May 27, 2020

How to Help a Close Friend with Addiction

For Kate Miller, the turning point in an addiction to the ADHD medicine Adderall came after a night out with an old friend. 
“She turned to me and asked sincerely, ‘What’s going on?’” Miller recalled in an article for The New York Times. “I finally saw outside myself for the first time. I broke down in tears and confessed I had been misusing my prescription.”
The Power of Friendships in Substance Abuse Recovery
Miller’s story testifies to the power of friendships in substance abuse recovery. And Miller is not alone. The presence of a close, supportive peer network is a decisive factor in achieving positive recovery outcomes, as numerous studies have confirmed. An article in Psychiatry Services, a journal of the American Psychiatric Association, attributed the following empirically measured outcomes to the presence of a supportive network of peers and friends:
  • Lower relapse rates;
  • Better treatment retention;
  • Improved relationships with treatment providers and social supports; and
  • Greater satisfaction with the overall treatment experience.
Social support is also known to build resilience to stress (a major trigger of addiction) and guards against depression and other mental illnesses — so much so that the general research consensus is that supportive friendships are essential to both physical and psychological health. Indeed, a supportive peer network is so important to successful recovery from drugs or alcohol that peer-based recovery support and formal peer-based recovery support services are now a core feature of recovery-oriented systems of behavioral health care.  
Four Tips for Helping a Friend with an Addiction
Such findings indicate that the intervention of a close friend may succeed even in situations where immediate family members’ appeals to quit drinking or using drugs have proven unsuccessful. But it’s also the case that not knowing how to help a close friend with addiction can be an obstacle to intervening effectively or intervening at all. Here are four quick tips that can help:
  1. Talk to your friend. That may seem like a no-brainer, but sometimes even broaching the topic of addiction can be intimidating. You may feel unprepared to open the conversation or afraid of potentially alienating your friend. That’s understandable — and don’t be afraid to share your apprehensions as well as your love and concern for your friend. 

    Then, in a non-confrontational way, describe the patterns or behaviors you’ve been noticing and invite your friend to share what’s going on and how they may be feeling about their drug or alcohol use. In Miller’s case, for example, it took a friend first checking in with the caring and direct question, “What is going on?” 

  2. Listen attentively and respectfully to your friend. That may sound easy, but it can be a challenge. Below are two pitfalls to avoid in your effort to listen attentively:

    • Avoid shaming messages. Such messages can subtly creep into a conversation via the best of intentions. For example, the use of “should” statements (as in “you should stop drinking”) and/or terminology of “what’s right” versus “what’s wrong” can imply that your friend’s addiction is a moral failing. That inevitably will only add to their already existing shame. Telling your friend that all they need to do is control their behavior and/or exercise healthier choices can achieve a similar effect.
    • Don’t try to fix your friend’s problem. If you’re focused on fixing your friend’s problems, you won’t be able to listen to their feelings in the present moment. This meaningful, emotional connection with your friend will be far more helpful than your advice or solutions.
  3. Note matter-of-factly what’s not working. In Miller’s case, what her friend said next upon hearing Miller’s tearful confession may sound a bit harsh. For Miller, though, it was just what she apparently needed to hear: 

    [My friend] looked at me with no sympathy: “Well, now you know that doesn’t work for you.” It was oddly empowering to look at it so simply. Unprovoked by anything other than my urge to irreversibly end this chapter of my life, I flushed the remaining medicine down the toilet.

    The helpful takeaway here is that when a friend divulges how their substance abuse is spiraling out of control and becoming painfully unmanageable, they may need to hear something along the lines of what Miller heard from her friend. You can say the same thing more sympathetically, too, although indulging at great length in expressions of sympathy may divert you from the main goal of helping your friend recognize their problem and do something about it. 

    Chances are that if your friend’s drug or alcohol use has progressed to the point of an addiction, they are already at least somewhat aware, if only very subliminally, that their substance abuse is not working for them. If they confide in you, your response can then be to mirror back for them, via a simple, matter-of-fact statement, what they already know deep down inside: that the drugs or alcohol aren’t working for them. A simple, matter-of-fact observation takes judgment out of the room and keeps your friend focused on what’s not working so that they are better positioned to take that next step — getting help — for themselves.

  4. Connect your friend with professional resources that can help. Addiction is a treatable disease for which detox and inpatient treatment offer genuine hope of recovery. Call a substance abuse hotline that can advise you and your friend of treatment options. The National Treatment Referral Helpline, a service provided by the Substance Abuse and Mental Health Services Administration, is a good place to start: Call 1-800-662-HELP (4357) or 1-800-487-4889.
Candice Rasa, LCSW, is clinical director of Beach House Center for Recovery, a drug and alcohol addiction rehabilitation center in Juno Beach, Florida. She has more than 10 years of experience in the mental health and substance arena. She supports healing in the clients she serves from a perspective of spirituality and alternative Eastern methods. 

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