Deal With Someone Who Is Having Problems With Drugs or Drinking

Abuse of drugs or alcohol is a complex disease. “Addiction” is a disease that causes dysfunction in your brain’s reward, motivation, and memory circuits. It will cause an addicted person to seek reward or relief through using the substance, often in spite of serious personal, health, and social risks.[1] Addiction and substance dependence can have a variety of contributing factors, including the person’s biology, his or her personal and social experiences, and psychological factors. Because it is incredibly complex, addiction should be treated by a professional. To help someone dealing with drugs or alcohol, you can learn about substance abuse, offer your support, and take care of yourself so you can stay strong.[2]

Steps

Staying Strong

  1. Determine what you can change. Trying to change someone else’s actions usually ends in frustration, because you cannot control another person’s behavior. However, you can change your own behavior.
    • For example, if a friend is having trouble with alcohol, you can avoid drinking alcohol around her. Offer other options for socializing, such as going to the movies instead of the bar.
    • Remember that you are not responsible for the person’s behavior, or its consequences. For example, if the person’s substance abuse is interfering with their ability to hold down a job, it is not your responsibility to pick up the slack. Doing so may actually enable the other person to continue abusing the substance.[1]
    • You do not have to make excuses for the other person, or cover up their substance use. You do not have to give the other person money to buy substances.
  2. Set boundaries. Boundaries are meant to protect both of you. They can help protect you from feeling abused, manipulated, or endangered. They can help the person you love know what is and what isn’t acceptable behavior.[3]
    • Consider what behaviors you are willing to be flexible with, and which are “hard lines.”
    • For example, the person may be hostile or rude to you, especially when s/he is using the substance. This is unacceptable behavior, but depending on your relationship, you may be willing to tolerate some level of it.
    • However, physical abuse or prolonged psychological abuse cause substantial damage. This is particularly true if young children are involved in the environment. As hard as it may seem, setting hard boundaries that absolutely prohibit this type of behavior is important to protect you and the other people affected by the user’s behavior.[4][5]
  3. Stand firm with your boundaries. There is a fine line between keeping yourself healthy and safe, and confronting your own prejudices and assumptions regarding substance use. It is important that the person with the substance issue know that you will not be bullied or manipulated into supporting their addiction. However, it’s also important that the person knows you are a source of the support they need, rather than the behaviors they might want from you.[6]
    • Enforce consequences, especially for hard line boundaries. These could be very small, such as not rescheduling plans to accommodate the other person. Or, they could be more significant, such as leaving the house or setting up a separate bank account.[7]
    • There is a difference between being flexible and putting yourself in danger. If you believe that you are in danger from the person using drugs or alcohol, call for help and leave the situation. 911, emergency services, and numerous hotlines are available.[8] Alcohol and drugs can cause violent and unpredictable behaviors even in those who don’t have a history of such actions.[9]
  4. Get some support for yourself. Caring for or even interacting with someone who is having problems with drugs or alcohol can be emotionally, mentally, and physically taxing. You may find it helpful to find your own sources of support, such as a support group or counseling.
    • Nar-Anon and Al-Anon are support networks for family and friends of those struggling with drugs or alcohol. Nar-Anon offers support meetings for family and friends of drug abusers.[10] Al-Anon offers support meetings for family and friends of alcohol abusers.[11]
    • You may also find meeting with a therapist helpful, particularly if you have feelings of guilt or responsibility for the other person. In some cases, the person may choose drugs or alcohol over you, and a therapist can help you work through that.
  5. Practice self-care. It’s important to take care of your body, as well as your emotions. Caring for others is a very stressful experience, and can put you at increased risk of becoming ill.[12] Taking proper care of yourself also sets a good example of self-care for your loved one.
    • Get enough sleep. Try to avoid stimulants in the evening. Don’t use screens for a few hours before going to bed. Establish a regular “routine” for before bed.[13]
    • Eat well. Eat plenty of fruits, vegetables, and high-fiber complex carbohydrates. Stress can wreak havoc on your immune system, and the antioxidants in fruits and vegetables can help boost your body’s ability to fight off illness. Complex carbohydrates, like sweet potatoes, brown rice, and legumes, may cause your brain to produce serotonin, a relaxing hormone.[14]
    • Exercise. Exercise will not only keep you fit, it can reduce the effect of stress.[15] Exercises that focus on your breath and mindfulness, such as Yoga and Tai Chi, may be particularly helpful.
    • Reduce stress. You may find meditation helpful. Listening to quiet, slow music may relax you.[16] Breathing exercises, such as deep breathing, can help you feel calm and can even reduce your blood pressure.[17]
  6. Admit your limits. Caring for and supporting someone struggling with drugs or alcohol abuse can be exhausting. Don’t stretch yourself too thin, or put yourself in dangerous situations. If you don’t take care of yourself, you won’t be able to care for the other person either. There is no shame in respecting your own limitations and caring for yourself.[18][7]
    • People using alcohol and/or drugs may blame you for their problems. They may attempt to manipulate you by threatening to use or self-harm if you do not give them what you want. You will need to remind yourself that you are not responsible for anyone’s actions but your own.[4]
    • Alcohol and drugs can cause people to be in denial about the severity of their issues. They may lie to you about their behavior. They may steal or even use threats or violence to get more of the substance. Detaching from this situation may be your best option.[19]

Offering Support

  1. Talk with the person. Express your care for the person first of all. Tell the other person you love him or her and you are concerned about the behaviors you’ve observed. Offer your support in specifics, such as being willing to go find help with them.[1]
    • Don’t use emotional appeals to “guilt trip” the person. This could make the compulsion to abuse the substance worse.[18]
    • Don’t try to talk with the person when s/he is under the influence of drugs or alcohol. S/he will not be in a rational mindset, and his or her judgment may be impaired.[20]
  2. Locate support resources in your area. There are many resources available for substance abuse, and many are free or low-cost. The most popular and widely successful option is process-oriented group programs, such as Alcoholics Anonymous.[21] These programs are valuable for a variety of reasons, but especially because they emphasize building and reinforcing a strong network of social support.[22] These networks, which often include 24-hour mentorship and a community of shared experiences, are usually very helpful for both users who are struggling and for people who are trying to stop using.[23]
    • “Contingency management” programs can be helpful in treating alcohol, stimulants, opioids, marijuana, and nicotine abuse. These programs are often run at local clinics and involve providing “rewards” or other positive reinforcement for staying off the abused substance.[24]
  3. Consider therapy. Many counselors and therapists are trained to provide support for those struggling with addiction. Because addiction is often present along with other psychological issues, such as depression, PTSD, or anxiety, seeking help from a mental health professional can help the person figure out some of the underlying reasons behind their substance abuse.[25]
    • Family therapy can be a good option if the person you are helping is a relative or partner. Research shows that Family Behavior Therapy (FBT) can help change dysfunctional patterns within family relationships that contribute to or aggravate substance abuse. It can also teach both you and the person struggling how to cope with addiction.[26]
    • Cognitive-Behavioral Therapy (CBT) can be helpful in treating the abuse of alcohol, marijuana, cocaine, methamphetamine, and nicotine.[27] CBT focuses on improving a person’s sense of self-efficacy by teaching them to identify and challenge problematic thoughts and behaviors.
    • Motivational Enhancement Therapy (MET) can be used to help a person overcome resistance to starting a treatment plan for substance abuse. It is commonly most effective for people who abuse alcohol or marijuana. It is usually not as effective at motivating people who are abusing other drugs, such as cocaine or heroin.[23]
  4. Consider an inpatient rehabilitation center. If you have immediate concerns, an inpatient rehab center may be appropriate. These programs are particularly important if the person is using substances such as cocaine, crack, heroin, or certain prescriptions. Withdrawal from these substances must be managed by medical professionals; drastic or sudden alterations in the use of these substances could cause severe medical complications or even death.[28]
    • These centers completely remove individuals from their outside situation. The person will “detox” under medical supervision. Often, these centers combine medical management with counseling or other education programs. [29]
    • Inpatient programs offer 24-hour supervised care, which can be useful if the person is still highly motivated to seek out and abuse substances.[30]
    • These centers also remove social and environmental triggers. For example, a person may be more likely to use substances if they are around friends who do so, or if they are in a particular place that is associated with substance use for them.
    • These programs can be costly and require a significant time commitment. In most cases, the person must be willing to enter rehab.
    • “Detoxing” alone is rarely enough to overcome an addiction. Behavioral change, such as that promoted by therapy, is necessary to fully recover.[29]
    • The Substance Abuse and Mental Health Services Administration has a "Behavioral Health Treatment Services Locator" on their website.[31]
  5. Consult with a physician. If an inpatient facility is inappropriate or too expensive, the person with the substance use issue should consult with a doctor to come up with a plan for treatment. The person using the substance should be under medical supervision when implementing this plan, in order to avoid severe complications or even death.
    • The American Society of Addiction Medicine has a “Find a Physician” feature on its website.[32] The American Academy of Addiction Psychiatry has a Patient Referral Program.[33]
    • The doctor or treatment provider may also help you come up with ways to support the person through the plan.[34]
  6. Remember that there is no cookie-cutter solution. Each individual’s situation is unique, and thus, his or her treatment will need to be tailored to suit that situation. You may need to explore many types of support and treatment options before you find one that works.[35]
    • Remember that this will be a process, not an immediate result. You and your loved one may experience many setbacks and relapses. Stay patient.

Helping Them Through the Process

  1. Organize strong social networks. Research supports the idea that humans fundamentally need social relationships. Social support can help support personal well-being, and is particularly helpful in situations involving substance abuse problems.[36]
    • How the person understands his or her support network is equally important. For example, if everyone in the person’s “local context,” or community, is constantly telling them that they are a “bad person” or that they will never get better, the individual might feel compelled to continue using the substance because they don’t feel they have better alternatives.[37]
    • On the other hand, communities that support a person struggling with substance abuse may help that person feel stronger and encouraged to succeed.
  2. Focus on positive outcomes. Focusing on even small successes can help motivate a person who is struggling with drugs or alcohol to keep going. “Preaching” at a person or emphasizing failures will not be effective, and could actually encourage the person to abuse the substance to assuage their guilt.[1]
    • For example, you could ask questions such as “What has been going well for you today?” or “What have you been struggling with the most?”
    • Praise even small successes and efforts. Alcoholics Anonymous is famous for its “One day at a time” motto, which focuses on overcoming addiction on a daily basis, rather than as a monumental task.[38] Check in frequently with the person and encourage any positive behaviors, no matter how small.
  3. Note the other person’s behavior. Changes in the person’s daily routine may signify that s/he has started using substances again. Unusual mood swings or increased aggression or defensiveness may occur.[18]
    • Missing school or work regularly, or a drop in performance, may also be a sign of substance abuse.
  4. Communicate directly. Don’t assume that the person’s behavior or attitude is due to substance abuse. Ask directly about problems you’ve observed, but try to avoid sounding accusatory or judgmental.
    • For example, if your teenager has missed school all week, you could approach him this way: “I just got a call from the school. They told me you haven’t attend all week. Can we talk about the reason why you missed school this week?” This approach offers the other person the chance to share their experience with you, rather than putting them on the defensive.
    • Avoid harsh or accusative language. For example, an unproductive way of confronting your teenager could look like this: “Your school called and you haven’t shown up all week. Are you using drugs again? You’re grounded.”
  5. Make positive associations. Demonstrate your support for the other person without constantly reminding them of their problems. You don’t want the only time you interact with the person to be when you confront them about their drug or alcohol issues. Socialize with the person. Ask about his or her life. Go out to the movies or dinner. Help them feel comfortable around you, and they may be more comfortable opening up to you.
    • Offering other opportunities to find enjoyment may also help the person realize that they don’t need to rely on drugs or alcohol as much.

Understanding Addictions

  1. Understand the role of biology. Addiction is a highly complex neurobiological state.[1] Many of the behaviors that become addictive initially cause a state of intense pleasure, or a “high.” They may also temporarily relieve a sense of sadness or debility, which may cause the person to seek them out as relief.
    • Most addictive behaviors, such as drug and alcohol use, cause a spike in dopamine, a neurotransmitter in the brain that causes a feeling of pleasure. This heightened level of pleasure can become seen as the “standard” by the person engaging in the addictive behavior. Activities that used to be pleasurable often can no longer compete with the dopamine rush offered by drugs or alcohol.
    • Addiction changes a person’s reward circuitry. Even in the face of adverse consequences, an addicted person may pursue the reward or relief offered by the substance.
    • Dependence on a substance happens when more and more of the substance is required to produce the desired effect. Dependence is highly dangerous; larger and larger doses of the substance may be consumed, and this often results in overdose and even death.[39]
    • Several substances, including alcohol and cocaine, damage the frontal lobes of the brain, which help control impulses and manage delayed gratification.[40][41] Without such regulation, individuals may have significantly impaired judgment and difficulty understanding consequences.[42][43]
    • Genetic factors also help determine whether an individual will develop an addiction.[1]
  2. Recognize the social element of addiction. Research suggests that the availability of social stimulation may play a role in using and developing addictions to substances.[44] Those living with fewer resources, such as individuals living in isolation or poverty, may be more inclined to use harmful substances because of a lack of other options to experience pleasure.
    • One study showed that rats living in a “resource rich” environment, with sources of pleasure, recreation, and socializing, were less likely to use or become addicted to substances than rats living in “resource poor” environments.[45]
    • It is important to understand how the person’s environment can increase or decrease the potential for him or her to use substances[37] For example, parental or family conflict, peer pressure, and high levels of stress are all associated with higher levels of substance abuse.[46]
  3. Understand the psychological dimension of addiction. Addiction is more than biology or social pressures. Each person’s unique psychology, their emotions and desires, can affect their predisposition to addiction and how they handle it.[47]
    • Protective factors such as supportive family and friends can help boost an addicted individual’s “resilience,” or ability to deal with their addiction.[46] However, the individual must be motivated to work on his or her behavior.
  4. Refrain from judging the person. The abuse of substances involves a highly complex set of issues, and each person’s situation is unique to him or her. Judging an addicted individual will not help him or her “wake up” to the danger of the situation; it could, however, drive the person away from a source of emotional and moral support. Remember that this person is a person, not merely an “addict.”
    • Society promotes many myths about addiction. Common beliefs include the idea that substance abusers “have no willpower” or that certain drugs will immediately cause mental illness or psychosis if they are tried “even once.” These beliefs are not supported by research and can promote prejudice against people struggling with substance abuse.[48]
    • Research has shown that many people are less likely to show empathy to someone who is suffering if we believe they somehow “deserve” what they are experiencing. Understanding the complex and tangled web of factors that contribute to addiction may help you avoid falling into this simplistic way of thinking.[49]

Tips

  • Remember that you are only responsible for your choices and actions. It can hurt when people you love make choices that are bad for them, but you can only change your own behaviors.
  • Support groups can be a great resource for friends and family of people with drug or alcohol problems. Everyone there has been through the same thing you’re experiencing. You may hear advice that helps you, and at the very least you’ll find empathy and understanding.

Warnings

  • Offer love and support, but don’t put yourself at risk or in danger. If you feel unsafe or abused in your situation, find a way to leave, or ask for help.

Related Articles

  • Deal with a Loved One with an Addiction

Sources and Citations

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 http://www.asam.org/for-the-public/definition-of-addiction
  2. ↑ https://www.ncadd.org/family-friends/concerned-about-someone
  3. ↑ http://www.promises.com/articles/family-and-parenting/healthy-boundaries-addicts-alcoholics/
  4. ↑ 4.0 4.1 Orzeck, T. L., Rokach, A., & Chin, J. (2010). The Effects of Traumatic and Abusive Relationships. Journal of Loss and Trauma, 15(3), 167–192.
  5. ↑ Wilson, S., Houmøller, K., & Bernays, S. (2012). “Home, and not some house”: young people’s sensory construction of family relationships in domestic spaces. Children’s Geographies, 10(1), 95–107. http://doi.org/10.1080/14733285.2011.638172
  6. ↑ https://www.psychologytoday.com/blog/heartache-hope/201106/setting-your-boundaries
  7. ↑ 7.0 7.1 http://www.mb.al-anon.alateen.org/Detachment.pdf
  8. ↑ http://www.thehotline.org
  9. ↑ Christiansen, J. (2014). Living With An Alcoholic: Learn To Live With or Leave Your Alcoholic Husband or Wife.
  10. ↑ http://www.nar-anon.org/find-a-meeting/
  11. ↑ http://www.al-anon.org/
  12. ↑ https://caregiver.org/taking-care-you-self-care-family-caregivers
  13. ↑ http://www.adaa.org/understanding-anxiety/related-illnesses/sleep-disorders
  14. ↑ http://pcrm.org/health/health-topics/how-to-eat-right-to-reduce-stress
  15. ↑ http://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/physical-activity-reduces-st
  16. ↑ http://www.ryot.org/scientists-create-relaxing-song-world/375837
  17. ↑ http://www.webmd.com/balance/stress-management/stress-management-breathing-exercises-for-relaxation
  18. ↑ 18.0 18.1 18.2 http://www.helpguide.org/articles/addiction/drug-abuse-and-addiction.htm
  19. ↑ Gorski, T. T. (2001). Denial Management Counseling Professional Guide: Advanced Clinical Skills for Motivating Substance Abusers to Recover. Independence, MO: Herald Pub House.
  20. ↑ http://www.drugfree.org/want-help-adult-family-member-friend-drug-alcohol-problem-7-suggestions/
  21. ↑ http://www.aa.org/
  22. ↑ Kaskutas, L. A., Bond, J., & Humphreys, K. (2002). Social networks as mediators of the effect of Alcoholics Anonymous. Addiction, 97(7), 891–900. http://doi.org/10.1046/j.1360-0443.2002.00118.x
  23. ↑ 23.0 23.1 Scott, J., Connors, G. J., & Miller, W. R. (2003). Participation and involvement in Alcoholics Anonymous. In T. F. Babor & F. K. Del (Eds.), Treatment matching in alcoholism (pp. 184–204). New York, NY, US: Cambridge University Press.
  24. ↑ http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-0
  25. ↑ http://www.webmd.com/mental-health/addiction/counseling-and-addiction-how-therapy-can-help
  26. ↑ http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-5
  27. ↑ http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral
  28. ↑ Herman, M. A., & Roberto, M. (2015). The addicted brain: understanding the neurophysiological mechanisms of addictive disorders. Frontiers in Integrative Neuroscience, 9, 18.
  29. ↑ 29.0 29.1 http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs
  30. ↑ http://www.recovery.org/topics/find-the-best-residential-inpatient-rehab-center/
  31. ↑ https://findtreatment.samhsa.gov/
  32. ↑ http://community.asam.org/search/default.asp?m=basic
  33. ↑ http://www.aaap.org/?page_id=658?sid=658
  34. ↑ http://www.drugabuse.gov/related-topics/treatment/what-to-do-if-your-adult-friend-or-loved-one-has-problem-drugs
  35. ↑ Sacco, P. A. (2013). RIGHT NOW ENOUGH IS ENOUGH! Overcoming Your Addictions And Bad Habits For Good. Bradenton, FL: Booklocker.com, Inc.
  36. ↑ Sprinson, J. S., & Berrick, K. (2010). Unconditional Care: Relationship-Based, Behavioral Intervention with Vulnerable Children and Families (1 edition). Oxford ; New York: Oxford University Press.
  37. ↑ 37.0 37.1 Duff, C. (2007). Towards a theory of drug use contexts: Space, embodiment and practice. Addiction Research & Theory, 15(5), 503–519. http://doi.org/10.1080/16066350601165448.
  38. ↑ http://www.aa.org/pages/en_US/frequently-asked-questions-about-aa-history
  39. ↑ http://www.who.int/substance_abuse/information-sheet/en/
  40. ↑ http://www.elementsbehavioralhealth.com/drug-abuse-addiction/cocaine-users-brains-abnormal-frontal-lobes/
  41. ↑ http://www.sciencedaily.com/releases/2013/11/131119193624.htm
  42. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730661/
  43. ↑ http://www.apa.org/monitor/jun01/cogcentral.aspx
  44. ↑ Hari, J. (2015). Chasing the Scream: The First and Last Days of the War on Drugs. New York: Bloomsbury USA. http://chasingthescream.com/
  45. ↑ http://www.sciencedirect.com/science/article/pii/S0014488607000052
  46. ↑ 46.0 46.1 http://www.sagepub.com/upm-data/11207_Chapter_5.pdf
  47. ↑ Damasio, A. (2005). Descartes’ Error: Emotion, Reason, and the Human Brain (Reprint edition). London: Penguin Books.
  48. ↑ Hart, C. (2014). High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society (Reprint edition). Harper Perennial.
  49. ↑ http://dl.acm.org/citation.cfm?id=1739202
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