How to help someone with a substance use problem or addiction

If someone you know is living with a problem with alcohol or drugs (or any other type of addiction), you will be wondering how to help. Although it can be a hard decision for someone to gain support for their problem, there are a few ways you can help:

  • Build trust and a safe space for them to talk so they will be more likely to listen.
  • Whilst calm, let them know how the issue is affecting them and others.
  • Be supportive and non-judgemental. Substance use disorders are a really difficult thing to battle and usually reflects other, underlying issues.
  • Notice that someone with a substance use issue is likely to be experiencing some form of distress, although they may find it hard to talk about.
  • Setbacks can happen. Don’t give up. Communicate and help them to know that you appreciate their motivation to change.
  • Set boundaries and consequences agreed with the individual, to help them stick with their journey of change when they are ready.
  • Encourage professional treatment and help them take steps to locate treatment when they are ready.

*Reminder: only have these conversations with your loved ones when you are both sober. Drugs and alcohol will interfere with the ability to effectively communicate concerns and for those concerns to be heard and understood.

It can be very challenging for family members and friends when someone they love is struggling. It’s very tempting to fall into communication traps when we feel frustrated and worried.

Here are some things to avoid when talking with your loved one about changes:

Don’t expect immediate change. Recovery takes time and patience. For the person changing, they are not changing just their substance use, but their social habits, routines, coping strategies, friend groups, etc.

Don’t make threats or ultimatums. This leads to individuals feeling they cannot be honest and hiding their behaviour.

Don’t criticise their use or efforts. This leads to shame and can reduce their belief in themselves and their ability to change.

Don’t make assumptions about their reasons for using (i.e. They don’t care enough about their family, they’re selfish, etc.). Substance use is a deeply complex medical disease. Those struggling with use often wish more than anything that could change.

Don’t use ‘all-or-nothing’ statements. (i.e. “You always do….” or “You never do…”). These raise defensiveness and lead to arguments because they are rarely true.

Don’t continue in a conversation that has devolved into an argument. If there is name-calling, yelling, raised voices, lecturing–it’s a sign that you need to take a break.

Don’t engage in behaviour you are asking your loved one to stop. Even if you don’t have the same problems, engaging in the behaviour can feel hypocritical and you can better support your loved one by stopping with them in the beginning of their recovery journey.

Download our handout

Download our handout on communication techniques as a reminder of how to communicate during difficult situations. We encourage families to have this printed out and in front of them when having difficult conversations. We often recommend writing out statements using this guide prior to the conversation to avoid the traps listed above.

Why is my loved one not accepting help and what can I do?

There are many reasons it is difficult for someone to seek help.
Here are some of the things that get in the way of seeking treatment and suggestions for how you can help with each of them.

1. They may not agree they have a problem.

This is tough because it means they are not seeing the same issues as those closest to them. You can help by raising awareness of how the substance is impacting you personally and sharing observations about how the substance is impacting other areas of their life. Download the communication handout for how to raise concerns.

2. They may feel embarrassed and not want to discuss their substance use concerns with you or anyone.

Work to normalise substance use issues, they are very common with 10% of adults struggling with substance use concerns at some point in their life. If your loved one does not want to talk with you, encourage them to speak with their healthcare professionals. General Practitioners are often the front line of identifying issues and making treatment referrals.

3. They may have stigmatised beliefs about treatment and feel uncomfortable seeking help.

Seek opportunities to share your personal experiences with the benefits of mental and behavioural health treatment. If you have not been to treatment, encourage them to read the testimonials of other patients on the website. Many people feel uncomfortable upon seeking treatment for the first time and find they have a great experience.

4. They are worried about the consequences of admitting they have an issue with substances (e.g. losing their job, being treated differently by friends, losing relationships, etc.)

Explore these concerns with openness and curiosity. Normalise these worries because they are valid. Assure them you are by their side to help them.

5. They are using the substances to cope with an underlying issue and giving them up is scary.

This is a common experience. Substances, while they are often the problem we see on the surface, they are also being used to cope with something else going on. They may not have started this way for someone, but by the time they become a problem, substances have become a tried and true coping strategy for more serious issues (albeit, an unhealthy coping strategy). Understanding and naming this can help someone feel supported. Acknowledging that it’s not just the substances and making this change is hard can help reduce the fear associated with seeking care and making changes.

6. They do not want to change their substance use patterns.

There is not a simple way to help someone who does not want to make changes. Persuasion, as you probably already know, is not likely to work.

To help yourself and your loved one in this situation, we recommend setting clear boundaries around substance use. If it is affecting you, you are allowed to have personal boundaries around it.

This might look like any of the following:

  • Not going out with them while they are using
  • Not engaging in conversations with them while intoxicated
  • Not allowing substances in your home
  • Not allowing them in your home if they are intoxicated
  • Not lying for them or covering up their substance use
  • Not providing any financial support so long as they are actively using
  • Not bailing them out of any consequences associated with their use*

*The exception here being if they are going to engage in a behaviour that is potentially life threatening to themselves or others, like driving under the influence of substances or swimming while intoxicated. You should prevent life threatening behaviours if you are able to do so.

These boundaries may be difficult to set and painful to adhere to, but they are ultimately in everyone’s best interest. Setting boundaries allows you to feel less frustrated and these boundaries will help your loved one see the very real impact of their substance use on their life.

If you’re struggling with boundaries, we offer this quote from a former patient:

“I hated my parents for kicking me out of their house when I was using, I told them they were terrible parents, I said all sorts of horrible things to them. Looking back, it is what saved my life. It wasn’t until I was forced to really look at how my substance use was ruining my life that I was able to make changes.”

Support for families of those struggling with substance use disorders

Being in a relationship with an individual who is struggling with substance use issues can be difficult and often stressful. While our substance use programs often include a family component in our care, we also encourage individual therapy for spouses of those struggling with addiction. We utilize an approach called Community Reinforcement And Family Training Support and Prevention (CRAFT-SP). This approach can help family members struggling with an individual who is still in their active addiction to reclaim their own lives and help encourage their loved one to reduce use and/or seek treatment support. We also recommend that you seek additional assistance in the form of support groups for this purpose.

Al-Anon is a group that was formed to support those whose lives have been affected by someone else’s drinking. There is also Alateen for youth whose lives have been affected by another’s drinking; whether that person is in their life or their life is affected by their absence. There is Nar-Anon for those whose lives have been affected by someone else’s drug use.

There are meetings available in-person and online to accommodate anyone who would like this support.

To learn more about Al-Anon and Alateen:

To learn more about Naranon:

Cayman Islands Al-Anon information: