What to Do When Someone You Love Refuses Treatment

Is “no” the final answer?

Often not. People turn down treatment because they feel pressured, ashamed or afraid of withdrawal, and those feelings shift. You also don’t have to wait until they truly want it. The National Institute on Drug Abuse notes that treatment doesn’t need to be voluntary to be effective, and that pressure from family, an employer or the courts can get people into treatment and keep them there.¹

So be wary of “let them hit rock bottom.” With fentanyl in the drug supply, waiting for things to get worse can mean waiting for an overdose.⁴

What can you control while they say no?

Their safety

If they use opioids, or any pill or powder that didn’t come from a pharmacy, keep naloxone at home and in the car and tell everyone where it is. The nasal spray is sold without a prescription,² and it won’t harm someone who isn’t having an opioid overdose.³ Counterfeit pills are made to look like oxycodone or Xanax, and many people don’t know theirs contain fentanyl.⁴ The riskiest stretch is after a break, such as jail, a hospital stay or detox, because tolerance drops and a familiar amount can now cause an overdose.⁵ Our page on getting and using naloxone has the details.

Lock up or get rid of medicines in the house, especially opioids, sedatives and stimulants. Take-back programs and pharmacy drop-off boxes are the best way to dispose of most of them.¹¹

If they say they’ll quit drinking or benzodiazepines on their own, ask them to see a doctor first, since stopping suddenly after heavy use can cause seizures.¹⁴¹⁵

Children and money

Don’t leave children in the care of someone who is intoxicated, even if arranging other care starts a fight. On the money side, separate your bank accounts, change passwords and PINs, lock up anything that could be sold, and pay rent, phone and grocery bills directly rather than handing over cash.

What you pay for

A boundary says what you will do, not what you’ll make them do. You can stay close to someone and still refuse to fund or cover for their use. Decide your limits ahead of time, while you’re calm, and only state the ones you’ll keep. Boundaries vs enabling walks through common examples.

How do you keep the door open?

A standing offer like “If you ever want help, I’ll drive you that day” only works if you know where you’d drive. Raise it again when they’re sober and calm, or just after a consequence of their use, like a missed shift or a health scare. Avoid times when they’re intoxicated, in withdrawal, or when you’re angry. For the second conversation, see how to bring it up again without a fight.

Build your list now, before you need it. FindTreatment.gov, run by SAMHSA, lists facilities that state authorities have licensed, certified or approved, and lets you filter by services and payment.⁶ The SAMHSA National Helpline, 1-800-662-4357, is free, confidential and open 24/7 in English and Spanish, and can refer uninsured callers to state-funded treatment.⁷ If cost is the barrier, see treatment options without insurance.

Does anything work better than waiting or confronting?

Yes. CRAFT (Community Reinforcement and Family Training) is a family approach with solid research behind it. In a randomized trial it got more resistant loved ones into treatment than a confrontational intervention did, with 64% of trained family members succeeding.⁸ Read how CRAFT works and where to learn it.

Should we try an intervention or court-ordered treatment?

For most families, neither is the place to start. A professional intervention is a planned family meeting that asks the person to enter treatment. It can work, but it can also damage trust, and it doesn’t guarantee they’ll go or stay. See whether an intervention makes sense for you.

Many states let a court order treatment for substance use, but the laws vary, many places rarely use them because of funding and practical barriers, and there’s little research showing forced treatment works.¹⁰ Talk with a local attorney or your state behavioral health agency first, and read what involuntary treatment laws allow.

How do you take care of yourself while you wait?

Start now rather than after they get better. NIAAA advises families to look after themselves while they help, through support groups and professional help if needed.⁹ It lists Al-Anon and SMART Recovery Family & Friends as groups for family members;⁹ Nar-Anon is for families of people who use drugs. A therapist who works with families, ideally one trained in CRAFT, can support you and teach the skills above. If you’ve stopped sleeping or eating well, see your own doctor too. SAMHSA’s free guide, Navigating Mental Health and Substance Use Care, is written for families.¹² Our page on support for families compares these options.