It’s a tough situation to be in when you realize one of your friends may be suffering from drug addiction or alcoholism, and there isn’t usually an easy solution. On one hand, you want to help your friend, but on the other, you’re probably worried about overstepping your boundaries or making the problem worse.
If you’d like to help your friend address their problematic alcoholism or substance use, read on to learn more about the signs of addiction and how to provide constructive support.
Signs Your Friend Might Have an Addiction
If you suspect your friend is struggling with drug or alcohol abuse, there’s a good chance you’ve already observed some unusual changes in your friend’s mood, behavior, or physical appearance.
Some changes are more easily observed than others, however. Remember that it can be difficult to recognize certain signs of addiction, especially if you do not live with the person or see him or her on a daily basis.
Signs, symptoms, and behavioral changes used to make a diagnosis of a substance use disorder include:1
- Using a drug more often or in higher doses than originally intended.
- Needing to take more of a substance to achieve the initial effect (i.e., tolerance).
- Significant amount of time spent on acquiring, consuming, and recovering from substance abuse.
- Failed attempts to change, cut back, or discontinue use.
- Neglecting responsibilities due to drug use.
- Continuing to use a substance even when it causes relationship, familial, or professional problems.
- Strong cravings for the substance.
- Withdrawal symptoms when use is stopped or reduced.
- Missed work, family events, or social activities due to drug use.
- Engaging in substance use even when it is dangerous to do so.
- Continued use despite knowing a physical or psychological problems could be exacerbated by the substance.
Though different substances may have quite distinct effects profiles, some general signs and symptoms of substance use/misuse include: 2
- Spending more money than intended on drug or alcohol use.
- Poor hygiene or changes in physical appearance.
- Unusual weight loss or gain.
- Changes in pupil size.
- Frequent mood swings.
How to Help an Alcoholic or Addicted Friend?
While you may genuinely want to help your friend, you cannot make your friend stop using drugs: This is a decision he or she will have to come to on his or her own. You can, however, show them ongoing support and encourage them to seek professional help.
You may have watched the show Intervention or something similar on TV and been tempted to stage something similar. However, the National Institute on Drug Abuse (NIDA) recommends against this approach because there is no evidence that confrontational interventions work. In fact, they may do the opposite and discourage a person from seeking treatment.2
Instead of confronting your friend in a large group, it’s better to try to get him or her to see a professional.2 Conversations with friends and family can be emotionally loaded and may unintentionally make matters worse. People may be more willing to listen to a professional than they are their loved ones.
Some ways you may be able to help get your friend to see an addiction professional include:2
- Thinking about creative incentives you can use to get your friend to go for the initial appointment. See what motivates your friend and find ways to make treatment more appealing. When possible, choose positive reinforcement over negative reinforcement.
- Researching various treatment options and have a list ready to present to your friend.
- Looking for specific programs that will appeal to your friend. Think about amenities, locations, and approaches that might resonate with them personally.
Some other helpful ways might include:
- Sitting down and talking to your friend one-on-one, rather than approaching him in a group. This will be far less intimidating.
- Never trying to force your friend to stop using. Instead, focus on their strengths and empower them to make the choice.
- Thinking about any barriers to treatment your friend might have and strategize ways to overcome them (e.g., detox programs to help ease withdrawal symptoms, childcare services for parents in treatment, outpatient treatment that doesn’t interfere with work, affordable treatment options, etc.)
Supporting vs. Enabling a Friend in Need
Enabling typically starts out with good intentions, such as a person who just wants to help his or her family member or friend.
However, when it comes to substance abuse, helping in this manner may do more harm than good. When we take away the natural consequences of a person’s drug or alcohol abuse, we take away their incentive to change the behavior.3
Some examples of enabling include:
- Giving money to a person with a substance use disorder.
- Lying to an employer about the person’s absenteeism.
- Bailing a person out of jail.
- Getting items out of a pawnshop that a person has sold for drugs or alcohol.
- Repairing damages to property that were caused by a person’s substance abuse.
- Making excuses for the person.
- Fulfilling a person’s commitments or responsibilities when he or she is unable to do so due to substance use.
When trying to help a friend with substance use, it’s best to avoid enabling behaviors. You can support a person without enabling by setting clear and appropriate boundaries.
Especially in the long-term, you may want to weigh your own physical and emotional well-being over a friend’s addiction. Remember that you are not responsible for that person’s health, well-being, or choices: You aren’t able to “fix” them.
Other boundaries you set will be unique to you and your friend’s specific situation, but may include things such as refusing to clean up messes related to drug use, not providing money for drugs, and not lying for them. Your boundaries should separate you from the person’s substance use and the consequences of it.
How to Help Your Friend Find Treatment
If your friend asks for help finding treatment, praising your friend for having the courage to accept he or she has a problem and seeking help for it is a good way to start showing support.
A simple place to start is calling or searching online for different facilities to find the right doctor or addiction treatment specialist. When choosing addiction treatment, you should:
- Find a treatment program that is tailored to your friend’s unique needs. If he or she works during the day, look for an evening outpatient program. If your friend needs 24/7 care, look at inpatient programs. Some facilities offer specialized groups for LGBTQ+, veterans, or other communities.
- Consider the program’s credibility. Research the treatment center’s accreditation and look at their staff. Quality treatment centers commonly have a wide range of qualified staff on board, including psychiatrists and other addiction treating physicians, nurses, psychotherapists, addiction counselors, peer support staff, etc.
- Check if the treatments offered are evidence-based and backed by research.
- Determine if the duration of the program is right for your friend’s specific needs. Longer treatment durations may result in better treatment outcomes.4
- Look into available support programs such as 12-step groups and see how they fit into the addiction treatment program.
What if My Friend Can’t Afford Treatment?
Unfortunately, finances can be a significant barrier to treatment for many people. But even if your friend cannot afford treatment, there are some other potential options. If he or she has any form of health insurance, they may have more coverage for addiction treatment than initially thought. You can help by calling the number on the back of his or her insurance card and verifying what available substance abuse benefits are offered.
If your friend is uninsured or underinsured, there are still other options that can make addiction treatment more affordable. These include:
- Sliding scale treatment centers that are based on income.
- Addiction treatment scholarships.
- State-run programs that offer free or reduced-cost treatment.
- Loans and/or payment plans if the treatment center offers it.
- Credit cards.
What to Do if Your Friend Relapses
Some people who go through addiction treatment will end up relapsing at least once during their recovery.5 If your friend relapses and seems to give up hope of getting better, encourage him or her to keep trying.
Do not enable their substance use or other maladaptive behaviors; instead, continue to provide support and nonjudgmental concern for their well-being. Condemning or making them feel inadequate for relapsing could have the opposite effect. Instead, offer kindness, compassion, and understanding. Remind him or her that relapse is a normal part of recovery and does not mean he or she has failed.
Encourage your friend to continue to seek professional support. If he or she is not involved in any peer support groups or 12-step programs, you can help them find one. If he or she is involved, suggest that they call their sponsor for help as soon as possible. Depending on the situation, your friend may need to consider going back to treatment or trying a different form of treatment to help.
Supporting Your Friend’s Recovery
It’s integral for you and your friend to remember that recovery does not end when your friend completes treatment. Recovery is a lifelong process, and your friend will likely continue to need your support long after he or she has completed treatment.
To support your friend in maintaining sobriety:
- Lend a kind and compassionate ear if your friend wants to talk.
- Encourage healthy habits, hobbies, and routines. Get involved with your friend and help him or her participate in healthy activities such as exercising, eating healthy, and engaging in positive hobbies and activities that make them less likely to want to use drugs.
- Provide a sober and drug-free environment. This may mean taking a closer look at your own substance use. It can be challenging to support your friend in recovery if you have substance use issues of your own. Even if you only use recreationally, it’s best to avoid using drugs or alcohol in your friend’s presence. Instead, help encourage him or her to choose sober environments and friendships.
- Encourage your friend to stay involved in recovery support programs, counseling, and other aftercare programs to help prevent relapse.
- Practice patience, understanding, acceptance, and nonjudgmental support. Remember that recovery is a lifelong journey. Addictive behaviors don’t change overnight, and your friend may continue to make some mistakes throughout the process. Continue to provide your love and support as much as possible without being judgmental or condemning mistakes or relapses.
- American Psychological Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Ed- DSM-V. Washington, DC.
- National Institute on Drug Abuse (2016). What to do if Your Adult Friend has a Problem with Alcohol or Drugs.
- Lander, L., Howsare J., & Byrne, M. (2013). The impact of substance use disorders on families and children: from theory to practice. Social Work in Public Health 28(0), 194-205.
- National Institute on Drug Abuse. (2013). Is the duration of treatment sufficient?
- National Institute on Drug Abuse. (2018). Treatment and recovery.