If someone you love uses opioids, the most useful thing you can do often isn’t a single conversation — it’s a set of ongoing choices. Here’s what actually helps, based on approaches with evidence behind them (particularly CRAFT — Community Reinforcement and Family Training).

What tends to help

  • Naloxone in your home, and knowing how to use it — regardless of where things stand otherwise. [naloxone article]
  • Talking about specific behaviors and your own feelings, rather than labels — “I was scared when I couldn’t reach you last night” lands differently than “you’re an addict.”
  • Reinforcing non-using time — noticing and responding positively when they’re engaged, sober, or taking steps toward treatment, without making that engagement transactional or conditional on bigger promises.
  • Taking care of your own life and wellbeing in parallel — this isn’t selfish, it’s part of what CRAFT research shows actually improves outcomes for the person using, not just the family member.
  • Knowing what treatment options exist before a crisis, so that if they become willing, you’re not starting the search from zero in a stressful moment. [treatment finder / no-insurance article]

What tends not to help, even though it’s common advice

  • Ultimatums that you’re not prepared to follow through on — these tend to erode trust without changing behavior.
  • “Detaching with love” as total withdrawal of contact — some versions of this advice go further than the evidence supports; staying connected while protecting your own boundaries is different from cutting someone off entirely.
  • Waiting for “rock bottom” — there’s no evidence that withholding support produces better outcomes, and it carries real risk if it means someone is more isolated during a dangerous period.

If there’s an overdose risk right now

Don’t wait for a perfect moment to bring up naloxone. It’s not an accusation — it’s closer to a smoke detector. [naloxone article]

For yourself

Supporting someone through this is exhausting, and it’s common to feel guilt, anger, grief, and hope in the same week. [family/CRAFT section] You’re allowed to need support too.

Medically reviewed by [pending]. Sources: CRAFT model (Community Reinforcement and Family Training), SAMHSA.