How To Help an Alcoholic

Alcoholism is a moniker for the medical and psychiatric condition officially known as alcohol use disorder (AUD)—the compulsion to drink and inability to control excessive drinking. Ours is a society where beer, wine, and hard liquor appear almost everywhere beverages are sold. Wildly popular on college campuses, and often the main attraction at social and recreational events, alcohol is promoted incessantly through a billion-dollar-a-year advertising industry. Given this reality, it’s no wonder that approximately 17 million adults over the age of 18 are considered alcoholics and meet the diagnostic criteria for AUD. Of that vast number—only a fraction receive the professional help they need to overcome their condition.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcoholism is a chronic, relapsing disease that ravages physical health, wrecks psychological stability, and destroys families. Approximately 10 percent of children currently live with an alcoholic parent, and millions of lives are vicariously damaged through relationships with an alcoholic. Worse yet, alcohol is responsible for skyrocketing insurance rates, an overburdened criminal justice system and approximately 80-90 thousand deaths annually—a staggering statistic that equates to 2.5 million years of potential lost life (YPLL). Regardless of how “normal” or “socially acceptable” excessive alcohol consumption may seem, the epidemic of death and disability it generates is alarming.

THE LINK BETWEEN ALCOHOLISM AND CODEPENDENCE

The decision to help someone suffering from alcoholism is frequently overwhelming. Many alcoholics erroneously believe they are functional and do not require any help whatsoever, while some are legitimately high-functioning and able to succeed socially and professionally despite their addiction. Others deeply resent the toll alcohol has taken on their lives, but are too prideful to seek the help they so desperately need. Whatever the case may be—co-dependence feeds addictive behavior and should never interfere in a genuine desire to help someone struggling with alcoholism.

Co-dependence describes an unhealthy emotional, physical or psychological dependence on another (and often, all three simultaneously). This dependence leads to unhealthy enmeshment, lack of appropriate boundaries and toxic behaviors. Empirical evidence reveals an inextricable, highly problematic link between codependent behavior and alcoholism. In fact, co-dependence is a defining characteristic associated with alcoholism.  

The worst thing a caring friend, concerned family member, or worried employer can possibly do to help someone struggling with alcoholism is to exhibit co-dependent behaviors—even if done with the most loving of intentions. When it comes to setting clear boundaries and establishing freedom from co-dependent behaviors, the following provides a list of things never to do when trying to help an alcoholic:

• Bailing an alcoholic out of jail—an all too common scenario involves an alcoholic recently arrested for a DUI or reckless driving charge calling a friend or significant other to bail them out of jail. In many cases, the arrest is a second or third offense (sometimes more) and reveals the increasing severity of the problem. In such cases, by immediately rushing to their aid and paying their bail, you are enabling their destructive behavior and helping them avoid accountability. Without hitting rock bottom, many alcoholics never fully realize the seriousness of their condition and continue to play Russian roulette with their own lives and the lives of others.
• Loaning money or other financial favors—alcoholism is a costly habit and, contrary to popular misconception, is sometimes more expensive than other illicit drug addictions in the long-run. Alcoholism—and addiction in general—depends upon deception. Alcoholics often go to extremes to support their habit—lying, stealing and cheating their way into discretionary income. For this reason, loaning alcoholics money or engaging in other financial favors is never advisable unless there is an emergency requiring immediate medical attention.        
• Making excuses for inappropriate or malignant behavior—whenever you make excuses for the behavior of an alcoholic, you empower their continued descent into dysfunction. Some people naturally have a hard time removing empathy from their behavior toward an alcoholic, but this is a critical component of successful treatment. Regardless of what an alcoholic has done to harm themselves or others, never make excuses, rationalize or explain away their behavior.
• Participating in their drinking—unfortunately, many people not suffering from the disease of alcoholism engage in drinking sessions with an alcoholic or participate in other activities where alcohol is prevalent. This is a serious and often costly mistake that only reinforces the “normalcy” of behavior that has become pathological. If you truly care about a loved one or friend suffering from AUD, always seek alternative activities and recreational outings that do not involve alcohol.

CONFRONTATION AND INTERVENTION

Confronting an alcoholic’s behavior and/or staging an intervention is often an extremely difficult process. Many alcoholics are highly reactive to the idea that their behavior is “wrong,” or “destructive,” and respond negatively to even the best of intentions. In some cases, an alcoholic may verbally or even physically attack a loved one trying to intervene, or emotionally retreat behind an impenetrable wall when faced with the facts. Regardless of how difficult and unpleasant, this may be, once alcoholism has hijacked a friend or family member’s life—action must be taken.  

Friends and family members of alcoholics frequently find that their initial attempts at casually broaching the topic are met with denial or aggression. Many alcoholics feel secretly ashamed, haunted by the social stigma surrounding their condition and deeply self-loathing as a result. In general, the following suggestions can help make the difference between a successful or unsuccessful initial discussion:

• Make good, but not overly intense, eye contact and use non-violent language
• Communicate firmly and directly, but always kindly and humbly
• Be compassionate and willing to listen without editorializing or interrupting
• Always choose an appropriate time and setting—one that is casual and disarming
• Never act superior, perfect or condescending under any circumstances

In some cases, additional factors must be considered when addressing a loved one’s alcoholism. For example, many people inappropriately broach the topic while a loved one is intoxicated when it is much more effective to do so when they are sober and at full mental capacity. Additionally, many people put the blame entirely on the alcoholic, even while remaining calm and using language that is kind and delivered in a reasonable tone. This only foments resentment and elicits negative reactions as no one likes to be blamed.  Although we are all ultimately responsible for our actions, the blame is a sure fire way to alienate someone struggling with alcoholism and create an oppositional encounter.

Another factor that may unintentionally sabotage an early intervention is falling for false promises and insincere rhetoric. Some alcoholics, especially high-functioning alcoholics, are highly skilled in manipulative behavior which includes making false promises and saying whatever possible to get someone off their backs. In the event that an alcoholic makes a promise or establishes a definite plan, always be sure to follow up as soon as possible and hold them accountable.

Whenever a one-on-one, direct approach fails to make progress in reaching an alcoholic, always be prepared to enlist professional help. There numerous highly qualified alcohol intervention specialists skilled in the delicate art of confronting alcoholics when all other options have failed. For some families, hiring an alcohol intervention specialist, although costly, can literally mean the difference between life and death for their loved one. Whatever approach you choose when staging and intervention, always remember to exhibit self-compassion and never blame yourself for a friend or family member’s condition. Although you may be responsible for past enabling or co-dependent behavior, you are never responsible for their own choices—only they are.         

SEEKING TREATMENT

Alcoholism is an extremely serious, life-threatening disease that requires professional medical treatment and behavioral management. If you or a loved one is struggling with alcoholism, call a substance abuse professional today and begin seeking the help you need. Early intervention is critical to successful long-term outcomes. Never resort to self-guided treatment or at-home detox, as both can lead to serious complications and potentially fatal consequences.

And remember, alcoholism knows no personal, social, political, religious or economic boundaries. Anyone, at any time, can progress from recreational alcohol consumption into full-blown addiction and find themselves in need of professional help. Fortunately, there is an abundance of evidence-based treatment options and the Food and Drug Administration (FDA) approved pharmacological interventions that can now help in even the most serious cases.    

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

• “Alcohol Detox Guide”
• “Does Alcohol Cause You to Age Faster?”
• “What Is Alcohol Poisoning and Its Link to Addiction?”
• “The Long-Term Health Effects of Too Much Alcohol”

Sources:

International Journal of Drug Policy. Overview of harm reduction treatments for alcohol problems. July, 2006.

American Journal of Epidemiology. Stigma and Treatment for Alcohol Disorders in the United States. Dec, 2010.

Biomed Research International. Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care. May, 2014.

The Pharmaceutical Journal.  Searching for new medicines to treat alcohol addiction. March, 2017.