You can help someone with a drug addiction most by staying in contact, speaking calmly about what you have seen, rewarding the days they do not use, and refusing to cushion the damage drugs cause. In studies, families taught these skills got far more loved ones into treatment than families using older approaches. Look after your own safety and health while you do it, and call 999 if their life is ever in danger.
This guide is for families in Malaysia living with a husband, wife, son, daughter or sibling who uses drugs.
First, know when it is an emergency
Call 999 straight away if the person:
- cannot be woken, has pinpoint pupils, or is breathing slowly or with difficulty. These are the signs of an opioid overdose that the World Health Organization lists. The risk is higher when heroin is mixed with alcohol or sedative pills.
- has a seizure. Suddenly stopping sedative pills such as Erimin 5 can cause one.
- is hearing or seeing things, is very paranoid, or is threatening to hurt themselves or someone else. Heavy syabu use can cause psychosis, a state where a person loses touch with what is real.
If you are afraid of them, leave the house first and call from somewhere safe.
What actually helps
The best-studied method for families is called CRAFT (Community Reinforcement and Family Training). It teaches relatives to talk more positively, reward sober behaviour, stop shielding the person from the results of their use, build their own support, and protect themselves from violence. A 2012 study in the Journal of Substance Abuse Treatment summarised earlier trials: CRAFT led 60 to 71 per cent of loved ones into treatment, against 17 to 30 per cent for traditional approaches such as Al-Anon or Nar-Anon facilitation and the Johnson Institute intervention.
In daily life, that looks like this:
- Spend time with them when they are sober. Eat together, go out, talk about normal things. Sober time should feel better than using time.
- Step back when they are high. Calmly end the conversation or leave the room. Do not argue with someone who is intoxicated.
- Let the consequences land. If they miss work because of drugs, do not phone in sick for them.
- Notice the good days out loud. "It was good to have you at dinner tonight" does more than a lecture.
What to say, and what to avoid
Talk when they are sober and calm. Describe what you have seen and how it affects you, using "I" rather than "you". "I saw money go missing again and I am frightened" is easier to hear than "You are a drug addict."
Avoid shaming, name-calling, comparing them with others and bringing up every past failure at once. Our guide on talking to someone about getting help covers the first conversation in detail. If you are still unsure what you are dealing with, read the signs of drug use first.
Setting boundaries
A boundary is a rule about what you will do. It is not a punishment. Good boundaries are clear, few and kept.
- "I will not give you cash. I will pay for food or a bus fare directly."
- "Nobody uses drugs in this house."
- "If you shout at me, I will leave the room and we can talk later."
Say each one once, calmly, at a sober moment. Then keep it. A boundary that changes every time it is tested teaches the person to keep testing.
Money
Money is one of the hardest areas for families. CRAFT teaches relatives not to stand between the person and the results of their use, and giving cash, paying debts or replacing what has been sold does exactly that, even when it feels like kindness.
- Pay for needs directly: rent, groceries, a phone bill, treatment.
- Lock away cash, cards, jewellery and anything easy to sell.
- Separate joint bank accounts if your own money is at risk.
- Do not pay off debts to dealers or loan sharks without getting advice first.
Helping with cravings
Cravings are strong urges to use, and they are a normal part of stopping. You cannot switch them off for someone, but you can help them get through each one.
- Ask what sets the craving off: certain people, places, payday, stress or boredom. Plan around those times.
- Help them leave the situation. A walk, a drive, a meal or a call to someone they trust can help them ride out the urge.
- Keep the routine steady, with regular meals and regular sleep.
- Do not panic when they admit to a craving. Telling you is a good sign.
If they relapse
Relapse means using again after a period of stopping. It can happen, and it does not mean recovery is over.
The first concern is safety. After time without heroin or other opioids, the body's tolerance drops. MedlinePlus notes that most opioid overdose deaths happen in people who have just detoxed, and WHO describes a spike in overdoses in the weeks after release from prison. If someone has used again after a break, do not leave them alone, and call 999 if they show any overdose signs.
After that, stay calm, talk about what led to it, and get them back to their treatment team or into treatment as soon as you can.
Getting them to agree to treatment
Most people do not agree the first time. Things that help:
If they are willing, our guide to voluntary drug rehab in Malaysia sets out the routes that start with their own agreement.
- Have a specific option ready: a place, a cost and a date. "Will you come with me to talk to them?" is easier to accept than "You need help."
- Choose a calm moment when they are sober, and keep it private.
- Let a professional talk to them. A clinician's voice can land differently from a relative's.
- Explain that withdrawal does not have to be faced alone. For some drugs it needs medical care: sedative pills can cause seizures if stopped suddenly. Heroin withdrawal is very uncomfortable but not usually life threatening.
Treatment often combines talking therapy, medical care and support groups. For heroin and other opioids, medicines such as methadone or buprenorphine replace the drug in a controlled way. In Malaysia, methadone is dispensed through government hospitals and health clinics, among other places. Our drug rehabilitation centre page explains how a residential programme works.
Looking after yourself
Living with someone's addiction wears families down. The NHS says that getting help for yourself puts you in a better position to support the person you love.
- Talk to someone outside the situation: a friend, a counsellor or a family support group such as Al-Anon or Nar-Anon.
- Keep some of your own life going: work, friends, prayer, exercise, sleep.
- Talian HEAL 15555, run by the National Centre of Excellence for Mental Health, offers trained counsellors from 8am to midnight every day, including public holidays.
Common questions
How do I help someone addicted to drugs who does not want help?
Keep the relationship, set clear boundaries, and reward sober time. Stop protecting them from the results of their use. Ask again at calm moments, and get advice for yourself in the meantime. Families can call Salus before the person agrees to anything.
Should I give my husband or son money?
Avoid giving cash. Pay for food, bills or transport directly if you want to help, and keep valuables locked away. If you want to spend money on their recovery, put it towards treatment.
Can I force an adult into rehab?
Salus only admits adults who agree to come, because the programme is voluntary. You can still work towards that agreement, and a clinician can talk the options through with you first. Malaysia's separate laws on drugs and treatment are explained in our article on drug laws in Malaysia.
What do I do if they relapse after rehab?
Check that they are safe, since overdose risk is higher after a break. Stay calm, talk about what happened, and get them back in touch with their treatment team quickly, because one relapse does not cancel the progress they made.
How Salus can help
Salus runs a private, confidential, voluntary 90-day residential programme for adults aged 18 and over in Cyberjaya, Selangor. Each guest has a medical, psychiatric and psychological assessment on arrival, and withdrawal is managed alongside medical care. A Salus Clinician plans daily life alongside medical care. It costs RM7,000 per month, all-inclusive: private room, meals, 24-hour care and medical oversight, individual and group therapy, family sessions and an aftercare plan.
Families can call first, before the person agrees. We can help you plan what to say and what to offer. Call or WhatsApp Salus for a confidential conversation.
This article is general information, not medical advice.
