How to Help Someone with Drug or Alcohol Addiction
If you love someone with a drug or alcohol problem, you may be feeling a range of emotions, such as concern, anger, or frustration. Substance misuse can have negative impacts on not only the person who is using, but their friends and family as well. This article will help you understand more about substance use disorders, how to encourage your loved one to seek the help they need, and how to support them in their recovery.
Understanding Substance Addiction
Addiction is a chronic, relapsing disease otherwise known as a substance use disorder (SUD).1 When someone has an SUD, they can’t simply stop using drugs or alcohol through willpower alone, even if they want to.
It may sometimes be hard to tell when someone’s drug or alcohol use has become a problem. Some signs to look for include:10
- Spending a lot of time alone, or with new friends.
- Unexplained mood changes.
- Missing work or school.
- Sleeping at odd hours.
- Grooming changes, such as not showering or brushing their teeth.
- Eating more or less than before.
Signs your loved one’s substance use has turned from a problem into an SUD include having at least 2 of the following in a 12-month period:1,2,11
- Wanting but being unable to cut back or quit using substances.
- Having problems at work, home, or school due to substance use.
- Increased social conflict due to substance use.
- Using substances rather than doing things they used to enjoy, like hobbies or recreational activities.
- Spending a lot of time looking for substances, using them, or recovering from using them.
- Drinking or using drugs in dangerous situations (such as while driving or operating machinery).
- Using substances even when they know it makes mental or physical issues worse.
- Using more of a substance than intended.
- Needing to use more and more of a substance to get the same effect.
- Going through withdrawal when they try to stop using substances.
While it can be helpful to know the signs of an SUD so you can support your loved one, it’s important to accept what you can and can’t control. For example, you can’t force someone to admit they have a problem or seek treatment. Even if they’re not ready for treatment or you don’t know what to say, you’re doing enough on your end simply by offering support and showing your love and concern.
How to Talk to a Drug or Alcohol Addict
When talking to your loved one about their substance use, you should be aware that there may not be a “right time” for the conversation. Your loved one might not want to talk about it, but that doesn’t mean you should put off the talk. Starting the conversation is the first step to getting help.
How to Start the Conversation
First, it’s a good idea to wait until your loved one isn’t under the influence. Otherwise, they will probably be less willing to hear your concerns. Choose a quiet moment in a private setting with few distractions, such as at home or on a walk. You might be nervous or unsure, but that’s normal and completely okay. Remember to stay calm, be patient, and take a few deep breaths to help yourself stay on topic.
What to Say to Someone with Addiction
Express your concern and be direct. Focus on your experiences, feelings, and observations. Use “I” statements that let them know what you’ve noticed, such as how their drug or alcohol use is affecting your relationship or other areas of their life. Some examples:
- “I’m worried about you. Can we talk?”
- “I’ve noticed that you call in sick to work a lot. Do you want to talk about what is going on?”
- “I’m concerned that you wake up hungover every morning and I’m worried about the impact of your drinking on your health.”
- “I’ve noticed you don’t seem like yourself lately. How can I help?”
Remember that just as your concerns are important, your loved one’s feelings are valid too. They may be defensive or upset, but it’s important to remain calm and not get into an argument. Rather, you want to keep the focus on helping them. Listen to and express empathy for their feelings and concerns. You could say something such as, “I hear you. I love and care about you. How can I support you?”
Let your loved one know that it takes a lot of courage and strength to admit to a problem and seek help, and that SUDs are treatable.4 You might suggest that they talk to their doctor, who can assess the problem and help them find treatment. You can also help your loved one find treatment options. Offer to go with them to any appointments or attend family or group therapy, if they want that.
What Not to Say to Your Loved one
Try to avoid accusations or referring to your loved one as an addict or alcoholic. The preferred terms are “someone with a substance use disorder” or “someone who misuses alcohol or drugs.”3
Also try to avoid lecturing or criticizing. No one likes to be told what to do, and having an SUD doesn’t make them “wrong” or “bad.”
Don’t be confrontational. The types of “interventions” that you see on TV are rarely effective.4 They can even backfire and lead to anger or refusal to get treatment.4 Instead, try to imagine how you would like to be talked to if you were in your loved one’s shoes. Focus on getting them to at least talk to a doctor if they won’t talk to you.
Don’t blame your loved one for the problem. Remember that they have a disease that’s as real as any other chronic disease. So just as with other disease, they need treatment to get better.1
Take Care of Yourself
Caring for someone with an SUD can be challenging. So it’s important to take care of yourself as well and avoid enabling. Enabling means any behavior that protects your loved one from the consequences of their substance use. Examples include:5
- Lying to people to cover up your loved one’s substance use.
- Giving your loved one money.
- Bailing your loved one out of jail.
- Making excuses for why your loved one uses, such as “they’re so stressed, they deserve a drink.”
- Ignoring their drug use or thinking it’s not a problem.
Instead of enabling, set healthy boundaries. A boundary is a rule or limit that helps protect you and lets others know what you will and will not tolerate in a relationship. Use “I” statements when letting your loved one know your boundaries. Some examples of good boundaries include:
- I won’t lie to people about your drinking anymore.
- I won’t give you money.
- I won’t bail you out of jail.
- I won’t hang out with you when you are using drugs or drinking.
Remember that if you’re exhausted, it’s going to be harder to support your loved one. You may want to seek counseling for yourself so that you can process your own feelings. This could be one-on-one therapy, group counseling, or family support groups, such as Al-Anon or Nar-Anon.
Exploring Drug and Alcohol Treatment Options
If your loved one is willing to go to treatment, you can help them research treatment programs. If your loved one refuses to go to treatment, you could try learning the CRAFT approach. This training teaches family and friends good strategies for helping their loved ones get treatment.7
Common SUD treatment types include:8,9
- Detox. This is not technically a form of treatment. Rather, it is often the first step in the rehab process. Detox helps your loved one through withdrawal and become medically stable so they can enter treatment.
- Outpatient rehab, where your loved one lives at home but travels to a treatment center on a regular basis.
- Inpatient rehab, where they live at a residential treatment center and get round-the-clock monitoring, care, and support.
- Behavioral therapy, which is a broad category that can include methods such as cognitive-behavioral therapy (CBT) or contingency management (CM). CBT helps people identify unhelpful thoughts and increase positive, healthy behavior. CM uses positive reinforcement to help people stay away from drugs and alcohol.
- 12-step groups or other types of mutual support groups, which help people in recovery through the support of others who have been in the same situation.
No one type of treatment is better than others. The best treatment for your loved one depends on different factors, such as how bad their SUD is, whether they have other physical or mental health issues, and their insurance plan. The most important thing is that your loved one gets some form of help.
- National Institute on Drug Abuse. (2018). Media guide: The science of drug use and addiction: The basics.
- Office on Women’s Health. (2018). Alcohol use disorder, substance use disorder, and addiction.
- National Institute on Drug Abuse. (2020). Words matter: Preferred language for talking about addiction.
- National Institute on Drug Abuse. (2019). Step by step guides to finding treatment for drug use disorders: How to find help.
- University of Pennsylvania Health System. Enabling behaviors.
- University of Kentucky Human Resources. How to Create Healthy Boundaries.
- American Psychological Association. (2011). Community reinforcement and family training (CRAFT).
- National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (third edition).
- National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction.
- National Institute on Drug Abuse (n.d.) What is an addiction?
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.