Alcoholism is an older clinical term for a chronic disease called alcohol use disorder (AUD). When excessive drinking becomes compulsive, you are not able to control how much or how often you drink, and you experience negative mental and physical symptoms when you are not drinking, you may have AUD. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), more than 16 million people in the United States have this condition.
If you know someone who drinks a lot, whose behaviors around alcohol have changed, and who is unable to meet work, school, or social obligations because of alcohol, you may wonder how you can support them in overcoming this disease. You can help them by understanding the symptoms of AUD, learning about evidence-based approaches to treatment, and encouraging them to accept help.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists 11 criteria clinicians use to diagnose alcohol use disorder. They are:
Short-term effects from drinking too much include memory loss, blackouts, hangovers, injuries from falling, physical illness, mood swings, and changes to sleep, meals, and hygiene habits. Long-term, excessive drinking increases the risks of heart disease, liver disease, cancer, brain damage, stomach problems, and mental illness.
About 1 in 12 Americans struggles with AUD, according to NIAAA. The most affected age group is between 18 and 29 years old. However, anyone can struggle with alcohol addiction, and if someone you love exhibits the DSM-5 symptoms or struggling in other ways that may be related to alcohol, there are things you can do to encourage them to seek treatment and support them through the process.
It may be hard to know when someone struggles with AUD because many people who have this problem hide it or deny it for a long time. Alcoholism can move through several stages, many of which are easy to cover up or overlook.
Many stages of AUD involve hiding drinking problems or denying that there is a problem. You can intervene during any of these stages if you have concerns about your loved one. But what is the best way to approach someone you care about who might be struggling with alcohol abuse?
Before you express your concerns to a loved one about their drinking, learn about the signs and symptoms of AUD. The above list of stages and diagnostic criteria can help, but consider speaking with an addiction specialist, therapist, or physician about your concerns as well. Not only can this help clarify your worries, but these professionals can help you find and manage treatment resources, which can be important when speaking with your loved one. You may find it difficult to confront someone you love about their potential drinking problem. This may indicate that you also need support. You may struggle with enabling behaviors or codependence, so you should seek out therapy so that you can support your loved one.
Enabling refers to behaviors on the part of a spouse, partner, child, or close friend or relative that encourage one to continue their addictive behaviors. This includes giving the person money because they may not be able to afford rent, food, or necessities otherwise; excusing the person’s behaviors or intoxication, especially to employers or other loved ones; and otherwise making the person’s life easier because you want to avoid conflict.
Enabling can occur regardless of relationship, and it does not mean that you struggle with codependency, but it can be one sign of a codependent relationship. Signs that you may be in a codependent relationship with someone struggling with alcoholism include:
Codependency can occur without the presence of one partner struggling with addiction, but the concept of the codependent relationship developed from spouses of alcoholics who supported their partners in unhealthy ways. If you love someone who struggles with alcohol abuse, you may develop codependent behaviors simply because you care about the person and want them to be well. However, helping someone struggling with addiction means that you cannot protect them from the risks of substance abuse; you have to set boundaries for your own safety to best help your loved one.
Once you have the support you need to overcome any mental struggles of you own, you can consider an intervention for your loved one. You may consider working with a therapist, spiritual or religious leader, physician, or intervention specialist to structure the intervention. If you prefer to keep the intervention among loved ones, there are some steps to take that show compassion for your loved one, support for their struggles, and encouragement to seek treatment.
Although cable television has made interventions seem like intense emotional meetings, they should not be structured this way. An intervention is a gathering of family, friends, and some professionals like a therapist to express concerns about a loved one’s health and behaviors, and encourage them to seek treatment.
It is crucial that concerns about their health are expressed clearly, but there is no blame for harm caused to individual relationships. Show support for them getting treatment, but set clear boundaries on time and assistance. If the person continues to exhibit problems with alcohol, they will not receive financial or social help to cover up the consequences of the addiction.
Treatment for alcohol use disorder is, like other approaches to other substance use disorders, founded in medically supervised detox and behavioral therapy at a rehabilitation program. Medications such as disulfiram, acamprosate, and naltrexone may be used after safely detoxing from alcohol, but the biggest component of treating AUD is therapy. Inpatient and outpatient rehabilitation programs focus on behavioral therapy.
It is also important to know that alcohol use disorder, like other addictions, is a chronic brain disease, so relapse is part of the condition. Treatment can manage symptoms of the disorder and promote sobriety and health, but a return to treatment may sometimes be necessary. If you have a loved one who struggles with AUD, remember that this condition is a chronic illness, and your ongoing support is a vital part of their recovery.
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Stages of Alcoholism. (November 8, 2016). Healthline. from https://www.healthline.com/health/stages-alcoholism
When You Enable and Addict You’re Not Helping, You’re Hurting. (September 15, 2014). The Huffington Post. from https://www.huffingtonpost.ca/candace-plattor/enabling-an-addict_b_5589340.html
6 Signs of a Codependent Relationship. (September 19, 2016). Psychology Today. from https://www.psychologytoday.com/us/blog/anxiety-zen/201609/6-signs-codependent-relationship
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