How To Support Substance Use Recovery Of A Loved One

While it is important to help out a close person trying to get out of substance use habits, it is also important to draw lines and explain what you will and will not accept. This is part of the series on substance use shared by the Addictions Research Group team at Sangath India. In this article, they focus on supporting substance use recovery of a loved one.  

Part 1 of the series described about What is Substance Use Disorder

Part 2 talked of How to overcome a Substance Use Disorder

Acceptance 

Discovering that a loved one is using substances problematically can be shocking; it may be difficult to accept that they are struggling with substance use, and it is natural for many people to downplay the seriousness of the problem or deny its existence altogether. However, to be able to support your family member or friend, you must first begin to come to terms with the situation and the ways in which it is affecting your life. This may create feelings of discomfort at first, but it can ultimately allow you to feel more in control of the situation. 

Educate yourself about problematic substance use and recovery

One way to make your loved one’s problematic substance use less overwhelming is to gain a better understanding of the issue and the options available to tackle it. You could consult a doctor or refer to some trustworthy sources of information, such as books/articles written by professionals, accounts of people with lived experiences, and manuals prepared by health organisations. 

Lapse and Relapse

You could also learn about the common signs of relapse and create a plan of action in case of an emergency, including keeping numbers of hospitals, ambulances and helplines handy. If your loved one is willing to work on their substance use problem, you can help by collaboratively creating a plan to control or stop using the substance. You could help them identify triggers that caused lapses in the past and come up with concrete steps to avoid or manage those triggers without resorting to the substance. In addition, it will be helpful to create a plan for what has to be done if a lapse or relapse occurs. A lapse refers to a single occasion where your loved one has not stuck to their plan of controlling or stopping their substance use, while a relapse occurs when there are several instances of them using substances more frequently than previously decided. Having a plan in place can help prevent a lapse from turning into a relapse. 

Recovery is a Process

There are many misconceptions about people who are using substances problematically – their addiction is viewed as a moral failing rather than a health condition and are often blamed for what they are going through. Many people also believe that a relapse indicates their loved one’s treatment has failed. However, recovery is not a one-stop destination – it is a process with hurdles like relapse that can be overcome. Gathering accurate information will help you reduce any misunderstandings that may have been acting as a barrier to you helping your loved one and you will also be able to empathise with their struggle. 

Convey your support 

Your loved one may feel completely alone while they recover from a substance use disorder: words of encouragement and simply letting them know that you are there for them can go a long way. You could celebrate their achievements through the course of their treatment, such as when they have abstained from substances for an extended period. On the other hand, should they relapse, you could emphasise that recovery is still possible and you have faith in their ability to achieve the goals that they set for themselves.

Communication and Empathy

Active listening and body language are also important ways of communicating that you care about them. When they share something with you, it would be helpful to give them your undivided attention (don’t use your phone, watch TV, or complete household chores at the same time), rephrase what they have said to check that you have understood, and avoid passing any judgement. Use your body language to convey interest and empathy by ensuring that you are facing them, lean towards them, and nod as they speak.

In addition, you could also provide them with practical assistance. A key part of your loved one’s recovery is consulting professional help such as doctors, therapists, or rehabilitation centres. You can help them by finding these resources, booking their appointments, offering to accompany them to their visits and following up on their progress. 

Create an environment that is conducive to recovery 

It is important to ensure that your loved one’s environment does not have any triggers that will encourage them to resume using substances. It will be useful to: 

• Avoid engaging in substance use yourself, especially in front of your loved one 
• Remove any substances from your house; put prescription medication such as sleeping pills in a place where your loved one cannot access it 
• Help your loved one to find a social circle that is sober or reconnect with friends who are sober 
• Accompany them to or encourage them to avoid events where substances will be available, for example parties 
• Accompany them or drive them to any community activities that they can be a part of, like sports or cultural activities 
• Help them create an engaging routine which keeps them occupied with healthy activities and behaviours and makes them feel productive.

Build healthy relationships  

Many people may start to use substances to cope with conflicts with their family, friends or partners and resolving those might reduce substance use. In any case, developing a healthy relationship with your loved one might reduce the chance of a relapse and make their recovery easier. 

Firstly, you could attempt to promote a sense of togetherness by organising various activities with friends and family. Spending quality time with a supportive social circle could contribute to their overall wellbeing and serve as a distraction from using substances. 

Secondly, it is important to establish a healthy mode of communication. Try to have open and honest conversations about their substance use and the ways in which it is impacting your relationship. Avoid shouting, criticising, blaming or lecturing them and be clear in your communication instead. Refer to specific instances in the recent past and specific behaviours that were hurtful. Clearly state your expectation in a respectful manner. For example, say, “I felt hurt yesterday when you chose to drink instead of having dinner with me. I value our time together and would really like if we could have dinner together every day.” Avoid generalising your statements with “always” and “never”. For example, “you always choose to drink instead of spending time with me”. Be mindful about not pushing them to talk about something they do not want to disclose and respect their privacy. 

Set boundaries  

Helping your loved one should not come at a cost to your own commitments and well-being. When a close friend or family member is experiencing substance use issues, you may feel like you want to cover up for their actions, make excuses for them, take up the load of their responsibilities, and offer them unconditional support. However, you may unknowingly be engaging in what are referred to as ‘protecting behaviours’. Examples of this include: 

• Taking on all of their tasks 
• Cleaning up their mess
• Driving them to parties or gatherings where you know they will use substances 
• Accepting abusive behaviour 
• Tolerating being lied to about their usage of substances 
• Lending them money which you know will be used to purchase substances 
• Paying off their debts 

The reason these behaviours may do more harm than good is that the person with substance use problems no longer has the motivation to change, because they are not facing the consequences of their actions. Of course, there is no definite list of which behaviours are ‘protecting’ and deciding the extent to which you can support the person will depend on a number of factors, ultimately being a personal choice – it is difficult to take the extreme route and completely refuse a loved one when they are in a serious situation or their life is endangered. 

Hence, it is important to decide and verbally communicate your boundaries with them: make it clear which behaviours you will and will not accept. While these behaviours may vary from individual to individual, the common ‘protecting behaviours’ are mentioned above. Learn how to say ‘no’ – there may be times when your loved one attempts to push you into doing something that will allow them to use substances, for example, demanding money from you at regular intervals and threatening to steal if you don’t comply, but you must be firm with your limits. 

Self-care  

As a caretaker of a person engaging in problematic substance use, it is normal for you to experience a range of emotions, including anger, shame, guilt, hopelessness, fatigue, and sadness. Witnessing their difficulties can be emotionally taxing. You may also feel like your loved one is no longer the person they used to be before they began using substances, and you could be mourning the loss of the relationship you once shared. For these reasons, it is important that you develop a support system for yourself: see a therapist or counsellor, take breaks from spending time with your loved one with substance use problems, explore new hobbies, attend support groups for families and friends who are affected by substance use. 

Overall, a person’s recovery is ultimately their own responsibility. While you can provide your support and compassion, you should strike a balance with your personal boundaries, know when to step back, and understand that you can never force a person to change. You might find yourself in difficult situations where there are no clear answers such as when a loved one is refusing to seek professional help or not accepting that their substance use is problematic. Remember that certain things will be out of your control, and you have done the best that you can! 

Some resources/helplines that can be contacted for support are here.

This article is produced by the Addictions Research Group team at Sangath India. Our content production and editorial team includes Khushi Bhatia, Dr Abhijit Nadkarni, Miriam Sequeria, Kedar Mirchandani, and Shubhangi Kashyap.

Follow the Addictions Research Group on Instagram, Facebook, and Twitter.

References 

1. Becker, J. (2021, September 18). How to support people in recovery from a substance use disorder. LHSFNA. Retrieved July 18, 2022, from https://www.lhsfna.org/how-to-support-people-in-recovery-from-a-substance-use-disorder/  
2. Daley, D. C., & Douaihy, A. (2019). Treatment and recovery for the family. In A family guide to coping with substance use disorders (pp. 97-106). Oxford University Press. https://doi.org/10.1093/med-psych/9780190926632.001.0001 
3. “Get help now!” Sangath Surveys, https://www.sangathsurveys.com/find-help. Accessed 2 June 2022.
4. Green, K. E. (2021). Relationships in recovery: Repairing damage and building healthy connections while overcoming addiction. Guilford Publications. https://www.google.co.in/books/edition/Relationships_in_Recovery/WfgOEAAAQBAJ?hl=en&gbpv=1&printsec=frontcover 
5. Harrison, T. F., & Connery, H. S. (2019). Living with an addict. In The complete family guide to addiction: Everything you need to know now to help your loved one and yourself (pp. 45-106). Guilford Publications. https://books.google.co.in/books/about/The_Complete_Family_Guide_to_Addiction.html?id=zYSWDwAAQBAJ&redir_esc=y 
6. Hartney, E. (2021, October 3). 9 tips for communicating with someone who has an addiction. Verywell Mind. Retrieved July 18, 2022, from https://www.verywellmind.com/how-to-talk-to-an-addict-22012
7. Hartney, E. (2022, February 14). How you can emotionally support someone with an addiction. Verywell Mind. Retrieved July 18, 2022, from https://www.verywellmind.com/how-to-help-addicts-22238
8. The Recovery Village. (2022, May 7). How to help someone with drug addiction. The Recovery Village Drug and Alcohol Rehab. Retrieved July 18, 2022, from https://www.therecoveryvillage.com/drug-addiction/help-someone-drug-addiction/
9. Robinson, L., & Smith, M. (2021, April 6). Helping someone with a drug addiction. HelpGuide.org. Retrieved July 18, 2022, from https://www.helpguide.org/articles/addictions/helping-someone-with-drug-addiction.htm
10. Substance Abuse and Mental Health Services Administration. (2022, June 8). Resources for families coping with mental and substance use disorders. SAMHSA - Substance Abuse and Mental Health Services Administration. Retrieved July 18, 2022, from https://www.samhsa.gov/families
11. Substance Abuse and Mental Health Services Administration. (2020). Substance use disorder treatment and family therapy (39). SAMHSA. https://www.ncbi.nlm.nih.gov/books/NBK571088/