Substance misuse

Learn how substances such as alcohol and other drugs can be misused and ways you can support someone who's struggling.

Topics illustration alt

Also in this topic

Understanding substance misuse and how you can help

Is someone you care about currently misusing substances? Your support can play an important role in helping them cope and feel better.

It’s common to feel stuck between wanting to help and not knowing how. Even if you don’t know where to begin, or what will help, often simply being there for them can mean a great deal.

Caring for someone with a substance misuse problem can be really challenging. It’s common to feel worried, frustrated and alone, but remember there are support services available specifically for carers.

On this page you will find practical steps you can take to support someone with a substance misuse problem, ways to look after yourself, and support services to help.

Caring for someone struggling with substance misuse or addiction can be challenging, tiring, and sometimes frustrating. It’s really important to remember:

  1. Ultimately, we can’t always help someone else. You might try your best and do everything you can without them improving, and that’s not your fault or your failure.
  2. Some people might not want help, or not be ready for it, and that’s their choice to make. Sometimes the best you can do is to let them know you’re there if they change their mind.
  3. Always remember to look after yourself. You can’t pour from an empty cup, so being aware of your own needs and practicing self-care should always come first.

How can you recognise substance misuse?

Substance misuse can look different for everyone, and isn’t always easy to spot from the outside. For some substances (ie prescription medication) the line between normal use, and substance misuse, can be blurry.

Substance misuse can also be a symptom of other mental health problems, or more general challenges in life.

The question is not why the addiction, but why the pain?
Dr. Gabor Maté

Some of the signs your friend or family member might be struggling with substances include:

  • Changes in their mood or behaviour
  • Prioritising their use over family, relationship, work or school commitments
  • Expressing guilt and shame about their use, or their behaviour when under the influence
  • Spending money on the substance even when they can’t afford it
  • Making sure they never run out of the substance
  • Continuing to use the substance even if it causes problems in relationships
  • An inability to stop using the substance
  • Disconnecting from others, or isolating themselves
  • Acting paranoid or manic.

If you notice these changes in your friend or family member, it may be time to check in with them.

If you are unsure if someone you know is experiencing substance misuse, we have more information about understanding what it is here. If you’re still unsure about whether you should offer support, it’s usually best to simply ask the person if you can help, in a non-confrontational and non-judgemental way.

How to help

It’s common for people to reach for substances as a way to escape or soothe different types of pain. That pain could be physical, it could be related to painful memories or experiences, or come as a result of difficult life situations and circumstances.

When helping someone struggling with substances, it can be helpful to try to empathise with the underlying causes of their distress, rather than to assume that the substance or addiction itself is the only problem. It’s natural for everyone to want to soothe their pain. You can read more about causes of substance misuse here.

Remember, most people will want to have control over their own life and make their own decisions, so it’s important to respect their choices and boundaries. It’s usually most helpful to play a supportive role through non-judgemental conversation, and helpful actions.

  • Start a conversation

    Often one of the most powerful things you can do for a friend or family member is to let them know that you’re there for them.

    Knowing how and when to have this important conversation can be tricky.

    Here are a few tips:

    • Try to create time for the conversation when they’re not under the influence. If you notice them using or consuming, it’s natural to want to chat right then and there, but it’s best to find a time when you can both chat sober.
    • Gently let them know that you care about them, and want to help
    • Try to stay non-confrontational, and non-judgemental. It might be helpful to share how their substance use has affected you (if it has), rather than making assumptions or drawing conclusions about them.
    • Listen and be curious about their experience. Give them space to share if they choose to. You can ask open questions such as ‘how are you feeling?’ or ‘what’s going on for you at the moment?’
    • Sometimes it can help to open up about your own experiences (not necessarily with substances, but perhaps with other things that are going on for them), which can ‘give permission’ to your friend or family member to also share. Being vulnerable can be hard, but it’s easier if you’re both in the same boat.
    • Rather than jumping to solutions, it can be helpful to ask what they need from you in that moment. You might ask something like ‘would you like me to just listen right now, or would you like help thinking about what you might do from here?'
    • Try to resist the urge to paint a silver lining, or minimise their concerns. Instead, it can be helpful to validate their experience by saying things like ‘it sounds like you are going through a really tough time right now’ or ‘that must be so difficult for you’.

    It can be common for people to become defensive or angry, or deny they have a problem. This usually stems from a sense of shame about their use. If this happens, it’s best not to argue, and to try and revisit the conversation later.

    It can also be helpful to focus on how their use is impacting you, and to try to separate their use or behaviour while under the influence, from who they are as a person.

Dr. Brené Brown explains how to be truly empathetic through getting in touch with our own fragilities.

  • Offer practical support
  • Support them to seek help

Looking after yourself and your own mental health

It can be really hard to support someone struggling with substances. They may require extra attention or specific support that especially impact the people around them. If you’re feeling overwhelmed, you are not alone, and there are support services available specifically for anyone who supports those with mental health issues (also known as a carer).

Remember that ‘you can’t pour from an empty cup’. The best way you can care for someone else, is to make sure you are okay first. Looking after yourself as a carer means being tuned in to how you’re feeling, and looking after yourself when you need to.

This might include:

  • Setting healthy boundaries

    When a friend or family member is struggling with substance misuse, it’s natural to want to help them in any way you can. That might include supporting them financially, taking care of their responsibilities or rearranging your needs (and the needs of other people you support).

    Although it might feel like you’re helping, this can end up shielding them from the consequences of their actions, and actually end up ‘enabling’ their continued use (not to mention the important effect on your own wellbeing).

    Setting healthy boundaries and saying ‘no’ to your loved one can be really challenging, but can also provide the motivation they need to seek help and change. Healthy boundaries might include:

    • Limiting the practical things you have time and energy to help with
    • Saying ‘no’ to providing financial help
    • Prioritising your needs, or the needs of other people you support
    • When, where and how you’re comfortable interacting with them.
  • Share your caring role
  • Talk to people with similar experiences

Actively practice self-care

  • Be kind to yourself

    Being kind to yourself while caring for others is really important. You might feel frustrated, stretched, or even powerless, but adding shame or guilt to those emotions by criticising yourself will only make you feel worse.

    It’s ok to reduce the expectations you’ve set for yourself, and to take a break when you need it.

  • Eating well
  • Getting regular exercise
  • Avoiding substances
  • Getting enough sleep
  • Getting out into nature
  • Developing a routine
  • Engage in your hobbies

Download our Care Guide for more tips on how to support your loved one through difficult times.

Was this page useful?

Your feedback helps us improve the service for people like you.

We'd love to hear why!