How to talk to someone about opiate use

When to raise it, words that help, words that end the conversation, and what to do if the answer is no.

Updated October 2026. Sources are linked on this page.

Illustration of a mother and her adult son walking side by side on a park path

The short answer

Best time: A calm, private moment when the person is not high, not in withdrawal and not in the middle of an argument.
What to say: Say what you have seen and how you feel, ask open questions, and listen more than you talk.
If they say no: Leave the door open, keep naloxone nearby and try again another day, because it often takes many conversations.

Pick a moment when they can hear you

The right words at the wrong time go nowhere. Someone who is high will not take much in. Someone in withdrawal feels too sick to think about anything except feeling better.

Look for an ordinary, quiet moment. A car ride, a walk or a morning coffee often works better than a sit-down talk, because nobody has to hold eye contact.

Choose somewhere private. Nobody opens up in front of an audience.
Go one to one if you can. A group can feel like an ambush.
Wait until you are calm yourself. If you are shaking with anger, it can wait a day.
Keep it short. Ten honest minutes do more than a two-hour argument.

If you are not sure what you are seeing, the page on signs of opiate addiction can help you put it into words first.

Words that help

SAMHSA’s guidance for families comes down to this: listen without judgment and speak with kindness. These are the pieces it recommends.

Ask open questions

Open questions cannot be answered with a yes or a no. They usually start with how or what. SAMHSA gives examples such as “How would you like things to be different?” and “What do you miss?”

Say what you see and how you feel

Start from your own side. “I found you asleep at the table twice this week and I was frightened” is hard to argue with. “You are out of control” is easy to argue with.

Show that you heard them

Repeat back what they said in your own words: “I heard you say you are scared of getting sick if you stop.” It tells them you are listening, and it clears up misunderstandings.

Name what is still good

SAMHSA suggests commenting on the person’s strengths. A list of everything they are doing wrong tends to close them off to asking for help. Thank them for talking to you, even if it went badly.

Words that shut the conversation down

	Instead of this	Try this
Labels	“You’re hopeless. You’ll never change.”	“I’m worried about how much you’re using.”
Blame	“Look what you’re doing to this family.”	“I miss you. I miss how things were.”
Demands	“You’re going to rehab, end of story.”	“Would you look at some options with me?”
Threats	“Stop or you’ll never see us again.”	“I can’t give you cash any more. I will drive you to an appointment.”
Prying	“Are you high right now?”	“How have the last few days been?”

Shame makes people hide, and hiding is dangerous with opioids. If the talk heats up, stop. Say “I love you, and we can pick this up later.” You have not failed. You have kept the door open.

Have one next step ready

If the person says “maybe” or “I don’t know how”, that is an opening. Offer something small and specific.

Offer to sit with them while they call a clinic, or to make the call yourself.
Have two or three places written down from the treatment directory for your state.
Know the money answer. Fear of the bill stops a lot of people, so read what treatment costs before you talk.
Tell them about medication treatment. Many people do not know that fear of withdrawal can be dealt with by a prescriber.

SAMHSA also suggests ending by summing up what you heard, asking how you can support them, and asking if you can check in again. If they are thinking it over, ready to stop is written for them.

What to do when they say no

Most people say no the first time. Some say no many times. SAMHSA is clear that it may take many conversations before someone gets help, and that you can let them know you will be there when they are ready.

In the meantime, keep them safer. Get naloxone and learn how to use it. Stay in touch.

A family approach with evidence behind it

There is a structured program for exactly this situation called Community Reinforcement and Family Training, or CRAFT. A SAMHSA treatment guide (TIP 64) describes it as an evidence-based approach for spouses, parents and siblings. It teaches family members clear, respectful communication and better self-care, and it has been shown to help people enter treatment while easing strain on the family.

Some counselors and family programs teach CRAFT. Ask about it when you look for support for yourself.

Why this page does not suggest a surprise confrontation

You may have seen staged “interventions” on television, with a room full of relatives and an ultimatum. This site does not recommend them. The public guidance for families points the other way: calm, private, honest talks, repeated as often as it takes.

If the person talks about wanting to die, call or text 988. If they cannot be woken or are not breathing, call 911. For free treatment referral at any hour, SAMHSA’s National Helpline is 1-800-662-4357.

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Questions people ask us

What if they deny there is a problem?

Do not argue the point. Say what you have seen, say you are worried, and leave it there. Pushing for a confession usually ends the talk. People often come back to a conversation days later, once they have had time alone with it, so let them know the door stays open.

Should we hold a family intervention?

This site does not recommend surprise, confrontational meetings. Public guidance for families favors private, respectful conversations and listening. A SAMHSA treatment guide describes CRAFT, a program that teaches family members clear and direct communication, as an evidence-based way to help someone enter treatment.

Should I talk to them while they are high?

It is better to wait. Someone who is high will not take in much, and a tense talk can turn into a fight. The exception is safety. If they are hard to wake or breathing slowly, treat it as a possible overdose, call 911 and use naloxone if you have it.

How many times should I bring it up?

As many times as it takes, with space in between. SAMHSA notes that it may take many conversations before a person gets help. Short, calm check-ins every so often work better than daily pressure. Between talks, keep things as normal and warm as you can.

Sources

This page is general information, not medical advice. Talk with a clinician about your own situation.

Need help right now?

Someone is not breathing: call 911 Crisis or thoughts of suicide: call or text 988 Free treatment referral, 24/7: 1-800-662-4357 (SAMHSA National Helpline)