How to Help a Friend With Drug or Alcohol Addiction
When a friend is struggling with an addiction, it can be difficult to know how to help. If you suspect that your friend has a problem with drugs or alcohol, you might begin by educating yourself on substance use disorders and how to access treatment.
This guide will help you learn more about the signs of addiction and provide tips on providing the best help possible.
How to Know if My Friend is Struggling with Addiction
Addiction is a chronic relapsing disease characterized by a loss of control and continued substance use despite negative consequences.1 It’s not up to you to diagnose your friend’s addiction—only a physician or other qualified clinician can do this—but it is helpful to know the warning signs.
Realize, however, that the signs of substance abuse are not always obvious, particularly in the early stages when it might be easier for your friend to hide or explain them away. It can also be hard to know if your friend’s drug use is progressing to the point where they need professional help when you don’t live with the person and/or you don’t see them every day.
Signs Someone May Have a Drug or Alcohol Addiction
Some of the signs that you may begin noticing in a friend who is developing a problem with substance use include:2
- Appearing depressed, anxious, or irritable.
- Having trouble concentrating or thinking clearly.
- Experiencing blackouts.
- Frequently getting injured while under the influence.
- Frequently getting into legal trouble.
- Spending money on drugs or alcohol instead of on necessities such as food or rent.
- Suddenly performing poorly at work or in school.
- Changing their social groups.
You may also notice changes in your friend such as:2
- Different sleep or eating habits.
- Unusual smells on their breath or clothes.
- Frequently dilated or constricted pupils or bloodshot appearance to their eyes.
- Secretive or suspicious behavior (sneaking out late, hiding things, lying).
- Mood swings.
The criteria that professionals use to diagnose a substance use disorder (SUD) include:3
- The substance in question is used in larger amounts or over a longer period than intended.
- An inability to stop or cut back despite a desire to do so.
- Strong urges or cravings to use the drug.
- An excessive amount of time is spent in drug-related activities (finding, using, or recovering from the drug).
- Using drugs or alcohol results in conflict in relationships with family and friends.
- Finding it difficult to manage work, home, or school obligations because of substance use.
- Giving up important hobbies or professional/social activities due to substance use.
- Using substances in hazardous situations (such as while driving).
- Continuing to use substances despite suspecting or knowing that doing so is causing or worsening physical or psychological problems.
- Tolerance, or needing more of the substance to achieve previous effects.
- Withdrawal, or unpleasant and uncomfortable symptoms that occur when the person stops using drugs or alcohol.
How to Encourage a Friend to Seek Addiction Treatment
A person needs to want to get sober; you cannot force a friend to stop using drugs or alcohol. However, you can be supportive and encourage them to seek help.
You might be tempted to stage an intervention such as those you may have seen on TV, but the National Institute on Drug Abuse (NIDA) states that there is no evidence to support the use of confrontational interventions.4 Instead, try the following:4,5
- Encouraging your friend to talk to their family doctor, which can feel less confrontational or loaded than a conversation with family or friends. Your friend may be more open to listening to the recommendations of a professional.
- Looking into treatment options. You can look for a treatment center online through the Substance Abuse and Mental Health Services Administration’s (SAMHSA) treatment finder. Consider factors such as location, cost, and amenities and try to find options that will appeal to your friend.
- Help them break down barriers to treatment. This might include discussing your friend’s objections and fears about treatment. For example, they may be afraid of withdrawal symptoms, but you can reassure them that many programs offer safe, comfortable detox. They may also be worried about leaving for treatment while neglecting their daily responsibilities. If you’re able to, you might offer to help with or arrange for assistance with day-to-day issues such as childcare, bills, or household chores.
How NOT to Enable your Friends with Their Addiction
You may want to do everything you can to help your friend with their substance abuse, but be aware that there is often a fine line between helping and enabling. You may be trying to help by assuming your friend’s responsibilities when they’re too intoxicated or by lending them money, but doing so may be unintentionally reinforcing their substance use. Facing the consequences of their substance use may be what your friend needs to find the motivation to get help.6
It can be hard to break the habit of enabling, especially when you truly want to protect your friend and when you’ve been doing it for a long time. However, stopping enabling behavior as well as setting boundaries and establishing limits can go a long way in helping your friend begin to face some of the consequences of their continued substance use, which could ultimately help them in the long run.
Once you’ve decided what your boundaries are:7,8
- Explain to your friend the boundaries you’ve set. Let them know you will no longer bail your friend out if they get into trouble. Explain that you are doing this from a position of love and concern, not punishment, because you want to see them get healthier.
- Letting them accept responsibility for their actions. Don’t call in sick to work for them if they have a hangover.
- Avoid making excuses to others for their behavior. Also avoid accepting blame or guilt for your friend’s drug or alcohol use.
- Avoid giving your friend money. It’s not easy to say no, but remember that doing so may help them to continue using drugs or alcohol.
- Take care of yourself. It can be exhausting and overwhelming when someone you care about is suffering from a drug or alcohol addiction. You need to prioritize your own needs so that you don’t let your own health go by the wayside while attempting to help a friend. You can choose to detach yourself not from your friend but from their substance use. Make the choice not to try and control their use or the consequences of their use.
How to Help a Friend Get to Rehab for Drugs or Alcohol Abuse
If your friend has admitted that they need help, you can take a number of steps to assist them in finding substance abuse treatment, such as:4
- Helping them find a doctor who treats addiction. You can call around to local doctors or search the American Academy of Addiction Psychiatry’s (AAAP) website for addiction treatment physicians in your area who are AAAP members.
- Helping them find another type of addiction specialist. You can research psychologists, clinical social workers, licensed family therapists, or certified drug and alcohol counselors in your area and ask if they have experience in treating the type of substance use your friend struggles with (and if not, asking them if they can refer you to colleagues who do).
- Providing support and encouragement and letting them know how much bravery it takes to ask for and accept help.
- Helping them research drug abuse treatment programs.
Some of the things to look for in a treatment program include:
- Your friend might prefer to stay close to home or they might want to go to a location where they’ll feel more anonymous and far away from friends who use or environmental triggers.
- Price and payment options. Your friend may be able to afford programs that offer luxurious amenities, or they may have more limited means. You can help them to research programs at different price points and also help them discuss options like loans and financing with specific facilities. (See more below.)
- Qualifications of staff. Not all rehab center staff have the same qualifications. Do some research about the experience of the treatment teams at different programs to help your friend choose a quality program.
- Types of therapies used. Ask any prospective programs whether they utilize evidence-based treatments, such as cognitive-behavioral therapy.9
Options for Paying for Drug or Alcohol Treatment
Many insurance plans cover all or part of the cost of addiction treatment, so your friend may be able to afford more than he realizes. If your friend has insurance, you could offer to call the number on his card to verify his benefits or you can do this with Laguna Treatment Hospitals free insurance benefits verification check.
If your friend does not have insurance or if their insurance doesn’t cover the entire fee, they can always consider alternative payment options. Recovery centers often offer loans or sliding scales (which are usually based on income or ability to pay), and many also offer scholarships to help defray the costs of treatment.
State-run programs may be more affordable for people who cannot afford private treatment. SAMHSA has a directory of Single State Agencies (SSA) for Substance Abuse Services, where you can find the contact information for your state’s governing substance abuse agency.
Treatment costs vary by type of treatment. The type of treatment your friend requires is based on their individual needs (i.e. people with more severe addictions may be best helped by inpatient rehab, while outpatient treatment is beneficial for people with less severe substance use disorders who have the support at home they need to stay sober).10
Inpatient drug or alcohol treatment offers residential, round-the-clock care and tends to be more expensive than outpatient treatment, where people live at home and commute to a recovery center for treatment. The price of inpatient treatment also varies by length of stay; for example, long-term programs tend to cost more than shorter-term rehabilitation stays.11
Your friend may also need medical detox based on which substances they’ve been abusing. The prospect of withdrawal can be very nerve-wracking for many people who are thinking about quitting drugs. You can explain to your friend that medical detoxification programs like the one at Laguna Treatment Hospital are staffed with medical professionals who will provide high-quality care to keep them safe and alleviate their discomfort during this time.
What to Do if a Friend Relapses on Drugs or Alcohol
Many people relapse while they are in recovery. Relapse rates are similar to those of other chronic health conditions, such as hypertension and asthma.1
If your friend relapses and feels hopeless, encourage them to continue their recovery. Explain that relapse isn’t an indication of failure, but it could be a sign that your friend needs some sort of adjustment. This could include participating in a different type of treatment program, remaining in the program for a longer period of time, or perhaps seeking assistance through recovery groups. Many therapies and aftercare programs are designed to prevent relapse and help people stay on the road to recovery.
Without enabling or judging, support your friend and let them know you want them to be happy. Let them know that you will help them get back into a treatment program if that’s what they decide to do.
Supporting Your Friend’s Sobriety After Rehab
You can support your friend’s sobriety in a number of ways, such as:
- Helping them find a recovery group like Alcoholics Anonymous (AA) or SMART Recovery. You can help provide transportation to meetings if needed.
- Participating in support groups for family and friends of people with addiction, such as Al-Anon, Nar-Anon, or SMART Recovery for Friends and Family.
- Encouraging your friend to take part in alumni activities if their treatment program offers one. You can attend events with your friend if it’s allowed.
- Avoiding using alcohol or drugs while your friend is around. You don’t necessarily need to stop using (if that’s your choice), but know that using in front of your friend can be a trigger to relapse. You can also ask your friend what they prefer, for example, ask if they would rather you not drink in front of them or, if you share a living space, if they would prefer it if alcohol was removed from the home.2
- National Institute on Drug Abuse. (2018). Drugs, Brains, and Behavior: The Science of Addiction.
- Herie, M., Godden, T., Shenfeld, J. & Kelly, C. (2010). Addiction: An Informative Guide.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association.
- National Institute on Drug Abuse. (2016). What to Do If Your Adult Friend or Loved One Has a Problem with Drugs.
- Kathyleen Tomlin, K, Walker, D.R., Grover, J. et. al. (n.d.). Motivational Interviewing: Enhancing Motivation for Change—A Learner’s Manual for the American Indian/Alaska Native Counselor.
- Connolly, M. (2017). Are You Enabling the Addict in Your Life?
- Washington State Employee Assistance Program (EAP). (2016). Codependency and Addiction.
- Scruggs, S.M., Meyer, R., Kayo, R. (n.d.). COMMUNITY REINFORCEMENT AND FAMILY TRAINING SUPPORT and PREVENTION (CRAFT-SP).
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
- National Institute on Drug Abuse. (2018). Types of Treatment Programs.
- Mass.gov. Substance Abuse Services Descriptions.