Supporting someone with alcohol or drug problems: what the latest research says

Researchers use different definitions of a lapse and relapse. In one US study of 563 people treated for alcohol problems, most who drank again followed a pattern of less frequent drinking rather than sustained frequent heavy drinking [1]. The finding is limited to one older alcohol-treatment study. Any return to drinking still needs to be taken seriously. With opioids, even one return to use after a break can be fatal.

UK alcohol guidance recommends helping someone respond to a lapse without treating all their progress as lost [2]. Encourage them to reconnect with their service and review what support they need.

“Thanks for telling me. What would help you get support again?”

A US survey included 2,002 adults who said they had resolved a significant alcohol or drug problem. Half reported no more than two serious recovery attempts; the mean was just over five because some reported many attempts [3]. The survey relied on people's recollections, so it cannot tell someone how many attempts they will need. Needing help again does not erase earlier progress.

A 2019 review of 321 studies linked alcohol relapse with other mental health problems, more severe alcohol problems, craving and use of other substances. Supportive relationships, confidence and a sense of purpose were associated with a lower risk, although the studies used different definitions and methods [4].

A US study of 312 people recovering mainly from crack cocaine or heroin found that social support, meaning and other resources were associated with recovery and wellbeing a year later [5]. These are associations, not proof that one factor causes recovery. Ordinary time together, hobbies and practical help can be valuable; families cannot guarantee that someone will stay well.

A 2020 Cochrane review included 27 studies and 10,565 people. It found high-certainty evidence that structured, professionally delivered programmes encouraging AA participation improved continuous abstinence at 12 months compared with treatments such as CBT. This advantage was also seen at longer follow-up. Results for drinking intensity and other harms were less clearly different [6]. The strongest evidence concerned these structured programmes and staying completely off alcohol.

In an observational US study of 647 adults, differences between twelve-step groups, SMART Recovery, LifeRing and Women for Sobriety were no longer clear after accounting for people's starting goals [7]. Participants chose their groups, so this does not prove equal effectiveness. If they want to try a meeting, you could help find one or go along where welcome. Which group they choose is up to them.

A 2020 review of 16 trials, involving 2,115 people, found a modest advantage for treatments involving a partner, parent or another close person over individual treatments. Benefits on substance use and related problems were still evident 12 - 18 months after treatment [8]. The programmes differed; this was not simply a test of adding a few family sessions to otherwise identical care.

An older review of behavioural couples therapy also found benefits at follow-up [9]. UK alcohol guidance recommends considering it when a partner wants to participate, but not where there is current domestic abuse or the partner is also drinking problematically [2]. If the person agrees and it feels safe for you, ask their keyworker what family involvement could look like.

CRAFT (Community Reinforcement and Family Training) helps families with communication, encouraging changes in substance use and looking after themselves. A 2020 review found higher treatment-entry rates than comparison approaches, but results varied widely [10]. In a 2024 trial of 113 parents of young adults, CRAFT did not clearly improve treatment entry compared with structured counselling; both groups reported less substance use by their son or daughter [11].

These studies mainly concern getting someone into treatment; how well CRAFT prevents later relapse remains uncertain. Ask a trained practitioner which skills fit your situation. Setting boundaries should never mean withholding emergency help or putting yourself in danger.

Tolerance to heroin can fall after just a few days without it. Returning to a previously used amount can cause an overdose [12]. A review of six prison systems found drug-related deaths were much more likely in the first two weeks after release than in weeks 3 - 12; the size of that increase varied between countries [13]. These figures describe groups, not one person's risk.

An English study of 151,983 people treated for opioid dependence also found a higher risk of fatal drug poisoning while out of treatment [14]. The evidence supports careful planning when treatment ends or changes. Risks vary with the person's circumstances. Before release or discharge, ask the service about continuing treatment, follow-up, naloxone and training.

Alcohol withdrawal is a separate danger. Someone who is physically dependent should get medical advice before stopping suddenly [15].

The 5-Step Method gives family members time with a trained practitioner to talk, understand substance use, consider how they cope and find support. UK alcohol guidance says services should offer families help even when the person using alcohol is not in treatment [2].

A UK trial of 143 relatives, published in 2009, found no clear difference between a brief intervention with a handbook and a fuller intervention at 12 weeks [16]. A Dutch evaluation began with 145 family members; those followed up reported less burden, but there was no control group and many did not complete follow-up [17]. How much support someone needs will vary.

A 2026 trial of 126 rural Australian family members found better depression, life-satisfaction and coping scores after online CRAFT than after a waitlist with reading materials [18]. Longer-term benefits remain uncertain. Ask your local drug and alcohol service for an appointment for yourself.

Naloxone can temporarily reverse an opioid overdose while an ambulance is on the way [19]. UK rules allow specified services and professionals, including pharmacists, to supply it without a prescription to people at risk and to family or friends [20][21]. This does not mean every pharmacy stocks or supplies it. Ask the local drug and alcohol service for a kit and training.

In Scotland, Scottish Families Affected by Alcohol and Drugs runs a Click and Deliver scheme [22]. If an overdose happens, call 999, use available naloxone as instructed and stay with the person. Its effect can wear off, so emergency help is still needed even if they wake up [19].

Next check due: 3 November 2026. Details to check: Supply arrangements and local access.

SMART Recovery UK offers meetings for people affected by someone else's substance use. Its meeting finder includes online and in-person Family & Friends groups; use that filter to check the current times and any joining requirements [23]. The CRAFT studies above are not trials of these particular meetings.

Al-Anon supports people affected by someone else's drinking. Its UK volunteer helpline, 0800 0086 811, is free and open 10am - 10pm every day [24]. Volunteers offer peer support and information about meetings, rather than medical advice.

Adfam offers an online forum and family support, including one-to-one options whose cost and availability depend on the service. It does not run a helpline [25]. Addiction Family Support offers free individual, couples, group and bereavement support. Its helpline, 0300 888 3853, opens daily, with different hours across the week; check the linked timetable [26][27].

In Scotland, Scottish Families Affected by Alcohol and Drugs offers support on 08080 10 10 11 [28]. You can contact these services about your own needs, whether or not the person you support is seeking help.

Next check due: 3 November 2026. Details to check: Helpline hours and support availability.