Dr Simon Adamson
Are you worried about the drinking or other drug use of someone in your family?
If you answered yes to the question above you may be concerned for a variety of reasons, because substance use can lead to a range of problems. You may be aware of your family member’s actual consumption pattern, or possibly you’ve noticed the effects on family finances, or your family member’s behaviour, which could include being intoxicated, aggressive/violent, experiencing poor sleep, appetite or low mood or secretiveness. Of course many of these behaviours can have other explanations and so it is common for people to feel uncertainty, not only about how to approach their loved one’s substance use problem but also to be unsure of whether or not there is a problem
The best way to resolve this uncertainty is also the best first step in addressing the issue – talk to them! In preparing for this discussion it’s helpful to first set out what you need from this discussion and what their needs are. Outcomes you are likely to want are: to find out if they do in fact have a substance use problem, reassurance that they are also concerned and would like to change, and for them to acknowledge how their substance use affects you and others in the family. What they need is to become aware that there is a problem if they are not already, and to then resolve to make changes.
Whether or not this change will require formal support from a treatment service depends on the severity of their problem and also their preference. Whatever the seriousness of the problem, your family member is likely to have some ambivalence about changing, because there will be reasons they chose to use drugs/drink in the first place, whether it’s in response to stress or other pressures, or simply because they enjoy it. Also they may lack confidence in their own abilities to change. These are both reasons behind the often hidden nature of an alcohol or other drug problem.
Your concern and love for them are the most important tools you have undertaking this process. As well as concern however, it is also normal to feel anger, frustration and resentment. Tender feelings, such as love, may have been overtaken by these reactionary negative feelings. For someone with a substance use problem there is often a feeling of powerless, with loss of control a hallmark of addiction, and substance use often developing in response to difficulties about which the person feels unable to cope. Raising the issue in an accusing angry manner will simply serve to inflame these feelings and is very likely to elicit a defensive reaction, typically denial/minimisation or anger and accusation, none of which is very helpful. You are entitled however to let them know how their alcohol or other drug use is affecting them and to set out what is and isn’t acceptable behaviour in your household. Try balance this by reminding them of the positive things about them that you liked or admired before their alcohol or other drug use got out of hand. Remember that change is more likely to happen by you and your family member working together, rather than in opposition to one another.
