One thing I often get asked or I often hear people say is that a loved one has to hit ‘rock bottom’ before they will start to think about changing their substance use.


I personally believe THIS IS NOT TRUE!

Here are ten reasons why…

  1. The message that a lot of services give is that nothing can be done unless the person using substances wants to change- this is not entirely true. No, we cannot force somebody to go into treatment for substance use. The individual has to be willing themselves. A very good practitioner and/or a family member to influence change in somebody. Waiting for someone to hit ‘rock bottom’ implies that NOTHING can be done when, in fact, it can. We can work with families to teach them the skills to support their love one and reduce pressure on the family. Or, get somebody through the door with a good practitioner and they might just stay.
  2. As it’s implied that ‘rock-bottom’ has to be reached, this leaves families with a painful wait until their loved one loses everything, and creating more stress and worry waiting for this journey to end, leaving them completely powerless.
  3. This often leaves a question around whether they should cut ties with their loved one or practise ‘tough love’. I do not agree with this either. Yes, people can unknowingly enable a loved one’s substance use and make it a little easier, but the suggestion that throwing them out on the street will help them to change is not going to be effective. People who have problems surrounding substance use need to know you love them and that you care.
  4. Harm reduction is always an option! If a loved one is not even entertaining the fact they have a problem, that’s fine. Another approach can be tried. It’s called harm-reduction. It’s easy to assume that abstinence is the only way forward, which means that people have to stop using and there is no other way to live. The reality is that if someone wants to continue to drink or use drugs, then we can support them to do it in the safest way possible. You never know, this type of support may even convince your loved one to change like in this article
  5. These opinions ignore the fact that you are the people living with your loved one’s substance use. You are the people that can be instrumental in supporting someone to change. You can help your loved one see that it is more attractive being sober than it is to be intoxicated.
  6. This does not help your mental and physical health. The Drug Strategy, 2017, states that “Evidence-based psychological interventions which involve family members should be available locally and local areas should ensure that the support needs of families and carers affected by drug misuse are appropriately met.” What we should be doing when families ring up for help is to be offering you a service for you, regardless of whether your loved one wants to change.
  7. Problematic substance use can be influenced by environmental changes. Families and friends are in a position to initiate this influence. They can change the environment and their responses when their loved one’s drinks or uses drugs. Families can be supported to help tip the balance so that the negative consequences of substance use outweigh the positives. Family members can show them that being sober is more attractive than being intoxicated.
  8. Family members have also been labelled as ‘co-dependent’, ‘controlling’, ‘victims’ and enablers (Landau et al) this adds further weight to families not wanting to get support for themselves. I believe families are POWERFUL, not powerless.
  9. A study took place in 2001 by Marlowe et al and concluded that ‘virtually all participants reported a combination of both negative and positive pressures’ 35% of these pressures was family pressure. So, this suggests that along with other pressures, this is a pretty high percentage that responded to their family. Therefore, ‘rock bottom’ was not necessary for them to change.
  10. ‘Intervention’ is often advertised as an alternative way of getting a loved one into treatment. It assumes addiction is a disease and therefore they have no control over their choices. Each member of the family takes it in turns to read out a prepared speech to the person having problems with substance use and then they are whisked off to rehab or alternative for forced treatment. How long do you think this success lasts for long term? I’m sure this method works for some people but I work using a person centred approach so it’s not for me (and rehab is not the only option- but that’s another blog for another day).


As you can see, there are lots of myths, beliefs and varying methods to support substance users. I challenge some of these. What is important is that you research them and find out what is best for you and your loved one at the time you are seeking help.


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,