If one of your loved ones is a problem drinker, you might naturally have asked yourself how to help an alcoholic.
Maybe you’ve wondered if it’s possible to encourage a family member recover from alcohol dependence, questioned whether you should intervene or stay completely clear.
The answer is deeply nuanced and we’ll be exploring the issue of helping someone drinking to excess today.
In order to do that, though, you need to have a sound overview of what constitutes alcoholism.
What Is Alcoholism?
Alcoholism is a term commonly applied to someone suffering from alcohol use disorder.
When someone has alcoholism, both physical and psychological dependence has already developed. They might be experiencing problems controlling the way they drink. They are also likely to continue drinking to excess even in the face of these problems. At the stage when dependence on alcohol sets in, it’s commonplace for the backlash of heavy drinking to impact personal and professional relationships. Health complications as a result of drinking are also routine.
The latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), includes some changes. Where the fourth edition of DSM classified alcohol abuse and alcohol dependence separately, in DSM-5 they are integrated into a single disorder, AUD (alcohol use disorder.)
To assess whether someone might have AUD, 11 questions are posed regarding drinking habits over the previous year.
DSM-5 Criteria for AUD
- Alcohol is often consumed in larger amounts than initially intended
- There have been failed attempts to cut down or quit drinking
- Large swathes of time spent drinking or recovering from drinking
- Cravings for alcohol manifest
- Drinking and the after-effects routinely interfere with family life. Work or school is also frequently impacted
- Despite these problems, the individual continues to drink anyway
- Previously pleasurable activities are neglected and sidelined
- Engaging in risky behaviors on more than one occasion that increase the chances of being hurt or injured
- Continuing to drink even after feeling depressed or anxious
- Needing to drink more than before to get the same effect as tolerance builds
- Withdrawal symptoms occurring when the effects of alcohol wear off
Sub-classifications of AUD are:
- Mild (2-3 symptoms)
- Moderate (4-5 symptoms)
- Severe (6 or more symptoms)
Use these questions to form an initial assessment of whether your loved one really is struggling with AUD.
The Route To Alcoholism In 5 Stages
While there’s no absolutely fixed pattern that translates to every individual, there’s a fairly common pathway to alcohol use disorder.
- Stage 1: Sporadic abuse and occasional binge drinking
- Stage 2: Increased consumption
- Stage 3: Problem drinking
- Stage 4: Alcohol dependence
- Stage 5: Addiction and alcoholism (AUD)
Stage 1: Sporadic abuse and occasional binge drinking
Experimentation with alcohol is frequently seen in young adults testing their limits, often within the confines of a college fraternity or society.
This early stage of drinking often involves binge drinking. This is characterized as men drinking 5 or more alcoholic drinks in 2 hours or less. For women, it’s 4 drinks within the same time frame.
Binge drinking can easily lead to alcohol poisoning and other health complications.
Stage 2: Increased consumption
When consumption becomes more frequent, the experimental stage is now history.
By this second stage, perhaps the person is drinking every weekend rather than only at parties.
Drinkers leave the experimental stage when their alcohol consumption becomes more frequent. Instead of just drinking at parties once in a while, you may find yourself drinking every weekend.
Someone drinking regularly differs slightly from someone who drinks moderately. Where a moderate drinker often chooses to grab a glass of wine with dinner, a regular drinker will often use alcohol to feel good, alleviate stress or to combat boredom and loneliness.
It’s easy for someone drinking on a regular basis to slip over the line into problem drinking…
Stage 3: Problem drinking
If the person drinking regularly starts to feel the effects of this habit, frequent and uncontrolled use becomes more problematic.
At this stage of problem drinking, it’s common for problems with depression and sleep to manifest. Sickness from heavy drinking is common. Drink driving is also much more likely when someone has reached this stage.
Ask yourself if your loved one has:
- Decreased social activity
- New friends
- Problems talking with strangers
- Relationship problems
If so, they might very well be a problem drinker already with dependence not too far off…
Stage 4: Alcohol dependence
Dependence on alcohol kicks in after the problem drinking stage if the person doesn’t remedy their habits. It’s possible to be dependent on alcohol without being fully addicted.
If someone is dependent on alcohol, they’ll have a strong attachment to alcohol at the expense of their regular routine and lifestyle. Alcohol becomes all-consuming.
Someone becoming dependent on alcohol will evidently be aware of the negative effects but unable to exercise proper control.
Tolerance builds so more and more alcohol is needed to reap the same dividends. As the person consumes increasing amounts of alcohol, so the effects on the mind and body become more damaging.
Withdrawal symptoms in the absence of alcohol are also characteristic of dependence. From nausea and tremors to sweating, insomnia and a racing heart, you should be able to spot these symptoms in a loved one quite easily.
Stage 5: Addiction and alcoholism (AUD)
By the time someone has alcohol use disorder, drinking is no longer about pleasure. The person will have a physical and also a psychological need to drink.
Cravings can be severe when the person has no access to alcohol and addiction to other drugs is also reasonably common.
You can use the above framework to determine whether you think your loved one is already suffering from AUD.
With that overview in place, you should be able to establish whether your friend or family member really does need help. If so, what can you do?
What Can You Do To Help
Before taking any firm steps to confront a loved one you suspect is drinking too much, do your due diligence. While it’s imperative to act, you shouldn’t rush into it.
There’s a big difference between someone drinking too much occasionally and someone with alcoholism or alcohol use disorder. When someone is suffering from AUD, there’s no such thing as drinking in moderation.
So, read through all the above signs and symptoms of alcoholism and take advantage of appropriate resources. From Alcoholics Anonymous and Al-Anon through to government sites like SAMHSA (Substance Abuse and Mental Health Services Administration) and NIAAA (National Institute on Alcohol Abuse and Alcoholism), familiarize yourself fully with alcohol use disorder.
5 Ways To Help
- Practice makes perfect
- Get the time and place right
- Listen closely and don’t judge
- Be supportive
- Intervene if necessary
1) Practice makes perfect
While you don’t know precisely how the conversation will pan out, you can certainly prepare yourself for the most expected responses.
Make sure you stay positive and avoid making hurtful statements if possible.
Keep everything as personal as possible. Using “I” instead of “You” is a great strategy to minimize accusation and to say the same thing in a more palatable manner.
Rather than telling your loved one outright, “You’re an alcoholic and you need to sort it out”, ask yourself if you can’t make a similar statement less confrontational.
If you say instead something like, “I love you and I’m so concerned about the way drinking might be harming you and your health”, you’re far less likely to provoke a negative reaction.
To be clear here, you need to be specific so you can get the message home but do not do this in a direct and blaming fashion. Try to plan in advance how you’ll remain calm however the discussion progresses.
The planning stage needn’t take long and you should then think about how best to approach your loved one.
2) Get the time and place right
The most crucial element here is not to speak with your loved one when they’re intoxicated. You’re highly unlikely to achieve what you want if you do this.
Choose somewhere quiet and private, ideally where your loved one will feel comfortable and relaxed.
In general, early mornings are likely to be the best time and home the best place. Make it personal and appropriate for your loved one.
3) Listen closely and don’t judge
Absolutely honesty is key if you want to help someone with a drinking problem.
Even more important, you need to listen rather than speaking. This might be tough if you have lots you want to get off your chest and out into the open.
Once you have initiated a dialogue, be prepared for your loved one to be in denial. This is common and you should back off temporarily to give the person time to take what you’ve said on board.
4) Be supportive
Your role is to offer to help. It’s down to your loved one whether or not they choose to accept that support. Ultimately, you won’t be able to force someone into recovery if they don’t have the desire to stop drinking.
If your loved one claims they’ll try to cut back on drinking, be empathetic, non-judgmental, and supportive. That said, you should make it clear that actions count.
If appropriate, you should underscore the importance of seeking professional help. Whether this takes the form of residential rehab or an intensive outpatient program depends on the extent of the drinking problem and individual circumstances.
5) Intervene if necessary
Simply approaching a loved one to voice your concerns is not the same as staging an intervention.
If you met with resistance during initial discussions, give it some time then try again.
In the event of continued failure to engage your loved one, you might consider a formal intervention.
An intervention is a process where friends, family and possibly co-workers get together and confront an individual with the goal of getting them into treatment. Often, a professional counsellor will also be involved.
Hopefully, a combination of the above tactics will help your loved one to understand the extent of their drinking problem and to commit to recovery.
What To Avoid
If you’re hoping to help a loved one you suspect of being alcoholic, there are also a few things you should avoid.
- Do not blame yourself. None of this is your fault. If your loved one reacts poorly suggesting they only drink to excess because of something you’re doing wrong, ignore this. Remove any blame from yourself.
- Stop covering up your loved one’s drinking habit. If your friend or family member is in denial about their drinking and you continue to cover up their habit, you’re playing into their hands and making it easier for them. Stop this immediately.
- Don’t accept the unacceptable. If you continue to accept intolerable behavior, you risk a full-bore abusive relationship developing. Stop cutting your loved one slack “because they’re drunk.” If children are involved, make sure they’re protected from any unacceptable behavior. Children can end up psychologically damaged in the long-term when living conditions are characterized by an abusive, heavy drinker in the house.
- Quit enabling their behavior. When you make things easy for an alcoholic to continue drinking, you are enabling them. Allow your loved one to face up to the consequences of their alcoholism rather than shielding them from any backlash.
- Get help ASAP. While you should not rush helping your loved one, adopting the ostrich approach won’t work either. Take action and help them to the best of your abilities then involve professional assistance if necessary.
Everything so far has been about your loved one but how about you?
You should never overlook helping yourself.
Remember To Help Yourself, Too
If a close friend or family member is struggling with alcoholism, chances are this will have an impact on you as well.
Don’t be afraid to ask for help yourself and always look after your own physical and mental health.
Avoid codependency. This occurs if you become so intent on helping your loved one get well, you do so at the expense of your own wellbeing.
What To Do Next
If you are concerned about a loved one drinking too much, get in touch with us here at Landmark Recovery.
We have a number of different treatment centers and we can help your loved one on the road to a full and sustained recovery. So if you’re still wondering how to help an alcoholic, call us today at 888-448-0302.
Dec 2, 2019
Posted in: Alcohol