When one of your friends starts to get messed up on alcohol or drugs, it can be really tough to bring it up and talk to him about it. Most people just keep their mouths shut because they don't want to seem nosy or puritanical. It's much easier to maintain the assumption that everything's cool. Unfortunately, substance abuse is just not cool – in fact, it really sucks. There's nothing worse, apart from being dismembered with a boat hook, than watching a friend get eaten up by her addiction until she's not your friend anymore. The time to talk to your friends about the crap they're ingesting is before it eats them up and they lose everything. If you know someone who might have a problem, read on and see what you think about our advice.

Please note that we are not professional counselors. We'll tell you how to get in touch with counselors or treatment centers, but your friend needs professional help, not you. What we hope to provide is mostly common-sense advice for anyone who wants to be a good friend to someone who needs one.


It's not always easy to see when someone's use of alcohol or drugs is turning into abuse. You are probably aware of some of the occasions on which your friend has partied hearty, but you don't know if she is going home and inhaling cleaning products by herself all night. Do some research on what drug abuse looks like. Needless to say, if you do become aware of that sort of behavior, it is what we refer to as a "warning sign."

A research project called the International Classification of Diseases–10 (ICD-10) identifies a list of warning signs that can help you to determine whether or not your friend has a problem. Have a look.

ICD-10 Warning Signs

Three or more of the following must have been experienced or exhibited at some time during the previous year:

  • Difficulties in controlling substance-taking behavior in terms of its onset, termination or levels of use.

  • A strong desire or sense of compulsion to take the substance.

  • Progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects.

  • Persisting with substance use despite clear evidence of overtly harmful consequences, depressive mood states consequent to heavy use, or drug related impairment of cognitive functioning.

  • Evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses.

  • A physiological withdrawal state when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms.

The funny thing about lists like these is that just about anyone who likes to take a drink from time to time will look at it and think "It looks like I have a problem!" Don't worry about that. This article is about poking your nose into other people's business, not taking responsibility for your own actions. What level of use constitutes a problem depends heavily on what sort of drug a person is using.

For example, it is possible, and some consider it quite healthy, to have a drink a day for your entire life without it becoming a problem. It is not, on the other hand, possible to have a safe level of cocaine or heroin use. One dose of either drug can kill you under particular circumstances, and it's difficult to tell when you're in those circumstances. Furthermore, we've known too many people who claimed that their cocaine use was "just an occasional indulgence" or "something I do at parties." Normal, successful people say things like this and end up addicted, sleeping in doorways, with crack pipes duct taped to their heads.

The bottom line is, look at the list of diagnostic guidelines above, and try to see where your friend fits in. If your friend is using cocaine or heroin, skip the guidelines – there's a problem. Otherwise, if you think a number of the guidelines do apply, resolve to sit down with your friend and talk about his or her substance use/abuse.