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Watching a loved one struggle with addiction can be one of the most heartbreaking things life throws at you.
Addiction is a disease that doesn’t always look the same for everyone. For some, addiction can be drinking excessively on a regular basis. For others it can be daily drug use. In 2018, an estimated 20.3 million people aged 12 and higher have a substance abuse disorder with 89.8% not receiving treatment.1
In this guide, you’ll find helpful information about the nature of addiction, finding the right treatment for your loved one, and how to take care of yourself during this stressful time.
It’s hard to admit that someone you love—whether it’s a parent, child, significant other, or close relative—may have a problem with alcohol or drugs. Family and loved ones can play a critical role in motivating people struggling with addiction to enter and remain in treatment. In a 12-year follow-up study of opioid addicts, 75% acknowledged family as a major reason for entering a treatment program.2 For both your and his or her sake, it’s paramount to be aware of some of the signs.
Although different substances have varied effects, some general signs can indicate that someone you care about might have a problem. These signs may be a result of intoxication or they could be a result of withdrawal following physical dependency. When looking for warning signs of addiction, you should consider physical, mental/emotional, and behavioral changes.
General physical signs of a substance use disorder can include:3
When monitoring your loved one for mental/emotional changes, keep an eye out for:3, 4
Behavioral changes also often occur when a substance use disorder is present. These warning signs may include:3, 4
Unfortunately, addiction doesn’t just affect the person who has a substance use disorder—it often affects the entire family. Your loved one may be in denial, rationalizing their addiction, or projecting onto members of the family. In cases like these, family members often respond in complementary ways to protect themselves from the consequences of their loved one’s addiction ultimately resulting in isolation of the affected individual as well as family members.5
Sometimes, behavior you may feel is helping a loved one could actually enable their substance use by minimizing the consequences of their actions.6, 7
A parent bailing his or her child out of jail repeatedly, or a spouse reporting to his or her partner’s employer that they are sick when actually they are unable to get up for work after staying up late drinking or getting high, are just two examples of what enabling behavior looks like.
Although enabling doesn’t often feel like a negative action, it can help reinforce the behavior you may be trying to prevent.6 By helping your loved one avoid the full consequences of their actions, you could be unintentionally making it possible for them to continue problematic alcohol or other drug use.
Learning how to establish healthy boundaries is part of the recovery process.6
If your loved one has exhibited signs of addiction, it may be time to talk to them about their substance use and motivate them to seek treatment. This can be a difficult conversation, so it may be helpful to have a professional—like a doctor or therapist—assist you and your family at this time to keep the conversation objective, and help you to display a positive view toward your loved on while exhibiting a negative attitude toward the addiction.4
The use of confrontational and coercive interventions, such as those shown on television, is not supported by the evidence as an effective tool for creating lasting change. There are, however, supportive interventional approaches that have been effective in guiding a resistant family member into accepting and entering treatment. These approaches are typically done in concert with certified mental health professionals.4
The ARISE method gently eases your family into intervention and is part of the recovery method for 6 months after. Certified ARISE interventionists work with the substance user, his or her family, as well as the treatment center to help guide the person through the beginning of recovery.8
Community Reinforcement and Family Training (CRAFT) is another non-confrontational approach to intervention, where Concerned Significant Others (CSOs) learn how to motivate their loved one who is using drugs to slowly change their behaviors. This approach could help the substance user lower his or her use of drugs even before entering treatment.9
When deciding how to approach your loved one, you might consider consulting with a medical or mental health professional to get some tips to prepare or assist in developing a supportive interventional approach.
If you’ve made it this far, congratulations: your loved one is willing to enter treatment. But there are several things to consider when your loved one makes this decision.
Here are some factors to think about before choosing a treatment facility.
Some treatment facilities cater to specific populations, such as male or female only or adolescent or adult only. Others have programs for LGBTQ clients, veterans, or those who are involved in the criminal justice system. Some facilities are faith-based.
Keep these factors in mind when choosing a facility to make sure that it’s a good fit.
There are several different behavioral therapies that can be used to treat substance use disorder, including cognitive-behavioral therapy, contingency management, a community reinforcement approach, motivational enhancement therapy, and family therapy. 10
When successful, these therapies can help people stay in treatment, give them a reason to stay sober, help them change their beliefs and behaviors regarding substance use, and improve their ability to manage stressful situations and location triggers that can lead to cravings and relapse. 10
Some facilities provide medication to assist patients with detoxification to maintain sobriety, manage cravings, or to treat underlying mental health issues that may have contributed to the substance use disorder.10 These facilities will have a medical professional on staff, like a doctor, and a support team like nurses, as well.11
Counseling or psychotherapy should be provided by a licensed professional as well, such as a social worker, mental health counselor, or licensed professional counselor, depending on the requirements in your state.10 If you aren’t sure how to find a reputable treatment provider, a good place to start is the Substance Abuse and Mental Health Services Administration’s behavioral health treatment services locator.
Many people with substance use disorders also have a co-occurring condition. This can be a mental health condition, such as depression, anxiety, or PTSD, or a physical health condition, like HIV infection, hepatitis, or liver disease. If your loved one has a co-occurring disorder, you may want to look for a facility that can treat all of their conditions at the same time.10
Substance use treatment involves more than just stopping substance use. Over time, a person in recovery’s needs change, and their treatment plan must change as well to meet their needs.10 p4 Ideally, you want to find a treatment facility that will help set your loved one up for success by establishing a plan for care from start to finish.
Once your loved one agrees to treatment and a facility is chosen, the next likely step will be a provider conducting an assessment.11 This will evaluate what type of treatment your loved one will need and any other conditions that may need to be addressed while in treatment. The following are some of the more common treatment areas:
Outpatient treatment strategies differ widely in intensity and approach and is based on the individual patient’s needs. Extensive social (community and/or family) support is critical to successfully overcoming addiction in outpatient settings.
Some different kinds of outpatient community- and family-based treatments include:10
If your loved one is a teenager, there are several therapies developed specifically for adolescents. Two of those are:10
Family support and involvement is valuable for anyone seeking to overcome addiction. Family therapy can be a valuable component to inpatient or outpatient treatment as well as during aftercare. It can help you to motivate your loved one to stay sober and maximize treatment progress.10 It also provides the family with positive coping skills, an understanding of how to support their loved one, and the knowledge of how to manage a relapse.7
Health insurance generally covers at least part of the cost of substance use treatment.3 You can discuss payment options and insurance coverage with your insurance company, or with the facility when scheduling an appointment. If you don’t have insurance, low-cost options are available, and the facility may help your loved one apply for benefits.
Helping a loved one with an addiction can be draining, so make sure you’re taking care of yourself as you take care of them. Practicing self-care is a good way to deal with stress and frustration.
It may feel like your loved one is choosing drugs over the family, but addiction changes circuits in the brain that can make it difficult for them to know how to function without drugs.3, 10 These changes can make it difficult for them to stop using, even after they have detoxed. 3, 10 While it’s difficult, recovery is possible with proper treatment and support.
It can be easy to get lost in caring for a loved one with an addiction, but it’s essential to make time to care for yourself as well. Some great self-care strategies are:12, 13