Most families land here unsure how bad things are and afraid of saying the wrong thing. That’s a normal place to start, and you don’t need proof or a plan yet. Answer the three questions below and you’ll get the page that fits where things stand today, whether that’s the warning signs or what to do after a no.
Where should we start?
Find your starting point
InteractiveHow sure are you that there’s a problem?
See possible outcomes
- Start with the signs Knowing what to watch for will help you speak clearly when you do raise it.
- Plan the first conversation Pick a calm, sober moment, bring two specific examples, and have one option ready, like a doctor’s visit.
- Get a professional assessment Let a clinician’s assessment decide the level of care rather than a program’s admissions line, and book it while they’re willing.
- After a no Leave the offer standing and look after your household in the meantime. Families have more options here than it can seem.
- Try a calmer approach Arguments rarely move anyone. Families can learn skills that make a yes likelier.
What’s in this section?
Getting help, step by step
For the whole path through treatment and after, see the complete family guide. One caution if your loved one decides to quit: stopping heavy daily drinking or benzodiazepines such as Xanax all at once can cause seizures, so have them see a doctor first.45
What the numbers say
Substance use problems are common. SAMHSA’s 2025 national survey estimated that 44.6 million people aged 12 and older in the U.S. (15.3%) had a substance use disorder in the past year.1 Of the 47.2 million who needed treatment, about 1 in 6 (16.0%) received any,16 and most adults who went without neither sought it nor thought they needed it.1
So if your loved one insists they’re fine, that’s typical, and you don’t have to wait for rock bottom. Treatment doesn’t need to be voluntary to work, and pressure from family, an employer or the courts can increase how often people enter and stay in treatment.2
Getting help also rarely means a residential stay. Of the 7.6 million people treated in 2025, 4.4 million had outpatient care and 3.6 million used telehealth, against 2.2 million in inpatient or residential care; some had more than one type.6 Among adults who said they had ever had a problem with drugs or alcohol, 73.0% considered themselves recovered or in recovery.1
Maria noticed her son Jordan, 24, missing shifts and borrowing money he didn’t repay. Instead of booking rehab that night, she wrote down two things she’d seen and waited for a calm Sunday. She asked him to see his doctor “just to get information.” He said no. Two weeks later, after a missed shift cost him a paycheck, he said yes. The assessment recommended outpatient care.
Frequently asked questions
Is there someone I can call for advice, even if my loved one won't?
Yes. The SAMHSA National Helpline, 1-800-662-4357, is free, confidential and open around the clock, in English and Spanish. Family members can call too. It refers callers to local treatment, support groups and community organizations. You can also text your ZIP code to 435748 (HELP4U); the text service is in English only.3
What if we can't afford treatment?
The Helpline refers people with no insurance or too little coverage to their state office for state-funded treatment, and often to programs that charge on a sliding fee scale or accept Medicaid or Medicare.3 See low-cost and public treatment options.
Sources
- SAMHSA — Highlights for the 2025 National Survey on Drug Use and Health (2026). samhsa.gov/data/sites/default/files/NSDUH-2025-Annual-Release/2025-nsd… — accessed Oct 2026
- NIDA — Principles of Drug Addiction Treatment: A Research-Based Guide (3rd edition). nida.nih.gov/sites/default/files/podat-3rdEd-508.pdf — accessed Oct 2026
- SAMHSA — National Helpline. samhsa.gov/find-help/helplines/national-helpline — accessed Oct 2026
- FDA — FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class, Drug Safety Communication (September 23, 2020). fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning… — accessed Oct 2026
- American Society of Addiction Medicine — The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management (2020). asam.org/docs/default-source/quality-science/the_asam_clinical_practic… — accessed Oct 2026
- SAMHSA — Key Substance Use and Mental Health Indicators in the United States: Results from the 2025 National Survey on Drug Use and Health (2026). samhsa.gov/data/sites/default/files/reports/rpt57150/2025-nsduh-annual… — accessed Oct 2026