Helping a loved one go to rehab

The short answer

Start with calm, specific conversations rather than a surprise confrontation: family-training approaches such as CRAFT, which teach you to reward sober behaviour and raise treatment at good moments, have the strongest evidence.

An adult has to agree to go, so focus on making treatment easy to say yes to, then plan the medical checks, travel and money with care. Get support for yourself too, and plan the return home before they leave.

How do I start the conversation?

In a randomised trial, family members trained in CRAFT got 64% of reluctant problem drinkers into treatment, compared with 30% for a confrontational intervention and 13% for Al-Anon facilitation.^[1]

CRAFT stands for Community Reinforcement and Family Training. Instead of confronting the person, a therapist coaches you to change how you respond at home, so that sober time is more rewarding and drinking or drug use is not.^[4]

A 2010 review of four trials found that CRAFT engaged about two-thirds of people who had refused treatment, usually after four to six sessions with the family member.^[2] A 2020 review of 14 studies found it about twice as effective as comparison approaches, with the best results when families had both individual and group sessions; self-help workbooks alone did less well.^[3]

CRAFT works best with a trained therapist, but its core ideas, alongside the US National Institute on Alcohol Abuse and Alcoholism (NIAAA) advice on starting the conversation, can guide your first talks:^[4][6]

• Pick your moment. Talk when they are sober and calm, not while they are drinking or using, and not in the middle of a row.
• Keep it calm and specific. Say what you have noticed and how it affects you ("I was frightened when you drove home on Friday"), rather than labels or blame.
• Reward the times they are sober. Spend time together when they are not using, and step back when they are, without rescuing them from every consequence.
• Have a concrete offer ready. "I've found two programs and I'll help with the travel" is easier to accept than "you need help".
• Accept "not yet". Keep the door open and try again when there is a natural opening, such as after a bad morning or a health scare.
• Put safety first. CRAFT therapists discuss the risk of violence before anything else. If you feel unsafe, get help before you raise treatment.

Do surprise interventions work?

The television-style "intervention", where family and friends confront someone at a surprise meeting and present an ultimatum, comes from the Johnson Institute model. The evidence for it is limited.

In the 1999 trial, 70% of families trained for a Johnson-style intervention decided not to go through with the confrontation. Most of those who did go ahead got their relative into treatment, but overall only 30% of families succeeded, against 64% with CRAFT.^[1]

The NIAAA says CRAFT has been shown to be more effective than confronting the person in an intervention, and its advice to families is: "Don't gang up on the person or back him or her into a corner."^[5][6] If you hire a professional interventionist, ask which method they use, what they charge and whether any treatment center pays them.

Can you make an adult go to rehab?

No. An adult has to agree to travel abroad for treatment. Don't plan to get someone onto a plane under false pretences: it breaks trust, and arriving in withdrawal, unwilling, in a foreign country is a safety risk.

The laws that allow treatment without consent are narrow and run by doctors and courts, not families, and none of these examples lets a family send someone overseas:

• UK. The Mental Health Act 1983 states that dependence on alcohol or drugs is not, on its own, a mental disorder for the purposes of the Act.^[8]
• Australia. New South Wales offers involuntary treatment as an option of last resort for severe dependence; only a medical practitioner can refer someone, and the typical stay is 28 days.^[9]
• US. A 2015 review found that 33 states had laws allowing civil commitment for substance use. These are court processes for treatment within that state.^[18]
• Thailand. The Mental Health Act allows treatment without consent for people with a mental illness who pose a serious danger or lack capacity, after medical and legal review. Substance use is not currently part of its definition of mental illness; draft amendments discussed in 2024 would add it.^[10]

Pressure is not the same as force. The US National Institute on Drug Abuse (NIDA) notes that treatment does not need to be voluntary to be effective, and that pressure or incentives from family, employers or courts can increase treatment entry and retention.^[7] Clear, consistent boundaries are legitimate; deception and physical coercion are not.

Planning treatment in Thailand

Once your loved one says yes, things can move fast, and it is tempting to book the first bed offered. Take a few days to check the essentials. Our guides to choosing a rehab and safety checks cover the center itself; this section covers the trip.

Medical clearance before the flight

Ask their own doctor to see them before you book, and share the center's detox plan with that doctor. Alcohol withdrawal usually starts within 6 to 12 hours of the last drink, and the NHS warns that stopping suddenly can be very dangerous for someone who is dependent.^[11] That window is shorter than many flights to Thailand from Europe or North America.

Agree in advance whether detox will start at home, in a hospital or on arrival, and how drinking or drug use will be handled during the trip. Medicines should travel in their original packaging with a doctor's letter; our guide to bringing medication to Thailand covers controlled drugs.

Who travels with them

Someone at risk of withdrawal, or still unsure about going, is better not travelling alone. The usual options are:

• A family member or friend who stays calm under pressure and can cope with delays and transit.
• The center's own staff. Many centers offer airport pickup, and some offer an escort for the flight, sometimes for a fee.^[19]
• A paid escort or sober companion. Ask about their training, what they will do if your relative becomes unwell or changes their mind on the way, and whether a treatment center pays them.

An escort has no legal power to force an adult onto a plane or into a center. Treat any service that offers to move an unwilling adult as a serious warning sign.

Money and contracts

• A written quote showing what is included and what costs extra, such as detox, medicines and hospital care
• The deposit and refund policy, including what happens if they leave in the first week
• Who signs the contract, and who is liable for extra charges
• Written consent from your loved one for the center to give you updates
• Insurance checked for both treatment and travel
• The right visa for the length of stay

Published deposits include about US$2,000, sometimes non-refundable, and some centers ask for half the fee before arrival (see our cost guide). Check cover in our insurance guide and entry rules in our visa guide.

Don't assume travel insurance will help. UK government guidance says most policies don't cover events after excessive drinking or recreational drug use, that mental health conditions must be declared, and that planned treatment abroad usually invalidates a standard policy.^[12][13]

Looking after yourself

Getting support for yourself is not selfish, and it helps whatever your loved one decides. In the 1999 trial, family members' own wellbeing and relationship quality improved with all three approaches, not only the one that got more people into treatment.^[1]

Groups for families and friends (all offer online meetings you can join from anywhere):

• Al-Anon Family Groups, for people worried about someone's drinking.
• Nar-Anon Family Groups, a 12-step program for family and friends of people who use drugs.
• SMART Recovery Family & Friends, a non-12-step program that says its approach is grounded partly in CRAFT.^[14]

Support where you live:

• UK. Adfam, a charity for people affected by someone else's drinking, drug use or gambling, offers one-to-one support and an online forum. Local drug and alcohol services may also know of family groups near you.
• Australia. Family Drug Support Australia runs a 24-hour support line, family meetings and courses. Carer Gateway is the Australian Government's free service for unpaid carers, with counselling, coaching and peer support.
• US. The NIAAA's Alcohol Treatment Navigator lists support for family members, and FindTreatment.gov is the federal government's search tool for local treatment services.

Planning for their return

The return home is when old routines, places and friends come back, so plan it before they leave Thailand, ideally during the last week of the program. Our guide to what happens in a 28-day program explains the discharge and aftercare plans to ask for.

• Book appointments at home before the flight: their doctor, a counsellor or local treatment service, and a support group.
• Agree house rules together, for example whether there will be alcohol in the house, and what everyone will do if things start to slip.
• Ask to see their relapse-prevention plan, so you know their warning signs and what they want from you.
• Treat a relapse as a signal, not the end. NIDA puts relapse rates for substance use disorders at 40–60%, similar to other chronic illnesses, and says relapse doesn't mean treatment has failed.^[15]
• Keep going to your own support. The months after rehab can be as hard for families as the months before.

If your loved one used opioids, know the overdose risk. After a period without using, someone who goes back to their old dose can overdose more easily, and the World Health Organization lists returning to opioids after detox as a risk factor.^[16][17] WHO recommends that naloxone, which can reverse an opioid overdose, be available to people likely to witness one, including families; ask a doctor or pharmacist at home how to get it.