Having a family member struggle with substances can be physically draining, emotionally exhausting and downright confusing. It can kick up a bunch of emotions that can be really crushing: shame, guilt, anger, betrayal, and the desire to isolate away from it all. Many family members can fall into quite a deep hole as they struggle to help their loved one and manage the rest of their responsibilities and relationships.

Thankfully, there are tools to climb out of that hole. Instead of using a shovel to dig deeper and deeper (and feel worse and worse), years of scientific research and clinical experience have given us ladders to climb back to the sun. It is not easy; it takes understanding, patience, practice, courage, and clarity. Helping your loved one will also take support and learning new skills.

A Shift in Understanding

The first step is fundamentally understanding your loved one’s relationship with substances in a new way. Over 50 years of research and clinical experience have found that having kindness and compassion, toward your loved one and to yourself is a scientifically supported strategy for helping. How do you do that? You have to shift the way that you look at someone who is struggling with substances by changing your understanding of them.

The first thing to understand is that behaviors make sense, including using substances. What do we mean? We humans ALL do things because we get something out of it. And when we don’t, we stop engaging in the behavior? People don’t put their hand on a hot stove or drink rotten milk more than once! People who use alcohol and other drugs over and over (and over) do so because they get something out of it like feeling good, not feeling depressed, anxiety reduction, feeling accepted, being able to focus, getting to sleep, not being in pain. These all sound like pretty normal things to want right? Accepting this reality can increase your ability to have kindness and compassion towards your loved one.

The next thing to understand is that one size doesn’t fit all. Your loved one’s behavior makes sense to them in very specific ways. While it is very likely that you have heard “here’s what addiction is and here’s what addicts do,” closer to the truth is that everyone is different and a person’s decision to use substances makes sense to them in their own way. Everyone who chooses to use substances has different reasons for engaging in the behaviors and their reasons for changing and how they change are also different. Would you really make the same recommendations to these different people?

  • “I’m a soldier with PTSD from fighting in Iraq…drives me crazy
  • “I’m a teen in a pretty crazy abusive house who is terrified and angry most of the time”
  • “I have ADHD and I’m desperate to get into college but I can’t study without a ton of Adderall”
  • “I’m a grieving 60 yr old who lost my husband last year, and I need to sleep”
  • “I’m a firefighter with chronic pain from work-related injuries and opiates get me through the day”

The truth is, all of these people are very different and it’s important to understand how their substance use choices “make sense” to them because, as it turns out, understanding is one of the ways to start helping think of other ways to achieve their goals.

The last big thing to understand is that change takes time. If you are hoping your loved one will change their relationship with a substance, you need to keep in mind that you are asking them to give up something that specifically “works” for them. While there is a downside to their use (which is why you want them to change!), there is simultaneously an ongoing pull for them to go back to the thing they know and that still works. This dynamic is not “denial”, or being a jerk, it’s going back to what makes sense to them.

The pull to return to the old behavior while wanting to try the new is ambivalence and it is a normal and expected part of the change process. Adding in new things (like exercise, meditation, meetings, connection) that make sense to them will eventually help them change, but not usually overnight. That’s just not how new learning and change works. Leaving a behavior that works behind requires the addition of new things, practice, patience, and motivation (a reason to change).

We are sure you have heard messages like “don’t enable” “you have to be tough” or that your loved one is just in denial. These ideas are just about trying to force compliance and change. While that kind of forcing might help you feel clear and activated in the moment, it’s not likely to help your loved one.

Instead, stepping back and understanding that their behavior makes sense to them, knowing it matters in very specific ways to them, and understanding that it will take time to change comprise the ladder that can help them (and you!) get out of that hole. These understandings are compassionate ways to deal with another person and will have a big impact on them.