Caring Enough To Confront
When someone you care about has a problem with alcohol or other drugs.
Confronting someone you care about with his or her use of alcohol or other drugs is rarely easy. Because confrontation makes many of us uncomfortable, we too often convince ourselves to remain silent. We might say, "Well, it's not like I don't drink. Besides, it's really none of my business," or, "She uses a lot, but she says she can quit anytime she wants." Unfortunately, our unwillingness to speak out often means that those with real problems may never be confronted with their behaviors. By our silence, those with problems are left to assume that we either approve of their behaviors or simply don't care. But when we care enough to confront, even if it's by anonymous note, we open the door for those with problems to get help.
Confronting someone may be difficult, but it's not impossible. The following frequently asked questions and answers will help you determine if confronting someone is necessary and give you recommendations on how to proceed. Also available are resources and tools that can help you to confront.
- “Does someone I care about have a problem with alcohol or other drugs?”
- “How can I tell if it’s a real problem or if I’m overreacting?”
- “Maybe its not that serious. What if I just wait and see if they snap out of it?”
- “Doesn’t a person have to ‘bottom-out’ before they get help?”
- “I want to help, but I’m not sure what to do.”
- “How do I confront them with their behavior and urge them how to get help?”
- “What if I’ve tried to help and they still don’t listen?”
- “This is really stressing me out! I have my own life to think about! What do I do?”
- “I don’t think I have the courage to confront, but I want to do something. How can I bring up the subject without them getting mad at me?”
Problems with alcohol or other drugs are not uncommon, especially on college campuses. If someone appears to have a problem, they probably do. Unfortunately, we have come to accept problem drinking and drug use as "normal" or "acceptable" while at college, when in reality, nothing could be further from the truth. We can often become blind to the fact that most students (even those attending UF) drink very responsibly and avoid using drugs altogether. If someone close to you is having a problem, they are not alone, but it is also not typical of student behavior. Don't try to convince yourself that it is. Remember there is no guarantee that behaviors begun while in college won't continue for a lifetime.
Chances are, you are not a doctor. Don't worry about the diagnosis. As a friend, your role is to notice, care, and confront. But you will want to base your decision to confront on facts. Let's face it, sometimes it's tough to tell if someone has a problem. Rarely will someone march up to you and say, "I have a drinking problem. Please help me." In fact, they will probably do everything possible to deny or hide the problem. Still, there are certain warning signs that may indicate someone has a problem, especially if they appear frequently.
If you notice ANY of the following in someone you care for, they may have a problem if they are:
- getting high or drunk on a regular basis
- lying about things, especially how much they are drinking or using
- avoiding you or others in order to get drunk or high
- giving up activities they used to do (such as sports, homework, hanging out with friends who don’t drink or use)
- planning in advance to get drunk or high
- worrying that there will not be enough alcohol or drugs readily available
- getting drunk or high alone
- hiding alcohol or drugs
- having to drink or use more in order to get the same euphoric effect
- believing that alcohol or drugs have to be present in order to relax, have a good time, or, in extreme cases, execute everyday activities
- frequent hangovers
- pressuring others to drink or use
- taking risks while drunk or high (driving, swimming, boating, having sex, etc.)
- having “blackouts” - forgetting what happened while under the influence of alcohol or other drugs (SPECIAL NOTE: This is an important sign! Those with problems might laugh it off as no big deal or even pretend to remember so as to minimize the seriousness of blackouts. Don’t be tricked into believing this is “no big deal.” It is!)
- feeling run-down, hopeless, depressed, or even suicidal
- sounding selfish, not caring what other people think or feel about their use or behavior
- constantly talking about drinking or using
- missing work or school, or poor performance due to drinking or drug use
- getting in trouble with RAs, the police, etc.
- being suspended from school for an alcohol or drug related violation
Signs such as changes in mood, difficulty in getting along with others, poor school performance, irritability, and depression might be explained by other causes. Unless you observe drug use or excessive drinking, it can be hard to determine the cause of these problems. Your first step is to contact a qualified alcohol and drug professional who can give you further advice. Counseling Services can assist you in this area.
They may come to the realization that they have a problem and get help on their own. But that's not likely. Typically, people with alcohol or drug problems don't like to admit it, even to themselves. In the beginning, they often say they feel great and that using alcohol or drugs is the best thing that's ever happened to them. This is the hook. It is why people continue to use drugs. Alcohol and drugs work by providing the user with good feelings for the short term. But things usually change for the worse. As tolerance builds, it takes more of the substance to produce the same feelings of euphoria in the user. Eventually, alcohol and drugs no longer make them feel good, but instead they are drinking or using to keep from feeling bad. They will need it to simply function. They can become addicted. If they don't get help, they can develop serious psychological problems, such as suicidal depression, or serious physical problems, such as liver or brain damage. Some may be injured or die in an overdose or alcohol or drug related accident. Their use will impair their judgment and they might suffer any number of negative consequences (such as getting a DUI, contracting a sexually transmitted disease or HIV, becoming pregnant, being involved in a sexual assault, being involved in a fight, etc.) Substance abuse is dangerous. It can ruin your health, cause you to harm others, cause you to lose friends and family, distract you from your goals and ambitions, and cost you your self-respect.
Taking a "wait-and-see" stance is risky. The question you should ask yourself is, "How will I feel if something bad happens, knowing I could have said something, but choose to keep my concerns to myself?"
"Bottoming-out" can be different for everyone. It doesn't have to mean losing everything. While it is true that most people have to feel some motivation to change, they won't all need to hit what we consider "rock bottom" before getting help. What you can do is to help "raise the bottom" for friends and family members. Bringing problem behavior to their attention BEFORE it gets out of hand, especially behaviors that happen repeatedly, can help them to see that their drinking or drug use DOES have negative consequences. But be careful not to preach. Preaching at someone rarely works and it can further alienate someone who may already feel alone. However, a nudge at the right time to seek help may be just what the person needs. Be compassionate. Be patient. But be ready to act.
The first step is getting them to talk to someone about their drinking or drug use. Eventually, they will need to admit that there is a problem, but don't feel that they have to admit it to you or that it has to happen right away. Your friend will need your understanding and support above all else. Also, become knowledgeable about the available resources for when they finally decide to get help. You can't force them to get help, but you can help them find competent assistance programs once they make the decision. You can find many of those resources on this website.
If you are worried about someone, it is also important for YOU to speak with someone in private who is knowledgeable and reassuring. Asking someone for help in this matter is not being disloyal to your friend or loved one. It is important that you know the facts on helping someone before you begin. While this website attempts to provide you with useful information, it is not intended as a substitute for meeting with a health care professional.
This is typically called an "intervention." Traditionally, there are two ways to intervene with a substance abuser: an informal intervention (a personal discussion with the abuser) or a structured intervention (bringing together a group of people to explore with the abuser how the behavior has affected all their lives). The structured intervention is typically facilitated by a professional and only used when the person has repeatedly declined to get help when confronted informally.
In any intervention, the most important thing to remember is to never approach the abuser when he/she is high or drunk. The intervention will most likely be completely ineffective as the abuser will not be thinking clearly. Also avoid confronting the abuser when you are acutely upset or feeling extremely emotional. It's important for you to remain calm and focused on the task at hand: getting the abuser to agree to talk to a professional about their alcohol or drug use or enter a treatment program (if necessary).
Some additional recommendations on effective confrontation strategies:
- Choose the time and place carefully, in private, when they are sober.
- Couch your comments in concern for the person’s health and well-being.
- Avoid labeling the person. Instead of calling the person a “problem drinker” or alcoholic, simply state that the behaviors are causing problems.
- Cite specific incidents resulting from their substance use (such as getting into a fight, passing out, getting arrested, etc.)
- Stick to what your know firsthand, not rumor or hearsay.
- Be confident and positive, reaffirming that the person is loved and valued, but the behavior is not.
- Speak using “I” statements, not “you” statements. (Instead of saying, “You are taking a huge risk when you drink and drive,” try, “When you drink and drive, I don’t sleep well because I am so worried you might get hurt.”) This might help offset some defensiveness on the part of the abuser and focuses on the negative consequences of the behavior.
- Be prepared for denial and resentment. While it is difficult for you to confront someone, it is also difficult to be confronted. Remember, it is important to remain calm and focused.
- Be supportive and hopeful for change. Reassure them that you will help them get the help they need and that you believe in their ability to change.
- Be persistent. If you don’t obtain agreement to change or to get help the first time, don’t be afraid to try again later. It may take time and repetition for your friend to accept what you’ve said. Encourage other friends who are concerned to speak out as well.
Some things to avoid when helping a loved one:
- Don’t attempt to punish, threaten, bribe, or preach.
- Don’t be a martyr. Avoid emotional appeals. They may only increase feelings of guilt and the compulsion to drink or use drugs.
- Don’t take over their responsibilities, leaving them with no sense of importance or dignity.
- Don’t hide or dump bottles, throw out drugs, or shelter them from situations. You cannot be everywhere and the person should not rely on you to protect them.
Do not drink or use drugs with your friend.
If you do, you could be sending a mixed message to them regarding how you feel about their behavior. The last thing you want to do is look like a hypocrite.
Above all, don't feel guilty for your loved one's behavior.
One of the most important things to remember is that you cannot "fix" your friend. They are lucky to have someone who cares, but you should be prepared to set limits. Encourage them to seek assistance and to help themselves. Do not make a habit of doing things for your friends that they can do for themselves. Do not enable their behaviors by giving them money, cleaning up their mess, or covering up for their behavior. Do not insulate them from feeling the consequences of their actions. Those consequences may be the impetus that motivates them to finally make a change.
You may have to accept that your friend is not prepared to hear what you are saying. You may want to consider asking for help from other people who are close to your friend. Contacting a family member or close friend of the person may be appropriate, especially if you feel he/she is taking significant risks with his/her health and well-being. This may be a difficult discussion to have as well. The people you speak with may have no idea about your friend's behavior or may be in denial as well. Remember all of the tips about confronting. They apply here as well.
This will most likely be hard on you too. The situation may leave you feeling lonely, afraid, and confused. You may be asking yourself, "What if I get them in trouble," "What if they hate me for this," or "What if they hurt themselves or someone else?" You may need to talk with someone about how this situation is impacting you. Counseling resources available to your loved one are also available to you. Remember, every problem drinker or drug user affects approximately 4 other people around them. You are not alone. Support groups like Al-Anon are especially designed for the family and friends of alcoholics. Take care of yourself above all. If you don't, how can you expect to be of help to your friend?
In addition, be very careful not to place yourself in dangerous situations when your friends are drunk or high. Let them know you care, but that you deserve to be safe. Also, if you or your friends are in immediate danger (such as if they become violent or suffer from an overdose or alcohol poisoning), call for help immediately. Your first priority is to get yourself and your loved one out of danger. Finally, if it becomes necessary to limit or cease contact with them, be honest and let them know why you have made this decision. Let them know you still care and want them to get help, but for your own safety and well being, you must set limits.
"I don't think I have the courage to confront, but I want to do something. How can I bring up the subject without getting them mad at me?"
There are no guarantees that your friend won't get upset if the issue of his/her substance use is broached. You may want to consider an anonymous note as an alternative intervention. While it may be more meaningful if they know who it came from, at least they will know that someone cares and is noticing their behaviors as being harmful. Try writing a letter or note to send to your friend, leave it where they are sure to notice it. Decide for yourself if you are comfortable with signing your name.