Supporting a Loved One: Medication & Recovery

When someone you care about begins or restarts their recovery from alcohol use disorder (AUD), it can feel challenging to know the right thing to do or say. Your care is meaningful; someone’s support system can be instrumental to their healing. Whether it’s the first time someone has tried to stop drinking or their 100th time, supporting a loved one can make them feel less alone in the process. 

Recovery can look different for everyone, depending on their AUD and treatment. It’s helpful to be informed of someone’s treatment plan so you know how to support them. Treatment may include any of the following or a combination of methods. 

• Medication to treat AUD
• Time at an inpatient or outpatient rehabilitation center
• Peer-support groups including alcoholics anonymous (AA), Refuge Recovery, and SMART Recovery. 
• Behavioral therapy

What to Expect in the Early Stages of Recovery

When someone you love begins recovery, they might seem like a different person. Emotional and physical symptoms can be strongest in the early stages of recovery. While this can certainly make caring for someone challenging at first, it’s important to remember that this stage is short-lived. 

It can be helpful to familiarize yourself with how naltrexone, a medication for AUD, works. Naltrexone stops the euphoric effects of alcohol by blocking opioid receptors. It can be effective as soon as someone takes their first dose. Typically, people take one pill per day.

While naltrexone can block alcohol cravings, it doesn’t stop withdrawal symptoms. Withdrawal symptoms can range from mild to severe, depending on the length and extent of alcohol use. Naltrexone does not prevent someone from getting drunk. 

While you can manage mild withdrawal symptoms at home, severe withdrawal effects, such as heart palpitations and tremors, may require hospitalization. Withdrawal symptoms usually don’t last more than a couple of days. 

If someone should miss their naltrexone dose, they should take it as soon as they remember. If it’s too close to the next day’s dose, simply resume taking it then. Not everyone experiences side effects while taking naltrexone, but it’s a good rule of thumb to know what to expect if they do. If the person expresses concern, you can assuage them and offer care at home so long as their side effects are mild. Usually, side effects only last a few days. 

Mild side effects of naltrexone include the following (1).

• Cramping or nausea
• Anxiety or nervousness
• Trouble sleeping
• Headache
• Joint or muscle pain
• Unusual exhaustion

What Can Support Include?

Support can be wide-ranging, from practical tasks to emotional care. The kind of support that someone needs depends on the person. In the early stages of recovery, someone might not know how to ask for what they need. Offering a few forms of support can be helpful. Support can include any of the following.

• Driving someone to their meeting, outpatient program, therapy appointment, or doctor’s office. 
• Bringing a meal over for someone who is trying to stop drinking.
• Meeting a loved one at an alcohol-free location, such as a coffee shop, to mitigate triggers.
• Listening to your loved one and ensuring that they know you’re available if they experience a craving for alcohol.

Another form of support is reading up on AUD and understanding the signs of relapse. Relapse can be a normal part of recovery, though it’s generally lower among those who take naltrexone (2). If someone you love is in relapse or falling off their treatment protocol, you can spot the signs and point them out. You can’t prevent someone you care about from relapsing, but you can encourage them to get back to their treatment. 

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Know Your Boundaries

When you provide support for someone, it’s helpful to know what you are and are not comfortable with offering. A healthy boundary might look like limiting your contact with someone if they are actively drinking but showing up when you hear their interest or commitment to recovery. 

What Not to Do

• Use harmful language

It’s essential to keep your language nonjudgmental and person-centered. Instead of calling your loved one a stigmatizing term like “addict” or “alcoholic”, you could say someone you love is struggling with AUD.

• Ask someone to stay sober for you

While it can be frustrating to watch someone you care about drink, they need to want to recover for themselves before anyone else. 

• Provide helicopter support

While you can support someone, recovery is up to them. Constantly monitoring someone’s usage takes away their autonomy. 

• Place blame

Addiction is never someone’s fault, even though it sometimes comes with painful repercussions for loved ones. Many people with AUD are well aware of the painful imprint that it can leave on friends and family. 

• Not talk about 

Sometimes, knowing what to say when someone is going through treatment can be tricky, especially if it’s the first time around. You might not know how to bring it up. It’s always better to open communication than stay quiet. As AUD is still stigmatized, asking about someone’s experience can help diffuse shame around it. Some helpful check-in phrases include the following.

• How can I support you through treatment?
• I want to check in and see how you’re doing. 
• Do you know that I’m here for you?
• I’m happy to listen whenever you need it.

Remember to Help Yourself

Supporting someone through recovery can be taxing. If you need a break, communicate it directly with your loved one and specify when you’ll be back. It’s helpful not to put the needs of another ahead of your own to avoid pouring from an empty cup. Take time for self-care every day while caring for someone else. 

It’s essential to remember that even with a highly effective treatment like naltrexone, recovery is an ongoing process. While someone may seem much better after starting naltrexone, medication doesn’t heal AUD; your emotional support still matters. While you can’t stop someone from drinking, you can support them throughout their recovery, whichever path they take to get there.

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