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How To Help A Friend With A Substance Use Problem

Your support is vital.
PeopleImages via Getty Images
PeopleImages via Getty Images

Life was never easy for Dorri Olds. She had her first suicidal thought at age 5 β€” her mother had yelled at her seemingly out of nowhere, and it shook her in a profound way. By age 11 she had smoked marijuana for the first time, quickly picking up a habit. Soon, she was drinking alcohol and using drugs regularly with a group of kids from her neighborhood.

"I loved the ritual of doing something you're not supposed to do. That was exciting to me," Olds told HuffPost. "I liked the wild kids. It was almost like seeing something shiny and sparkly and going after it."

Things took a dark turn at age 13 for Olds, who is now 55, sober and a full-time freelance writer based in New York. She was raped by five of the boys she'd been hanging out with and she developed a severe addiction to drugs and alcohol.

She was medicating her trauma, she explained, and trying to pretend the assault had never happened by preventing herself from thinking about it. (She's now working on a book project about sexual assault victims who were afraid to tell their stories and the effects of rape trauma.)

By age 26, Olds found that she couldn't keep a job, and her relationships were getting shorter and shorter. That's when her best friend and roommate stepped in to tell her enough was enough.

"I think I must have been up all night doing coke, and he must have known," she said. "He shook me like a rag doll, and this vein on his forehead popped out and he started to cry and yell at me and he said, 'I am not going to watch you kill yourself β€” that's it. If you don't stop right now, I'm leaving. Do you hear me? I'm leaving.'"

Soon after, she got herself into a treatment center and started attending regular Alcoholics Anonymous meetings, and has been sober ever since.

"It's a really hard thing to do, tough love, but I really think it's the only thing that seems to work," Olds said.

Tough love is one way to support a friend struggling with addiction, but there are others, too. And for the estimated 21 million Americans living with substance use disorders, support from friends could be the first step toward getting treatment.

Research has consistently found that support from friends is associated with positive outcomes ― including abstaining from drug and alcohol use, and remaining sober ― and tough love can in fact motivate people with substance use issues to seek treatment.

If someone you love is fighting an addiction, here are a few things you can do to offer them support:

Talk to your friend.

Sal Raichbach, a psychologist and chief of ethics and compliance at the Ambrosia Treatment Center, says that having an open, honest dialogue about addiction β€” when your friend is sober β€” can be an important move. Your friend might not respond well at first, but having a nonjudgmental conversation about your feelings and fears can open up a line of communication and, on some level, let your friend know they can talk to you.

"If the person struggling is in denial, is unwilling to admit the severity of their problem, or doesn't want to talk, it still leaves room for that communication to take place in the future," Raichbach said.

Start by letting your friend know you've noticed certain troubling behaviors, and tell them you'd like to address those behaviors. But always remember to keep judgment out of your voice.

"The best way to tell someone to get help without blaming or shaming them is to understand the disease of addiction before approaching them," Raichbach said. "Their actions might be selfish, but behind those actions are a sick person."

Never enable your friend.

Whatever you do, don't enable your friend's addiction β€” and that doesn't mean just refraining from alcohol or drug use around them (though you should do that, too). Based on her experience, Olds says that loaning money to someone with addiction or bailing them out of addiction-related jams can enable their drug or alcohol use.

Raichbach agrees, and adds that offering to lend an ear when your friend needs support, or helping to look for a treatment center if they don't know where to start, are good alternatives to enabling their addictions.

"Just don't work harder than they do at getting them sober," he said.

Consider an intervention.

If you're unfamiliar with the premise of an intervention, here's the gist: You get a loved one with a substance use problem into a room with others who love them, and you each explain the effect their addiction is having on your lives. You should have a therapist or intervention strategist present, and you might have resources ready to offer your friend, such as referrals to treatment centers or locations of AA meetings.

"Interventions can be a fantastic resource for getting friends and family the help they need," Raichbach said. "They allow friends and family of the struggling individual, and often the individual themselves, to express their feelings and concerns in a constructive way β€” and make a plan [for recovery]."

You can learn more about how to stage an intervention here.

Consider tough love.

Olds says that while she knows relationships suffer when someone has an addiction, those people who do keep up friendships may at some point find that using a "tough love" strategy is the last option they have to help their friend get treatment.

"I know people in AA who have had to lock their kids out of their homes. They say, 'You're on your own,'" she explained. "They've tried everything β€” they've tried rehab, they've tried meetings, they've tried talking to them β€” and [the child] won't stop. I really think the only answer is to cut them off."

Raichbach says that giving "tough love" can be emotionally challenging as a friend, but "it can provide an essential push or incentive for them to seek help."

Take care of yourself.

Being friends with someone living with an addiction is emotionally intense. Both Olds and Raichbach say it's important to take care of yourself while you're supporting your friend. Raichbach recommends setting boundaries and sticking to them, and Olds encourages friends of people with substance use disorders to attend support meetings as a way to understand the disease and hear from others facing similar struggles.

"The best thing you can do to help that person... is go to therapy and go to Al-Anon," she said. "And if you go to therapy, go to somebody who understands addiction."

Remain supportive while your friend is in recovery.

Once your friend has made the huge decision to enter treatment, continuing to support them is critical to their recovery. Olds says that reaching out, sleeping over if necessary, being there when your friend needs to talk or just bringing food are practical ways to help someone who's recovering from an addiction. And refraining from drug and alcohol use in front of your friend is not only respectful ― it's essential to your friend's well-being.

Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

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