How to Talk to an Addict on the Fence About Treatment

This article featured Donny Martinelli, our former Director of Admissions. Meet Zack Traynor, our new Director of Admissions here!

A person addicted to drugs or alcohol is often the first to recognize they need treatment. This clarity can be a turning point, but it’s often fleeting. The nature of addiction is such that within hours of admitting to yourself that you need to go to rehab, you’re back at the bar drinking again or using drugs.

Family members often call FHE Health for help when they see their loved one in this painful limbo (between acknowledging they have a problem and choosing to go to rehab). In addition to offering expert advice about how to talk to an addict, our counselors regularly provide the added layer of outside guidance and support that most families need to successfully convince their loved one to get treatment. (If you’re having trouble convincing someone to seek treatment—please call our treatment helpline right away. All of our counselors are in successful, long-term recovery, know what it’s like to be on the fence about treatment, and are able to successfully reach people who are in this place.)

Director of Admissions Donny Martinelli manages our team of counselors. He’s regularly consulted about ways to convince family members or friends to go to treatment. In a recent interview, he shared tips about how to talk to an addict, what to say to them if they’re in denial, and why the once-popular notion of how to “confront” an addict is really not helpful or persuasive for someone who is unsure about rehab….

Convincing Someone to Seek Care – What to Avoid

The moment when you approach someone about their drug or alcohol problem (and the need to seek treatment) can be very emotional—understandably so. The stakes are often high: The person might be persuaded to go to rehab or might not; and, in the worst-case scenario, they could turn their back and walk away, into potentially deeper addiction.

These pressures can make it a scary prospect to convince someone to seek care. With a little preparation about what not to do, though, the encounter doesn’t have to be so scary. Martinelli emphasized “the thing that families have to stay away from” is judgment and criticism. Questions like “‘Why do you do this?,’ ‘How did you end up here again?’—all the things like who, what, when, where, whys—all that does is bring on shame, which brings on defense from an addict,” Martinelli said. “The more you shame us, the more we’re going to retaliate in anger or clam up and not say anything.”

Don’t “Confront” the Addict – Ways to Talk About Someone’s Addiction

Like shame-inducing questions that can push someone away from treatment, the old adage that you “confront” an addict is actually counter-productive, Martinelli continued: “If you get condescending or criticizing, they are going to close up nine times out of 10.” As someone who recovered from alcoholism more than 20 years ago, he went on to share from personal experience what it was like to be on the receiving end of these sorts of interrogations.

His advice: “Confrontation sounds angry and judgmental. You have to approach it from concern, so it’s not so much a confrontation but—if you’re a spouse—‘Hey, this is the person I fell in love with and something is changing you.’ Then you’re not shaming them.” (Martinelli explained that the stigma attached to addiction can quickly make it feel to an addict like people are shaming them.)

When you’re coming from a place of love and care rather than confrontation, tell your loved one you’re concerned about their health, based on the behaviors you’re seeing, Martinelli said: “Point out the behaviors that rationally aren’t something you’d do [if you were not addicted] … You don’t want to be mean or vindictive—just give observations of what you see happening, and maybe that opens up the addict’s eyes to see ‘I’m not doing that anymore.’”

Some examples of behavioral observations you might make, according to Martinelli:

• “You look like you’ve lost 20 or 30 pounds.”
• “You used to make your hair perfect and cared about how you look but now you don’t even wear makeup.”
• “You’re awake and the light in your room is on all night long, so I’m worried about your health since you’re not sleeping at all.”
• “You’re driving under the influence with your children in the car.”
• “You leave the house and don’t come back for days.”
• “After drinking, you become depressed and can’t function for days.”

In other words, “You have to walk the person through the behaviors that are endangering them,” Martinelli said.

He also recommended writing a script ahead of time for what you want to say and referenced those emotionally dramatic interactions in the show “Intervention” as the perfect example of what to avoid. “When you go in with no script, everyone’s angry. This [conversation] can’t be that kind of emotional thing,” Martinelli said. “Sometimes it’s better to write down what you want to say and read it, because that gives you a better opportunity to control your emotions and avoid going off a different road.”

How an Outside Expert Can Help

Hopefully, it’s a choice to go to treatment. (Martinelli pointed out that when someone is forced to go to treatment, they usually aren’t engaged in the treatment process.) But when a person is struggling with drugs or alcohol, “someone coming and telling you that you have a choice doesn’t mean anything. Inside the head of an alcoholic, it’s, ‘Well, if I really had a choice, do you think I’d be doing this?’ It doesn’t feel like a choice,” Martinelli explained.

It’s also frequently true that “the addict knows they need help—they know better than anybody truthfully. They just don’t know what to do, so the guidance has to come with a firm but loving hand.”

This guidance is where an outside expert can be especially helpful. Recalling his own experience with alcoholism and the process that led him to choose treatment, Martinelli said he knew he needed help, only didn’t know what to do and wanted to be told.

Another reason to consult outside expertise rather than go it alone when a loved one has a drug or alcohol problem: “An addict/alcoholic—they believe strangers more than their family, because none of that shame or guilt is involved. This is just a person with a shared experience, so it’s much easier for us, sometimes, to believe the outsider.”

Note the mention of “a person with a shared experience.” Martinelli said it’s much harder for an addict in denial to make excuses or say “you don’t understand” to someone who has been in the same shoes. This way “when the addict/alcoholic puts up their denial, [the counselor] can call it what it is. What are you going to say to them—’you don’t understand?’ I absolutely understand.”

Another advantage to consulting an outside expert with recovery experience (like a FHE counselor) is that “everyone in here has that experience, so they share their own experience from going to treatment (how that came about, how it worked out, how their lives are today) and they have a distinct advantage that way.”

The Importance of a Follow-Up Plan

It’s very important to have a follow-up plan in place before talking with an addict who’s on the fence about treatment. In the event that they say they want to go to treatment they’ll need immediate support connecting with a treatment center. This window of time right before they enter rehab is especially critical. An addict can have a change of heart quickly. In the absence of a clear plan about where to go for rehab or a smooth hand-off to the treatment center, drugs and alcohol can seem like the better option after all.

If someone you love is addicted to drugs or alcohol, and you need assistance with a follow-up plan or other steps, we can help. Call us today to learn how.