Do you directly tell a loved one with substance use they need help? They make it clear they know but not actively taking steps.
Motivational Interviewing is most helpful in these situations. Basically it’s just asking questions and helping them see the reality of what they’re doing vs telling them they need to change.
So if they make a comment that they know they need help, you can be curious and ask if there’s anything that’s keeping them from getting help? Then you can find the reasons (usually the underlying reason is fear: fear of change, fear of the unknown, etc). Then just keep asking questions and listen. There’s no need to tell them what to do, but asking them open ended questions can help them see their own thought process from a different perspective, and that can inspire change within them.