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

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shutterstock_22034956 (2)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.

1. How Can I Tell If I’m Overreacting to a Substance Abuse 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:

* Read about the signs and symptoms of substance use.

* Observe the person’s behavior closely over a period of days or weeks to understand what leads you to think there is a problem. This information will be good to have if you decide to talk with other family members about the situation, seek advice from a professional or speak directly with the person. But don’t feel you need an exhaustive picture of the problem before

* Share your observations with other family members and friends to determine how they see the situation. If they agree there is a problem, figure out who will talk to the person about getting help.

* Contact a substance abuse professional, mental health professional, physician, employee assistance professional, guidance counselor, clergy or other helping professional to help you. Describe your family member’s substance use pattern to see whether the professional would deem it a problem. Provide details such as the type of alcohol or other drugs, how much the person is using, how often, how long the pattern has continued, negative consequences and the person’s response to discussions or confrontations about substance use.

* Ensure that you and other family members are safe from potential physical or emotional harm. If there is a threat or feat of physical violence you should develop a safety plan.

2. What Are the Benefits of Early Identification and Action?

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, their health or self-respect.

Identification can be done through a screening by a health care professional, employee assistance professional or even a 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 possibly treatment.

In general, though, all people are better equipped to work on recovery if their substance use problem is discovered and confronted early. Treatment in the early stages of a substance use disorder is likely to be less intense, less disruptive and cause less anxiety.

Waiting for people to ask for help is a risky strategy. Without help, family members can expect crises like arrests, medical emergencies, job loss, 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 substance users can experience school behavior problems and poor academic performance and are more likely to become substance users 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, but 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 and so will the 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 impaired friend or family member. Getting help for yourself may seem counter-intuitive, but is crucial so you can better cope with the myriad problems that emerge and effectively overcome the obstacles to wellness and recovery.

Some people find when they seek help for themselves that the person with the substance use problem gets angry, 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 substance user to seek help.

3. How Can I Bring Up the Subject with the Substance User? Will the Discussion Make the Situation Worse?

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, secretly drink or use other drugs even more and hide it from everyone 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 behavior changes, or doesn’t realize that his or her substance use was a problem or was causing problems. 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:

* Don’t bring up the subject when the person is under the influence of alcohol or other drugs. When people are high, they are less able to understand logic and are more likely to be impatient, dismissive, angry and blaming. Some people have poor impulse control and may act irrationally or violently if the subject is brought up while he or she is under the influence.

* Don’t be under the influence of substances yourself.

* Establish a time to talk when the two of you can have more than a few minutes alone. Your goal is to have a dialogue — a two-way conversation in which you can state your concerns and understand the person’s perception of the situation. Ask if you can set a time to speak in the next few days to discuss something on your mind. If the person responds by saying, “Now is fine,” tell them you’d prefer to set time aside and not be interrupted.

* When you meet, tell your family member that you care for him or her. Emphasize that it’s this concern for their well-being that has led you to have this conversation.

* List the behaviors you’ve observed, state that you are worried about the effect drinking or drug use is having and express concern about continued use.

* Create a two-way dialogue so the person doesn’t feel lectured or badgered. Use open-ended questions.

* If the person states that there is definitely not a problem, ask to talk again at some point in the future. Your goal is not to convince the person that there is a problem, but to let them know that you believe there is one and that your belief is based on observable behaviors.

* Don’t try to speculate, explore motives or judge. It can sidetrack you from the main point.

* Don’t expect a dramatic shift in thinking or behavior right away; this conversation may be the first time the person has thought about this problem.

* Keep in mind that there is no quick fix – prepare yourself for the long haul.

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 or abuse 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, 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 addicts have tried this strategy and couldn’t stop or remain abstinent for any 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 the substance abuse, drug abuse, alcohol abuse or other addictions or Al-Aanon, a Twelve-Step organization providing help to family members of alcoholics. 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 risks, including withdrawal symptoms with 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.

4. How Do I Help Someone Understand That He or She Has a Problem?

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 might be able to have an effective discussion. Or maybe the substance user 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:

* Don’t try to talk when either one of you is under the influence.

* Do protect yourself and others around you from physical harm.

* Do call police if there is violence.

* Do set limits that will protect your home, finances and relationships, and stick to those limits.
And if you are at your wits’ end, you might consider a formal intervention.

5. How Do I Help Someone Who May Need Treatment?

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 users, 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.

6. How Do I Help Someone Who Needs Treatment?

Formal treatment takes many forms, and no one type of treatment is best for everyone. There are many roads to recovery.

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 of a 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 Substance Abuse Treatment Facility Locator.

7. What Should I Do in an Alcohol or Drug Emergency?

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

* Lost consciousness after taking drugs.

* Became unconscious after drinking alcohol, especially if five or more drinks were consumed in a short period of time.

* Had a seizure.

* Had been drinking and is seriously considering suicide.

* Has a history of heavy drinking and has severe withdrawal symptoms, such as confusion and severe trembling. Severe withdrawal symptoms, such as delirium tremens (DTs), can cause death.

 

14 Responses to this article

  1. Alicia / July 24, 2014 at 8:01 am

    I am 16, and I have a friend on the other side of the Atlantic who is 15 and smokes marijuana. I want to tell him that it’s really not healthy, and illegal to boot, but I don’t want to have arguments or affect our friendship in any way. I am concerned for his health, and I want to help, but I don’t know how. Any suggestions?

  2. Kenneth W / July 23, 2014 at 5:50 pm

    I am 46 years old and have been struggling with addiction to drugs and alcohol for over 3 decades. In my early teen years I started drinking and smoking cigarettes. I never felt I fit in with any of my peers, so this was my solution. I was an exceptional student in high school and got several scholarships to various universities. Alcohol and cigarettes soon progressed to marijuana, LSD, mushrooms, opium (raw), hashish, MDMA, ketamine, cocaine, and any type of pill I could get my hands on. I saw several therapists and psychiatrists, but I wasn’t honest with any of them and they prescribed me Xanax… BIG mistake.. this was perhaps the most potent addiction I had… every time I tried to quit, I was unable to do so for longer than a couple of months. I lost scholarships, many jobs, relationships (1 marriage and another fiancee), possessions which I sold to get more drugs and alcohol, etc.. I am lucky that I never stole to finance my habits. On April 1st of this year, I decided to take my own life because I could not get rid of these things.. I set the date of April 4th to ‘do the deed’. On April 4th I drove my truck into my garage, closed the door, and waited for carbon monoxide to take me away. After close to 40 minutes I was getting very drowsy when I heard a voice (which was not like anything I had heard before) telling me to ‘Stop, get out’… I looked around but no one was there… Again I heard ‘Stop, get out’… (I have never been diagnosed with anything that I could attribute this voice to).. Somehow I managed to get out of the garage and I awoke sometime later with EMTs standing over me.. they took me to the hospital where I stayed for several days.. after discharge I was basically homeless as no one would take me in.. my sister let me stay on her couch until we could figure something out.. One of her friends invited me to go to a meeting of Alcoholics Anonymous, I said yes just to please them.. It was one of the best decisions I ever made. I now understand what was driving my addictions, I have a plan to work the steps and a sponsor that cares. And best of all, I have a relationship with God, who for some reason chose to save me from myself. The world is a new place and I see everything in a new way. There are so many ways to get over addictions and to make a positive contribution to the world (sports, volunteer work, etc..) And there are so many good programs to help with addictions.. PLEASE reach out and let someone help, don’t go through the hell on Earth I put myself through!

  3. Avatar of stacey
    stacey / July 5, 2014 at 7:41 pm

    My husband of 25 years is a alcoholic. He goes to work everyday that he can and plus overtime as well. He drinks every day, skips maybe one day a month. He doesn’t physically abuse me, it’s the mental abuse that’s killing me and my daughter. He shows us no attention, he hides his beer, he drinks and rides around every night (without us of course). I don’t work cause I’m afraid of having him alone only because he’s agonist set my house on fire once when my two boys were younger. I’ve lost countless number of jobs due to his drinking. I have major depression issues… I wanna leave but I have no where to go. I’m tired of trying, he wants no help what so ever.

    • Avatar of Pat
      Pat / July 21, 2014 at 9:11 pm

      Hi Stacey,
      It sounds like you are dealing with so many issues…the substance abuse, the emotional abuse, the employment problems and mental health all while trying to care for your children. In our area the local domestic violence facility provides counseling for women to figure out what to do in situations like yours. If you cannot find a local organization, you could try the national hotline number…800-799-7233 perhaps just to explore options. There may be other community mental health agencies that could provide support as well — just a thought. I hope you and your daughter can find peace.
      Pat

  4. Joel H / June 27, 2014 at 10:17 am

    I Just moved from Florida to Kentucky and have been on subtext and Xanax for three years. I am willing to drive to Chicago st Louis or Nashville . does anyone know of a place that might could help me?

    • Avatar of Julie
      Julie / June 27, 2014 at 10:26 am

      Joel H-

      Please call the Partnership for Drug-Free Kids’ Parents Toll-Free Helpline at 1-855-DRUGFREE (1-855-378-4373). The helpline is open Monday through Friday, 10:00 am to 6:00 pm ET. Our professionally-trained and caring specialists will let you know of helpful resources available to you in your area.

    • Rob / July 7, 2014 at 5:23 pm

      If you’d like to remain in Florida and want the help to detox of the subutex and xanax, we can help you here in Ft. Lauderdale. We offer individalized, inpatient 30/60/90 day programs that would help you detox first and learn how to manage urges and stay substance free for after care.

      You can check out our website at http://www.OceanBreezeRecovery.org or call us at (888) 895-7336

      Regardless of what route you take, you’ve made a good choice to get sober. Clear minded thinking is awesome. Best of luck to you.

  5. Dave / June 22, 2014 at 1:04 pm

    Today, I’m 115 days sober and grateful. I had been drinking for in excess “BEER” for over 25 years, 6, 7 maybe, 8 or 9 per Day/Night, for “YEARS”, Coors “Lite”. Lite beer no issue “right”? I drank for any reason, good or bad, any situation, good or bad, “IT” would trigger the thought to drink. I’d wake up in the morning with a hangover, drink coffee, go to work, drink coffee, eat lunch, get through the day, only to start immediately upon arrival at home. 6, 7, 8 or 9 beers later, then sleep. I developed my beer “BRAIN CALCULATOR” that knew how many “Beers” were left in the “fridge” for the next “days” drinks. “It” would recalculate throughout the day, “it” would make sure “I would have “ENOUGH”” when I arrived home that evening. Sound familiar? I was not hurtful or abusive to my family (that I know of), just a guy who drank daily and went to bed early each night. My work performance suffered and eventually I was asked to leave. 17 years I threw away. Anyone have any thought of this? I’m blessed and grateful for a still working mind, although I’m sure it was effected by my drinking. Anyway, 30 or so days unemployed my “BRAIN CALCULATOR” (let’s just call it what is really is “MY ADDICTION”) was humming along at full force. I’d run through my daily plans, only to get to the drinking faster, as I had all the time in the world now. And, I’d make all the time necessary to get to “THE DRINKING”. But now the daily amounts were rising and the money was not, so I had to turn to the hard alcohol to get the most for my money. At around 25 days or so of not working, the guilt and hangovers were getting to me, I started researching AA and addiction websites, my brain calculator was in full swing and my “guilt” were fighting harsh battles. “HOW COULD I EVER STOP”. The last day that I drank was February 26th, I drank a ½ liter bottle of Gin and 7 beers the night before, I woke up the next morning, hangover and ashamed’ I looked up an AA meeting, “Yelled” at myself to go, then “Forced” myself to go, It was one of the hardest things I had done in all my life time, to admit “I NEEDED HELP”. I FORCED MYSELF TO GO. I’ll never forget the meeting, I walked in, sat down, one person said that this was AA, I advised of my last night’s drinking amounts and asked if I “Qualified”, they ALL said “YES YOU DO”. I sat down and listened, was giving a 24 hour chip, signifying 24 hours of sobriety, I have stopped drinking fully for now 115 days and I wish someone would have told me what I would go through to quit, what I would feel physically and mentally. So I’ll share this with you. The “NON DRINKING” part was managed with exercise, walk and walk and walk into you burn out the cravings, Drink water all day long, over and over again, eat healthy, Greens, Salads, any vegetables with greens. Internally, your body will have cravings, I ate “ICE CREAM”, ICE CREAM and more ICE CREAM until it filled me up and settled my stomach. I went to meetings and found out things, the best was, “EVERONE HAS THE SAME FEELINGS” and Questions; … How do I stop? Why did this happen to me? Can quitting be done? Quilt, Depression, Highs, and Lows. The people I met had seen it just like me and had somehow quit, and wanted no more than that for “ME”. So far it worked, it was a BITCH, Hardest thing I’d ever done. 115 days, Can’t lie to you (and make sure you don’t lie to YOURSELF), I still think about it, but not so much anymore. Still have the “ICE CREAM” daily. And most of all “There is no greater help that I had then my faith”. I was raised to believe in God, I always have. I leaned on him “HARD” for strength and asked for help daily. I wanted to be “A Better Man, Husband & Father” I wondered, “If to quit, you need to have something to quit for”, BECAUSE ALCOHOL TAKES AWAY YOUR WILL!!! YOU JUST HAVE TO REBULID IT. I was lucky, all I had to do was look at my family. So please, IT CAN BE DONE. Your hopes can be met, the addiction clock can be reset and eventually will “shut off”. So stop with your pride and get help, any insights are a start. Go to a meeting, LISTEN, you will find many people with your same plight. It helped me immensely to know “OTHERS FEEL THE SAME PAIN”, their insight will align with your pain and give you reason to stay off alcohol. I HOPE THIS HELPS YOU…. AND YOU KNOW WHO YOU ARE…..

    • Rob / July 8, 2014 at 1:08 pm

      Congratulations Dave. I don’t know you, but your story is awesome and obviously, so is your will power. Thanks for sharing and best of luck to you~ One Day at a Time :)

  6. Jan Beauregard, Ph.D. / June 16, 2014 at 8:24 pm

    I think there are many good points in this article but it is also important to mention that addiction is a bio-psycho-social disorder and that the using behavior is a morbid form of coping. Interventions are not as effective as using motivational techniques – like those suggested in the CRAFT Model where families use a combination of positive reinforcement and consequences. It is also important to address trauma issues as underlying trauma often drives relapse behavior.

    • Kimberly Bruner / June 22, 2014 at 3:50 am

      I am the mother of an adult child (daughter) who has been a heroin addict for 17 years. We need help and don’t know where to turn. My daughter is ready for a clean life but has no idea what that is anymore or how to go about rediscovering it. Please help me save my daughters life. Please help us. Here’s my e-mail (1coolmomkb@gmail) I look forward to your reply. Thank you for taking the time to read this.

  7. Anne Fletcher / June 13, 2014 at 7:41 pm

    I’m surprised that this article doesn’t mention CRAFT (Community Reinforcement and Family Training) the only evidence-based approach for families who have a loved one with addiction. It has been shown to be an effective way to increase the odds that he/she will enter treatment, far more effective than addiction “interventions.”

    Anne Fletcher, Author of Inside Rehab

  8. Fr. Jack Kearney / June 12, 2014 at 8:11 pm

    Thank you for this article. I would add that if you want to seek the help of a professional interventionist you should make sure that they are at the very least a certified addictions counselor, recognized by they state they work in. Lots of phony and sub-par credentials out there. I would also ask them if they are specially trained and certified in evidence-based family intervention practices. If their response is something like “no, but our style is very effective” then I would look elsewhere.

  9. Avatar of Brian
    Brian / June 11, 2014 at 8:27 am

    It all needs a holistic approach to overcome addiction. The steps you have mentioned are really effective in getting over addiction.

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