Man talking to woman about addiction

If you have a loved one who you suspect has a substance abuse problem and is denial about his or her addiction, you’re likely aware about how difficult it can be to broach the topic of addiction with him or her. Addicts in denial are, by nature, defensive. Any feedback you give them about their behavior will likely be seen as misplaced concern, or worse, criticism.

It won’t matter how you approach the conversation either. You can be nice and say “all the right things” and calmly present the facts, or you can raise your voice and threaten divorce or jail. But if they aren’t ready to see reality, there’s likely not a lot you can do to convince them otherwise.

That doesn’t mean you should stop trying. Make repeated efforts to talk to them about their behavior. Every time a new incident occurs—whether it be a forgotten appointment, missed workday, or financial calamity—use it as an opportunity to nudge the conversation toward convincing your loved one to seek help.

The following are a few tips to get you started.

The dos and dont’s of talking to a loved one about his or her substance use.

Do: Keep calm—Save the venting for other friends and family members. When it’s time to talk to your loved one about his substance abuse, it’s important to remain as cool and calm as possible. Stick with the facts and whatever speech you’ve rehearsed. Your loved one will likely get angry and defensive and may try to pick a fight, but resist the urge to be drawn into an argument. Say what you need to say and then exit the conversation.

Don’t: Be judgmental—It can be easy to judge, especially when the person’s behavior seems so wrong and the solution to her problems seems so clear. “Why can’t you just get your act together!?” you might be tempted to yell. But reacting harshly will likely only cause your loved one to shut down or get defensive. It can help to remember that addiction is not a choice; it’s a disease. Your loved one may have made a choice to use that first time, but once addiction sets in, the freedom to “choose” to use or not use no longer exists. Any rational decision-making skills she may have once had are now completely clouded by her mental illness.

Do: Talk about how your loved one’s behavior makes you feel—Rather than discussing the relative merits of his behavior, focus on how those specific behaviors have made you feel. Use “I” statements and don’t hold back. Be brutally honest. There is no reason to protect him from the truth or feel guilty about your feelings. If you felt humiliated by the way your loved one acted at that party, tell him. If you feared for your life when your loved one drove drunk, you need to let him know. Those in the throes of addiction are so completely preoccupied by their own feelings, desires, and needs that they are often completely clueless to how their behavior has been affecting others. 

DO: Talk to your loved one first thing in the morning—You want to make sure your loved one is sober and clear-headed when you confront her. That is why catching her after she wakes up and before she’s had the chance to take her first drink might be best your chance of having a level-headed conversation.

DON’T: Talk to your loved one when he is under the influence—You may think that because he isn’t “that drunk” that he’ll be able to handle the conversation, but the reality is that substances of any sort are mood and mind altering by design, so even just a little can cause your loved one to react in an irrational and overly emotional manner. Be patient and wait until he has sobered up.

Remaining calm and withholding judgment may be well and good, but what exactly are you supposed to say when you finally have your loved one in front of you? Are there particular phrases or words that might have more of an effect than others?

We put that question to some of the staff at Las Vegas Recovery Center and here is the advice they had to share.

What to Say to an Addict in Denial: LVRC Staff Offer Some Words of Wisdom:

What to say to an addict advice from Dr Pohl

Denial stands for Don’t Even kNow I’m Lying. The only way to overcome denial is to tell the truth. The problem is getting the addict to see and hear the truth. What might help is telling a loved one: I love you and want the best for you… followed by the truth without judgment or anger.

– Dr. Mel Pohl
Chief Medical Officer
Las Vegas Recovery Center

Hortensia offers advice on what to say to an addict

Family members trying to encourage their loved ones to get help should state “I remember when…” and then share a memory about who their loved one used to be or what their goals were. This tends to jar the memory and be motivating.

– Hortensia DeJesus
Family Services and Outpatient Manager
Las Vegas Recovery Center

Paul offers some tips on what to say to an addict in denial

Use ‘S.E.T’ – Support. Empathy. Truth. For example, a family member could say: “I appreciate that you’re upset when I say I think you have a problem, and I see that would be hard to hear and you would feel upset about it. But the truth is, you do have a drug problem and need to get help.” The family member should continue to repeat variations of this over and over again.

Another tactic is a softer approach. A family member could say:

  • “Please consider that you might have a drug problem. Just think about it.”
  • “I’m worried about you and fearful of something bad happening to you as a result of your drug use.”
  • “It is a real problem for me to see you hurting yourself and I am not willing to justify seeing you do this and not say or do anything about it.”

– Paul Hinshaw
Senior Inpatient Counselor
Las Vegas Recovery Center

Reade explains what you should say to an addict who is in denial

When speaking with a loved one, spouse or partner, it can help to say: “If you continue to use, you’ll lose your job, me, and your self respect. Surrender and ask me to help you or else you will die.”

– Reade Hulburd
Community Relations Representative
Las Vegas Recovery Center

Justin's advice about what to say to an addict who is in denial

Addicts can be analyzed, counseled, reasoned with, prayed over, threatened, beaten, and locked up, and they will not stop using until they are ready to stop using. I ask addicts if the way they are living has become unacceptable to them. It is usually unacceptable to everyone around them long before it becomes unacceptable to them. When it is unacceptable to the addict, change is possible.

– Justin Fisse
VP of Business Development and Admissions
Las Vegas Recovery Center


About Las Vegas Recovery Center (LVRC): LVRC is a chronic pain and addiction treatment center. Our full-service facility, located in northwest Las Vegas, offers a range of services, including drug detox, inpatient and outpatient services, and a robust family and alumni program. Contact us for further details.

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