These are the questions we ask ourselves when we experience an addiction-related loss. Yet instead of worrying over hypothetical “what-ifs,” let’s focus on a question that could prevent future losses: what should you do if someone you know appears to be abusing drugs or alcohol?

Talk to him or her about it. This is particularly important if they have been sober and recently relapsed. Tell that person that you’re concerned about their behavior, and that you’re afraid they might lose something truly important (a job, spouse, a long-term goal, etc.) The bottom line is: if you’re afraid of losing someone to addiction, let that person know.

Expect that person to get angry with you. After all, they have chosen to use drugs or alcohol at what they think is a “manageable” level—but for most of us in recovery, “manageable” use just isn’t feasible. In any case, you shouldn’t allow someone’s anger to prevent you from sharing your fears.

Don’t forget to take care of yourself; if you don’t want someone drinking or using in your company or in your house, tell them. There’s nothing wrong with drawing a line.

Finally, remind that person that no matter what happens, you’ll be there if problems arise and they want help getting sober again. You’ll support him or her in any way you can. You’ll do your best to help that person get the help they need.

I’ve had the terrible experience of not pushing someone who said he would get help for his addiction—he was dead two weeks later. The questions we ask ourselves are inevitable: Could I have stopped this if I had pushed harder? If I had taken him to treatment? In my friend’s case, I’ll never know the answer. Is this my fault? For that question, the answer is always no. We don’t cause addiction, and we can’t cure it. But we want to know that we did our very best to help the people we love before it’s too late.

Deni Carise, Ph.D.
Chief Clinical Officer
Phoenix House

All too often, people in recovery keep their stories quiet, due in large part to the stigma associated with addiction that still persists in our society.  I remember my own concerns when I was asked to go very public with my recovery story at the National Press Conference celebrating Recovery Month in 2008. But like Ainge, I recognized that sharing my journey was part of recovery and I believed that I had come far enough in my career that negative results from going public would be outweighed by the possible good it could do. Opening up, first to friends and family members, often communicated how best to support me in my recovery. (At parties, for instance, the people in my life know not to serve me alcohol.)  Later, when I told my story in a much more public forum, I did so because I felt I could serve as living proof that substance abusers can and do get better, sometimes much better.  The recovery community should applaud Ainge for helping to spread this important message.  The public already knows that people abusing drugs and alcohol do foolish, harmful things.  What they won’t know, if we don’t tell them, is that people in recovery can go on to do wonderful things.

Ainge’s story also helps us get the word out that addiction can affect anyone.  A talented young player from a famous football family, Ainge seemed to “have it all.”  Yet his drug use escalated from marijuana to alcohol and prescription medications and finally to cocaine and heroin.  During his rookie year with the Jets, he now admits he was taking 25 Percocets at a time. When he finally sought treatment, he says he was “on a one-way street to hell.” Although most of us aren’t sports stars, many of us in recovery can relate to Ainge’s experience because we too were at the height of promising careers when drugs took over our lives. Addiction, we discovered, does not discriminate based on a person’s achievement level or potential for success.

Fortunately, recovery doesn’t discriminate either. Those who find the help they need and commit to managing their recovery can go on to lead productive, rewarding lives.  For this reason, I’m optimistic about Erik Ainge.  Although he’s not sure about his future in football, he knows that his top priority is to maintain his sobriety, which is exactly where his focus should be.  “I want this to be the last time I ever have to try to get clean,” he says, “and I’m going slowly.” If he continues to put his recovery first, taking it one day at a time, he’ll come out a winner, no matter what the scoreboard says.

Deni Carise, Ph.D.
Chief Clinical Officer
Phoenix House

Those who knew him tell of his physical and psychic pain. But most addicts suffer psychic pain — often not fully appreciated until they begin to unearth their demons in treatment. Like Michael, many addicts are hooked in the course of proper medical treatment. Most physicians appreciate the potential for patients becoming addicted. This can occur even with the most prudent medical management. But the combination of sorrow over declining bodily powers and physical pain provide an all too common pathway to prescription drug misuse. Sadly, there are physicians who become passively or actively involved in their patient’s addiction to prescription drugs. Moreover, it’s also very difficult to say “no” to someone with Michael’s star power. Many prescription drug addicts see multiple doctors, zigging and zagging between different doctors and different pharmacies. Their dose levels rise, and their overall function falls.

I suspect the puzzle of Michael Jackson’s drug use and bodily failure will be more clearly analyzed. But ultimately, his death should be remembered, as was Elvis Presley’s, as preventable, and the enablers, professional or otherwise, should be held accountable.