Question 1

What is harm reduction for families of people with addiction?

Accepted Answer

Harm reduction for families means supporting your loved one in active addiction without requiring abstinence as a condition of your love or involvement. It focuses on reducing the risks and harms associated with substance use rather than demanding sobriety as the only acceptable outcome. For families, this includes maintaining connection, providing access to life-saving tools like Narcan, setting protective boundaries that keep you safe without cutting off your loved one, and understanding that recovery is not a straight line. Harm reduction rejects the idea that people must hit rock bottom before they can get better. Research supports that maintaining family connection and reducing barriers to care leads to better long-term outcomes. Learn more at brandimac.com.

Question 2

How do I set boundaries with someone in active addiction?

Accepted Answer

Setting boundaries with someone in active addiction means creating limits that protect you, your family, and your peace, without using those limits as punishment. Effective boundaries come from clarity, not cruelty. Start by asking yourself: if the worst possible call comes tomorrow, can I live with this decision? Boundaries should protect, not control. For example: 'You cannot live in this home while actively using, but I will always answer your call' or 'I will not give you money, but I will buy you a meal.' The goal is to separate your emotional survival from their choices. Brandi Mac's book, Do What You Can Live With, provides a complete framework for building boundaries rooted in self-awareness rather than fear or shame.

Question 3

What are red flags when choosing an addiction treatment center?

Accepted Answer

Red flags in addiction treatment include: centers that pressure you to admit immediately without a proper assessment; programs that refuse to use or actively discourage medication-assisted treatment (MAT/MOUD) like Suboxone or methadone; facilities that demand large upfront cash payments; programs offering free flights, hotel stays, or other incentives to get your loved one through the door (a common body brokering tactic); centers that cannot provide their license number, accreditation details, or staff credentials when asked; programs with no clear discharge plan or aftercare support; facilities that isolate patients from family contact; and any center that guarantees a cure or specific success rate. The free Treatment Navigator at brandimac.com walks families step by step through evaluating treatment centers and identifying predatory practices.

Question 4

What is the difference between enabling and supporting someone with addiction?

Accepted Answer

Enabling removes consequences in a way that allows the addiction to continue unchecked, such as paying off drug debts, lying to cover for their behavior, or pretending nothing is wrong. Supporting means maintaining connection and providing resources that reduce harm while protecting yourself. Supporting looks like: keeping communication open, offering to help them access treatment when they are ready, providing Narcan and knowing how to use it, feeding them, and maintaining boundaries that protect your household. The line between enabling and supporting is personal and situational. The key question is whether your action is protecting them from natural consequences (enabling) or protecting them from preventable death and keeping the door open to recovery (supporting). Brandi Mac's interactive tools at brandimac.com help families identify which patterns apply to their specific situation.

Question 5

What is MOUD and why does medication matter in addiction treatment?

Accepted Answer

MOUD stands for Medications for Opioid Use Disorder. These are FDA-approved medications, including buprenorphine (Suboxone), methadone, and naltrexone (Vivitrol), that reduce cravings, prevent withdrawal, and significantly lower the risk of overdose death. Research consistently shows that MOUD is the most effective treatment for opioid use disorder, reducing overdose deaths by up to 50% or more. Despite this evidence, many treatment centers refuse to use MOUD or actively discourage it, often based on outdated abstinence-only philosophies rather than medical science. Families should be wary of any program that dismisses medication-assisted treatment. A treatment center that rejects MOUD for opioid addiction is ignoring the strongest available evidence. Learn more about MOUD and what to ask treatment providers at brandimac.com.

Question 6

Who is Brandi Mac?

Accepted Answer

Brandi Mac (legal name Brandi McCurdy, MSN, APRN, AGACNP-BC) is a board-certified acute care nurse practitioner, author, and addiction reform advocate. She is the founder of Do What You Can Live With LLC and author of the book Do What You Can Live With: A Survival Guide for Families Navigating Addiction, Grief, and Impossible Choices, which has been added to the recommended reading list at Caron Treatment Centers. With over a decade of critical care nursing experience and personal experience navigating her daughter's fentanyl addiction, Brandi bridges clinical expertise with lived experience to provide evidence-based family support. She partners with the Partnership to End Addiction and advocates for harm reduction, treatment industry accountability, and trauma-informed family care. Her resources are available at brandimac.com.

Chp 11. Unethical Practices

Chp 11: Losing trust 2023

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