HOW TO TALK TO SOMEONE AFFECTED
BY SUBSTANCE USE DISORDER

Substance use disorder quickly leads to an inability to moderate alcohol, illicit drugs, and legal medications. The person suffering from substance use disorder will continue to use their substance of choice, despite the potential for serious side effects. This can be a painful reality when someone very close to you is affected by the disease. Nobody wants to commit a crime or overdose on a substance; however, tragedies such as overdoses and automobile accidents seem to be a regular occurrence among individuals who are in active addiction. It seems to come with the territory. Why does this happen and what can everyone do to help?

When we talk about substance use disorder, we are really talking about a brain disease. Addiction is a disease that significantly affects the limbic system and the executive branch of brain functioning, which can lead to a number of ill-advised decisions, behaviors, and thought patterns. If you want to know how to talk to someone affected by substance use disorder, you’ll have to understand how it affects the individual who has it.

ADDICTION: A BRAIN DISEASE

Many of the family members who have walked through the doors of The Blanchard Institute have believed – at one point or another  that their son/wife/daughter/friend/husband/wife’s addiction was a matter of choice. While it may have once been a choice to throw back a few cans of beer, a person that is severely dependent on a substance no longer has the power of control.

This is because substance use disorder is a brain disorder characterized by an inability to stop using substances. It is not a matter of choice after a certain line has been crossed. Addiction significantly affects the limbic system, the frontal lobe, and the frontal cortex.

Here are just a few functions that those parts of the brain are responsible for:

  • ABILITY TO ORGANIZE THOUGHTS
  • PLANNING FOR THE FUTURE
  • IMPULSE CONTROL
  • PROBLEM SOLVING
  • RATIONAL DECISION MAKING
  • HOW A PERSON DEALS WITH CHRONIC STRESS
  • EMOTIONAL REGULATION
  • AND MUCH, MUCH MORE.

Once these areas of the brain are marginalized due to substance use disorder, you can expect to be ruled by impulses, cravings, and desires. In fact, many people with prefrontal cortex damage – addict or not – exhibit highly blunted emotional responses, which can lead to very poor social choices. What once seemed like a terrible idea… is no longer that bad of an idea. The element of the brain that separates us from reptiles is shut down.

HOW DO WE COMMUNICATE?

If you think a loved one has a substance use disorder that is heavily impacting their life and the lives of others, proper communication is necessary. Let’s talk about emotional intensity and why it’s important to remain calm.

Remember a time that was intense: think of the environment, the atmosphere, and the people. Now, think on a scale of 1-10. 1 being absolutely calm and mellow, with 10 akin to someone screaming at the top of their lungs. We like to call the range of 6-10 as “drunk on emotion”. This level of emotional reactivity generally results in spoken statements that are regrettable, unhealthy, reactionary, hurtful, and/or irrational. If you’ve ever written a novella of an email to someone that you particularly disagreed with, you probably know what we are talking about.

Here’s the truth: almost all of the decisions that you make at the 6-10 range will be things you’ll have to end up apologizing for. Revolutions are fought in the 6-10 range. This is not the range of emotional intensity that anyone should be at when trying to convince an addict to go to rehabilitation. Having the self-awareness to realize that you’re not responding well to a situation is the first step in learning how to communicate effectively. Have you ever started to shake, “see red”, or clenched your fist? Does a hard-beating heart sound familiar? Everyone’s body responds in a different way somatically, so knowing the warning signs is crucial.

DON’T BE DRUNK ON EMOTION

Remind yourself to breathe and do not lose your self awareness. If you want someone with substance use disorder to respond to you, you do not want to go about it in an emotional, accusatory fashion. Take a breath, get your wits about you, and choose your words carefully.

The conversation needs to be all about “I” statements, not “you” statements. “I am really worried about you” sounds a lot better than “you have a problem”. Focus on how much you care, rather than what the other person is doing wrong. It can be the difference between a person seeking help and a person leaving treatment. This becomes even more important when dealing with an angry individual. Facing a conversation with someone that may be in denial can be nerve-wracking, which is why it is so important to come from an angle of love and compassion.

PROPER COMMUNICATION

While we always advocate for professional medical intervention, learning how to communicate with someone who is misusing substances can increase their potential to be heard.

AVOID CONFRONTATION

A calm and collected dialogue should be sought when
talking to someone about their substance use disorder.
Confrontation and accusation will NOT create a safe place
for anyone. Instead of “you are _____”, use phrases such
as “I feel”, “I have noticed”, or “I think”. Chances are, the
person who cannot stop using substances knows that
what they are doing is maladjusted. They’re usually very
aware that the road they are walking down is not the
smartest. Focus on the actual hard facts and describe
your own emotions within the 1-5 emotional range.

SET SOLID BOUNDARIES

If you set a boundary, make sure everyone in the family/-
support network is on the same page. Even the most
effective boundary can be lost in the meaning of what you
communicate. If family members and loved ones are not
on the same page, even a straightforward boundary can be
lost. The only thing you can control is your own actions
and reactions towards your loved one. For example, if you
state that you’ll no longer support your teenager unless
they go to a therapist/institute, make sure that you are
prepared to stick to the boundary.

DISCUSS THE FUTURE

Since the frontal cortex is partially shut down during
active addiction, someone who is suffering from
substance use disorder is probably not thinking about the
future consequences of their actions. Describe your fear
of future worsening, as your loved one is probably only
thinking about the next fix.

COMMIT TO COMPASSION

The road to recovery can be grueling, which is why a
commitment to communication and compassion are key if
you want a loved one to seek help. A brain with active
substance use disorder and a brain with a healthy level of
functioning look very different. Always remember that you
are dealing with a brain disease.

SUBSTANCE USE DISORDER AND MENTAL HEALTH PROGRAMS IN NORTH CAROLINA

The Blanchard Institute offers a safe, comfortable environment for patients and their families to be emotionally connected to their
treatment provider. Our comprehensive treatment plans are highly individualized and treat a variety of mental health disorders, including
substance use disorder. Our compassionate team of counselors, medical practitioners, and therapists will be with you every step of
the way.

We believe that there is a great deal more to recovery than abstinence. In fact, putting down the substance is just the first step. We treat
the underlying issues of substance use disorder to ensure a life-long recovery from addiction. For the best North Carolina dual diagnosis
treatment program, contact The Blanchard Institute today!

contact us today