How to Recognize When a Family Member May Be Struggling With Opioid Addiction and How to Help
-
Warning signs of Opioid Addiction
How to Approach a Family Member Struggling With Opioid Addiction and Help Them Accept Treatment
If They Say Yes to Help
If They’re Not Ready Yet
Final Thoughts
-
If you or a loved one is struggling with opioid use and addiction, please call 6063934632 to schedule an assessment.
Opioid addiction often begins subtly. Families may not notice the signs until the situation becomes serious. Early recognition saves lives.
Summary:
In this article, Dr. Rose O. Uradu, Medical Director, draws on years of frontline experience caring for individuals and families affected by opioid use disorder. She explains how addiction often develops quietly, outlines the behavioral and physical warning signs families may notice first, and offers clear guidance on when concern should turn into action.
Warning Signs of Opioid Addiction
Behavioral Warning Signs
• Losing interest in routines or responsibilities
• No longer meeting work obligations or responsibilities, or declining school grades
• Taking medication more frequently than prescribed and running out of medication early
• Doctor-shopping or frequent refill requests
• Driving or engaging in other risky activities while under the influence of the drug
• Neglected appearance, including lack of interest in clothing, grooming, or personal appearance
• Changes in behavior, including major efforts to prevent family members from entering their room or being secretive about who their friends are
• Money issues, such as sudden requests for money without a reasonable explanation, discovering missing money, or noticing that items of value have disappeared from the home
Recognizing Physical Red Flags
• Pupils that are smaller than usual
• Slurred speech
• Drowsiness or “nodding off”
• Unexplained weight loss
• Frequent flu-like symptoms, which may be signs of withdrawal when they attempt to stop taking the drug
• Unexplained track marks or bruises
How to Approach a Family Member Struggling With Opioid Addiction, and Help Them Accept Treatment
Talking to a loved one about opioid addiction is one of the hardest conversations a family can face. Many people delay it out of fear. For example, fear of saying the wrong thing, fear of pushing the person away, or fear of what they might hear.
Yet, when done thoughtfully and compassionately, these conversations can open the door to life-saving help.
This guide explains how to approach a family member struggling with opioid addiction, how to increase the chance they acknowledge the problem, and how to encourage them to accept help—without shaming, threatening, or destroying the relationship.
First, Understand What You’re Really Up Against
Opioid addiction is not simply denial or stubbornness. It is a brain-based medical condition that affects:
• Insight and judgment
• Risk assessment
• Emotional regulation
• Motivation and decision-making
Your loved one may genuinely not see their use the way you do—or they may see it clearly but feel overwhelmed, ashamed, or terrified of withdrawal and life without opioids.
Resistance is usually fear, not defiance.
What Not to Do (Even Though It’s Tempting)
Many well-intended approaches actually make things worse. Avoid:
• Lecturing or giving long speeches
• Shaming (“You’re ruining your life / our family”)
• Ultimatums you aren’t ready to enforce
• Comparing them to “worse” addicts
• Arguing about whether they’re “really addicted”
• Having the conversation when you’re angry or emotional
Steps for Approaches that Could Help
Step 1: Choose the Right Moment
Timing matters more than wording.
Best times to talk:
• When they are sober or less impaired
• After a concerning event (missed work, overdose scare, health issue)
• In a private, calm setting
• When there is enough time for a real conversation
Avoid talking:
• During intoxication or withdrawal
• In front of others
• In the middle of conflict
Step 2: Lead With Concern, Not Accusation
Start from a place of care, not diagnosis.
Use “I” statements, not “you” statements.
Examples:
• “I’ve noticed you seem really exhausted and overwhelmed lately, and I’m worried about you.”
• “I care about you, and I’m scared about what could happen if things continue this way.”
• “I’m not here to judge you—I just want to understand what you’re going through.”
Step 3: Describe What You’ve Observed—Factually
Stick to specific behaviors, not labels.
Instead of:
“You’re an addict.”
Say:
“I’ve noticed you’ve been missing work, running out of your medication early, and sleeping most of the day. That worries me.”
Step 4: Expect Denial and Don’t Argue With It
If they say:
• “I don’t have a problem.”
• “I can stop anytime.”
• “It’s not that bad.”
Do not debate or try to prove them wrong.
Instead, respond with curiosity:
• “Help me understand how you see it.”
• “What do you think would need to happen for it to become a problem?”
• “What worries you most about changing right now?”
Step 5: Acknowledge Fear and Ambivalence
Many people are terrified of:
• Withdrawal
• Losing pain control
• Failing treatment
• Being judged
• Life without opioids
You can say:
“I imagine part of you wants things to change, and part of you is really scared. That makes sense.”
Step 6: Offer Help, Not Control
Instead of telling them what they must do, offer options.
Examples:
• “Would you be open to just talking to a professional and asking questions?”
• “We could explore treatment together—no commitment yet.”
• “There are treatments that help with cravings and withdrawal. You wouldn’t have to do this alone.”
Step 7: Be Prepared With Realistic Treatment Options
Vague suggestions (“You should get help”) are less effective than concrete ones.
Helpful preparation includes:
• Knowing local treatment providers
• Understanding medication-assisted treatment (buprenorphine, methadone, naltrexone)
• Being ready to help with logistics (appointments, transportation, childcare)
Step 8: Accept That Admission May Be Gradual
Some people don’t say:
“You’re right, I need help.”
Instead, progress may look like:
• Admitting they’re “not okay”
• Agreeing to talk to someone
• Asking questions about treatment
• Accepting naloxone
• Agreeing not to use alone
These are still wins.
Step 9: Set Loving, Clear Boundaries
Supporting someone does not mean enabling.
Boundaries may include:
• Not giving money that could fund drug use
• Not lying to cover consequences
• Protecting children and household safety
Boundaries should be:
• Calm
• Clear
• Consistent
• About your behavior—not controlling theirs
Step 10: Take Care of Yourself
Loving someone with opioid addiction is exhausting.
You may need:
• Counseling
• Family support groups
• Education about addiction
• Space to process fear, grief, and anger
You matter, too.
If They Say Yes to Help, Act Quickly
Motivation can be fragile and time-limited.
If they agree to treatment:
• Help schedule the appointment immediately
• Reduce barriers
• Stay supportive through the first steps
Early engagement saves lives.
If They’re Not Ready Yet
Keep the door open.
You can say:
“I love you. I’m here. When you’re ready, we’ll take the next step together.”
Final Thoughts
You cannot force someone to admit they have a problem but you can create the conditions where honesty, safety, and hope become possible. Recovery often begins with one calm, compassionate conversation.
We’ll talk more soon on the next blog.
Until then, stay safe
