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How to talk to someone about their alcohol and drug use

Updated: Nov 3, 2020


Talking to a loved one about their alcohol and drug use can feel uncomfortable and awkward. Many are afraid they are overstepping their bounds, or that bringing it up will hurt their relationship.[1]

While it’s natural to try and avoid the discomfort of addressing these issues with a family member or friend, the longer you wait to seek help for a substance use disorder, the worse the condition can become.

This information is designed to help you support a loved one in crisis by breaking the process down into small steps. This can help you think through how to communicate with your loved ones even if they don’t feel “ready”.

Every conversation counts. Think of the conversation as having four distinct components:

  1. Planning and preparation;

  2. Starting the conversation or an “opener”;

  3. Providing feedback; and 

  4. Exploring options together.

Every conversation counts. 

If your loved one isn’t open to the conversation, you may only get through step one, but that’s ok. Each of these discussions can help further the conversation and let the individual know that you are there for them.


Plan and Prepare

Think about what you want to say beforehand. The old adage of “think before you speak” is especially important when we are feeling emotional or worried about someone.  Managing your emotions and staying calm and compassionate is very important. You may feel anger, betrayal, or even shame, but being aware of how you are feeling and planning for the conversation in advance will help.  

It’s also important to consider timing. Find a calm moment without interruptions. Do not attempt to have the conversation when they are under the influence, when they are more likely to react negatively and less likely to understand you fully. 

Focus on showing empathy and listening without judgement.

The language you use around addiction is also important. Remember to avoid labels like addict, junkie, and alcoholic. Instead use phrases like trouble with drug use, or problem with drinking/ alcohol use. Problems and troubles are fixable and treatable; whereas labels make a person feel less than and blamed.

Starting the Conversation


Always begin the conversation with love and concern and try to avoid making any kind of accusations.

Starter talking points may look like:

  • I’ve noticed you’ve been drinking a lot lately and I’m worried about you.

  • I’ve noticed you’ve been using heroin again and I’m worried about you.

Listen and be patient. Make sure you give time for their response and listen carefully to what they’re saying.

Focus on empathy and listening without judgement. It is important to be mindful of your body language and tone, such as:

  • Staying seated

  • Using a soft, calm tone of voice

Avoid things like:

  • Standing

  • Crossing your arms

  • Pointing your finger or making any aggressive gestures with your hands

  • Using a loud voice or curse words

After you have started the conversation and are aware of your visual cues and body language, offer encouraging words, such as:

  • I want you to know that you are not alone.

  • It may not seem like it right now, but you can be in control of your life again.

  • I love you and want to help.


Provide Feedback


Once you’ve started the conversation, it’s helpful to provide specific examples. You can share your concerns about their behavior or your worries about their substance use and its effects on their health. Try to use non-blaming language. Do not raise your voice or get angry; instead share specific behaviors or incidents and how they worried you. 

Try and use pronouns like “I” or “we” to avoid making your loved one feel defensive. “I am concerned about the methamphetamines you are using.” 

Feedback talking points may include:

  • I’m worried that your behaviors change when you drink. Last night, for example ____________.

  • Your overdose on opioids has me worried that you will have another overdose. 

  • I’m concerned that your drug use is affecting your relationships / children / job / health. For example, ____________________.

  • How are you feeling about your drinking? I’ve noticed you’ve been drinking more than usual.

Develop an Action Plan

The third step in the conversation is to ask if they would be willing to seek professional help and together develop an action plan. If your loved one is willing, offer to help find a nearby health care provider who can conduct an assessment. 


Then, develop an action plan:

  • Let’s talk about getting an assessment, which would help find the right treatment and recovery plan. 

  • I am here for you, and I want to help in any way that I can. 

  • We are here for you and in this together. I think we all might benefit by going to family counseling. 

If They’re Not Ready

Don’t give up hope if this conversation doesn’t “work” the first time. Every conversation counts. They may not be open to the topic and may become defensive. If this happens, let it go for the time being. 

Sample talking points if you are met with resistance include:

  1. I understand you’re not feeling ready to take steps today. Let’s pause this conversation and revisit at another time. 

  2. I understand you need more time, but I want to make clear my expectations and boundaries when it comes to your alcohol/drug use, including:

  • You cannot drink/use around me; 

  • I don’t want alcohol/drugs in my home; and 

  • I will not provide money to purchase alcohol/drugs, etc.

3. I’m here to help when you’re ready and want to get help.





An excerpt from Navigating Addiction and Treatment: A Guide for Families, Addiction Policy Forum, 2020. 

 

A Note From Addiction Policy Forum


Substance use disorders get worse over time. The earlier treatment starts the better the chances for long-term recovery. Many families are wrongly told to “wait for rock bottom” and that their loved one needs to feel ready to seek treatment in order for it to work. The idea that we should wait for the disease to get worse before seeking treatment is dangerous. Imagine if we waited until stage 4 to treat cancer. Decades of research has proven that the earlier someone is treated, the better their outcomes—and that treatment works just as well for patients who are compelled to start treatment by outside forces as it does for those who are self-motivated to enter treatment.


Help is Here


If you have questions or need to speak with someone for support, call or text (833) 301-4357 today. Our staff of trained counselors at Addiction Policy Forum provides free, confidential support to anyone in need of help with a Substance Use Disorder issue, including patients, families and healthcare providers.


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References:


1. Substance Abuse and Mental Health Services Administration. (2019). Supporting A Loved One Dealing With Mental And/Or Substance Use Disorders: Starting The Conversation. Retrieved from www.samhsa.gov/sites/default/files/samhsa_families_conversation_guide_final508.pdf

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