You should not have to become a clinician to help
The honest starting point is this: when substance use and mental-health symptoms are both present, both need attention, and the order of operations is a clinical question, not a family debate. Your job is not to diagnose. It is to stay connected, communicate clearly, protect reasonable boundaries, and get professional guidance involved. That is more than enough, and it matters more than families usually believe.
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When Someone Refuses Treatment
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Family Resources
Most of the people who reach out to us are family members. This step-by-step guide is written for you.
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How Admissions Works
A simple, supportive walkthrough of how to get started — from your first call through intake and arrival.
Learn moreWhat helps when you talk to them
- Pick a calm, sober moment, not the middle of a crisis or an argument
- Describe what you see, specifically and without labels: missed work, sleepless nights, the drinking, the isolation
- Say what you are afraid of, plainly and briefly
- Ask questions and listen more than you lecture
- Offer to help them take one step, a call, an assessment, a ride, rather than demanding they fix everything
- Expect defensiveness the first time, and do not treat one conversation as the only chance
What tends to make things worse
Arguing about whether it is really addiction or really mental illness usually goes nowhere, because the answer is often both and neither label motivates change by itself. Shaming, threatening, and diagnosing at the kitchen table push people into secrecy. So does quietly absorbing every consequence: paying the debts, calling in sick for them, smoothing over each crisis. Support means staying connected to the person. It does not mean protecting the pattern from reality. And do not manage their psychiatric medication yourself, urging them to stop or start anything; medication questions belong with their prescriber, and abrupt stops can be genuinely dangerous.
Boundaries that protect you both
Boundaries are not punishments. They are statements about what you will and will not participate in: money you will not lend, lies you will not tell, behavior you will not accept in your home. Clear boundaries, stated calmly and kept consistently, often do more than any speech. They also protect your own health, which matters in its own right and because burned-out families cannot help anyone. Get support for yourself, whether or not your loved one accepts help: therapy, family groups, and honest conversations with people who understand.
When it is a crisis
Know the emergency lines before you need them
Call or text 988, the Suicide and Crisis Lifeline, if your loved one talks about suicide or you are worried about their safety. Call 911 for suicide attempts, threats of harm, severe psychosis, suspected overdose, severe withdrawal, or any immediate danger. You do not have to judge whether it is serious enough. Make the call.
How Present Moments Recovery works with families
When you call, you speak with someone who understands the program and takes time to hear the full situation, and you do not need a confirmed diagnosis, a treatment plan, or your loved one's permission to have that first conversation. We can help you understand what an integrated assessment involves, what levels of care might fit, and how to talk about it at home. When a client enters treatment, family involvement continues where clinically appropriate: education about how addiction and mental health interact, communication support, realistic expectations for stabilization, and a shared understanding of relapse warning signs like isolation, stopped medication, sleep collapse, and returning hopelessness.
“The beauty of our Continuum of Care model is a consistent treatment team from the beginning of the journey until the client is ready to fly solo. Clients are able to establish trust with their primary counselor, while the team supports them from the first day of care through their transition into the next appropriate stage of recovery.”
You do not need the full picture before calling
Tell us what you are seeing. We will help you sort out what kind of assessment or care may fit. Call or text (619) 363-4767. No pressure, just a conversation.
Frequently asked questions
How do I know if it is addiction, mental illness, or both?
Often you cannot tell from the outside, and you do not need to. When substance use and mental-health symptoms are both present, both deserve professional assessment. Your role is to describe what you see and help connect the person to an evaluation, not to settle the diagnosis first.
They say the drinking is just how they cope with depression. Are they right?
They may be partly right, and that is exactly the problem. Self-medication provides short-term relief while usually deepening the underlying symptoms and adding dependence. The answer is not to debate the explanation but to treat both the mood and the substance use together.
Should I make sure they keep taking their psychiatric medication?
Encourage consistency and appointments, but do not become the medication police, and never push someone to stop or change a prescription. Medication decisions belong with a qualified prescriber. If you believe medication is being misused or mixed dangerously with substances, share that concern with their treatment provider.
What if they refuse any kind of help?
Stay connected, keep your boundaries, stop shielding the pattern from consequences, and get support for yourself. Refusal is often a stage, not a final answer, and families who remain steady and informed are usually in the best position when the window opens. You can also call us to talk through the situation before your loved one is willing to.
When should I treat it as an emergency?
Any talk of suicide with intent or a plan, a suicide attempt, threats of harm, severe psychosis or dangerous paranoia, suspected overdose, or severe withdrawal is an emergency. Call or text 988 for a suicide or mental-health crisis and 911 for immediate danger. Do not wait to be certain.
