Signs, Secrets and Symptoms

When my phone rings, it's not just crummy news. Often, a heartbreaking event has occurred. Like last week, a woman called crying: "I came home from the hospital, I'd been quite sick and there he was, drunk again, wearing nothing but my housecoat! Before I knew it, he had a knife to my throat."

That caller was a 67-year-old grandmother from the Midwest describing the irrational behavior of her husband of 42 years, a retired physician. Her family was outraged by the news and demanded he get help. Although her husband's problems had been smoldering for years, it wasn't until the flames became impossible to ignore that she sought help. Why did she wait so long to act? There are a few reasons: Dr. Robert Friedman, medical director at Seabrook House treatment centers, reminds us that families all too often protect the addicted by keeping up appearances: "Many families have a culture of secrecy. We all have such busy lives, we're moving so fast and have our hands full with managing our schedules. So it's all too easy to let what's unpleasant, hard to bring up and talk about get swept aside."

People also wait for things to work themselves out. One study has found that it takes friends and family, as a group, seven years to admit there is a problem. That's eighty-four months! Wait, worry, pray. Repeat. You hope things will just resolve themselves, but you have a sinking feeling the situation is just getting worse. And you're right.

The sad truth is most addicts struggle in plain sight. We see them, we share their pain. And when that "last straw" occurs—a car accident, an eviction notice, an obesity-related stroke—that escalates a life into crisis, it's rarely the case that those gathered around didn't see it coming. It's simply that they didn't want to acknowledge the problem or they didn't understand that addictions rarely work themselves out.

Next: 4 telltale signs of abuse

If you're concerned about someone in your life, consider these telltale signs:

Isolation: Is your once-close daughter suddenly unreachable and uncharacteristically out of touch? Does it seem like she has stopped returning calls or emails for weeks on end?

Extreme irritability: Has your dear old Dad transformed from Dr. Jekyll into Mr. Hyde? Do minor snafus send him over the edge? Does he strike the family dog just for being in the way? Fly into a rage when the car in front of him is going too slow? Seem antisocial when he once looked forward to visits from the grandkids?

Shifts in sleep patterns, energy and motivation: Does your best friend seem tired and distracted all the time now? Has she lost her spark? Does she seem to be gaining weight? Is she no longer interested in going out and making plans with you? Is she deeply in debt or lying about how much money she spends on unhealthy habits?

Increased dependency on drugs of alcohol: This may seem obvious, but social drinking or prescription drug use may have become an addiction if your love one seems unstable or unable to function until she has a stiff drink or pill to steady nerves. Have you increasingly heard desperate statements such as: "I need my Xanax," or "I need my Klonipin", "I need my glass of wine and I'll be okay" or "Just get me a drink and give me a minute"?

If the person you're thinking about seems like a changed person, it's because she truly is. You need to understand that dependency on something to self-soothe is an affliction of the body, mind and spirit—and it has a neuro-physical base. Over time, the habitual user has transformed her central nervous system and her brain chemistry in such a way that perpetuates the cycle and the disease. At that point, impulse control has gone out the window.

What I find really alarming is there are an estimated 22 million Americans who are struggling with addiction and only 3 million who seek help for it. Part of the resistance to seeking help and change is that we have a broken, hurried healthcare system. For instance, some doctors would rather prescribe quick-fix pills for a patient's anxiety, sleeplessness, difficulty focusing and fatigue rather than help them reduce and relieve it.

I am not issuing a condemnation of all doctors or medical institutions—far from it—but here's an interesting development in the ongoing legal case of model Anna Nicole Smith that outraged me. It illustrates what we are up against.

Next: The epidemic of drug use

On September 22, 2010, the Associated Press reported that Dr. Perry G. Fine (Dr. Fine! I know, I know!), a pain medication specialist, testified in an Los Angeles courtroom that Anna Nicole, who died in 2007, was not an addict, though she had been given prescriptions amounting to 1,500 pills (which included various opiates and muscle relaxants) in a single month.

Many see Anna Nicole's case as a personal tragedy—she lost her life and left her infant daughter motherless. That is very, very sad. But abuse of prescription medication is the number one problem keeping my HelpLine ringing off the hook, more than alcohol or drugs, and dwarfing food problems.

Abuse of doctor-prescribed medications has ripple effects that put us all in danger. A prime example is the alarming increase of reckless drug-drivers: people who drive under the influence of prescription meds that impair their vision, reflexes, depth perception, motor coordination and response time—all key elements to safety on the road. "Drug driving is epidemic." Seabrook House's Dr. Friedman explains. "It's a combination of dissociation and sense of entitlement that allows someone who abuses prescription drugs to get behind the wheel. It's a bigger problem than drunk driving, because there's more awareness that you shouldn't drink and drive, while most people think nothing of popping a few doctor-endorsed pills before heading out on the road."

There's another reason drug drivers get a free pass: There is no foolproof way for law enforcement to test for that impairment. There isn't yet the equivalent of a Breathalyzer test for pill poppers. When a drunk driver is pulled over and instructed to "blow, buddy, blow," the numbers don't lie.

The friends and family I meet who want to help their addicted loved ones are stuck in slow-motion (or no-motion) because they believe they lack the knowledge, money and even the "perfect" relationships that allow a frank, honest discussion of the problem. As I mentioned, it takes most families about seven years to admit there's a problem and another two years—nine in total!—before they build up the courage to act.

If you're concerned about someone but you're not sure how serious the problem is, ask yourself: What do I know for sure? What do I suspect? What does my heart confirm?

How often does your friend or family member who struggles with chemical dependency withhold truth, under-report the story or outright lie?

We all have a beautiful built-in Secret Response Unit, which I call "the tug." This tug is that gut feeling that lets you know something is not quite right. The tug is important: Many addicts will die while family and friends decide what to do. Don't ignore the tug. Respond as it grows stronger.

There are all kinds of secrets involved in addiction—many of them harmful—but there is one that is important: You are the one you have been waiting for to help yourself and the ones you love. You have the history, connectedness and love to break through the crisis, the stalemate. From where you stand, you may act with loving and powerful purpose. Respond as a family, as a group. There is strength in numbers. You can breathe life into hope, make change begin and become the miracle you've been praying would arrive.


Brad Lamm is a board-registered interventionist and regular guest on The Dr. Oz Show. He is an author of How to Change Someone You Love and the upcoming How to Help the One You Love: A New Way to Intervene.

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