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How to Initiate a Recovery Conversation   

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Opening a dialog with a person struggling with substance use can be challenging—but it’s less intimidating if you plan the conversation.

Talking with a loved one about their substance use can be one of the most difficult things you ever do. But it can also be one of the most important because it can represent the first step on the individual’s road to recovery.

Even just thinking about having this conversation may make you anxious. After all, there are multiple unknowns in bringing up the subject to your loved one. Will you say the right things? Will you be able to get through to your loved one? How will they react?

What’s more, as substance use disorder is a chronic disease and recovery entails numerous peaks and valleys, your initial conversation will likely be the just first of many you will have with the individual throughout their recovery.

While having a substance-use conversation is never easy, the good news is that, if you plan, and use positive communication strategies you can have some control over how it goes.

Taking Control of the Conversation

Here are some tips for planning a successful substance-use conversation with your loved one.

Do Your Homework

An effective conversation begins with having the facts and understanding what you’re dealing with. Research the short- and long-term effects of the substance or substances you believe your loved one is using, as well as the signs of problem use. Helpful resources include, but are not limited to, the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism.

In addition to aiding you in having a more informed conversation, this knowledge can help you determine the best treatment options for your loved one.

Choose the Right Time and Place

When and where you have the conversation matters. To make sure you’ll be at your best and are likely to have their full attention, don’t initiate the conversation while your loved one is under the influence of a substance. Also, find a quiet and private place for the conversation to avoid embarrassing them and to help put you both at ease.

Ask Questions

While you will have one or more messages you want to convey to your loved one, you are more likely to have a productive conversation if you initiate a dialog. Asking questions will improve the likelihood that the individual feels heard, as opposed to being “lectured to.”

Be Prepared to Listen

Engaging in a dialog with your loved one can also help you learn more about their situation and their substance use—information that might help you make sense of your loved one’s troubling behavior. You don’t have to agree with what is being said and still understand.

But you only get this information if you ask questions and listen—really listen—to their responses.

Anticipate Their Reactions

Depending on the individual, they may react to the conversation with denial, anger, volatility—or a combination of these. Expecting a negative reaction can lead to your postponing or avoiding having the conversation. However, negative reactions are easier to accept and navigate when you have planned for them in advance.

Prior to the conversation, think through what you plan to say and anticipate how your loved one will react. Then plan how you will respond in turn. Mapping the conversation out on paper, with the messages you want to get across, anticipated reactions, and your responses can help you feel more in control of the conversation and its outcomes. It can also make you more confident in delivering your message.

Practice

Once you have planned the conversation, you can further boost your confidence and effectiveness by practicing. You can do this by yourself (repeatedly running through the conversation out loud or in your head) or by roleplaying the conversation with someone you trust. By taking a turn playing the role of your loved one, you can gain additional insights into how they might react.

Get Help

As with all aspects of dealing with a loved one with a substance use issue, one of your greatest strengths is your support network. Families Strong WV can help. We offer free support groups based on years of experience assisting the loved ones of substance users.

For more support with a family member or friend with substance use issues, visit familiesstrongwv.com to find an upcoming group near you. If you have questions about our program, get in touch with our team today at (681) 378-2086 or email [email protected]. Families Strong WV offers 8-week long group sessions which will equip you with the tools and resources to support your loved one no matter how tough things get.

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Families Strong is a free, 8-week support group for the families and friends of individuals who are using substances. It is designed to help reduce the negative effects of substance use issues on families. The program is developed and guided by Mosaic Group, nationally recognized experts in behavioral health. To learn more about the program and how your organization or state agency can partner with Mosaic Group to implement it, contact us at [email protected].

Tools for Providers & Practice Staff

Getting Started with Buprenorphine

Audience: Provider

Purpose: This guide helps providers support patients interested in MOUD, covering patient assessment, treatment, follow-up, and billing codes.

Provider Information on Medications

Audience: Provider

Purpose: A quick reference for providers to support shared decision-making with patients by offering detailed information on each MOUD medication.

MOUD Quick Induction Guide

Audience: Provider

Purpose: A practical step-by-step tool for providers initiating patients on MOUD, offering best practice guidance for prescribing during induction.

“How To Take Buprenorphine At Home” Induction Guide

Audience: Patient

Purpose: This tool provides patients with step-by-step instructions how to take Buprenorphine and explains potential side effects.

Precipitated Withdrawal

Audience: Provider

Purpose: This tool covers symptoms of precipitated withdrawal, challenges, prevention strategies, and treatment options.

Medical Assistant and Office Staff FAQs

Audience: Provider/Practice Staff

Purpose: This tool addresses common patient and staff questions, covering opioid withdrawal, scheduling, and medication refills.

Billing and Coding for Office-Based Treatment

Audience: Provide/Practice Staff

Purpose: This tool provides guidance on billing and reimbursement, including toxicology testing, telehealth modifiers, and Medicare codes.

Prescriber Resource Guide

Audience: Provide/Practice Staff

Purpose: This guide lists Maryland-specific resources for patients needing a higher level of substance use or mental health treatment, or having social needs.  It also includes prescriber resources for MOUD.

Point of Care Testing in Primary Care

Audience: Provider

Purpose: A comprehensive guide for initiating CLIA-waived point of care lab testing (POCT) in primary care settings in cluding information on certification.

Tools for Patients

Patient-Provider Treatment Agreement

Audience: Patient

Purpose: A customizable treatment agreement to outline program expectations and safety precautions, establishing a shared understanding between patients and providers.

MOUD Medications Overview

Audience: Patient

Purpose: A patient-friendly document detailing all available MOUD options, highlighting the benefits and risks to involve patients in shared decision-making.

“How To Take Buprenorphine At Home” Induction Guide

Audience: Patient

Purpose: This tool provides patients with step-by-step instructions how to take Buprenorphine and explains potential side effects.

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