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How Enabling Can Fuel Addiction

In a most basic definition, the term “enabling” refers to any behavior performed by the loved one of someone with a substance use disorder that enables that person to continue abusing the substance. This could be behavior as direct as giving the person money with which to buy drugs or alcohol or giving them the substance itself, but there are also many far less direct ways in which the people who surround an addict could, mostly unwittingly, be fueling their continued drug use. 

For instance, if someone loses their job due to an addiction, actions like paying their non-drug related expenses or allowing them to live in your house rent-free could be considered enabling, because they are sparing the person from fully facing the consequences of their job loss, and because the person now does not have to get another job in order to survive or to live in comfort. 

This could in turn “enable” them to spend their days getting high rather than get back on the track to formal employment and a more stable life. Similarly, another common way that loved ones can enable addicts is by covering up for their mistakes—making excuses to their boss for missed days of work or bailing them out of jail after a DUI. 

Enabling may also involve taking over responsibilities for an addict, such as doing work or chores that they are too incapacitated to do themselves, thus enabling them to continue the behaviors that incapacitate them. 

Enabling, though, shouldn’t be confused with offering support, which would look more like the kinds of behaviors that can enable the addict to get help: helping them to find an appropriate form of treatment and assisting them in procuring that treatment when they may lack the emotional or practical resources to do so on their own. 

There are many different reasons behind enabling as there are reasons to enable: you may be in denial of the problem yourself, or you might feel that the person will be safer under your roof or using safely purchased substances than they would be if out on the street procuring from unknown dealers. There may be some truth to these ideas, though another unfortunate truth is that allowing them to remain in their addiction will place them in greater danger in the long-term.

There may also be an element of codependency, which can involve a conscious or subconscious need on your part to feel needed by the addict, or a comfort-through-familiarity with the usual dynamics of your relationship. Or, also as part of a long-standing pattern, you may simply be feeling too emotionally burnt out to have the energy to resist an addict’s sometimes forceful and emotionally manipulative demands. 

If you find yourself in such a fraught situation, it might be worth contacting a mental health professional who can give you individualized insight into the situation and the role you may be playing in your loved one’s addiction.

Another more insidious form of enabling is enabling that takes place through condoning the addict’s behavior. For instance, if you allow the person to abuse the substance or to become severely intoxicated around you without ever mentioning it, you’re basically sending them the message that their behavior is ok. 

Not to say that you shouldn’t offer emotional support to an addict or that you should deny them your love and companionship, as they are likely in incredible mental pain due to their condition and all the guilt, fear, and shame that can come with it, meaning that they be in more need than ever of the respite and affirmation of their worthiness that a caring presence could provide. 

You should also avoid actions like abruptly cutting the addict off, which could send them into a dangerous downward spiral. Instead, you should try calmly drawing a boundary, such as giving the person a clear ultimatum that lets them know the point by which they need to seek help or cease drug use, and clearly stating the consequences if they do not. 

What you should do, though, is send a clear verbal message to them that their behavior is not OK, and try talking to them about the problems you have observed with their current pattern of behavior and the risks you fear they may face if it persists.

In doing so, you should make it clear that the problem is with their disease and their behavior as opposed to with them as a person, and that you are concerned about their health and safety rather than the moral implications of what they are doing. 

In extreme cases, if a loved one remains resistant to getting help themselves and has clearly become a danger to themselves or others, you may be able to compel them to enter addiction treatment by using the Marchman Act, a Florida statute that allows for the involuntary commitment if someone whose substance abuse has severely impaired their judgment when it comes to their own condition. 

To learn more about how one of our skilled intervention counselors can help you through the process of confronting a loved one about their addiction or filing a Marchman act petition, feel free to call us anytime at 833-497-3808 or to contact us online anytime here.

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How Reactive Attachment Disorder Can Fuel Addiction

Reactive attachment disorder is a relatively rare condition that can present in early childhood, and one that is associated primarily with serious childhood trauma such as abuse or neglect that is suffered during the earliest period of their life, generally before they are 8 months old. It can also be associated with changes to a primary caregiver during the same period or the traumatic loss of a caregiver.  

These factors prevent the child from forming a healthy attachment with their caregiver as most children do, which can seriously disturb the internal model of relationships that normal children eventually form. Such a child will then become unusually withdrawn and less able to form bonds and relationships with others, as evidenced by the fact that they will not seek out comfort from others and may instead react negatively to attempts that are made to comfort them or to provide them with love and care. 

On the other hand, there also exists a “disinhibited” form of reactive attachment disorder, in which children, instead of becoming withdrawn, will instead not exhibit the appropriate discrimination when it comes to their attachment figures. 

Such children may be overeager to trust unfamiliar adults, which can pose a safety issue, and they may not show a preference for their caregiver over a stranger or the developmentally appropriate behavior of checking back in with their caregiver after venturing off. To complicate matters further, some children with reactive attachment disorder may also display behavior that has features of both inhibited and disinhibited attachment. 

Along with the attachment issues that are at the core of their disease, children with reactive attachment disorder will also typically display other signs of behavioral disturbance, such as a decreased ability to regulate their emotions, unexplained sadness, fearfulness, and irritability, or disproportionate responses to change or stress. 

These symptoms will often lead children with reactive attachment disorder to struggle socially in school as well as at home and should be apparent before a child is five years old. They also should not be better explained by a pervasive developmental disorder like autism, which can cause similar symptoms but is not related to a traumatic history. 

There is no standard treatment for reactive attachment disorder, but the child should obviously first and foremost be removed from the neglectful or abusive environment. Then, caregivers can work to establish a safe environment for the child and to establish a more secure attachment with them. Therapy and treatment can focus on improving children’s social and emotional regulation skills, and on providing them with the opportunity to establish meaningful and positive social relationships. 

However, if the child is not given adequate opportunity to form these relationships, or does not adequately resolve their original trauma, symptoms of reactive attachment disorder can persist into adulthood, which is where this diagnosis can potentially intersect with issues of substance abuse. 

Though the condition is rare enough that relatively few formal studies have been done on reactive attachment disorder outcomes, adults who displayed symptoms of reactive attachment disorder may still exhibit disturbed attachment, such as a reluctance to form relationships with others or a diminished ability to establish and maintain those relationships. 

They may also continue to struggle with symptoms like hyperactivity, anxiety, depression, and feelings of loneliness or emptiness, all of which have well-documented associations with the abuse of substances as an attempt to “self-medicate” emotional distress. 

If this behavior becomes sufficiently entrenched, treatment for the substance abuse disorder may be required in the form of a residential or outpatient treatment program. There, intensive therapy can help the person to tease out the roots of their addiction and address their traumatic past, as well as to learn new coping mechanisms and other emotional regulation skills that will help them to build the healthy relationships with others that will help them to maintain their sobriety.

In extreme cases, use of the Marchman Act may be required to force someone who is struggling with substance abuse due to the aftereffects of reactive attachment disorder or any other psychological condition to undergo this intensive treatment and turn their life back around, especially if their loved ones are perceiving clear signs that the person is becoming a danger to themselves or others. 

The Marchman Act is a Florida statute that allows for the involuntary commitment of someone who poses such a danger due to their substance abuse provided certain other conditions are met. Though this extreme measure should typically only be tried after lesser measures like talking to the person have failed, it is sometimes necessary for loved ones to take this painful step to ensure their safety. 

To learn more about the Marchman Act and how one of our skilled intervention counselors can guide you through the process of obtaining your loved one the appropriate treatment, you can call us anytime at 833-497-3808 or contact us online anytime here.

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How Fentanyl Is Making Addiction Deadlier Than Ever

Recent statistics have shown that the overdose rates in the United States have risen to an unprecedented high, topping 100,000 for the first time ever in the period between April 2020 and April 2021, representing a 30 percent increase from the year before.

While part of this increase is due to the COVID-19 pandemic, which contributed to overdose deaths by making people more isolated and more despairing, it is also due in alarmingly large part to the proliferation of fentanyl, a synthetic opioid drug that is up to 30 times more potent than heroin and 50 to 100 times more potent than morphine. 

64 percent of the reported overdoses appear to have involved synthetic opioids like fentanyl, which was developed for pain management in cancer patients and is sold in prescription drugs under names like Actiq, Duragesic, and Sublimaze. 

However, synthetic fentanyl that is now being produced mostly in Mexico and China and imported into the United States is now infiltrating much of its drug supply. Fentanyl can be produced in powder forms that can be pressed into pills or in liquid forms sold as eye drops or nasal sprays, and can be injected, smoked, or snorted.

It produces a similar sense of euphoria to other opioid drugs, first showing up in dangerously powerful heroin laced with the substance but then as an additive to other street drugs like cocaine, methamphetamine, MDMA, and even marijuana.

As opposed to heroin, which is made from a poppy plant that must be grown, fentanyl can be made anywhere, making it difficult to regulate. It can also be made and sold far more cheaply, which, combined with its incredible potency, is a recipe for disaster, as dealers add it in to give their drugs a “kick” despite its incredible lethality.  

As little as three milligrams of fentanyl can be a fatal dose, a tenth of the amount of the 30 milligrams of heroin that would pose a similar risk. The strength of fentanyl also means that its overdoses are more difficult to reverse, sometimes showing resistance to the overdose-reducing drug Narcan or requiring higher doses of it. 

Even more worrisome, the DEA recently issued a warning about the proliferation of fentanyl pressed to look like legitimate opioid pain medications like Percocet or Oxycodone that they are far more potent than, dangerously increasing the risk of an unintentional overdose. Fentanyl laced imitators of non-opiate drugs, like Xanax and Adderall, have also been reported. The agency reports seizing 9.5 million of these fake pills this year, more than in the previous two combined. 

Experts refer to fentanyl as a “different beast” than its predecessors and worry that the crisis will only worsen. This is evidenced by tragic stories like the one described in one of the source articles listed below of the death of 13 year old Luca Manuel, who took a counterfeit Percocet laced with fentanyl that he bought to cope with pain from a root canal and died of an overdose. It is now not only heavy drug users who are at risk of overdose but anyone who so much as dabbles in almost any illegal drug. 

On the bright side, the scope of the current overdose crisis has prompted the Biden administration to take action. Reportedly, they are considering making fentanyl easier to research, which could result in better ways of combating its effects. They are also considering reclassifying it as a schedule 1 drug, meaning it would be classified as having no medical use and its possession could be more harshly persecuted. 

They have also allowed for federal funding of test strips that can detect the presence of fentanyl in illicit drugs that can be distributed to at risk users, while New York has opened up the US’s first supervised injection sites, where trained professionals will be on site to reverse any overdoses that do occur. 

While these harm reduction measures are steps in the right direction, the surest way to avoid fentanyl contamination is, of course, by not doing drugs at all. The fact that fentanyl is making so much of our drug supply so unsafe means that drug abuse and addiction is more dangerous than ever, as it only takes one unwitting use of an unsafe batch to invoke an irreversible tragedy. 

If you are worried about a loved one who is currently suffering from addiction, now is no time to let the problem go unaddressed. If you have already tried talking to them about their addiction and they remain resistant to getting help, it may be time to learn more about the Marchman Act, a Florida statute that allows someone who is a danger to themselves or others due to a substance abuse disorder to be involuntarily committed to a treatment program provided certain other conditions are met.  

To learn more about the Marchman Act or about how one of our skilled intervention counselors can help you through the process of confronting your loved one or of filing a Marchman Act petition if lesser measures are unsuccessful, feel free to call us anytime at 833-497-3808 or to contact us online anytime here.

Sources:

https://www.theguardian.com/us-news/2021/dec/08/us-fentanyl-deaths-narcan-roger-crystal

https://www.npr.org/2021/09/27/1040899776/dea-public-safety-alert-fake-prescription-drugs-fentanyl?preview=

https://www.statnews.com/2016/09/29/why-fentanyl-is-deadlier-than-heroin/

https://www.theguardian.com/us-news/2021/nov/22/fentanyl-deaths-spike-us-tragedy

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When An Addict Tries “Pulling A Geographic”

To those who have not experienced it, many aspects of an addict’s psychology can be baffling, including the tendency that some addicts have to react to the fact that their life has become unmanageable due to their substance abuse by packing up and leaving town to start fresh somewhere else entirely. 

This practice is known informally within recovery circles as “pulling a geographic,” and, like drug addiction itself,  it is a usually misguided way of seeking external changes as a solution to internal problems, a literal running away from one’s problems as opposed to the emotional running away from one’s problems represented by getting high. 

While an addict who is pulling a geographic may admit that they have a problem, they may declare that their surroundings are the problem, and thus that problem can be solved by simply changing where they live. If they can move somewhere else, escape their burnout and change their scenery, perhaps get a new job and then find a new circle of friends, then, they say, everything will be fine. 

This, of course, ignores what might be clear to outsiders what is the most pressing cause of the issues: their substance abuse. While someone who is struggling with an addiction may indeed have problems in many other areas of their life, addressing those problems can be a tempting way for them to avoid facing the hard and scary truth that they have a serious substance problem and that getting clean for good is likely the only lasting solution to the reasons that their lifestyle has become dysfunctional. 

In the worst case scenario, suddenly “pulling a geographic” while exhibiting many of the other signs that their addiction has escalated to a critically dangerous level may also be an indication of a person’s conscious or subconscious plan to go entirely off grid to continue abusing substances in a place where they may have less people looking over their shoulder, a dangerous indication of denial of or apathy to the seriousness of their circumstances. 

However, in other ways, the desire to move to a new place could actually be a good sign insofar as it indicates a willingness to start over, a symbolic new beginning that could actually help them cut ties with the people, places, and things that they associate with addiction. A new start, though, is not in itself a cure, for one important reason that is another common saying in the recovery world: “wherever you go, there you are.”

In other words, if someone simply packs up and runs from a wrecked life without addressing the underlying issues that caused it to collapse and learning better coping mechanisms that they can use to manage their emotions instead, those issues are wont to reappear somewhere else. 

So even if an addict is heading out with better intentions, maybe even intentions of getting clean, being away from one’s support system and any accountability might not be the best recipe for facilitating recovery, especially during their vulnerable early stages of it. 

Pulling a geographic could also be a cause for concern because it may make it harder for loved ones to intervene in the case of an emergency or to even be aware that that emergency is occuring.  For instance, they may not be able to contact emergency services in the case of an overdose, and the Marchman Act, a Florida law that allows for the involuntary commitment of someone whose substance abuse has made them a danger to themselves or others (provided that certain other conditions are met,) can generally only be served if the person is physically in the county that you are filing the Marchman Act petition in.

For these reasons, it might be worth trying to step in before an addict acts on plans to leave the area if you become aware of those plans in advance, perhaps by encouraging them to seek treatment rather than escape. Or, in what might be a good compromise, perhaps you could suggest that they can move in addition to committing to a more traditional treatment plan that will be in place in their new surroundings rather than instead of one. 

If they remain intent on leaving without committing to such a plan, though, it may be best to try to intervene before they do. To learn more about how one of our skilled intervention counselors can help you start a conversation with your loved one about their substance abuse, and, if such an effort is unsuccessful, guide you through the process of starting the Marchman Act proceedings, feel free to call us anytime at 833-497-3808 or to contact us online anytime here.

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Five Tips For Talking To A Loved One About An Addiction

While the Marchman Act, which allows for the involuntary commitment of people who have become a danger to themselves or others because of their substance abuse, is usually used as a last resort, there are many lesser measures that you can take to help protect your loved one before such a crisis point has been reached. 

For instance, if things have not yet escalated to the point where you fear for their well being, you could try simply talking to them about the possibility of voluntarily undergoing substance abuse treatment. Here are a few tips to give you a framework for how you should approach such a conversation. 

1. Don’t Be Afraid To Reach Out At All

While confronting a loved one about something as weighty as an addiction may be daunting, that doesn’t mean you should be afraid to reach out. The earlier that an addict gets treatment, the more likely they are to recover, as the addiction will simply get more entrenched the longer your loved one engages in it. 

Adding to that, the risk that your loved one could suffer an overdose or another fatal or otherwise irreversible consequence if they continue along their current path should outweigh your fear of experiencing discomfort during the conversation or damaging the relationship by confronting them. 

For someone whose substance abuse problem has not yet escalated into a full-blown addiction, it’s possible that they actually haven’t realized they have a problem, and they may be able to get back on the right path after you point out to them the extremity of their behavior without formal treatment. 

For others, realizing a loved one is concerned enough to step in may be the wake up call they need to consider professional treatment, and they may even be relieved that you have reached out to them and that you no longer have to bear the burden of their addiction alone. 

2. Be Prepared For The Conversation To Be Difficult

However, none of the above is to say that such a conversation will be easy. A loved one may become defensive when confronted about a drug problem that they are too afraid or ashamed to admit to, and instead may make excuses, try to wheedle out of the discussion and deny your accusations, or react with outrage. 

Even if they do have that kind of negative reaction, your willingness to talk to them may open the door for them to reach out down the road when they are more comfortable if you make it clear that you are a safe person to come to. 

To minimize reactivity and turmoil during discussion of such a fraught topic, try to approach them while both you and they are in as calm of a state as possible. Ideally, you also should not approach them while they are intoxicated, but as some addicts may be in the habit of getting high almost constantly, confronting them while they do not have their full faculties available is better than not confronting them at all. 

3. Emphasize Facts Rather Than Your Emotions

While it is reasonable for you to feel all kinds of negative emotions in reaction to a loved one’s substance abuse problem, they are not likely the best thing to bring to the table in a discussion with someone who is struggling. 

Instead, you should make an argument to them by bringing up specific incidents that illustrate why you are concerned: raising examples of things they have done that are illegal, dangerous, or out of line with the moral values of their sober self, or of relationships that they have damaged or opportunities they have lost because of their drug use.  

You could also lend credence to your argument by either confronting them with another person who is also concerned or mentioning that others in their life share your concerns around their substance abuse. 

4. Show Support And Concern As Opposed to Judgement Or Shaming

While addiction can sometimes make it difficult to relate to a loved one, you should never lose sight of the fact that they are a human being deserving of respect, dignity, and empathy rather than a problem to be solved. 

Thus, you should make it clear that you are having this conversation with them because you love them and are concerned about their well-being, not because you have a moral objection to their behavior or think they are a bad person.

You should also avoid using stigmatizing language like “addict” or “junkie,” and try asking them open questions about what they are experiencing that show that you care about their perspective and experience rather than only pursuing the agenda of getting them into treatment, however important that goal may be. 

To prepare for this conversation, you may also want to educate yourself on addiction, which will help you to direct any negative emotions you do express to the disease of addiction and not the loved one themselves. You should also try to be positive about the future and the fact that full recovery is possible, offering examples of role models who prove just that. 

5. Offer Concrete Next Steps

Even if your loved one is able to hear your concerns and agrees with you that treatment is needed, they may say that they are not ready for treatment yet and offer reasons they need to delay getting help that may not amount to anything but excuses. While you don’t want to push your loved one too hard and risk burning a bridge, you should also be aware that condoning a drug addiction can be a slippery slope to enabling one. 

Depending on your relationship with the person and their mental and emotional status, you may arrange a time to check back in so that you can confirm they have begun the process of seeking treatment, or you may proceed directly to helping them through the process of securing a place in a treatment center. 

You should also make clear that you will be supportive to them throughout their recovery—for example, you can promise to visit them or talk to them on the phone if they are entering an inpatient program, or offer to drive them to and from their outpatient appointments.

Get Through To A Loved One With The Help Of A Skilled Intervention Counselor

If an initial attempt to talk to a loved one about their addiction didn’t go as well as you hoped, don’t despair. The help of a professional like one of our skilled intervention counselors may be the bridge you need to get through to your loved one, and they can also assist you in filing a Marchman Act petition if an attempted intervention remains unsuccessful. 

If you have talked to a loved one and found that they are amenable to treatment, you should also feel free to contact us for help with finding a treatment center appropriate to your loved one’s needs and answering any other questions you may have about addiction and recovery. To learn more, reach out anytime by calling 833-497-3808 or contacting us online here.

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Is Tough Love the Right Approach for Addiction?

You may have heard the term “tough love” tossed around in relation to how one should deal with addiction in a loved one. But whether or not tough love is the “right” approach for you and the person you are concerned about depends how exactly you define the term and what actions you are considering taking. 

This is because it can sometimes be difficult to distinguish setting appropriate boundaries or ceasing behaviors that may be enabling a loved one’s addiction with a more punitive or demeaning approach. 

While the former may be necessary for your own or your family’s physical safety or emotional health and could spur your loved one to seek treatment, the latter is unlikely to be productive and is far more likely to be harmful. 

When Tough Love Might Be Appropriate

One instance in which tough love may be the way to go is when it refers to the loved ones of an addict deciding to stop behaviors that may have been enabling them. Though it may have been done with the best of intentions, providing an addict with money that they can use for drugs, excusing their bad behavior, or even just giving them a roof over their head, may allow an addict to continue to abuse drugs without experiencing the repercussions that might help them realize that their lifestyle is not sustainable. 

Thus, if you have their best interests at heart, doing something as harsh as monetarily cutting a loved one off or kicking them out of the house until they can get clean may be an appropriate action, especially if their behavior while intoxicated poses a safety risk to you or others in the family. 

Other examples of this kind of tough love could include a refusal to help the addict with legal problems, alerting the addict’s employer or anyone else their addiction is affecting, or alerting the authorities so that they may prosecute the addict for any crimes committed or ensure the safety of any children the addict’s behavior may be putting at risk. For some addicts, it takes measures like this to get them to come to their senses and agree to get help, though they are likely to react with anger before submitting to this help.

In these cases, you should state the tough-love boundaries you plan on enacting clearly and directly, and in a calm, rational manner instead of impulsively and emotionally. Setting these clear boundaries may spur your loved one to consider recovering, or, in sadder situations, it may be the beginning of the process of disentangling yourself from a family member who is unwilling to change. 

When Tough Love Might Not Be The Best Approach

Though tough love can sometimes refer to the boundary-setting practices described above, they can also describe efforts to break down a person’s will and spirit in the hopes of making them so desperate that they will recover. As opposed to protecting them, this type of tough love has the aim of shaming, punishing, and humiliating the addict, who is likely already in an incredibly fragile mental state. 

While anger and resentment of an addicted loved one are completely valid emotions you should take the time to work through on your own, they are unlikely to be productive when directed towards the loved one in question. Likewise, while a reasoned discussion of the risks of drug use could be persuasive to your loved one when they are in a sober and calm state, emotional scare tactics may simply drive them further into denial. 

On the other hand, making it clear to your loved one how much you still value and care about them and that they will have your full support if and when they decide to seek treatment could be incredibly powerful.

Someone who is suffering from addiction is struggling with a complex disease, which means that the actions they undertake during the course of that disease are not fully their fault, nor are they necessarily a reflection of the person underneath that may have a chance to reemerge if your loved one chooses recovery.  

While giving an active addict material things or practical help could be an enabling slippery slope, giving them compassion costs nothing, and can do no harm. Even if someone is dangerously out of control, you can still for example, take their phone calls, communicate with them virtually, or meet with them in safe, public settings. 

In general, tough love should only be used after gentler approaches have failed. However, each person and situation is different, and a threat that could motivate one addict to recover could be the thing to send another into a dangerous downward spiral. Thus, the safest thing to do when wondering how or if you should use tough love when dealing with an addicted loved one is to contact a professional, such as one of our skilled intervention counselors.  

Using The Marchman Act To Force A Loved One Into Treatment

No matter how much you care about an addicted loved one, there is no surefire way to “make” them stop using drugs. However,  if a loved one’s behavior is so out of control that you believe they may be a danger to themselves or others, you can attempt to invoke the Marchman Act, a Florida statute that allows for the involuntary commitment of someone whose substance abuse has reached such a threshold provided that other criteria are met. 

Though it should always be used as a last resort due to the potential that such a harsh measure could cause lasting damage to your relationship with your loved one, the Marchman Act is an example of the right kind of tough love, as it is invoked with the intention of preserving their well-being rather than punishing or shaming them.

To learn more about the Marchman Act, addiction treatment, and how one of our skilled intervention counselors can help you find help for a loved one, feel free to reach out to us today at 833-497-3808.

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What To Do If You Think Someone Has Overdosed

If you are a loved one of someone who is struggling with addiction, the idea that the person you are concerned about may suffer an overdose before you are able to convince them to undergo treatment may be one of your worst nightmares. 

And your fear is in fact a very reasonable one. Drug overdoses are devastatingly common, with yearly overdose deaths having surpassed 100,000 per year in the US, making Americans more likely to die from an overdose than they are from car crashes and gunshot wounds combined. Here are some signs that someone may be experiencing a drug overdose, and some simple instructions that could be life-saving if you do find yourself dealing with someone who you think has OD’d. 

Symptoms of An Overdose

Though symptoms of an overdose can vary depending on what drug has been consumed, the most obvious cause for alarm is if someone appears unresponsive or unconscious, especially if you attempt to wake them and they are unable to be roused. 

Another cause for immediate concern is someone whose breathing has become slow and shallow or stopped altogether, or who has an unusually slow, erratic, or stopped heartbeat. You may also notice choking or gurgling sounds from someone who is choking on their own vomit or on their tongue, or that someone appears to be having seizures. Blue lips or fingernails, pale, clammy skin, and chest pain are other immediate causes for alarm. 

Someone who appears unusually confused, disoriented, anxious, uncoordinated, or agitated may also be experiencing an overdose, or are showing signs that they are in an intoxicated state that may progress towards one. With certain drugs, death may also occur from overheating or dehydration, so keep an eye out for signs of these conditions as well. 

What To Do If Someone Is Experiencing An Overdose

As impossible as it may sound, you should try to stay calm as you work through the situation, and the first thing that you will probably want to do is call 911, and let them know immediately that someone is not breathing if that is the case. 

You should be prepared to tell emergency services your address, or about any landmarks that you are near or your approximate location if you do not know the address that you are at. They may also ask for the person’s age and sex and for any relevant medical information, including what the person has taken, which you should answer as accurately as possible to waste no time in getting them the right treatment. If you have access to any of these drugs,

Then, while you wait for first responders, it may be necessary to perform rescue breathing, if the person has a pulse but is not breathing, or CPR, which involves cycles of rescue breaths and chest compressions, if their heart appears to have stopped as well. 

If the person is unconscious but is still breathing, or if they begin breathing again after you perform rescue breathing, you will want to place them in the recovery position to keep their airway open and reduce the risk that they will choke or their breathing will cease. Turn the person onto their side, bend their upper knee to support their body, and turn their face to the side. Then, tilt their head back and lift their chin to open their airway, and make sure that there is not anything blocking it. 

If you are attempting to revive someone from an opioid overdose, you may also be able to do so with naloxone, which is available as the intranasal spray Narcan as well as in an injectable formulation. If someone you know routinely abuses opioids, you should have naloxone on hand in case of just such an emergency, and know the basics of how to use it. This includes appropriate dosing, since a dose too high may send an opioid user into instant, painful withdrawal, which could prompt them to take more drugs and put themselves at further risk. 

You should also beware that since the effects of naloxone are temporary and it will take the person awhile to clear the opiates from their system, you may need to revive the person with it more than once, even if they do not take any more drugs in the meantime. Other complications of opioid overdose can also occur, so you should still call emergency services so they can monitor and assess the situation rather than attempt to handle it yourself. 

What Not To Do If You Think Someone Has Overdosed

Along with what you should do, you should also be aware of things that you should not do if someone appears to be overdosing. For instance, while it is ok to try to wake someone up and a good idea to try to keep them awake, such as by engaging them in conversation, you should not try to perk them up with coffee or give them anything else to drink. This is unlikely to be helpful but may cause vomiting, which presents the risk of choking. You should also not attempt to induce vomiting for the same reason. 

You should also not try putting the person in a bath to wake them up, as this presents a drowning hazard, or try waking them up with ice, since cooling them down could slow down their system further. Nor should you try injuring them or injecting them with another drug (such as an upper if they have OD’d on downers) or with salt water, as this is unlikely to help matters and is likely to cause further harm. 

You also shouldn’t be afraid to contact emergency services because you fear legal retribution for you or your loved one’s drug use—emergency services will usually not contact the police, and most states have Good Samaritan laws to protect anyone who calls 911 in an emergency even if they have been involved in drug-related criminal activity. 

Finally, do not leave the person alone unless it is absolutely necessary. If another safety issue means that you absolutely must, be sure to put the person in the recovery position before you do so, and to leave the door open so that emergency responders will not have any barriers to reaching the person. And under no circumstances should you let the person resume using the substance they have overdosed on or any other drugs, even if they appear to be “recovered.” 

But the best way of protecting someone from an overdose is preventing it altogether by curtailing a person’s substance abuse. If your loved one has been abusing substances and is uninterested in pursuing treatment on their own, you may be able to have them committed involuntarily using the Marchman Act if certain other conditions are met. To learn more about the Marchman Act or how one of our skilled intervention counselors can help guide you through the Marchman Act process, contact us now at 833.995.1007 or online here.

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The Differences Between Residential Treatment And Intensive Outpatient

While addiction treatment can take many forms, perhaps the most meaningful distinction to be found is the distinction between residential and outpatient forms of addiction treatment. If a Marchman Act Petition is successful, a defendant may be court ordered to enroll in either of these treatment formats, depending on such factors as the severity of their illness, the availability of beds, and their family situation. 

Here is a little more information about these different forms of treatment, so that you can assess which one may be right for your loved one and know what to expect depending on which choice you, the courts, or your loved one’s treatment team ultimately end up making. 

What Is Residential Treatment?

Residential or inpatient addiction treatment is probably what most people think of when they imagine “rehab.” These closed facilities require patients to physically live inside the facility, and may be preceded by a period of acute detox (which will typically last for a period of around five to seven days) if it is deemed medically necessary for a physically dependent addict. 

This form of treatment is generally recommended for patients who are suffering from severe substance abuse problems, for whom less intensive forms of treatment have previously been unsuccessful, or who do not have strong support systems or family resources at home, meaning that the risk of relapse is high if they remain in that environment. Residential care may also be recommended for patients who present with violent or suicidal behavior that could constitute a risk if they remained in the community. 

Once a patient moves on from detox to residential treatment proper, they will likely stay for an average of around twenty eight days, with a higher end of sixty to ninety days or even longer for patients who present suffering from severe dependencies. Afterward, the patient may transition into an outpatient program or another less intensive form of treatment before moving on to an aftercare plan, which may still involve regular therapy and regular attendance at support group meetings. 

What Is Intensive Outpatient Treatment?

To be considered an intensive outpatient program, treatment typically involves the patient’s participation in treatment programs for around 8 hours a day on at least 3 days a week, making it an appropriate option for patients who have substance dependencies but who are not at acute physical or psychological risk due to their addiction.

Ideally, these patients should have a strong motivation to get sober and a supportive family environment they can safely reside in while undergoing this treatment. Intensive outpatient is also an attractive option for patients who need to continue to fulfill professional or personal obligations while also receiving intensive treatment for an addiction. 

Does My Loved One Need Residential or Intensive Outpatient Treatment For Their Addiction?

Which form of treatment would be most appropriate for your loved one is dependent on their individual needs, as both options have their own unique pros and cons. For instance, while residential treatment has the benefit of practically eliminating the risk of relapse, it is generally more expensive than outpatient programs, and some patients may find the environment so restrictive that they may forgo treatment entirely rather than endure such restrictive confinement. 

On the other hand, while intensive outpatient allows the patient more opportunity to give in to temptation, it provides the benefit of allowing patients to experience all the tension, responsibilities, and triggers of everyday life while still being supported by the guidance of their treatment program, which is why it is so valuable for patients who are transitioning out of a more restrictive treatment program like residential.

One “middle ground” option that allows many patients to strike a successful balance between freedom and supervision is to enroll in an intensive outpatient program while residing in a sober living residence. This way, they will be subject to more strictures than they would be if they were living on their own or in their family home, but will still be able to attend to obligations in the outside world and adapt to the reality of everyday life without substances. 

Traditional requirements in such sober living homes include the maintenance of a one hundred percent substance free living space, regular drug tests, regular attendance at all treatment program appointments, daily curfews, adherence to household guidelines, and/or daily attendance at the appropriate twelve step meeting (i. e. Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous). 

For more information about the differences between these two forms of substance abuse treatment or how you can use the Marchman Act to help a loved one who is struggling with an addiction, feel free to call our helpline anytime at 833.995.1007 or to contact us online here. Our skilled intervention counselors can guide you through every step of the Marchman Act process, including finding an appropriate inpatient or outpatient facility that is suited to your loved one’s individual needs. 

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How Do I Start The Marchman Act Process And What Should I Expect?

While filing the Marchman Act is never an easy thing for a filing family member or their loved one, setting the Marchman Act process into motion is actually fairly simple, only requiring the filing of a Petition for Examination.

The specific procedure for filing this petition varies by county, but to look at Palm Beach County as an example, the petition takes the form of a five page document that requires “specific facts of recent behavior” to support your claim that your loved one is either a danger to themselves or a danger to others or too incapacitated by their substance abuse to recognize their need for care. 

Along with this description sheet, you will also be required you to fill out a date of birth form, notice of related cases, and cover sheet, and will need to get this petition notarized. Then, you will file it to unified family court. Palm Beach County requires no filing fees, but the person you are filing this petition for must be physically located in Palm Beach County at the time of filing. 

Then, in response to this petition, the judge may decide to set a hearing that will take place in the following ten days. Both the petitioner and the respondent are required to be at this hearing, which will determine whether assessment is necessary. The judge may also make an emergency or “exparte” order without hearing, which will take effect immediately. 

Then, law enforcement will be authorized to take the person into custody and to deliver them to the nearest Marchman Act receiving facility. This order will be good for the next seven days, unless the judge specifies that it should last for less. 

Then, the facility will have 72 hours to assess the patient. After that, they will release the patient if they do not meet the criteria for involuntary admission, release them for voluntary inpatient or outpatient treatment if the patient is amenable, or file a petition with the court to request involuntary services.

This petition can only be filed by the facility administrator, not the friend or family member who filed the initial petition for examination, and must include the written opinion of two psychiatrists or clinical psychologists, both of whom must have examined the patient face to face. It is also required that the evaluation prove that no less restrictive treatment option could reasonably be expected to improve the patient’s condition.

Another hearing will be set within five days of the filing of this second Petition for Involuntary Services, and the judge will assign the defendant a public defender unless they have a private attorney. One of the examining psychiatrists must provide testimony, and both sides can call any other witnesses that they wish to. 

Then, if the judge chooses to grant this petition, they will order that the defendant be retained at the facility that assessed them or transferred to a different one that is more appropriate to their needs. They will be ordered to remain in treatment for a period of up to 90 days, and the facility will have the option of filing an additional Petition for Involuntary Services for an extension of the order if they believe the patient requires any additional services. 

The ordered treatment can be inpatient or outpatient, and can only be required based on substance abuse, and not based on another mental health issue (in which case the Baker Act may be more appropriate.) It also cannot interfere with or substitute individual’s existing mental health treatment. 

It’s also worth noting that even inpatient treatment centers are not locked down facilities, so a defendant may choose to leave treatment of their own accord, though they will be risking legal consequences and even jail time if they choose to do so. In this case, a defendant may be ordered back to court for a  hearing that will determine whether they are found in contempt. 

You should also be aware that it will not be the court’s responsibility to find a bed and a receiving facility, or to pay for treatment. A Marchman Act petition also cannot interfere with a criminal case, be used to locate a missing person, or be used solely to make a child obey their parents, though parents can file on a child’s behalf.

For more information about what you can expect and what will be expected of you as you navigate the Marchman Act process, as well as how one of our skilled intervention counselors can guide you through the emotionally fraught proceedings, feel free to contact our helpline anytime at 833-497-3808, or to contact us online anytime here.

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Five Signs It Might Be Time To Use The Marchman Act

Someone who finds themselves considering the Marchman Act, the Florida statute that allows for the involuntary commitment of someone who has been abusing substances and meets certain other criteria, is not likely to be taking the matter lightly. Forcing treatment on a loved one is never pleasant for anyone involved, but, in some high-risk situations, it may be the best option to take to ensure their long-term health and safety. The following signs are some serious tip offs that your loved one may be spiraling out of control, and that your intervention may be required.

1. They Are Unable To Manage Their Own Lives

The further one falls into an addiction, the less able they will be to engage in life and attend to even sometimes their most basic responsibilities. Someone who is unable to maintain their professional, personal, or academic obligations due to their substance abuse—i. e., someone who is failing or dropping out of school, quitting or getting fired from a job, or mismanaging significant family responsibilities like childcare, is likely incapacitated enough that the Marchman Act should be seriously considered. 

This also holds true of someone who is only seemingly functional because you or others have been making excuses for them or covering up for their mistakes. The more profound someone’s withdrawal from or inability to cope with life is, the more concerned you should be.

2. Their Physical Health Is Deteriorating

If someone persists in their substance abuse despite the fact that it is causing them serious health consequences, intensive professional treatment is most likely needed. If someone refuses to stop or curtail their use even after showing clear signs of drug-related health issues—for instance, liver problems or cognitive impairment due to alcohol abuse— you absolutely have grounds to step in. 

You may also want to be aware of visual signals of a severe drug problem, such as someone who is seriously underweight. You might notice open sores from untreated wounds, possibly acquired from the injection of IV drugs, or that someone has stopped paying attention to even basic personal hygiene. 

3. They Are Engaging In Increasingly Risky Behavior

Whenever someone uses illicit drugs or abuses legal ones, they are putting themselves at at least some risk, but a pattern of escalating risk-taking demonstrates pretty clearly that that Marchman Act may be warranted. Along with the risks arising from drug use itself, you may notice that someone is engaging in unsafe sex while intoxicated, or engaging in behaviors that come with the risk of legal consequences to be able to abuse or afford drugs, like stealing, intoxicated driving, shoplifting, or even attempting to forge prescriptions. 

Another cause for alarm is escalation in the substance abuse itself: someone switching from snorting or smoking a substance to injecting it, from prescription opioids to a street drug like heroin, or from habitual use to constant intoxication. For certain drugs, and certain drug combinations, overdose is a very real threat that requires the utmost precautions be taken, even if that means involuntary commitment.

4. Their Behavior Or Mental State Has Become Increasingly Volatile

Someone who is out of control due to their addiction may demonstrate increasingly unpredictable behavior. They may appear inordinately depressed or worryingly grandiose or paranoid, going on crying jags or flying into rages at the drop of a hat. They might regularly be so high that they have trouble understanding what is going on or relating to you in any meaningful way, or may even appear be out of touch with reality altogether.

Additionally, you should also be concerned if someone who you believe is suffering from addiction suddenly disappears or becomes uncommunicative. It may be worth tracking them down and attempting to use the Marchman Act in case they have gone off the grid because they are in crisis, in which case you might be able to stop a dangerous spiral. 

5. They Show Signs Of Being A Danger To Themselves Or Others

Patterns of escalating use and increasing emotional instability tie into the most important sign it might be time to use the Marchman Act: if someone is clearly a danger to themselves or others. Danger to others can take the form of abuse or threats of abuse, or another actual or attempted crime, such a threat of harm if someone does not provide them with money for drugs.

It can also involve behaviors like drunk driving, or someone who is engaging in another dangerous activity while intoxicated (e.g. a doctor performing surgery, a pilot flying). Danger to others might also take the form of a parent who is routinely attempting to care for children while also showing signs that they are suffering from a serious substance abuse problem that impairs their judgement. 

As far as danger to oneself, along with neglect of one’s health or escalating drug use, you should beware of potential suicidality. Someone who describes wanting to die or states that they do not care if they do is raising a serious red flag, and in this case, the Baker Act might be an option as well.

As tragic cases like the one behind Casey’s Law indicate, it is far better safe than sorry if you are worried about someone who is exhibiting any of these signs or who is otherwise seriously incapacitated. For guidance on whether the Baker Act or the Marchman Act is more appropriate for your loved one, or for any other questions or inquiries about the Marchman Act and how to begin the process of filing a Marchman Act petition, feel free to call us any time at 833-497-3808, or to contact one of our skilled intervention counselors using this online form. 

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