Information for family and friends of people with substance use disorder

You are likely here because someone you care about and love may be struggling with substance use disorder (SUD).

SUD affects family and friends in addition to the person with the disorder. It’s normal to feel frustrated or sad about the impact on your loved one and to want to help and support them on their recovery path.

A few key things that all friends and family members should know:

  • SUD is a real health condition.
  • Everyone’s recovery path and timeline are different.
  • Evidence shows that for opioid use disorder (OUD), medications like buprenorphine and methadone are the only treatments that can lower someone’s risk of dying from opioid overdose.
  • If someone is doing well on their current treatment, support what’s working!

Below you’ll find information and tools to help you better understand SUD, especially OUD and stimulant use disorder (StimUD), and the treatment options that are available.

Ready for treatment and/or recovery supports?
Contact the WA Recovery Help Line.

Understanding substance use disorder (SUD) 

SUD is a medical condition that affects how the brain works. It makes it hard for a person to control their use of drugs or alcohol, even when it causes problems in their life. For some people, drugs hijack the brain’s natural reward system, making drugs or alcohol the most rewarding thing in a person’s life.

SUDs can be mild, moderate, or severe, and they affect everyone differently.

What about opioid or stimulant use disorder?

Two common types of substance use disorders are:

Each type of use disorder affects the brain and body in different ways and may require different types of treatment.

Why can’t they just quit? Did I do something wrong?

It’s normal to feel scared, frustrated, or helpless when someone you care about is struggling with substance use. You might wonder why they can’t just stop—or if it’s somehow your fault. But SUD is a chronic health condition, not a choice or a failure of willpower.

People with SUD may return to use (sometimes called a “relapse”), but that doesn’t mean they’ve failed. It may mean they need more support or a different kind of care.

Stigma—feeling judged or ashamed—can make it harder for people to seek help. Being kind, patient, and informed can make a big difference.

Learn more

Treatment options

Treatment options for opioid use disorder (OUD)

There are safe, effective treatments for OUD:

  • Medications for opioid use disorder (MOUD)—like buprenorphine and methadone—are the most effective treatments.
  • High quality counseling, such as cognitive behavioral therapy, can benefit some people.

Learn more

Get help now: Washington Recovery Help Line

What are the best treatment options for young people who use opioids?

Young people with opioid use disorder can benefit from the same medications used for adults. These treatments are safe and effective when used under medical supervision.

Learn more

Get help now: Washington Recovery Help Line

Treatment options for stimulant use disorder (StimUD)

There are safe, effective treatments for StimUD:

  • Behavioral treatments like contingency management, exercise therapy, counseling, and peer support are effective.
  • While there are no FDA-approved medications for StimUD, there are medications that may help people as they cut back on their use. Medications that health care providers may offer include:
    • Bupropion, mirtazapine, or long-acting injectable naltrexone plus bupropion may be used to help people who are trying to stop and/or reduce methamphetamine use.
    • Topiramate, bupropion, disulfiram, modafinil, or long-acting amphetamines may be used to help people who are trying to stop and/or reduce cocaine use.
  • Some people may benefit from treatment for co-occurring mental health conditions.
  • There are also other ways to support the health of people who use stimulants beyond treatment for stimulant StimUD.

Learn more

Get help now: Washington Recovery Help Line

What about counseling?

Counseling and peer recovery support can play a key role in treatment and recovery.

Options include:

  • High quality individual or group counseling, like cognitive behavioral therapy (CBT)
  • Peer recovery support, such as SMART Recovery
  • Behavioral therapies like contingency management
  • Support for co-occurring mental health conditions

Learn more: Counseling and Recovery Supports

Get help now: Washington Recovery Help Line

Supporting a loved oneA parent hugging their adult child to show them care and support

When it comes to supporting someone with SUD, you don’t have to have all the answers. Just being there—without judgment—can be powerful.

Here are a few ways to help:

  • Start the conversation: “I’m worried about your use” can open the door.
  • Be curious, not confrontational.
  • Stay connected.
  • Affirm the positive.
  • Offer hope.

Adapted from Dr. K. Michelle Peavy’s article: How to Ask if They’re Getting Addicted

Learn more about talking to teens and young adults: Talk Even If | WA Friends for Life

Safety planning

It’s essential to help people who use substances be as safe as possible and to provide honest, nonjudgmental support.

If needed, share resources & information:

Naloxone is a medicine that can reverse an opioid overdose. Friends and family should know how to use it.

Learn more about how to support a loved one following an overdose: Toolkit for Friends and Family (WA HCA)

How can I support a young person who uses substances?

For people of all ages, connection is key. Many people in recovery say that having someone who didn’t give up on them helped them keep going.

Most young people may feel shame or try to hide their use. This can be dangerous—especially if they’re using opioids alone, because in the event of an overdose, there is no one there to help. Staying connected, even while setting boundaries, can help keep them safe.

Learn more: Supporting the Health of Youth Who Use Fentanyl/Opioids – A guide for family and friends | Parenting Toward Recovery (Partnership to End Addiction) | Talk Even If (Public Health-Seattle King County)

Taking care of yourselfA person at home drinking tea on their couch with a cat curled in their lap and a journal

Supporting someone with substance use disorder can be emotionally exhausting. It’s important to care for your own well-being too:

  • Learn about SUD and treatment options
  • Set and communicate your boundaries
  • Talk to others—friends, professionals, or support groups
  • Pay attention to your own mental health
  • Practice self-care and stay safe

Learn about CRAFT (Community Reinforcement and Family Training)

CRAFT is a proven approach that helps families support a loved one’s recovery while also taking care of their own well-being. It teaches communication skills, how to set healthy boundaries, and ways to encourage positive change—without confrontation.

You matter, too.

More information about CRAFT: Center for Motivation & Change | Family Support – Partnership to End Addiction | Helping Families Help

Resources for well-being

Readings

  • Beyond Addiction by Jeffery Foote, PhD; Carrie Wilkens, PhD; and Nicole Kosanke, PhD of the Center for Motivation and Change, with Stephanie Higgs

Podcast

Resources

Substance-related information  

Finding care in Washington 

  • Washington Tele-buprenorphine Hotline: (206) 289-0287

Emotional support for family, friends & concerned significant others 

  • CRAFT – Tools for communication and behavior change

Advocacy and education