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


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.

Am I 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:

The benefits of taking action early

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.

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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.

How to raise the subject

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:

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.

How to help someone understand they need help

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:

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

How can you help a loved one get the help they need

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.

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.

What should you do in an emergency?

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