How to Talk to a Loved One About Substance Use | One Healthy Boston

Behavioral Health

How to Talk to a Loved One About Substance Use

When a friend or loved one is struggling with addiction, it’s hard not to want to help. Although Substance Use Disorder affects more than 19.7 million Americans aged 12 and over, it’s still a difficult subject to broach.  How do you talk to someone about the harm substance misuse is having on their health, personality and relationships without them feeling attacked or alienated?

About Substance Use Disorder

Substance Use Disorder, also known as SUD, is the clinical diagnosis of a disease that affects a person’s ability to control the use of brain chemical-altering substances, such as alcohol, illegal drugs or prescription medications. Over time, this pattern of use can lead to health problems, relationship strain and difficulty leading a happy, productive life.

The most commonly misused substances include:

  • Alcohol: Easily accessible and relatively inexpensive, alcohol is the most commonly misused substance with an estimated 16 million people who meet the criteria for Alcohol Use Disorder.
  • Marijuana: Because cannabis is now legal for recreational use in Massachusetts, like alcohol, it’s accessibility and inexpensiveness make it easy to misuse.
  • Prescription Pain Relievers: When we talk about “the opioid epidemic” we’re talking about the misuse of pain relievers like codeine, hydrocodone, morphine, or fentanyl.
  • Cocaine: Despite its ability to elevate heart rate and blood pressure to dangerous levels, more than a million people in the U.S. are actively addicted to cocaine and its powerful stimulant effects.
  • Tranquilizers & Sedatives: Typically prescribed for anxiety or insomnia, tranquilizers (benzodiazepines, muscle relaxants and anti-anxiety medications) and sedatives (barbiturates and sleep medications) are commonly misused depressants.

Although we still don’t know what causes SUD, genetics, peer pressure, stress and concurrent mental health issues like anxiety, depression, ADD or PTSD can all factor into one’s substance use. That’s why it’s so incredibly important to consider other factors that may be contributing to your loved one’s substance use when confronting them.

Words Matter

Regardless of the fact that Substance Use Disorder is a medical condition, those who suffer from it still have to overcome the stigma of addiction. There’s an extreme amount of prejudice and discrimination around the words that are commonly used to describe people who have SUD. Words like “junkie,” “user,” and “drunk” pass judgement rather than promote healing.

At South Shore Health, we’ve recently teamed up with the Grayken Center for Addiction Medicine at Boston Medical Center on an initiative aimed at reducing the stigma around Substance Use Disorder by recognizing that what you say – and how you say it – can help or hinder one’s recovery. The Words Matter model seeks to remove those harmful terms from our everyday vocabulary and advocates for improving clinical interactions, treatment options and health insurance reimbursements for people seeking help for SUD.

Learn more about the Words Matter campaign and the Nurse Champions who have helped bring it to life at South Shore Health.

7 Tips for Talking About Substance Use 

  1. Initiate a conversation when your friend or loved one is sober – preferably in a private place.
  2. Keep the conversation civil, calm and free of judgment. Remember: words matter.
  3. Listen and try to understand how they feel about their substance use.
  4. Don’t force the subject; your friend or loved one may not be ready to talk about their condition or confront the fact they have a problem.
  5. Give examples of their behavior and express your concerns without accusing them of wrongdoing.
  6. Show respect and support. Let them know that you love them despite their substance use, that you’re concerned by their patterns of use, and that you’ll support them through recovery.
  7. Encourage treatment, but understand that behaviors can’t change overnight.

Recovery Starts with a Conversation

No one wakes up and says, “Today’s the day that I’m going to become addicted.” It’s a gradual and insidious process that can be hard to recognize when you’re in the thick of it. When your friend or loved one is suffering from SUD, opening your heart and having that tough conversation can be the first step to saving their life.

Once they’ve decided to seek help, your work isn’t over. Recovery is a process. It’s important to show consistent support, celebrate successes big and small, and help them overcome the inevitable obstacles and roadblocks. What you do and say makes a difference – maybe not today, maybe not tomorrow, but in the long run. And that’s the goal: To help your friend or loved one overcome Substance Use Disorder so that there is a long run.

If you would like help with Substance Use Disorder or more advice for talking to a loved one who is struggling with substance use, talk with your primary care provider to request an appointment with a behavioral health specialist.


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