If you’re worried that your partner may be abusing opioids, you are not alone. Opioids include prescription painkillers like hydrocodone, oxycodone, and codeine, as well as heroin, and they have created an incredibly dangerous national crisis. It’s estimated that of the 21.5 million Americans with a substance use disorder in 2014, over two million were users of some kind of opioid. Because of their extremely addictive qualities, even those who are prescribed these strong painkillers often end up susceptible to abusing them; worse, many may not even realize that what they’re doing is drug abuse.
The signs of opioid abuse in your spouse might be tough to identify if you don’t know exactly what to look for. This guide will teach you what symptoms to look for — physically, mentally, and behaviorally — and offer advice on how to talk to your partner. If it becomes apparent that your loved one does indeed have a substance use disorder involving opioids, there are all kinds of options to not only save his or her life, but your marriage, too.
Spotting the signs of opioid addiction may depend on your spouse’s situation: if the problem started after he or she was prescribed a strong painkiller to deal with a chronic pain condition or following a surgical procedure in the past, they may have become very good at concealing their habits. Keep in mind, however, that just because you aren’t aware of them ever taking an opioid doesn’t mean they haven’t. Not every symptom of abuse will show up in every partner, so it’s important to keep your situation in perspective.
Further, although you have the closest proximity to your spouse, it isn’t always easy to recognize this kind of problem. Maybe you wrote off strange behavior because you know your partner has been struggling to cope with a tough situation at work, or you didn’t think anything of a heated argument because the two of you have been experiencing marital woes. This doesn’t make you a bad partner or someone to blame, but it does mean you need to evaluate what’s going on in a more objective manner.
Part of why these symptoms are difficult to attribute to an opioid abuse problem is because many are associated with other conditions like stress, poor eating habits, and even the flu. If you’ve noticed one or more of these signs in your spouse, next consider whether you’ve noticed any behavioral signs:
Finally, you should also look for signs of withdrawal. If your spouse seems to have regular bouts of illness that could be consistent with running out of pills, keep an eye out for:
Withdrawal symptoms do tend to mirror those of the flu, so again, it’s important to look for a combination of all factors before leaping to judgment.
One of the great dangers about opioids is that because they can be so expensive and attaining them en masse can raise many red flags, abusers tend to look for a cheaper alternative: heroin. Often, it’s simply easier and more cost efficient to switch or supplement a painkiller habit with heroin, all while receiving the same kind of high from using it. Many of the symptoms will be similar to those for painkillers, but some additional signs of heroin abuse to look out for include:
There are also some considerations to make about the state of your relationship with your partner. Substance abuse often creates issues between spouses, whether it’s cutting back on the time you spend together or creating distance between you emotionally. It often causes regular arguments, even if you haven’t confronted him or her about abuse. You may be fighting about money issues, miscommunications, or frustrating changes in your partner’s behavior: failing to stick to their word, letting important responsibilities fall to the wayside, deceptive behavior, or unexplained, potentially late-night outings.
You may think that your partner would never allow a substance to come between you, and if a habit had gotten out of control, that he or she would stop using or at the very least confide in you. Unfortunately, that isn’t always the case. Sometimes a drug abuser doesn’t realize the consequences of their actions and may not realize just how much their behavior is hurting you; or maybe they see it, but are so powerless against their addiction that they can’t find the strength to quit. They may also feel ashamed and worry that you will leave them if you know there’s a problem, especially if you have children together. Sadly, this can also cause a perilous continuous downward spiral: the addicted partner continues to use and you fight over its repercussions, then they use as a way to cope. Again, this does not mean you are partly to blame, but understanding the vicious cycle of addiction may help you understand what’s going on with your partner a little better.
If you’ve come to the conclusion that your partner is abusing opioids, or if you have strong suspicions but still aren’t completely certain, it’s time to talk to him or her. Don’t rush to call an intervention with friends and family — you owe it to your spouse to at least give them a chance to come clean to you privately, and getting others immediately involved could alienate them even further. Plus, if your suspicions end up being wrong and he or she is able to prove that drug abuse isn’t the culprit, you’ll have taken a very private matter public and potentially even humiliate your partner. First, approach them solo.
Try to find a time that it’s going to be just you and your partner; no children, no potential for guests at the door, and no plans on the agenda. In a calm, collected manner, let him or her know that you love and support them, and that their well-being means a lot to you. Be sure to watch the way you’re presenting yourself so that you don’t come off as condescending or superior; it’s important that they don’t feed judged and are comfortable talking. Don’t look at the conversation as a confrontation or intervention: look at it as an opportunity to have a safe, honest conversation.
“I’ve noticed you haven’t been sleeping as much lately,” instead of, “You’re up all hours of the night.”
“I’ve noticed you haven’t wanted to be as social with our friends lately. I know that you’ve been having a really tough time at work, but I wanted to make sure there isn’t anything else going on.”
Come prepared with specific observations to discuss, but don’t be accusatory. Aim for statements like, “I’ve noticed you haven’t been sleeping as much lately,” instead of, “You’re up all hours of the night.” Lay out the behaviors and other signs that you’ve noticed, and ask if there is anything going on. Focus on showing your genuine concern, and even acknowledge other stressors they may be facing. For example: “I’ve noticed you haven’t wanted to be as social with our friends lately. I know that you’ve been having a really tough time at work, but I wanted to make sure there isn’t anything else going on.”
Pay close attention to how your partner responds. Does he or she become immediately defensive — perhaps taking a step back from you or crossing their arms — or do they seem at least somewhat open to discussion? Even if they don’t admit there’s an addiction problem right away, it’s a good sign if they appear willing to talk. However, if they do become overly defensive or upset, don’t pursue the conversation further. Let them know that you love them and are available to talk if they ever want to, and walk away. Having this crucial conversation while your partner has closed him or herself off will be counter-productive, so know when to step away and plan to revisit the topic.
“Don’t accuse them of lying unless you can directly prove it.”
If your spouse is receptive, though, keep the conversation going. If they casually shrug it off as something else, calmly make your case. For example: “You say it’s because you’re worried about your mom’s Alzheimer’s diagnosis last week, but I’ve been noticing your mood has been somewhat unpredictable for the last couple of months. I was surprised at your anger during our road trip two weeks ago, for instance.” The point is not to list off everything your partner has done to make you suspicious, but instead to let him or her know exactly why you’re concerned by providing specific evidence. Don’t make accusations, but don’t let him or her get away with answers that don’t make sense, either. Keep your cool even if you get frustrated, and reiterate that you’re speaking to them out of concern and love. Don’t accuse them of lying unless you can directly prove it, and if so, give them the opportunity to explain.
It’s also important to remember that denial is a major symptom of addiction, so getting through to your spouse can take time and repeated efforts. If you’ve tried speaking to them on your own a few times, you may want to consider asking a trusted loved one for their help. It’s best to go with someone who knows your partner well like a parent, sibling, or close friend; they may even be able to give you additional insight into his or her situation. If a few of you decide to try to initiate a conversation together, keep the numbers small and avoid making it seem like you’re ganging up on your partner.
Bringing in additional support is especially important if you worry that your safety and that of your children (if you have them) is at risk. If your spouse has started to have violent tendencies or bring around questionable people, there’s no time to waste in acting. Get your children out of the house and safely in the care of a loved one, then be prepared to have a more frank conversation with your spouse. If after several conversations you haven’t shaken the feeling that something is going on, it’s likely that you’re right, and that means spelling out the problem the next time you try to talk to them.
Though you may be tempted to make your partner choose between family and drugs, resist making threats unless you’re absolutely committed to them. If you tell your spouse you won’t come back home until they receive treatment, make sure you have a guaranteed safe place to stay and hold true to your word: not only for your own safety, but because making idle threats only enables their drug abuse.
If your spouse does admit to an opioid abuse problem, do your best to be understanding and open to whatever they have to say. There could be more to the issue than you’re aware of, and it’s important that he or she feels heard. Avoid lecturing or preaching. They’ve likely been silently kicking themselves for quite some time, even telling themselves they don’t deserve a better life. It’s better to focus on letting them know that, even if you don’t totally understand, you want to help them get better.
The best option for your loved one is to seek professional opioid abuse rehabilitation. You can research valuable options beforehand — it may help to have a little information on what your insurance covers, which centers are nearby, and what kind of programs are offered — or offer to look together. Don’t blindside your loved one by choosing exactly which treatment center they’ll be going to and paying ahead of time, and don’t plan to end your conversation by getting in the car and driving straight to a rehab facility. Involuntary addiction treatment is only legal in certain states, and it’s debated whether or not forcing someone to get clean is long-lasting. It may be hard to accept, but your spouse has to make the decision to get clean for themselves.
Your spouse may be receptive to the idea of treatment, but worried about others finding out. Let him or her know that you respect their privacy, and that no one really has to know — if an employer needs a doctor’s note in order to grant someone medical leave, the kind of treatment doesn’t have to be specified. It’s against the law for health care providers to share a person’s medical information with anyone. Remind your partner, however, that everyone can relate to making mistakes big and small; what’s important is correcting them, and many will show compassion and support for someone making a genuine effort to get sober.
If you have children, don’t forget to establish how you’ll talk to them about what’s going on. Decide together. You’ll need to take into account each child’s age, maturity level, and general understanding of these kinds of issues. You may want to reach out to a counselor who specializes in child psychiatry for professional advice on how to approach the topic. In the end, though, one of the most important things to let your kids know is that both parents love them, want the best life for them, and want to make things better.
Offer to go with your partner when he or she checks in to treatment, but be prepared for the possibility that they may feel too ashamed and ask someone else to take them. Most treatment centers involve the family in the rehabilitation process, be it through visits or family counseling. Sometimes these sessions can bring up a lot of tough issues and are often quite emotional — and that’s OK. You’re allowed to feel betrayed by your spouse’s deception and they are allowed to feel hurt over your struggle to understand. Be open and honest with each other throughout the process, and take advantage of the experienced counselors you work with; remember, they’ve helped dozens of families pick up the pieces, so their input is important. You may not agree with everything, but keeping an open mind is crucial.
You may want to consider seeking counseling outside of the sessions with your partner. It helps to find a therapist with experience in drug abuse and marriage counseling; often, your local Narcotics Anonymous (NA) group can offer resources. It may also be helpful to attend an NA meeting — they’re free, found throughout the country, and can help you gain understanding into your spouse’s habit. It’s also a wonderful way to meet others that have loved ones with an addiction and build a special kind of support group. Though your friends and family will try their best to understand your feelings, having someone who knows exactly what you’re going through can make an important difference in your own recovery.
When your spouse leaves treatment and comes home, keep in mind that there’s going to be an adjustment period. You’ll likely have to work together to rebuild lost trust, and find productive ways to communicate about the recovery process. It will likely be difficult for your spouse in the beginning, so try your best to offer consistent support and understanding. Keep up with your counseling sessions — you may want to consider marriage counseling, as well — and do what you can to support your spouse’s NA meeting attendance. Offer to go with them, or to give them a ride there, and don’t be afraid to ask about them afterward; it’s important that their recovery doesn’t become a taboo subject to discuss.
One of the most important things you can do to support your spouse’s recovery is to keep the lines of communication open. If there are certain fights that keep recurring, seek advice from your counselor. You may also still need to seek the support of a trusted loved one to help you cope with the many life changes, but don’t forget to respect your partner’s privacy: don’t share anything about them that you wouldn’t want them sharing about you.
It’s a long and challenging road, but your spouse can overcome their addiction. Spotting the signs and finding treatment are vital first steps, but some of the toughest work comes with learning a new way of life with sobriety. Remember that you love each other and have fought many battles side-by-side: this is simply the next one, and you can win.