Helping an Adult Family Member or Friend with a Drug or Alcohol Addiction

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Do you have an adult family member or friend with a drug or alcohol problem? You’re probably wondering how you can help. Here are 7 answers to questions you may be asking.

1. How Can I Tell If I’m Overreacting to a Substance Use Problem?

If you are noticing problems in friend or family member’s work, health, family, finances, relationships, social functioning, legal issues, self-esteem or self-respect, you are not overreacting.

Continuing to use substances in spite of the fact that such behavior is causing problems, is a problem in and of itself. It shows that substance use has become more important than the problems it causes. Someone who is unwilling to discuss the issue or consider whether there might be a problem is a strong indicator that a problem exists.

Some actions you can take:

  • Read about the signs and symptoms of substance use.
  • Observe the person’s behavior closely over a period of days or weeks to understand what leads you to think there is a problem. This information will be good to have if you decide to talk with other family members about the situation, seek advice from a professional, or speak directly with the person. However, don’t feel you need an exhaustive picture of the problem before.
  • Share your observations with other family members and friends to determine how they see the situation. If they agree there is a problem, figure out who will talk to the person about getting help.
  • Contact a substance use professional, mental health professional, physician, employee assistance professional, guidance counselor, clergy or other helping professional to help you. Describe your family member’s substance use pattern to see whether the professional would deem it a problem. Provide details such as: type of alcohol or other drugs, how much the person is using, how often they are using, how long the pattern has continued, negative consequences, and the person’s response to discussions or confrontations about substance use.
  • Ensure that you and other family members are safe from potential physical or emotional harm. If there is a threat or possibility of physical violence, you should develop a safety plan.

2. What Are the Benefits of Early Identification and Action?

Movies, books, and magazines often portray people who “hit bottom” before they can be helped. However, this representation is a myth. People do not need to bottom out to be helped. Research shows that early identification of the problem is a much more effective solution for substance use problems.

Early identification occurs at the first signs of a problem — before anyone has suffered a traumatic event, dropped out of school, or lost important relationships, jobs, health, or self-respect.

Identification can be done through a health care professional screening, employee assistance professional, or family member. What happens after the screening depends on the results of the test. Some people can learn to cut back, while some need further assessment and possible treatment.

In general, all people are better equipped to work on recovery if their substance use problem is discovered and confronted early on. Treatment in the early stages of a substance use disorder is likely to be less intense, less disruptive, and cause less anxiety.

Download the Treatment eBook now, our complete guide to finding the right care and treatment for a loved one struggling with drug or alcohol use >>

Waiting for people to ask for help is a risky strategy. Without help, family members can expect crises like arrests, medical emergencies, loss of job, public embarrassment, and even death.

Also, as untreated problems continue, family members develop their own issues. Partners of people who have substance use problems can suffer greatly.  Common symptoms include headaches, backaches, digestive problems, depression, anxiety, and panic attacks. Children of parents with substance use disorders can experience school behavior problems, poor academic performance, and are more likely to struggle with addiction themselves.

It is not easy to live with someone who is using mind-altering substances. Taking steps to begin treatment and recovery can be a painful process. However, it is the only path that holds promise for something better. As long as family members deny that there is a problem, the problem will progress along with suffering.

Start by getting help for yourself. Restore your own emotional stability and bring new direction and meaning to your life.  You will be better equipped to deflect crises and arguments and shift interactions with your struggling friend or family member. Getting help for yourself may seem counter-intuitive, but is crucial so you can effectively overcome the obstacles to wellness and recovery and better cope with the many problems that may emerge.

Some people find that when they seek help for themselves, the person struggling with addiction gets angry. This may be perhaps because the efforts represent a loss of control. Also, getting help signals that you are serious about changing the situation.

Some people threaten those seeking help to stop their efforts. Remain firm in your resolve to go forward and be aware of your personal safety.

It’s never too soon for you or for the person with an active addiction to seek help.

3. How Can I Bring Up the Subject to the Person Struggling with Addiction? Will the Discussion Make the Situation Worse?

People often worry that initiating a discussion with the person with the problem will lead him or her to take drastic steps. They might make a scene in front of other family members, move out of the house, drop out of school, use more excessively, try to hide their problem, or retaliate against them or other family members. However, you might find the conversation to be a wonderfully productive experience. Perhaps the person simply hasn’t noticed behavioral changes or doesn’t realize that his or her substance use was or is causing a problem. And without change, the problems may become so severe that the same drastic outcomes could result.

Following a few guidelines will help you have a discussion:

  • Don’t bring up the subject when the person is under the influence of alcohol or drugs. When people are inebriated, they are less able to understand logic and are more likely to be impatient, dismissive, angry, and blameful. Some people have poor impulse control and may act irrationally or violently if the subject is brought up while he or she is under the influence.
  • Don’t be under the influence of substances yourself.
  • Establish a time to talk when the two of you can have more than a few minutes alone. Your goal is to have a dialogue — a two-way conversation in which you can state your concerns and understand the person’s perception of the situation. Ask if you can set a time to speak in the next few days to discuss something on your mind. If the person responds by saying, “Now is fine,” tell them you’d prefer to set time aside and not be interrupted.
  • When you meet, tell your family member or friend that you care for him or her. Emphasize that you wanted to have this conversation because you’re concerned for their well-being.
  • List the behaviors you’ve observed, state that you are worried about the effect drinking or drug use is having and express concern about continued use.
  • Create a two-way dialogue so the person doesn’t feel lectured or badgered and use open-ended questions.
  • If the person states that there is definitely not a problem, ask to talk again at some point in the future. Your goal is not to convince the person that there is a problem, but to let them know that you believe there is one and that your belief is based on observable behaviors.
  • Don’t try to speculate, explore motives, or judge. It can sidetrack you from the main point.
  • Don’t expect a dramatic shift in thinking or behavior right away; this conversation may be the first time the person has thought about this problem.
  • Keep in mind that there is no quick fix – prepare yourself for the long haul.

If the problem has only occurred over a short period of time or has not reached a severe stage, it is possible that the adult you care about could successfully cut back on the use of alcohol or other drugs. If the person has not tried cutting back, you could suggest this strategy as a first step. Some people in the risky stages of substance use, or even in the early stage of addiction, are able to cut back and consistently use only minimal amounts in the future.

You may find, though — as many do — that people who can cut back are the exception, not the rule. Many people try to cut down and discover that they can’t, or that they can only cut back for a few days or a few weeks before resuming heavy or excessive use. Trying to cut down and failing may help the person realize that the problem is more extensive than once thought.

You may also find that the person is able to stop completely. But many struggling with addiction have tried this strategy and couldn’t stop or remain abstinent for a significant amount of time. Ideally, the person should be assessed by a professional who can determine the best course of action depending on the severity of the problem and the person’s medical, psychological, and social history. If you sense the person is willing to consider that there is a problem, suggest that an evaluation or a consultation with a trusted medical or mental health professional. (This suggestion may be too threatening for some people during a first conversation of this kind.)

To talk with others struggling with similar issues, consider SMART Recovery Friends & Family, which offer science-based, secular support group meeting (both online and in-person) to help those who are affected by drug, alcohol, or other addictions. Al-Aanon, a Twelve-Step organization, is also a positive way to provide help family members struggling with an alcohol problem. Meetings are widely available and free of charge.

Although you probably want the substance use to stop as soon as possible, immediate abstinence from  certain drugs has certain risks including withdrawal symptoms and serious medical consequences. Many people need to be admitted to a detoxification center to help them physically withdraw.

Even if detoxification is not necessary, a formal, structured treatment program is vital for sustained abstinence. A health care professional or substance use counselor can help you and the person in need assess your options.

To encourage the person to stop, you might want to tell them ways you would be willing to help make it easier – for example, going to counseling together or providing transportation or childcare.

4. How Do I Help Someone Understand That He or She Has a Problem?

Friends and family members may feel that they constantly express concerns about a loved one’s substance use but never see any changes. You may have reached this point after weeks or months of giving lectures, making threats, ignoring behaviors, accepting promises of change, giving second chances, or imposing consequences.

Experts recommend developing and repeating a consistent, positive message: “We care about you and we want you to get help.” Define substance use as a problem for you and others who care about the person. Avoid blaming, arguing, and reproaching, and expect denial, distortion, avoidance, rationalization, and intellectualization of the problem.

Perhaps a friend, another family member, doctor, clergy, boss, co-worker, or other significant person in their life might be able to have an effective discussion. Or maybe the person with the substance use disorder would respond to activities you can do together, such as reviewing brochures or videos, meeting with a professional, or going to a self-help SMART Recovery or Twelve Step meeting.

DOs and DON’Ts
As you continue to try to talk to the person in need of help, please remember these important details:

  • Don’t try to talk when either one of you is under the influence.
  • Do protect yourself and others around you from physical harm.
  • Do call police if there is violence.
  • Do set limits that will protect your home, finances, and relationships and stick to those limits.

And if you are at your wits’ end, you might consider a formal intervention.

5. How Do I Help Someone Who May Need Treatment?

Mention the word “treatment” in relation to substance use and many people think of long-term residential facilities or detox. In fact, treatment includes both of these options — and a variety of others.

Treatment addresses the individual’s physical, psychological, emotional, and social conditions. Sustained reduction in alcohol or other drug use and sustained increases in personal health and social function are the primary goals.

The type of treatment is based on the severity of the problem. For risky people with an active addiction, treatment can be as simple as a screening and a brief intervention. For people exhibiting signs of dependence or addiction, a screening will probably lead to a referral for more intense level of care.

All treatment starts with a screening, which is a series of questions about the amount and frequency of alcohol or other drug use and the consequences it may be causing. Screening can be done by many types of professionals, including a physician in a hospital or an office, a nurse, a clinical social worker, or a licensed substance abuse counselor.

After a screening, some people may need a brief intervention, usually done by a health professional. During a brief intervention, people receive feedback on their substance use based on the screening results. Frequently, people are asked to cut back or stop their use. If they are ready to cut down, the health care professional will work with them to set a goal based on lower consumption. They may also be encouraged to reflect on why they use and how their lives will change by lowering their use. People who want to stop substance use will most likely be referred for additional evaluation or treatment.

To help someone you know who you think may have a substance use problem, you first need to get them screened. Your best bet is to talk to your own physician or employee assistance professional about referring you to someone who can help, such as a licensed substance abuse counselor or family therapist.

6. How Do I Help Someone Who Needs Treatment?

Formal treatment takes many forms and no one type of treatment is best for everyone. There are many roads to recovery.

You may think that you need to choose just the right program for your family member and if you don’t, treatment will fail. But experts believe that any number of programs can lead to success – if the person is willing to accept help from others and invest energy in working on recovery. A physician or another health care professional can also help you choose where someone should go for treatment.

To find a treatment program, visit SAMHSA’s Behavioral Health Treatment Services Locator.

7. What Should I Do in an Alcohol or Drug Emergency?

Does your loved one have any of the following symptoms? If so, call 911 or other emergency services immediately.

  • Lost consciousness after taking drugs.
  • Became unconscious after drinking alcohol, especially if five or more drinks were consumed in a short period of time.
  • Had a seizure.
  • Had been drinking and is seriously considering suicide.
  • Has a history of heavy drinking and has severe withdrawal symptoms, such as confusion and severe trembling. Severe withdrawal symptoms, such as delirium tremens (DTs), can cause death.

Any more questions? Please visit our Helpline to learn more and get one-on-one help.

521 Responses

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    Neil

    October 27, 2017 at 7:14 AM

    I personally find it hard to identify if someone is hooked onto substance abuse. I lost a colleague due to that and I’m feeling bad for not being aware then. I could have identified his addiction and probably save him. Any tips on the diagnosis part?

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      Pat

      October 27, 2017 at 8:57 AM

      Hi Neil,
      First, I’m so sorry you lost your colleague – it’s so hard when you think you know someone only to learn that he was struggling with substance use.

      Sometimes the signs and symptoms are dependent on the substance used. For example, people under the influence of opioids typically have pinpoint pupils and may seem very lethargic, whereas someone under the influence of cocaine may seem very energetic.

      Usually there are behavioral changes such as isolating from family and friends, a change in sleep patterns, and/or withdrawal from activities the person used to truly enjoy. In some cases there are physical changes such as a loss of weight.

      If you’d like more specific information, please take a look at our drug guides https://drugfree.org/drug-guide/

      Wishing you the best,
      Pat

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        Neil

        November 8, 2017 at 10:17 PM

        Hi Pat,

        Thanks for your reply. Ok now that I understand better on how to identify the behavioural changes, the next step I believe would be to send them to a rehab or detox center right? If so, would the duration of stay in the rehab center matter at all? I’ve been researching many websites online and one particular website I came across http://www.7dayalcoholrehab.com recommends a 7-day stay is sufficed, however wouldn’t a 30 day or 90 days be more effective due to the longer duration? I’m confused can you explain the difference in effectiveness between a 7 day and a 30 or 90 day treatment?

        Thanks in advance Pat!

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          Pat

          November 9, 2017 at 8:11 AM

          Hi Neil,

          You raise a great question about length of treatment as generally there is no one size fits all, not only in terms of length of treatment, but level of care as well (i.e. counseling, intensive outpatient program, partial hospitalization program and residential or rehab).

          I know you asked about opioids, but want to highlight that detox under medical supervision is required as an initial step for heavy use of alcohol or benzodiazepines (Xanax, Ativan, Klonopin and Valium) to prevent seizures. Although detox from heroin and other opioids without medical help is less dangerous than for alcohol and benzodiazepines, generally, it is a less painful experience with help. The most important thing to note though is that detox is not treatment.

          Generally speaking, the longer a person is connected to treatment, the better the outcomes, meaning that the person is likely to achieve his or her recovery goals. Given our current medical care system, it’s unlikely that insurance will cover lengthy stays in residential treatment, preferring to cover outpatient treatment instead due to the costs.

          As I mentioned the kind of treatment and length of stay must be individualized. There are considerations like other mental health disorders (depression, anxiety, bipolar), trauma history, social supports, employment/ school, housing situation, legal issues that may preclude a person going to treatment in another state, and of course, ability to afford co-pays, deductibles, etc.

          Also, with heroin and other opioids medications can be very helpful to reduce cravings and the risks of overdose. They should be part of a comprehensive treatment program regardless of level of care. Having Narcan on hand and knowing how to use it are critical as well.

          The best course of action is to get an evaluation from and addiction counselor.

          Thanks for your interest Neil!

          Sending my best,
          Pat

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            Neil

            November 11, 2017 at 2:50 AM

            Hi Pat,

            Thanks for the great explanation! It has certainly help me to understand more about dealing with addiction in general.

            God Bless!

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    Ernest London

    August 30, 2017 at 11:32 AM

    Thanks for the information about substance abuse. My best friend is struggling with addiction, and I want to find ways to help him. I like that you mentioned that you should talk to other family members and friends to get a consensus. That way, you can present a united front and it doesn’t have to come from just one person. I will be sure to give this a try.

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    Pat

    April 5, 2017 at 9:16 AM

    Hi Martha,
    I am so sorry that you are struggling so with your partner. It might help you to attend a support group like Al-anon or Families Anonymous where others will understand what you are going through and be able to provide support.

    It might help you to read Beyond Addiction by Dr. Foote as he does a great job of describing what you can do to get a loved one into treatment while taking care of yourself.

    I hope you find some peace and recovery,
    Pat

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    Martha Durant

    April 4, 2017 at 2:15 AM

    I am losing all hope for my partner. She have falling off the wagon again. After 10years of been clean. She start back to drinking. Went to rehabilitate for 30 Days. Stay sober for 4months and somewhere down the road she fell off. I have started to give up on her.and the relationship. She is becoming an embarrassing to me. Sometime she show up at work high. Or come home everyday after work high. And just don’t care about it. And this is began to stress me out. Part of me wants to leave. The other part are saying to keep hanging in to help her again. Which I am tired of watching her going through this and refused to get help again. Sign my life is began to fall apart.

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