Spotting a Drinking Problem in Someone Close
Spotting a drinking problem often starts when friends or family members begin to notice some troubling behavior. These behaviors are signs of an alcohol use disorder (AUD) that may be mild, moderate or severe.
- Drinking more than planned
- Not being able to stop drinking once you start
- Making excuses for your drinking
- Not remembering what you did the previous day or night
- Avoiding social activities with family or friends because you're embarrassed by your alcohol use
- Feeling guilty about your drinking habits
If you notice these signs in a loved one, it may be time to talk to them.
People who are struggling with an alcohol use disorder may also:
- Not care about their health and well-being because of drinking
- Have trouble at work or school because of drinking
- Continue to drink even though it's causing family problems
A pattern of lost control around alcohol could be a sign of AUD. This includes continuing to drink even though it may have led to negative consequences such as relationship problems, job loss, legal issues, or health problems.
They drink more than they intended to or for longer than they wanted to. They are unable to control how much alcohol they consume in a certain amount of time.
They have withdrawal symptoms when trying to quit alcohol or reduce the amount consumed (such as feeling anxious or nervous, trouble sleeping, nausea or vomiting).
A person who has AUD is often reluctant to admit it. He or she may deny or make excuses for drinking behavior and problems, blame others, lie about the amount of alcohol consumed, and refuse treatment. Family members can have a hard time knowing when to intervene because there are no external symptoms like bruises or broken bones that can be seen.
How to Open the Conversation
Open-ended questions invite more than yes-or-no answers and provide an opportunity for a deeper conversation. Here are some examples:
What has been most difficult about drinking?
How do you think it's affected your family or work life?
What have you tried in the past to cut down on your drinking?
It's normal to feel frustrated, scared, confused, angry, or resentful when a loved one is struggling with alcohol use. But these feelings won't help you get through to them. Instead of pointing out what they're doing wrong, comment on their strengths. For example: "I know that you are usually a very responsible parent, so I'm really worried about the times your drinking may have made it harder for you to be there for your kids."
Be direct but respectful when talking with someone who is struggling with alcohol use disorder. Start by asking open-ended questions about how they feel and what's been going on.
Let them know that you're there to help, but don't pressure or judge them. If they tell you they want to cut down or quit drinking, follow up with concrete suggestions for the next steps they can take toward recovery.
Use these tips as guidelines for how to talk with your loved one:
- Be prepared for their reaction, whether it is anger, sadness, fear, or denial.
- Make sure you have enough time to talk without distractions.
- Explain that you want to talk about something that has been bothering you.
- Tell them what concerns you.
- Ask them how they feel.
- Encourage them to open up by listening and being supportive. Avoid interrupting.
If they choose to get help, let them know you're there for them during the process. If they decide not to get help or if it's too difficult to talk with them at this time, you can always reach out for support from a professional. Try talking to a counselor or therapist.
It may take time before your loved one agrees to get help. That's OK! Be patient, compassionate, and understanding. It's important to keep having the conversation until they're ready.
Moves That Usually Backfire
Confrontational interventions often push people away from seeking treatment rather than toward it. However, family members can have a positive influence by helping the person recognize the problem and consider entering treatment. Instead of a "confrontation," an alternative approach is to use CRAFT (Community Reinforcement and Family Training).
CRAFT teaches concerned friends or family members how to:
- Ignore behaviors associated with drinking or drug use.
- Reinforce changes in behavior (e.g., going to work, spending time with children) related to sobriety or help-seeking.
- Allow the drinker to experience the natural consequences of drinking (e.g., an argument over drinking) without trying to protect him or her from these consequences.
Shielding someone from every consequence of their addiction makes it harder for them to recognize how harmful it is and easier for them to keep hiding the problem. It also takes away the chance for them to experience consequences on their own terms, at a time of their choosing.
When you talk with someone about getting help for alcohol addiction, avoid:
Being judgmental. It can make the person defensive and less likely to listen to what you have to say. This also includes lecturing or using guilt to try and get them to change.
Making threats or ultimatums. Saying things like "If you don't go to treatment, we'll kick you out of the house" may work in the short term, but if they're willing to live on the street rather than get help, this tactic isn't effective.
Helping a person who drinks too much can be challenging, and it's important that you take care of yourself as well. If you're angry or upset, talk with a friend about your feelings before talking with the drinker. If things get out of hand during the conversation, leave the room and take a few minutes to cool off.
Looking for Treatment Together
Make an appointment with a family doctor or primary care provider. This step is important because it's always wise to see a medical professional before starting treatment for any addiction. A primary care provider (PCP) can screen for and help treat alcohol use disorder and other health conditions. In addition, PCPs can coordinate care among multiple providers.
Prepare for the appointment by making a list of questions about AUD you would like answered. Also prepare questions that are specific to your situation.
A primary care visit can open referral paths to additional treatment options. A primary care provider may also be able to provide AUD medications at the same time. If a loved one is uncomfortable discussing their drinking with their primary care provider, another option is to reach out to an addiction medicine specialist or a licensed mental health counselor.
A complete assessment helps match care to each person's needs. The assessment will evaluate a person's readiness for treatment and may include a review of past alcohol use, other mental health issues, history of prior treatments, and family history.
The results of the assessment determine which of these levels is appropriate:
Detoxification (detox). Supervised medical attention to manage symptoms while the body clears the alcohol.
Outpatient treatment. Therapy and counseling are provided in office visits for several hours a week.
Intensive outpatient/partial hospitalization. Therapy, counseling, or medication in an intensive program that meets for coordinated outpatient care.
Residential care. Inpatient programs, 24-hour-a-day supervision by treatment staff.
Community Service Boards can connect someone with behavioral healthcare.
Family counseling sessions repair strained relationships and rebuild trust and understanding between family members. Family therapy also helps families cope better with relapses. Involving the whole family in a loved one's recovery helps everyone understand what's happening, why it's important to support treatment efforts, and how they can contribute.
When the Situation Is an Emergency
Severe alcohol withdrawal can become life-threatening. This occurs when a person stops drinking after heavy or prolonged use and then goes into delirium tremens (DTs). DTs are characterized by hallucinations, seizures, severe confusion, and agitation. Medical care is needed immediately.
Signs include:
- Confusion or difficulty thinking
- Tremors or seizures
- Hallucinations
- Irritability or agitation
- Rapid heartbeat
Other serious complications of alcohol withdrawal can occur. These include:
If you think someone is in DTs, seek emergency help immediately.
The staff at a hospital or withdrawal facility can monitor your condition and give you medications to help ease the symptoms of alcohol withdrawal.
GCAL professionals can provide telephonic crisis help. They have mobile crisis teams available for dispatch. Individuals may be linked with urgent appointment services. Individuals may find a crisis or detox bed that's open across the state. In a non-emergency, GCAL can link individuals with a state-funded provider in their area.
GCAL works with the 988 Suicide and Crisis Lifeline.
Anyone may buy naloxone at a pharmacy in Georgia without an individual prescription.
Medical Amnesty exists for people seeking medical assistance for someone experiencing overdose symptoms.
Support Aimed at Family Members
Support aimed at family members includes peer-led groups as well as professional services. Some examples include:
Al-Anon/Alateen - A worldwide fellowship of relatives and friends of alcoholics who provide understanding, encouragement, and support for each other.
SMART Recovery for Family and Friends - Based on cognitive-behavioral principles and is available online. It focuses on providing information and training in problem-solving methods to help family members cope with the problems created by their loved one's drinking. This can also be done as an individual family member program or a group program.
Professional services may include support groups with other people whose loved ones have AUD.
Alateen, sponsored by Al-Anon, offers the same kind of peer support for teens and younger relatives in similar circumstances.
As a partner or family member of an alcoholic, you may feel isolated. You might not understand what your loved one is experiencing. You may feel responsible for the person's drinking.
These feelings can also lead to family conflict, including arguments over money, the children, other family members, work, and general life management. These issues can strain relationships, making it difficult to function as a family.
Protecting Your Own Health While Helping
Daily time for yourself can look different depending on your needs. It could be something as simple as going outside to breathe in fresh air or taking a walk around the block.
Here are some tips:
- Schedule time for yourself every day. This can be as simple as going outside or reading. It's important to take time away from caring for others.
- Take breaks throughout the day if you feel stressed. Get up and stretch, go for a walk, or listen to music. These short breaks can help reduce stress levels and keep you feeling refreshed.
- Prioritize your self-care activities. If possible, try to schedule them into your week so they become a part of your routine.
Setting limits on what you can offer, and finding ways to take care of yourself, are important steps toward staying healthy while supporting a loved one with an addiction problem. The following guidelines may be helpful:
- Set realistic goals for the changes you want to make in your relationship.
- Be firm but kind about your expectations; don't give ultimatums that you can't or won't follow through on.
- Don't try to control your loved one's behavior. Your goal is to change the way you interact with him or her so that drinking behavior changes.
- Don't enable your loved one to continue drinking by covering up the problem (for example, lying for your loved one or making excuses for his or her behavior).
- Set limits on what you can offer (for example, you won't lie for him/her, but you will be available to listen).
Caring for yourself during this time is not selfish. By taking care of yourself first, you are better able to support your loved one.
Other ways you can care for yourself include:
- Reading
- Listening to music
- Talking to friends and family
- Writing in a journal