How to Talk With a Loved One About Alcohol Dependency
Maybe you’ve seen your friend swigging on the sly from mini bottles of alcohol that magically appear from her purse. Maybe she can’t get through a dinner without consuming at least four drinks. Whatever the scenario, alcohol dependency, a chronic medical condition that includes a strong craving for alcohol and inability to control consumption, can have serious health consequences, says Michael Damioli, LCSW, the clinical director at Colorado Medication Assisted Recovery. In Thornton, CO.
Heavy Drinking vs. Dependence
A recent study conducted by the CDC found that nearly one in three adults drink excessively, yet, only about one in 30 is alcohol dependent. There’s a difference between drinking heavily or abusing alcohol and a dependence. Excessive drinking includes bingeing (four or more drinks at a time for women or five or more drinks for men) or consuming eight or more drinks a week for women or 15 or more drinks a week for men. Signs of being physically dependent on alcohol for daily functioning also include withdrawal symptoms such as shakes, cold sweats, headaches, or nausea, Damioli says.
Act Fast for Best Outcomes
If a loved one is showing signs of alcohol dependence, he or she needs help—and fast. “The earlier someone gets care, the better their potential outcomes,” Damioli says. Substance abuse issues can deteriorate rapidly, adds Monty Ghosh, M.D., an assistant clinical professor addiction medicine at the University of Alberta in Canada. Remember, though, that alcohol dependency has an underlying emotional component and most alcohol-dependent individuals seek comfort by consuming alcohol. So be supportive and non-judgmental in how you express your concerns, or it could potentially exacerbate the problem. Follow this guide to having the convo in the gentlest, most effective way possible.
Handle With Care
Always approach from a place of love, care, and concern. Most people who are struggling with severe alcohol use really do want to stop drinking but may be scared or not know what to do, Damioli says. “Coming from a place of concern instead of confrontation helps to defuse someone’s defense mechanisms caused by their embarrassment from the stigma of addiction,” he says. Doing so in private can often be less intimidating, but feel free to include other friends and family who want to help; this can create a strong message of care and concern, Damioli says.
Have a Plan
“Bringing resources from the community, contacts for counselors or physicians, as well as treatment options can be very helpful,” Dr. Ghosh says. “The key is to empower the person to make choices for themselves.” But because you might not know the extent of the problem beforehand, it’s best to identify an expert that the person can go to after your conversation in order to begin the process of help and healing, Damioli says. “It’s also extremely beneficial to educate yourself on alcohol dependence before talking. That way you are coming from a place of knowledge and experience.”
Practice Ahead of Time
This kind of chat can be daunting with a capital D. But practice helps make perfect. “You might speak with a therapist, professional, or trusted friend about the conversation before you have it,” Damioli says. It can also be helpful to role play. And, if you need to set a boundary with the person you’re trying to help, it’s best to know exactly what that is and how to convey it before talking to them about it, Damioli says. Boundaries are letting the other person know your reactions to and consequences of their behaviors. “It’s not an attempt to stop or control their actions,” he says.
When you talk with your loved one, don’t point blame or criticize. Use “I” statements such as, “I am concerned, anxious, and scared when I see you drinking the way that you do," Damioli says. Be specific when setting boundaries. “An appropriate boundary is not ‘you have to stop drinking immediately,’ but, ‘I will not spend time with you while you are drinking’ or in an extreme case, ‘If you are going to continue drinking then you are not welcome to… live in my house…. be in my life, and so on.’”
The best way to navigate these issues is by asking the person suffering to share their thoughts and feelings about the situation,” Dr. Ghosh says. “If there is strong denial or opposition, using motivational interviewing techniques can be incredibly helpful.” This involves using key questions to increase someone's intrinsic motivation to change a behavior. “Have active discussions with the person using substances and exploring the pros and cons of continuing to drink, learning what it would take for them to stop, and what drives them to keep drinking,” Dr. Ghosh says.
Willingness to seek help can often wane very quickly, Damioli says. “Even if someone is very motivated at the time of your conversation it is not unlikely for that willingness to go away after a few days, hours, or even minutes. Consistent follow up is a demonstration of support that can make a big difference in someone’s ability to make changes,” he says. Going to treatment may be extremely scary, so having a friendly, caring face along for the ride can be very beneficial, Damioli says. “Taking someone to treatment is a generous gift that might make the difference in their follow through.”
Seek Help—for Yourself
Caring for someone with an addiction is not easy, especially if it’s been years in the making. Seeking support for yourself and learning about the impact of alcoholism and how to set boundaries is important for your own wellbeing, Damioli says. “Look for therapists who specialize in working with family members of those with addiction and/or find support from Al-Anon which is a 12-step meeting designed for friends and family of alcoholics.” And remember to be kind to yourself. Your loved one may be fighting alcohol dependency but the impact is felt in your life, too.
Rates of Alcohol Dependence: Preventing Chronic Disease. (2014.) “Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011.” https://www.cdc.gov/pcd/issues/2014/14_0329.htm
Understanding Alcohol Use Disorder: Mayo Clinic. (n.d.) “Alcohol Use Disorder.” https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243
Criteria for Alcohol Dependence: The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking. (2007). “Alcohol Abuse.” https://www.ncbi.nlm.nih.gov/books/NBK44358/