When a loved one has an addiction

If someone you love has a problem with addiction, your top priority is to take care of yourself before you can take care of anybody else. Think about the instructions you get on an airplane: "If the cabin pressure drops, secure your own oxygen mask first, then help others with theirs." That philosophy applies here, too.

You can turn to support groups like Al-Anon (an AA spin-off for the family and friends of alcoholics) or Alateen (an offshoot of Al-Anon geared toward teenagers and preteens who are affected by the drinking of a parent or other close relative) for help. These groups are free and open to the public, and they have frequent meetings in most towns (see the Al-Anon/Alateen website for more information).

These fellowship groups can help you better understand your loved one's problem with addiction. In particular, you can learn you aren't responsible for it and that you can't force him or her to stop. These groups also can teach you effective ways to cope as your friend or family member faces the consequences of addiction and, if all goes well, finds his or her way to recovery.

Some groups advocate "tough love" — confronting people with addiction and trying to force them to seek help while others recommend the exact opposite approach. For example, the CRAFT (Community Reinforcement Approach and Family Training) intervention encourages family members to avoid confrontation and instead use encouragement and other positive motivational strategies when trying to convince a loved one to seek help for addiction.

You also may want to seek advice and support from a therapist, clergy member, doctor, or social worker who is knowledgeable about addiction.

Interventions: How do you help a loved one who refuses help?

In an intervention, family and close friends gather with the person with addiction to discuss the issue. Historically, clinicians advocated a rather draconian approach to interventions, instructing those holding the intervention to begin by asking the identified patient to be quiet and simply listen. In this approach, the affected person had no say in the discussion, and was often given an ultimatum.

Many clinicians now favor a more interactive approach to interventions, where the person with addiction can voice concerns without fear of reproach. Contemporary intervention approaches use various devices to gain the interest of the person with addiction so that the family doesn't have to cut ties or support.

Interventions, whether traditional or contemporary, share some common elements. At the outset, the affected person's family and loved ones recount how the problem with addiction has affected each of them. By confronting the loved one with the consequences of the addiction, both objective and subjective, an intervention might penetrate the person's denial and help him or her decide to seek treatment.

Don't do this on your own

Because an intervention is a complicated and delicate process, friends and family members should not try it on their own. Seek the help of a professional — such as a doctor, therapist, or member of the clergy — who has experience with the process.

Timing is crucial. It's best to set up an intervention shortly after an addiction-related problem has occurred and to investigate treatment options in advance.

Bear in mind that interventions can be painful and do not always work. In fact, interventions can backfire, because they can make people with addiction feel alienated from his or her support system. This can further distance them from the help they need. For these reasons, interventions should be considered only as a last resort in response to a desperate situation.

Addiction can be devastating. The good news is that there are a number of effective treatments for addiction, including self-help strategies, psychotherapy, medications, and rehabilitation programs. Get the strategies in the Harvard Special Health Report, Overcoming Addiction: Finding an effective path toward recovery.