A significant share of the calls our clinic receives are not from people seeking treatment. They are from a parent, a partner, an adult child or a friend, asking some version of the same question: what do I do when they will not go?

There is no method that reliably makes another adult accept treatment. What there is, is a set of things that keep someone alive and connected until they decide, and a set of things that reliably make matters worse.

Start with the survival facts

Before anything about motivation, three practical things reduce the chance of the worst outcome, and none of them require the person to want treatment.

  • Get naloxone and learn to use it. Free take home kits are available across British Columbia at pharmacies and health units. Have one where the person actually is.
  • Ask them not to use alone. Most fatal overdoses happen alone behind a closed door. Overdose prevention sites and the Lifeguard app both exist for this. If they will not use either, ask them to leave the door unlocked and to tell someone.
  • Know that calling for help is protected. The Good Samaritan Drug Overdose Act protects people at the scene of an overdose from charges for simple possession. Fear of police stops people calling, and that fear is worth addressing directly.

What the evidence says about pressure

The confrontational intervention familiar from television performs poorly in research. It has low uptake and a real risk of rupturing the relationship, which removes the very connection that later makes treatment possible.

Ultimatums are a mixed picture. A boundary you will genuinely keep can be useful and is sometimes necessary for your own sake. A boundary announced in anger and abandoned a week later teaches that your words do not mean much. If you are going to draw a line, draw one you can hold.

What performs better is unglamorous. Approaches built on listening rather than arguing, on asking what they want rather than telling them what they need, and on keeping the door open, consistently outperform confrontation. The aim is not to win the argument today. It is to be the person they call when something shifts.

Staying in contact without endorsing the situation

People worry that staying connected amounts to approval. In practice, isolation is what makes drug use more dangerous, not less. You can decline to give money, decline to lie for someone, and still answer the phone.

A few things that tend to help:

  • Separate the person from the use in how you talk. Words like addict and clean carry judgement that closes conversations.
  • Ask questions rather than issuing statements. What would have to change for you to consider it opens more than you should get help.
  • Offer specific, small help. A lift to an appointment is easier to accept than an offer to fix everything.
  • Do not make your affection conditional on progress. That is the single thing most likely to end contact.

Being ready for the window

Willingness is rarely a permanent state that arrives and stays. It tends to come in windows, sometimes only hours long, often after something frightening. The difference between a window that leads to treatment and one that closes is usually how much friction is in the way.

So do the preparation in advance. Know which clinic they could attend and its hours. Know that no referral is required in British Columbia. Know that a same day assessment is possible. Have the number saved. When someone says maybe, the answer you want to have ready is that they are open now and I will drive you, not that you will look into it.

You can also call a clinic yourself, before that moment, and ask what would happen if they walked in. We take those calls regularly and we are happy to take yours. We cannot discuss another adult medical information with you, but we can tell you exactly how the process works.

Looking after yourself is not optional

People in this position frequently arrive exhausted, financially strained and carrying a guilt that does not belong to them. It is worth saying plainly that you did not cause this and you cannot control it.

Support for families exists across British Columbia, and using it makes you better at this rather than worse. Al Anon, Nar Anon and family support programmes through regional health authorities all provide it. If the strain is affecting your own health, that is a reason to see your own doctor, not a sign of weakness.

The most useful thing you can be, over a long period, is still there and still standing. That is easier to sustain if you are not doing it alone.