Want to talk to a friend with a substance use problem but don't know how?

It can be hard to watch someone you know struggle with a substance abuse issue. It can also be hard to initiate a conversation with them about it - what if they’re offended? Will they even listen to me? Will my intervention help?

A person with addiction may experience different levels of motivation or readiness to change, before they decide to quit. Whether they act upon your suggestion depends on where they are in their readiness. And as with all change, it is most effective when the motivation comes from within. 

That said, a person with addiction may be aware of the impact of their habit but feel unable to stop using the substance (whether alcohol, tobacco or drugs). If you have a certain level of influence with your friend or colleague, your intervention may let them know that they have support, should they attempt to quit; and may even prompt them to get help.

What not to say to someone with addiction

Often, when speaking to someone with addiction, our concern might prompt us to say something that the other perceives as blame, particularly when our statements imply that they’re making a wrong choice. These could include statements such as:

• Can’t you see you’re ruining your life and health?

• Don’t you care about your family and children?

• You can’t quit at this rate

• You’re being an irresponsible spouse/ employee/ parent

• Your alcohol is the cause of all your problems

Any comments that lead to the listener feeling criticized might lead to the person feeling defensive, and makes it less likely that they will consider what you are telling them.

What can I say instead?

Begin the conversation casually. The timing may be important: it’s unlikely that they will be in a frame of mind to listen to you if they’re intoxicated, or feeling physically unwell. Check with them before you begin the conversation if they’re willing to talk to you.

You can begin the conversation by referring to the behavior that you’ve observed in them. “I’ve noticed that you’ve been late to work quite often recently, and I’m concerned about you.” A person who’s addicted to a substance may find it hard to focus on how their habit is impacting their relationships and the people around them, and this information can offer them a perspective. Leading with your concern helps keep the conversation going.

Instead of referring to the adverse effects of the substance, talk about the impact of their habit on their health or work, or something else that matters to them. “I’ve noticed that you’ve been consistently late arriving to work the last few weeks. Is there a problem? Do you need help?”

If they want to tell you about their habit, or why they use the substance, listen to them without interrupting - give them the space to express themselves, even if they’re saying something you don’t agree with; consider their point of view. Maybe they’re using the substance due to stress or loneliness, or even want to quit but don’t know how and feel frustrated about it.

Leave it open: “Would you consider seeking help to quit?”

Assure them of your support and offer them options without coercing them into taking them.

It can be very challenging to talk to a friend or loved one about their substance use, without wanting to convince them or make them quit. It is not easy to detach from their actions and understand where the limit of your influence ends, which is why self-care becomes absolutely essential.

Before you begin the conversation, ask yourself what support you may need to talk to your loved one. This could include having a conversation with someone you trust or with a counselor or a helpline to get clearer about what you can say. And be prepared to receive a defensive response from the other.  If the person is unwilling to seek help, all you can do is wait. Should that happen, you may feel helpless, angry or frustrated; but if you’re overwhelmed with the emotions and stress approaching a counselor or therapist can help you come to terms with the situation.

This piece has been written with inputs from Dr Divya Nallur, senior consultant psychiatrist, People Tree Marga, Bangalore.