When someone you love uses substances

Worry is a sign of love. But constant fear wears down your body and mind. Learning skills and finding support can turn some of that fear into action.

Anger is understandable. Acting on it with yelling or lecturing usually pushes people away. Active listening helps shift the tone away from anger and lecturing.

Stigma, or fear of it, can stop people from sharing a loved one’s health condition with family or friends. Many families keep it secret and end up feeling alone.

Many families grieve while their loved one is still alive. Grief can sit right next to hope. Both are allowed.

CRAFT helps families avoid both cutting off their loved one and waiting for them to hit rock bottom. You can start helping now.

It can be easy to list everything a person is doing wrong, but that can close them off to asking for help. Listening without judgment and speaking with kindness keeps the door open.

A review of 14 studies found the CRAFT approach was about twice as effective as other approaches at helping a loved one start treatment, even when they had not been ready before.

Looking at what tends to come before use, like stress, certain friends, or payday, helps you understand the problems underneath. Addressing those can be a bridge toward healthier choices.

Active listening shifts the tone away from anger and lecturing. Calm, clear words make it easier for your loved one to hear you.

Celebrating your loved one’s successes is far more effective than punishment and confrontation. When they are not using, spend good time together and notice the effort.

Ideas

• Cook a favorite meal together
• Plan a walk, game or movie
• Say what you appreciate about them
• Thank them for showing up

Letting a loved one experience the results of their use can guide change. The exception is anything too severe, like drinking and driving, where safety comes first.

It may take many conversations before someone gets help. Ask if you can follow up and check in later.

Good moments can be

• After a scare or a bad morning
• When they bring up a worry themselves
• When they are calm and not using

Keeping yourself healthy puts you in a much better position to help. Family members using CRAFT have reported better mental health and family relationships.

• Ask open questions that need more than a yes or no
• Comment on their strengths
• Repeat back what you heard: "I heard you say…"
• Thank them for talking

Words to try

• "I love you, and I’m worried about you."
• "What’s been hardest lately?"
• "How can I help?"
• "I’m here when you’re ready."

Listing everything they are doing wrong can close them off to asking for help.

• Labels like "addict" or "junkie"
• Talking while they are high or drunk
• Threats you will not follow through on

If they don’t want to talk, let them know you will be there when they are ready. Remind them that talking takes courage and asking for help is a big step.

• Driving them to an appointment
• Paying a bill directly, instead of giving cash
• Sharing a meal or time together when they are sober
• Sitting with them while they call a helpline

• Covering for them with work or school
• Giving cash that may go to substances
• Making excuses to family or friends
• Cleaning up every problem so they never feel the impact

1. Choose one limit that matters most
2. Say it calmly, when they are sober: "I won’t…, but I will…"
3. Follow through, kindly and every time
4. Get support from others, so you are not holding it alone

Alateen, part of Al-Anon Family Groups, is for young people, mostly teens, affected by someone else’s drinking. It has no fees or dues. Narateen is the teen group within Nar-Anon, for teens who love someone who uses drugs.

A school counselor, coach or relative can give a child extra steady support. You do not have to share every detail, just enough for them to watch out for your child.

Al-Anon is a mutual support program for people whose lives have been affected by someone else’s drinking. It offers in-person, online and phone meetings.

Website: al-anon.org

Nar-Anon is a 12-step program for family and friends of people with drug addiction. It has in-person and virtual meetings in several languages.

Website: nar-anon.org

Partnership to End Addiction offers a free, confidential helpline for families: 1-855-378-4373. Specialists can talk through your situation with you, and the same site teaches CRAFT skills for families.

A counselor can help you with stress, boundaries and hard feelings. Some counselors offer CRAFT for families. The SAMHSA National Helpline also serves family members and can point you to local support.