How Do You Talk to Someone About Their Drug or Alcohol Use?

To talk to someone about their drug or alcohol use, choose a private, calm moment when they are sober, tell them you care, and describe what you have noticed. Then ask open questions and really listen (SAMHSA; NIAAA). You can’t force someone to get care, so the goal of a first talk is to keep the door open, not to win an argument (SAMHSA).

If the person won’t wake up, is breathing very slowly, or you think they may hurt themselves, this is not the time to talk. Call 911 or call or text 988 now (CDC; SAMHSA).

How do you start the conversation?

Start by picking the right time and place, then lead with care instead of blame. Here is what federal health agencies suggest:

• Wait until they are sober and calm. NIAAA says a holiday dinner is not a good time, and neither is when your loved one is intoxicated (NIAAA).
• Find a private spot. Choose a private setting with few distractions, such as at home or on a walk (SAMHSA).
• Plan what you will say. Think it through first, and maybe practice with someone else, because these talks can get emotional (NIAAA).
• Speak for yourself. Start with “I” and say how you feel, as SAMHSA’s sample phrases do, such as “I’ve been worried about you” (SAMHSA).
• Name specific behaviors. Describe the reasons for your concern (SAMHSA). Keep it small and specific, and state the problem neutrally (NIDA).
• Listen more than you talk. Repeat back what you heard so they feel understood (SAMHSA).

Don’t gang up on the person or back them into a corner. You want them to feel supported, not threatened (NIAAA).

What should you say, and what should you avoid?

Use warm, specific, first-person words, and avoid blame, labels, and lectures. These examples come straight from SAMHSA and NIDA guidance:

It also helps to remember the facts. Alcohol use disorder is a medical problem, not a lack of willpower, and there are treatments that work (NIAAA). If you are not sure what words they use for themselves, NIDA suggests simply asking (NIDA).

What if they deny it or get angry?

If they deny it or get angry, stay calm, step back, and try again later. It may take many conversations before someone gets help (SAMHSA). If they don’t want to talk, let them know you’ll be there when they’re ready (SAMHSA).

If you feel yourself getting too upset, NIDA’s CALM steps can help. Control your thoughts and actions, assess whether you are too upset to go on, leave if you are feeling too angry, and make a plan to come back to it within 24 hours (NIDA). If they turn down the treatment options you found, NIAAA suggests giving them time to think and then asking what kinds of help they might be willing to try (NIAAA).

If anyone is in danger, call 911 (SAMHSA). Your safety comes first.

What is enabling, and how do you set boundaries?

Enabling generally means shielding a person from the natural results of their use, which can make it easier to keep using. CRAFT, a research-based family program, teaches families to reward healthy, non-using behavior while “withdrawing protection against negative natural consequences of using substances” (McCarthy et al., PMC). In practice, that can mean you stop covering for them, but you keep showing warmth when they are sober.

Boundaries are a clear statement of what you will and won’t do. SAMHSA suggests telling the person what you are willing and not willing to do (SAMHSA). Its example: “I can pick up the mail and check on your apartment while you’re in treatment, but I don’t have the money right now to help you pay for treatment” (SAMHSA).

If their needs are taking over your life, you can also set times to talk and stick to them (SAMHSA). A boundary works best when it is calm, specific, and something you will actually follow through on.

Do confrontational “interventions” work?

Confrontational interventions can work for some families, but a gentler approach called CRAFT gets more people into treatment. NIAAA says CRAFT “has been shown to be more effective than confronting the person in an ‘intervention'” (NIAAA). CRAFT teaches family members ways to encourage positive behaviors at home (NIAAA).

In a randomized trial of 130 family members, here is how often the person with a drinking problem entered treatment (Miller et al., 1999):

The confrontation results need context. In that study, 70% of families chose not to go through with the confrontation, but when they did, 75% got their loved one into treatment (Miller et al., 1999). A review of 4 trials with 264 family members found CRAFT produced about twice the treatment entry of the Johnson Institute intervention and three times that of Al-Anon/Nar-Anon (Roozen et al., 2010).

The evidence base is small, so no approach is guaranteed. Still, CRAFT helped about two-thirds of reluctant loved ones start treatment, usually after 4 to 6 sessions (Roozen et al., 2010). See evidence-based interventions for substance abuse.

How do you talk with a teen about drugs or alcohol?

With a teen, have many short, low-key talks instead of one big lecture (SAMHSA). Over 80% of young people ages 10 to 18 say their parents are the leading influence on whether they drink (SAMHSA).

SAMHSA’s “Talk. They Hear You.” campaign suggests five goals (SAMHSA):

1. Show you disapprove of underage drinking and other drug misuse.
2. Show you care about your child’s health, wellness, and success.
3. Show you’re a good source of information.
4. Show you’re paying attention, without prying.
5. Build their skills for saying no, such as a code word they can text you.

NIDA’s family guide adds a few basics. Pick a time when you can focus fully, have a plan, and be calm and patient (NIDA). Make clear, simple rules, and be ready to follow through (NIDA).

Signs of a problem can include new friends, lower grades, skipped classes, lost interest in favorite activities, and changes in eating or sleeping (NIDA). If you find a problem, try not to blame yourself or your child, and act now to find help (SAMHSA). If a parent is the one entering care, see talking to your kids about going to rehab and caring for your kids during rehab.

When is it an emergency?

It is an emergency if the person may be overdosing or may be thinking about suicide. Call 911 for an emergency, and call or text 988 for a mental health or suicide crisis (SAMHSA).

Using drugs or alcohol more often can also be a suicide warning sign (NIMH). For more on overdose, see the fentanyl guide, including what to do in an overdose.

How do you get support for yourself?

You can get support from mutual-help groups, a therapist, or a free helpline, and you deserve it. Caring for someone with a substance use problem can be highly stressful and emotionally draining (SAMHSA).

• Mutual-help groups: Al-Anon offers peer-led support groups for people affected by someone’s drinking, and Alateen is for teens (NIAAA). Nar-Anon describes itself as a 12-step program for family and friends of people with drug addiction.
• Family therapy: many treatment programs offer it as part of care (NIAAA). Read about family therapy after addiction treatment.
• Daily self-care: make time each day for yourself, such as going outside, reading, or listening to music (SAMHSA).
• A helpline: SAMHSA’s National Helpline gives free, confidential treatment referrals to individuals and families, 24/7 (SAMHSA).

Support helps you even if your loved one is not ready. In the trial above, family members improved in how they functioned no matter which approach they were given (Miller et al., 1999).

What is the next step toward treatment?

The next step is to have a few treatment options ready for when your loved one says yes. Ask whether they would rather see a therapist one-on-one, try group counseling, or start with a doctor, and offer to search together (NIAAA). The SAMHSA National Helpline can refer you to local treatment facilities, support groups, and community groups (SAMHSA).

Once they are in treatment, families can help by getting involved, and many programs offer family counseling (NIAAA). For opioid or alcohol use disorder, ask about medication-assisted treatment. If they are high-functioning and hide it well, see signs of a high-functioning alcoholic.

Sources

1. Supporting a Loved One: Starting the Conversation, SAMHSA
2. Helping a Loved One Dealing With Mental and/or Substance Use Disorders, SAMHSA
3. How to Help Someone, SAMHSA, 2023
4. How to Talk to Someone About Help, SAMHSA
5. Mental Health, Drugs and Alcohol: Taking Care of Yourself, SAMHSA
6. Crisis Help: Suicide, Mental Health, Drug, and Alcohol Issues, SAMHSA
7. SAMHSA’s National Helpline, SAMHSA
8. Five Conversation Goals, “Talk. They Hear You.”, SAMHSA
9. How To Tell If Your Child Is Drinking Alcohol, SAMHSA
10. Starting the Conversation, NIAAA Alcohol Treatment Navigator
11. FAQs: Searching for Alcohol Treatment, NIAAA Alcohol Treatment Navigator
12. Caretaker Support Resources, NIAAA Alcohol Treatment Navigator
13. Family Checkup: Positive Parenting Prevents Drug Abuse, NIDA
14. Words Matter: Preferred Language for Talking About Addiction, NIDA
15. What Are the Signs of Having a Problem With Drugs?, NIDA, 2021
16. Miller WR, Meyers RJ, Tonigan JS. Engaging the unmotivated in treatment for alcohol problems, Journal of Consulting and Clinical Psychology, 1999
17. Roozen HG, de Waart R, van der Kroft P. Community reinforcement and family training: an effective option to engage treatment-resistant substance-abusing individuals in treatment, Addiction, 2010
18. McCarthy JM, et al. Pilot Development and Feasibility of Telehealth CRAFT for Early Psychosis and Substance Use, PMC
19. What to Do If You Think Someone Is Overdosing, CDC, 2024
20. Warning Signs of Suicide, NIMH, 2025