How to Help a Loved One Who Doesn’t Want Treatment

It was a Tuesday morning in June when I found my sister, Erin, sitting on the porch, cigarette in hand, wrapped in a hoodie even though it was already warm out. Her eyes were red and not just from lack of sleep. From something much deeper. Grief, maybe. Numbness, definitely. Her gaze fixed on a tree across the yard, like she was hoping it would tell her what to do next.

“I’m fine,” she said before I could say anything.

But she wasn’t fine. I knew it. I think she knew it deep down. The vodka bottles stuffed behind the laundry hamper, the late-night calls with no memory the next day, the missed work shifts, the bruises she didn’t want to talk about—none of it was fine.

Still, every time I brought up treatment, she clammed up. Defensive. Sharp.

“I don’t need help,” she said.

“I’m not an addict.”

“Leave it alone.”

So what do you do when someone you love is clearly struggling, but refuses to see it, refuses to hear you, refuses to get help? 

You can’t force change, but you’re not powerless either. This is where it gets hard. And this is where we begin.It’s not simple, but it’s not hopeless, either.

Why people resist treatment

First, we need to stop expecting people in crisis to behave rationally. Addiction changes the brain, completely rewires it so that the substance feels like a need, not a want. According to the Canadian Mental Health Association, more than 21% of Canadians will meet the criteria for a substance use disorder in their lifetime. And sadly, most never receive formal treatment.

One major reason is denial. Addiction isn’t a conscious choice; for most, it’s a survival mechanism. Admitting the truth would mean confronting shame, trauma, or the fear of losing control. According to a report by Mental Health Research Canada, more than half of Canadians struggling with addiction say they delay getting help because they fear judgment or stigma.

Some may also struggle with trust, especially if they’ve been dismissed or shamed in the past. They might think, “What’s the point?” or feel that treatment is for other people, not for them. 

Others may have had bad experiences in previous programmes, leaving them skeptical or guarded. Whatever the root, their resistance is a response to deeper wounds.

So, when your loved one says they don’t need treatment, it’s probably not about pride or rebellion. It’s probably about fear. And fear needs gentleness, not force.

You can’t make someone get help. But you can do this:

1. Start with compassion, not confrontation

Think of this less like a battle and more like building a bridge. You’re trying to stay connected and keep the lines of communication open so they feel safe enough to consider change. This doesn’t mean ignoring the harm their behaviour causes. But it means choosing words that reach the human underneath the addiction.

Use phrases like:

• “I’m scared for you because I care about you.”
• “You don’t have to go through this alone.”
• “What would help you feel supported right now?”

Avoid accusations. Avoid lectures. Most people in active addiction are already drowning in shame and don’t need others piling it on more.

And it’s okay if the conversation doesn’t go well because it may not. You might fumble. They might get angry. Just coming back to that conversation again can be more powerful than any perfectly crafted speech.

2. Get educated on what you’re dealing with

Understanding the science of addiction as a disease, not a choice, helps shift your mindset from frustration to empathy. Learn about co-occurring mental health conditions, too. Many people struggling with substance use are also battling untreated trauma, anxiety, or depression.

Places like the Centre for Addiction and Mental Health (CAMH) or Canadian Mental Health Association (CMHA) offer excellent resources for families trying to understand what their loved one is facing.

3. Set boundaries that protect you, not punish them

You don’t have to accept abusive or manipulative behavior just because someone is struggling. Boundaries aren’t about punishment. They’re how you protect your own peace while still caring.

Saying, “I can’t give you money when you’re using,” or “I can’t allow you to stay here if you’re not sober,” is not cruel. It’s clarity. And clarity creates the conditions where healing might eventually happen.

If you’re not sure where your boundaries should be, talking to a therapist or joining a support group like Al-Anon can help you.

4. Plant seeds without forcing growth

Offer information gently. Mention resources, but don’t demand action. You can say:

• “I found a place that seems really understanding. If you ever want to talk about it, I’ll be here.”
• “I know you’re not ready. I just want you to know options exist.”

Sometimes, the goal is simply to keep the conversation going. Change usually doesn’t crash in like a wave. Instead, it shows up quiet and clumsy, in moments when you least expect it.

5. Get support for yourself first

Trying to save someone who doesn’t want to be saved will emotionally drain you. Their pain will quickly become your pain.

Support groups like Families for Addiction Recovery or individual counselling can help you process the intense feelings that come with loving someone in active addiction. You don’t need to carry it all alone because you are not alone.

Even if they never agree to get help, you still deserve support. Loving someone in addiction can twist you up inside: grief, guilt, and even resentment fighting for space. Working through those emotions in a safe space is one of the most loving things you can do. Not just for yourself, but for them.

When things escalate: Considering an intervention

There will likely come a time when conversations aren’t enough, when your loved one’s substance use puts them or others in immediate danger. This is when a structured intervention, guided by a professional, might be necessary.

A trained interventionist can help you:

• Plan what to say and how to say it
• Involve others who can speak with compassion and authority
• Present treatment options in a way that’s clear but not coercive

Done well, interventions can lead to acceptance and change. But they must be grounded in love, not shame.

What if they still say no?

This is the hardest part. Sometimes, even after everything, you educate yourself, you set boundaries, you speak from the heart, they still refuse help. And that’s a brutal truth to sit with.

But here’s what’s also true: people do recover. Often not on the first try. Sometimes not even on the second or third or fourth.  But seeds you planted today may bloom later, when they finally hit a turning point.

According to the Recovery Research Institute, nearly 75% of people who experience addiction eventually recover. Recovery isn’t rare. It’s possible. But it rarely follows a straight line.

So stay connected. Not codependent. Just connected.

Coming full circle

The turning point with my sister eventually came. It wasn’t after a dramatic breakdown, that’s for sure. It was a Tuesday again, a different one. She’d just missed another shift at work. She was pale, shaky, silent.

I sat down beside her on the same porch where I’d once stood pleading. This time, I didn’t say much. Just: “Are you tired yet?”

She nodded. That was it. A nod. But it was the first real yes.

We called a treatment centre that day. She didn’t go right away. There were relapses. Detours. More pain. But eventually, she did go.

And today, she’s three years sober.

When she was finally ready, she knew where to turn. She didn’t do it for me. She did it for herself. That’s the only kind of recovery that lasts.

Centres for Health & Healing is here to help

If someone you love is struggling with addiction and refusing help, you don’t have to carry that weight alone. At Centres for Health & Healing, we support families as much as we support individuals. We understand the confusion and heartache of watching someone you care about drift further away and not knowing how to reach them.

You don’t have to have all the answers. You don’t need to wait until things get worse.

Reach out. Call. Email. Ask the hard questions. We’ll meet you with real answers and real support.

Whether you’re just looking for guidance or actively exploring treatment options, we’re here, and we’re ready when you are.

Let’s talk about what healing could look like. Let’s figure it out together.