Of the estimated 23 million people in the United States who are living with a substance abuse issue, only about 3 million get care, according to Open Society Foundations. Sometimes, issues of insurance and payment stand in the way between addiction and recovery. In other cases, people don’t heal because the damage caused by addiction remains hidden to them. Even as their lives fall apart, they remain convinced that they are happy, healthy and in control. An intervention is designed to break through this wall of denial, helping addicted people to see the need for treatment and healing.

Many interventions take the form of letters, meaning that each person participating in the conversation creates a letter addressed to the addicted person, and when the day of the intervention arrives, people read their letters aloud. Obviously, these letters play an important role in helping people to accept the need for addiction treatment, and most families spend several days working on their letters. But knowing a little more about how typical letters sound and how they are structured might help family members to get a jumpstart on the work that lies ahead. This article will outline the important components of an intervention letter, along with hypothetical examples of what a completed letter might sound like. This hypothetical example is written from the point of view of a wife to her husband, but it could easily be modified to fit almost any addicted person and any concerned loved one.

Opening Statement

intervention lettersAddicted people might be frightened or afraid when an intervention begins, certain that they’ll be attacked or disgraced due to the choices they’ve made in the past. The first part of every intervention letter should remind addicted people that they are loved and valued and that the family is there only to help and to provide a solution to the terrible problem of addiction. It’s perfectly acceptable to be emotional here, as long as the feelings expressed are genuine.

Example: “Darling, I came to this meeting simply because I love you so much. I remember the day we first met and how my heart seemed to skip a beat when I saw you walking across the gym floor to ask me to dance. I loved building a home with you, and watching you hold our baby daughter for the first time is a moment I’ll just never forget. I’ve been so proud to see you succeed in your work, and when you were promoted, I thought I would burst with pride. You mean everything to me, and that’s why I wanted to talk with you and urge you to get help.”

Outlining the Situation

People with addictions often don’t mean to harm their family members, but they may have a complete lack of insight about the dangers their behaviors might hold.

Researchers writing in the Harvard Review of Psychiatry discuss this lack of insight, and they suggest that this phenomenon can impact people in different ways. Some people don’t think they have a problem at all, while others think they have some kind of problem that doesn’t really need treatment. It’s tempting to respond to denial with labels, calling the person an “addict,” a “drunk” or a “loser.” In general, this isn’t helpful. Labels don’t help to change a person’s mind as much as shut that person down and halt future communication. Instead, it’s best to simply outline the addiction’s impact in clear terms based on facts. That’s what this section of an intervention letter is designed to do.

In this section, families can mention specific instances in which they’ve noticed the addiction behavior. They might cite law enforcement action, test results or even the number of missed days from work. Any hard facts that are attributable to the addiction is best placed in this section.

Example: “Over the past six months, I’ve noticed that alcohol is becoming a significant problem. Last week, you were arrested for driving under the influence, and when your breath was tested, you had twice the legal limit of alcohol in your blood. Prior to that, I took you to the hospital for treatment when you came home intoxicated and fell, cutting open your head. Finally, I attended our daughter’s graduation from high school by myself because you were drinking at a bar with your friends. Your work has always been so important to you, but I noticed that you’ve missed five of the past 15 work days, because you were too sick from drinking the night before.”

Making It Personal

While many of the behaviors associated with addiction take their toll on the addicted person, there are some parts of addictive behavior that can ruin a family’s functioning. For example, people with addictions to Vicodin might pay as much as $25 per pill, according to CNN Money, and they might take hundreds of these pills each day. This can put a huge hole in the family budget. In addition, substance abuse can leave families feeling abandoned and guilty, and those feelings might be hard to bear.

Being honest is always a good idea, but families should take care to use positive language. Terms to avoid include:

  • “You always.” Substitute with specifics, such as “last Friday.”
  • “You make me feel.” Replace with the softer, “When this happens, I feel.”
  • “This is your fault.” Omit altogether. This isn’t the time to place blame.
  • “Why won’t you stop hurting me?” Substitute with the gentler, “I want things to get better.”
Example: “Alcohol is also beginning to be a difficulty in my life. When I bring the recycling barrel to the street, filled to the brim with bottles, I feel embarrassed and ashamed, certain that our neighbors are judging us. Yesterday, when we went to dinner, you drank a bottle of wine at the table and started to slur your speech and talk too loudly. It was our anniversary, and I wanted to show you how much I value our relationship, but instead, I was worried about your safety, and I was angry that my plans weren’t valued.”

Providing the Solution

Up to this point, the letter has been focused on shining a light on the poor behavior and helping the person to see the need for care.

Now, families can begin to get positive and provide the person in need with a solution that can help.

Here, the family can discuss the treatment options available, and each letter should prompt the person to get help. Glossing over the details is acceptable, as the letters are just designed to introduce the concept of treatment. The real nitty-gritty of decision-making might come later in the conversation, and the family might then answer any questions the person has about how treatment might work.

Example: “I miss the man I married, and I hope you’ll enter a treatment program for addiction. Here are two brochures for programs I’ve researched for you. I think you’ll like them, and I’m willing to bring you to the program you choose right now. I will also work with your office, so you can get the time off you need, and I’ll handle all the affairs at home until you come back. As soon as you agree, we’ll get started.”

Consequences for Refusal

Some people will quickly accept the treatment programs provided after listening to the heartfelt expressions of love and concern provided by their families.

But there are some people who continue to believe they don’t need care, and they may not agree to enter treatment programs until they face a real consequence due to their refusal.

This section of the letter contains those consequences. In an article in the Journal of Substance Abuse Treatment, researchers call these statements “alternative consequences,” and they’re best used when they’re closely tied to compliance with treatment. Families that use vague statements like “You have to, or else” won’t find success, but families that get specific may provide a prompt that allows people to understand what will happen to them if they continue to harbor an addiction. These consequences might sound harsh, and they shouldn’t be so harsh that families won’t follow up on them, but they can be meaningful.

Good examples include:

  • Refusal of financial support
  • Sole custody of children or pets
  • Change in living arrangements
  • Refusal to nurse someone to health after a binge

Some families read these consequences right away, ending their letters with the vision of how life would be without treatment. Others hold their consequences in reserve, reading them aloud only when the addicted person has listened to everyone speak and continues to refuse care. Either method could be useful.

Example: “I feel so strongly about this issue that I am willing to take steps to change my life, if you won’t change yours. If you don’t accept treatment, I will open a separate checking account, so my money won’t be spent on alcohol. If you don’t accept treatment, I will start sleeping in the guest room each night, so your snoring won’t keep me awake. If you don’t accept treatment, I will not bring you to any public function with me, including family gatherings and workplace activities, and neither will I attend such events with you. Please, will you accept help, so these things won’t need to happen?”

Getting Help

As these examples make clear, writing an intervention letter can be a stressful and emotional experience, and there’s a lot of pressure on families as they write. If you’d like to get help with your intervention letter, please call us. We can help you find a family mediator who can help you write it and help you rehearse reading it. Call to find out more.