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How a Teen Can Help a Friend with a Substance Abuse Problem

A Guide for Teens

A Guide for Teens

Does your friend have an alcohol or other drug problem?
What can you do to help?

A Note to Teens

This page was developed to assist you in helping a friend who has a problem with alcohol or other drugs. Sometimes, being a good friend means you have to intervene, but before you get involved it is important to understand what is really going on with your friend.

Please note that two important resource lists are provided at the end of this brochure: (1) a resource and referral guide that provides a list of organizations that you or your friend can contact for more information; and (2) a state-by-state listing of hotlines to call for help and/or information on alcohol and other drug problems.

No matter what, in order to get better, your friend eventually has to admit that he or she has a problem and make an effort to get help. You can be the one that encourages and guides your friend to seek this help.

I know this kid Josh, and all he likes to do is party. What's up with him? He's out of control, he can't handle it.

How can I tell if my friend has a drinking or other drug problem?

Sometimes it's tough to tell. Most kids won't walk up to someone they're close to and ask for help. In fact, your friend will probably do everything possible to deny or hide the problem. But, there are signs you can look for. People with serious substance abuse problems say things like," I can stop drinking or using other drugs any time I want to" - but they don't. They may be o.k. to hang around with, until they get high - then they often act like jerks or get into fights. No one is sure why some people get into trouble with alcohol or other drugs. There are signs, however, when substances are taking control of someone's life. Some of these signs are easy to see, others aren't, but if you see them happening over and over again, chances are your friend needs help.

If your friend has one or more of the following warning signs, he or she may have a problem with alcohol or other drugs:

  • getting drunk or high on drugs on a regular basis
  • lying about things, or about how much alcohol or other drugs he or she is using
  • avoiding you in order to get drunk or high
  • giving up activities he or she used to do, such as sports, homework, or hanging out with friends who don't drink or use other drugs
  • planning drinking in advance, hiding alcohol, drinking or using other drugs alone
  • having to drink more to get the same high
  • believing that in order to have fun you need to drink or use other drugs
  • frequent hangovers
  • pressuring others to drink or use other drugs
  • taking risks, including sexual risks
  • having "blackouts" - forgetting what he or she did the night before while drinking (if you tell your friend what happened, he or she might pretend to remember, or laugh it off as no big deal)
  • feeling run-down, hopeless, depressed, or even suicidal
  • sounding selfish and not caring about others
  • constantly talking about drinking or using other drugs
  • getting in trouble with the law
  • drinking and driving
  • suspension from school for an alcohol- or other drug-related incident

How serious can my friend's drinking or other drug problem be? What can it lead to?

My friend Alison is drinking too much and she is worrying me. She thinks she can handle it, but she can't. She says drinkings no crime, and its the thing to do Not all people who drink or use other drugs develop the same symptoms or consequences, but one thing is for sure: If your friend has a drinking or other drug problem and doesn't get help, things can get much worse. People with serious drinking or other drug problems don't like to admit it, even to themselves. In the beginning, they often say they feel great, that drinking or smoking pot or doing a few lines of cocaine is the best thing that ever happened to them. But then things change for the worse. Eventually, if they don't get help, they can develop serious psychological problems such as suicidal depression, and serious physical problems such as liver damage and brain damage; and some will die from an overdose. Getting drunk or high impairs judgment, and may lead to behaviors that people wouldn't do ordinarily if they weren't under the influence of these substances - such as having unsafe sex which could result in pregnancy, AIDS, or other sexually transmitted diseases. Substance abuse is dangerous; it can ruin your friend's health, cause your friend to drop out of school, lose friends, lose values, and even lose his or her self-respect.

Alcohol and other drugs don't care who you are, what color you are, if you're rich or poor, how old you are, your sex, or where you're from. They don't care if you're a jock, a cheerleader, or a genius.

What would cause my friend to have a serious drinking or other drug problem?

Doug's avoiding problems by drinking. Doug's dad drinks too much, and now Doug's becoming just like him. he's numbing himself. He's just drinking not to think about it.
Lots of things lead to these problems. For one thing, these difficulties often run in families, just like heart disease and cancer. If your friend's parents are alcoholic, or there is a family history of alcoholism or other drug addiction, your friend is more likely to become alcoholic or drug dependent.

People often drink or use other drugs to avoid things that bother them - pressure from friends, stress in the family, hassles, the feeling that adults are on their case, the lousy feeling that they're different from everyone else in the world. They use these substances just to feel better. The problem is, drinking or using other drugs eventually makes things worse because all you care about is getting high, and once you start it's hard to stop; you need to use more just to feel normal. Alcohol and other substances change the way you think, and you start to believe things are better or worse than they really are. Alcohol and other drugs may make you feel good when you're high, but when they wear off, depression sets in.

Why is it so hard for individuals to get help for themselves?

It's tough for most people to admit that they have a serious substance abuse problem. It's especially hard to admit it when you're young because you think that kind of thing could never happen to you. Many people believe that alcoholics and other drug addicts are old people, or are street people, when, in reality, they can be anyone. People who have a serious problem with drinking or using other drugs might say that they are not using that much and that they won't get addicted. Denying that there's a problem is very common. In fact, this denial, along with hiding the substance abuse from friends, becomes almost as big a problem as the drinking or other drug use itself. Becoming dependent on alcohol or other drugs makes you want to cut off the people who care about you, and you can end up feeling lonely and afraid.

To avoid being found out, serious problem drinkers and other drug users often spend more and more time alone, and think they can solve their problem all by themselves, or that a boyfriend or girlfriend can solve it for them. Getting better doesn't work that way. What has to happen is that your friend has to admit that alcohol and/or other drugs are messing up his or her life. However, you can help even if your friend does not admit to having a problem.

What can I do to help my friend?

Keep ReadingIt is possible for you to help a friend who is in serious trouble with alcohol or other drugs. Whether or not your friend takes your advice and gets help is really your friend's decision and responsibility. Sometimes, approaching the friend in trouble with another mutual friend can make our intervention easier since there is safety and support in numbers.

The first step in getting help is for your friend to talk to someone about his or her alcohol and drug use. Eventually, your friend will need to admit that there is a problem, and to agree to stop drinking and/or using other drugs completely. Your friend needs support and understanding, and someone he or she can trust to talk to about the problem. You can't force a friend to get help, but you can encourage and support your friend to seek and find professional help.

If you are worried about a friend, it is important for you to speak to someone in private who is knowledgeable and reassuring. Telling someone isn't being disloyal to your friend. It's important to know the facts about what's happening to your friend if you plan to help. Don't try to help your friend on your own until you have talked to someone you can trust - a counselor, teacher, doctor, nurse, parent, or someone at your church or synagogue. Ask this person to keep the conversation confidential. You don't have to mention your friend by name; you can just talk generally about the problem. Talking to a professional will help you figure out what the best steps are for you to take.

I keep trying to talk to Karen but shes not listening. I don't know how to tell her she has a problem without getting her mad at me.If you decide to speak to your friend, here are some guidelines that you and your advisor should consider in planning how and what you could do to help:

  • Make sure the timing is right. Talk to your friend when he or she is sober of straight - before school is a good time.
  • Never accuse your friend of being an alcoholic or a drug addict, but do express your concern. Try not to blame your friend for the problem; if you do, he or she might be turned off right away.
  • Talk about your feelings. Tell your friend you're worried, and how it feels for you to see him or her drunk or high on other drugs.
  • Tell your friend what you've seen him or her do when drinking or using other drugs. Give specific examples. Tell your friend you want to help.
  • Speak in a caring and understanding tone of voice, not with pity but with friendship.
  • Be prepared for denial and anger. Your friend may say there is nothing wrong and may get mad at you. Many people with alcohol and other drug problems react this way. When confronted, many users will defend their use, blame others for the problem, or give excuses for why they drink or use other drugs.
  • Find out where help is available. You could offer to go with your friend to get help, but be prepared to follow through. This gesture will show your friend that you really care.
  • You need to tell your friend that you are worried about him or her, and that someone who can help needs to be told. Your friend might get really mad at you, but if you say nothing, things may get worse and your friend may be in more danger.
  • Your friend's problem is probably hard on you, too. The situation may have left you feeling lonely and afraid. Maybe you've thought, "What if I get my friend in trouble? What if I lose my friend over this? What if I don't do anything and something awful happens?" It's hard to keep all of these questions and feelings to yourself. It's important that you talk about them. You can share these feelings with the person that you go to for help about your friend's problem. There are also support groups for people like you who are trying to help a friend, such as AL-Anon or Alateen, where you can learn more about people's alcohol and other drug use problems. Your school may have a substance abuse prevention counselor as well. (See the end of this brochure for a list of places to go to for help or to get more information.)

What does my friend have to do to get help?

How're we gonna get Kareem some help? We should talk to him. Probably the hardest decision your friend will be faced with is admitting that he or she has a problem. To get better and recover, your friend has to get some help to stop drinking or using other drugs.

Facing such a problem and asking for help can be a scary thing to do. Your friend will have to take an honest look at where drinking or other drug use has brought him or her, and admit that it has caused emotional and maybe physical pain. Your friend will have to see that it has robbed him or her of real friends, creativity, happiness, spirit, the respect of others, and even self-respect, and that it keeps your friend from growing up.

Your friend will not be able to solve this problem alone. He or she will need experienced help. A good counselor will support your friend and direct him or her to the kind of treatment and/or support groups that are most helpful.

Encourage your friend to talk to other people with drinking and other drug problems who are now in recovery, such as members of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). These groups are confidential, self-help organizations that offer assistance to anyone who has a drinking or other drug problem and wants to do something about it. AA and NA members are recovering alcoholics and addicts, so they have a special understanding of each other. Talking with others who have experienced similar problems is an important part of recovery. New members are encouraged to stay away from alcohol or other drugs "one day at a time." There is no fee for membership in these organizations. If your friend is afraid to go to a meeting alone, you can go along with him or her to an "open" meeting. Friends and family members are welcome to attend this type of meeting, and there are special meetings in most neighborhoods or communities. Local branches of AA and NA are listed in your phone directory.

If your friend has a drinking or other drug problem, you may be the only one willing to reach out and help. Your friend may not appreciate your help right away, or he or she may realize it means you really care. Ultimately, it's up to your friend to get help. It is not your responsibility to make that happen. In fact, you can't make that happen. All you can do is talk to your friend, show how much you care, and encourage him or her to get help. Your concern and support might be just what is needed to help your friend turn his or her life around.

However, if your friend is in serious trouble with alcohol or other drugs, and you have been unable to get your friend to get help on his or her own, you should consider speaking with your friend's parents or guardian. The potential consequences to your friend's life can be too severe to do nothing.

Resource and Referral Guide

Adult Children of Alcoholics
World Service Organization
P.O. Box 3216
Torrance, CA 90505
310-534-1815, M-F, 2:30-6:30pm
(West Coast time)
No referrals, list of meetings only

Al-Anon Family Group Headquarters
P.O. Box 862
Midtown Station
New York, NY 10018
U.S. Meeting Information:

(for teens who are worried about someone else's drinking)
P.O. Box 862
Midtown Station
New York, NY 10018
U.S. Meeting Information:

Alcoholics Anonymous (AA)
General Service Office
P.O. Box 459
Grand Central Station
New York, NY 10163

Children of Alcoholics Foundation, Inc.
(focuses on youth aged 10-16 but also includes adult children; is a private foundation that develops and disseminates information, but does not run groups)
555 Madison Avenue, 4th Floor
New York, NY 10022
212-754-0656 or 800-359-COAF

Cocaine Anonymous
6125 Washington Boulevard
Suite 202
Culver City, CA 90232

Families Anonymous
P.O. Box 528
Van Nuys, CA 91408
800-736-9805 or 818-989-7841

Hazelden Center for Youth and Families
11505 36th Avenue North
Plymouth, MN 55441-2398

Mothers Against Drunk Driving (MADD)
511 E. John Carpenter Freeway
Suite 700
Irving, TX 75062
Victim Hotline:
800-438-6233 (GET MADD)

Naranon Family Group Headquarters, Inc.
P.O. Box 2562
Palos Verdes Peninsula, CA 90274

Narcotics Anonymous (NA)
World Service Office
P.O. Box 9999
Van Nuys, CA 91409

National Association for Children of Alcoholics (NACOA)
11426 Rockville Pike, Suite 100
Rockville, MD 20852

National Clearinghouse for Alcohol and Drug Information (NCADI)
(Federal Government organization that provides free information on substance abuse)
P.O. Box 2345
Rockville, MD 20847-2345
TDD 800-487-4889

National Council on Alcoholism and Drug Dependence, Inc. (NCADD)
12 West 21 Street, 8th Floor
New York, NY 10010

National Highway Traffic Safety Administration
400 7th Street, SW
Washington, DC 20590
Auto Safety Hotline: 800-424-9393

National Organization of Student Assistance Programs and Partners
4760 Walnut Street, #106
Boulder, CO 80301

Many of these national organizations have local chapters which are listed in your phone directory. You can also look under Drug or Alcohol Counseling to find a treatment center or other resources you can call in your area. All 800 numbers are toll-free.

State Referral Phone Numbers for Alcohol/Drug Problems

The following is a state-by-state listing of phone numbers to call for referral for help with alcohol and other drug problems. All 800 numbers are toll-free.

205-270-4650 or call community mental health center

(Anchorage # for Alaska only)
(Juneau # for Alaska only)



800-879-2772 (national toll free #)
9am-5pm, voice mail other times

303-331-8201, M-F, 8am-5pm



District of Columbia
Local Health Department:
WACADA Hotline: 202-783-1300
800-662-HELP (national toll-free #)
7 days a week, 9am-3am






Alcohol: 800-444-9999 or 312-346-1475
Other Drugs: 800-272-2544


515-281-3641, M-F, 8am-4:30pm


800-432-9337 (KY only)
502-564-2880, M-F, 8am-4:30pm

504-342-9350, M-F 8am-4:30pm

800-499-0027 (ME only)
207-287-2595, M-F, 8am-5pm


800-327-5050 (MA only) 24-hours 617-727-1960



601-359-1288, M-F, 8am-5pm


406-444-2827, M-F, 8am-5pm


800-992-0900 (Carson City only)
702-687-4790 (northern Nevada)
702-486-5250 (elsewhere in Nevada) M-F, 8am-5pm

New Hampshire
800-852-3345 (NH only)

New Jersey
800-322-5525 (NJ only)

New Mexico
800-962-8963 (national # works outside of Albuquerque) M-F, 8:30am-5pm

New York
800-252-2557 (NY only)
For drugs other than alcohol: 800-522-5353

North Carolina
919-733-4670, M-F, 8am-5pm

North Dakota
800-642-6042 (ND only) M-F, 8am-5pm


800-522-9054 (OK only) 24 hours
405-271-2444 (out-of-state)

800-621-1646 (OR only)
503-232-8083 (Portland)

800-582-7746 (national # & PA #)
M-F, 8am-4:30pm

Puerto Rico
800-462-4495 (PR only)
7 days a week, 7am-11pm

Rhode Island
800-622-7422 (RI only)

South Carolina
800-942-DIAL [800-942-3425]

South Dakota
605-773-3123, M-F, 8am-5pm


800-832-9623 (TX only)
512-867-8700, M-F, 8am-5pm



800-451-5544 (VA only)
M-F, 9am-6pm

800-562-1240 (WA only)

West Virginia


307-777-7116, M-F, 9am-5pm

Prepared and published by:
Center for Health Communication
Harvard School of Public Health
677 Huntington Avenue
Boston, MA 02115

Additional copies are available free-of-charge (while supplies last) from:
National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847

Academic Excellence AwardWe encourage reproduction and distribution of this publication, provided by SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI) Web site:


The Center for Health Communication of the Harvard School of Public Health is dedicated to exploring innovative uses of mass communication to promote healthful behaviors and lifestyles. This brochure was prepared under the auspices of the Center's Harvard Alcohol Project, an initiative which as been supported by grants from the Commonwealth Fund, the Exxon corporation, the GTE Foundation, the JM Foundation, the Max Factor Family Foundation, the Metropolitan Life Foundation, the Pew Charitable Trusts, and the Scaife Family Foundation.

The Center is especially grateful to the Scaife Family Foundation for supporting research that made this brochure possible; and to the Metropolitan Life Foundation for supporting the development, writing, design, and printing of this brochure. We also appreciate the assistance of the staff of the U.S. Department of Education for their helpful comments and suggestions.

This brochure was written by Betsy O'Connor, M.A./L.R.C., Visiting Fellow at the Center for Health Communication of the Harvard School of Public Health, and Director of Interventions at the Gosnold Treatment Center in Falmouth, Massachusetts.

Copyright 1994 President and Fellows of Harvard College

Harvard School of Public Health Metropolitan Life Foundation