What should I do about friend's escalating drug use?

Dear Reader,

It's great that you're such a concerned friend in a difficult situation. You're right to note that when harm reduction methods haven't been taken, ecstasy can be a risky, and potentially dangerous, drug to take. So, too, are cigarettes, blunts, and steroids. However, he's lucky to have you as a friend because you care and want to help. A friend's drug use can be troubling and unpredictable. While there is no guarantee that he will remain your friend if you approach him about his decision to use drugs, as his friend, it may be worth the risk.

In terms of how to help him, consider the following strategies:

• Educate yourself. Learn about drugs and addiction by reading up on the current information about substance abuse, consulting health experts, and tapping into local resources. Is there a health educator, guidance counselor, health professional, or supportive family member who you can talk with, ask questions, or get support? Gaining knowledge and an understanding of drug misuse, abuse, and addiction may help you figure out what you can say to your friend and strategies to help him in the future.
• Think about what you will say. You could tell your friend that you're worried about his decision to use drugs, and tell him how his behavior affects you and your friendship. Be specific, and mention your concern for his health. Also, explore the possible reasons behind his drug use. For instance, you might say, "I've noticed you're smoking again and doing other drugs lately. I'm worried about you. Is everything okay?" Or, "I'm worried that your smoking and drug use will cause serious harm to your health." Think about whether his drug use has had a negative impact on his daily activities. For example, has he missed a significant number of classes? Is he sleeping much more or much less than he used to? Also, how has his escalated drug use influenced his relationships? Think about your relationship with him. How have his decisions to smoke and use drugs affected your friendship and the way you feel about him? You might say, "The fact that you talk about drugs all the time worries me, especially since you don't seem to be interested in anything else. We used to talk about our lives all the time. Did something happen?" 
• Choose a workable time. Choose a quiet and relaxed environment if and when you decide to talk with him about your concerns. Also, make sure he's sober when you have this kind of conversation. If you have any shared activities you two do together often, it may be a good time to talk to him after that. You may want to keep your first approach brief, and caring. If he begins to get angry or hostile, back off and approach him at another time after you've taken some time to gather your thoughts.
• Prepare for rejection. Your friend may deny that his drug use is a problem or he may become defensive about it. Don't take this personally; he may not feel that his substance use is a problem in his day-to-day life, and he's not required to agree with you. All you can do is bring it to him, share your concerns, and let him know that if it's something he ever does want to talk about, that you'll be there for him. 
• Challenge your friend to think about his behavior. He may be smoking out of habit. Or, maybe he's so overwhelmed with his troubles that he doesn't know what else to do. Why do you think his behavior has changed so drastically? Have there been any stressful events that happened in his life lately? Often people misuse or abuse substances to deny feelings or to avoid responsibilities. Drug use is also sometimes related to intense feelings. When a person feels overly anxious, scared, or depressed, they may choose to use drugs to manage or get rid of those emotions. If you do decide to talk to him about his behavior, he may not want to talk with you about it. If he does open up to you, be prepared with ways you can help him. You can offer to hang out with him, step in when the urge to smoke or use drugs comes up, or plan diversions. Some people have had success by suggesting that a friend stay sober when going out to see at least what it feels like to be with friends without smoking or using drugs.

It makes sense that your friend's behavior worries you — it's hard to see your friend going down a difficult path. During this time, it's wise set some personal boundaries for how much time and energy you will put into trying to help him. In the long run, this will prevent you from becoming overwhelmed, stressed, or burnt out. You can be supportive and offer suggestions to your friend, but he will have to recognize for himself when he's ready to change.