage
- You have triggers too
- 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, 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 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.” 
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?
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. 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 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” 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 – 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.” 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! 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.
(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.”
 Ibid. Accessed on 9.26.18.
 Denning, P & Little, J. (2017). Over the Influence, 2nd Edition. Guilford Press. NY:NY. p221.
 Ibid. p13-14.
 Denning, P & Little, J. (2017). Over the Influence, 2nd Edition. Guilford Press. NY:NY. p221.
 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%.
 https://www.fds.org.au/newsletters/letter-to-family-and-friends (accessed 10.22.2018)
 https://en.wikipedia.org/wiki/Transtheoretical_model (accessed 10.22.2018)
 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/
 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 was privileged to have co-founder Carol Katz Beyer invited to participate on an international panel of experts at the Rutgers University School of Law on October 31, 2018. Randy Thompson, founder of Help Not Handcuffs hosted the discussion on “Drug Decriminalization: The Triumph of Human Rights and Health over the Drug War”
Randy Thompson, founder of Help Not Handcuffs, in conjunction with The Open Society Foundations (OSF), The Rutgers Criminal Law Society and the Rutgers Public Interest Law Student Association, coordinated the event featuring Dr.João Goulão, the Portuguese Drug Czar, Kasia Malinowska, Director of the Global Drug Policy Program at OSF, Tess Borden, Staff Attorney for the ACLU-NJ and Carol Katz Beyer of FSDP as speakers.
What was detailed was nothing short of amazing! Portugal, which decriminalized all drugs has almost non-existent overdose deaths. In Portugal, harm reduction is so well developed that it is significantly reduced overdose deaths and the spread of HIV/AIDS and HepC; and they provide superior treatment on demand for those who want it, at less than 1/10th of the cost to taxpayers compared to the New Jersey system
Kasia engaged Dr. Goulão in a conversation and he brilliantly articulated the history of how the Portugal model came to be. He illustrated that change is possible when the goal is to elevate society through the lens of public health with strategies and solutions rooted in compassion and science.
Tess detailed the egregious human rights violations that the US policies of prohibition and criminalization are inflicting on families.
Carol eloquently elucidated the issues and harms that our families needlessly suffer as a consequence of the war on drugs as well as recommended public health solutions. Carol said, “I cannot express enough how privileged I felt to be present in the company of Dr. João Goulão who articulated so poignantly what transformative solutions in drug policy reform look like”.
Immense appreciation and thanks go to Randy, who did a tremendous job organizing this important event and skillfully moderating. There was a robust Q and A afterwards as audience members representing Rutgers law students, healthcare professionals, and community members.
I cannot express enough how privileged I felt to be present in the company of Dr. João Goulão who articulated so poignantly what transformative solutions in drug policy reform look like–FSDP co-founder Carol Katz Beyer.
Because of your ongoing support, we are bringing our communities together, empowering families, restoring health and saving lives!