Talking to someone who may be struggling with drugs or alcohol is never easy — but it can be the first step toward helping them get the support they need.

“It starts with your suspicion that something is wrong,” says J. Craig Allen, MD, medical director of Rushford in the Hartford HealthCare Behavioral Health Network. “It can be challenging because the signs and symptoms of substance use problems can look the same as those for physical or other psychiatric issues. But, if you have a gut feeling something is wrong, you can’t be helpful unless you ask.”

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Recognizing the signs of addiction

How can you tell if someone is struggling with drugs or alcohol? Dr. Allen says to look for:

  • Changes in mood, personality or behavior
  • Worsening hygiene or appearance
  • Missing work, school or social functions
  • Physical health changes
  • Legal issues
  • Financial struggles

“If you continue to see these changes over a period of time, you can share your concerns with the person or check with other family members or friends to see what they are observing,” he says. “It can also help to review your concerns with a professional.”

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When is it time to offer help?

Don’t wait for them to ask for help — that moment may never come.

“It’s a fallacy that someone with a substance use disorder has to ask for assistance. A substance use disorder impacts insight and judgement, so the affected may be unable to recognize their own problem,” he says.

And it’s a myth that you need to wait for the person to hit “rock bottom”, adds Dr. Allen.

“The earlier people get help, the better the outcomes will be.”

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How to offer help.

Every situation is unique, but here are a few ways you can support someone who may have a substance use problem:

  • Explore Community Resources: Consider harm reduction services like the Connecticut Harm Reduction Coalition, or support groups like Alcoholics Anonymous or Narcotics Anonymous.
  • Encourage Professional Support: If they’re employed, they may have access to help through an Employee Assistance Program.
  • Connect with Addiction Specialists: Local programs offer a wide range of addiction care.

“Sometimes you may need to be direct, especially with younger people,” Dr. Allen advises. But try to respect their goals and wishes, empowering them to make healthy choices.

What if they refuse help?

There may be times when, despite your best efforts, someone is not ready to accept help.

“When someone with a substance use disorder is not seeking help but continues harmful behaviors, it’s important to set limits and boundaries for the safety of everyone,” Dr. Allen says.

This is sometimes known as “tough love.” While it may feel harsh, it can be the best approach in these situations. You can continue to offer support for treatment without enabling the addictive behavior.