How to Help a Loved One With Addiction

You can ask for professional help even if your loved one refuses treatment.

You do not have to wait for them to “hit rock bottom”. First establish whether anybody is in immediate danger. Then work out the next practical step.

Call 082 747 3422. Available 24 hours a day, 365 days a year.

First: is anybody in immediate danger?

Safety comes before persuasion.

Get urgent medical help if there is:

• an overdose or suspected overdose
• severe or complicated withdrawal
• immediate suicidal danger
• psychosis or extreme confusion
• serious violence or threats involving weapons
• dangerous driving while intoxicated
• a child or vulnerable person in immediate danger

Do not try to stage an intervention while somebody is severely intoxicated, psychotic, violent or medically unstable.

If it is not an emergency, you have more time to plan.

Start with what is actually happening

You do not need to diagnose the person yourself.

Gather the facts you know.

Useful information includes:

• alcohol or drugs being used
• how often they are using
• when they last used
• previous withdrawal problems
• seizures or overdoses
• current medication
• psychiatric or mental-health history
• previous rehabilitation
• recent relapse
• work, legal or financial consequences
• where they are now
• whether they have medical aid
• whether they are willing to discuss treatment

Do not delay asking for help because you do not know every answer.

Start with what you know.

Stop trying to win the argument

Arguments about whether somebody is “really an addict” often achieve very little.

Talk about things you can observe.

For example:

“You have missed work three times this month, borrowed money from us twice and driven after drinking. I am worried about what is happening. I want us to speak to somebody about treatment.”

Keep the conversation concrete.

A useful conversation has three parts:

1. What happened?
2. Why are you concerned?
3. What are you asking them to do next?

That next step might be a telephone screening, medical assessment, psychiatric assessment or prepared admission.

Support treatment, not continued addiction

Families often rescue somebody because they are frightened.

That does not make them responsible for the addiction.

But some forms of help can unintentionally make continued drinking or drug use easier.

Examples include:

• repeatedly paying substance-related debts
• lying to an employer
• replacing money that disappears
• providing unrestricted cash
• allowing unsafe behaviour in the home
• repeatedly solving crises while nothing changes

A better question is:

Does what I am doing increase safety and support treatment, or does it make continued harmful use easier?

Paying a treatment provider directly may support recovery.

Repeatedly replacing money lost through drug use is different.

Set boundaries you can actually keep

A boundary describes what you will do.

It is not an attempt to control another adult.

Examples:

• “I will not give you cash.”
• “You cannot drive my vehicle after drinking or using drugs.”
• “If you become violent, I will leave and call for help.”
• “I will help you get treatment.”
• “I will pay a treatment provider directly, but I will not pay another drug debt.”

Do not announce consequences you are not prepared to carry out.

Where children, housing, employment, significant finances or legal rights are involved, appropriate professional or legal advice may also be needed.

What if they refuse treatment?

Refusal is common.

It does not mean the family has no options.

You can still:

• get professional guidance
• understand what treatment may be required
• change how the family responds
• establish realistic boundaries
• prepare an appropriate treatment pathway
• consider a professional intervention

WHO and UNODC treatment standards recognise family-oriented approaches, including approaches that can work with families when the person using drugs refuses to participate in treatment.

When should we consider an intervention?

A professional addiction intervention may be appropriate when serious harm continues despite repeated conversations, promises or attempts to stop.

It should not be an uncontrolled confrontation.

Preparation matters.

The family needs to know:

• who should participate
• what the immediate concerns are
• what treatment is being proposed
• what boundaries will change
• what happens if treatment is accepted
• what happens if it is refused

Gareth Carter, CCMI-M, has worked in addiction treatment and recovery since 1995 and has conducted more than 200 professional interventions.

Prepare treatment before the next crisis

A person may refuse treatment repeatedly and then unexpectedly say yes.

That opportunity can disappear quickly.

If residential treatment may be required, establish as much as possible beforehand:

• whether medical detoxification may be necessary
• psychiatric or mental-health needs
• the appropriate level of care
• previous treatment and relapse
• likely treatment duration
• medical-aid or private funding
• admission requirements
• medication information
• transport
• what happens after the initial treatment period

The aim is not to choose a rehab from a list.

It is to understand what level and setting of care are appropriate.

Medical aid does not need to become your administrative problem

If the person has South African medical aid, tell us which scheme and plan.

You do not need to learn the authorisation system yourself.

Rehab admissions teams handle this work every day. They know the diagnosis codes, clinical motivation, scheme requirements and paperwork required for pre-authorisation.

The treating clinical provider completes the formal clinical assessment and medical-aid authorisation.

WDR helps coordinate the practical treatment and admission pathway around that process.

What happens if they suddenly agree to treatment?

Move while the willingness is there.

That does not mean rushing into an unsuitable admission.

It means the important decisions should ideally already have been considered.

Depending on the case, WDR can assist with:

• pre-admission screening
• care planning
• family communication
• admission coordination
• communication with the receiving clinical team
• transport
• professional chaperoning
• travel arrangements
• sober companionship where appropriate

Where medical detoxification, inpatient rehabilitation, psychiatric treatment or other regulated clinical care is required, that treatment is delivered by the appropriately licensed clinical provider.

The family needs support too

Addiction can reorganise an entire household.

Family members may find themselves constantly:

• checking where the person is
• checking bank accounts
• managing children around the addiction
• covering missed responsibilities
• trying to prevent the next crisis
• policing alcohol or drug use
• dealing with broken promises

Family support can play an important role in helping somebody enter and remain in treatment, and family therapy or counselling can also benefit the wider family.

Getting support for yourself is not dependent on the addicted person first agreeing to treatment.

How WeDoRecover helps

WDR works with the problem before, during and around admission.

Depending on the situation, that may include:

• confidential pre-admission screening
• family consultation
• care planning
• professional intervention
• determining the appropriate level and setting of care
• admission coordination
• communication with clinical teams
• treatment transport
• chaperoning
• sober companionship
• continuing recovery planning

Our role is not to hand you a list of rehabs and leave you to work it out yourself.

We help establish what needs to happen next and coordinate the practical pathway into appropriate care.

Start with one call

You do not need your loved one sitting next to you before you phone.

Tell us what is happening.

We can work from there.

Call 082 747 3422
Email [email protected]
Available 24 hours a day, 365 days a year.

Clinical reference: NIDA, Principles of Drug Addiction Treatment: A Research-Based Guide.