J Subst Abuse Treat. 2022 Oct;141:108839. doi: 10.1016/j.jsat.2022.108839. Epub 2022 Jul 16.
This personal narrative describes our family's struggle with my adult son's substance use disorder (SUD). Years of traditional tough love treatment programs worsened his SUD and our relationship. When he experienced drug induced psychosis and was hospitalized, I realized I needed to change my approach and understand his behaviors.
I reached out to the recovery community and spoke with many individuals who had walked in my son's shoes. They described feelings of loneliness, self-loathing, and hopelessness while being on the receiving end of tough love. They further described the contrast between those negative feelings, and the life affirming hope associated with communication, empathy, and inclusion. I became inspired to research programs that are based on communication, science, and connection, rather than isolation, judgment, and punishment.
Family and community are powerful tools and can motive change. An evidence-based program called CRAFT (Community Reinforcement and Family Training) encourages relationships and teaches families skills to connect with their loved ones by effectively communicating and reinforcing positive behaviors, even in the context of unhealthy behaviors. Receiving praise for healthy behavior, recognition for good work, or even a positive acknowledgement for taking baby steps toward self-care can activate the same dopamine-producing reward system as drugs. Individuals with SUD can learn how to feel good in ways that do not involve using substances. Traditional patient-focused treatment programs, which encourage separation, punishment, and distance should not be considered the only approach to treatment.
Loved ones are not powerless. While we can't make a person change, we can contribute to making them want to change. We have more influence than we once thought possible and need to proactively seek out empirically supported family-based programs that reinforce these approaches.
这篇个人叙事描述了我们家庭与我成年儿子药物使用障碍（SUD）的斗争。多年来传统的严厉爱治疗方案恶化了他的 SUD 和我们的关系。当他经历药物引起的精神病并住院时，我意识到我需要改变我的方法并理解他的行为。
我联系了康复社区，并与许多与我儿子有过类似经历的人交谈。他们描述了在接受严厉爱时感到孤独、自我厌恶和绝望的感受。他们进一步描述了这些负面感受与沟通、同理心和包容所带来的充满希望的生活之间的对比。我受到启发，开始研究基于沟通、科学和联系而不是孤立、评判和惩罚的计划。
家庭和社区是强大的工具，可以促进改变。一种名为 CRAFT（社区强化和家庭培训）的循证计划鼓励关系，并通过有效沟通和强化积极行为，教会家庭与亲人建立联系的技能，即使在不健康行为的背景下也是如此。对健康行为的赞扬、对良好工作的认可，甚至是对自我护理的积极认可，都可以激活与药物相同的产生多巴胺的奖励系统。患有 SUD 的个体可以学习如何以不涉及使用物质的方式感觉良好。传统的以患者为中心的治疗方案，鼓励分离、惩罚和疏远，不应被视为唯一的治疗方法。
亲人并非无能为力。虽然我们不能让一个人改变，但我们可以为让他们想要改变做出贡献。我们比以前想象的更有影响力，需要积极寻求强化这些方法的循证家庭为基础的计划。
