Instead of harping on the harm, get to the heart of the matter.
I would argue that asking about “likes” or reasons for the love of alcohol or any other drug is probably the most important question a counsellor, Keyworker or helper can ask a person who has a drug problem. This is the exact opposite of the generally accepted approach, which is to begin discussions with a focus on harm, hoping to motivate change. The assumption is that if people knew about and fully grasped the extent of the harm from their drug use, they would surely quit. This, however, we know isn’t true. Usually, people with addictions are substantially informed and alarmed about the harm. They continue using or drinking despite this knowledge.
Some addicts requesting help and others don’t. What is most interesting from an addiction professionals perspective is: Why do people continue to indulge despite their knowledge of the harm? What is so compelling? To get to the heart of the matter, the truly revolutionary question is: “What do you like about drugs?”
Traditionally-trained Keyworkers resist asking about drug or alcohol benefits and consider it dangerous: “I don’t want to trigger or enable drug or alcohol use” are normally the responses given. First off, clients don’t need to come to a Keyworker to be triggered. That can happen anywhere, anytime. Triggers are all around addicts. The real challenge is helping them learn to deal with triggers and manage their feelings in a productive way. Second, helping people understand what they like about drugs or alcohol– what motivates them to use drugs – is all about increasing self-understanding, which is something completely different from granting approval or encouraging indulgence. In fact, it is a very important part of the process of making decisions to change.
Rather than being helpful, focusing on harm generally elicits defensiveness. Individuals with addictive problems see such probing as a power play; with people around them trying to talk them into something and control their lives. It can be insulting, too, as in: “Look at what you’re doing to yourself.” It creates an oppositional relationship.
In contrast, when people with addictions are asked what they like about drugs or alcohol, they usually seem surprised and say, “No one ever asked me that before.” Some of them actually say: “Finally someone who wants to listen to my point of view.” They recognise that someone is curious about them and their thinking and not merely dedicated to trying to convince them to quit. This helps form an alliance – a sense of partnership and support that will be appreciated and built on over time. It also helps in three other substantial ways.
Firstly, Ask The Right Question To Promote A Positive Relationship
Asking people what they like about drugs or alcohol helps them validate their own experiences. They might start by saying they like drugs or alcohol “because they feel good,” but as they dig deeper into answering this question, they uncover a meaningful explanation of why they are doing what they are doing, without attaching shame, guilt, embarrassment or judgment. They might, for example, come to realise that drugs “feel good” because they help them relax in social situations, or fall asleep at night, or overcome boredom, or manage anger, guilt, shame, or cope with physical or mental pain or depressive moods. They will see that their drug or alcohol use has been an attempt to cope with life; not a result of stupidity or shameful impulses.
Second, Making An Informed Decision
With an understanding of drug or alcohol benefits, people are in a position to make fully-informed decisions about their substance use. They will clearly understand what they would be losing and why it will be a big challenge to succeed if they were to decide to quit or set new limits on their drug or alcohol use.
Thirdly, Help Them See Things From A Different Perspective
A full understanding of what they would be losing helps people prepare for making changes and consider how they will take care of themselves without drugs, alcohol or even simply, with less of them. For example: “How will I cope with stress or pain”. I stop drinking (or drink less)?” In this sense, it helps them carve a pathway to successful change.
People with drug or alcohol problems have been beaten to death by probing discussions about the harm from their substance use. It’s time to give them something they can use: Ask them what they like about drugs or alcohol?. This is not a setup question to get to the harm. It’s an empowering question that helps them understand and take control of their lives, including their substance use.