How to Talk to a Loved One with a Suspected Substance Use Issue

Everyone goes through stressful times, and we all have different ways of coping. But if you notice a loved one is showing signs of a substance use disorder, such as a change in mood, personality or behavior (irritability or agitation), changes in weight or appetite (weight loss or gain), being secretive, paranoid or sudden disinterest in hobbies, it’s important to say something.

“The sooner there is a thoughtful discussion, the better,” says Robert Henderson, BSN, RN, PMH-BC, HN-BC, CARN, an addiction nurse navigator at Raritan Bay Medical Center and Old Bridge Medical Center. “People often wonder when the right moment is to approach a loved one about this. The truth is that the discussion will not be an easy one, and the discussion will likely be the first step in a longer journey. So the right moment is usually right now.”

How to Approach a Loved One with Substance Use Disorder

Robert offers a few tips to keep in mind when approaching your loved one about their substance use:

• Remind yourself that addiction is a medical condition. You wouldn’t get angry at someone for having congestive heart failure, diabetes or cancer, for example. Keeping the same mindframe with someone with substance use disorder is important.
• Be generously compassionate. You may not fully understand what your loved one is going through, and it may be complex and involve past trauma, abuse or other lifelong challenges. Showing an openness to listen and understand are the foundation of healing and change. 
• Be direct, but don’t accuse. Robert suggests avoiding language that implies judgment by saying something like, “I love you and I’ve noticed these things going on. I am concerned and want to make sure you’re alright, and I can assist you in getting the help you need.”
• Carefully choose the time and place to talk. There is often a sense of shame associated with substance use, and individuals in the midst of addiction often deny or avoid the topic. It may be difficult, but it is best to have any discussion when they are able to have a lucid conversation.
• Approach the person in a small group of those your loved one is closest to, but don’t ambush them with a huge intervention.
• Treat the person with respect and acknowledge that this is going to be a process.

What to Expect When Addressing Your Loved One’s Substance Use Disorder

Naturally, people can react in many different ways when approached about a substance use issue. It’s normal for people to deny, become angry or defensive. “It might be a bit of a roller coaster. Try not to take things personally,” Robert says.

Let your loved one know that you will be there when they are ready to seek help, and remind them that this is a disease and you aren’t judging them for it.

While love and compassion are key, it’s important to maintain strict healthy boundaries. If children are involved, they may need to be removed from the home temporarily. You may need to rethink how your finances are shared to protect yourself but also your loved one who is struggling with substance use disorder.

Words Matter When It Comes to Substance Use Disorder

There can be a lot of shame around substance use issues, so the words we use to discuss the subject matter. Professionals are actively working to reframe the narrative around addition.

Robert offers some guidance:

• Say “substance use” instead of “substance abuse.”
• Avoid the word “addict.”

“When you talk about someone with an addiction, it’s the person first and then the disease. The disease does not define them,” Robert says. “I always recommend to loved ones that addiction is usually not a choice that people consciously make. They often want to change but don’t know where to begin or seek help.”

Removing negative words or the connotation that someone is “dirty” or “weak” for using can help people feel less shame and allow them to be more open to seeking help and treatment.

Next Steps & Resources:

• To find a behavioral health professional near you, call 800-822-8905 or visit our website.
• Learn more about behavioral health services at Hackensack Meridian Health.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.