SAMHSA’s 2015 National Survey on Drug Use and Health reported that in the previous year, 7.8% of individuals age 12 and older had a substance use disorder.1 This is 20.8 million people, a staggering number that reveals that addiction is a very real and prevalent problem.
If you are worried your loved one may be struggling with addiction, you might feel a mixture of anxiety, sadness, or anger, as well as some confusion about what to do. The following frequently asked questions may help provide some guidance and support as you figure out how to best proceed in helping your loved one.
How can I tell if my loved one is addicted?
Often, a good starting point here is noticing any significant change in behavior. If your loved one starts acting differently and you suspect the change is a result of drug use, check for the following more specific examples of a substance abuse problem:
- They seem irritable and may even lash out if confronted about their substance use.
- They are using their drug of choice more often and demonstrating increased tolerance (needing more and more to produce the same effects).
- They get sick when they don’t use (withdrawal).
- They seem to have a preoccupation with using the drug, and it may even seem their lives are starting to revolve around it.
- They keep using despite numerous consequences to their relationships, jobs, or finances or despite legal problems from using, buying, or selling drugs.
- They are consistently lying to you about where they’ve been or what their money is going towards.
- They have seemed more isolated and don’t seem to enjoy or participate in the things they used to.
- They have made numerous attempts to cut back or quit using but have not been successful.
Why can’t they just quit?
As a friend or family member, it can feel very frustrating and confusing to watch someone close to you put drug use above everything else, including your relationship. If, for example, your husband is an alcoholic, you might feel that he loves alcohol more than you. From your perspective, it doesn’t make sense why he keeps choosing to drink when it is destroying his and your lives.
While your loved one may have made the choice to begin using, as addiction develops, it feels much less like a choice over time and rather a necessity.
However, it is important to understand that research has shown that addiction impacts the brain, particularly the reward system, causing the user to have an extremely strong desire to keep using. The reward associated with drug use can be so powerful that it overtakes the feelings associated with healthy and pleasurable activities like exercising, eating, or even having sex—over time, the drug may be the only vehicle for the brain to experience pleasure. And if the user is physically dependent, not using will make them feel very ill and may even be medically dangerous (e.g., alcohol withdrawal can be deadly).
While your loved one may have made the choice to begin using, as addiction develops, it feels much less like a choice over time and rather a necessity. This physical addiction is then further complicated by the social and psychological aspects of addiction, such as feeling a need to use to be comfortable in social situations or in order to cope with distressing feelings and experiences. A National Institute of Health fact sheet stated that “Recent scientific advances have revolutionized our understanding of addiction as a chronic, relapsing disease and not a moral failure.”2 So even though it may seem to you that your loved is deciding not to quit, their experience is much more complicated, and they likely need a comprehensive course of treatment to address their addiction.
How can I better understand addiction?
It is important to educate yourself on addiction before taking any concrete actions to help your loved one. There are many books and online resources that may help, such as the National Institute on Drug Abuse. If you want one-on-one guidance, consider scheduling your own appointment with an addiction counselor or professional who can answer any questions you have and help you learn to best support yourself and your loved one.
It may also help you to sit in on an open AA or NA meeting so that you can get more of an inside look into the experiences of those struggling with addiction. (Some meetings are closed, so make sure to ask first before planning to attend.) The more you know, the more compassion you might feel and the better you will be at offering empathy and support.
Can I make my loved one get help?
It is normal for you to be concerned about the safety of your loved one and those around them if they are struggling with an addiction, and you may be wondering if there is a way to force them to get help. A 2015 review of statutes from July 2010 through October 2012 found that 33 states allow for civil commitment for substance abuse, meaning there may be some action you can take to make your loved one seek treatment.3 Typically, there would need to be some indication that your loved one is a danger to herself or someone else. Search for the relevant statutes in your state or contact a local treatment center which may be able to educate you on your rights where you live.
You might also think about holding an intervention to force someone into treatment (see below). In this case, however, it is important to remember that you do not have the power to make someone want to change. Furthermore, although the consequences you set up in the intervention may prove successful motivators in the short-term, individuals who have intrinsic motivation to get well are likely to be more successful long-term than those who are only going to treatment because they feel pressured.
Do interventions work?
You may be wondering if you should plan an intervention to get your loved one to stop using drugs. If you are considering this as an option, you’ll need to make sure you’ve planned it well and have a specific desired outcome (e.g., your loved one agreeing to enter a treatment program). You won’t want to conduct an intervention spontaneously, as a lack of preparedness combined with reactive communication could result in anger, hurt feelings, and no resolution or positive outcomes.
A lack of preparedness combined with reactive communication could result in anger, hurt feelings, and no resolution or positive outcomes.
It is important to spend some time thinking about what you want to say and how you want to say it beforehand. In general, approaching your loved one in a manner that voices how much you care about them will likely be much more effective than approaching them with a mindset of punishment and condemnation.
Regardless of whether you choose to do a formal intervention, which might include assistance from a professional who specializes in addictions, communicating your concerns with your loved one might help influence them to seek treatment. In fact, a 2004 study in the American Journal of Drug and Alcohol Abuse found that involvement from concerned significant others had a positive impact on treatment engagement.4
If you have decided you would like to try an intervention, here are some tips you may want to consider when communicating your worries and your desired changes:
- Make sure you are speaking from a place of love and concern rather than anger.
- Do your best to stay calm so that your emotions don’t escalate those of your loved one.
- Be specific and focus on behaviors and consequences rather than making broad statements about their character.
- Try to be brief so you keep their attention and get your important points across.
How can I support them if they aren’t ready for treatment?
If your loved one is resisting treatment, you may be feeling angry, hurt, scared, and helpless. Getting your own support may be helpful so that you can work through your emotions, enabling you to better handle the situations that arise, while attending to your own mental and physical health.
You can continue to express your care and concern and present your loved one with options for help—whether that be recommending treatment or offering to attend meetings with them. It will also be important to set boundaries about what you will and will no longer do for them while they continue to use. In other words, you can make sure that in the meantime you are not enabling their drug use.
How can I help them find a treatment program that is right for them?
If your loved one has decided they are ready to take the next step and enter a treatment program for their addiction, you can help them to search for a program that best meets their needs. If you know any mental health professionals or addiction specialists in your area, you might also consider consulting with them to get some recommendations.
Ideally, you will want to look for a program that not only specializes in the particular addiction with which your loved one is struggling, but one that also addresses any co-occurring mental health issues or underlying problems that have fueled or exacerbated the addiction.
How can I best support my loved one while they are in treatment?
While your loved one is in treatment, you can continue to reinforce your care and support for them. Depending on the program they are in, you may be able to visit during certain times. You can affirm to them that you will be there for them when they get out. You could also assure them that you are getting the education and help you need while they are in treatment so that you can support them to the best of your ability as they navigate their recovery.
What happens when they come home?
First, it may be helpful to remind yourself that your loved one has been through something very difficult on many levels—physically, mentally, and emotionally. The transition from the safe and regulated environment of a treatment center back to daily life can be a difficult one. You might want to express to them how happy and proud you are that they decided to get and receive help and encourage them to continue to receive support in their recovery. It may help to soften the abrupt shift in environment if they continue to attend support group meetings and receive some outpatient counseling, particularly some that is focused on relapse prevention.
It may be helpful to remind yourself that your loved one has been through something very difficult on many levels.
You can also help to support them by fostering an environment that is conducive to recovery. For example, if they live with you, it is best to keep any addictive substances out of the house (e.g., alcohol, even if that wasn’t their substance of choice). Additionally, you can encourage and support their recovery by offering to engage in sober activities with them.
Are there ways to help me deal with my loved one’s addiction?
First, it is important that you don’t take your loved one’s addiction personally. Addiction is stronger than their willpower and can overtake all other priorities, including their relationships.
There are support groups for family members and friends of addicted individuals. Whether it is alcohol or other drugs, you can find a group of people who understand and share the same struggles as you. Groups include Al-Anon and Nar-Anon.
Lastly, you can focus on taking great care of yourself so that you are in a healthy place to help your loved one and can model healthy behaviors. Focus on getting exercise (this is a great way to reduce stress!), eating healthy, and getting adequate sleep.
What should I do if I think my loved one relapsed?
If your loved one relapses, know that this is common and does not mean that they are back to square one. In fact, many people relapse multiple times on their way to long-term recovery from drugs. Try not to judge them, work to instill hope, and encourage any extra support or additional counseling they may need to get back on track.
- Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health.
- National Institutes of Health (2013). Drug Abuse and Addiction.
- Christopher, P., Pinals, D., Stayton, T., Sanders, K., Blumberg, L. (2015). Nature and Utilization of Civil Commitment for Substance Abuse in the United States. Journal of the American Academy of Psychiatry and the Law, 43 (3), 313-320.
- Landau, J., Stanton, MD, Brinkman-Sull, D., Ikle, D., McCormick, D., Garrett, J., B…Wamboldt, F. (2004). Outcomes with the ARISE approach to engaging reluctant drug and alcohol dependent individuals in treatment. American Journal of Drug and Alcohol abuse. 30(4):711-48.