What helps Choose one calm time to talk. Avoid serious conversations during intoxication. Focus on specific harms rather than debating how much or how often someone drinks. Encourage a clinical assessment and evidence-based treatment options, including outpatient care, intensive outpatient programs, residential care and medications for alcohol use disorder. Learn more: https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-use-disorder Support yourself with family education and peer support. Family guidance: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/helping-someone-with-alcohol-problem What to avoid Covering for missed work, legal trouble or repeated unsafe behavior Making threats you cannot enforce Safety note Alcohol withdrawal can be medically serious. Seek urgent medical care if severe symptoms appear. Withdrawal overview: https://www.niaaa.nih.gov/publications/clinical-guides-and-manuals/withdrawal-management

What helps Treat overdose risk as urgent. Keep naloxone available if opioids may be involved. Naloxone information: https://www.cdc.gov/overdose/prevention/naloxone.html Encourage treatment for opioid use disorder and ask providers about medication options such as buprenorphine or methadone when appropriate. Treatment overview: https://nida.nih.gov/research-topics/medications-opioid-use-disorder Look for programs that offer ongoing care beyond detox, since relapse risk is high without follow-up treatment. What to ask a provider Do you offer medication-assisted treatment What levels of care are available How do you support long-term recovery Safety note Overdose risk increases when opioids are mixed with alcohol or benzodiazepines. Risk factors: https://www.cdc.gov/overdose/prevention/index.html

What helps Do not pressure sudden stopping. Encourage medical supervision and a gradual taper. Clinical guidance: https://www.ncbi.nlm.nih.gov/books/NBK470159/ If benzodiazepines are combined with alcohol or opioids, treat risk as urgent and seek medical guidance. Overdose prevention: https://www.hhs.gov/overdose/prevention/index.html Ask providers whether anxiety, panic or insomnia is being addressed alongside tapering. What to avoid “Cold turkey” demands Managing withdrawal without medical oversight Safety note Benzodiazepine withdrawal can be medically dangerous. Seek urgent care for severe symptoms.

What helps Watch for sleep collapse, paranoia, agitation or extreme mood changes. Keep conversations brief, calm and focused on safety. Encourage an assessment that includes both substance use and mental health screening. Treatment principles: https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide When to seek urgent help Psychosis, suicidal statements or aggressive behavior require immediate evaluation.

What helps Focus on functioning: school, work, relationships and safety rather than debates about whether marijuana is addictive. When more than one substance is involved, encourage a full assessment that looks at all use patterns together. Polysubstance overview: https://nida.nih.gov/research-topics/polysubstance-use Set clear boundaries around driving, money and safety in the home. What to avoid Narrow conversations that focus on only one substance when multiple are involved