Use this when you feel pulled in different directions, or when a conversation about change keeps becoming an argument.
Uncertainty is something to understand
You might want better sleep or fewer arguments without feeling ready to stop using. You may fear withdrawal or losing a way of coping. Ask yourself which part feels important, difficult or possible. Readiness can change and differ between actions.
A substance use disorder is a treatable health condition. A chronic-disease approach keeps care available while priorities and needs change. For families and clinicians, this means listening without shaming or defining someone by their use. Respecting choice can sit alongside honest concern and a personal boundary.
If you are supporting someone
Ask permission: 'Would it be okay to talk about how things have been?' Try an open question, listen, then reflect back what you understood: 'Part of you wants something different, and part of you is worried about what that would involve.' Check whether you got it right.
Before offering advice, ask what information would help. Give a small amount and invite the person's response. They may choose a different step or decline the suggestion. Keep the invitation to talk open without demanding a promise.
Reduce harm while decisions are still taking shape
A GP or alcohol and other drug service can discuss options even when stopping is not the current goal. Practical precautions include:
- Avoid mixing alcohol and other drugs; combinations can increase overdose risk.
- Avoid using drugs alone, where nobody could call for help. Another person's presence does not make use safe.
- Plan transport that does not require driving after use; do not rely on feeling okay.
- If injecting, do not share equipment. A Needle and Syringe Program can provide sterile equipment and advice.
Leave a clear way back
If you are offering support, agree on a realistic next contact together, if the person wants one. Make clear that the person can return even if use continues or the plan changes. Readiness is not a reason to delay urgent care. These precautions reduce some risks; they cannot remove all harm.
For health professionals
A place in the clinical conversation
Explore ambivalence without treating stated readiness as a prognosis or a condition of care. Offer proportionate harm reduction, reassess risk and arrange follow-up. This discussion aid is not motivational-interviewing training, a capacity assessment or a triage tool.
Use the sheet alongside your clinical assessment. It does not produce a diagnosis, measure risk or determine treatment. If seeking a specialist opinion, state the clinical question and relevant history using the usual referral pathway.