How to Help Someone With a Substance Use Problem

Most of us know someone with an alcohol or drug problem. For some of us that person is a close friend or family member. You want to help, but it’s hard to figure out exactly how to do this. It’s an uncomfortable conversation to have. You don’t want to impose judgement, but you want this person to know that you are worried about their behavior. Their use is affecting you too and you need things to change. Often nothing is said because it’s easier to avoid the conversation or you’re afraid of feelings getting hurt.

Here’s the thing, I guarantee that if the drug or alcohol problem isn’t talked about, then nothing will change. Someone needs to make the seriousness of the substance use a reality. It may be a friend acknowledging that they have a problem or it might be you voicing how you feel about their use. As the saying goes, “The first step is admitting you have a problem”. Or how about, “The first step is telling someone they have a problem”?  No?

It’s important to understand that your brain and a person in active addictions brain is not functioning on the same level. What seems logical and obvious to you is not to the substance user. Their life is consumed by this substance; obsessing about it, using it, withdrawing from it. Most likely, mental health issues are intertwined with the substance use as well. Not to mention the damage that chronic use does to the brain. Do not assume that the substance user knows that they have a problem just because it is apparent to you.

Let’s assume they do know they have a problem. So, what’s there to talk about? Do they know that there is help available? Do they know they deserve to get help? Personally, I knew that I had a problem for years. What I didn’t know was that things could change. I had tried to stop so many times that I thought it was impossible. I knew that there was substance use treatment for other people, but I didn’t think I belonged there. In the beginning, I didn’t think that I was “bad enough” to need treatment. Looking back, I see this as a form of denial. I wasn’t sure what “bad enough” looked like; just knew it wasn’t me. Maybe I was envisioning what most of us mistakenly assume drug addicts should look like; dirty, angry, passed out in an alley somewhere. But after years of use, once I decided “yep, things are bad enough”, I didn’t think I deserved to get help. I thought that surely with all of the consequences I incurred because of my drinking, I should be able to stop on my own. If I couldn’t, then there must be something wrong with me. There is so much shame, pain, and punishment that goes along with addiction that you start to believe you aren’t worthy of help. I needed someone to help me get from feeling hopeless to seeing possibilities. Do your research and figure out what treatment options are available. Have these resources handy when they’re ready for help.

Talking about a loved ones use gives you power. It lets them know what you will or will not tolerate. Before you begin this discussion, decide what you will no longer put up with and communicate this clearly. Figure out how you will set boundaries around this relationship so that you are not consumed by this addiction also. Not only does this help you to be a healthier person, it communicates to the substance user that you will no longer be enabling their behavior.

Okay, so you get that talking about it is important. How’s this going to play out? It could go a few different ways. One…They will get angry and defensive. They will get mad at you. They may avoid you or block you out of their life. But they will know that you care about them and are available to help when they’re ready. You are sending the message that they matter and they deserve to get better. Two…They are relieved that you see what is happening in their life. They are thankful to be able to talk about this with someone. They feel loved knowing that you are aware of this problem and want to help. They may even want to know more about the options for help.

Unfortunately, there’s always the possibility that they will continue to use and they choose to never get help. But how would you feel if something tragic happened to them and you never said anything? No matter what the reaction, you have planted a seed. There is no going back once it’s out in the open. No more pretending that the use isn’t a problem or that it’s not affecting everyone around them. Talking about it interrupts the cycle of use and urges something to change.

Let’s stop being afraid to talk about this thing that is killing our loved ones. Let’s not contribute to the stigma and fear of addiction. This is not something to be ashamed of, but something to be recognized and treated.