Questions to Ask an Addict
Questions for a difficult conversation with someone you believe is using: how to open it, what to ask instead of accusing, and what to do with the answers. Keep it short, keep it calm, and expect this to take more than one conversation.
The questions
Open any question for the note
How have you been, really?
Why ask it
A plain opening with no accusation in it. The pause before the answer often tells you more than the answer, and it leaves them the choice of how far to go.
Can we talk about something difficult for ten minutes?
Why ask it
Asking permission and naming a limit lowers the threat. It also means the conversation has an agreed end, which makes it easier to start another one later.
How are you sleeping and eating at the moment?
Why ask it
Concrete and hard to argue with. It opens the subject through health rather than behavior, and the answers are often the first honest thing said.
What does a normal day look like for you right now?
Why ask it
Neutral on the surface and quietly informative. Listen for what has dropped out of the day: work, meals, people, anything with a fixed time.
What is the hardest part of your day?
Why ask it
Asks about difficulty without naming a cause. Mornings, evenings alone, or the hours after work all point to different things worth understanding.
What are you most worried about at the moment?
Why ask it
Their worry may be money, a job, a court date, or their children rather than the substance itself. Those worries are usually where any change starts.
Do you want things to be different, or is this not the time to talk about that?
Why ask it
Offers a real exit, which makes an honest answer possible. Ambivalence is the normal answer, and hearing it is more useful than pushing for a commitment.
If anything could change, what would you want changed first?
Why ask it
Lets them set the target. If they name sleep, or a relationship, rather than using, start there rather than correcting them.
Has anything helped before, even for a while?
Why ask it
Past attempts that partly worked carry practical information: a clinic, a person, a job, a period away. Treat a short success as a success.
Has anything been tried that made things worse?
Why ask it
You are trying not to repeat it. Families, employers, and services often re-run the same intervention with more intensity and the same result.
What is actually in the way of getting help?
Why ask it
Expect the obstacles to be practical: waiting lists, cost, no transport, no childcare, losing shifts. Those are things another person can sometimes solve.
Is there anything I could do this week that would help?
Why ask it
One week is a small enough frame to get a real request. Beware of the answer being money; that usually needs a separate conversation about what you will and will not do.
Who do you trust enough to talk to about this?
Why ask it
It may not be you, and that is not a failure. A named person, a cousin, an old friend, a nurse, is more use than a general willingness to talk.
Have you seen a doctor about any of this, and would you let me help you arrange it?
Why ask it
Splits a large decision into an appointment. Offering the logistics, the call, the lift, the waiting room, removes the part people most often stall on.
Is there anything about stopping that frightens you?
Why ask it
Fear of withdrawal keeps many people using, and with alcohol or sedatives that fear is medically reasonable. If this comes up, the answer is a doctor, not encouragement.
Do you feel safe where you are staying?
Why ask it
Housing, debt and the people around them often matter more in the short term than the substance. Ask before assuming that treatment is the first problem to solve.
What do you need me to stop doing?
Why ask it
Uncomfortable and worth asking. The answer may be checking up, lecturing, or telling other relatives, and hearing it is what keeps the channel open.
What do you want me to do if you call me in the middle of the night?
Why ask it
Agree this while things are calm. It protects both of you, and it forces you to be honest about what you can actually offer at three in the morning.
If this got worse, what would you want to happen?
Why ask it
A serious question asked once, without a threat attached. Some people will name a person to call or a place to go, and that is worth writing down.
Whatever happens next, is there anything you want me to know?
Why ask it
Closes without a demand. It also signals that the relationship is not conditional on them agreeing to anything today, which is often the only useful outcome of a first conversation.
Having the Conversation
Practical guidance for the conversation itself
How to Approach It
Pick a time when they are not intoxicated
Nothing said during intoxication is likely to be remembered or acted on. A quiet morning, a drive, or a walk works better than a confrontation after an incident.
Describe what you have seen, not what you conclude
Naming two or three specific things you noticed is harder to deny than a label. Diagnoses and the word addict tend to end the conversation in the first minute.
Expect several conversations
People rarely decide anything the first time the subject is raised. The aim of one talk is to keep the next one possible.
Be specific about what you will do
Offering to make a phone call, drive them, or sit in a waiting room is worth more than an open promise of support.
What Makes It Worse
Ultimatums you will not keep
A boundary that is stated and then abandoned teaches that nothing you say holds. Only say what you are able to follow through on.
Shame as leverage
Reciting the harm done, in front of others or alone, reliably produces defensiveness. It also makes it less likely they will tell you when things get worse.
Searching, then confronting
Presenting what you found turns the conversation into a case against them. If you already know, you can say so plainly without producing evidence.
Solving it alone
Managing this quietly, without support of your own, is how families become exhausted. Groups for relatives exist in most places and are worth using.
Safety and Medical Points
- Withdrawal from alcohol and from sedatives such as benzodiazepines can be medically dangerous. Stopping abruptly is not something to encourage without medical advice.
- Tolerance falls during any break in use, which raises the risk of overdose if someone returns to a previous dose. This is worth saying out loud, calmly, if opioids are involved.
- If opioids are involved, ask a pharmacist or clinician whether naloxone is available to you where you live and how to use it.
- If they talk about ending their life, or you believe they are in immediate danger, contact local emergency or crisis services rather than waiting.
- Keep the numbers you might need written down somewhere, before you need them.