Reaching out to help someone with an alcohol or drug problem is not easy.
All too often, close friends and family turn a blind eye to the situation and hope that the person will eventually see sense. But addiction will not go away and denial prevents the person from appreciating the full extent of the problem and its consequences.
Heavy drinkers are less able to make conscious choices about their drinking and so the involvement of family, friends and employers can make a difference.
A flexible caring approach rather than a harsh one is important. You must be non-confrontational and persuasive.
Using positive language is key to this empathetic approach. Dr Jacobson suggests using phrases such as:
- “I wonder if you drink less your health/well-being may improve.”
- “I’ve noticed that you aren’t so positive about life since you’ve been drinking more. This isn’t the kind of person I know you to be. I’m not bringing it up to upset you, but because I’m concerned.”
- “I’ve noticed you’re not doing as much exercise as you used to.”
- “I thought it was great when you were going to yoga/football/your night class etc.”
Keep your cool
Accept that it will be a difficult situation and expect the person to be defensive and hostile.
Meanwhile, it’s definitely best to avoid harsh criticism, making judgements and labels such as “alcoholic”. To avoid circular conversations (Them: “No, I’m not!” You: “Yes, you are.”) It’s also best to keep your questions open, “I’ve noticed X, what do you think?” rather than “don’t you think you have a problem?”
You may be frightened or angry but avoid blame and angry confrontations. They need to be able to focus on what is being said, not how it is being said.
Express Concern & Offer Help
Begin at the outset by expressing your deep concern and your commitment to help and support them in taking positive action.
Present the Facts
Present the actual facts about their drinking or drug misuse and be specific about their behaviour. Avoid moral judgements and opinions. Instead of “I think you drink too much”, say: “last night you were slurring your speech and shouting, you drove on the wrong side of the road, it was really frightening”.
Explain that they have an Illness
Explain that a serious alcohol or drug problem is an illness, not a moral weakness or lack of willpower. Tell them that they are a decent human being with a very destructive illness, one which leads to a progressive decline and a potentially fatal outcome. Help them to recognise that the only way to deal with this illness is through abstinence. To achieve this help will be needed and you can support them.
Use Leverage where Possible
The more leverage/bargaining power you have the better, and it helps to set healthy boundaries. But don’t confuse this with ‘threats’, you must intend to carry out anything you say. If you are an employer it may be necessary to offer a choice of treatment or risk one’s career. You are not forcing the person to get help, you are offering a choice. A sheriff or magistrate may decide that the person can have a choice between treatment or jail. Parents may decide that grandchildren are at risk unless their grandparent seeks help. Speak with deep concern but firmness.
Engage Others: Group Intervention
A group can have more impact. A spouse can use older children, a brother/sister, a minister and at work other colleagues can be involved. If each person is armed with specific facts the effect can be powerful.
Again, a group can act separately: several people over the course of a couple of weeks can approach the person suggesting the need for help and leaving the same card or telephone number for professional help.
Offer Information and Professional Help
Leave information around work. Have the names and telephone numbers of agencies or professionals who provide treatment ready at your fingertips.
Offer to phone at once for them. All too often the person will promise to seek help but will not follow through. If they do not accept help then leave the door open; don’t nag and don’t scold. It may be enough to plant the seed. With a friend it may take months or longer before they agree to treatment.
Practice Tough Love
Place responsibility where it lies, with the addict. Do not take the burden of responsibility on yourself.
Too often help and treatment are not offered because the outcome is seen to be hopeless. But 50% of addicts and alcoholic patients can and do recover and there are excellent results for early problem drinkers.
Recommend a Self-Help Group
Recommend the self-help groups of Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). Offer to take your friend to a meeting and go along with them. AA prescribes abstinence gently, one day at a time. AA provides hope, support, and exposure to stable recovery. The experience of realisation, sober fellowship and mutual support take the place of previous lonely struggle and isolation. Remember that attending these self-help meetings may not be a palatable experience at the beginning, and they will complain, but they should be encouraged to persevere.
Family members themselves will be greatly helped by attending Al-Anon, the self-help group for families and significant others, where through the experience of other family members you will be able to find some solutions for yourself and your loved one.
Consider Early Intervention
As with any illness, alcoholism responds best to early intervention and needs to be confronted at an early stage for the best outcomes. All too often the problem is ignored until there is a major crisis. Collusion at the workplace is also all too frequent and the underperforming colleague is tolerated until given a golden handshake or simply fired on a technicality. The longer we ignore the problem the greater the health risks: brain damage, liver damage and a poor prognosis.
Adapted from Castle Craig.
Download the Alcohol focus factsheet here.