Helping someone with opiate addiction

Families wear themselves out trying to manage things that were never in their hands. Sorting the two lists is a relief, even when it stings.

What is not yours to control

• Whether the person uses today.
• Whether they agree to treatment. SAMHSA says it plainly: you cannot force someone to get care.
• How fast recovery goes, or whether there is a return to use along the way.

What is yours to control

• How you speak to them, and how often you check in.
• What you know about treatment and what it costs.
• Whether there is naloxone in the house and whether everyone knows where it is.
• What you will and will not pay for, and what happens in your home.
• Your own sleep, health and support.

The second list is longer than most people expect.

Stay connected

People are more likely to ask for help from someone they still trust. That means keeping the conversation open, even when you disagree with what they are doing. SAMHSA’s advice is to listen without judgment, speak with kindness and expect that it may take many conversations.

The guide on how to talk to someone about their opiate use has words that tend to help and words that tend to end the talk.

Know the options before they ask

Readiness comes and goes. When your person says “I can’t keep doing this,” it helps to already know what to do next. Read about opiate addiction treatment now, so you are not starting from zero on a hard night.

The short version: there are FDA-approved medications for opioid use disorder (buprenorphine, methadone and naltrexone), and most treatment happens in outpatient clinics while people keep living at home.

Keep naloxone in the house

Naloxone is a nasal spray that reverses an opioid overdose. It is sold without a prescription, and many health departments give it out free. Keeping it nearby does not mean you approve of drug use. It means you are ready. The naloxone guide shows how to spot an overdose and use the spray.

Look after yourself

This can go on for a long time, and you will be more use to everyone if you are not running on empty. Family support groups, counseling and a few protected hours a week all count. See support for yourself.

Limits matter here too. Setting boundaries lets you protect your money, your home and your peace without cutting the person off.

You may have been told to step back until the person “hits bottom”. This site does not give that advice.

Fentanyl is a very strong opioid. CDC notes that it can take more than one dose of naloxone to reverse an overdose that involves it. With a drug that strong, the low point people are told to wait for can be an overdose.

Risk also goes up after a break. SAMHSA lists people who have had a period without opioids, including people just released from jail, among those who most need naloxone close by. Tolerance drops fast, so an amount the person once handled can stop their breathing.

Treatment works for people who are still working, still parenting and still holding things together. A job, a home and a family that is still speaking to them all make recovery easier to hold on to.

Be ready for setbacks as well. A return to use is common, and it does not mean treatment failed or that your effort was wasted. It means the plan needs another look.

Cost is often the reason families put off looking. It is worth checking before you assume the worst.

Medicaid offers free or low-cost coverage to people who qualify, and the rules differ by state. Many clinics charge on a sliding scale based on income. SAMHSA’s National Helpline can refer people without insurance to state-funded programs. The cost of treatment guide goes through each situation, including having no insurance at all.

Privacy is the other common fear. Federal law gives substance use treatment records their own strict privacy rule, on top of the usual medical privacy law. In general, a program needs the patient’s written consent before it shares them with an employer or a relative.

When you want names and phone numbers, the state treatment directory lists real facilities that offer medication treatment and accept Medicaid. You can make the first calls yourself and have the details ready.

An overdose can look like deep sleep. CDC lists these signs: the person cannot be woken, breathing is slow or shallow, there are choking or gurgling sounds, lips or nails are discolored, and pupils are very small.

• Call 911 if someone is not breathing or cannot be woken. Give naloxone if you have it, lay them on their side and stay until help comes.
• Call or text 988 if you or they are in crisis or thinking about suicide.
• Call 1-800-662-4357, SAMHSA’s National Helpline, for free treatment referral, 24 hours a day.

If you are not sure whether it is an overdose, CDC says to treat it like one. Help right now explains what happens when you call each number.