How to Help an Addicted Friend or Family Member

man drinking beer

Is your loved one struggling with addiction? | Wavebreakmedia/iStock/Getty Images

The following is a guest post by William Schroeder, counselor and owner of Just Mind, and Daniel Hochman, a psychiatrist and founder of  Self Recovery. 

Whether you realize it or not, all of us know someone who has or is struggling with substance abuse or full-blown addiction. I recently lost an old friend to addiction; sadly, she wasn’t the first. When these losses occur, it’s a sobering reminder of the challenge at hand for our country. Addiction is an equal-opportunity destroyer of lives that picks on the poor and rich, young and the old, and everyone in between.

My name is William Schroeder, and I’m a counselor in Austin, Texas. I own a group counseling practice called Just Mind. Joining me is Daniel Hochman, who is a psychiatrist in Austin as well. In addition to his patient-focused work, Daniel also works with addiction and started Self Recovery, an online recovery program for those looking for a more comprehensive, holistic approach that addresses underlying issues. Together, we understand addiction and we discuss it daily. We often hear the same questions come up in patient sessions surrounding addiction and we’ve attempted to answer some of the most common ones below.

What are some of the telltale signs of addiction?

This can vary from person to person, but often it’s paying attention to what’s different with them. Most of us know what it looks like when someone is really in the depths of addiction, but what if they still have it “under control,” but are approaching the danger zone? You might notice them not showing up on time (work or personal commitments), pulling back from healthy relationships and diving into worse ones, becoming less reliable, being defensive and irritable, disappearing for hours at a time, and getting tighter on money. Rapid changes in money and/or appearance can be strong indicators of when their controlled habit is unraveling into full-blown addiction and they’re just along for the ride.

What is the first thing I should do if I become aware that a loved one is battling addiction?

We suggest talking to them about it, but not in a threatening way. So many people jump in with the perfectly wrong approach and say something like: “I think you’re an alcoholic and you need to stop.” That’s the quickest way to make them defensive and avoid talking about it. One of the trickiest things about addiction can be the isolation the user experiences. Many people use an obsession with substances as a way to cope, so shaming them about it doesn’t help.

Many times, addiction is an indication of something else the patient is struggling with, so our suggestion is really just trying to connect in a safe, loving way, but showing concern. Mention some specific changes you’ve noticed them display in their behavior or actions. Something like, “I notice you’ve been more upset with people recently, and that you’ve been drinking a lot more at the same time. I’m worried about you. What’s bothering you?” This is much easier and inviting for them to respond to or at least begin the conversation.

How can I best show support?

You may need to set boundaries, but if done in a firm and loving way, this is more effective than making them feel worse about their situation. We really don’t think anyone wants to be an addict. Research points to how important it is to have a community of support for those who are struggling with addiction. This is part of the idea behind sober houses and decriminalization of drug crimes in most European cities.

It is also helpful to separate the person from their addiction and make it like the addiction is its own being. You might say, “I love you, but I sometimes get anxious when I worry the addiction might come back.” Instead of, “I hate your addiction.” It depersonalizes it, which can help the person to be less defensive. Remember that your goal is to show someone you care and hope that they use you as a support to get the help they need. When different approaches are studied, the best ones are the types that treat the person like a regular human being who needs help.

If my loved one is already seeing a therapist or psychiatrist, should I call that professional? Would the therapist or doctor be willing to talk with me or is confidentiality an issue?

This is something that comes up a lot at both of our private practices. We will sometimes have friends or family call in with something that alarmed them about our patient, such as having a severe relapse or displaying troubling behavior like we highlighted above. Unfortunately, unless we have a signed agreement allowing us to talk with those involved with the patient, we can’t call them back to discuss it due to confidentiality. That being said, if you think you have valuable information about someone in a treatment program, a good provider will want to know that and will make use of it. Just don’t expect us or the clinic to call you back, write you back or acknowledge your correspondence, but rest assured we’re taking your alert seriously and the information is being heard and addressed.

I’m at wit’s end! Can I have a loved one involuntarily sent to rehab? At what point should I do this, if at all?

For good reason, it is difficult to legally force a free person (yes, even while intoxicated) into any kind of treatment. It is possible to involuntarily commit someone to detox, and most states have a mechanism for that. That involves proving with documentation the likelihood of imminent physical harm (beyond the usual damage of drugs or alcohol) or a lack of capacity to provide for his or her own basic needs. In practice, this is exceedingly rare considering the amount of people harming themselves with their addiction every day. It can be impractical to force detoxification when the reality is that meaningful change is a longer process. So, the answer to the question relies on which situation and state you’re in.

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