What to Say When Someone You Love Is Struggling With Substance Use

When someone you love is struggling with substance use, knowing what to say can feel incredibly difficult.

You may be worried about their health. You may be frustrated by things that have happened. You may feel scared about what could happen next. And underneath all of that, you may simply want them to know that you care.

But conversations about substance use can quickly become tense, especially when fear, shame, or anger enter the room.

You might find yourself thinking:

Should I bring it up? What if I make things worse? What if they get angry? What if they deny there's a problem? What if I say the wrong thing?

There is no perfect script for these conversations. But there are ways to approach them that can make it more likely that your loved one feels safe enough to listen, talk, and consider support.

As we recognize International Overdose Awareness Day on August 31, it's an important time to remember that overdose prevention isn't just about knowing the statistics. It's also about reducing stigma, recognizing warning signs, and creating opportunities for people to connect with help.

Start With Concern, Not Judgment

One of the most important things you can communicate is: “I care about you.”

It can be tempting to lead with everything your loved one is doing wrong. You may want to list the missed responsibilities, broken promises, arguments, or consequences you've witnessed.

But approaching the conversation with a list of grievances can make someone feel attacked—and when people feel attacked, they are often more likely to become defensive or shut down.

Instead, focus on what you've noticed and why you're concerned.

You might say:

“I've noticed you've been struggling lately, and I'm worried about you.”

Or:

“I care about you, and I've noticed some changes that make me concerned about how you're doing.”

The goal isn't to convince them that they're a “bad” person or force them to admit they have a problem.

The goal is to open a door.

Avoid Shame-Based Language

Substance use can already come with enormous amounts of shame.

People may feel embarrassed about their behavior, worried about disappointing their families, or afraid that others will see them differently. Adding more shame rarely makes it easier for someone to ask for help.

Try to avoid statements like:

• “Why can't you just stop?”

• “You're throwing your life away.”

• “Think about what you're doing to your family.”

• “You have to want help.”

• “If you really cared about us, you would quit.”

Even when these statements come from genuine fear and frustration, they can reinforce the idea that someone needs to hide their struggles rather than talk about them.

Instead, try language that separates the person from the behavior.

“I'm worried about what you're going through” communicates something very different from “You're a problem.”

Talk About What You've Observed

If you're concerned about someone's substance use, stick to specific observations rather than assumptions about their motives or character.

Instead of:

“You don't care about anyone anymore.”

Try:

“I've noticed you've been missing work and canceling plans more often, and I'm worried about you.”

Instead of:

“You're completely out of control.”

Try:

“I've noticed that you've been using more frequently, and I'm concerned about what that could mean for your health.”

Specific observations give the other person something concrete to respond to without making them feel like they have to defend their entire identity.

Listen More Than You Lecture

It's natural to want to explain everything you've learned about addiction, tell your loved one what they need to do, or convince them to get treatment immediately.

But sometimes the most helpful thing you can do is listen.

Ask open-ended questions:

“How have things been feeling for you lately?”

“Do you feel like your substance use has been helping you cope with something?”

“Have you thought about getting support?”

“What would make it easier for you to consider getting help?”

You don't have to have all the answers. You also don't have to immediately fix what they're telling you. Sometimes being willing to sit with an uncomfortable conversation is an important first step.

Remember That Substance Use May Be Serving a Purpose

This doesn't mean substance use is healthy or safe. It means that understanding why someone is using can help you better understand what they may be experiencing.

For some people, substances become a way to cope with anxiety, depression, trauma, grief, loneliness, chronic stress, or other painful experiences.

If you only focus on stopping the behavior without understanding what the behavior is doing for the person, you may miss an important part of the picture.

You might ask:

“What do you feel like you get from using?”

“What are you trying to escape or cope with when you use?”

These questions aren't about excusing substance use. They're about understanding the person behind it.

Don't Turn the Conversation Into an Argument

Your loved one may deny that there is a problem.

They may become defensive. They may tell you that you're overreacting. They may not be ready to consider treatment.

As difficult as that can be, arguing usually isn't the most productive response.

You can acknowledge their perspective while still being honest about your concerns.

Try:

“I hear that you don't see it the same way I do. I still want you to know that I'm concerned, and I'm here if you ever want to talk.”

You can care about someone without forcing them to agree with you.

And sometimes, planting the seed of concern is more productive than trying to win the conversation.

Encourage Professional Support

Family support can be incredibly important, but you don't have to become your loved one's therapist, case manager, or treatment provider.

Encourage them to connect with appropriate professional support, which may include a therapist, psychiatrist, primary care provider, addiction specialist, or treatment program.

You might say:

“You don't have to figure this out by yourself. Would you be open to talking with someone who understands substance use?”

If they're hesitant, you can offer to help them research options or accompany them to an appointment if appropriate.

Know When a Conversation Becomes an Emergency

A supportive conversation is important, but there are situations where immediate action matters more than finding the perfect words.

If you believe someone is experiencing an overdose or is in immediate medical danger, seek emergency medical help rather than trying to handle the situation on your own.

Learning basic overdose response, including recognizing signs of an overdose and knowing how to access naloxone (Narcan), can be an important part of overdose awareness and prevention.

International Overdose Awareness Day is a reminder that prevention isn't only about what happens after someone is struggling. It's also about making sure people and communities have the knowledge and resources to respond when an emergency occurs.

Supporting Someone Doesn't Mean Losing Yourself

This is an important piece that often gets overlooked.

When you love someone who is struggling with substance use, you may spend so much energy worrying about them that you stop paying attention to yourself.

You may constantly monitor their behavior, cover for them, make excuses, give money, manage crises, or put your own needs aside.

Supporting someone does not mean you have to accept behavior that is harmful to you.