When a friend shows signs of abusing alcohol or other drugs, it's hard to know what to do or say. Addiction may also be called "substance use disorder."
Drug abuse refers to a deliberate decision to use alcohol, an illegal drug, or a medicine in an unsafe way. Drug abuse can lead to addiction.
Substance use disorders are classified as mild, moderate, or severe based on symptoms.
Addiction means losing control over your drug use. It reflects a severe substance use disorder. Addiction interferes with one's insight into knowing how or when to stop.
Addiction begins with alcohol or drug abuse. Drugs and alcohol interfere with normal brain functioning. But they also have a long-term effect on the brain. At some point, changes happen in the brain that can turn drug and alcohol abuse into addiction.
Addiction can be physical, psychological, or both.
Physical addiction. A person's body becomes dependent on the drug. It needs more and more of it to get the same effect. This is called tolerance. When the person stops using the drug, they may have withdrawal symptoms. Alcohol or benzodiazepine withdrawal can be dangerous and may need inpatient monitoring and treatment to be done safely.
Psychological addiction. A person's mind craves the feeling that the drug gives. Or the person feels emotionally awful when they stop using the drug. The person can be overcome by the desire to get more of the drug.
Research has shown that addiction is a brain disorder. It's just as life-threatening as heart disease, diabetes, or emphysema. It can even be more life-threatening than these conditions. Like other long-term (chronic) illnesses, people with an addiction can have periods of relapse and recovery. The behavior and social symptoms of addiction can hurt family, friends, or coworkers. But you may be in the best position to help the addict understand the need to seek treatment. Most people who are in recovery say they got help because a friend or relative was honest with them about their drinking or drug use.
When deciding if you should speak to your friend, you may have some concerns, such as:
Fear or mixed feelings about getting involved in someone else's life. Just remember, addiction to alcohol or other drugs is a leading cause of death.
You believe someone else will say something. But it's important not to wait for someone else to step up.
You may feel hurt by your friend's past actions or behaviors. So it's important to take responsibility for your feelings, too.
It's also important to have an idea about the amount of alcohol or drug abuse. Think about how it is affecting your friend as well as others. If your friend has alcohol- or drug-related problems, they need help.
When a person has a psychological or emotional craving for a drug, you may see certain symptoms. Your friend may:
See drugs or alcohol as a solution, not the problem
Take drugs or alcohol in larger and larger amounts or over a longer time
Be preoccupied with getting drugs or drinking alcohol
Steal or sell their things to buy drugs or alcohol
Feel anxious, grouchy, depressed
Withdraw from contact with friends and family
Lose interest in school, work, or hobbies
Socialize with others who abuse drugs or drink to excess
Have mood swings
Have problems at work and at home
Has trouble with relationships
Take part in dangerous behavior, such as driving while drunk or high-risk sex
When a person’s body becomes dependent on a drug, you may see some of the following symptoms:
Needs more drugs or alcohol for the same effect
Weight loss or weight gain
Physical withdrawal symptoms when not taking the drug or drinking
The following can help you talk with your friend:
Don't try to talk when your friend is drunk or high. It's also a good idea to meet in a quiet, neutral place. But not at a bar or any place else that serves alcohol.
Talk about the effect your friend's drinking or drug use has on whatever the person cares about most, such as career or children. Your friend may not be concerned about their own situation. But they may care deeply for their children and what the problem may be doing to them.
Be prepared for a variety of reactions, from sadness to anger. Think through how you will respond to each reaction, including exiting the situation if it gets out-of-hand.
Be aware of treatment or recovery resources available in your community. Find the local phone number for Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). Learn what treatment resources are available in your area by calling your state's Office of Substance Abuse Services or searching the Substance Abuse and Mental Health Services Administration's treatment locator. This website also has treatment locators specifically for opiate abuse.
If your friend doesn't want to go to AA or NA, talk with other people who know and care about your friend to see if they have other ideas. Also consider getting support for yourself, such as Al-Anon or Nar-Anon. These are networks of support groups for family and friends of people with substance use disorders.