According to the Substance Abuse and Mental Health Services Administration (SAMHSA), more than 46 million Americans aged 12 and older struggled with a substance use disorder in 2021. People struggle with prescription medication, alcohol, and illicit drugs and many of them are unaware that they have a problem. At the same time, only about 11% of people with substance use disorders ever seek professional help, thanks in part to denial, social stigma, and factors such as poverty or responsibilities. While most of these factors are external, denial is one that is problematic and getting past it may be crucial to getting your loved one into therapy or drug rehab.
If your loved one is abusing drugs or alcohol for whatever reason, they are likely to want to avoid acknowledging that for as long as possible. People want to think of themselves as strong, capable, and in control, not a victim. Taking the steps to push someone towards acknowledging addiction is the first step to getting them help but it can be a difficult one. Your loved one may react with anger, blame, and may even lash out if you attempt to approach them about addiction. However, if your loved one shows any of these 8 signs of denial, they likely do have a problem and will benefit from intervention, recognition, and rehab.
1. Blame
Addicts very often focus their ego (sense of self) inward or focus it around their substance of choice. This results in a shift in behavior and thought processes, where the self becomes more important. This allows people to easily jump to irrational points of blame, where someone else can cause their drinking, their drug use, or their behavior. For example, a non-addict will almost never say something like “If you didn’t nag, I wouldn’t drink”, but addicts very often use similar phrases.
This process of blaming others for addiction or for consistent use is very often part of avoidance. “If it’s someone else’s fault, it can’t be mine.” Addicts will blame circumstance, “I’ll quit drinking when I get that promotion and we don’t have to struggle anymore”, living conditions “If the house weren’t such a pig sty all the time I’d be less stressed”, people “my boss is driving me crazy”, stress, and many other factors.
While these factors can be contributors, they’re never a direct reason and they certainly should not be blamed for drug or alcohol abuse. However, the mere aspect of assigning that guilt to someone or something else means that the addict is in denial, they are looking for a reason outside of themselves for problematic behavior.
2. Rationalizing Harmful Behavior
Most people are aware of harmful behavior, apologetic for it, and able to recognize how their actions impact others. Addicts often are not. If someone rationalizes harmful behavior, especially in terms of blame, they are likely in denial.
For example, addicts will often create excuses for drinking, driving under the influence, using in a situation that is harmful, or even using at work. These rationalizations can range from simple and inane arguments such as “it was only the once” to deeper arguments like “I need something to cope with X” but are always a case of an addict legitimizing harmful behavior.
3. Avoidance
Many addicts will participate in denial by simply avoiding the fact that they have a problem. This can result in the individual walking out of conversations, changing the subject, avoiding you, or even pretending that they are in control. Here, the classic “I can quit anytime I want” comes into play, where the addict simply avoids that they might have a problem by pretending to have control.
Avoidance is extremely common but also difficult to get around. Here, you may want to stage an intervention, present an individual with more information, or simply wait for them to come around to their own problematic use if they are not in danger.
4. Lying
Outright lying is a very common denial tactic but while a healthy person understands that what they are saying is a lie, an addict might not. Addicts will often deny substance use, deny the extent of their problem, or minimize the extent of their problem or total usage but they will also quite often have deceived themselves into believing this is true.
When an addict says “Just one more” they often believe it. Similarly, when they say “I only used once last week”, they will often believe it, even if that very much is not the case.
If someone in your life is lying about how much of a substance they are using, their pattern of abuse, or even if they are using at all, they are likely struggling with denial.
5. Comparing Own Behavior to Other’s
People often compare their own behavior to others to highlight good things, but when addicts do it, it’s often with the wrong intent. Here, individuals will find someone who is using a lot, whose situation is worse than their own, or whose behavior is worse than their own and use phrases like “At least I’m not”, or “I could be”. The problem here is that if someone is rationalizing their own problematic behavior by saying “It could be worse”, they’re ignoring that they have a problem now and they do need help.
6. Hiding Substance Use
Hiding substance abuse from others often allows an addict to hide it from themselves. This can involve taking more pills from a prescription than prescribed, drinking a great deal in secret, or otherwise consuming drugs or alcohol in a secretive manner and lying about it. Here, addicts often engage in deceptive practices, such as refilling alcohol bottles, having a secret stash of pills, and maintaining a public façade of temperance.
This façade is extremely deceptive, because it allows addicts to abuse substances without tracking how much they are using. While it does mean they are deliberately hiding their actual substance use, most will be deceiving themselves as well, keeping up with the idea that they are fine so long as no one finds out.
7. Manipulating Others
Addicts often resort to manipulative behavior in order to get people to back off, to hide substance abuse, or to acquire substances. If your loved one is engaging in manipulative behavior for any of these reasons, they are likely addicted and very likely in denial as well.
For example, if you approach an addict with information about their substance abuse and they turn it around on you or another family member, they are being manipulative. This behavior can be difficult to get around, it can be frustrating, and it can be hurtful, but is most often a sign that the addict is trying to rationalize their behavior by focusing on someone else’s or by creating a different problem.
8. Legitimizing Substance Abuse as Necessary
In any case where an addict legitimizes their substance abuse as necessary for their health, happiness, or life, they are in denial of their problem. This phenomenon is very common in instances where individuals are addicted to prescription medication, self-medicating to manage stress or trauma, or using drugs such as Ritalin for performance. Here, the person will attribute their substance abuse to a problem, rationalize that they need it and that it is helping them, and continue using even at the cost of what they are using it for. Legitimization is always a sign of denial, because drug or alcohol abuse is never a positive or helpful thing.
How to Talk to an Addict in Denial
Talking to someone you care about who’s stuck in denial in addiction can be heartbreaking. You might see the changes in their behavior, the pain it’s causing, and the path they’re headed down but they just can’t, or won’t, see it for themselves. That’s the power of denial. It’s not just about refusing to face the truth, it’s often a way of protecting themselves from guilt, shame, or fear of what comes next.
When you’re ready to talk to them, come from a place of love and concern—not judgment. Use gentle, honest language. Instead of saying things like “You need to stop,” try, “I’ve noticed you’ve been struggling lately, and I’m really worried about you.” Sharing your feelings and observations helps open the door to conversation, rather than shutting it down.
It’s also helpful to understand the stages of denial in addiction. Some people truly believe they don’t have a problem, while others know deep down but can’t face the weight of change. Recognizing where your loved one is emotionally can help you connect in a way that feels supportive, not threatening.
Most importantly, be patient. Change doesn’t happen overnight. Keep the conversation open, avoid enabling, and remind them that help is available when they’re ready. A calm, caring voice in the middle of their struggle might be exactly what they need to hear, even if they don’t respond right away.
Call 12 South Recovery Today!
If someone you love is struggling with drug or alcohol addiction, help is available and recovery is possible. Getting them into a trusted rehab program is a powerful first step. At 12 South Recovery, we provide a safe, supportive environment where your loved one can detox under medical supervision and begin to heal with proven therapies like cognitive behavioral therapy, individual counseling, and group support.
While denial can make it hard to take that first step, intervening with care and urgency can save a life. Don’t wait. Reach out to 12 South Recovery today and let us help your loved one reclaim their health, hope, and future.
