Helping a Loved One With Addiction in Maryland: A Guide for Families

Watching someone you love struggle with addiction is one of the most painful experiences a human being can have. You may feel helpless, frightened, angry, ashamed, or so exhausted that you can barely function. You have probably tried reasoning with them. You may have given money you did not have. You have certainly lost sleep. And if none of it seems to have made any difference, you might be wondering whether anything ever will.

Here is what you need to hear first: this is not your fault, and you are not alone. In Maryland, tens of thousands of families are navigating exactly what you are navigating — because Maryland has one of the most severe substance use disorder crises in the United States. Understanding what you are dealing with and what actually helps can change everything.

Understanding Addiction as a Disease

The Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute on Drug Abuse (NIDA) classify addiction — clinically known as substance use disorder (SUD) — as a chronic brain disease. This is not metaphor. Decades of neuroscience research have demonstrated that prolonged substance use produces measurable, observable changes in the brain’s reward systems, prefrontal cortex, and stress response mechanisms.

These changes impair decision-making, self-control, and the ability to resist cravings in ways that cannot simply be overcome through willpower. The person you love is not choosing to hurt you, and their inability to stop is a symptom of their condition — not a moral failing or a statement about how much they care about you.

Understanding addiction as a disease also has practical implications: it means treatment works. People recover from opioid use disorder, alcohol use disorder, and stimulant use disorder every single day in Maryland. Recovery is the expected outcome when people receive appropriate treatment and ongoing support.

What Families Often Get Wrong

Families dealing with a loved one’s addiction — even families who are loving, intelligent, and deeply committed — often inadvertently make things worse before they make things better. The most common mistake is enabling.

Enabling does not mean you don’t love your person. It means your attempts to protect them from consequences are, in fact, protecting them from the experiences that are most likely to motivate them to seek help. Common forms of enabling include:

• Giving money that will be used to buy substances (even when you believe the stated purpose)
• Covering up consequences of their use to employers, family members, or others
• Allowing substance use in your home
• Repeatedly bailing them out of financial, legal, or housing crises caused by their use
• Making threats you do not follow through on

The research on this is clear: natural consequences — financial, relational, legal, health-related — are often what eventually motivate a person to accept help. Cushioning those consequences delays that moment.

This does not mean being cruel or cutting off contact. It means being clear and consistent about what you will and will not do, and following through.

Setting Boundaries That Mean Something

Boundaries protect you and your household. They are not punishments — they are statements of what you are and are not willing to do. Effective boundaries:

• Are specific and behavioral (“I will not give you cash” — not “you need to stop this”)
• Are stated calmly, without ultimatum energy
• Are enforced consistently — every time, not most of the time
• Are things you are genuinely prepared to follow through on

A boundary you set but cannot enforce is not a boundary — it is a statement of frustration, and it teaches your loved one that your words do not have weight. Working with a therapist who specializes in family systems and addiction can help you identify what your actual limits are and develop strategies to hold them.

The CRAFT Approach: Evidence-Based Family Intervention

Community Reinforcement and Family Training (CRAFT) is the most research-backed approach for family members trying to help someone enter treatment. Developed by Dr. Robert Meyers at the University of New Mexico, CRAFT teaches family members to:

• Use positive reinforcement strategically to encourage non-using behavior
• Allow natural consequences of using behavior without protecting the person from them
• Communicate in ways that reduce conflict and strengthen connection
• Recognize and respond to “windows of motivation” — moments when the person seems most open to treatment
• Protect their own well-being throughout the process

Studies consistently find that family members trained in CRAFT are more successful at getting their loved ones into treatment than those using confrontational intervention approaches or attending Al-Anon alone — with treatment entry rates of 64–74 percent across multiple studies.

Maryland therapists trained in CRAFT can be found through the CRAFT Institute (robertjmeyersphd.com) and through SAMHSA’s treatment locator at findtreatment.gov.

Maryland-Specific Resources for Families

Al-Anon: A free mutual support program for family members of people with alcohol use disorder. Maryland has in-person meetings throughout the state and online options. alanon.org

Nar-Anon: The equivalent for families affected by any drug addiction. naranon.com

SMART Recovery Family and Friends: A secular, evidence-based alternative to Al-Anon and Nar-Anon. smartrecovery.org

Maryland Department of Health, Behavioral Health Administration (BHA): The BHA’s website (health.maryland.gov/bha) has resources for families, including information on the state’s treatment system.

Maryland Helpline: 1-800-422-0009 — provides information and referrals for families as well as individuals

Johns Hopkins Center for Addiction and Pregnancy: For Maryland families with a pregnant loved one with substance use disorder, this program provides specialized, comprehensive care

Community Behavioral Health Centers: Many Maryland counties fund community behavioral health centers that provide family counseling and support services on sliding-scale fees. Contact your county health department for information.

When to Consider Intervention

A formal intervention may be appropriate when your loved one completely refuses to acknowledge any problem despite clear consequences, or when their use has reached a level of danger that demands action. There are several approaches:

Professional Intervention: A certified intervention professional (CIP), certified by the Association of Intervention Specialists (AIS) or Network of Independent Interventionists (NII), facilitates a structured conversation between your loved one and family members. Look for credentials and verify their approach is evidence-based. Confrontational “TV-style” interventions have a poor evidence base — CRAFT-informed approaches do much better.

Maryland’s Health General Article (Involuntary Commitment): Maryland law provides a pathway for involuntary emergency evaluation when a person has a mental disorder (including substance use disorder) and is imminently dangerous to themselves or others. This is a high bar, and it is a last resort — but it is available when safety is an immediate concern. Maryland’s crisis line (1-800-422-0009) can help families understand when this is appropriate.

Taking Care of Yourself

The hardest thing about loving someone with addiction is that you cannot control their choices. What you can control is how you respond — and whether you take care of yourself in the process.

Families of people with substance use disorder have significantly elevated rates of depression, anxiety, PTSD, and physical health problems. These are not signs of weakness — they are the expected effects of chronic, unresolved stress and grief.

Your wellbeing matters independently of your loved one’s recovery. Regular exercise, adequate sleep, social connection, therapy, and peer support are not luxuries — they are necessities when you are living close to addiction.

When Your Loved One Says Yes to Help

Be prepared. Readiness to accept treatment can be fleeting. Have information ready before the moment arrives:

• Know your loved one’s insurance coverage and what it covers
• Have two or three treatment options identified
• Know who to call to get them admitted quickly
• Have a plan for transportation and logistics

The Maryland Helpline (1-800-422-0009) and our Maryland Addiction Hotline can help you prepare and, when the moment comes, move quickly.

Get Help Today

You do not have to figure this out alone. Our Maryland Addiction Hotline provides guidance for families as well as individuals — helping you understand the disease, identify resources, and find the support you need to navigate this without losing yourself.

Call our Maryland Addiction Hotline today. Confidential, free, and available 24/7. We are here for the whole family.