The holiday season can be tough for many, especially those experiencing homelessness, trauma, and mental health and substance use challenges. Marc Dones shares his tips for supporting family and friends living with substance use disorders during the holidays and throughout the year.
- Don’t Talk About “Choices.”
As Christmas and the New Year draw closer, many people living with substance use disorders (SUDs) are hearing a familiar refrain: “Make good choices over the holidays.” This is less helpful than you may think. While it certainly can be difficult to get through the holidays when folks around you are engaging in behaviors you’re no longer able to, “choice” has little to do with it.
Substance use disorders are chronic diseases affecting powerful mesolimbic circuitry in the brain. These diseases are compulsive disorders similar to obsessive-compulsive disorder or compulsive gambling. People living with SUDs don’t use substances to feel pleasure—they use them to feel relief. If you have trouble imagining the difference, think about being given a piece of candy in contrast to removing a nail that had been driven through your hand. Different, right?
To be helpful during the holidays—and all year long for that matter—focus on prevention planning. Rather than saying, “Make good choices,” ask, “Have you put together a use prevention plan? If not, is that something we can do together?”
Identify strategies for not using when the person experiences craving. For example, if he or she finds cooking to be relaxing, suggest spending time in the kitchen preparing meals. If time passes more quickly for him or her when reading, suggest a trip to the bookstore to splurge on some new reading materials. The holidays are filled with triggers for using and relapsing. By identifying strategies like these in advance, you can reduce the potential of harm.
- Adapt Family Traditions.
Many people think about how best to support loved ones over the holidays—especially if they are beginning a journey of recovery and are unable to have alcohol or other substances for the first time.
Many families may not know how to coordinate a meal. Do we serve alcohol and if so, how do we relate to a person in recovery? While family dynamics can be difficult and are unique to each situation, a good rule of thumb is to think of SUDs in the same way you think about other chronic conditions such as diabetes or asthma.
We would never say: “Well, we generally have ice cream with this dessert, but since Jim is diabetic, we have decided not to serve it.” Why? Because it embarrasses Jim, makes it seem like he’s the reason we are depriving others of ice cream and like there is something shameful about his illness. Instead, we can say, “There’s ice cream in the kitchen for those who would like it!” Maybe Jim isn’t the only person who can’t have ice cream. Maybe the kids shouldn’t be having ice cream because of its high sugar content. If you wouldn’t say it about someone with diabetes, don’t say it about someone with SUDs!
- Remember that Words Matter.
In this post I haven’t used the terms “addict” or “addiction.” Instead, I have referred to people living with a substance use disorder. This is a deliberate choice. Many words are stigmatizing and can be hurtful. I encourage you to adopt the term “person living with a substance use disorder” instead of “addict” or “addiction.”
Person-first language describes the problem as a disease—not a choice or a moral failure. It separates the two in the same way I would say, “Person living with HIV.” These changes in our language are more than symbolic; they impact the way people think and interact. The more we shift away from stigma-laden words towards language that highlights the problem as a disease that people have to live with, the more we are likely to empathize and be supportive.
SUDs are powerful illnesses requiring that we work together to eradicate the stigma and shame so that everyone can get the help they need and deserve. Share your tips for supporting people with SUDs during the holidays and year-round!
Learn more from Marc during t3’s course on Opioid Overdose Prevention (Tuesdays, January 12-January 26 from 2-3:15 PM ET)!