How frustrating is it when we can see that someone we love has problems, yet they don’t seem to see it themselves? When they do see it, it’s a short-term realisation then, usually, a step back into their own behaviours.


For families and friends of that individual, it may seem that it is them that have to put up with the behaviours associated with drug and alcohol use and the consequences of it, while our loved one clearly does not give a flying one!


For anyone that knows how addiction works, I have written before about how a substance can change the functioning of the brain. Drugs and alcohol mess around with our dopamine, which is reward and pleasure neurotransmitter in the brain. This regulates our movement and emotional responses. Dopamine also regulates our thoughts, actions and behaviour. If anyone has ever taken a substance, we can probably recognise this association and why sometimes, when we drink or use drugs, we fall over, our inhibitions disappear, and we might do some pretty rubbish or wild things that we just wouldn’t normally do. (I may or may not be speaking from experience!) What this means is that eventually, pleasure-seeking behaviours will only ever include alcohol or drugs. You can spot this when ourselves, our friends or family members centre activities around substance use.


So, it’s no wonder then, that if drugs mess around with our brain, that we aren’t always that responsive to meeting other people’s needs because we’re too busy thinking about our own.


I believe people use drugs either to get away from something, or to get something out of it. People who use substances problematically are often trying to get away from something or might be trying to avoid any current or previous traumatic experience. There are lots of examples of this and brilliant research into Adverse Childhood Experiences and how these affect our health outcomes as adults.




The things we get out of alcohol and drugs obviously depend on the individual. There are always negative and positive consequences to substance use. The trick is, to figure out what they are for your loved one and then make sure that they experience those negatives as much as possible. Sounds harsh, right? It takes practice. We call these natural consequences. Families and friends will try to ‘help’ their loved one’s by clearing up after them, hiding the truth so they don’t feel bad the next day, not wanting to leave them in their own puke and so on. Listen. If someone has serious a problem with substance use, we need to allow them to feel discomfort or they will never change.




As always, we need to get the balance right and don’t just leave them to it. Your loved one needs to know that you are there for them no matter what. You love them. You care for them and you will be there for them.


You won’t tolerate abuse, you will have boundaries and you will be in their company more when they are sober than drunk. This is a reward for being sober.


You can’t change someone else, you can only change yourself. Get help for you because, by changing your approach to your loved one’s substance use, you can influence their behaviour in the long run.


I can help


My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area or via Skype worldwide.

I also have an online therapeutic programme. Take a look at my services here

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Take care,