A: Dr. Brian Fuehrlein
What to do when your loved one doesn’t want help?
Sometimes an honest, frank conversation can prompt the path to recovery, but when it comes to SUDs, it can be difficult for people struggling to see or acknowledge the extent of harm their substance use is causing to themselves and to others. Know that your support matters and try to be patient--even if a loved one doesn’t want to get help when you offer it. He or she will remember what you said and may be ready to engage in treatment at another time.
Try to respond to resistance with compassion and optimism—keeping in mind that your loved one may be feeling ashamed, afraid, hopeless, and isolated. When possible, continue to offer your support in finding help and reminders that addiction is treatable.
Remember, severe SUDs “hijack” the brain, making the person who is struggling think that the substance is more important than anything else and thus fearful about what could happen if that substance is taken away. By the time a substance use disorder has progressed to addiction, living without the substance feels impossible—like being told you aren’t going to be able to breathe air anymore. Because of the way addiction impacts brain function, it is common for patients to rail against the idea of going to treatment.
What to do next depends heavily on your relationship to the person. For example, if your teenage son is resistant to getting help, the course of action will look very different from a coworker or friend not being open to your concerns.
If a friend doesn’t want help:
Stay in touch and know that there are other ways to show your concern and support, such as suggesting activities that do not involve alcohol or drug use.
Don't offer alcohol when they visit and/or encourage meetings, etc that don’t involve alcohol.
Don't continue to lend money if that's an ongoing problem. Don't accept late-night calls if you suspect your friend is using.
If the person hesitates or says he or she drinks a lot but doesn't have a problem, suggest a formal assessment by a professional who is trained and knowledgeable about substance use disorder.
Just because your loved one doesn’t want help or treatment now doesn’t mean they never will. If you want to be the person that your loved one reaches out to when they are ready to accept help, you will need to maintain a supportive, loving relationship letting them know you are there for them when they are ready. It is important that you prepare and plan ahead. This might mean researching treatment and payment options and meeting with counselors or treatment facilities. When and if the time comes when they ask for help, you will need to act quickly. Having all of the resources prepared in advance will enable you to swing into action.
Dr. Brian Fuehrlein
Associate Professor of Psychiatry, Yale University School of Medicine; Director, Psychiatric Emergency Room, VA Connecticut Healthcare System
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.
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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.