09/12/2013 02:24 pm ET Updated Nov 12, 2013

Is Your Friend Over-Medicating?

Every so often someone writes me about how to respond to a friend with a prescription drug addiction. Wanting to ask someone with far more experience than I have on this painful subject, I interviewed Michelle Dunbar, executive director of St. Jude Retreats -- a non 12-step alternative to conventional alcohol and drug treatment. Hope this is helpful! And blessings on you as you navigate this friendship in a way that enhances your life and hers.

Q: A very close friend of mine seems to be struggling right now. She is under a lot of stress at work and is also separating from her husband. I know she is on medication for her anxiety but I am concerned she may be taking too much. She seemed spaced out the last few times I've seen her. What should I do?

A: This can be a very difficult subject to broach with anyone, but can be especially troublesome with a close friend. The best approach to take is one of concern. Be careful not to judge or jump to conclusions. Clearly she's going through a hard time and needs friends now more than ever. I recommend scheduling a lunch date with her or even stopping by her home early in the day. Do not bring up the drug use, but instead empathize with her about the troubles she's experiencing in her life with her work and family. Let her know that you're concerned because she seems tired and out of it when you've seen her. Knowing she has an ally, she may spontaneously admit to overdoing it on her meds or you may learn she is not sleeping well or is struggling with other health problems.

Q: What if she admits she's overtaking her meds?

A: Be cautious not to overreact or show alarm. It she's telling you this usually means she realizes the problem and is ready to make a change. You can suggest to her alternative stress-relieving activities that you can do together such as a daily walk, joining a weekly yoga class, getting a mani-pedi or spending a day at the spa. You can offer to check in on her each evening when she may be feeling most lonely and overwhelmed, and also help her to find solutions to her problems at work. You can offer to help her plan her move, or fix up her home once the separation is complete or provide childcare while she takes care of things. Often times just knowing she is not alone will change her entire outlook on her life.

Q: Should I suggest she see her doctor?

A: That can also be a good idea. You may want to suggest she talk with her doctor about getting off the medications and using non-medical remedies such as exercise, relaxation tapes, massage therapy and other alternative stress relieving activities. She may also seek a Cognitive Behavioral Therapist that will help her to readjust her thinking and gain a new perspective and outlook on her life.

Q: What if she becomes defensive and shuts down?

A: Then it is important to keep the conversation as light as possible. Relate a funny anecdote or story. In order to help her you must gain her complete trust. Reassure her that you are there for her and are willing to help in any way that you can. If she has close family or other close friends, you may want to talk with them about your concerns. Perhaps there is someone else with whom she may be more receptive. However be cautious that your concerns do not turn into gossip as that will make her feel more alone than ever.

Q: What about intervention? Isn't it better to have a group of friends talk with her or should I talk with her privately?

A: If you were the one struggling, which approach would you prefer? A group of people all talking at you, or a private one-on-one conversation? The answer is clear; most people prefer to be approached privately. The group intervention approach puts the individual struggling on the defensive right from the start. She will feel as if she is being attacked and the fight or flight response will be activated. On the other hand talking privately with her is not at all threatening. Be careful not to say things like, "everyone thinks..." or "we're all concerned..." as this approach has much the same effect as the group intervention approach. It will imply you have all been gossiping about her and will push her away from those that can help.

Q: Overall, what is the best way to approach a friend you feel may have an alcohol or drug problem?

A: Above all else, stay calm and use common sense. Think of how you would most like to be approached if you were struggling with a personal problem and do that. Keep judgments and accusations regarding drug and alcohol use to yourself and ask about the problems you have seen firsthand that are unusual for this person, such as sudden consistent tardiness at work or social outings, isolating at home, volatile mood swings, frequent trips to the emergency room, drunk dialing or witnessing multiple drunken/high episodes. Kindly let her know that you care about her and want to help; and let her know you are there for her when she is ready.

Thank you Michelle!

Other posts that be of help: This Friendship Is Going Negative, What Do I Do? and How to Respond to a Friend In Crisis.

For more by Shasta Nelson, M.Div., click here.

For more on mental health, click here.