Talking to someone about their use

Bringing up a loved one's substance use is one of the hardest conversations you might ever have - and how you approach it can make a real difference.

What it is

Talking to someone about their substance use means raising a sensitive topic in a way that opens the door to change, rather than closing it through blame or confrontation. Many people avoid these conversations out of fear of conflict, denial, or making things worse. But research consistently shows that a calm, caring approach - focused on genuine concern rather than judgement - is far more likely to be heard than an angry confrontation or an ultimatum delivered in the heat of the moment.

Signs to notice

• Wondering whether to say something, and putting it off out of fear of their reaction
• Noticing the substance use affecting their health, relationships, work or safety
• Feeling like the relationship is being shaped around managing or avoiding their use
• The person seeming defensive or dismissive whenever the topic comes up, even briefly
• Your own anxiety, resentment or exhaustion building around the situation

What helps

• Choose a calm, private moment - never during or right after use, and never in front of others
• Use "I" statements: "I've noticed... I'm worried about..." rather than accusations like "You always..."
• Come from a place of care, not control - you can't force someone to change, but you can express concern
• Listen more than you talk, and expect denial or defensiveness as a normal first reaction
• Avoid ultimatums you're not prepared to follow through on
• Offer specific next steps, like a referral to Cleared Mind's EAP or another counsellor, rather than a vague "you need help"
• Look after your own wellbeing too - these conversations are draining, and you deserve support as well

When to reach out for help

If the person's use puts their safety or others' safety at immediate risk, don't wait for the perfect conversation - get help right away. If you're feeling overwhelmed by the situation, or unsure how to approach it, a counsellor can help you prepare and support you through the process.

Getting help in South Africa

Cleared Mind's EAP counsellors can help you plan this conversation and support you afterwards, whatever the outcome. SADAG's Mental Health Line (011 234 4837) offers guidance for families and friends of people who use substances.

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If you or someone else is in immediate danger, reach out now. SADAG Suicide Crisis Helpline (24h): 0800 567 567 or SMS 31393. SAPS 10111, ambulance 10177, GBV Command Centre 0800 428 428.