“I lost my best friends, I lost myself, I lost my family. I was so damn distant, I was so depressed, I didn’t have any patience for my family, couldn’t even get myself to play with my nephew. He didn’t like me. He couldn’t even feel my presence.”

Dina* was just another teenager experimenting with a couple of joints here, a few beers there. She never imagined it might take control over her. She never thought a few highs to get over some family issues might eventually lead her into cocaine, acid and other hard drugs.

Drugs alienated her from her family, she moved out of her family home and lost her best friends. She behaved in ways she never thought she would, stealing to get a fix and hanging out with the wrong crowd — or any crowd that might just provide her with her dose.

(*The names of all recovering addicts have been changed to protect their privacy.)
“It harmed me very badly. It scarred my soul,” Dina says.

Dina, 26, comes from a broken home — divorced parents with an abusive father and a mother who after the divorce was absent from her life and failed to see her daughter’s need for help. Now, almost four years into her drug dependence, Dina wishes her mother had paid more attention to her. She wishes her friends understood better and saw her as the person they knew she once was, not the person that drugs made her become.

 “I was very vulnerable. I needed help, I needed attention,” Dina recalls. “My best friends gave up on me when they thought I lost my way. I wish they stuck in there and dragged me back. I am very angry with my mom. I am positive that the lack of attention on her part led me right into drugs.”

Dina is not an exceptional case. In fact, she isn’t even in such bad shape compared to other substance abusers. Unlike many suffering from drug addiction, Dina has a home, a job and some sort of control over her life. But she is a classic example of the role families play in the journey toward — and out of — addiction. A dysfunctional family can drive a person to use drugs to escape the tough times; once in the grip of addiction, it’s hard to find a helping hand to overcome it.

But mind you, the helping hand, even if extended with all the love in the world, may do more harm than good. Drug addiction affects all family members, and their reactions to the problem quite often drives their loved one deeper into their addiction.

Family comes first
Experts say that families and loved ones play a crucial role in determining if and when the drug addict will seek help and recover.

Drug addiction often inspires the worst reactions from family members, ranging from denial to extreme violence or even overprotectiveness that enables the addict to simply use more with fewer consequences.

It also takes a great toll on the family that is left dealing with someone they no longer recognize, suffering from a disease they have almost zero awareness.

“The drug addiction prescription is simple, but it needs patience and needs to have several parties involved in the treatment,” says Suheir Lutfi, head of the Egyptian Center for Fighting Addiction. “A major part of those parties is the family.”

Lutfi, who also founded and headed the state’s Fund for Drug Control and Treatment of Addiction, estimates that almost 90 percent of the treatment falls jointly on the shoulders of the family and the addicts themselves.

This is why experts believe that before the drug abuser can hope to recover from this disease, the family needs to understand the causes and early signs of addiction and, most importantly, how to deal with addicts to lead them to safety. They also need to know how it affects them and how to take care of themselves.
 

Haunting shadow
“I was treating [a] married couple who were both addicted. […]They both came from the upper middle class, and at the age of nine, their daughter hadn’t yet gone to school. They just didn’t care and didn’t pay her any attention,” recalls Khaled Helmy, director of training and research at Al Nozha Hospital and Resort of Psychiatry and Addiction Therapy. “The girl would wake up early and feed herself while her parents were asleep. The mother would wake up at four in the afternoon and ask the girl to fix her breakfast. It was heartbreaking.”

An addicted caregiver is a danger to the child. With an addicted breadwinner, the financial burden will eventually fall onto the shoulders of a another member of the family. And it often has more dramatic consequences than just a financial one.

Helmy tells the story of an addict who took his daughter along when he went to get a fix from his dealer. “He didn’t have any money, and the dealer asked for his daughter’s earring. [The addict] was in such a hurry to get the earring that he anxiously grabbed it from his daughter’s ear and ended up cutting her ear.”

Enslaved by his need for the drug, an addict will ignore the priorities or principles he once held sacred — even sacrificing his nearest and dearest for one high.

Helmy recalls another case where a recovering heroin addict attempted suicide the moment he was sober enough to realize he had actually given his own sister away to the drug dealer in exchange for a fix.

Karim, a recovered addict in his late 30s, says he used heroin for more years than he wanted to count. He recalls that when his addiction escalated and he ran out of money as his work deteriorated, he ended up stealing from his immediate family — something he never imagined he would ever do.

Lutfi is quick to point out that a person in the grip of an addiction is not in his right mind. Misbehavior, stealing or even violence are perceived as a lack of principles, when in reality, they are symptoms of a disease that is hard to combat.

 “It is like someone with a fever,” she explains. “He doesn’t act as he normally would. His behaviors are just symptoms of this fever.”
Unlike caring for a simple fever, however, drug addiction has a dramatic psychological impact that, if unrecognized, can destroy a family.

Ayman Kodeira, a specialist in Addiction Medicine at Behman Psychiatric Hospital, says that codependency in addiction is a common problem.

“If the parents have an unhealthy relationship, the drug dependence develops a relationship between them — a bond,” explains Kodeira.

This means that, ultimately, if no intervention is sought, the family becomes dependent on this problem, and, if it goes away, the family falls apart.

Kodeira says he has seen many cases where the parents divorce as soon as their child recovers from addiction.

Another common problem that addiction causes in the family is the blame game. Kodeira explains that anger and guilt often translate into blaming other family members for the addiction.

Helmy warns of possible effects of ignoring a sibling while treating an addiction in the family. The sibling may turn to drugs to get through the tough times or to try to win back some of the attention given to the addict.
 

Dysfunctional all round
Much like a flu virus needs certain environments to thrive, addiction feeds on anxieties and stressful environments. This means that dysfunctional families, as stereotypical as that may sound, are very friendly environments for substance abuse to live in.

“I was going through a lot in my life, more than I could take,” Dina recounts. “I believe this stuff just found me. I never sought it, it just came to me. But I never said no, I needed it.”

Dina started experimenting with drugs almost 10 years ago. After the traumatizing experience of her mother being raped and two years after her parents’ divorce. Dina started occasionally experimenting with drugs to get through it. But it wasn’t until her mother started bringing a man back home and Dina was exposed to the sounds of their lovemaking that she resorted to drugs. By the time Dina found out years later that her mother had been informally married to the man through an urfi marriage, her relationship with her mother had long fallen apart. “It broke me,” she says.

“I don’t want to place the blame on my parents, but I had a hard life and a terrible childhood. I went through a lot and it played a part of who I am,” Dina pauses as she is faced with a daunting memory. “I am not exaggerating when I tell you that this is just the tip of the iceberg.”

Helmy explains that almost 80 percent of youth with drug dependence come from dysfunctional families. It could be a single-parent family, a family where parents are not very involved with their children, a physically or psychologically absent father, an unstable relationship between the parents or an overall stressful family environment.

It becomes a vicious circle. According to Helmy, the addict initially resorts to drugs to escape family issues, and this dysfunctional family is unwilling or unable to provide the support needed to help the addict recover.

Dina recalls her mother had noticed her severe weight loss and temper issues and made her take a drug test. It came out negative as Dina was trying to quit at the time, and her mother never raised the issue again.
 

Stages of realization
Part of the challenge is getting the family to recognize there is a problem. Helmy explains that the first stage is almost always denial, when the family simply looks for excuses to explain the child’s unusual behavior; whether they know or don’t know about their addiction. He adds that families normally learn about the problem two years after their children become addicted.

Then they go through a phase of secrecy, where the family hides the issue. The reason is the social stigma involved with addiction, says Madiha El Safty, professor of sociology at the American University in Cairo. The stigma is so strong that none of the families approached for this article would agree to be interviewed, not even on an anonymous basis — it was a page they want to turn and not discuss with anyone.

Many of the addicts did not want their families interviewed, saying their loved ones had already been through enough.

When an addict realizes that one member of the family wants to keep his addiction from the rest of the family, he is likely to manipulate the situation. Helmy gives an example of a mother who gives her addicted child money out of fear that if she refuses, the child threatens to reveal the problem to the rest of the family or the neighbors.

When the whole family finally comes to realize and accepts the situation, they are typically reluctant to seek treatment due to the social stigma associated with addiction. But this is changing. Lutfi explains when she first launched the fund in 1997, they used to get one addict every month; in 2003 when she left, the fund was receiving 500 addicts daily.

Still, El Safty explains it remains a huge social stigma. This means that just as the addict is reluctant to seek help, the families often don’t want people to see them or their children walking into a rehabilitation center.

Helmy says that the family must realize that regardless of the stigma, an addict needs professional help to quit. He advises, “Once they know they have an addict in the house they need to discuss the subject among themselves and agree on a certain approach collectively.”

 
Too much love
The cultural tendency to be protective of children often magnifies an addict’s drug problem. This is especially true in collectivist societies like Egypt where children don’t leave the family home until they are married, and they aren’t expected to be independent by the time they graduate school.

The parents keep giving unconditionally to make sure their sons and daughters are taken care of. Whatever trouble the child gets into, mom, dad or even the beloved spouse are immediately there to the rescue — and the addict won’t hesitate to take advantage of them.

This is often reinforced by the guilt families might feel about the addiction problem. Kodeira explains that then the addict uses emotional blackmail: “He knows exactly what to say to each one to help them [enable] his addiction.”

Helmy calls this enabling, where the family, for instance, finances the addict’s habit during exam time because they are afraid he will fail if they don’t. They might also cover for him when he misses appointments to keep him out of trouble.

Georgette Savvides, the director of Psychealth and a counseling and occupational psychologist, explains that normally, if the husband is addicted, the wife will take charge and support the family. The wife enables her husband to continue his addiction in two ways, first by constantly filling in for him and second by crying and nagging about his problem.

“[Say] I am an addict. I am ashamed; will I run to treat it? I am going to go and use because I feel bad and guilty and I don’t want to feel,” Savvides explains. “The two things addicts are always running away from are reality, which is responsibility, and emotions.”

Enabling can be as simple as giving money or doing the laundry or having food ready whenever the addict comes in. But experience has shown that the addict is unlikely to seek treatment unless he feels his habit is harming him in some way — when euphoria comes with no price, it is almost impossible to give up.

Kodeira and Savvides both say that families need to set limits and boundaries. In fact, the experts often ask the families to lock their doors and not let the addicts in anymore. It sounds extreme, but it might be the only way the addict will finally realize there are consequences to what he does.

“If I used the substance and still went home, slept in my bed and everything, I would be crazy to quit,” says Kodeira.

 “The more space you give him to destroy himself, as we say, the easier you are making it for him to seek help,” Savvides explains. “You always hear from recovered addicts, ‘I stopped when my mother threw me out.’”

Again, in an Eastern society like ours, it is unorthodox to throw a child out on the streets — even if it is to help him.

 “Parents fear the dependent will steal if they don’t give him money, so in someway or another they are supplying his drug,” says Kodeira. “Eventually, he will steal because of tolerance to the drug building up.

So his consumption will increase and what he has today won’t last him tomorrow. But he needs to learn to handle the consequences, including those of stealing.”

No tough love
At the very opposite end of the spectrum, some families deal with the addict as a criminal who needs punishment, although many addicts want to quit but can’t.

Dina tried to quit several times, but each time she fell back into her habit. When asked if she felt guilty afterward, Dina quickly says, “Big time. You know what the walk of shame is? Every time I finish the night and the coke [cocaine] is out of my system. The feeling of guilt just comes naturally.”

Khaled, a 24-year-old recovered addict who battled with his habit for over seven years, says he tried to quit for almost three years before he finally succeeded. “In the last period before I quit, I used to buy the fix and I would sit and cry. I just couldn’t shoot up anymore.”

Ignoring silent pleas for help and ignoring the fact that the addict himself is often incapable of quitting even if he sincerely wants to, the parents may resort to punishment. They may lock the addict up or even go so far as to tie him up or physically abuse him. But addiction is never a fan of tough love; if anything, it will escalate the problem.

Khaled recalls the many times his parents tried forcing him into rehab — he just ran away over and over again.

Similarly, locking a drug dependent up will not work either. Rasha Mohamed, deputy executive director of Narconon, an international rehabilitation center, says that an addict is likely to have a stash hidden at home. In the unlikely event that he doesn’t, the effects of withdrawal may make him violent.

Without the right medical and psychological support, cutting an addict off is not the solution.

Khaled says his parents tried to decrease his allowance, but he always found a source of money to finance his habit, “be it legal or illegal, it didn’t matter.”

The right formula, experts agree, is loving firmness.

If the family wants to confront the addict, it has to be done calmly, firmly and with affection and understanding. The parents can’t keep blaming the addict, accusing and judging him.

“Confrontation can’t be scolding and telling him this is wrong and so on,” says Kodeira. “But rather asking him ‘what are you missing, how are you feeling, why did you do this, what do you think will happen if you go on like that?’”

Nour Salah, vice chairman of Narconon, suggests that to tackle the problem at earlier stages, parents should solve it from the core. “A user uses to be happy,” Salah says, “so I should find an alternative to make him happy without this harm from the very beginning, be it a hobby or an interest.”

worth fighting for
Khaled says he lost everything: seven years in a college he didn’t really like, childhood dreams gone to waste and relationships ruined due to addiction.

When asked what he gained in his recovery, Karim immediately says, “myself.” Friendships he had lost during his addiction were rekindled, to his surprise, and shortly after his recovery he was able to marry and start a family, something he never thought he could have.

“Of course my parents never left me, but I see something in their eyes that I haven’t seen before — happiness. I never saw that when I used to shoot up,” he smiles. “It is enough that my family can depend on me now, they can ask for my help and I never had this before. On the contrary, I totally depended on them for money, for solving problems, to find me a job, everything.”

Once he overcame his addiction, Khaled explains proudly, “My life changed completely from someone living for pleasure alone to someone who can handle responsibility and I am so much happier now.”

The clinicians, users and families know the road to recovery is long and rocky, but they can also tell you from experience, it is worth the journey.

“I never imagined I could be so happy, to find a baby running around me and playing and speaking,” Karim drifts off. “The blessing of feelings is a huge gain for me, my life had no feelings at all. I didn’t feel anything. And now I do.” 

Many addiction recovery programs also have support groups for family members of addicts. Seek professional help if one of your loved ones is an addict and ask to be directed to an Narcotics Anonymous meeting in Egypt.


Signs of drug addiction
• A change in routine; dropping a hobby or an interest
• A change in sleeping patterns, waking up very late or being too hyper
• Losing too much weight or overeating
• Changing the friends he/she hangs out with; an addict normally
    befriends other users only
• Deteriorating performance in school or at work
• Less time spent at home and more privacy
• Distancing him/herself from the family
• Reddened or tired eyes
• Unable to manage finances
• Loss of belongings around the house
• Lying
Mood swings.et