How to Talk to a Spouse Who’s Abusing Substances

The coronavirus pandemic has many of us at loose ends.

After six months of restricted movement, decreased social contact, and uncertainty about the big picture, millions of people in the U.S. are stressed out, anxious, and stir-crazy. Some of us have found relatively productive ways to process these emotions. We do online yoga, take daily walks, Facetime with family, or work on new hobbies.

We may still be a little stir crazy, but we’re getting by.

However, some of us have trouble with all the downtime. Walks, yoga, and hobbies don’t help with the stress.

For some of us – and maybe for your spouse – the pandemic-related stress has caused an increase in substance use. It may have even led to substance abuse. If you’re worried your spouse is abusing substances, watch for the following signs and symptoms:

Behavioral Signs of Substance Abuse

  • Abrupt personality changes/mood swings
  • Irritability or anger
  • Dishonesty
  • Paranoia
  • Missing money/unexplained expenses
  • Secretive behavior
  • Changes in work performance
  • Withdrawal from favorite people and activities
  • Drastic changes in sleep patterns
  • Drastic changes in eating patterns

Physical Signs of Substance Abuse

  • Red or watery eyes
  • Alcohol or smoke breath
  • Poor coordination and falls
  • Passing out
  • Hyperactivity
  • Inactivity
  • Shakes and tremors
  • Clammy palms
  • Nausea or vomiting
  • Decline in personal hygiene

Understand that when they occur alone or occasionally, the signs and symptoms above may not mean your spouse is abusing substances. When you see an escalating pattern of behavior that includes the signs and symptoms above combined with personal knowledge of substance use – meaning you know your spouse uses substances because you’ve witnessed it – then what you’re seeing may be a transition from substance use to substance abuse and possible addiction.

If that’s the case, then it’s time to have the talk.

How to Have the Conversation

The hardest part of this might be gathering the courage to initiate the conversation. Remember: this comes from a place of love and concern. You owe it to yourself and to them to express your feelings and offer to help in any way you can. You may be nervous, and that’s okay. Marshal your emotions, coax the butterflies in your belly to fly in formation, and take solace in the fact you’re doing the right thing – even if it’s incredibly hard.

Here’s a step-by-step approach that has a good chance of success:

1. Schedule It

Arrange a time for the conversation. Tell them you have something important you need to discuss with them and prepare yourself to bring up to topic in a calm, rational manner. If they show up for the conversation under the influence of substances – i.e. intoxicated – then reschedule it. Also, if you find that you’re emotional before the conversation, consider rescheduling. You need to be clear headed and pursue your goals for the conversation in a dispassionate manner.

2. Love First

It’s important to stay calm and unemotional during the conversation, but it’s also important to lead with love, compassion, empathy, and understanding. You can do both: lead with emotion and stay calm and dispassionate. The first thing they need to hear from you is that you love and support them. That’s why you’re having the conversation. When that’s clearly established, you can move on to the topic at hand.

3. Use Examples

Tell them what you see. Describe – with concrete examples – the aspects of their substance use-related behavior that concern you. This is essential. The examples you use must be clear, simple, and unambiguous. Tell them exactly what you observed, what you experienced, and the effect their actions had on you. For example, “You always come home high,” is not clear and concrete. However, “Tuesday night you came home high and I watched you pass out on the porch with a lit cigarette between your fingers,” is a clear, concrete example of red-flag behavior.

4. Let Them Talk

After you say what you need to say, it’s your turn to listen. Let them talk. Listen without interrupting. As you lead your talk with empathy and love, also listen with empathy and love. Keep your body open and neutral: no crossed arms, pacing, or fidgeting. Give them your full attention, and try to avoid planning your response while they speak. If you’re doing that, you’re not really listening – you’re planning. When you really listen, you have a greater chance of learning where they’re coming from.

5. Be Specific

When you describe behaviors of theirs that concern you, they need to be clear and simple. The same goes for the behavior of theirs you want to see. Be specific. Be clear. Keep it simple. Tell them what you would like to see. Offer ideas for specific behavioral changes that you think will improve your relationship and their overall health and wellbeing.

The most important thing to remember about this conversation is that it’s not a conflict. If things get heated, take a step back. Take a break, maybe take a walk, and pick back up when you’ve had a moment to cool down. Your goal is to share your concern with your loved one and have them take positive action to remedy the situation. You have the best chance of achieving that goal if you maintain a cool head the entire time.

The Next Step: Treatment and Support

You need to plan for the conversation, and you also need to plan for what comes after the conversation. Come up with action steps that you and your spouse can take right away. If the conversation goes well – meaning they hear and understand your concerns and are ready to make changes – then you can help them take the next step. You can offer suggestions for community support groups like AA or NA, or you can offer information on outpatient, intensive outpatient, partial hospitalization, or residential treatment. If you have a treatment center in mind, you can have physical brochures at hand, or the website up and ready. Both you and your spouse should understand that treatment for substance abuse works: millions of people have entered recovery and learned to live life without substances. Treatment works – and if your spouse is abusing substances, the sooner they get treatment, the better their chance at achieving sustained, lifelong recovery.