How do I approach a loved one about my concerns of their substance abuse?



I am an alcoholic in recovery. I have 3+ years in sobriety and am active in 12 step program. My brother is fully aware of my addiction and my recovery and I am very open with him about my path and struggles. He and I are very close and open with each other. I am concerned about his alcohol use. He has tried to quit on his own once before but had bad hallucinations while detoxing himself. I don’t know how to approach him


Hey @brad - great to have you here :slight_smile: congrats on your journey so far! I bet you have wisdom you can share with this community - please take a look around and chime in where you can!

Regarding your question…
I wonder - what helped you see the light (so to speak) and shift your attention into recovery and away from drinking? Would any insight from your journey apply to your brothers? Would similar motivations apply to him?

Couple tips we’ve found to work well:

  1. Ask permission to have the conversation eg. “I’m getting concerned about your health, I’ve been there too and I really care about you so would love to chat about it, would now be a good time?” And if not…when would work for you?
    Being sober for this conversation is a requirement!

  2. Listen more than you talk, try to understand what’s behind the drinking. What need is it solving for? Is it covering up social anxiety, or feeling stifled or stressed in his career?
    Knowing this might give us clues as to how to get at the underlying pain.

  3. When you do talk to him about it, try to tap into his motivations to reduce harmful using behavior - eg. what are some negative affects of the drinking that you can both agree on? This is a great tactic to set the wheels in motion to change habits.

  4. Avoid attacking the drinking itself - this often leads to defensiveness.

  5. What are some non-drinking activities he likes to do - perhaps that you like to do together that you can plan and schedule and that he can look forward to. Can you do one this week? Things outside or social can really help reset.

Other tips include: empathizing with what he’s going through - which you’re well positioned to do since you’ve been there and know how hard it is! And offering to help. Start by asking how he’d like you to support him.

What I am less able to answer is, what medical options might help ease the ‘detox’ process. Do you have experience with this, or have local professionals that could help? Sometimes medication can be a big help in the tricky beginning phase.



Hi @brad! So awesome to hear 3+ years in recovery, keep up the good work! I know part of working the program is helping others, and if that other is your brother the desire to help is amplified. I can relate a lot, I spent years trying to help my brother get help and it can be a long hard road, but well worth it!

The tips @polly wrote about are a fantastic guide to talking to your brother about your concerns.

Because he has tried to quit on his own in the past and had serious negative withdrawal symptoms I would strongly encourage him to seek medical attention at a detox center if he decides to stop drinking. Due to the hallucinations it’s clear he is most likely going to need this in order to safely detox. So, the conversation you have with him may be about getting him into a detox center?

The more you know the better you can guide the conversation so here is the criteria from the DSM V on alcohol withdrawal:

A. Cessation of (or reduction in) alcohol use that has been heavy and prolonged.

B. Two (or more) of the following, developing within several hours to a few days after the cessation of (or reduction in) alcohol use described in Criterion A:

  1. Autonomic hyperactivity (e.g., sweating or pulse rate greater than 100 bpm).

  2. Increased hand tremor.

  3. Insomnia.

  4. Nausea or vomiting.

  5. Transient visual, tactile, or auditory hallucinations or illusions.

  6. Psychomotor agitation.

  7. Anxiety.

  8. Generalized tonic-clonic seizures.

Acute alcohol withdrawal occurs as an episode usually lasting 4-5 days and only after extended periods of heavy drinking. Symptoms usually peak in intensity the second day of abstinence.

If you ever have concerns that any of the above is happening I’d recommend bringing him to the nearest emergency room or calling 911.

Hope this helped! The more you know :slight_smile: Let me know if you have any questions!