Family/friend doesn't want help
If someone you care about is experiencing an alcohol or other drug addiction but doesn’t want to get help, you might be left feeling defeated, frustrated, or distressed.
You may have tried having open and ongoing conversations with them but they’re not ready to seek professional support - or they might feel they don’t need it.
This could be because they’re worried about going through withdrawal, or concerned they’ll be stigmatised by treatment providers.1 They could be going through a stressful life event, or experiencing mental ill health, and using alcohol or other drugs to cope. They might even have completed a treatment program in the past but are now experiencing a relapse.2
There are different types of alcohol and drug use, and not all require treatment.
Use doesn’t necessarily mean someone needs help. In fact, a problem or addiction is better measured by how that use is affecting someone’s life, and the lives of those around them.
A drug addiction is generally when someone is unable to control or stop their use, even though it’s causing harm.2, 3
Is involuntary treatment available?
Involuntary treatment isn’t available in Australia apart from restricted court run programs in Victoria and NSW.
This is because detox or in-patient services generally aren’t effective if the person is not motivated and ready to seek help. Involuntary treatment can also cause further physical or psychological harm and take away from a person’s human rights.4-6
Although you want the peron you care about to get better, they must be ready and willing to seek help – you can’t make this decision for them.
Offering support
Even if someone isn’t ready to get help now, they might be in the future. Let them know if they change their mind, there’s help and support available.
And, if they’ve previously completed a rehabilitation or other treatment program and didn’t have a good experience, or have since lapsed or relapsed, let them know there are many other options out there.
People who experience addiction often move between different ‘stages of change’.
This means sometimes they might be more motivated to try treatment than at other times.7 You can talk to an alcohol and other drug treatment service about how to encourage and support the person you care about motivation.
To find local services call the National Alcohol and Other Drug Hotline on 1800 250 015.
Understanding addiction
It can help to understand more about the complex nature of alcohol or other drug addiction.
Addiction can affect people from all walks of life, and no one chooses to become addicted to alcohol or other drugs. It’s both psychological and physical, and affects behaviour and self-control.3
Common addiction risk factors include:
- experiences of poverty
- experiences of trauma or abuse
- drinking or using drugs from a young age
- having a parent or family member with a dependence
- lack of parental supervision as a child
- mental ill health
- overall low quality of life.3,8,9
You can find out more about why people use drugs here, and get info on specific drugs on the Drug Facts page or via Text the Effects.
If the person you care about is continuing to use alcohol or other drugs, there are ways to minimise some of the negative health impacts.
Try to encourage them to reduce harm by:
- Visiting their GP: getting a regular heath checkup can help detect and treat any underlying health issues, or vitamin deficiencies such as low levels of vitamin B1 (Thiamine) which can result from excessive drinking.
- Using safe injecting equipment: for people who inject drugs, safe equipment can reduce the risk of blood-borne viruses such as hepatitis C. You can find a Needle and Syringe Program here or by calling the National Alcohol and Other Drug Hotline.
- Carrying naloxone: naloxone can temporarily reverse an opioid overdose, such as from prescription painkillers or heroin. You can access naloxone at participating pharmacies, or with a GP prescription. Find out more here: Where to access naloxone.
- Accessing pharmacotherapy: this is an option for people addicted to opioids. It involves taking a legally prescribed substitute medication to reduce cravings and withdrawal symptoms.
- Not driving or operating heavy machinery: driving while over the legal blood alcohol limit, or drug affected, can put them and others at risk of harm. And if caught by police they may be fined or charged. Try to get them to use other forms of transport instead if intoxicated.
- Not injecting alone: people in Melbourne or Sydney who inject drugs can visit a Medically Supervised Injecting Centre (MSIC). These centres save lives by responding to overdoses that occur onsite. They also link people to other health services.
- Avoiding risky combinations: some combos are riskier than others, such as mixing opioids and alcohol. Let the person you care about know about the Drug Facts page as a good place to get more info.
If you suspect someone is experiencing an overdose call triple zero (000) immediately - paramedics aren’t required to involve police unless they feel threatened.
If you’re concerned for someone’s general wellbeing and can’t reach them, you can request a police welfare check by calling triple zero (000) or contacting your local police station.
For more tips on reducing harm, visit Hi-Ground’s website.
By establishing boundaries with the person you care about you can promote accountability and respect, maintain your relationship, and manage conflict.
Even if it’s challenging in the beginning, maintaining boundaries can help improve the wellbeing of you, your family and the person you care about in the long-term.10
Communicate your boundaries when the person you care about isn’t intoxicated, try to find a calm time to sit down and talk. Avoid making threats or blaming them, instead focus on what the consequences are if they treat you in a way that’s unacceptable to you.
Clearly state your boundaries and try to be consistent when implementing them.
Your boundaries might include:
- behaviours you will, or won’t tolerate
- rules regarding drinking or drug use in your home
- whether you will give or lend the person you care about money or provide financial support
- if you allow them to have visitors to the family home
- time limits for when you’re available – such as not answering calls after a certain time to ensure you get a full night’s sleep.10, 11
Whatever boundaries you choose, make sure you are comfortable with them and they’re realistic for the person you care about and the situation. Boundaries also vary depending on the type relationship you have with someone - rules and limits for a teenager will look quite different to those for an adult relative or partner.12
It’s important to take care of yourself while supporting someone you care about.
Self-care strategies include:
- Looking after your physical and mental health by eating healthy and staying active.
- Talking and socialising with supportive family and friends.
- Continuing to engage in activities such as a hobby you enjoy.
- Seeking professional support through your GP, mental health professional or family support group (listed below).
- Practicing mindfulness to help manage stress and anxiety.
- Taking a break from supporting the person you care about if you feel you need some space. Let them know when you’ll be available again, but right now you need some time to yourself.
Help and support
Support services provide practical help, information and support to families, partners and friends affected by a someone you care about's substance use.
There are help and support services available in each state or territory:
- Family Drug Help VIC, SA, TAS: 1300 660 068
- Family Drug Support NSW, QLD, NT, TAS: 1300 368 186
- Parent and Family Drug Support Line Perth metro: 08 9442 5050, WA regional: 1800 653 203
- Relationships Australia: 1300 364 277
- Breakthrough for Families Queensland
- Family and Friends Support Programs
- Breathing Space
- Bergstein RS, King K, Melendez-Torres GJ, Latimore AD. Refusal to accept emergency medical transport following opioid overdose, and conditions that may promote connections to care. The International journal on drug policy [Internet]. 2021 [17.02.2023]; 97:[103296 p.].
- el-Guebaly N, Carrà G, Galanter M, Baldacchino AM. Textbook of Addiction Treatment International Perspectives. Cham: Springer International Publishing AG; 2020 [17.02.2023].
- National Institute of Drug Abuse (NIDA). What Is drug addiction? 2020 [13.02.2023].
- Pilarinos A, Barker B, Nosova E, Milloy MJ, Hayashi K, Wood E, et al. Coercion into addiction treatment and subsequent substance use patterns among people who use illicit drugs in Vancouver, Canada. Addiction [Internet]. 2020 [10.02.2023]; 115(1):[97-106 pp.].
- Werb D, Kamarulzaman A, Meacham MC, Rafful C, Fischer B, Strathdee SA, et al. The effectiveness of compulsory drug treatment: A systematic review. International Journal of Drug Policy [Internet]. 2016 [10.02.2023]; 28:[1-9 pp.].
- Chase J. The Ethics of Compulsory Treatment of Addictions Under Canadian Legislation: Restricting Freedom to Promote Long-Term Autonomy? Canadian Journal of Addiction [Internet]. 2020 [10.02.2023]; 11(1):[6-13 pp.].
- DiClemente CC, Schlundt D, Gemmell L. Readiness and stages of change in addiction treatment. The American journal on addictions [Internet]. 2004 [23.02.2023]; 13(2):[103-19 pp.].
- National Institute of Drug Abuse (NIDA). Genetics: The Blueprint of Health and Disease 2019 [13.02.2023].
- Nawi AM, Ismail R, Ibrahim F, Hassan MR, Manaf MRA, Amit N, et al. Risk and protective factors of drug abuse among adolescents: a systematic review. BMC Public Health [Internet]. 2021 [13.02.2023]; 21(1).
- Break Through. Ice Education for Families: Information and Resources 2019 [17.02.2023].
- Missouridou E, Segredou I, Esseridou D, Papadatou D. Routine care interventions with the parents of adult drug and alcohol users. Drugs: Education, Prevention and Policy [Internet]. 2019 [17.02.2023]; 26(3):[273-9 pp.].
- Nordgren J, Richert T, Svensson B, Johnson B. Say No and Close the Door? Codependency Troubles among Parents of Adult Children with Drug Problems in Sweden 2020 [17.02.2023].