Supporting Someone With Addiction

Q: People have to hit rock bottom before they can recover.

This is a myth. Earlier help works better, not worse. Waiting for rock bottom means waiting for more damage. For some people, rock bottom is an overdose. People recover from every stage.

Q: Taking methadone or buprenorphine is just swapping one drug for another.

This is a myth. They are medicines that cut the risk of death by more than half. Taken as prescribed, they steady the brain without the high and the crash. That is what lets people work, raise children, and stay alive.

Q: Relapse means treatment has failed.

This is a myth. Relapse is common, and it is a reason to adjust treatment, not end it. Relapse rates here are similar to those for asthma and high blood pressure. Nobody says their inhaler failed.

Q: Addiction is a choice, so people can just stop.

This is a myth. The first use is often a choice. Addiction changes how later choices are made. Choice does still matter, which is why rewards help. But cravings, cues and a lowered mood make stopping far harder than it looks from outside.

Q: Most people who try drugs do not become addicted.

This one is true. True. For alcohol, cocaine and cannabis, most people who ever use them never become dependent. Nicotine is the exception. About two in three do.

Q: Most people with addiction eventually recover.

This one is true. True. In the United States alone, about 22 million adults say they once had a drug or alcohol problem and no longer do.

Substance use disorder, commonly called addiction, is continued use despite harm, with craving, loss of control over the amount used, and a brain reward system that has reorganised itself around the substance.

Also called: Addiction, Substance dependence, Drug addiction, Alcohol use disorder.

ICD-10 F10-F19 · ICD-11 6C40

The word "addict" does damage of its own.

People with addiction get described by the thing they struggle with, as if that were the whole person. Studies show this changes how they are treated. Even doctors judge the same patient more harshly when that person is called a "substance abuser" instead of someone with "a substance use disorder". Shame then stops people asking for help. It keeps them away from the treatments that work.

START HERE

The same message, two replies

Tap any reply to see what it does.

i messed up again. 3 weeks clean and i used last night. dont know why i bother

Lands well

I'm really glad you told me. Three weeks is real, and it still counts.

This treats the slip as part of recovery, not the end of it. Honesty after a slip is worth protecting.

doesnt feel like it

Are you safe right now? Do you want to call your worker together?

This checks safety first, because tolerance drops after a break. Then it points back to the support that already exists.

yeah ok. can you stay on the phone

Of course.

This is presence, not a lecture. Connection is one of the weights that holds the balance.

Lands badly

after everything? I thought you were done with that

The disappointment is understandable. It still lands as shame, and shame is a common trigger for using again.

you just need to want it more

This makes it a question of willpower. The person almost certainly wants it very much already.

ok.

dont tell me about it next time if youre going to keep doing it

This teaches them to hide slips. Hidden use is more dangerous, and help arrives later.

Seen. Doesn't mention it to anyone again.

AND WHAT TO DO

If you are close to someone with a substance problem

Use their name and plain words. Say "someone who uses drugs", never "a junkie".
Talk to them when they are sober and calm. Talk about what you have seen and how it affects you. Do not talk about who they are as a person.
If opioids are involved, learn about naloxone. Keep it somewhere you both know about.
Look after yourself too. Family programmes such as CRAFT, Community Reinforcement and Family Training, get more people into treatment than confronting them does.
Expect slips. Stay on their side through them.

MYTH CHECK

Six things people say. Two of them are true.

Answer before you read the answer. It sticks better.

People have to hit rock bottom before they can recover.

Verdict: myth.

Earlier help works better, not worse.

Waiting for rock bottom means waiting for more damage. For some people, rock bottom is an overdose. People recover from every stage.

Taking methadone or buprenorphine is just swapping one drug for another.

Verdict: myth.

They are medicines that cut the risk of death by more than half.

Taken as prescribed, they steady the brain without the high and the crash. That is what lets people work, raise children, and stay alive.

Relapse means treatment has failed.

Verdict: myth.

Relapse is common, and it is a reason to adjust treatment, not end it.

Relapse rates here are similar to those for asthma and high blood pressure. Nobody says their inhaler failed.

Addiction is a choice, so people can just stop.

Verdict: myth.

The first use is often a choice. Addiction changes how later choices are made.

Choice does still matter, which is why rewards help. But cravings, cues and a lowered mood make stopping far harder than it looks from outside.

Most people who try drugs do not become addicted.

Verdict: true.

True.

For alcohol, cocaine and cannabis, most people who ever use them never become dependent. Nicotine is the exception. About two in three do.

Most people with addiction eventually recover.

Verdict: true.

True.

In the United States alone, about 22 million adults say they once had a drug or alcohol problem and no longer do.

WHAT THE MISUNDERSTANDING COSTS

1 in 12 — people with a drug use disorder worldwide got any treatment at all.

people with a drug use disorder worldwide got any treatment at all.

Shame is a large part of it. People hide their use from doctors, employers and family. They do not ask for help until things are very bad.

For women the gap is wider still. Only about 1 in 18 are treated. Fear of losing their children is a major reason.

THE SAME ACT, TWICE

What it looks like, and what it is

Tap a card to turn it around.

Keeps choosing drink over family.

They are trying not to, every single day. The pull is strongest at exactly the times the family needs them most.

Missed another appointment.

They were in withdrawal that morning. They had no bus fare. And there was the shame of walking in again after last time.

Doesn't even seem to enjoy it.

They do not enjoy it. It stopped being fun long ago. Now it is the thing that makes them feel normal.

On methadone, so still an addict.

They are in treatment, working, and alive. The medicine is the reason.

Went back to the same friends.

Those are the only people who never judged them. Somewhere else to belong has to come first.

Relapsed after a year clean.

That year of recovery still counts. The slip can be caught early, as long as they are not too afraid to say it.

BACKGROUND

Where the stigma comes from

It looks like a choice

Every use involves an action. So people assume every use is freely chosen, and blame follows.

The words

Words like "addict", "junkie", "clean" and "dirty" turn an illness into a character. Putting the person first is not just politeness. It changes how people get treated.

It is illegal

Using many drugs is a crime. That links a health problem to punishment, and it makes asking for help risky.

The public face

The people you see struggling in public are a small and very unwell minority. Most people with substance problems are invisible. So are most people in recovery.