How to help someone with addiction

Hunter Michael Shepard overcame addiction in the heart of the opioid epidemic. Today he is a trained addiction interventionist who has guided families from every corner of the world. This guide pairs that experience with what public health agencies say about helping someone you love.

Addiction is a treatable condition

Start with a fact that is easy to lose in the fear: addiction can be treated. The National Institute on Drug Abuse (NIDA) says plainly that addiction is a treatable disorder, and that research based treatment helps people stop using drugs and get their lives back.

NIDA compares addiction to chronic conditions such as heart disease and asthma: treatment manages it rather than curing it, and a return to use does not mean treatment has failed. It means it is time to restart or adjust treatment with a doctor. Your loved one is not a lost cause, and a setback is not the end of the story.

What helps

Calm, honest conversations

Pick a moment when your loved one is sober and you are both calm. Say what you have noticed and why it worries you, then listen. SAMHSA, the federal agency for substance use and mental health services, advises families to listen without judgment and speak with kindness. It suggests asking open questions, such as "How would you like things to be different?", pointing out their strengths, and repeating back what you heard so they feel understood.

Expect more than one talk. SAMHSA notes it may take many conversations before someone gets help. MedlinePlus, from the National Library of Medicine, adds that people with addiction show far less denial when they are treated with empathy and respect rather than told what to do or confronted. For a step by step way to prepare, read findingrehab.io's guide to talking with someone you love without a blowup.

Clear, loving boundaries

A boundary is a plain statement of what you will and will not do. SAMHSA's advice on taking care of yourself includes telling the person clearly what you are willing to do and what you are not: you might drive them to an appointment, for example, but stop giving them cash. Choose boundaries you can keep. The Addiction Intervention Co. explains how to set healthy boundaries with someone in active addiction.

Stop covering for them

Love makes it tempting to smooth things over: calling their boss with an excuse, paying debts their use created, or hiding problems from the family. Covering shields them from the real weight of the problem and leaves you carrying it. Stepping back is not punishment. You can stop rescuing them from the fallout and still offer every kind of help with recovery.

Look after yourself

Watching someone you love struggle is exhausting. The same SAMHSA page encourages family members to protect their own health: set times to talk instead of being on call at every hour, make a little time each day for yourself, and find a support group. You will be more help to them if you are not running on empty.

What usually backfires

These come from love and fear, but they tend to push people away from help:

• Shame and labels. NIDA explains that feeling stigmatized can make people less willing to seek treatment. It suggests saying "a person with a substance use disorder" instead of words like "addict" or "junkie."
• Lectures and lists of everything they have done wrong. SAMHSA warns that focusing on what someone is doing wrong can close them off to asking for help.
• Arguing while they are high, drunk or in withdrawal.
• Threats you will not carry out. An ultimatum you do not keep teaches that your words can be ignored.
• Carrying it all in secret. You deserve support too, and it exists (see below).

How to talk about treatment

Before you bring up treatment, do some homework, so you can offer something specific instead of a vague "you need help":

• Look up two or three programs that fit their situation and insurance, using our guide on how to find addiction treatment that fits.
• Find out what their insurance covers, or what free and low cost options exist nearby.
• Decide what you can offer: a ride, help with the first phone call, or company at the first appointment.

Then keep the conversation about care, not blame. You might say, "I found two programs that take your insurance. Would you call one with me?" SAMHSA suggests ending these talks by summing up what you heard, asking how you can support them, and asking whether you can check in again. The Addiction Intervention Co. has more on how to talk to a loved one about going to rehab.

If they say yes, act quickly, and talk to a doctor or the program about stopping safely. Withdrawal can be dangerous: FindTreatment.gov notes it can sometimes be severe enough to cause hallucinations or convulsions.

If they refuse

A "no" hurts, but it does not have to be the end of the conversation. SAMHSA is honest that you cannot force someone to get care, and that the best thing you can do is be there and listen without judgment. Let them know you will be ready when they are, keep your boundaries, and keep looking after yourself.

The Addiction Intervention Co. has a practical guide on what to do when a loved one refuses treatment. If many caring conversations have not moved anything, some families choose a professional intervention: a planned, guided conversation with a treatment program ready the same day. Our guide What is an addiction intervention? explains how it works.

If opioids are involved, keep naloxone close

Naloxone is a medicine that rapidly reverses an opioid overdose, including overdoses involving heroin, fentanyl or prescription painkillers. NIDA advises families of someone who struggles with opioids to keep naloxone nearby, ask their loved one to carry it, and tell friends where it is. In 2023 the FDA approved the first naloxone nasal spray sold without a prescription, and many pharmacies carry naloxone.

Know the signs. SAMHSA lists these signs of an opioid overdose:

• The person will not wake up or respond to your voice or touch
• Breathing is very slow, not normal, or has stopped
• Pupils are tiny, like pinpoints
• Lips and nose look blue

If you see these signs, call 911 and give naloxone. NIDA says naloxone has no effect on someone without opioids in their system, and that it wears off in 30 to 90 minutes, so stay with the person until help arrives. Risk can be higher after a break from using, such as time in treatment or jail: NIDA explains that going back to the old amount can cause an overdose because the body is no longer used to it. A pharmacist can show you how to use naloxone, and findingrehab.io's guide to medications and naloxone covers the basics.

Support for you and your family

You do not have to figure this out alone.

• SAMHSA's National Helpline at 1 800 662 4357 is free, confidential and open 24/7, in English and Spanish. It serves families too, with referrals to local treatment and support groups.
• Family support groups. SAMHSA notes there are support groups specifically for family members coping with a loved one's drug or alcohol use.
• 988 is for you too. The 988 Lifeline lists substance use among the reasons to call or text, and it offers guidance on helping someone else.
• A role in treatment. When your loved one starts care, ask how the program involves families. FindTreatment.gov counts family involvement among the signs of quality treatment.

Related guides

• How to find addiction treatment that fits
• What is an addiction intervention?
• More resources from Hunter