More than 20 million Americans were diagnosed with substance use disorders in 2022. Addiction is a mental illness, and substance use can have devastating consequences for patients and their families. If you’re trying to help a loved one with a substance use disorder, you may be feeling frustrated, anxious, and exhausted. You might be wondering how to talk with your loved one and how to help him or her accept treatment.
People with substance use disorders go through a process of change before, during, and after treatment. This guide will help you learn more about the stages of change and the trouble with denial. It will also help you support your loved one and it may answer any questions about addiction treatment you may have during their journey to sobriety.
What Are the Stages of Change?
During treatment for substance use disorders, clients typically go through six stages of change. Psychologists have categorized the stages using the following framework:
As the name suggests, the pre-contemplation stage occurs before the client is aware that his or her substance use is a problem. Generally, clients in the pre-contemplation stage tend to think that their substance use is normal, and they may feel that their substance use is beneficial. They aren’t able to see the harm involved with substance use.
During the pre-contemplation stage, clients have no interest in changing their behaviors. They have no intention of altering their substance use patterns, and they haven’t made any plans to change.
When clients enter the contemplation stage, they start to consider making changes to their substance use behaviors. Even though they continue to display harmful behaviors, they feel uncertain about their substance use patterns, and they are starting to recognize the negative impacts of their substance use.
In this stage, clients recognize that their substance use is more harmful than helpful. They accept the downsides of substance use, and they believe they need to change. During the preparation stage, many clients want to change as quickly as possible. Within 12 months of entering this stage, they may make lots of unsuccessful attempts to change.
Clients with substance use take action to change their behavior patterns during this stage. It usually lasts for up to six months, and most clients seek therapy or rehab services at this time. When clients attempt to become sober, they may try out lots of new behaviors. These new behavior patterns could feel unfamiliar to them, and they might feel insecure. At this stage, the new behaviors haven’t become habits, and relapses are common.
Once clients reach the maintenance stage, they have made successful, sustained commitments to sobriety for at least six months, and they practice healthy behaviors as part of their recovery. They are able to cope with concerns in constructive ways, and they strive to use positive coping mechanisms for the rest of their lives. A relapse prevention plan is part of this stage, and clients focus on avoiding exposure to high-risk situations.
Clients at the termination stage are able to completely resist the temptation to use substances. They experience confidence, self-control, and a healthier life, and they pursue meaningful activities that give them a sense of purpose and fulfillment. At this stage, clients couldn’t imagine going back to their substance use behaviors.
As clients move through the stages of change, they may relapse. A relapse can occur at any stage. For example, an individual in the contemplation stage may move back to the pre-contemplation stage, and someone in the maintenance stage may move back to the action stage.
Why Is Denial in Addiction So Common?
Denial is a coping mechanism that prevents people from feeling fear or anxiety, and it is especially common in people with substance use issues. People who are struggling with substance use may be afraid to change, and they often struggle with feelings of shame and worthlessness.
The idea of confronting these feelings could be terrifying, especially if individuals with substance use issues believe that there is a stigma associated with getting treatment. As a result, clients are likely to deny that they have a problem. Some research suggests that substance use impairs a person’s sense of self-awareness and insight, and this impairment can result in denial.
What Are Some Examples of People in Denial About Their Addiction?
People in denial often try to rationalize their behavior. For example, they may minimize the severity of their substance use. They could have unrealistic beliefs that they won’t experience any negative consequences from their behaviors, and they might use avoidance mechanisms. In addition, people in denial could overestimate or underestimate their abilities to control their substance use.
Here are some common phrases you may hear from individuals who are in denial:
- I only do it two nights a week.
- It’s not a big deal.
- I’ve never been violent, so I don’t have a problem.
- I’ll just have one drink.
- I’ll go to the party, but I won’t drink or do drugs.
- I just do it to relax.
- I’ve got everything under control.
- I can stop when I want to.
- It doesn’t affect anyone else.
- It’s just a social thing.
How Should I Talk to an Addict in Denial?
To talk with an addict in denial, experts emphasize that it’s important to begin with a desire to support and help the person.
In addition to considering what to say to an addict in denial, it’s essential to plan the timing of the conversation carefully. Choose a time when you’re not feeling angry or judgemental. If you can, try to pick a time when the other person is likely to be relaxed and calm. Most importantly, make sure that you avoid having this conversation during a time when the other person is impaired or under the influence. Wait until they’re sober to start this chat.
What Should I Say to an Addict in Denial?
When you’re planning an intervention or what to say to an addict in denial, consider following this outline:
To have the best chance of a productive conversation, begin by asking for the other person’s permission to discuss his or her substance use. You could say, “Would it be okay if we talk about something? I’ve seen you struggling, and I want you to know how much I care about you and how much I want to help. I hope you’d help me if you noticed I was struggling, too.”
You could also try, “Could we chat for a few minutes? I’m worried about you, and I’d like to get your thoughts on the situation. Or, you may want to use, “Would you be open to talking with me about your substance use? I’d like to understand more so that I can help.”
Mention specific behaviors that are problematic. For example, you might say, “I saw that you didn’t feel well after you used drugs last weekend.” You could say, “I noticed that you passed out after we went to the party”.
For the other person to be receptive to your help, it’s beneficial to use statements that convey concern and respect. You may want to start by saying, “I care about you, and I want to help you through this. You’ve always helped me through my struggles, and I want to support you now.”
If the person has helped you through difficult times in the past, you could mention some specifics about how he or she helped you. You could express gratitude for his or her help, and you could mention that you’d like to be a source of strength for the person at this difficult time.
Although you want to support the person in denial, make sure that you set healthy boundaries to protect your own well-being. Let the addict in denial know that you won’t enable his or her substance use and that you won’t be around when substance use is taking place.
You might say, “Your substance use is really concerning to me, and I don’t want to support that behavior. I won’t be around when you’re using, and I can’t cover for you when you miss work or family events. I’m happy to see you when you’re not using. If you ever want to go to a recovery meeting, I’ll go with you.”
To conclude the conversation, ask the person for his or her thoughts on how you can provide support. If the person doesn’t have any ideas on this, you may want to offer suggestions. It’s a good idea to mention therapy and other treatment options at this time.
For example, you could suggest researching treatment options together, attending a support group together or hanging out together in a substance-free environment. In addition, you could offer to accompany the person to an appointment with a doctor or mental health professional.
What Should I Avoid Saying to an Addict in Denial?
When you talk with an addict in denial, it’s helpful to avoid using accusatory language, shame and blame. Substance use disorders are mental illnesses; they aren’t character flaws. If a person with substance use issues feels that he or she is being accused, shamed or blamed because of addiction, this could push the person away and prevent him or her from seeking treatment.
To avoid language that could be inflammatory, you may want to use “I” statements. You can use these to talk about how the person’s substance use makes you feel. For example, you could say, “I’m really worried about you.” When you start your statements with “I,” the person is less likely to feel ashamed or alienated during the conversation.
How Can I Help Someone With Substance Use Issues Find Treatment?
When you’re trying to help a person with substance use problems find treatment, it’s important to seek out professional care. While community support meetings can be very beneficial for people in recovery, most individuals will require inpatient or outpatient rehabilitation to make a full recovery. For example, they may need medication to help with withdrawal and maintenance, and they might need to have several types of psychotherapy.
If you’re helping a person with substance use in the Illinois area, you may want to consider the treatment options at Northern Illinois Recovery Center. We provide treatment for alcohol and drug addiction, and we have sober-living homes that clients can use after they complete their treatment. To learn more about our services, contact us by phone or online. We can help you with insurance verification and admissions, and we’re honored to be part of your journey.