What can I do to help?

Drug and alcohol users often feel trapped by their own behavior, especially if they have become dependent on a substance.
How to help a user, depends on the level of dependency they have reached. When someone is dependent on a substance, they can display extremely antisocial behavior making it harder to help them.

Knowing how to help and support a drug/alcohol user is complicated and difficult, which is why there are specialized agencies to treat people. Needless to say most families don’t have that expertise. However, there are ways of influencing the behavior of a drug/alcohol user, which families can develop with help and support.

To be able to help the user in your life you need to know a bit about how they change their drug/alcohol using behavior. Below is the Cycle of Change a well known model to explain the stages a user goes through.
A user usually goes through the Cycle several times before they find their own way to stop using - so giving up and then relapsing is a usual part of the journey of change.



This diagram adapted from Prochaska and DiClemente (1982) which shows the different stages a user typically goes through during their substance using.

1. Pre-Contemplation:

the substance user has no desire to change. They do not see their using as problematic even if others do.

How to help in the pre-contemplation stage: As the user doesn’t see there is anything to change, the most appropriate support is limiting the impact and harm of their substance use to them and to everyone else. Also help the user to become aware of the consequences of their use and associated behavior.

2. Contemplation:

At this stage the substance user starts considering their situation and whether they want to change. They are more aware of their situation and may want to get out of it. However, they are still using at this stage.

How to help in the contemplation stage: support at this stage continues to be about minimizing the impact and harm of substance use. In addition support can be given by helping to motivate the user to change, such as exploring with them the choices they have and offering them information to better inform their choice.

3. Preparation:

The user makes a decision to change their substance using behavior and starts to prepare them to do so.

How to help in the preparation stage: appropriate support involves helping and encouraging the user to make the changes they want to make, whilst acknowledging their anxiety about changing.

4. Action:

The user takes practical steps to bring about a change to their substance using behavior.

How to help in the action stage: appropriate support is about encouraging the positive changes the user is making in their behavior.

5. Maintenance:

When someone reaches maintenance they have achieved a change in their substance using behavior. A substance user may have either stopped using drugs or alcohol, or moved to a more controlled, less harmful way of using and is maintaining that change.

How to help in the maintenance stage: supporting the changes that have been made by the user, such as removing triggers to use from the home. It is important also to adjust to changes in family life and in the relationship with the user, which is likely to have resulted from the user’s changed behavior.

6. Lapse and Relapse:

A lapse is when the user briefly returns to their old substance using behavior. It is possible for them to go from lapse back to any stage of the cycle. However, a relapse is when the user fully returns to their old substance using behavior and then needs to go through the Cycle of Change again.

How to help in the lapse and relapse stages:

Appropriate support to the user is about reducing harm from substance use and helping the user re-engage with treatment, so a lapse doesn’t become relapse. Note that the suggested ways you might be able to help change with each stage of the Cycle. Therefore, if you offer information to someone about treatment when are at ’pre-contemplation’ they are unlikely to use it, however, this would be appropriate when they are at ’decision’ and ’action’. Understanding a substance user’s cycle and the support friends and families can provide is very important. The above is just a brief outline of how to help.

There are many more ways that you might be able to help at each stage. We suggest that you get help and support with exactly how you can do this.

Of course, drugs and alcohol can cause problems even when a user is not at a stage of dependency. There may be strong feelings of disapproval about their lifestyle, worry about what might happen to them, or concern about their health and well being. Where illegal drugs are involved, there is also the worry that the user will be caught, or that the wider community will perceive the whole family as ‘criminal’.

ADFAM’s suggestions:

• Inform yourself about the substance or substances they take, the likely difficulties and risks they have and how you can help with those.
  A place to start is the FRANK website: http://www.talktofrank.com/azofdrugs/a/
  Or you can access FARS’s Drug information section for Farsi and English translations.
• You need and deserve help to be able to offer support to the person who uses

Or access Useful Family links to find out about organizations that offer support to family members affected by a loved one’s substance misuse.

• Remember
  The limits of your influence. Families can offer help, but they cannot make someone do something they don’t want to do. A families’ help is however often needed, but trying to control what the user does is unlikely to have positive results in the long run. Families can choose how they respond to the situation they are in, but cannot choose how the user will behave.
• Equally, ignoring the problem or cutting all ties with the person who uses is unlikely to lead to what families want either.
• There is help out there for families. There are also others who have had the same experiences with their families.


The source of above information above is with the permission of ADFAM. For the direct link to this source click on: http://www.adfam.org.uk/index.php?content=family_help5&include=no