When invited guests at holiday gatherings include those struggling with substance abuse, what's a host or hostess to do?
Editor's Note: Celebrating the holidays can mean welcoming guests who have a lot of baggage. MD Magazine asked Constance Scharff, PhD, senior addiction research fellow and director of Addiction Research for the Cliffside Malibu addiction treatment center in Malibu, CA, for some advice.
It is estimated that one in 10 Americans is an addict, so the odds of having someone with a substance abuse problem over for the holidays are relatively good. If you or one of your patients doesn’t know how to handle having an addict as a guest for the holidays, there are practical steps to be taken.
1. Set boundaries. If it is your house and your party, you set the rules of engagement. Let the person know exactly what time you expect them to arrive. Don’t hold the meal if they are late. Unless they live in the home, do not allow them to spend the night. If you normally serve alcohol, keep to that tradition. You don’t have to serve anyone you think is going to over-indulge, even if you serve it to others. If your guest begins to cause problems, ask them to leave. If they don’t leave immediately, call the police to escort them out.
2. Live between enabling and tough love. You’ve invited this person into your home, so it’s not the time for tough love. Be gracious. At the same time, don’t enable. You are under no obligation to give this person anything — rides, money, phones, clothes, gifts, a place to spend the night – at all. If they are too high to drive, call them a cab, because that is a public service.
3. Remove or lock up drugs and alcohol. Yes, your drug-addict nephew is going to rifle through your medicine cabinet or dresser looking for drugs. Why? Because it is an easy score. Remove all substances of abuse — drugs and alcohol – to an area that is locked and keep the key on you. Include all medications for ailing elders who are staying in the house.
4. If your guest has a habit of stealing cash, credit cards, or household items, you’re asking for trouble by allowing them in the house.
5. Keep conversations neutral. This person is a guest. Don’t bring up the job your uncle just lost or talk about your disappointment that your daughter failed out of university. Talk about what you are grateful for. Addiction is serious and deadly. Focus on the love you feel. Let this be a time to remember for the right reasons. Addicts are loved, not bullied, into treatment.
6. Remember what the season is about. Share a meal. Watch a movie. Cook together. Play a board game. The holidays are about sharing time with those we love. But addicts do not have to be invited for all parts of the celebration. Do not ask your nearly-homeless, destitute brother over to watch as your children open the pile of gifts you bought them. Not only will it make everyone feel awkward, but you’re asking for the small electronics to go missing.
7. Talk about treatment. The best time to seek addiction treatment is right now. Let your loved one know in clear and loving terms that you care about them and what to see them get help. If they reject that help, don’t push it. But if they show any interest at all, be ready. Know about the treatment center you’d like them to go to and get online. The holidays are a great time to seek treatment. If your loved one is willing to go, let the gravy get cold and get them into a car. This is called the season of miracles for a reason.
One final thought… If anyone in the household, be it a guest for the evening or a family member who lives in the home, uses opioids, it is imperative to have naloxone on hand and know how to use it. Saving a life might not be the holiday miracle you’re looking for, but it is much better than a holiday tragedy.
Dr. Scharff can be reached at Cliffside Malibu.