The National Institute on Drug Abuse (NIDA) reports that over 40 million Americans over 12 struggle with substance use disorder. Local, state, and federal programs are not sitting idly by. They constantly create new programs, medicines, and protocols to combat alcohol and opioid addiction and many other types. Yet only 10% receive treatment.1
Having a friend with a substance use disorder can be difficult. Ultimatums, interventions, and other attempts to convince them to enter addiction treatment do not always work. However, that does not mean giving up on the friend.
Keep reading to discover simple steps to help an addicted friend.
Gain Knowledge About Addiction
The reasons someone misuses substances and the types and amounts of substances they use will differ from person to person. But the definition, criteria, signs, and symptoms of addiction will not differ. Knowledge is power. The more someone knows about drugs, alcohol, and addiction, the better they can help their friend get on the right track.
The Definition of Addiction
The American Psychological Association defines addiction, or a substance use disorder, as being a brain disorder in which someone is physically or psychologically dependent on drugs, alcohol, and for some, behaviors. Addiction is a process that starts with misusing substances, developing tolerance and dependence, and experiencing withdrawal symptoms when trying to stop.2
Criteria for Being Diagnosed with Addiction
Friends and family can claim someone has an addiction, such as an alcohol or opioid addiction, but for treatment diagnosis, they must meet specific criteria. Mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, created by the American Psychiatric Association, to diagnose substance use and mental health disorders. The diagnosis of addiction consists of eleven criteria within four categories, including the following.3
- Having cravings or overwhelming thoughts and desires to use the substance
- Using the substance for more extended periods and in larger amounts than they wanted to
- Spending most of their time seeking, using, and recovering from using the substance
- Having the desire to quit or cut back but being unable to do so on their own
- Being unable to fulfill obligations at home, work, school, and socially
- Continuing to misuse substances even though it causes personal and professional relationship problems
- Avoiding activities with friends, family, and coworkers to spend time misusing substances
- Continuing to misuse substances even though they know it can make physical or psychological conditions worse
- Seeking, obtaining, or using substances in physically unsafe locations
- Building a tolerance that requires using more of a substance to achieve the effects they desire
- Experiencing withdrawal symptoms when quitting, cutting back, or going without substances
The criteria also help determine the severity of symptoms, which fall into three classifications, such as:3
- Mild, two or three of the eleven criteria
- Moderate, four or five of the eleven criteria
- Severe, six or more of the eleven criteria
Specific Signs of an Addicted Friend
Aside from the criteria for diagnosing addiction, someone misusing drugs or alcohol will exhibit signs and symptoms unique to their situation. Having even one of the following can signal a friend in need of help:4
- Hanging out with a new group of friends, especially if they are known for substance misuse
- Isolating from friends, family, coworkers, and others
- Appearing tired, depressed, angry, or moody
- Avoiding activities that they once enjoyed
- Seeing changes in their hygiene
- Changing weight or eating habits
- Lying, stealing, and manipulative behaviors
- Legal troubles
- Spending money on drugs and alcohol rather than rent, food, etc.
Always note the changes they make in all areas of their life. Look for psychological, physical, behavioral, professional, academic, and social changes.
Motivate a Friend to Seek Addiction Treatment
Motivation comes in many forms, some out of fear and others out of encouragement. However, in 37 states of the U.S., you can force someone into drug and alcohol rehab, alcohol detox, or opiate detox if they meet the requirements for involuntary admission.
A judge will give the order for involuntary rehab if someone proves the following about the addict:5
- They have an addiction to drugs or alcohol.
- They have threatened, inflicted, or attempted to cause physical harm to themselves or another.
- The person is so incapacitated by drugs or alcohol that they cannot take care of themselves.
Involuntary commitment to drug rehab can save a friend’s life. However, it is not always needed. People often choose addiction treatment when they understand the process and what to expect. When someone refuses drug or alcohol treatment, a more assertive approach may be necessary.
Before approaching a friend, prepare for a meeting with them. First, learn why people refuse offers of alcohol detox, opiate detox, or any other treatment and create a solution to their problem, preventing a friend from using excuses for not going.
Know Why an Addicted Friend Refuses Help
When approached with getting help for an addiction, a friend may experience a level of fear, causing them to go on the defensive. Their fear is real, and it relates to being without the substances. Remember, addiction is a brain disorder, meaning drugs or alcohol take over the brain’s functioning. Over time, a person’s addicted brain thinks it needs the substance to survive.
When you approach a friend with the option of going to treatment, their initial response is a fear that they will not survive the withdrawal period. Yes, it is an irrational fear, but they cannot think clearly or rationally until the substances leave their system.
Other reasons an addicted friend may refuse an offer to get help include the following:6
- They use substances to cope with physical or emotional pain.
- They do not want to be away from their immediate family, including their children.
- They cannot afford addiction treatment.
- They are in denial and do not feel they have a problem.
- They think they can stop misusing substances on their own.
- They have not hit rock bottom.
- They can easily continue their addiction due to enabling friends and family.
- They fear withdrawal symptoms.
To help an addicted friend, have answers and solutions already in place for each of the reasons above and any other excuses they might try to use.
Friends of an addict must know how to set healthy boundaries to avoid enabling behaviors. For some, this may mean distancing themselves from their friend. For others, it may mean gaining a better understanding of appropriate boundaries.
Anything that makes you uncomfortable or helps a friend continue their addiction deserves a boundary. For example, allow a friend to borrow the vehicle if sober. If they drive drunk or high, a consequence must take place to let them know their actions are unacceptable. Consequences may involve calling the police for possible DUI, leaving the friend to find another way home, or distancing themselves.
Boundaries are necessary for both parties. They provide the following benefits:7
- Learning to say no and valuing personal time
- Reducing anger, hurt, and feelings of being used
- Increasing self-esteem and self-worth
- Feeling good by not participating in unhealthy behaviors
- Not becoming codependent
Present Multiple Addiction Treatment Options
An addicted friend may not know the various treatment options available today. They may have an outdated theory that they must enter detox in some distant location and be “locked up” for 90 days or longer, going through terrible withdrawals.
Explain that treatment options today include alcohol detox, opiate detox, and inpatient drug and alcohol rehab. It also includes intensive outpatient services and partial hospitalization programs. They can use medication-assisted treatments to help with withdrawals and connect with peer support groups, family therapies, and co-occurring and alternative therapies that help heal the whole self.
Go over each treatment option with them thoroughly. Discuss the benefits of each option. Encourage them to pick a treatment option immediately and help them enroll in a program. One of the easiest ways to do this is by calling the addiction treatment center directly while with a friend.
When you call Virtue Recovery Center, our recovery coordinator can answer questions regarding all levels of care and initiate the confidential screening and assessment process to determine which program may be best for your friend. We can discuss the costs of each program, therapeutic staff expertise, treatment methods, and aftercare support. We can even help you find resources to help you learn how to support your friend in recovery.
We are here for you. Give us a call today at (866) 382-3042.
- Substance Abuse and Mental Health Services Administration. (2021). Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health.
- The American Psychological Association. 2023. Substance Use, Abuse, and Addiction.
- McNeely J, Adam A. 2020. Substance Use Screening and Risk Assessment in Adults. Baltimore (MD): Johns Hopkins University. Table 3, DSM-5 Diagnostic Criteria for Diagnosing and Classifying Substance Use Disorders.
- National Library of Medicine. 2019. Medline Plus: Drug Use and Addiction.
- Partnership to End Addiction. 2021. Many States Allow Involuntary Commitment for Addiction Treatment.
- Mojtabai, R., Chen, L. Y., Kaufmann, C. N., & Crum, R. M. 2014. Comparing barriers to mental health treatment and substance use disorder treatment among individuals with comorbid major depression and substance use disorders. Journal of substance abuse treatment, 46(2), 268–273.
- Alcoholics Anonymous. 2023. The Psychology of Setting Boundaries with an Alcoholic.