What to do if an addict refuses treatment

Confronting the fact that a friend or a family member doesn’t really want to enter a recovery program in order to treat an addiction may leave you wondering what to do next. Just as treating an addiction is a process that needs to be very structured, it’s also important to take a structured approach to talk with anyone who might refuse treatment. More importantly, regardless of how an attempt to help them might turn out, you need to continue to be supportive to ensure that when the time comes for them to enter recovery, they’ll have people there to assist them.

Step 1: Acknowledge the Situation

When someone chooses to refuse treatment, it may raise some questions about whether they’re really an addict. People coping with drug or alcohol use disorders often can present very compelling arguments that they’re not in trouble. They may explain that they:

  • Only drink or get high to let off steam on the weekend
  • Insist that they’re highly functional
  • Are already cutting back their usage
  • Have fears they’ll lose their job if they are admitted to a treatment center
  • Need to be around to take care of their family
  • Will enter recovery after some big event, such as the holidays, a wedding, etc.
  • Won’t be able to afford rehab
  • Are worried about exposure to criminal charges

Rarely does a rational argument win out in these situations, so try to not dig in and make the discussion into a fight. The big thing is to recognize that you’re dealing with an addicted individual and you need to begin to take other steps to help them toward recovery. With the idea clearly framed, you’ll be able to confront other situations that might come up, such as if they beg you for money or need help making bail. This will ensure you don’t contribute more to the current problem.

Step 2: Learn More

Especially when dealing with an addict who refuses to seek help, it’s prudent to get educated about dealing with substance use disorders. You may also want to learn more about treating an overdose and obtain a supply of an antidote like Narcan if a loved one is using heroin or another opiate. It’s also wise to take a CPR course if you haven’t already been certified.

If you’re concerned that the person you care about is headed toward being charged with a crime, it’s also a good idea to talk with a drug law attorney. Conducting a consultation will give you a sense of how to address the situation if an addict is arrested. You can ask questions about things like the following:

  • Does your state offer any diversion programs?
  • Can someone charged with an offense still refuse treatment?

You’ll also want to get up to speed on the symptoms of different types of drugs, particularly if you’re not quite sure what the individual you’re dealing with is actually using. This is especially important to know if you’re worried that they’re engaged in mixed drug use, such as using cocaine to dial back the effects of heroin. Develop a written list of signs that your friend or family member is dealing with the misuse of specific drugs.

Step 3: Start Identifying What’s Going On

Having attained some degree of education about drugs and their symptoms, you should begin to figure out precisely what sort of situation your loved one is coping with. The first order of business is determining what drugs they’re actually using. Every drug has its own list of effects.

Someone who is using heroin, for example, might:

  • Seem out of it at times
  • Struggle to remember commitments
  • Withdraw from social life, especially interactions with non-users
  • Display medical issues, such as seizures or decreased breathing

On the flip side, a cocaine addict may be more likely to act:

  • Confrontational
  • Energetic
  • Twitchy
  • Violent
  • Panicky
  • Paranoid

You’ll also want to keep an eye for indicators that your loved one’s life is being disrupted by their misuse of alcohol or drugs. Regardless of the specific substance that might be abused, you may notice that they:

  • Aren’t grooming their hair as well as they used to
  • Haven’t bathed recently
  • Neglect to change their clothes
  • Try to hide their eyes by wearing sunglasses at inappropriate times
  • Disappear into the bathroom for unexplained reasons
  • Start forming friendships with people who use drugs

You may also begin to spot physical changes that are occurring, such as the phase that meth and cocaine users go through when they’re losing excess weight. As the addiction cycle continues, they’re likely to hit a point where they go from looking thin to downright scrawny.

By identifying the specific indications of a particular drug problem, you can start looking into treatment options tailored to the unique situation, such as dealing with someone who has a dual diagnosis. Even if they currently refuse treatment, it’s a good idea to have a recovery center in mind for when they come around. This will improve the chances they’ll get on board quickly during the period where they’re receptive to getting help.

Step 4: Get Them Medical Attention

Visiting a doctor and conducting a checkup may serve to give an addict a clearer picture of what they’re actually up against with a substance use disorder. This can frame the conversation in ways they might not have previously considered, such as learning about:

  • How much weight they’ve lost
  • Declines in motor skills
  • Diminished cognitive abilities
  • How their condition might continue to get worse
  • Toxicology reports
  • The effects of different drugs

It’s a good idea to give the doctor a heads-up about the situation before bringing an addict in for an exam. This will allow them to focus on a conversation that points your family member or friend toward recovery options. The experience may also provide better guidance regarding what specific drugs are being used.

Step 5: Stop Contributing to a Substance Use Problem

One of the more insidious aspects of addiction is that it compels people to seek money to fund their use. An addict may come straight out and ask for money, but they’ll often frame it as needing to cover rent or utility bills. Don’t assume that a presentation of bills is a legitimate reason for giving an addict money. It’s normal for a person with a substance use disorder to pay for drugs first, ask for money to cover bills and only then pay to keep the lights on. People with extreme addictions may be tempted to just buy more drugs.

An especially tricky aspect of this problem is that a user will often find ways around attempts to not contribute to their situation. You may try, for example, to directly buy something they need only to watch them turn around and sell it to convert into cash for drugs or alcohol. Friends and family often end up cutting addicts off completely in these situations.

It’s essential to make it known that you still care and that you’ll gladly help them if they need a ride to a recovery center. You don’t, however, want to put yourself in a situation where your finances are endangered because of their substance use disorder.

Step 6: Make a Clear Offer of Help

By this point, you should have collected a lot of information about the condition your loved one is in, what they’re using and which nearby treatment facilities are likely to offer suitable programs. At this stage, having acknowledged what the situation is and stopped contributing to it, you need to clearly state that you’re willing to help them get drug and alcohol counseling.

It’s normal for an addict to be emotional under such circumstances. You may be subjected to an outburst from them, or they might withdraw in the hope that non-engagement will kill the conversation. No matter what turn the discussion takes, you should:

  • Avoid being angry
  • Stay focused on the topic of recovery
  • Offer support
  • Refrain from being judgmental
  • Avoid escalating the situation with threats, such as saying you’ll call the police
  • Not use guilt
  • Remain encouraging

You should also try to avoid emotionally overcommitting to this moment. Many people with addiction issues don’t immediately jump in the car and go straight to rehab. With a little luck, they’ll understand, and you won’t eventually need to conduct a full-on intervention. You should, however, be prepared to provide steady friendship and support while they come to the conclusion themselves rather than being shocked if they refuse treatment. Knowing that you’ll be there to assist them in the process when the time comes will make it easier if they have a rock-bottom moment and decide to get help.

Step 7: Assess the Situation

Whether they refuse treatment or decide to go to rehab, you’ll need to assess where the situation stands. If they elect to go into recovery, you’ll need to make calls, set up an intake and provide transportation. Should they decide against entering rehab, you’ll need to start thinking about how to conduct an intervention.

Bear in mind that interventions don’t work the way they do on TV. A group of people don’t dramatically present an ultimatum and then watch as an addict emotionally caves. It’s often prudent to talk with a counselor at a treatment center, and it may be necessary to have a professional present to regulate the discussion during the intervention.

Step 8: Conducting an Intervention

Staging an intervention should take a couple weeks. You should be especially serious in thinking about who you invite to it. It’s critical that everyone who participates will be someone who can remain focused on the goal of directing the person to seek treatment. You don’t want to end up with people digging up old emotional wounds, screaming about unpaid debts and derailing the effort by providing anger or tears as conversational direction. If you have any doubts about the capacity of a potential participant to stay on point the entire time, do not include them.

Sort out everyone’s schedules to ensure they can be present. If possible, try to reserve a space that’s neutral, such as a conference room in a community center, in order to avoid reminders of emotional moments with the person you wish to help. You should also conduct a rehearsal in order to hear what everyone will say and place an emphasis on taking turns and staying on a defined script, even if your loved one tries to knock the intervention off course. Have contingencies in place in case the person decides to enter rehab right away, but be willing to accept that they may still refuse treatment.

Step 9: Following Through on Support

Helping someone get to a treatment center doesn’t mean your job is done. If they’re there on an outpatient basis, they may need rides back and forth. If they’re doing inpatient treatment, it will be helpful for visitors to come by regularly to check up on them. Someone should also be prepared to collect them when they’re done, and it’s important to have transportation for follow-up work, such as going to counseling sessions after completing treatment.

Recovery is a process, and it continues for years after the end of rehab. Don’t allow something that might feel like a major slip-up discourage you or your loved one, even if they’ve been clean for months. Remain supportive and keep a clear focus on what’s important: finding a path to a healthier and more stable life.