So far, this book has focused on the problems different drugs cause. It is now time to look at how to tackle these problems. This chapter will look at what treatments are available, how well they work and what you and your child can expect from your treating team.

A challenging fact about drug problems is that, unlike most other health problems, not everyone who needs help, wants it. Knowing that you have a problem and wanting to recover is sometimes called having insight into the condition. People with drug problems sometimes have poor insight into their problems and need for help. This can make things very difficult for worried relatives and concerned clinicians.

Some people want treatment, others don't

Many people who come to my clinic are suffering terribly from the effects of using drugs and are desperate to stop, but struggling to do this. They ask for my help to stop the drug use and get their lives back on track. Motivated to change, they work hard to get better and tend to do well in treatment.

But not everyone wants treatment, or even accepts there is anything wrong. Young people are sometimes dragged to see me by their worried parents. They don't think they have a problem, don't want to make any changes to their drug use and are usually very clear that I'm wasting my time.

In my experience, it is very difficult to help someone who does not wish to change. The treatment of drug problems is very much a collaborative effort between the patient and their treating team, with relatives often very involved. If there is no cooperation, helping someone can be tough, and I find it particularly upsetting to see people deteriorate when treatment could help. However, there is usually little point in trying to strong-arm into treatment someone who doesn't want help at that moment. A better approach is often to help them reduce their current risks as much as possible and keep gently explaining that treatment might help – if only they would agree to try it. Circumstances can change rapidly and as harms develop, so can the realisation that things can't go on as they are. Sometimes, keeping the door open and waiting is a better option than trying to push someone through it when they have dug in their heels.