It might be the hardest conversation you ever have, but talking to someone who may be addicted to drugs or alcohol could be the nudge they need to seek help.

“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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What are signs someone is addicted to drugs or alcohol?

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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How do I know when to offer help?

One thing’s certain – Dr. Allen says waiting for the person with a suspected problem to ask for help can be a long wait at best and, at worst, a disaster.

“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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What can I do to help?

Every situation is different, but understanding the available options and any related costs can help you more quickly connect the person with help.

Options include:

  • Community-based harm reduction services. Locally, this is the Connecticut Harm Reduction Coalition.
  • Recovery support programs. Choose from the Connecticut Community for Addiction Recovery, Smart Recovery, Alcoholic Anonymous, Narcotics Anonymous, etc.
  • Mental health care. Check the person’s employer to see if they offer help through an Employee Assistance Program.
  • Addiction specialists. Care is available at places like Rushford on an inpatient and outpatient basis.

You might need to be aggressive with your offer of help, especially with younger people, Dr. Allen says. If you anticipate a reaction that includes physical aggression, create a safety plan.

At the same time, try to tailor your approach to the person’s own goals and wishes so they feel empowered in their ability to make healthy and positive decisions.

Should I ever just leave the situation alone?

Sometimes with adults, family and friends are limited in what they can do to help, Dr. Allen admits.

“However, when someone with a substance use disorder is not seeking help but continuing to exhibit destructive and harmful behaviors, limits and boundaries need to be put in place for the health and safety of all,” he says. “You can continue to offer support for treatment while not enabling the addictive process.”

Sometimes people refer to this as “tough love” and while it seems cold and almost unloving, he says it is the best approach in such situations.