Someone you care about might be struggling with an addiction

Questions and strategies to help you have a supportive conversation when someone you care about might be struggling with an addiction.

This is one of a series of topics in the Supportive conversation library. Review the guidelines including what to do if you are concerned for another’s safety before engaging in the conversation.

What do you notice?

You notice that someone you care about might have an addiction. Maybe you notice that they have frequent injuries they’re involved in situations they can’t explain. Perhaps you notice significant mood changes, from irritability to extreme sadness. You might also notice that they have relationship issues or are confused about where their earnings are being spent as they don’t appear to be addressing the basics of life. Maybe you also notice a strong urge to use the substance on a frequent basis and a lack of control in delaying its use.

What do you need to understand?

Addiction is defined as a behaviour that is out of one’s control. The reasons why people use substances range from wanting to feel good, improving their performance or being curious, likely influenced by peer pressure or a perceived role model. The excessive use of substances is not good for one’s health, as it can change brain function and impair judgment, decision making, learning, memory and behaviour control. Addressing excessive substance use early can help reduce the long-term effect of damage to the brain and body and other preventable illnesses. One way to identify if an individual has an addiction is through the presence of the 4 Cs:

  • Craving
  • loss of Control of amount or frequency of use
  • Compulsion to use
  • use despite Consequences

*Adapted from “Addiction,” CAMH, 2020

What do you need to consider?

Some people may not think that their substance use is a problem. While this could be perceived as denial, it could also be the result of a lack of insight or education on the topic. Because the substance provides a positive effect on an individual mood or performance following intake, it may be difficult for them to consider the long-term negative impacts of the substance on their brain and body. We naturally want to avoid uncomfortable feelings, and a substance can provide relief,  which creates a confusing situation for the individual wanting to ease their physical or mental pain in the short-term. Instead of addressing the substance use, try to understand the reason for the use of the substance in order to help.

Engaging in a supportive conversation

Have the right mindset

Come into the conversation from a supportive place. Watch out for your hidden agenda, such as wanting to fix or influence the individual. Avoid “you” statements, such as “you always do…”. They often make the person feel judged or invalidated. Be curious and have the mindset that you don’t know anything about their experiences.

Questions to check your mindset:

  • What are my assumptions about this situation?
  • How will I keep my assumptions out of the conversation and be supportive?
  • What do I hope to achieve by having this conversation?
  • How can I keep my desires for an outcome from interfering with my ability to be supportive?

Notice

Notice changes in behaviour that aren’t typical for the person and ask about them. Don’t add your assumptions or opinions about why those changes may be  happening. If you’re wrong, the person may be discouraged from continuing the conversation.

Examples of “noticing” conversation starters:

  • “It seems like you have more injuries lately. I’m concerned. Can you tell me more about them?”
  • “I noticed your mood going up and down lately. Are you feeling okay? I’m concerned for you.”

Preparing for the response

Not all supportive conversations lead to an understanding of how you can help. Remember, the goal of a supportive conversation is to understand the individual’s needs and wants and whether they’re open to assistance. The guidelines below can help prepare you to respond when the person is open or not to a discussion.

When the individual doesn’t appear open to discussion – a closed-door response:

Not everyone’s comfortable being asked how they feel or exploring reasons why they’re behaving differently. You might get avoidant responses, like “I’m fine” or “It’s none of your business.” If this is the case, you can reiterate your concern and leave an opening for them to walk into when they’re ready.

  • “I was concerned about you and wanted to ask. If you say you’re okay, I’ll trust that you’re okay but if that changes, I’m here to support you if you need me.”

If the supportive conversation ends here, you should feel good that you noticed and asked about their well-being. Try not to take the response or tone personally despite the conversation not going anywhere. It takes courage to initiate these types of conversations, and it’s not your responsibility to force another to notice or change their behaviour.

When the individual appears to be open to discussion – an open-door response:

If the person confirms they feel differently or that life circumstances have changed for them, you’ve opened the door to having a supportive conversation.

The next statement might be:

  • “Tell me more. I want to better understand what you’re going through.”

Continue to follow the guidelines below for having a supportive conversation.

Continuing the conversation

Listen

Listen for where the individual feels unsupported or doesn’t have their needs met. When they’re finished speaking, confirm what you’re heard by rephrasing it and asking if you understand it correctly.

Examples of “listening” in the conversation include:

  • “I’m hearing that you find substances help to provide relief from some of the uncomfortable feelings that you have and don’t know any other way. Is that what I’m hearing?”

Highlight

Highlight strengths  you see in the person. Some examples could be courage or persistence in dealing with the situation they just shared with you.

Here’s an example of “calling out strengths” in the conversation include:

  • “Thank you for sharing. I didn’t know you were feeling this way and persisting on your own. That must have been a lot.”

Identify

Identify what support the individual wants  and connect them with relevant resources. Don’t insist on support or resources they don’t want or aren’t ready to accept.

Examples of “identifying support” in the conversation include:

  • “You’ve identified the need to address how to navigate your uncomfortable feelings with the use of substances, so how can I best support you at this time?”*
  • “I can support you with finding resources that might help to address this – would that be helpful?”

*Note: If there’s a limit on how you can be supportive, be specific about how you can help. The offer of support needs to be realistic and in line with your abilities and available time. Otherwise, talk about what’s realistic for both of you to do to create change in the other’s life.

Create

Create an action plan  with the individual to leverage their strengths and follow up on a regular basis, adding additional resources when they’re ready. Give a clear timeline or understanding of how you’ll be supportive.

 Here’s an example of “creating an action plan” in the conversation:

  • “I’m so glad we had this conversation. You mentioned a few things you wanted to explore to create some change in your life. I’ll follow through with my offer of support in the next week.”

Thank you for being supportive! You’ve taken the time to learn to have a conversation that lets  your loved one or friend know you notice and care about them. By showing concern, you can help them evaluate whether they should continue as is or address certain elements in their life. For some, this may be the beginning of a journey that will require the assistance of additional support services or professionals.

Additional resources

To be an effective supporter, it’s helpful to understand more of what your family member or friend’s experiencing. Check out these resources to provide more context about their experiences: