Questions to Ask About Drugs
Questions for a parent, partner or friend worried about someone's drug use. The first group is for the conversation itself, including what to ask about immediate safety. The last group is for assessing a treatment programme: medication options, what happens after a relapse, cost, and what families are told.
The questions
Open any question for the note
Can we talk about something I have been worried about, or is now a bad time?
Why ask it
Asking permission gives the other person a way to say not now, which makes it more likely they say yes later. Starting instead with a prepared speech tends to produce the argument you were hoping to avoid, and once that happens the topic gets harder to raise for months.
What is it doing for you?
Why ask it
Almost nobody is asked this, and it produces more than any question about how much or how often. Sleep, pain, social ease, quiet in their head: whatever the answer names is the thing that has to be replaced by something, which is why lectures about consequences change so little.
What are you using at the moment, and roughly how much in a normal week?
Why ask it
Expect an underestimate, and take it anyway as a starting point rather than correcting it. What matters most is the combination, since mixing opioids with alcohol or benzodiazepines is where the immediate danger sits, and people often do not think of prescriptions as part of the list.
Are you using alone, and does anyone know when you do?
Why ask it
This is a safety question rather than a moral one. Using alone is what turns an overdose into a death, and someone who will not stop can still agree to tell one person, leave a door unlocked, or stay on a call.
Is there naloxone in the house, and does anyone here know how to use it?
Why ask it
It is available without prescription in many places, works only on opioids, and is now worth having wherever there is any risk of counterfeit pills. Asking is practical, non accusatory, and one of the few things you can act on the same day whatever else is unresolved.
Is there anything about your own use that worries you?
Why ask it
Almost everyone has a private concern, and hearing it from them is worth far more than hearing yours from you. If the answer is nothing at all, do not argue the point, since the useful information is that this is where the conversation currently stands.
Has anything happened that scared you?
Why ask it
A blackout, a bad batch, a friend who did not wake up, a near miss driving. These specific memories tend to be the real motivators, and they surface more readily than any general question about consequences.
What in your life would you not want to lose?
Why ask it
Naming a job, a child, a flat or one particular relationship gives the conversation something to protect rather than something to condemn. If they cannot name anything, that is a serious answer and worth telling a professional about.
Have you tried to cut back before? What was the hardest part?
Why ask it
Previous attempts contain the plan for the next one, and the hardest part is usually a specific hour of the day, a person, or the physical symptoms of the first three days. A history of stopping unaided and going back is a reason to ask about medical support, not evidence of weak will.
What do you think would happen if you stopped tomorrow?
Why ask it
Answers about withdrawal indicate physical dependence, which means stopping abruptly needs medical advice, and with alcohol and benzodiazepines can be genuinely dangerous. Answers about boredom, grief or having no friends left point to what has to be arranged before any attempt is realistic.
What do you need from me that I am not doing, and what am I doing that makes it worse?
Why ask it
The second half is uncomfortable and is the part worth asking. Expect to hear about searching their room, telling relatives, or asking the same question every evening. You do not have to agree to stop, but you will learn what your current approach is costing.
Is there anything you want me to stop asking you about?
Why ask it
Conceding one topic often buys honesty on the others, and it signals that you are trying to stay in contact rather than build a case. If everything is off limits, say plainly what you still need to know and why.
If you needed help at three in the morning, would you call me? If not, who would you call?
Why ask it
This is the single most useful thing to establish, because the answer determines whether the worst night ends with someone getting help. A no is painful but actionable: find out who they would call, and make sure that person has your number.
Would you be willing to talk to a doctor about your options, without committing to stopping?
Why ask it
A lower bar than treatment, and often the step people will actually take. It also opens the door to medication and to treating pain, anxiety or sleep problems that are part of why use continues.
What does this programme actually provide, and who delivers it?
Why ask it
Ask for the daily schedule and the qualifications of the staff, not the philosophy. Some residential programmes are largely peer led with limited clinical involvement, which may still help, but you should know which you are buying.
Do you offer medication such as buprenorphine, methadone or naltrexone, and how do you decide?
Why ask it
For opioid dependence, medication is standard care with substantial evidence behind it. A programme that declines to offer or continue it, or that describes it as trading one drug for another, is departing from mainstream practice and you should hear their reasoning.
What happens if someone uses while they are in your programme?
Why ask it
Immediate discharge is common and is the moment of highest overdose risk, because tolerance has dropped. Ask whether they treat a relapse as a clinical event or a rule violation, and what the discharge plan looks like if someone is asked to leave.
What does the first week look like here, and is withdrawal medically supervised?
Why ask it
Alcohol and benzodiazepine withdrawal can require medical management, and opioid withdrawal is not usually dangerous but is often the reason people leave. Ask who is on site overnight and what medication is available for symptoms.
What does it cost, what does insurance cover, and what happens if the money runs out partway through?
Why ask it
Get the figure in writing along with what happens at the point coverage ends, since being discharged mid course is common and destabilising. Ask also whether the programme owns or is paid by any facility it refers people on to.
What support is there for the family, and what will you tell me if the patient is an adult?
Why ask it
You will probably be told very little without their written consent, which is worth understanding before you are hurt by it. Ask whether a release of information can be signed at admission, and what family sessions or separate family support the service runs.
Using these questions
Practical guidance for the conversation itself
Having the conversation
Pick a moment when they are not intoxicated or withdrawing
Nothing said during either is retained. Mid morning, on a walk, or in a car tends to work better than late evening, and a private setting matters because anyone questioned in front of family will defend themselves rather than talk.
Ask one question and then stop talking
Long silences are normal here and are usually where the honest answer comes from. Filling them with a second question, or with your own reasoning, converts the conversation into a case being made and invites a defence.
Deal with safety separately from stopping
Whether they stop is not something you control. Whether there is naloxone in the house, whether they use alone, and who they would call at night are all things that can change this week regardless. Keep those separate so progress on one is not held hostage to the other.
Say what you will do, not what they must do
Statements about your own behaviour, what you will pay for, who can stay in your home, what you will do if you find them unresponsive, are enforceable and honest. Conditions on their behaviour that you will not follow through on cost you credibility you will need later.
Practical things to sort out
- Get naloxone and make sure more than one person in the household knows how to use it and where it is kept.
- Learn the signs of an opioid overdose, and that snoring or gurgling in someone who cannot be woken is an emergency rather than sleep.
- In the United States, the SAMHSA national helpline on 1-800-662-4357 gives free confidential referrals around the clock. Elsewhere, ask a family doctor or a national drug service for local options.
- Find out whether your area has drug checking services, since counterfeit pills containing fentanyl are the main cause of unexpected overdose.
- Ask about a release of information form at any admission, or you may get no updates at all about an adult relative.
- Look for a family support group for yourself, in person or online, before you feel you have earned the right to need one.
Common pitfalls
Making one conversation carry everything
Planned confrontations with several family members present are memorable for the wrong reasons and rarely change behaviour. Several short exchanges over months, in which you stay someone they will still speak to, tend to do more.
Treating a relapse as the end
Return to use is common in the course of this condition, and the response that matters is how quickly someone gets back in contact with treatment. Reacting as though everything is undone makes concealment the rational choice next time.
Trusting a programme that promises outcomes
Claims of high success rates are usually unverifiable and often rest on counting only those who complete. Ask how they define success, over what period, and how many people they lose along the way.
Neglecting your own position
Money, sleep and your other relationships all erode quietly while attention is on someone else. Deciding in advance what you can sustain, and saying it plainly, is more useful than an offer of unlimited help that ends in resentment.