When Someone You Love Is An Alcoholic Or Addict
There’s no doubt about it: the opioid crisis in America is as serious as it sounds. The number of overdose related deaths has steadily been on the rise over the past decade, and our public health system feels the burden. We loosely used the term “druggie” in the 1990’s to describe someone less concerned with responsibility than his or next high.
But now, we wonder: Is pot really a gateway drug? Are the consequences of partying just a “laissez faire” approach to life, or will the next party end in a lethal overdose? A drunk driving accident? Media stories hit close to home and we all seem to know a family or two whose lives have been derailed by alcohol or chemical dependency.
While we can’t control the choices our loved ones make, we can know what to look for and how to wisely intervene. Most frequently, parents, spouses and caregivers ask:
“Is it really a problem, or not?”
In my experience a close family member or friend has astute intuition. If the thought crosses your mind that it’s
“more than kicking back and relaxing”
you’re likely right.
Oftentimes, we hem and haw over the “is it really a problem” question because we preemptively perceive the difficulty of the truth. Unearthing a problem as complex as addiction is undoubtedly difficult. It’s arguably more difficult, however, to sit with the knowledge that you chose passivity instead of caring support.
When it comes to heavy drug and/or alcohol use people tend to fall into two categories:
Category One: In your opinion, your loved one uses drugs and or alcohol too much. You would like to see him or her use less. However, this loved one of yours is able to stop or significantly decrease the use pattern without much strain or distress. When you talk to him or her about his “habit,” he acknowledges it’s a part of his lifestyle and isn’t defensive. There are no notable impacts to physical, social or occupational functioning.
Category Two: In your opinion your loved one uses drugs and/or alcohol too much. You really don’t see changes in your loved one’s use pattern. It is heavy, consistent and regular. This loved one doesn’t really “exist” without a glass of wine, a joint or the drug of choice. There may be notable impacts to physical, social or occupational functioning, and it may be obvious.
However, keep in mind addicts are often charismatic, hard-working and high-functioning. Work and social arenas may appear full and thriving. If a person is young, physical signs and symptoms may be minimal. However, when the topic of use is brought up, you find yourself met with defensiveness or notable superficiality. You also may feel as though you are walking on eggshells when the topic of use surfaces.
How to Know Someone is an Alcoholic or Addict
If category two resonates more fully with you than category one, your loved one may be an addict.
Clinicians categorize addiction or alcoholism as a “substance use disorder” There are eleven criteria that an individual must meet to receive the substance use diagnosis and it’s the professional, of course, that has the authority to diagnose. However, it’s family and friends on the front lines of the diagnosis before someone decides to get professional help.
In my years of clinical work, I’ve had plenty of clients present to my office and say:
“I think I’m depressed, but I’m not sure, do I have a depression diagnosis?”
“I think I’m hyperactive but I’m not sure, do I have an ADHD diagnosis?”
Never once have I had someone ask for diagnostic clarification for a substance use disorder.
Receiving a depression diagnosis gives reason to feelings of hopelessness and holds the promise of a treatment plan. Receiving a substance use diagnosis, however, begs for a commitment to sobriety and the relinquishment of the one thing that brings ease and satisfaction to life. Unless a “rock bottom” has been hit and triggers a strong motivation for change, most addicts choose to keep using their drug. (Whether or not it’s actually a choice is a different article, for a different time.)
Unfortunately for you, the family member, friend or caregiver, this often means you trek along with your loved one, not for days or weeks, but for years, wondering what to do and how to help his or her addiction.
How to Care for an Alcoholic or Addict
First, name your concern directly. Try something like:
“This is difficult to say because I know how sensitive and hard it is, but I think you drink too much. I actually think you’re addicted and misuse alcohol. I’m worried for you and would like to help you find some professional help.”
If this language is uncomfortable for you, tweak it- but bottom line, be direct, honest kind. Don’t talk a lot. Don’t use heavy emotionalism or sentimentality. Don’t be abrasive or harsh, either. Instead, speak straightforwardly and wait for a response.
Next, follow-up. I have never heard of a situation going smoothly in which the confronted addict responded with enthusiasm and receptivity. Usually, it’s met with defensiveness. If the defensiveness is abusive, of course, find safety and set your boundary. You may have done all you can do and separation is a painful necessity. However, if it’s low level defensiveness and discomfort that you experience, wait it out, and follow up in a week’s time, reiterating your concern. When you follow up, stay concrete.
Try something like:
“I know I mentioned it last week, but I did some research and I’ve found these resources. I’d like you to try one out. I’ll take you to your first appointment. I think this will be a good thing.”
These first two steps may need to be repeated every month until something catches or shifts. Stay consistent and simple in your language even if your loved one’s defensiveness or awkwardness feels hard to withstand.
In the meantime, set your own boundaries. Don’t drink or use with your loved one, otherwise, your concern won’t hold weight. You can be friendly, kind and approachable but don’t engage with your loved one when he or she is under the influence.
Remember, the ultimate goal is to refer your loved one to professional counsel and treatment before it’s too late.