Stacey Foley started using opioids while she was in an abusive relationship. When the relationship ended, her opioid use increased.

“I didn’t know how to work through the trauma,” Foley tells Public Good News. “I didn’t know how to handle my nervous system, and so opioids became my escape.”

Years later, after starting a new relationship and having two children, Foley recognized that her opioid use was affecting her parenting. She decided to make a change. Now, the Canadian speaker and writer has been in recovery from opioid use disorder for seven years.

Foley isn’t alone. After a doctor prescribed Lauren Wassum opioids to manage pain from an injury, she started using the medication to cope with the death of her uncle.

“I felt like the world was crashing around me. Really, it was that I just didn’t know how to deal with the grief,” Wassum says. Ten years later, after an overdose, she entered treatment. Now Wassum is a certified recovery specialist in Pennsylvania who helps others with substance use disorder live healthier lives.

Both Foley and Wassum say that support from others has been critical to their recovery.

“Every addiction is different. Every person is different. The best thing that you can really, truly do for someone is to be there to support them when they need it,” Foley says.

Read on to learn how you can support loved ones with OUD.

How does opioid addiction happen?

Taking opioids repeatedly, or differently than prescribed, can change how the brain works. The body may make fewer endorphins, chemicals that help regulate pain and stress. When people try to stop or reduce opioid use, they may experience withdrawal symptoms such as changes in body temperature, irritability, tremors, trouble sleeping, and intense cravings. This can make opioids hard to stop using and may lead to OUD.

OUD is a chronic health condition that can cause mental and physical distress. Because opioids can slow or stop breathing, OUD can also increase the risk of overdose and death. It can affect anyone at any stage of life.

“There’s no group that’s spared [from OUD],” Dr. Sarah S. Kawasaki, an addiction medicine specialist and associate professor at Penn State College of Medicine, explains.

What are signs that a loved one might be struggling with OUD?

OUD can cause physical symptoms like changes in pupil size, drowsiness, changes in appetite and weight, and flu-like symptoms. It can also show up in behavior, including pulling away from family, work, or daily responsibilities.

“Any addiction revolves around a pathologic craving,” Kawasaki says. “That craving leads to an inordinate amount of time spent thinking about how to earn money to get their next fix, how to achieve their next fix, how to avoid the negative symptoms of withdrawal. It’s doing so while neglecting family relationships, work relationships, financial obligations—at a great risk to personal freedom, to personal safety.”

James Sherman, a clinical research coordinator and lead substance use navigator at University of Pennsylvania’s Center for Addiction Medicine and Policy, is in recovery from OUD. He has firsthand experience with those behavioral changes.

“In my addiction, I often avoided interacting with my loved ones because I was fueled with so much guilt and shame due to my opioid use,” Sherman tells PGN. “In my drug use, work, family events, going to the doctor, adhering to my probation responsibilities—all of it went on the back burner.”

People with OUD might also show signs of emotional distress or mood changes.

“I think my husband always sort of had an inkling [that I was using opioids] because the high and low of opioids causes some pretty intense mood swings,” Foley says.

Seeing multiple health care providers for opioid prescriptions, or running out of medication early, can also be signs that someone may need help.

“If somebody has a prescription for opioids, but they find that they’re running out early, they need more and more, they’re frequenting emergency departments because they are running out of medicine and not feeling well and sometimes they use multiple prescribers—that is also a sign of addiction,” Kawasaki notes.

How can I support a loved one who’s living with OUD or in recovery?

Stay open and nonjudgmental.

Shame can keep people from seeking treatment or staying in recovery. A nonjudgmental approach can help loved ones with OUD make healthier choices.

“Sympathize with the person by focusing on concern rather than criticism,” Sherman says. “Emphasizing that ‘I care about you….’ rather than, ‘How could you do this?’”

Wassum’s partner modeled that approach when she sought treatment.

“When my overdose happened, he was like, ‘I will be here every step of the way. I know you can do this. I know you’re a good mom.’ Having that support makes a big difference,” she says.

Words and person-first language matter, too.

“Changing our language is really important—not calling someone an addict, a junkie, etc.,” Sherman says. “This is a person with a use disorder. This is someone you want to get better, instead of putting so much blame [on them].”

Check in regularly.

People living with OUD or in recovery may pull back from others, even when connection could help. Foley says regular phone calls, texts, and invitations can make a difference.

“[Support] really is about making sure that that person in your life knows that you’re there, that you’re checking on them, and that you’re supporting them because there are going to be so many days when temptation comes to use again,” she says.

Be patient.

A loved one may not be ready to seek help right away.

“When people try to push you into treatment and you’re not ready, that’s one of the hardest things,” Wassum says. “It’s almost like you feel like you have to go just to make them happy, and then you end up leaving or making it worse [for yourself] down the line.”

Being encouraging—rather than demanding—can help loved ones feel supported.

“I have found that using ‘we’ statements helps make loved ones feel like they’re not in this alone—‘We should schedule you an appointment,’ ‘We should try and get you into treatment,’” Sherman says.

When they’re ready, help them find treatment that fits their needs.

Treatment for OUD looks different from person to person. It may include counseling, peer support, in-patient treatment, or medication that helps people stop or reduce opioid use. Learning about and supporting a loved one’s treatment plan can help them stay in recovery.

“All too often, the treatments for opioid use disorder are equally as stigmatized as the illness of opioid use disorder, and that can be lethal,” Kawasaki says.

Medication for opioid use disorder is often misunderstood as “trading” one addiction for another. That’s not the case.

“You can think of [MOUD] in terms of any medication that you need to control a chronic illness. If you have high blood pressure, if you have diabetes, if you have HIV, if you need to take medicine to suppress an illness that can cause catastrophic outcomes, you depend on that medicine,” Kawasaki explains. “If you stopped any one of those medicines, eventually, you would need to be seen in the emergency department with complications from those issues. Similarly, that’s the case with [MOUD].”

Find treatment resources by contacting SAMHSA’s National Helpline (1-800-662-HELP) or talking to a health care provider.

This article first appeared on Public Good News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.