We asked experts what you can do to help—and how to protect yourself, too.

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Six years ago, I had a conversation with my daughter that no parent ever wants to have. She was 21 and numbing herself with drugs and alcohol after enduring a series of losses in her life. My vibrant, intellectually curious child had turned into someone I could barely recognize. As we sat at our kitchen table, I presented a choice that went against all of my instincts as a mother: She could go to rehab, or she could find another place to live.

Thankfully, she chose rehab. And she's been working hard at her recovery since. But I know what it's like to wake up at 3 a.m. terrified that a person you love is blacked out in a roadside ditch. It's a fear many American families experience: More than 20 million people in the U.S. suffer from a substance use disorder (SUD)—and the pandemic hasn't made things better. The Centers for Disease Control and Prevention (CDC) reported that in 2020 an estimated 93,331 people died from drug overdoses, the highest number of fatal overdoses ever recorded in one year.

If you are the parent, partner, child, sibling, or friend of someone struggling with addiction, you may feel lost and utterly helpless. But there are ways you can look out for your loved one, and yourself, on the long road ahead.

Health-Print-November-2021-When-Somone-You-Love-Is-Addicted-Illustration-by-Marco-Melgrati
Credit: Illustration by Marco Melgrati

Communicate your concerns

First, you need to find a time when your friend or family member is sober. "Just give them the facts," says Emilio Angulo, a certified alcohol and drug counselor who facilitates family programming at the Betty Ford Center in Rancho Mirage, California. It helps to use "I" statements rather than "you" statements, which can feel like accusations and trigger defensiveness, says Angulo. "Tell them, 'This is how I was impacted when this happened, and this is what I've seen and noticed.' "

Start researching

Know that the U.S. rehab industry is largely unregulated, and that many facilities use unscrupulous marketing techniques and misleading sales tactics. So it's important to consult credible resources for recommendations. Focus your search on "dual diagnosis" centers that also treat the mental health conditions that often underlie addiction—such as anxiety, depression, bipolar disorder, and post-traumatic stress disorder. Because so many people with an SUD have a co-occurring condition, they usually need treatment for both to get healthy.

Keep in mind, though, that your loved one may not be ready to face her problem. In that case, you can save your research for when she is ready.

Lead with compassion

Addiction is a medical illness. It is not a choice, and it is not a moral failing. The person you love is sick.

Addiction to drugs or alcohol alters the brain's structure and function. "Certain areas of the brain are taken over by these substances," explains Tyler Oesterle, MD, medical director of the Mayo Clinic's residential substance use disorders services in Rochester and Albert Lea, Minnesota. "People begin to prioritize the substance over everything else in their life." (This explains why someone in active addiction might show up drunk to Thanksgiving or get high before a job interview.)

The changes that occur in the brain can persist even after a person stops using, leaving her at high risk of relapse. "Some people equate relapse as 'failure,' when really relapse is an expected part of recovery," says Lipi Roy, MD, MPH, an addiction medicine physician and medical director of COVID Isolation & Quarantine Sites at Housing Works in New York City. "We don't tell people with diabetes that if they eat a doughnut, they've 'failed' treatment."

There's a common misconception that once someone completes a 28-day rehab program, they're cured. But according to the National Institute on Drug Abuse, most people need at least90 days of residential or outpatient treatment for a positive outcome. If your loved one suffers from opioid use disorder, they'll probably also need medication-assisted treatment (MAT). The drugs used in MAT—such as buprenorphine, methadone, or naltrexone—help manage cravings and withdrawal. "They do not substitute one addiction for another," says Dr. Roy. "They are evidence-based, lifesaving medicines."

Establish boundaries

When a person is in the throes of an SUD, she may lie, miss events, or engage in criminal behavior. Living with that person can be maddening, overwhelming, and heartbreaking. For the sake of self-preservation, you need to have boundaries and stick to them.

"Family members often look at boundaries as a way to control somebody else, but boundaries exist for our own protection," says Angulo. In other words, when you set a limit, you're identifying a behavior that is not acceptable to you.

Dr. Oesterle points to stealing as an example. "You can be really clear and honest with the person that's struggling and say, 'Look, I can't handle thievery in my house. That's not something I'll accommodate. So if you steal, you can no longer be here.' "

You might refuse to allow your loved one to use drugs or alcohol in your home. You might tell her that you'll no longer cover her debts or supply any financial support (other than to go to rehab). These types of nonnegotiables also provide some incentive for the person to get help.

Seek support

Watching someone you love suffer can be shattering. "The chronic stress impacts you physically, mentally, and spiritually," says Angulo. It's crucial to find help for yourself as well. Consider talking to a therapist or an addiction counselor, or join a support group such as Al-Anon, Nar-Anon, Celebrate Recovery (a Christian-based program), or SMART Recovery for Family & Friends. It's healing and powerful to be around people who understand what you're going through. Think of it as putting on your own oxygen mask first, says Dr. Oesterle, because when you take care of yourself, you're in much better shape to take care of the person you love, too. 

This article originally appeared in the November 2021 issue of Health Magazine. Click here to subscribe today!

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