How to Help: Addiction & Recovery Guide for Friends

Signs a Friend May Be Addicted to Drugs or Alcohol

Addiction is a chronic condition that involves continuing to use drugs (addiction) or alcohol (alcoholism) despite negative consequences, such as harm to a person’s physical and emotional health, relationships, and finances.¹  As addiction progresses, a person’s brain experiences changes to the areas involved in pleasure, stress, and self-control.¹ Fortunately addiction is a treatable condition that can be addressed with the proper help.²

If your friend is abusing drugs or alcohol, you may notice certain suspicious behaviors. It can be difficult, however, to identify all of these signs if you don’t live with him. Some signs to watch for include:³

• Talking about drugs or alcohol more often than usual.
• Changes in mood, such as periods of euphoria and increased energy or drowsiness and disorientation.
• Appearing secretive about what she is doing or where she is going.
• Spending time with new friends.
• Changes in appearance, such as bloodshot eyes, dilated pupils, or weight loss.
• Unusual sleeping or eating patterns.
• Financial problems.

Signs your friend’s substance use may be out of control and entering the territory of a full-blown addiction or alcoholism include:^4,5

• Using more drugs or alcohol (my friend drinks too much) than intended.
• Failed attempts in the past to cut down.
• Spending extended amounts of time getting, using, or recovering from the effects of a drug.
• Cravings to use more.
• Having trouble keeping up with responsibilities at home, work, or school because of drug use.
• Continuing to use even though it contributes to relationship conflicts.
• No longer participating in social, work-related, or leisurely activities that were once enjoyable.
• Using drugs in dangerous situations (e.g., before getting behind the wheel).
• Continuing to use drugs even though it has caused or worsened physical or psychological problems.
• Having to increase the dose to feel the desired effects.
• Withdrawal symptoms that arise when trying to stop or cut down.

How Can I Help an Alcoholic or Addicted Friend?

You cannot force a friend to stop using drugs. However, you can support and encourage her to get the help she needs to stop. You may wonder if holding an intervention will help your friend agree to go to treatment. Interventions that confront people’s addictions directly, like those shown on television, are not proven to be effective at helping people recover. In fact, this type of approach can backfire by increasing an addicted person’s anger and resistance to change.⁵

To help a friend stop using drugs or alcohol, consider alternative, non-confrontational approaches:⁵

• Encourage your friend to meet with his doctor or another medical or mental health professional to discuss addiction and treatment. Often people are more willing to take advice from professionals rather than their own friends or family.
• Look for treatment options on your own that you think will appeal to your friend. Present the list to your friend and offer to help contact the facilities.
• If your friend is resisting treatment, instead of getting angry, offer to help her come up with solutions to any barriers. For example, you can help her find childcare if needed or locate a facility that provides medical detox if she is concerned about withdrawal.
• Ask your friend what you can do to support him. He may ask you to go to a self-help meeting with him or call you when he has a craving.
• Maintain a positive and encouraging approach with your friend. Remind her that it takes courage to acknowledge an addiction and that recovery is possible. Communicate that you are here to provide support throughout the process.

Watch our full series on “How to Talk to a Loved One with an Addiction.”

Am I Enabling My Friend’s Addiction?

Enabling involves protecting a person from the consequences of drug or alcohol use.⁶ This makes it more comfortable for the person to continue using, since he does not have to face as many negative effects of his addiction. For example, someone may bail a friend out of jail after the person has been arrested for driving drunk. Often people may not realize that they are enabling a loved one’s drug use.

Enabling negatively affects the user and the person doing the enabling.

Enabling negatively affects the user and the person doing the enabling. The user does not have an opportunity to face the negative effects of drug use, which enables the addiction to get worse. The loved one who is enabling may be left feeling angry and resentful. The pattern of enabling a loved one’s addiction can cause problems in the relationship.

The first step in stopping a pattern of enabling a friend is to be aware that the enabling is happening. Signs that you may be enabling your addicted friend include:⁷

• You find yourself unable to set boundaries.
• You try to avoid thinking or talking about the problem and may deny to yourself or others that a problem exists.
• Other people have told you that you are enabling.
• You have helped your friend avoid negative consequences, such as paying her rent after she spent her money on drugs.
• You have lied to others to cover up your friend’s addiction.
• You have put your friend’s addiction ahead of your own needs or those of your family.
• You treat your friend more like a child than an equal.
• You feel taken advantage of by your friend.

Enablers have a hard time setting boundaries, but boundaries are necessary to show your friend that his behavior has consequences and also for your own well-being. Take some time to think about what you would like your boundaries to be. For example, you might decide that you will not give your friend money for drugs or alcohol or see him when he’s under the influence.

Once you have an idea of what your boundaries are, communicate them directly and clearly to your friend. Let your friend know you care about her but that you will not support her addiction any longer. You can also tell her that you will be there for her when she is ready to get help, but until that point you will no longer be party to her drug abuse.

Steps to Take if a Friend Asks for Help

If your friend asks for help finding treatment, this is a huge first step. As a friend, you can support him in finding the right program that matches his needs by:

• Helping him find a medical or mental health professional that specializes in addiction. You can assist your friend by calling around or looking up providers online. Meeting with a professional for an evaluation can help your friend determine what type of treatment and level of care would be best.
• Assisting him in researching addiction treatment programs. Compile a list of what your friend would like in a program. Depending upon your friend’s needs, you might look for programs that offer different types of groups, yoga, exercise, and alternative therapies, like art or equine therapy. If your friend also suffers from a mental illness, you might look for co-occurring disorder (dual diagnosis) programs, which specifically treat both addiction and mental illness.
• Offering support and encouragement throughout the process. Remind your friend that it takes considerable courage to accept they have a problem and ask for help.

Myth: Treatment Is Not Affordable

The cost of treatment varies depending upon the level of care a person needs. In general, inpatient treatment is more costly than outpatient, because inpatient requires staff to be available 24 hours a day. Other factors that may affect the cost of treatment include whether the program is private or publicly funded, types of services and amenities offered, location of the facility, and duration of stay.

There are many affordable addiction treatment options available. If your friend has health insurance, all or a portion of the costs may be covered by his insurance company. To find out how much is covered by his specific plan, you can help him call the customer service phone number on the back of his insurance card. Once you connect with an operator, you can ask to verify the benefits in order to find out whether there will be a deductible, copayment, or coinsurance. You can also quickly verify your benefits online for free here with no obligation to attend Greenhouse Treatment Center.

Some addiction treatment programs offer assistance to help reduce the costs of their programs for people who show strong motivation for recovery. These may include:

• Loans or payment plans, which allow you to slowly pay off the costs.
• Scholarships to cover some or all of the costs.
• Sliding scales, which allow you to pay a lower fee if your income is below a certain point.

In order to find out whether a program offers financial assistance, consider contacting them directly to ask how they can help you.

State-funded programs are another option for more affordable treatment. These facilities are funded by the government and may be available to people who have Medicaid or those who do not have health insurance. For a listing of local state-funded programs, see the Directory of Single State Agencies published by the Substance Abuse and Mental Health Services Administration.

What if My Friend Relapses?

Relapse, or a return to using drugs or alcohol after a period of sobriety, is sometimes a part of the recovery process. If your friend experiences a relapse, he may feel guilty, ashamed, and hopeless. Remind him that relapse is a normal part of the recovery process and is not a sign of failure. You can even compare your friend’s addiction to other chronic diseases, like diabetes, and remind him that chronic conditions sometimes involve setbacks.

Encourage him to modify his treatment by staying longer or trying a different approach. For example, he can go to inpatient instead of outpatient treatment or try a facility that offers evidence-based therapies, like Greenhouse Treatment Center. Facilities like Greenhouse offer a variety of therapies, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), contingency management, and holistic approaches. Attending a facility that offers a wide variety of approaches ensures that there is something for everyone.

The most important part of helping a friend through a relapse is continuing to provide support without enabling the addiction. Avoid judging your friend for having a relapse and instead express your concern in a nonjudgmental manner.

Supporting Your Friend’s Recovery

You can support your friend’s sobriety in a number of different ways:

• Avoid triggers. Ask your friend what triggers her to use drugs and/or alcohol and brainstorm how you can help her stay away from them.
• Abstain from drugs and alcohol. Your friend will be tempted to drink or use drugs if he sees other people doing so around him. To support your friend, try to avoid using drugs or alcohol in front of him.
• Encourage positive activities and hobbies. Your friend will be more motivated to stay sober if sobriety seems fun and interesting. Ask her to join you in something fun to take her mind off of using.
• Be a cheerleader. People who are addicted to drugs and alcohol are used to feeling shame and guilt. Remind your friend of how courageous she is and encourage her to continue fighting her addiction even when it is challenging.

As a friend of someone addicted to drugs and alcohol, you can play an important role in helping support your friend’s recovery from addiction.

References:

1. National Institute on Drug Abuse. (2018). Drugs, brains, and behavior: The science of addiction.
2. Matano, R. A., & Wanat, S. F. (2000). Addiction is a treatable disease, not a moral failing. The Western journal of medicine, 172(1), 63.
3. National Institute on Drug Abuse. (2018). Easy to read facts: What is addiction?
4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
5. National Institute on Drug Abuse. (2016). What to do if your adult friend or loved one has a problem with drugs.
6. Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: from theory to practice. Social work in public health, 28(3-4), 194–205.
7. University of Pennsylvania Health System. (n.d.). Stairway to Recovery.