Caring is enough to start a conversation.
This guide will help you:
- Recognize warning signs
- Talk to your friend with compassion
- Support their next steps
What is a substance use disorder?
A Substance Use Disorder (SUD) affects a person’s brain, body and behavior.
It is a medical condition involving a pattern of using substances that causes significant distress or problems. SUDs are considered brain disorders due to lasting changes in brain circuits.
SUDs can be mild (2–3 symptoms), moderate (4–5), or severe (6+).
Symptoms of SUD include:
- Using more than intended (higher quantity, more frequently, or over a longer period)
- Increasing tolerance (needing more of the substance for the same effect)
- Withdrawal symptoms
- Wanting to reduce or stop use but not being able to
- Craving
- Giving up important activities
- Continuing use despite danger
- Difficulty managing commitments due to use
- Spending a lot of time obtaining, using or recovering from use
- Continuing use despite relationship problems
- Continuing use despite worsening physical or psychological issues
Supporting a friend
You’re not a counselor, and that’s okay. You can still:
- Offer to go with them to a meeting or appointment
- Share resources like the campus counseling center
- Fill out a WashU Cares Report
How to talk with a friend using OARS
OARS stands for:
| Open-ended questions | “How have you been feeling about the amount you’ve been drinking lately?” |
| Affirmations | “Thanks for being open with me. I know these conversations aren’t always easy.” |
| Reflections | “It sounds like you’re starting to notice that using has been affecting your sleep and your classes, and that’s starting to worry you.” |
| Summaries | “So from what you’re saying, it seems like you’ve been drinking more to cope with stress, but it’s also causing issues with your focus and routine. You’re not sure what to do next, but you’re thinking about making a change.” |
| Next step | “Would it be helpful if I shared some resources or went with you to talk to someone on campus?” |
Pathways to recovery
There are many paths, including reduction, abstinence, therapy, medication‑assisted recovery (MAR), peer support and mutual aid groups. Everyone’s journey is different and should be respected.
There are also many definitions of recovery, and individuals practice various recovery formats. Below are some of the most common definitions of recovery:
- A process of change through which individuals improve their health and wellness, live a self-directed life and strive to reach their full potential
- A voluntarily maintained lifestyle characterized by sobriety, personal health and citizenship
- When a person has reached a state of physical and psychological health such that abstinence from dependency-producing drugs is complete and comfortable
Overall, many recovery formats emphasize three main pillars: growth, service and recovery.
What if a friend isn’t responsive?
If your friend isn’t open to talking right now, that’s okay. You can still:
- Let them know you’re here whenever they’re ready
- Follow up occasionally without pressure
- Offer support through actions (invite to alcohol‑free events)
- Consider filing a concern report with student support services if you’re worried about their safety
What you can do
Do:
- Use person‑first language (e.g., “person with a SUD”)
- Invite them to non‑substance‑based activities
- Share resources and walk with them if they’re open
- Check in regularly without pressure
- Use “I” statements (“I’ve noticed…”)
Don’t:
- Use labels like “addict” or “junkie”
- Shame or force change
- Assume one recovery path works for everyone
- Talk to others about their substance use (anonymity matters)
Resources
- SAMHSA Helpline: 1‑800‑662‑HELP
- na.org
- aa.org
- smartrecovery.org
- Call or text 988. The lifeline is for more than mental health crises; it can also be used for substance use concerns.
Campus resources
