When Someone Has a Substance Use Disorder: How to Give Support

Substance use disorder (SUD), also called drug use disorder (DUD), is when a person keeps using substances even when they are harmful or cause problems in their life.

• Alcohol.
• Tobacco.
• Marijuana.
• Stimulants, like cocaine and methamphetamine.
• Opioids, including heroin and some prescription pain medicines.

How does a substance use disorder affect my loved one?

• Want to use drugs or alcohol all the time.
• Not be able to stop or cut down, even if it causes problems with:
  • Relationships.
  • Work or school.
  • Their health, the law, and finances.
• Need to use more and more of the substance to feel the same effect as before.
• Have symptoms, like feeling very sick, when they stop using or use less of the substance.
• Have physical signs, such as:
  • Marks on the skin from injections.
  • Unhealthy teeth and gums.
  • Weight changes that they didn't plan.
• Have changes in how they think or act. This can include changes in mood, sleep, and memory.

What do I need to know about the treatment options?

• Getting help to safely get the substance out of their body. This is called detox.
• Taking medicines. These may be used to:
  • Help stop cravings by stopping the substance from having an effect or by making the person feel sick if they use it again.
  • Treat any other health issues.
• Joining a support group for SUD. These groups are an important part of long-term recovery for many people. Examples include:
  • Alcoholics Anonymous (AA).
  • Narcotics Anonymous (NA).
• Talking with a counselor or therapist. This may include daily sessions at a treatment center.
• Staying at a live-in treatment center for days or weeks.

SUD is a long-term illness. People often use a substance again after they stop.

How can I help someone with a substance use disorder?

Give general support

• Be kind, patient, a good listener, and encouraging.
• Ask the person what they want or need help with. This might include:
  • Reminding them to take their medicine.
  • Offering to go with them or helping them get to their therapy or other appointments.
  • Helping with daily tasks like laundry or cooking.
  • Asking them to go for walks or do fun things with you.
• Encourage them to avoid:
  • Being around people who use or sell drugs.
  • Going to places where drugs are available.
  • Going places or being around people that make them want to use drugs.

Find support and resources

• A health care provider.
• A mental health expert or substance use specialist.
• Substance Abuse and Mental Health Services Administration (SAMHSA):
  • Go to samhsa.gov/find-help.
  • Call SAMHSA's National Helpline: 1-800-662-HELP (4357)

• Just Think Twice at justthinktwice.gov.
• National Institute on Drug Abuse (NIDA) at nida.nih.gov. Then:
  1. Click "Search" and type "drugs A to Z" or "drug and alcohol IQ challenge."
  2. Find the link you need.

How can I create a safe environment?

• Talk with the person's health care provider about ways to lower the risk of harm. This may include:
  • Medicines that can prevent death from an overdose.
  • Referrals to programs that offer clean needles.
  • Counseling about sexual health.
• Make a written crisis plan. Include important phone numbers, like the local crisis intervention team. Make sure that:
  • The person helps write the plan and understands it.
  • Everyone who spends time with them knows about the plan and what to do in an emergency.
• If you think the person is driving while using drugs or alcohol, it's important to talk to them about how dangerous this is and why they need to stop.

How should I care for myself?

• Find someone you can talk to who can help you handle stress.
• Try to keep your normal daily routines, including getting enough sleep.
• Do things that help you relax. Don't feel guilty about taking time for yourself.
• Exercise, even if it's just a short walk a few times a week.

What are some signs that the SUD is getting worse?

• The person's symptoms come back or get worse.
• They're not taking medicines or going to therapy like they're supposed to.
• They stop talking to friends or family.

Get help right away if:

• Your loved one shows signs that they have taken too much of a drug. This is called an overdose. Signs can include:
  • Chest pain.
  • Confusion.
  • Sleepiness or trouble staying awake.
  • Slowed breathing.
  • Throwing up or feeling like they may throw up.
  • A seizure.

These symptoms may be an emergency. Do not wait to see if the symptoms will go away. Call 911 right away.

• You feel like your loved one may hurt themselves or others.
• Your loved one has talked about taking their own life.
• Your loved one shares other thoughts or feelings that worry you.

• Go to your nearest emergency room.
• Call 911.
• Contact the Suicide & Crisis Lifeline (24/7, free and confidential):
  • Call or text 988.
  • Chat online at chat.988lifeline.org.
• For Veterans and their loved ones:
  • Call 988 and press 1.
  • Text the Veterans Crisis Line at 838255.
  • Chat online at veteranscrisisline.net.