How to Help Someone Who Refuses Treatment

You can love someone and still not be able to make them walk into treatment. That refusal is the problem in front of you. A longer speech will not enroll them.

If they might be overdosing, seizing, or not breathing, call 911. If you or they are in a mental health crisis, call or text 988.

Tonight, name one thing you have actually seen, ask for one small step, and stop covering one consequence.

One fact, and one ask

Talk when they are as steady as they get, often earlier in the day, not in the middle of a fight or while they are intoxicated. Missed shifts or an unpaid bill is easier to hear than a label about their character.

Keep the ask small. A phone call, a same-week assessment, or a ride is easier to accept than a demand to enter a long program tonight. Have that step ready before you start. FindTreatment.gov lists facilities by location. Call or text (800) 653-9376 if you want help lining up the step while they are still saying no. Say you are calling for a loved one.

When they do want an assessment, use how a family member can help someone reach care. For the words of the talk, read how to talk about rehab. Some families practice that conversation with CRAFT. Keep a sentence you can reuse: "When you want an assessment, I know who to call."

Do not make them quit on the couch

If they drink heavily every day, or take a benzodiazepine such as alprazolam, clonazepam, or diazepam on a regular schedule, "stop tonight" can cause a seizure.

TIP 45 says people with a history of severe withdrawal, delirium tremens, or seizures are not good candidates for detoxification outside a medical setting, and it describes delirium tremens as potentially fatal. The FDA boxed warning says stopping a benzodiazepine suddenly, or cutting it too fast, can cause seizures. Ask for a medical assessment. Read detox at home versus medical care before you bargain in the kitchen. Alcohol treatment starts with that medical question. When they say yes, look through the NIAAA navigator.

If the fear is an opioid overdose

NIDA says buprenorphine, methadone, and naltrexone reduce overdose deaths. People lose tolerance during a break from opioids, so a return to a former amount raises overdose risk. SAMHSA's overdose toolkit says opioid withdrawal is usually not fatal, and that severe dehydration during withdrawal can still be dangerous.

If breathing is slow, they will not wake, or lips or fingertips look blue, give naloxone if you have it and stay until help arrives. The FDA approved a naloxone nasal spray for sale over the counter. Someone who receives naloxone still needs emergency care. After they are breathing, look at opioid treatment.

Stop covering one consequence

Paying a legal bill in secret, calling in sick for them, or handing over cash that funds use can make the next day easier to repeat. One plain sentence is enough: "I will not call your job and cover for you. I will drive you to an assessment if you ask."

Follow through on the sentence you said. A sober companion still requires their agreement. It is a different arrangement from doing this yourself.

Support that is about you

Al-Anon is mutual support for people affected by someone else's drinking. Nar-Anon is a 12-step program for family and friends of people with addiction. Your steadiness matters. Burning out does not make them safer.

Federal Part 2 rules generally require written consent before a substance use program shares records that would identify someone as having a substance use disorder. Some medical emergencies and some court orders are exceptions. Ask any program how it handles family calls and employer requests. If you are considering a court process, talk with a local attorney or a crisis team. Do not hold a family meeting while they need emergency medical care. On the day they say yes, start with how to find treatment.

Additional Resources

Sources cited on this page:

• SAMHSA TIP 45: Detoxification and Substance Abuse Treatment (settings and patient placement)
• FDA: Boxed warning to improve safe use of benzodiazepines
• FDA: Approval of the first over-the-counter naloxone nasal spray
• NIDA: Medications for Opioid Use Disorder
• NIDA: Misconceptions about maintenance treatment (tolerance and return to use)
• SAMHSA: Overdose Prevention and Response Toolkit
• SAMHSA: Opioid overdose prevention and reversal
• HHS: Understanding confidentiality of substance use disorder patient records (42 CFR Part 2)
• SAMHSA FindTreatment.gov
• Al-Anon Family Groups
• Nar-Anon Family Groups
• 988 Suicide & Crisis Lifeline

Common Questions