A guide for family and friends
Having a friend or family member struggle with opioid dependence is very difficult. It might be hard to understand what’s happening and why. If you think or know that someone you love is dependent on opioids, this guide will give you important information about what opioid dependence is, the kind of treatments that are available, and how you can help your loved one.
If you’re not sure what an opioid is read this page.
Anyone can become dependent on opioids. It doesn’t matter how old they are or what their background or life experience is.
People become dependent on opioids in different ways. Some people develop a dependence when they are prescribed medicines that contain opioids, while others become dependent after using drugs for enjoyment and pleasure. Not everyone who uses opioids (for whatever reason) will become dependent on them, but some do.
People use opioids for different reasons, and using opioids is very different to being dependent on or addicted to them. So, when should you be concerned about someone’s opioid use? The short answer is: when their use is increasing in dose and/or frequency; is affecting their behaviour; or they feel like they can’t stop using opioids.
Dependence happens when a person finds it hard to live normally without opioids because their body has become used to having the drug in their system. This is different from when a person finds it hard to function because of pain and treats the pain (under medical direction) with opioids.
Some people may use either legal or illegal opioids recreationally (for enjoyment) but this is not the same as dependence. For example, using opioids recreationally a few times a year doesn’t mean that the person is dependent on opioids.
Look out for these key signs of dependence:
- A person tells you they are worried about their opioid use
- Continuing to use opioids even without any medical need
- Increasing dose or frequency of opioid use
- Increasing time and effort spent obtaining opioids
- Anxiety or distress at the thought of not having opioids
- Less time spent on previously enjoyed activities
- Their opioid use is affecting their relationships, schooling or work
If you are worried about a friend or family member’s use of opioids, the best thing to do is to have a conversation with them about it. This can be tricky and awkward but there are some things you can do to make it easier for both them and you:
- First, choose an appropriate time and place to have the conversation where the person is comfortable, not in public or surrounded by others
- Try to avoid having the conversation when the person is affected by drugs or if you are upset with them
- Start the conversation by expressing care and concern: ‘I’ve noticed some changes in your behaviour and I’m worried about you. Is there something going on?’ Avoid confrontational statements or judgmental language like ‘You’re using drugs, aren’t you?’ or ‘Are you high?’. These are unhelpful and will likely make them defensive. Also avoid words like ‘addict’ or ‘junkie’
- Avoid threatening the person with consequences or giving ultimatums: ‘You need to stop, or you’ll die’
- Listen to the person, including their reasons for using opioids. You might not agree with their reasons but acknowledging them will make the person feel validated
- Acknowledge their experiences: ‘It sounds like you’ve been going through a lot lately’ or ‘It must be difficult feeling like that’
- Try to use ‘I’ statements and talk about your feelings: ‘I feel afraid when you use opioids. I’m worried that something bad will happen’
There are a few different treatment options for opioid dependence you can find here.
Medication-assisted treatment (MAT) for opioid dependence is very effective. It involves taking medication that stops the person from feeling cravings and prevents the start of withdrawal.
MAT has been shown to help people to reduce their drug taking, improve their health and social outcomes and lower their risk of drug-related harm like getting a blood-borne virus.
MAT ‘stabilises’ a person’s drug use, allowing them to return to their regular activity.
If your friend or family member begins medication assisted treatment for opioid dependence, there are a few things that you can expect.
- The person may appear drowsy or groggy as they adjust to the treatment
- They may seem to have less energy than usual
- They may need to go to regular doctor appointments, as often as once a week
- They will have to go to a pharmacy or clinic once a day to be given their medication
Medication-assisted treatment for opioid dependence is usually prescribed by a doctor and given out by a pharmacist. A person who is on MAT will need to have regular appointments with their doctor and will need to visit the pharmacy daily, especially when they first begin treatment. Longer-acting forms of MAT may also be available; the doctor who prescribed the treatment will let your friend or family member know if and when this is right for them.
Depending on where you live, MAT may be free or you many need to pay for it.
There are some issues that you should consider about this type of treatment:
- While on MAT, a person is still dependent on opioids and may have withdrawal symptoms if their dose is reduced
- The person will need to visit a clinic or pharmacy either daily or several times a week
- This can make travel very difficult, especially interstate or international travel
- Some people have side effects from the treatment
While deaths from overdose of these medications are uncommon, they can happen.
Opioid dependence can be very difficult for both the person who is using opioids and for their loved ones as well, so it’s important that you’re supported too.
Seeking help or support about these issues can be hard but the sooner you do, the better. Contact a trusted healthcare provider or a local drug and alcohol service for advice. They’ll be able to advise you about the supports that are available for both you and the person you’re worried about.
If the person you’re worried about is young (aged 25 or under), there may be specialist youth services in your area that can help you.
It’s really important that you take care of yourself. Supporting your friend or loved one should not come at the cost of your health or wellbeing. Remember to get enough sleep, eat well and keep doing the things you enjoy in life.
There are support services for the friends and family of people struggling with dependence. These can be a great way to connect with people who understand what you’re going through. To find local support services, talk to your healthcare provider or a local drug and alcohol service.