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  • Robert Schwebel, Ph.D.

8 Steps for Starting (or Restarting) Discussions About Substance Use Disorder with Loved Ones

Updated: Sep 28, 2020

Posted November 11, 2019 on The Fix.

Intervention is never easy. But this step-by-step guide can help you navigate the difficult task of talking to a loved one about their alcoholism or addiction.

When you know or suspect that a friend or family member has a drug problem, even well-intentioned conversations can turn prickly. Here are eight steps that may help smooth things out and pave the way to productive, respectful, and supportive discussions. Even if you already have a history of bickering and arguing, all is not lost. You can ask for a new start and then follow these steps. 

1. Keep Calm

If you’re worked up and agitated, it’ll be almost impossible to have respectful and cooperative dialogue. So, put aside your hurt, scared, or angry feelings. Take a deep breath. The feelings won’t go away, but maybe you can think of them as parked – pushed aside for the time being. Deep conversations that lead to connection and empathy require a measure of self-discipline. It’s difficult to process information and communicate effectively in emotionally charged discussions. 

2. Set Realistic Expectations

When you see or suspect a drug problem, you may want to rush to the rescue and fix everything right away. Maybe you think it’s best to demand a commitment to abstinence, or insist upon counseling, or even send the person to rehab. The thing is, no one wants to be “fixed.” The harder you push, the stronger the resistance you’ll encounter. The best way to help someone is to engage their brains – to get them to think things through for themselves and to make their own decisions. So, start with a reasonable and realistic expectation: to open the dialogue and increase mutual understanding. This won’t fix a substance use disorder, but it can improve the situation.

3. Ask Permission

It’s common courtesy to find out if someone is receptive to conversation at a particular moment. Start out by saying: “I’d like to talk with you about something that concerns me. Can I do that now? Is this a good time?” Asking permission gives your friend or family member a sense of control over the discussion and a moment to prepare for it. If not now, then you can ask: “When would be a good time?”

4. Explain Your Plan

Communication has to be a two-way street. You want to express your own point of view, but you need to also hear the point of view of your loved one. Make it clear that you want a mutual and cooperative exchange of information, and have as much desire to hear your friend or family member’s point of view as to express your own. This is important because communication about drug problems is often one-way, as in: “I know what’s going on and you need to quit drinking (or quit using drugs).”

You could put it this way: “I’d like to tell you what I’ve been thinking and feeling. I’d like to hear how you see things as well.” When friends and family members are treated with this type of respect, you might be surprised at how much they are willing to disclose.

5. Start From a Place of Concern

When you get the go-ahead to talk, start with an expression of concern based on your observations, being as specific as possible about what you have noticed, and your thoughts and feelings about it. You can also talk about how you are affected by the drug or alcohol use. Be sure to pause as you speak to give your partner time to think.

Here is an example of a well-stated expression of concern that combines observations, thoughts, and feelings:

“I’m concerned because I’ve noticed you’ve been drinking more often and in larger quantities in the last few months. It seems that you drink every night as soon as you get home from work, and much more than you used to drink. By dinnertime you’re often groggy and a little incoherent. Sometimes, you even fall asleep before dinner, then wake up and start drinking again. 

“I’m worried because, in my opinion, the amount you drink is unhealthy. I’m also concerned for myself. The drinking seems to interfere with us talking about our lives and enjoying each other’s company. I can’t say it’s all because of the alcohol. There might be other things happening. But it seems to be part of the pattern.”

Notice that these are “I” statements, as in: I’m concerned; I’ve noticed; and I’m worried. They merely express what the speaker saw, thought, felt, or noticed when certain events occurred. There are no labels or put-downs. They contrast with “You” statements, which are often pronouncements about a “truth,” or a dire prediction about the future:

• You’re an alcoholic.

• You drink too much.

• You’re addicted to opioids.You have a drug problem.

• You need to quit now.

• If you don’t quit now, you’ll end up a drunk in the street.

These “You” statements are opinions that may or may not be true. They are judgmental. Without explanation, they seem arbitrary. Without discussion and an understanding of the other person’s point of view, they come across as arrogant.

Be careful to steer clear of two pitfalls that could arouse defensiveness:

• Avoid self-certainty. It kills discussion. You may think you are right. You may be convinced you are right. You may even be right!! But keep an open mind and show some humility. Leave open the possibility that there are other ways to look at what is happening. (There’s always another side to a story.) Until you listen to what your communication partner says, you really don’t have the full picture: You may misunderstand something or not fully understand the situation.  

• Resist the urge to jump in with advice. It’s too early. You don’t even know what your friend or family member is thinking. Save recommendations and advice for later.

6. Request Feedback

You can be sure your friend or family member will have a reaction, perhaps a very emotional one. So, in good faith ask: “What do you think about what I just said?” Also: “Please tell me how you see things.” At this point, you never know what to expect and you’ll have to use your best judgment about how to proceed. If your partner is highly receptive, then listen to carefully to what is said and then proceed to the next step.

If your partner gets angry and highly defensive, back off, stay calm, and let some time pass. Take the high road and avoid an argument. Later, when things calm down, you can say: “You know, I told you how I see things. I’d like to know how you see things.” 

7. Listen to Understand, Not to Argue

Too often while someone else is talking, people get busy developing their counter-arguments. This transforms a discussion into a debate. While your friend or family member talks, try to listen closely and understand their perception of the issue. You will certainly increase your understanding of your partner, and quite possibly be surprised by what you learn. Maybe the problem is not as big as you thought. Maybe there have been changes you didn’t notice. Maybe you will get some clarity as to why your friend or family member was using drugs. Maybe you’ll discover that your friend or family member is also concerned about the drug use. To the extent you show respect and demonstrate open-mindedness, you serve as a role model to your communication partners.

8. Seek Mutual Understanding

Now you can say, “Let’s see if we understand each other.” A good way to do this is by using what is called reflective listening: you make an effort to paraphrase what the other person said, then ask: “Did I understand you correctly?” Then, you allow for clarification. When people reflectively listen to each other, there are two advantages:

We often get insight when we hear our own thoughts reflected back to us. 

We think twice when we have to paraphrase what someone else said.

Reflective listening will force you and your communication partner to think hard about what each of you say. Of course, you hope your loved one will be influenced by your presentation. You can be sure, too, that they want to be understood and hope that you will be open-minded.

At this point, you have to use your best judgment about what comes next. You could try to calmly discuss differences, now or in the future. You might want to ask if there is anything you could do that your loved one might find helpful. Also, you could politely ask if you can offer advice. Regardless, these eight steps are foundational to a productive dialogue and can stand alone as a measure of success. Savor it and avoid the rush for a quick fix.

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