How to Talk to a Loved One About Going to Rehab: A Conversation Guide

3. Be Compassionate

This conversation is going to be hard, and likely painful for both of you. There’s no way around that. Your loved one may lash out at you, argue, or simply ignore what you’re saying. It’s natural to feel anger and sadness in response.

However, it’s absolutely vital that you remain level-headed. Don’t express your frustration to them. By engaging in a fight, you send the message that this subject is negotiable, and that you might be in the wrong. Instead, state your case as simply and kindly as you can, and listen to their response as a way of collecting more information. Plan a time to process your own feelings with someone else after the conversation ends.

4. Validate Their Struggle

It’s important to understand that having a substance use disorder is not a choice. Your loved one’s impulses may be outside their control, and caused by a combination of brain chemistry and adverse life experiences. This is because substance misuse activates the brain’s reward system¹ “by directly raising the levels of dopamine. Although each addictive drug also has its own unique effects, which is why alcohol feels different from cocaine or heroin, stimulation of the dopamine component of the reward system seems to be a common denominator.”

Even if a person does not enjoy the feeling of being high, they may be driven to use substances in order to increase their dopamine levels. It can be difficult to see a way out of this cycle. And no matter how hard it is for you to be around their unhealthy behavior, it’s likely harder for them to experience it.

Despite this, people who misuse substances are still responsible for their behavior. It’s possible to hold them accountable for their actions, without attacking them or thinking of them as “bad people.” The best way to encourage change is to approach them with kindness, understanding, and respect.

5. Be Honest and Specific

You can be kind without minimizing the impact of their behavior. Be compassionate, but firm. This is your opportunity to share your experience of their addiction, with as much detail as you can. Talk about how their behavior has affected you, and how you’ve seen it affect them.

However, “brutal” honesty can easily turn into an attack. Instead, make simple, objective statements that brook no argument. For example, saying “you ruined my birthday” is an accusation. On the other hand, saying “you showed up 3 hours late on my birthday, and we missed our dinner reservation,” conveys the same idea through purely factual information.

5. Be Firm

It’s likely that your loved one has a different narrative than yours. They certainly have more information about their own behavior than you do, but they may also have excuses that you find questionable. These different narratives can make it hard to agree on the facts of the issue.

Denial is the tendency of people with substance use disorders² to ignore their symptoms “in spite of evidence to the contrary.” This is a very common symptom of substance use disorders. If your loved one is in denial, they may try to argue with your version of events. You may be tempted to give in to their arguments, out of compassion or just exhaustion.

However, it’s important that you not give in. Doing so can validate their denial, and enable their substance misuse. Instead, accept that this conversation will be stressful for you both. That’s ok. While it may be painful in the short term, this particular type of discomfort may help them grow and heal over time.

6. Share Resources

Before you start the conversation, it’s best to do some research into your loved one’s options. Starting rehab can be very daunting, and people with severe substance use disorders might not be able to handle the logistics without help.

You may need their help with certain specifics, but you can certainly get started on your own. As you prepare to talk to them, try to answer as many of these questions as you can in advance.

• Will their insurance cover rehab?
• Will they be able to take time off work to attend rehab?
• Are there programs that meet their unique needs? For example, some rehabs treat the misuse of specific substances and co-occurring disorders.
• Are there appropriate rehabs in their area? Or, can your loved one travel to rehab?
• Which treatment styles suit them best? For example, they might benefit from a 12-Step program, gender-specific treatment, or an intensive outpatient program (IOP).
• Is your loved one a candidate for alternative treatment, like ibogaine therapy?

In order to get this information, it may be helpful to talk to the admissions team at a rehab center. These experts have a great deal of experience helping people begin treatment, and they may have valuable advice.

Arrive at the initial conversation with specific resources in hand. Remember, though, that this is your loved one’s process, and not yours. Unless you’re their parent or guardian, all you can do is make suggestions. It’s up to them to decide how to proceed.

7. Plan Together

At the end of the conversation, it’s time to make a plan. If your loved one is receptive to your ideas, you can help them decide which steps to take next. This may mean any number of things, from attending a local support group to connecting with an inpatient rehab program.

In some cases, however, they won’t be willing to accept your help. If that’s the case, be prepared to set boundaries and care for your own mental health. Only you can decide what boundaries are appropriate here. However, if there are no consequences to their refusal, you’ll send the message that your opinion is unimportant.

If you’re struggling to set boundaries with someone who has a substance use disorder, you may benefit from learning more about codependency.³ This pattern of behavior often develops in response to dysfunctional relationship dynamics, and it may impact other areas of your life. After the crisis passes—either because the person gets help, or because you decide to step back—you may need to make time for your own healing process.

Following Through

After you talk to a loved one about their substance misuse, it’s important to follow through on your commitments. If they accept your help, that may mean helping them get into a rehab program, advocating on their behalf, or just spending time with them. Alternatively, it may mean setting strong boundaries with them, or even severing the relationship.

People in the throes of substance misuse often lack structure. If you really want to help, it’s absolutely vital that you do exactly what you say you’re going to do. Don’t agree to help with anything specific unless you have the capacity to carry it out to completion. And in the same vein, don’t articulate boundaries unless you’re prepared to uphold them. Doing otherwise might just serve to destabilize the person you’re trying to help, and may even lead to further self-destructive behavior.

And remember that while this conversation is extremely important, it’s just one step. No matter how well or poorly it goes, life will go on, and both you and your loved one will move forward. You can’t predict or control the future. But you can set the intention to heal, and encourage the people around you to do the same.

If you’re looking for a rehab program for a loved one, you can browse our directory of rehabs, which lists key information like pricing, location, insurance accepted, and more.

Reviewed by Rajnandini Rathod

1. How addiction hijacks our reward system. (n.d.). Dana Foundation. Retrieved February 28, 2022, from https://www.dana.org/article/how-addiction-hijacks-our-reward-system/ [↩]
2. Addictionary—Glossary of substance use disorder terminology. (n.d.). Recovery Research Institute. Retrieved February 28, 2022, from https://www.recoveryanswers.org/addiction-ary/ [↩]
3. Codependency: An Educational Fact Sheet from the Florida Alcohol and Drug Abuse Association. (n.d.). Florida Alcohol and Drug Abuse Association. Retrieved January 5, 2022, from https://ocw.umb.edu/counseling-and-school-psychology/substance-abuse-and-the-family/New%20Folder/codependency.pdf/at_download/codependency.pdf [↩]