At Modern Therapy & Wellness, several of our clinicians specialize in working with substance use, addiction, recovery, and the impact these struggle can have on individuals, coupes and families.
One of the hardest realities about addiction is that people often know they need help long before they’re ready to say it out loud.
Families wonder:
“Is this serious enough for treatment?”
“Are they functioning… or barely holding things together?”
“Why can’t they just stop?”
“What actually happens when someone goes to rehab?”
To explore these questions, I recently sat down with Ronnie Delaune, LPC LAC NCC, Regional Director of Community Outreach for Avenues Recovery Centers of Louisiana and a person in long-term recovery.
What stood out most during our conversation was this:
Addiction is rarely just about substances.
It’s often about fear, shame, coping, avoidance, and a growing loss of control that slowly impacts nearly every area of life.
So how can someone tell if they may need inpatient treatment instead of weekly therapy?
Ronnie explained that many people already know internally that things have crossed a line, even if they struggle to admit it out loud.
He shared that one helpful tool is the CAGE assessment, which asks questions like:
- Have you tried to cut down?
- Do you feel annoyed when others express concern?
- Have you felt guilty about your drinking or substance use?
- Have you needed substances to function or calm yourself?
But beyond assessments, Ronnie emphasized looking honestly at daily life.
“Am I able to maintain employment? Are my relationships affected? Am I able to go days without using or obsessively thinking about using? Does my social life revolve around drinking or using?”
One particularly important point he made was that weekly therapy alone is often not enough in the early stages of recovery. “Meeting with a therapist once a week for one hour is rarely enough, at least initially.” This doesn’t mean therapy is unimportant. In fact, therapy is often a crucial part of long-term recovery. But when addiction has become severe, people often need much more structure, accountability, support, and stabilization than one session a week can provide.
Our clinicians at Modern Therapy & Wellness shared:
“Weekly therapy is often a starting point for clients who may end up needing a higher level of care. Beginning with weekly therapy can allow people to look at the impacts that the substance is causing in their life and relationships. It can also allow them to begin breaking denial or minimizing the impacts of the substance, whether that is drinking or other substances.” “We often see individuals who are minimizing how much substances are affecting them because they are still functioning in certain areas of life. But many people are struggling long before things completely fall apart.”
What are signs substance use may be becoming dangerous, even if someone still seems “functional”?
Ronnie explained that addiction doesn’t always look dramatic in the beginning.
Sometimes the signs are subtle:
- changes in sleep
- changes in appetite
- withdrawal from relationships
- increased irritability
- emotional instability
- hygiene changes
- obsessive thinking about substances
Other times, the impact becomes more visible through:
- employment problems
- financial strain
- legal issues
- relationship conflict
- emotional decline
One of the most important reminders from our conversation was that “functioning” does not necessarily mean healthy.
Many people are surviving while privately struggling.
What keeps people from getting help sooner?
According to Ronnie, the answer is often denial and fear. “Addicts tend to think they can stop at any time… or they’ll stop when it’s time.” But when people begin realizing they cannot stop on their own, fear often takes over.
Fear of:
- looking weak
- disappointing family
- losing relationships
- losing jobs
- being judged
- facing painful emotions without substances
Ronnie said something during our conversation that felt particularly powerful:
“These fear-based thoughts are precisely the opposite of reality.”
Many people fear treatment will destroy their lives, when in reality addiction is often already quietly doing that.
What does the admission process actually look like?
One of the biggest misconceptions about treatment is that entering rehab is extremely complicated. Ronnie explained that the process is often much simpler than people expect.
Typically, the admissions process includes:
- a brief phone screening
- questions about substances being used
- insurance verification
- transportation coordination if needed
Depending on the person’s needs, treatment may include detox, residential treatment, or intensive outpatient care. He also emphasized that not everyone requires detox, although medically supervised detox is often necessary for substances such as alcohol, benzodiazepines, and opioids.
Perhaps most importantly, Ronnie repeatedly emphasized this idea:
People do not have to wait until everything completely falls apart before seeking help. And many people deserve support long before they reach what others might consider “rock bottom.”
(Part Two will explore what families often misunderstand about addiction, relapse, and the emotional realities of early recovery.)
If you or someone you love is struggling with substance use and wondering what level of support may be appropriate, help is available.
For questions about treatment, admissions, detox, or recovery support:
Ronnie Delaune, LPC LAC NCC
Regional Director of Community Outreach
Avenues Recovery Centers of Louisiana
504-495-1552
Ronald.delaune@
At Modern Therapy & Wellness, several of our clinicians specialize in substance use, addiction, recovery, and the impact addiction can have on individuals, couples, and families. To learn more about therapy support or to schedule an appointment:
info@moderntherapyandwellness.