Maybe it’s your best friend. Or your sister, or a favorite colleague at work. It happens slowly. What were they like before? Upbeat, always laughing? Devoted and kind? Now the friend or family member you once knew has been replaced by someone with a substance use disorder. It’s a transformation, and not a good one.
You hardly recognize them. These days they ridicule you for disagreeing with their way of life. They don’t want to spend time with you, and when they do, you’re left drained. Their emotions are unpredictable. Sometimes it’s disinterest, sometimes it’s rage, and at other times it’s desperation that demands money. You’re left feeling angry and helpless.
How do you respond? There are patterns.
Some people take control and try to “fix” the issue. Without their loved one’s input, they organize treatment, find a lovely rehab with intense therapy and job-assistance, then ship the individual off. The problem: Someone who doesn’t want help can’t be helped. Forced rehab is rarely beneficial.
Others give into the individual’s demands and, to avoid problems, will do anything it takes to keep them from suffering the consequences of their actions. Family and friends hide the addiction, apologize for the arguments, hand over money, provide shelter even though it’s hurting them, and pay all fines and bail. This makes the substance use disorder worse.
It’s easy to find yourself stuck in one of these patterns, but it doesn’t have to be that way. If you care about someone with a substance use problem, here are 13 tips to guide you through it.
Tips for Helping Someone With a Drug Problem
Educate yourself about addiction. Read everything you can about substance use disorders and alcoholism, and familiarize yourself with treatment resources in your community. Your loved one might need guidance when they’re ready. For additional support, consider attending Al-Anon and co-dependency meetings.
Don’t do anything that hurts you. It’s common for people to sacrifice their needs for someone they care about, but the expression, “You can’t help someone else if you don’t care for yourself first,” is particularly important here. Be conscious of your actions. Pay attention to what you’re doing to help the individual: If it’s hurting you, do things differently!
Remember small steps. Focus your energies on promoting abstinence and sobriety before insisting the person get a high-paying job, go back to graduate school, or start saving to rent an apartment. Adjust your expectations according to “where they are” and applaud each step, no matter how small.
Avoid name calling and fault-finding. You’ll be fuming and pained at times, but try not to hurt your loved one on purpose. Avoid attacking them verbally or physically, as that will just push them further into their addiction.
Don’t work harder than they do. It happens to the best of us: We do all the work. Parents will spin circles around their adult child trying to get them clean and sober. Mom and Dad run a mini drug rehab, monitoring where the person drives and who they talk to, ensuring they make it to 12-Step meetings, and limiting contact with shady friends. The adult child does what they can to break the rules. If you’re that parent, halt! Look at what your loved one is doing (and not doing) to help themselves. Match their efforts – but do nothing more. Don’t run a mini rehab. If their living at home is unhealthy, ask them to leave.
Show, don’t do. People with addiction are stuck in a narrow world. They’re too distracted to practice healthy skills. They need help. However, sometimes it’s best to avoid doing things for them; rather, show them how to do these things themselves.
Offer your advice carefully. Make your recommendations more powerful by limiting how often you give them. The less said, the more that’s heard.
Set healthy boundaries. Boundaries are meant to help you protect yourself, do what is best for your loved one (even though boundaries may be opposite to what they want), and improve the health of the relationship. Do not use boundaries to punish or shame. Examples of good boundaries might include checking urine toxicology tests regularly as a requirement to live at home or requiring 25 dollars of rent each month.
Don’t help them use drugs. Don’t enable. This means don’t give them large sums of money, let them talk obsessively about the joys of using, make excuses for them, bail them out of jail repeatedly, or take ownership of their mistakes. Don’t rescue them each time they relapse. Don’t pay for their addiction. People are more likely to change if they aren’t rescued from the negative consequences of their actions.
Help them with basic needs. If you want to provide support, buy the goods and services the person needs instead of giving them money. Gift cards for small amounts at the local supermarket might be an option, but if motivated your loved one can still trade these for drugs. Gifts of food are sometimes best. There are other ways to help. If you have the information, educate them about resources in the community. This might include a list of shelters, soup kitchens, free clothes closets, free employment assistance, and warm places to spend the day.
Support their efforts to quit. If they wish to stop, encourage their endeavors. Consider offering rides to doctor’s appointments, 12-Step meetings, and support groups. Refer them to the SAMHSA Treatment Referral Hotline, 1-877-726-4727.
Encourage your loved one to seek professional help. Remember you can’t “fix” a person with a drug problem. They need professional help. Encourage them to get treatment. Many individuals also struggle with anxiety, depression, unstable diabetes, chronic pain, and other problems. They should see a psychiatrist or family doctor to get the help they need. There are many free or sliding scale clinics available to people without insurance; have your loved one look into county mental health and medical services.
Let them look for treatment. Treatment can include inpatient detoxification, short and long-term residential rehabilitation, intensive outpatient, the Salvation Army, wilderness programs, substance abuse and mental health clinics, psychotherapy, Methadone and Suboxone maintenance treatment (for opiate use disorders), a visit to the emergency room, and everything in between. 12-Step meetings are very helpful too. Help them find treatment options, but let them fill out online applications and make phone calls themselves. Finally, if your loved one has been using for a while, they shouldn’t quit suddenly; they may need hospitalization for withdrawal symptoms.
Recognize and acknowledge the potential the person has within them. Remind them of their past achievements and that it’s never too late to start over. Paint a positive image of a future without drugs or alcohol. If they do quit, congratulate them for each new day sober.
It’s not easy caring for someone with a substance use disorder. Hopefully these ideas give you some direction. Remember, you’ll have a mix of emotions, many negative. This is normal. Consider talking to a friend to blow off some steam, but don’t take it out on the addict. Write a scathing letter but don’t send it off. Keep a journal. If things are bad, talk to your primary care doctor about help for stress, insomnia, depression, or anxiety. Consider touching bases with a mental health professional if you feel buried under the stress.
For more information, check out Questions about Substance Use Disorders and Addiction. You’ll also find more recommendations at the SAMHSA Resources for Families Coping with Mental and Substance Use Disorders.