How to Help Someone Stop Drinking

Alcohol is as inseparable from American culture as oxygen is from air—a ubiquitously abused legal poison that does not discriminate in its physical and psychological destruction.  Although deceptive marketing practices portray alcohol as a pleasurable, socially acceptable, and even “sexy” beverage, it is a neurotoxin and global killer that knows no socioeconomic boundaries.  According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), approximately 90,000 people die annually from alcohol-related deaths in the US, with over 65 million Americans reporting binge drinking within the past month.

GETTING INFORMED

Two of the major problems surrounding America’s alcohol epidemic involve misinformation and lack of education into the nature of alcohol abuse.  For example, of the approximately 17 million Americans struggling with an alcohol use disorder (AUD), only 7 percent receive professional treatment. This means that millions of Americans in dire need of treatment continue drinking irresponsibly and to detrimental effect—yet believe they don’t have a problem serious enough to warrant professional intervention. The very first step necessary for family members and friends to be more effective in helping a loved one stop drinking is to become educated about the nature of alcoholism. And the very first step in getting educated lies in understanding that alcoholism is a chronic, relapsing disease—not a “casual problem” or “temporarily problematic behavior.”  

Instead of taking an alcoholic’s destructive actions personally, it is vital to understand that they are sick and suffering from an addiction that could have been triggered by challenging circumstances in their life, or a genetic proclivity.  An excellent first step to becoming informed is to attend a local Al-Anon meeting, and if that is not possible, one of the many online discussion groups that are free to join.  At its core, Al-Anon teaches detachment from the self-created problems of an alcoholic—but not the person.

By attending a local meeting, you will encounter other people who are facing the same difficulties and have similar stories to share. This creates a solid network of supportive contacts that you can fall back on when feeling discouraged—an inevitable part of participating in a loved one’s recovery. You will also learn how some of your behaviors may be unintentionally enabling them and how to turn those behaviors around. For those not immediately inclined toward group participation, there is an abundance of literature available via the internet or at local libraries on how to be supportive without being co-dependent. 

EARLY WARNING SIGNS

Alcoholism tends to follow a predictable pattern that begins with recreational indulgence and eventually escalates into a life and health-destroying disease. Many alcoholics, and even heavy social drinkers, minimize or deny the seriousness of their condition, telling concerned family members and friends that “all is well,” or to “leave well enough alone.”  Closer examination of their condition, however, paints an entirely different portrait and may include the following warning signs:

• DUIs, DWIs, personal and professional problems, being fired or suspended from work or school as a result of intoxication.
• Trouble in maintaining commitments, fulfilling social obligations, or marital responsibilities.
• A noticeable decline in physical and/or mental health and outward appearance.
• Avoidance, withdrawal, or self-imposed social isolation.
• Uncharacteristic depression, anxiety, or suicidal ideation (SI).
• Drinking patterns that shift from being occasional and moderate, to frequent and excessive.
• Spending the vast majority of time thinking about their next drink or recovering from the effects of intoxication.
• Displaying increasingly manipulative or controlling behavior designed to support their addiction.

THE ABC’S OF INTERVENTION

Confronting an alcoholic’s self-destructive behavior can be exceptionally difficult. Alcoholics are often highly defensive and react negatively when presented with evidence that their lifestyle and/or behaviors are toxic, not only to themselves but to others. As a result, they may react with hostility to even the purest, most loving intentions.  Family members and friends may feel secretly threatened by the attitudes and behaviors they have experienced, or openly fear physical violence or emotional alienation as a direct consequence of their involvement. In an all too common scenario, friends and family members find that their initial attempts at casually addressing their loved one’s alcoholism are met with denial, avoidance, or aggression. In general, the following suggestions can help make the difference between a successful or unsuccessful initial discussion:

• Communicate firmly and directly, but always kindly and without making assumptions.
• Choose an appropriate time and setting to broach the subject, preferably one that is relaxing—such as in the privacy of your home or in the presence of a mutually trusted friend in an upbeat, public setting.
• Make good eye contact, using non-violent language whenever possible. For example, try to use open-ended questions and avoid superior or condemning speech.
• Be compassionate and willing to actually listen. Many alcoholics and “problem drinkers” secretly suffer from unresolved trauma or debilitating stress.
• Never address a loved one’s alcoholism while that individual is intoxicated, only while they are sober and fully cognizant.

Unfortunately, during some “initial discussions,” frustrated family members, loved ones, and friends may blame the alcoholic entirely for their predicament despite using neutral language delivered in a supportive tone.  This is a recipe for disaster and only serves to foment resentment and further damage communication. Another common reason early interventions fail is the use of false promises and insincere rhetoric. Many alcoholics—especially high-functioning alcoholics—are skilled in a wide range of manipulative behaviors which include making deliberately false promises or saying whatever possible to avoid accountability or suspicion. A truly effective intervention demands accountability, and the person or persons facilitating it must be prepared to follow-up on empty promises or insincere statements with decisive action.

Whenever a casual, direct approach to confronting an alcoholic fails, consider enlisting the help of a professional alcohol intervention specialist.  Many alcohol intervention specialists are verbally and clinically skilled, a combination of attributes that can work wonders in reaching even the most difficult-to-reach alcoholics.

INITIAL DETOX AND SUBSEQUENT TREATMENT

Once an alcoholic agrees to stop drinking, it is imperative that they seek a professional medical diagnosis before enrolling in treatment. Moderate to severe cases of alcoholism may require hospitalization or admission into a residential facility specializing in alcohol withdrawal and subsequent treatment. Typically, the first step in the medical management and clinical treatment of alcoholism is detox—an intense, short-term process that lasts approximately 5-7 days.

After successfully completing medically managed detox—or following short-term hospitalization—clients may choose to enroll in an inpatient treatment program. This popular treatment protocol provides an excellent foundation for physical and psychological stabilization and is considered the industry gold standard. Unlike outpatient facilities, which are less intensive and potentially longer-term, inpatient facilities provide residential treatment for a period of approximately one month to three months. Reputable inpatient facilities feature cutting-edge clinical care and offer an impressive variety of ancillary services and benefits. In addition to a primary regimen that includes evidence-based, medication-assisted treatment (MAT), some facilities boast a comprehensive treatment protocol offering the following advantages:

• Specialized therapeutic modalities including cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), trauma-focused therapy (TFT), narrative therapy, motivational interviewing (MI), and family therapy.
• Aftercare services, alumni networking, and community volunteer opportunities
• On-site recreational amenities such as a gym, swimming pool, or close proximity to the ocean, mountains, or other scenic areas
• Inclusion of mindfulness, meditation, or other spiritual/holistic activities in addition to traditional Alcoholics Anonymous (AA) involvement and 12-step recovery.
• A high therapist-to-client ratio designed to ensure premium clinical care.

MAT is a crucial aspect of effective alcohol treatment. Although over 150 medications have undergone clinical trials for the treatment of alcohol withdrawal in recent years, the following medications are currently used with great frequency and reliability:

• Disulfiram
• Naltrexone
• Acamprosate
• Benzodiazepines “Benzos”
• Beta-blockers
• Clonodine

Alcoholism is often caused, exacerbated, or accompanied by co-occurring substance abuse or mental health disorders such as bi-polar depression and generalized anxiety disorder (GAD).  Depending upon the results of in-depth psychiatric evaluations and comprehensive clinical assessments, clients may need to be treated for one or more co-occurring disorders so that optimal treatment outcomes can be achieved.  

TAKING ACTION

If you or someone you love are struggling with alcohol addiction and in need of help, call a substance abuse professional today. Alcoholism can affect any one, at any time, regardless of age, race, gender, socioeconomic status, genetic predisposition, or profession. Alcohol is not a harmless recreational beverage—it is a potent neurotoxin with potentially fatal consequences. There is no such thing as “seeking help later,” or an “ideal time to enroll in a treatment program.” As evidence-based research has repeatedly proven, treatment delayed is often treatment lost, and time is a luxury you simply cannot afford.

For more about alcoholism and recovery, check out these related articles:

• “The Legal High: Why Alcohol is so Addictive”
• “What Is Alcohol Poisoning and Its Link to Addiction?”
• “The Long-Term Health Effects of Too Much Alcohol”
• “Alcohol or Drugs: The Shocking Answer to What’s Worse for You, From the Experts”

Sources:

• American Journal of Epidemiology. Stigma and Treatment for Alcohol Disorders in the United States. Dec, 2010.
• International Journal of Drug Policy. Overview of harm reduction treatments for alcohol problems. July, 2006.
• Health Affairs. The Economics of Alcohol Abuse and Alcohol Control Policies. March, 2002.
• Journal of Hepatology. Managing excessive alcohol consumption at a population level: The earlier the better. March, 2018.