I m concerned about someone who has an addiction 1. I m concerned about someone who has an addiction. What can I do?

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1 I m concerned about someone who has an addiction 1 I m concerned about someone who has an addiction. What can I do? 300 S. Adams, Green Bay, WI January 2014

2 I m concerned about someone who has an addiction 2 What can I do? Where do I start? First, know that you are not alone!. There are thousands of people in Brown County who have struggled with trying to get someone they care about to stop using alcohol and/or drugs. There are many resources available to help you find the support you need to get help for yourself and to encourage the person you care about to get help, too. This brochure will walk you through the different levels of services that are available in Brown County. It will explain when various services might be appropriate, how to access services, and the types of funding and payment options that are available for Alcohol and Other Drug Abuse (AODA) services. Contents Want someone to talk to about getting help?... 3 How can I get them to stop drinking/using? Police Custody Signature Commitment... 4 Al-Anon... 5 AODA Services & Treatment for the Addicted Person Addictions Support Group... 6 Assessment... 7 Individual Therapy Group Therapy... 8 Intensive Outpatient Therapy (IOP) Day Treatment... 9 Residential Treatment... 9 Medically Monitored/Managed Inpatient Treatment Detoxification Hospitalization (Detox) Additional AODA Supports Aftercare Relapse Prevention Co-occurring Disorders Treatment Family Education & Counseling Services Paying for AODA Treatment Taking Care of Yourself Support Groups for Families Individual Therapy for Family Members Change is Possible! Stages of Change HOW TO HELP PEOPLE WHO DON T WANT HELP... Attachment

3 I m concerned about someone who has an addiction 3 Want someone to talk to about getting help? If you need help one-on-one, right now, call the 24-hour Crisis Center Hotline at A counselor will answer your call and talk with you about your situation and what kind of help you need. The Crisis Center of Family Services provides free, professional, short term counseling for any situation you may be facing, including: alcohol and drug abuse, depression, relationship issues, and suicide. If you want help for dealing with a loved one s alcohol/drug problem in a group setting or over the phone, call the Al-Anon/Alateen Hotline at Al-Anon is a 12-step recovery program for friends and family members of alcoholics. Its purpose is to help families and friends of alcoholics recover from the effects of living with the problem drinking of a relative or friend. No registration is required all you need to do is show up. There is no fee to attend. Alateen is a similar program designed for young people. What happens when I call? The person who answers the telephone will be able to provide information about Al-Anon meetings and how to get started on your recovery journey. You can also check out the local Al-Anon website, for meeting times. How can I get them to stop drinking/using? The short answer is: you can t. You do not have the ability to MAKE the person you are concerned about stop drinking or using drugs. That person is responsible for getting help. Does that mean you can t do anything? Absolutely not! You have already done something. You ve recognized that there is a problem that needs to change. The resources listed on the following pages are options available in Brown County to help you deal with your loved one s alcohol and/or drug use. These are not AODA treatment services, but are options for encouraging the person you are concerned about to recognize that they need help.

4 I m concerned about someone who has an addiction 4 Police Custody You can call if you are unable to control the intoxicated person and you see him or her as a serious safety risk. The police will evaluate the situation and decide if it warrants taking the person to the Emergency Room to be medically cleared and then transferred to the Brown County Community Treatment Center. It is up to the individual officer who responds to the call to evaluate the dangerousness of the situation. When would I use this service? This intervention can only be used when the person s safety is in imminent danger. For example, they are walking down the middle of the street extremely intoxicated and you fear for their safety. How do I find out more? For more information on police custody and its appropriateness for your situation, contact Brown County Human Services AODA Intake at Signature Commitment A 3 signature commitment is a legal process for having someone admitted to inpatient AODA treatment against their will. For a 3 signature commitment to be enacted, a court must rule that the person is in imminent danger of death or harming someone else due to their alcohol/drug use. Drunk driving is not enough evidence to enact a 3 signature commitment. When would I use this service? This option should only be used when the person is clearly a danger to him/herself and other options have been exhausted. The courts typically request that a doctor be willing to testify that the addicted person is facing severe physical damage due to their alcohol/drug use. People who are admitted to treatment through 3 signature commitment are often enraged about being committed and their attitude toward treatment is often negatively affected. How do I find out more? For more information on the 3 signature commitment process, contact Brown County Human Services AODA Intake at

5 I m concerned about someone who has an addiction 5 Al-Anon Al-Anon is a 12-step recovery program for friends and family members of alcoholics. No registration is required all you need to do is show up. There is no fee to attend. When would I use this service? People attend Al-Anon meetings at many different stages for support, information, and to learn new ways of interacting with the person they are concerned about. Al-Anon is about the family member s recovery from the effects of the disease of alcoholism. A change in one family member does mean a change for the entire family, but doesn t necessarily mean anyone will get sober. The person you are concerned about does not need to be attending an addictions support group or be in AODA treatment for you to attend. How do I find out more? Call Al-Anon/Alateen at or visit their website: The person who answers the telephone will be able to provide information about Al-Anon and current meeting times. AODA Services & Treatment for the Addicted Person You are not responsible for getting help for the person you are concerned about that s up to them. The information in this section is provided to arm you with information about AODA treatment options, so when your loved one is ready to get help, you will have the information to get started. The AODA services listed below are in order of the least restrictive to the most restrictive options. There is no one right place to start. If your loved one is willing to try any option, encourage them to do so. If you are unsure what level of service is appropriate for the person you are concerned about, encourage them to meet with an AODA counselor for an assessment. Alcohol and drug abuse counselors have a saying: people change not because they see the light, but because they feel the heat. Each of the services listed below has a flame symbol next to it indicating the amount of heat a person may be feeling to seek help at that level.

6 I m concerned about someone who has an addiction 6 Addiction Support Groups (i.e., Alcoholics Anonymous, Narcotics Anonymous) Support groups are a place to meet with others who share similar struggles with alcohol/drugs to give each other support and hope. Support groups are attended voluntarily and are run by group members, not a therapist. Most have a non-religious, spiritual component and follow 12 step guidelines. People who struggle with AODA issues attend support groups at many different stages of recovery. Some people are curious about recovery and go to a support group meeting just to check it out. In the early stages of AODA recovery, some people attend meetings daily. Some people who have been in recovery for many years attend meetings as a way to support their sobriety. Every week, there are several support group meetings in Brown County. There is no referral needed to attend a support group all you need to do is show up. Some support groups offer closed meetings for alcoholics/addicts and open meetings for anyone interested in finding out about the group. Support groups charge no membership dues or fees. For more information about support groups in Brown County, see The AODA Treatment Providers Network of Brown County, available at the ADRC or on the ADRC website, by clicking on Help Finding Services and then click on Mental Health & AODA.

7 I m concerned about someone who has an addiction 7 Assessment An AODA assessment is a meeting with a counselor to talk about a person s current alcohol and drug use, and what they have tried in the past to get help for their alcohol/drug use. Based on that person s individual situation, the counselor will make recommendations about the type of services that will be the right fit for them. If the person you are concerned about is unsure what level of AODA services is the right fit for them, encourage them to get an assessment. Some people seek out an AODA assessment because they are concerned about their alcohol/drug use and want to get help. Others are court-ordered to get an assessment, or told by their employer to get an assessment as a condition of employment. What happens after the assessment? Once the person has completed an AODA assessment, their counselor will make recommendations about the type of services that are the best fit for them and they will be referred to services that are appropriate for their situation. They will not be automatically admitted to an inpatient alcohol/drug treatment program. Most people who seek help for alcohol/drug issues are not admitted to a residential or inpatient program. The counselor will recommend the least restrictive treatment option that can be effective. Many people have success recovering from addiction without ever going through a residential or inpatient treatment program. There are many agencies and counselors who provide AODA assessments in Brown County. For a listing of providers who do AODA assessments, refer to The AODA Treatment Providers Network of Brown County, available at the ADRC or on the ADRC website, Click on Help Finding Services and then click on Mental Health & AODA. Individual Therapy Individual therapy is when a client meets individually with a therapist or counselor; some providers refer to individual therapy as one-on-ones. The client and therapist set treatment goals related to the client s individual situation, then meet for therapy sessions to work on these goals.

8 I m concerned about someone who has an addiction 8 Individual therapy is a useful tool for exploring one s own life situation in-depth. It s a chance to set specific, achievable goals to change your life for the better. Individual therapy is often incorporated into other forms of treatment as well, such as residential or inpatient programs. There are many therapists who provide individual therapy for issues related to alcohol/drug use. To schedule an appointment, simply call the provider of your choice. When seeking out a therapist, ask if they have experience with alcohol/drug issues. For a listing of treatment providers and the payment options they accept, see The AODA Treatment Providers Network of Brown County, available at the ADRC or on the ADRC website, by clicking on Help Finding Services and then click on Mental Health & AODA. Group Therapy In group therapy, clients meet together in a group context one to three times per week with others who share similar issues. Group therapy is different than a support group in that it is facilitated by a therapist and group members set specific treatment goals that they work toward. Group therapy can sometimes be an effective treatment at different stages of AODA recovery. Meeting in a group allows clients the opportunity to share experiences and give each other feedback and hope. Group therapy is also incorporated into other forms of treatment, such as residential or inpatient programs. For a listing of treatment providers who offer group therapy and the payment options they accept, see The AODA Treatment Providers Network of Brown County, available at the ADRC or on the ADRC website. Intensive Outpatient Therapy (IOP) IOP programs provide intensive counseling while allowing the client to continue their normal activities (such as work or school) in the community. IOP programs meet up to 12 hours per week (average in most programs is 9 hours, 3 hours/3 x per week) over the course of several weeks and are available during daytime and evening hours. IOP services include group therapy, individual therapy and education; IOPs are facilitated by a therapist.

9 I m concerned about someone who has an addiction 9 People who need an intensive program to help them begin their recovery journey, but want to be able to continue their normal activities may see IOP as a good fit. IOP may also be an option for people who, due to financial limitations, cannot afford residential or inpatient treatment. There are many agencies that provide IOP services in Brown County. For a listing of treatment providers who offer IOP services and the payment options they accept, see The AODA Treatment Providers Network of Brown County. Available at the ADRC or on the ADRC website, This service can be accessed following an assessment (completed by an alcohol and drug abuse counselor) where this level of service is recommended. Day Treatment Day treatment programs provide similar services to IOPs, but are more intensive. They meet during the day for more than 12 hours weekly, allowing participants to return home in the evening. People who need an intensive program to help them begin their recovery journey, but are not interested in a residential or inpatient setting, may see day treatment as a good fit. Day treatment may also be an option for people who, due to financial limitations, cannot afford residential or inpatient treatment. This service can be accessed following an assessment (completed by an alcohol and drug abuse counselor) where this level of service is recommended. Residential Treatment Residential programs provide 24/7 treatment in a non-medical, home-like, unlocked environment. While the length of residential treatment can vary, an initial stay at a residential facility is generally 28 days. Treatment includes education, group and individual therapy sessions. Residential treatment is appropriate for people who have not been successful in IOP programs, or whose alcohol and/or drug use is severe enough to warrant 24-hour care. In Brown County, the Jackie Nitschke Center operates a Residential Treatment program. Call for further information.

10 I m concerned about someone who has an addiction 10 Medically Monitored/Managed Inpatient Treatment Inpatient treatment provides 24/7 treatment in a hospital-like setting with medical staff available to administer medications and provide medical evaluations & care. Treatment includes medication management, education, group and individual therapy sessions. Inpatient treatment is appropriate for people who need 24/7 care and medication to aid in their AODA recovery. This service can be accessed following an assessment (completed by an alcohol and drug abuse counselor) where this level of service is recommended. Detoxification Hospitalization (Detox) Detox involves 24/7 medical care to medically stabilize and assist a patient through severe and/or life threatening withdrawal symptoms. This level of treatment is appropriate for people who, due to the nature of their alcohol/drug use, are likely to experience severe and/or life threatening physical effects when they stop using alcohol/drugs. If you have any concerns about you or a loved one experiencing withdrawal symptoms, go to any area hospital s emergency room to have a doctor medically assess the need for inpatient detoxification. Based on the assessment, the doctor will recommend appropriate services. Additional AODA Supports Aftercare Aftercare, also known as continuing care, involves therapist-facilitated, once a week group therapy for 16 to 32 weeks. Aftercare is typically recommended for the addicted person following IOP or residential treatment. Relapse Prevention Relapse prevention typically provides group therapy for clients who have attended treatment in the past and have a history of relapse (returning to using alcohol/drugs). This treatment focuses on relapse triggers, warning signs, and assists clients in developing a relapse prevention plan.

11 I m concerned about someone who has an addiction 11 Co-occurring Disorders Treatment Many people with AODA issues also struggle with mental health issues such as depression, anxiety, and schizophrenia. Treatment providers recognize that AODA issues and mental health issues are related to each other and work to address these issues at the same time. Family Education and Counseling Services When the person you are concerned about decides to enter treatment, you may be asked to participate in the process. Many treatment programs encourage family members and significant others to become involved in their loved ones AODA treatment through educational programs. These programs help family members understand the disease of addiction and its causes, effects, and treatment options. Some treatment programs also provide counseling for couples or families. For more information about counseling options for you, see Taking Care of Yourself on page 12. Paying for AODA Treatment People considering AODA treatment often wonder how they will pay for services. Fortunately, there are many different ways to pay for AODA treatment services in Brown County. Do not let a lack of funds keep you from encouraging the person you are concerned about to seek treatment! Many AODA treatment providers have payment plans and funding sources to help pay for services. Encourage your loved one to check with their health insurance provider to see what services may be covered under their health insurance plan. Listed below are common payment options for AODA services. Encourage your loved one to check with any treatment provider they are considering to see which options are available to them. Private pay (also called self-pay). This payment option is exactly what it sounds like. Private pay means that the person pays out-of-pocket for treatment services. Most programs have a private pay option, in addition to other forms of payment. Sliding fee scale. Many treatment providers offer a sliding fee scale for payment. This means that the amount a person pays is adjusted based on their income. Insurance. The person s medical insurance policy may provide coverage for AODA and/or mental health treatment. Policies vary and some insurance companies only cover services offered by preferred providers (certain clinics or agencies), so check with their insurance company before assuming they are covered.

12 I m concerned about someone who has an addiction 12 Medicaid. If a person has health care coverage through the Wisconsin Forward Health Medicaid program, Medicaid will pay for many AODA treatment options. Some AODA treatment providers in Brown County accept Medicaid as payment. Encourage your loved one to check with any AODA treatment program they are considering to see if they accept Medicaid funding. Medicaid will pay for Detoxification Hospitalization (Detox), but not Residential Treatment, as services must be medical in nature. County Funding. Most AODA services offered through the Brown County Community Treatment Center and Brown County Human Services AODA Department are available to Brown County residents who do not have insurance to pay for services. Taking care of yourself Recovery from alcohol/drug abuse is not just an adjustment for the person in treatment it s also an adjustment for you. As the person you are concerned about begins treatment, it will change your relationship. You will develop new routines, re-adjust responsibilities, and start to deal with past conflicts. All this change can be stressful on your relationship and on you. Fortunately, there are many resources available in Brown County to support you through these changes. Support Groups for Families Support groups such as Al-Anon, Alateen and Families Anonymous provide an opportunity for family members to share experiences and support for each other. No registration is required and there is no fee to attend these groups. When would I use this service? People attend support groups at many different stages for support, information, and to learn new ways of coping. Some people are curious about recovery and go to a support group meeting just to check it out. There is no wrong time to attend a support group. How do I find out more? Family support groups offer meetings 7 days a week in Brown County. For information about meeting times and locations, see The AODA Treatment Providers Network of Brown County, available at the ADRC or on the ADRC website,

13 I m concerned about someone who has an addiction 13 Individual Therapy for Family Members Individual therapy is when a consumer meets individually with a therapist or counselor; some providers refer to individual therapy as one-on-ones. The consumer and therapist set treatment goals related to the client s individual situation, then meet for therapy sessions to work on these goals. When would I use this service? While you cannot change the person you are concerned about, you can seek help for yourself. Individual therapy is a useful tool for exploring your own life situation in-depth. It s a chance to set specific, achievable goals to change your life for the better. Individual therapy can be helpful at any stage of recovery even before the person you care about decides to get help for him/herself. How do I find out more? There are many therapists who provide individual therapy for issues related to alcohol/drug use. To schedule an appointment, simply call the provider of your choice. When seeking out a therapist, ask if they have experience with alcohol/drug issues. For a listing of treatment providers with expertise in AODA issues and the payment options they accept, see The AODA Treatment Providers Network of Brown County, available at the ADRC or on the ADRC website. Change is Possible! Nobody can go back and start a new beginning, but anyone can start today and make a new ending. ~Maria Robinson Change is not only possible, it is happening every day. Right now in Brown County, people struggling with a loved one s alcohol and/or drug use are making that first call or taking that first step toward getting help. Take the information you have learned from this brochure and become one of those people. Listen to that still, small voice that says, This might work and I ll try it. ~Diane Mariechild

14 Stages of Change * I m concerned about someone who has an addiction 14 Just as you cannot MAKE the person you are concerned about stop drinking or using drugs, there are certain stages in that person s pattern of drinking/using during which they may be more or less open to getting help. Look over the stages listed below to see where the person you care about may be now. DENIAL (PRECONTEMPLATION)- the person is in denial, doesn t recognize the seriousness of their problem. They may make comments like I m not out of control with my drinking, I don t really use that much, I am not an addict because or I love using, and I find it much more helpful to me than harmful. ADMISSION (CONTEMPLATION)- the person may be thinking about changing and interested intellectually in learning more about addiction. They may be making comments such as I guess my drinking has gotten out of control at times... or I m wondering what my life would be like without using/drinking. ACCEPTANCE (PREPARATION)- the person begins to visualize their life sober and sees benefits to this change. There is an attitude and behavior readiness to change. They may make comments such as I want my life back, I don t want to use anymore, My life would be so much better if I could just get back on track. The person may be distancing themselves from using friends or at least considering that it is not in their best interest to hang around them. ACTION- the person begins to make changes toward abstinence or toward getting help by changing where they spend their time and who they spend it with. The simple action of coming in for an AODA assessment may be a sign of their readiness to change. MAINTENANCE- the person continues to apply aspects of what he or she has learned in treatment to his or her daily life---one day at a time. At this stage there is a high risk for relapse, therefore relapse prevention education is necessary. RELAPSE- although not formally recognized as a stage, relapse (drinking or using drugs after recovery has begun) is often a part of the recovery process. Relapse does not mean failure! Relapse as part of the recovery process can be a way for the person to learn further about their dependency and the powerlessness and unmanageability that goes with it. * Adapted from Stages of Change Theory as it applies to Women s Recovery Journey Intensive Outpatient Treatment Program, Family Services, Baeten, T.; based on Substance abuse treatment and stages of change. Connors, G., Donovan D., & DiClemente, C. The Guilford Press: New York, 2001.

15 I m concerned about someone who has an addiction 15 HOW TO HELP PEOPLE WHO DON T WANT HELP 1. Begin by getting information about alcoholism or drug abuse. 2. Become aware of treatment agencies and services in your community (get literature). 3. Attend Al-Anon or Adult Child groups for support and to learn new ways of coping. 4. Leave pamphlets and literature around the house. 5. Break the no-talk rule. Stop walking on eggshells. 6. Identify your enabling behavior and stop it making excuses, blaming, nagging, over-working. 7. Suggest individual seek some help. (Caring, concerned, tough love) 8. Set your own limits to what you can do for the person. 9. Call person s doctor and explain your concerns to him or her. Contact employer also. 10. Discuss problems with neighbors and friends. They probably already know and can give support to you and perhaps also share concerns with individual. 11. Encourage kids to talk with teachers or school counselors. Get it out in the open. 12. Alateen for kids. Alatot for little ones. Other Twelve Step groups as appropriate. 13. Practice detachment and letting go tough love. --Letting go does not mean to stop caring; it means I can t do it for someone else. --Letting go is not to cut myself off; it s the realization I can t control another. --Letting go is not to enable; but to allow learning from natural sequences. LSS Intervention Training Manual, LSS Intervention Team

16 I m concerned about someone who has an addiction 16 --Letting go is not to admit powerlessness; but means the outcome is not in my hands. --Letting go is not to try to change or blame another; it s to make the most of myself. --Letting go is not to care for, but to care about. --Letting go is not to deny, but to accept. --Letting go is not to nag, scold, or argue; but instead to search out my own shortcomings and correct them. --Letting go is to not regret the past; but to grow and live for the future. --Letting go is to fear less and to live more. 14. Explore with other family members how each feels and has been affected by chemical use. The following are important keys for family members to watch out for: a. Use of minor tranquilizers for stress and sleeping problems. b. A history of family treatment of alcohol or drug problems. c. Family arguments before, during, or after using. d. Decrease in school performance, acting out against school mates, hostility. e. Poor sleep/eating habits. f. Depression and other emotional problems. g. Legal problems, auto accidents. h. Psychosomatic complaints, headaches, back, neck. i. Isolating/withdrawing from friends and/or others. 15. Get help as a family. 16. Talk with a counselor. 17. If the previous do not work, consider the following: a. Utilize any existing handles to force a healthy solution: 1. Legal OWI 2. Medical Physician 3. Employer Supervisor 4. Family consequences b. Participate in an intervention (with counseling help) c. Commitment to treatment. See you doctor, attorney or counselor. LSS Intervention Training Manual, LSS Intervention Team

17 I m concerned about someone who has an addiction 17 Brown County Human Services The ADRC thanks Mary Miceli-Wink of the Brown County Human Services AODA Department and Tina Baeten of Family Services of Northeastern Wisconsin, Inc. for their valuable input in creating this brochure. Information is provided courtesy of the Aging & Disability Resource Center of Brown County and may be reproduced so long as credit to the agency is retained and distribution is for noncommercial purposes only. For additional information, please contact the ADRC at (920) The ADRC of Brown County is an equal opportunity, access, affirmative action employer and provider. W:communityresources\mentalhealth&aoda\whatcanido 1/15/2014

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