Today I worked with a very familiar case scenario. An anguished mother contacted me about her son who is abusing drugs and alcohol. She wanted to know what she could do about his using. I have met with families who are at their wits end after trying every possible approach they could think of.

Very few addicts spontaneously stop using and maintain their sobriety. It is generally accepted that a treatment intervention of some sort is required. Whether this intervention come through a 12 step fellowship, a clinic, or a religious experience is immaterial; the fact remains that addicts can't seem to get clean without outside help of some sort.

I presented her with the dilemma she faces: If her son is unable or unwilling to seek help then she can either force him into treatment or she can stand back and hope that he reaches "rock bottom" (a point where hypothetically an addict becomes willing to ask for help).

Certain organizations suggest that parents learn how to cope with their anxiety and allow their children to reach rock bottom. They maintain that the addict will not stop using until the pain of quitting is less than the pain of using. Of course very few families want to stand back and watch a loved one walk the path of destruction associated with addiction. There is the very real possibility of death, either through overdose, suicide, or accidents arising from the high-risk lifestyle.

If she chooses to force her son into managed care on the grounds that he is unable to care for himself then she faces his anger.

A useful suggestion to families can be that they place a "bottom line" on the addicts behaviour. This technique explicitly states a course of action the family will take if the addict does the bottom line behaviour.