by Robert Weiss, LCSW, CSAT-S

Addicts are very easy to spot. They are those dirty, smelly, unkempt men hanging out under bridges, in front of convenience stores, in back alleys, and in all the other unsavory places that “healthy” people never go. Addicts sleep in the gutter. Addicts get arrested a lot. Addicts are completely estranged from their families. Addicts definitely do not have jobs. Nor do they have friends.

Addiction: The Reality

Only about 10 percent of addicts fall into the easily identified “low bottom” stereotype described above. The other 90 percent are people that most of us deal with in our day-to-day lives, often regularly, without our knowing about their addiction. This is because the vast majority of addicts work very hard to hide their problem, be it alcoholism, drug addiction, or a behavioral addiction like eating, shopping, gambling, or sex. The simple truth is most addicts are functional for long periods of time, maintaining jobs and even marriages while keeping their problem relatively hidden.

Of course, the people around addicts are usually fairly helpful in this regard. This is because most of us, addicted or not, want to keep our problems quiet and out of sight. In return, we are usually inclined to “not notice” the eccentric, unusual, and erratic behaviors of others. And when we do notice, instead of having the bad taste to mention these issues, we create in our own minds excuses for what the other person is doing. This is especially true in family settings, where spouses need to believe their significant other is trustworthy and dependable, where parents need to believe they’ve done a good job raising their children, and kids in turn need to believe their parents are perfectly normal and consistently doing the right thing. In other words, family members are especially adept at looking the other way.

Because of this, most addicts end up having to experience some sort of catastrophic event before their addiction comes to light and gets dealt with. Often they must get arrested, become physically or mentally unwell, get fired, file for bankruptcy, get kicked out school or a marriage, or experience some other similarly extreme consequence before they’ll admit to a problem. In the absence of dire consequences, most addicts are able to sleepwalk through a denial-driven fog for years on end – and those around them either don’t recognize it or choose to ignore it for fear of rocking the boat.

Signs of Addiction

Perhaps you are wondering if someone you know and care about may be suffering from some form of addiction. If that person is not a low bottom addict, it can be difficult to know. That said, there are plenty of potential giveaways. Any and all of these signs can be indicative of active addiction, though none is definitive in terms of saying “Yes, this person is an addict.” If, however, you spot several of these issues in someone you care about, it may be time to speak up. (More on this later.)

• Deceitfulness: Addicts are liars. Addicts fib and make excuses with cold, calculated precision, especially when it comes to protecting their addiction. If/when they are confronted about their lies, they deny, they justify, they minimize, and they externalize, placing the blame on others.
• Manipulation: Addicts hide their addiction by convincing you to believe their story, however unlikely it may be, rather than trusting your own feelings and intuition. They are incredibly persistent with this; they will keep at it until you wear down and give in. Often, they will try to make you feel as if you are the one with a problem (lack of trust, imagining things, etc.)
• Mood Swings: Some addicts can seem hyperactive and extremely happy, followed by periods of depression, irritability, and lethargy. Other addicts can seem pleasant and mellow, followed by periods of anxiety, paranoia, and anger. Usually, if questioned, they blame these mood swings on the actions of others or on events beyond their control.
• Physical Isolation and Withdrawal: The easiest way to keep an addiction secret is to hide from anyone who might recognize the problem. Sometimes addicts just disappear completely. Later, of course, they tell semi-plausible lies and stories to explain away their absence.
• Emotional Isolation and Withdrawal: Because they tend to withdraw physically, and because they tend to be so unpredictably moody, addicts nearly always struggle with interpersonal relationships. Because of this, they are notoriously non-intimate. They almost never willingly share about their feelings or their problems.
• Trouble at Work or in School: Over time, addicts lose focus on most things that don’t involve their addiction. As such, work and school tend to suffer. Many addicts are able to maintain in these arenas for long periods, even though they’re operating at much less than full capacity. Usually the decline here is slow and difficult to notice, but it is almost always present.
• Financial Issues: It doesn’t matter what a person’s addiction is, it’s expensive. Even addicts with jobs that pay extremely well tend to live on the edge financially. Some become habitually late paying their bills. Some start to ignore their financial obligations altogether.
• Declining Physical and Emotional Health: Addicts often experience either an increase or a decrease in appetite and/or sleep. Sometimes they binge and purge with one, the other, or both. Usually, because of this, their appearance declines. The signs will look different depending on the addict, with eating disorders manifesting much differently than, say, alcoholism or a gambling addiction. Usually changes to health and appearance are gradual and therefore difficult to notice, but they are almost always there.

What You Can Do To Help

If you think a friend, family member, or client may be an addict, usually the best thing you can do is talk to that person about it. Before doing this, though, you may want to take (or at least consider) the following steps:

• Talk to others who are also close to the addict to get their take on the situation. If you think it will help, you can try to grow an alliance of family/friends/supportive others who can help you to confront the addict.
• Gather as much factual information as you can about what the addict is actually doing and how it is affecting his/her life (and the lives of others, such as yourself).
• Consider how the addict is likely to respond to a confrontation. If you think a confrontation may be contentious, difficult, and possibly unproductive, consider hiring a professional interventionist, as doing so increases your odds of success.

It’s important to know before you approach an addict that confrontation is the absolute last thing he or she wants. Even addicts who know they have a serious problem will nearly always resist. If you truly care about an addict, you will persist despite that person’s reluctance and potential anger.

Usually the best way to confront an addict is to start by saying you are concerned about his or her wellbeing, and you think there might be a problem. Then you should list a few of the concrete, undeniable facts that are causing you to worry. Be as specific as possible with these facts. “You’ve shown up late to our last three lunch dates reeking of vodka and slurring.” “You’ve been fired from your last three jobs because you were smoking pot in the break-room.” “You’re constantly either jittery or despondent, and you’ve lost 20 pounds in the last four weeks, and none of your friends will talk to you anymore.” Etc. After this, you should say that although you love them, you can no longer sit idly by while they ruin their life. Then you can offer to help them find treatment and/or a 12-step recovery program that can help them overcome their addiction. After that, it’s pretty much up to the addict as to whether he or she wants to accept the help you’ve offered.

With or without the assistance of an intervention specialist, the end goals are the same:

1. Let the addict know that you care about him or her.
2. Let the addict know that you are worried (and why).
3. Let the addict know that you will no longer co-sign or support his or her destructive behaviors.
4. Let the addict know that you hope he or she will accept the help you are offering.

It is important to remember throughout this process that you cannot get well for another person. Nor can you create in that person the motivation needed for recovery. The choice to get well or not is the addict’s and nobody else’s. No matter how badly you want this person to recover, no matter how great your love for this person, you can’t magically make it happen. When and if the addict decides that he or she wants help, that help is available in abundance. But until that time the best you can do is to voice your concerns and stop enabling the addiction. If you find yourself struggling, you may wish to attend Al-Anon, CoDA (Codependents Anonymous), or similar meetings as a way to help yourself. In these programs you will meet other concerned, loving people who are trying to live a healthy life while dealing with another person’s addiction. Sure, you may wonder why you’re the one getting help when it’s someone else who has the addiction, and this is a perfectly natural reaction. If and when you have it, remind yourself that you’re in a difficult situation, even if you didn’t cause it, and you deserve support and self-care that will make your life better.

For more information about addiction and recovery, check out the websites of the National Council on Alcoholism and Drug Dependence and The Ranch, among others. Useful books for addicts seeking recovery include Facing Addiction: Starting Recovery from Alcohol and Drugs and Living Sober. For people who are struggling with a friend or family member’s addiction, Codependents’ Guide to the Twelve Steps can be a useful resource.

Robert Weiss LCSW, CSAT-S is Senior Vice President of Clinical Development with Elements Behavioral Health. He has developed clinical programs for The Ranch outside Nashville, Tennessee, Promises Treatment Centers in Malibu, and The Sexual Recovery Institute in Los Angeles. He has also provided clinical multi-addiction training and behavioral health program development for the US military and treatment centers throughout the United States, Europe, and Asia.