DRINK & DRUGS NEWS :: Q&A

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Question:

My friend is a persistent drug and alcohol user. I have offered to get him help from the treatment agency where I work, but he has threatened to break off our friendship if I interfere and betray his confidence. Should I break his trust to save his life? [Joanna, Leicester]

Your replies...

Dear Joanna

You can take a horse to water but you can't make it drink. You have made your friend aware of the dangers of what they are doing and you have offered to help them find help for their problem - the rest I am afraid is up to them.

Drug treatment is shown to have a very low success rate when the client has to be coerced into treatment (just look at the evidence from the DIP services if you don't believe me). Your friend will access help when the time is right for them, and only they will know when that time is. All you can do is be a good friend and be there when the time comes.

Ben, by email

Dear Joanna

I'm assuming from your concern that you think your friend's drugs use has reached harmful levels? He obviously does not, and ultimately as an adult he has to decide what is right for him. You cannot make that decision for him and on a practical level nor can you drag him by the hair to his nearest drug treatment service. All you can do is provide him with information to allow him to make an informed decision on his drug taking. You have to try and remember he is your friend not one of your clients. All you can do is offer advice when he asks for it and provide support when he needs it.

Bill W, Birmingham

I am guessing you'll get a lot of responses going on about client confidentiality and the like - but that is not the issue here. There is a clear difference between client confidentiality and confidentiality between friends. And you also have responsibilities towards your friends which are different, and wider, than those towards clients.

So if you think it's in your friend's best interests to break his confidence, you have every right to do so. You may even have a moral responsibility to do so - though you have to be prepared to lose him if you do. Having said all that, I can't actually see much benefit in trying to get your friend into treatment if he doesn't want to go - they would be unlikely to accept him, he'd be unlikely to go even if they did, and would be even less likely to stay.

I know, because I have been in a very similar same situation myself. I did actually persuade an agency to take a friend of mine in, I even managed (after many very heated and unpleasant arguments) to get him in a car to go there - but when he got there he refused to go in. Over the following year he nearly died twice - but eventually did go in to treatment, on his own terms, and did really well. And we're friends again too!

Derek, Acocks Green, West Midlands

Dear Joanna,

With reference to the dilemma you find yourself in:

Firstly, I would query why you have suggested getting your friend help from the treatment agency where you work - what about client confidentiality? How comfortable do you think your friend would feel being treated in your workplace?

Secondly, why are you assuming that you would save his life? The vast majority of drug and alcohol users do not die from their habit.

Thirdly, from what you say, he has already indicated in no uncertain terms that he does not want your help. It may be that he is not having particular problems with his use at the moment and is not ready to seek help or move into treatment.

Back off, Joanna, keep your friendship and hard as it is, wait until he indicates that he wants help. Successful treatment and support always has to come at a point when the user himself is ready to choose that option.

Your friend is fortunate that you are so concerned about his welfare so don't jeapordise your friendship in your rush to make him 'well'.

Good luck and best wishes,

Irene MacDonald. CPSG, Cheltenham

Dear Joanna

No matter how hard we try to help someone, if they are not ready for help (they may never be) they will not accept it. It feels like your friend wants you to be a 'just a friend' and accept them as they are. By trying to force your friend to get help is sending the message that you don't accept or respect them.

It's so hard to watch someone you care about slowly killing themselves, but the reality is it is your friend's choice.

It sounds really tough, all the best.

Liz, Shrewsbury

Dear Joanna,

You have kindly made the offer to arrange help for your friend at your agency and he has declined that offer. It sounds as if your friend might not be ready to access treatment at the moment and trying to coerce him into engaging with your agency might only encourage him to withdraw further away from help.

What you can do is support him as a friend; be available to talk, visit, go out for coffee or a movie or whatever. Ask him if there is anything you can do for him at the moment and see what he says. After all, you are his friend, not his keyworker, so make sure you treat him as such and not like one of your clients.

Also, Joanna, what about you? It can be extremely painful witnessing a friend going through destructive drug and/or alcohol use. Sometimes, we might decide to make the difficult decision of having to walk away if their substance misuse affects us too much. It could be useful to ask yourself how your friend's using is affecting you, and if you need any support yourself; Families Anonymous offer support groups for those affected by loved ones who use drugs and alcohol.

Good luck.

Phil, by email

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