Alcohol and drug abuse are an unfortunate part of life for many Americans. Whether it’s from personal experience or from watching a friend or loved one struggle, millions of Americans are directly affected by drug and/or alcohol addiction each year.1
Signs of an Addiction
With the prevalence of alcohol and drug abuse so high, there’s a chance that at some point you may suspect someone you know is struggling with addiction. So how do you know if someone might be addicted? Treatment professionals diagnose addiction, or what is more formally known as a substance use disorder, based on a set of characteristic signs, symptoms, and behavioral changes.
Such diagnostic criteria include:2
- Drinking or using drugs more or longer than intended.
- Trying more than once to reduce substance use without success.
- Craving, or having a strong desire, to use drugs or alcohol.
- Engaging in risky behavior while under the influence of drugs and/or alcohol.
- Needing to use more and more of the substance to feel the same effects, also referred to as developing a tolerance.
- Continuing to use alcohol or drugs even with the knowledge that it is making a physical condition worse.
- Spending a lot of time thinking about using, preparing to use, using, and recovering from using drugs and alcohol.
- Drug or alcohol use results in failing to complete obligations at work, school, or home.
- Continuing to use drugs and alcohol despite having conflicts over it with family, friends, and coworkers.
- Choosing substance use over other activities that were previously important or enjoyable, such as sports, hobbies, or entertainments.
- Experiencing a characteristic, substance-specific withdrawal syndrome when not using drugs or alcohol.
Diagnostic criteria aside, identifying the signs of alcohol and drug use and abuse is not always so straightforward. Trying to assess a potential problem requires honesty and candor. It also can require seeing the person often, so if you don’t live with your friend, it can be difficult to pick up on or confirm the more subtle signs that they need help.
It’s important to remember that only a mental health, substance abuse, or healthcare professional can accurately and thoroughly complete the diagnostic process.
Are You Enabling Your Friend?
“Enabling” is a word that is often heard in addiction treatment circles, but what does it mean? Enabling behaviors on your part may be helping your friend avoid the consequences of their substance abuse.3
You may be enabling your friend if you are:
- Making excuses for someone’s behavior.
- Taking care of their responsibilities to try to help them avoid getting into trouble for their substance use.
- Giving them money that may be used to buy alcohol, drugs, or other substances.
- Giving them money for other expenses after they have spent all their money on alcohol or drugs.
Refusing to engage in enabling behavior can make it clear that you do not want to encourage or excuse their substance abuse. You can stop enabling by:
- Ceasing to explain away/make excuses for your friend’s behavior.
- Refusing to do their jobs, manage their responsibilities, or solve their problems for them.
- Refusing to provide money for them.
Enabling behaviors may be the first impulse when you are spending time with your friend, but if you are able to be mindful and avoid these actions, ultimately you may be able to help this person get better.
How to Help a Friend Stop Using Drugs
Watching someone you care about abuse substances can be painful, and it can also lead to feelings of helplessness. You cannot force someone to abstain from use and become sober. Likewise, you cannot force them into treatment against their will.
What you can do, however, is offer support, knowledge, and resources as you encourage them to seek help. Navigating the world of addiction recovery and treatment is difficult. By becoming informed, you can aid your friend in understanding where to go to get help when they’re ready.
Confrontational interventions like those seen on TV are not recommended.4 Rather, try to encourage your friend to visit a doctor. Conversations with professionals won’t be as loaded or emotional as those with friends or family.4
Some actions you can take to support your friend in finding the right treatment program include:
- Looking for treatment options and presenting them to your friend.
- Trying to find programs that appeal to your friend (considering the location, provided amenities, or other features).
- Offering to help them break down barriers to going into treatment, such as helping them to find childcare, if needed.
- Helping them to see past and overcome initial objections. For example, they may be afraid of withdrawal, but many programs offer safe, comfortable detox.
Luckily, a wide range of treatment options are available for those wanting to quit drinking or using drugs and maintain sobriety. Many experts in addiction treatment recommend having more than one resource in mind for the best chance of success. Some options for this include: 5
- Detox. This stage is intended to help your friend safely withdraw from drugs or alcohol with professional medical help. While detox is a type of treatment, it is not a substitute for the full continuum of rehabilitation or substance abuse treatment efforts.
- Inpatient Treatment. Residential/live-in treatment settings offer an intensive option for treatment of alcohol and/or drug addiction.
- Intensive Outpatient. Your friend would continue to live at home while attending treatment sessions. The idea behind intensive outpatient treatment is that you learn to live a sober lifestyle while also going about your regular life activities.
- Group Support. Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are programs specifically for people who struggle with alcohol or drug addiction, respectfully. Most communities across the country have many other free, peer-led support groups.
Addiction treatment can be quite successful. It often takes continual assessment, modification, and support, but achieving sobriety is possible.6
What to Do if a Friend Asks for Help Finding Treatment
It’s also possible that your friend will come to recognize their substance abuse on their own and will look to you for help. If your friend asks for help finding treatment, you can:
- Assist them in doing an internet search of local treatment options.
- Help them email/call their doctor asking for a list of recommendations for substance abuse specialists they’ve worked with in the past.
- Talk to them about the various options for treatment (provided above) and talk through what modality they might be most comfortable with.
- Understand that even after sorting through the various treatment options, it might take time for your friend or family member to commit to change and enter treatment.
- Support and encourage your friend and tell them how much courage it takes to accept that they need help and to ask for it.
It’s important to consider other factors as well, such as your friend’s insurance coverage, any co-occurring illnesses, and their support networks. When evaluating treatment programs, be sure to get outside opinions and to look into the treatment center’s reputation and certifications.
Affording Addiction Treatment
The fear of the high cost of treatment can be a potential barrier for some people seeking addiction services. You might help your friend or family member by educating yourself about what their health insurance covers, if they have it. This information can be learned by calling the “benefits” or “customer service” number on the back of their insurance card.
If your friend doesn’t have health insurance or their plan does not include addiction treatment, other options are available. For example:4
- Some treatment programs offer a sliding fee scale in which the payment amount is based on the patient’s income.
- States and other non-profit agencies frequently offer no-cost treatment programs for people in financial and medical need.
- As noted previously, traditional peer-support programs like AA are always free and can be attended by anyone, regardless of income.
Less intensive treatment (for example, weekly outpatient treatment) is often less expensive than more intensive treatment (for example, inpatient treatment). Understanding the cost difference between treatment modalities is essential when trying to stick to a budget.
What to Do If Your Friend Relapses
It’s common for those in addiction treatment to relapse and use again. In fact, it’s so common that many providers now understand relapse as a normal part of the treatment process.7
As such, if your loved one relapses, you can assure them that all their hard work is not lost.
You might encourage them to lean on their healthcare providers now more than ever to help understand the triggers that led them back to substance use. Relapse is not something to feel embarrassed about, but it is a time to reconnect and re-commit to treatment.
Supporting Your Friend’s Recovery
There are no simple answers for how to support a friend or family member in recovery, as every relationship is different. However, you can ask of them questions like:
- How can I help you in your recovery?
- Is there anything that I am doing that is making sobriety difficult for you?
- Would you prefer if I didn’t use alcohol or other substances around you?
- How can I be a supportive friend/family member to you right now?
Don’t be afraid to ask open-ended questions like this—and make sure you listen to the answers. You may find that touching base with your loved one regularly is helpful too. Needs and desires may change in different stages of recovery, leading to different ways you can be supportive.
- National Institute on Drug Abuse. (2015). Nationwide trends.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA: American Psychiatric Association.
- 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. (2016). What to do if your adult friend or loved one has a problem with drugs.
- National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction.
- National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: a research-based guide (third edition).
- National Institute on Drug Abuse. (2018). Drugs, brains, and behavior: the science of addiction.