Emergency now
Abnormal breathing, inability to wake, blue lips, collapse, seizure, severe chest pain, dangerous confusion, suicidal behavior or uncontrolled violence requires 101.
The first decision: emergency, urgent assessment or planned conversation?
Urgent professional assessment
Several nights without sleep, hallucinations, escalating paranoia, severe withdrawal, mixed substances, pregnancy or rapid deterioration should not wait for a family meeting.
Planned sober conversation
If there is no immediate danger, prepare facts, one speaker, one treatment option and clear boundaries before approaching the person.
Do not diagnose from appearance aloneSleepiness, agitation, panic, confusion or unusual behavior can have medical, psychiatric or substance-related causes. When the situation is unclear and risk is rising, seek professional assessment.
Facts to collect before the conversation
A factual timeline helps the family, emergency staff and the treatment team understand what changed.
Use pattern
Known or suspected substance, street name, packaging, last use, frequency, route and whether the source is prescribed or unknown.
Sleep and behavior
Last normal sleep, agitation, sedation, secrecy, paranoia, hallucinations, aggression, disappearing and sudden mood changes.
Physical signs
Breathing, consciousness, chest pain, tremor, sweating, vomiting, injuries, seizures, overheating and unexplained collapse.
Mixed use
Alcohol, benzodiazepines, sleeping pills, pregabalin, antidepressants, opioids, stimulants and other medications.
Functional harm
Driving, work, children, money, debts, police contact, missing items, unsafe people in the home and repeated crises.
Previous attempts
Past detox, rehabilitation, psychiatric care, medications, periods of stability, relapse triggers and why follow-up ended.
How to have the first useful conversation
Prepare
Choose a time when the person is sober enough to understand. Remove children from the conflict and make sure the setting is safe.
One speaker
Use one calm family representative. A group confrontation can feel like an attack and turn facts into a shouting match.
Name facts
Say what happened: missed work, several nights without sleep, abnormal breathing, debt, threats or repeated withdrawal. Avoid labels and humiliation.
Offer one route
Present a concrete next step that is already prepared: confidential assessment, transport plan, documents and a contact person.
State boundaries
Explain calmly what the family will no longer finance, hide, permit in the home or expose children and others to.
What usually makes the situation worse
- Arguing during intoxication. The person may not be able to process consequences, and conflict can increase medical or physical risk.
- Giving money to end the immediate scene. Short-term calm can preserve access and delay treatment.
- Running a home detox. Families should not prescribe, taper, substitute or supervise unknown withdrawal without medical assessment.
- Making threats that will not be kept. Repeated ultimatums without action teach everyone that boundaries are temporary.
- Protecting the secret at any cost. Privacy matters, but it must not hide danger from the professionals responsible for care.
- Searching for a perfect confession. Treatment can begin from observed risk and impaired control even when the person minimizes or denies the problem.
A family safety and boundary plan
Children and vulnerable people
Keep them away from intoxication, violence, unsafe driving, unsecured substances and chaotic visitors.
Money and property
Use one agreed policy for cash, cards, loans, debts, valuables and payments. Avoid secret exceptions between relatives.
Vehicles and driving
Do not allow unsafe driving. Call emergency or police services when immediate public danger cannot be controlled safely.
Medication
Secure household medication when appropriate and report actual use accurately. Do not make clinical changes without the physician.
Home access
Decide what behavior, substances, threats and visitors are not permitted in the home and who will enforce that decision.
One communication line
Choose who communicates with the clinic and how essential updates are shared so the family does not create contradictory plans.
If the person refuses help
Refusal does not mean the family must return to the old arrangement.
Keep emergency rules
Refusal never changes the response to abnormal breathing, collapse, seizure, psychosis, suicidal behavior or uncontrolled violence.
Stop covering consequences
Do not call employers with invented explanations, hide debts, replace stolen property or make secret payments that preserve the cycle.
Repeat one concrete offer
Keep the treatment route available and specific without restarting the same argument every hour.
Get family guidance
The family can ask for professional help with boundaries, communication and safety even before the person agrees to treatment.
From crisis to a treatment route
Step 1
Emergency care or urgent medical assessment when the signs require it.
Step 2
Clarify substances, withdrawal, physical condition, psychiatric risk, medications and immediate level of care.
Step 3
Stabilize and complete detox when clinically indicated under licensed medical responsibility.
Step 4
Move into structured rehabilitation: sleep, routine, craving, responsibility, family boundaries and relapse prevention.
Step 5
Prepare follow-up, work, housing, money, medication, support and a rapid response to warning signs.
Dr. Moshe Golin
Psychiatrist and addiction physician • 40 years of experience
Dr. Golin and the MAAVAR CLINIC medical team make clinical decisions about assessment, diagnosis, detox, stabilization, medication, psychiatric care and the appropriate level of treatment.
The family's role is to provide accurate facts and protect safety — not to diagnose, prescribe or run an improvised medical unit at home.
Anonymous composite example
The useful change was one plan, not a louder argumentA family described several nights without sleep, missing money, frightening calls and repeated promises. Different relatives were paying debts and giving contradictory ultimatums. They documented the timeline, chose one speaker, prepared an assessment route and agreed on boundaries for money, driving and the home. Identifying details have been combined and changed.
Sources and safety context
This page offers general family guidance and does not replace emergency care, diagnosis or individual treatment.
Magen David AdomEmergency medical help in Israel
National Institute on Drug AbuseTreatment and recovery
SAMHSAHelping someone
World Health OrganizationOpioid overdose
Family action FAQ
What should I do first if someone is using drugs?
First decide whether there is an emergency. If the person cannot be woken, breathes abnormally, has a seizure, severe chest pain, dangerous confusion, suicidal behavior or violent loss of control, call Magen David Adom at 101.
Should I confront the person while they are intoxicated?
Usually no. Protect immediate safety, avoid escalating arguments and wait for a calmer, sober period unless urgent medical help is required.
What facts should the family record?
Record the suspected substance, last use, sleep, breathing, consciousness, behavior changes, mixed substances, medications, money, threats, driving, children in the home and previous treatment.
What if we do not know which drug was used?
Describe what you observed and keep packaging, names or photos only if doing so is safe. Unknown or mixed substances increase uncertainty and may require urgent medical assessment.
Should the family pay debts or provide money to stop a crisis?
Money decisions should follow one agreed family boundary plan. Repeated secret payments can preserve access and prevent the real risk from becoming visible to the treatment team.
Can we force the person to admit there is an addiction?
A productive conversation focuses on observable facts, safety and one concrete treatment option. Winning an argument about labels is less important than moving toward assessment and clear boundaries.
What if the person refuses help?
The family can still protect children, vehicles, money, medications and the home, stop covering consequences, document risk and ask professionals how to maintain one consistent response.
Can detox be arranged at home?
The family should not improvise detox or medication changes. Alcohol, benzodiazepines, opioids, mixed use and unknown substances can require medical assessment and a different level of care.
How can MAAVAR CLINIC help?
MAAVAR CLINIC can review the situation confidentially, identify immediate medical questions, organize assessment and explain the transition from stabilization into structured rehabilitation and family planning.
Can the first contact be discreet?
Yes. You can begin with a short confidential message describing the situation without publishing it or involving unnecessary people. Immediate danger still requires emergency services.
Prepare the route before the next calm period disappears
Send a short factual description: suspected substance, last use, sleep, breathing, behavior, mixed substances, money, threats, children in the home and previous attempts to help.
Ask for confidential guidance
Immediate medical or physical danger requires emergency services. In Israel call Magen David Adom at 101.
+972 54-757-8876