Relationships with Drug Users
Resolving strained relationships between drug users and their caregivers is not always possible. Relationships between drug users and their parents and partners were often difficult even before an HIV diagnosis.
Sometimes addiction is a family illness and everyone is participating in the addiction process: parents or partners pay bills, make excuses, solve problems, make problems bearable. Sometimes everyone in the family is a user of some sort and dependent on alcohol or drugs. Sometimes relationships cannot bear the strain of addiction, and families have already drifted apart. Sometimes, as with gayness, families have known all along. A friend of Helen’s called a hospital social worker and said, “My brother is in the hospital, probably with AIDS, probably from using drugs. He won’t tell me, and I don’t want to ask. Can you help me talk to him?” The social worker agreed to say only that the sister had expressed concerns, and set up a visit. When they got together, he told her his life was changing and he was going to need her support. “Finally,” said the sister, “we really got together. We had a wonderful time.”Some families simply accept the addiction. Helen’s family says, “This is the way Helen is. We do what we can. We just keep going.” Other families try to fight the drug problem by withholding care until the user is off drugs. When a friend of Helen’s told his mother he became infected with HIV from injecting drugs, his mother took off her shoe, hit him with it, and said she’d take care of his infection but not his drug problem, so if he wanted help he’d better get off drugs. Like Helen’s friend’s mother, caregivers often insist on detoxification as a condition for care.
The decision of whether to fight the addiction or accept it is extraordinarily painful. Do you insist on detoxification and risk letting people be sick without your care and support? Or do you accept them as they are and risk letting them continue to hurt themselves? Get help with the decision from mental health professionals—psychiatrists, psychologists, social workers—or from professional drug counselors.
Professional drug counselors can be found in drug rehabilitation programs and programs in psychiatric hospitals, regular hospitals, Veterans Administration hospitals, or family and children’s social service agencies.Substance abusers, whose main priority is finding alcohol or drugs, often have problems in complying assiduously with the complex regimen necessary to treat HIV infection. Substance abusers also have problems taking the medications if they have periods of intoxication or if they are confined and detoxifying. Still, the medical profession has been notoriously unsuccessful in predicting who will comply with a medication regimen and who won’t, especially when it has based its predictions on socioeconomic status. The physician’s common assumption is that the person who lives next door is affluent, compliant, and a model patient; while the homeless, jobless addict from the inner city won’t follow a complex medical regimen. Such assumptions are often wrong. Everyone needs a chance, and people can usually predict, based on self-knowledge, how likely they are to comply.
The relationships between drug users and their caregivers are not always unstable. If the relationship was stable before HIV infection entered their lives, it will be stable afterward. Caregivers of drug users, however, often need help from mental health professionals.
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- Bartlett J.G., Finkbeiner A.K.. The Guide to Living with HIV Infection: Developed at the Johns Hopkins AIDS Clinic. Johns Hopkins University Press,2006. — 407 p., 2006
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