February 25th, 2022

I’m Concerned About My Loved One’s Substance Use

by Stacey Davis, LCSW-C

Suspecting that a loved one has an addiction can be scary and talking to them about it can be even scarier.  When you love someone, you want to keep them safe and addiction is anything but safe.  It’s important to remember that you cannot force someone to admit they’re an addict or force them to get help but, if you suspect someone you care about is abusing substances, there are things you can do to help.  

Drug or alcohol addiction isn’t always easy to spot and you may second guess yourself/feel guilty or even make excuses for what you’re seeing or hearing from your loved one.  An addict’s job is to keep their addiction secret so, bringing it to light can be a challenge but, if you know what to look for, you can begin to unravel the web.  Some signs that your loved one may have an issue with substances include:

  • Experiencing problems at work, school, or at home that are uncharacteristic for your loved one, such as decreased productivity, neglecting responsibilities, and loss of interest in things they used to enjoy, which may lead to losing a job, dropping out of school, or ending long term relationships.
  • New health issues may develop, such as sleep disturbance, significant weight loss or gain, cognitive problems like forgetfulness, and glassy or bloodshot eyes.  They may appear sleepier or more fatigued than usual and, depending on what substance their using, you may notice frequent sniffing, dilated pupils, or shaking.
  • Changes to their mood and behavior may occur, where your loved one is more secretive or you begin to be aware of more lies being told about where they’re going or have been, how much money they’re spending and for what, or they may be quick to anger, especially if you attempt to talk to them about what you’re noticing.  You may notice that they’re more moody or disconnected from the family or hobbies.  They may neglect their appearance and/or hygiene.
  • Financial issues may begin to surface or worsen over time.  They may run up credit card debt or owe money to several different family members or friends without truthful explanation.  Your loved one may even steal from you, their parents, siblings, etc.

You may also notice things in your home that would indicate your loved one is using, and possibly abusing, substances, ie. paraphernalia, such as small plastic baggies, rolling paper, pipes, burnt foil and spoons, syringes (or syringe caps), and/or prescription medication bottles that don’t belong to them.

Addiction doesn’t happen overnight and these things that you’re seeing have probably been developing over a significant amount of time, either just under the radar or now your loved one is getting deeper into their addiction therefore making their behaviors harder to hide.  Starting a conversation with someone you care about regarding their substance use is never easy and it’s important to remember to approach with kindness and a willingness to help.  Remember that your loved one didn’t start using substances with the goal to become an addict and are likely scared and feeling shame and looking for a way out, however, either don’t know how to ask for help or don’t feel ready for the work recovery takes.  Addiction often begins as a way to cope with pain, whether physical or emotional, and the belief that the substance will provide relief from that pain.  Stress tends to fuel addictive behaviors so criticizing and shaming will likely not be an effective way to get them to talk to you about that they need.   

It’s also important to understand that addiction is a disease of the brain and has “hijacked” your loved one’s good decision making skills.  The part of the brain where addiction lives is focused on impulses and survival.  The brain changes so much in active addiction that your loved one truly believes they require the substance to remain alive; that they will literally die without their drug.  This is what makes stopping use so difficult for the addict to fathom, let alone accept.  

When you have enough “evidence” that your loved one is an addict, you may be having feelings of shock, anger, disappointment, etc., therefore, it’s important to choose a time when you are feeling calm and, ideally, when your loved one is sober/not under the influence to talk with them. Here are some tips for how to have this important conversation:

  • Don’t wait.  You don’t have to wait until your loved one has hit “rock bottom”, ie. getting arrested, losing a job, suffering a medical emergency, to let them know you’re concerned.  The earlier an addiction is treated, the better.
  • Be honest.  Let your loved one know that you care about them and are worried about their health and well being.  Provide your loved one with examples of their behaviors you have observed that concerned you and be honest with them about how it makes you feel.
  • Listen to what they have to say, even if you don’t agree.  The more your loved one feels heard and not judged, the more likely it is that they’ll talk to you and see you as a support.
  • Provide your loved one with helpful information.  Now that you have told them you suspect they have a problem and are concerned, give them information for places or people that can help.  There are several different options when it comes to deciding to get treatment.  Depending on the substance, your loved one may require medically-assisted detox.  Withdrawal from substances like alcohol and Benzodiazepines can be very dangerous, even fatal, so it’s important to consult a medical professional before restricting all substances.  Additional/ongoing options include: Inpatient treatment, outpatient treatment, individual counseling, medication-assisted treatment, and peer/community support meetings, such as Alcoholics/Narcotics Anonymous, SMART, and Recovery Dharma.

Be prepared for your loved one to deny their addiction or minimize the severity of their use.  Many addicts will feel a sense of shame when confronted with the evidence of their behaviors and may become defensive.  Remember what was stated earlier- you can’t force your loved one to admit their an addict or to change their behavior.  Being willing to adjust your expectations is important, so as to avoid disappointment or a sense of failure.  You can encourage your loved one to get help, but ultimately, they must decide if and when they’re ready to address the issue.  Your loved one’s readiness to change is a personal decision and may not coincide with your timetable.  Remember to be patient and continue to provide them options for help.  The waiting can be the hardest part of this process.  You may be able to clearly see the self-destructing behaviors your loved one is engaging in but their readiness is not your decision.  

That being said, you also don’t have to continue to support their poor choices.  Boundary setting is important for you and your addicted loved one.  When someone you love has a problem with drugs and alcohol, it can be easy to fall into the trap of shielding them from the consequences of their addiction.  This behavior is referred to as enabling.  You may cover up for your loved one, make excuses to others for their behaviors, provide financial support when they fail to pay their bills, and rearrange your life to accommodate them.  While this may seem supportive, enabling actually perpetuates your loved one’s addiction and can damage your own health and well being at the same time.  It may be difficult to set boundaries with your addicted loved one but protecting the person from the consequences of their addiction can remove their motivation to get help and change.  Loving an addict in a healthy way often requires holding them accountable for their actions and setting limits and boundaries for unacceptable behaviors.  Setting boundaries can be extremely difficult and painful for both the addict and the boundary-setter but ignoring behaviors or making excuses can lead to even more significant consequences. Some examples of common boundaries include: not allowing drug use or drug users in the home and not keeping substances in the house; not covering up or making excuses for your loved one when they fail to fulfill their responsibilities; refusing to give them money to buy drugs, pay off debts, or cover legal expenses if they are arrested due to their addiction; and insisting on respect for you and the others around them.  When you’ve decided to set boundaries, make your loved one aware of what they are and what the consequences are for crossing them.  It’s unfair to expect your loved one to follow boundaries that they are unaware exist.  Also, be consistent and follow through with expectations related to the boundaries that have been set.  Addicts don’t like boundaries and this will likely be a difficult adjustment for all parties involved.  Remind yourself why you are doing this.  No one likes to see their loved one suffer but boundaries are often what leads to the addict making the decision to get help and make changes.  

The stress of watching someone you love battle addiction can take a toll on your mental and physical health so finding resources for stress relief is very important.  Engaging in yoga, meditation, and deep breathing, as well as eating and sleeping well, can help keep stress at a manageable level.  Accepting that your loved one’s addiction and whether they choose recovery are out of your control can be very challenging.  You may ask yourself what you could have done to prevent this from happening or blame yourself for not seeing things clearer sooner.  Do not dwell on the circumstances that you cannot change nor blame yourself for your loved one’s choices.

It is important to remember to take care of yourself.  Trying to love and help an addict can be emotionally and physically draining and, if you forget to take care of yourself, you won’t have anything left to give when your loved one finally does agree to get help.  Discovering consistent ways to “fill your tank” and refuel your energy is important. Maintaining interests and relationships is also important, as it can be easy to allow your loved one’s battle with addiction consume you and take you away from things that bring you joy. Talking to others who are facing similar challenges can help you find comfort and new coping skills.  Just like addicts seeking recovery have peer support meetings they can attend, family members also have options for peer support meetings, like Al-Anon, Nar-Anon, and SMART Family and Friends.  

Your loved one has decided to get help for their addiction.  Now what? Many things will change once your loved one chooses recovery.  Many families struggle with the changes, even though most are positive.  Change is difficult and there is often trauma left in the wake of active addiction for all parties involved. Ways you can support your loved one as they embark on their recovery journey are: practice patience, as change is hard and sometimes very slow to develop; remove all alcohol and other substances from the home to help your loved one with temptations to return to use; offer your support and a listening ear but do not attempt be your loved one’s recovery adviser, they have clinicians for that.   You may have heard the phrase “addiction is a family disease” and wonder what it means.  It does not mean that everyone in the family is an addict but that everyone in the family is affected by the addict’s behaviors and all members of the family need their own version of recovery.  It is not uncommon for your loved one’s addiction to leave wounds on all the people who love them and those wounds need time to heal.  Healing may look different for every family but often includes counseling for all involved, whether as a family, individually, or both, so that everyone involved has a safe place to explore how the addict’s use has impacted them and what to do now that everything is exposed.

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