How to Help People with Addiction Who Are Mandated to Abstinence

1. Help them get medical care and needed medications to achieve physical and mental stability.

2. Help them substitute the word “longing” for “craving.” Ask, “What are you aware of longing for? Try to be as specific as possible.” With compassion, and without judgment, help them figure out, other than to stave off withdrawal, what wants and needs the substances met.

3. Help them discover “good enough” replacements so they can still get their wants and needs met.

4. Help them figure out how to stay away from it, its items, its people, and its gathering places.

5. Help them come up with plans, and to access resources, to increase the stability of their living situations, finances, and relationships.

6. Help them learn skills that may help people abstain in any situation, regardless of their problems.

7. Help them identify addiction myths and realities* so they can help themselves get evidence-based care, and not get sidetracked by belief-based practices.

8. If you’re a person with addiction attempting to help others, “Walk the talk.” Provide skillful support. Share what’s working for you, and share what you’re working on and why. Show that support, skills, and stability work – not folklore, criticism, confrontation, punishment, shame, humiliation, and stigma.

Help that helps

*Addiction Myths and Realities

Myth: You became addicted because you’re a bad person and you’ve done wrong. To become un-addicted, you need to become a good person. Further, you need to admit to, take responsibility for, apologize for, and make restitution for your wrongdoing.

Reality: Addiction is a medical illness involving structures and functions of the human brain. Before they developed addiction, most people experienced trauma. More than half have a mental illness.

Myth: You have to “hit bottom” before you’re ready to abstain.

Reality: People with untreated medical illnesses are at risk of premature death.

Myth: You can become addicted the first time you use.

Reality: Use ≠ addiction. According to research, 70-80% of people who use substances – in any way, of any kind – do not become addicted to them.

Myth: Pregnant mothers on illegal drugs or on prescribed medications give birth to addicted babies.

Reality: Use ≠ addiction ≠ dependence. Babies may be born dependent upon substances their mothers take, including blood pressure and antidepressant medications, but they are not born addicted. According to NIDA, “Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” Babies are incapable of knowing what medication is missing, much less how to seek and use it.

Myth: If you’re on medication, you’ve traded one addiction for another.

Reality: Use ≠ addiction ≠ dependence. People on medications may become dependent upon them, meaning they will experience physical symptoms if they stop taking the medications. Taking drugs/medications as prescribed is not “compulsive drug seeking and use” and does not result in behavior that causes harmful consequences.

Myth: If you’re on medication, you’re not really abstinent.

Reality: Laypeople without medical expertise and without knowledge of a particular individual’s particular medical conditions, who mandate whether or not individuals should have medications prescribed to them by medical professionals, put lives in danger.

. . . . .

This post is an online version of one in a series of handouts I am creating for people with addiction who have been mandated to substance abstinence by authorities, including drug courts. I have strong views about this. But right here, right now, people with addiction need help and they’re either not getting it, or what they’re getting isn’t working. The handouts are my attempt to strong arm aside belief and theory and present distillations of what research reports helps people abstain. An Insider’s Guide to Early Abstinence may also be helpful.

Last updated 1/16/20

The views expressed are mine alone and do not necessarily reflect the positions of my employers, co-workers, clients, family members or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.


  1. Brandon Lowe says

    Please send this to the va health practioners’monitoring program!