Drink Problem – Someone you know?

When someone close to you has a drinking problem

When someone close to you has a drinking problem is for anyone who is concerned about a family member’s, partner’s or close friend’s alcohol use.

Being close to someone with a “drinking problem” can be difficult and emotionally draining. While there are no simple answers, we hope you find the following information helpful.

  • What is a drinking problem?
  • Problems related to alcohol use
  • Tolerance and dependence
  • What can I do if I am concerned about their drinking?
  • Effective communication
  • Looking after yourself
  • Where can I turn for support?
  • Treatment options
  • Supporting someone in treatment
What is a drinking problem?
It is difficult to define what a drinking problem is. Other people, including the person drinking, may not view what you perceive as a problem/s, the same way.

Many experts agree that a drinking problem is not measured by how much a person drinks but by how alcohol affects the person’s life and the lives of those around them.

Problems related to alcohol use

There are many problems related to excessive drinking including:

  • Family/relationship problems: Alcohol use may lead to conflict with family or friends. Not recognising that their alcohol use is causing problems, or refusing to admit this can be very frustrating and of concern to family and friends.
  • Work problems: People may take more sick days than usual or be unable to work properly due to the direct effects of alcohol or from being “hung-over”.
  • Accidents: Alcohol use may affect a person’s ability to respond appropriately to a given situation, their ability to think clearly, their ability to maintain attention, and may cause physical symptoms such as blurred vision, drowsiness and nausea. Such effects can increase the risk of car accidents, drownings, and increase the chance of having an accident at work.
  • Legal problems: Drink driving may lead to fines, loss of licence and even imprisonment. A person can also be charged for being drunk and disorderly. Other crimes are commonly alcohol-related. Alcohol is involved in three out of four violent assaults, and about half of all serious crimes.
    For legal advice relating to someone’s alcohol use, contact a legal service in your state/territory.
  • Financial problems: The cost of excessive alcohol use may mean that there is not enough money left to pay for a range of goods and services. This may include regular bills, food and clothing, and other purchases that may increase a person’s quality of life such as entertainment and leisure.
  • Health problems: Regularly drinking large amounts of alcohol can cause many health problems including brain injury, liver cirrhosis or cancer, heart problems, high blood pressure, inflamed pancreas and stomach ulcers. Women who drink heavily over a period of time risk gynaecological problems, menstrual problems and breast cancer. Men who drink heavily risk impotence and shrinking of the testicles. According to the National Health and Medical Research Council more than four standard drinks a day for men and more than two standard drinks a day for women, may lead to health problems.
  • Sexual problems: Heavy drinking may reduce people’s ability to perform sexually.

Tolerance and Dependence

Tolerance: People who drink heavily usually develop a tolerance to alcohol. They need to drink more and more to get the same effect. This means that some people can drink large amounts of alcohol without appearing drunk. However, the higher the level of alcohol consumed, the greater the risk of problems affecting health and daily life.
 
Dependence: There are degrees of dependency, from mild dependency to compulsive alcohol use (often referred to as alcoholism). It is impossible to say how long or how often a person must use alcohol before they start to become dependent.

Dependence can be psychological or physical, or both.

People who are psychologically dependent on alcohol feel compelled in certain, or in a number of different situations, to use alcohol in order to function effectively, or to achieve emotional satisfaction.

Physical dependence is when a person’s body adapts to alcohol and becomes use to functioning with alcohol present.

If a physically and/or psychologically dependent person suddenly stops drinking alcohol, they may experience withdrawal symptoms as they readjust to functioning without alcohol. Withdrawal symptoms are different for each person. There are numerous types of withdrawal symptoms that may be experienced. The first 24 hours are often associated with loss of appetite, nausea, anxiety, inability to sleep, irritability, confusion, tremors and sweating. These symptoms peak between 24 to 72 hours. In severe cases withdrawal may cause convulsions, cramps, vomiting, delusions, hallucinations and even death.

Any person physically dependent on alcohol who is considering giving up or significantly cutting down, should first see a general practitioner or talk to an alcohol and drug treatment agency who can assess and treat any potential withdrawal symptoms.

What can I do if I am concerned about their drinking?

Concerned family and friends are often the first to recognise problems resulting from someone’s alcohol use, however, often they don’t know what to do about it. There are a number of strategies that may assist including.
 
Planning: Establish and be clear about what level/type of involvement you are prepared to commit yourself to. To assist in making these decisions, it may be helpful to speak with a drug and alcohol professional, other members of your family or concerned friends. Discuss what level of support each person is prepared to make and the roles that each person will undertake. Find out what resources are needed such as written information on alcohol and what support services are available.

By talking and gaining clarity on what people can and cannot expect from one another helps to develop a network of support and to avoid feeling isolated and overwhelmed by the situation.
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Avoid contributing to the situation: You may want to protect the person who is drinking from the consequences of their behaviour. For example, making excuses for them, paying their bills, or apologising for them.

You may think or say:

She can’t be an alcoholic. She doesn’t drink everyday.”

Sorry about the noise last night. We had a bit of a row.”

When things get better at work, I’m sure he won’t drink as much.”

John won’t be in to work today. He’s not well.”

She’s an alcoholic, she can’t help it.”

Being “too helpful”, “too caring” or “too forgiving”, can make it much easier for the person to continue drinking. They won’t have to face up to the consequences of their drinking, because everything is being done for them. They still have their job because you rang up work making excuses when they were hung-over. They still have somewhere to live because you paid the rent. They still have friends because you apologised for them.

The best way to help is to stop protecting them. Support the person, not their alcohol use. Let the person face up to the consequences by refusing to support their drinking. This can be very difficult, especially if there are children in the family and you are trying to keep family life as stable as possible. However, the person drinking is unlikely to change if they never have to face the consequences of their behaviour.
 
Talk with them. Keep the communication open. One of the most important steps in bringing about change is to acknowledge what is going on and to explain how you feel to the person drinking.

There is no easy way to start talking about drinking problems. The person with a drinking problem may deny everything. They may give excuses, promise to change or get angry and try to blame you.

It took me weeks to work up the courage. I rehearsed everything I was going to say in my head, yet I still kept putting it off, waiting for a better time. Eventually I realised that there would never be a perfect moment. I just had to come out with it.”

Pete flew off the handle as soon as I brought it up. He denied everything and said I was just getting at him. I took deep breaths, remained calm and let his insults pass over me. I was determined to just tell him the way I felt and what was happening with me.”

Talking with the person drinking will not bring about instant change but it’s a start. The following suggestions may help:

  • Explain how YOU feel and how their drinking is affecting YOU. Give concrete examples of their behaviour and how you feel about it.

  • Try to remain calm and logical and stick to the point you wish to get across to them. Refuse to be drawn into an argument.

  • Encourage them to seek professional help.

These suggestions may be easier said than done but it is important for the person with a drinking problem to realise how his or her behaviour is affecting you.
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Effective communication
An important part of effectively addressing another person’s drinking and the impact it is having involves communication. Communication is a two-way process in which listening plays an important part. People want to be understood and to know that others are open to hearing what they have to say. Effective communication is not about giving lectures or judging the person.
 
Use ‘I’ statements instead of ‘you’ statements

Try instead of
“I’m really worried about…” “You should…” or “You must…”
“I feel… when you…” “Your problem is…”
“I am concerned that…” “You’d better… or else…”

Open questions allow a person to explore their thoughts and feelings without it being like an interrogation. For example, ask for their thoughts on their own alcohol use. Ask if they see any problems or potential risks and how they think these can be addressed.
 
Listen carefully and actively without being judgmental. Allow and encourage the person you’re concerned about to speak in full sentences and to finish what they have to say without interruption. After they have finished speaking, reflect back to them what you have understood that they have said. For example, “So what you are saying is…”. Allow them to clarify any misunderstandings.
 
Choose an appropriate time to talk. If a person is caught at a time when they are unprepared, they may be more inclined to react defensively. Also, try to remove any distractions, such as the telephone. Avoid attempting an important discussion while they are under the influence of alcohol.
 
Be clear and honest about your feelings. It is important that your concerns are heard. Let them know that it is not them as a person that you don’t approve of, but particular behaviour/s.
 
Privacy. Think about consequences before acting. For example, is it worth searching through someone’s room or belongings if it means potentially losing their trust?
 
Negotiate. When all parties participate in setting guidelines it is more likely that everyone will adhere to them. Work towards agreement on consequences if guidelines are broken. It is important that these consequences are also enforced.
 
Support and encourage positive behaviour. Avoid focusing only on negatives.

Looking after yourself

Sometimes you can be so concerned about the person drinking that you forget about yourself. The situation can become the central focus of those affected by the person’s drinking. One of the most important steps you can take is to not allow alcohol to affect all aspects of your life. Adopting such an approach can be of benefit to both you and the person drinking.

If you have always looked after someone with a drinking problem and protected them in the past, it will be difficult to change your thinking and behaviour. You may feel guilty. You may feel as though you’re giving up on them when they need you most. You may feel as though you’re making things worse. It is important to acknowledge to yourself the courage it takes to do things differently, and that often this will involve small steps and sometimes temporary set backs. In other words, be supportive to yourself.

In certain circumstances, such as if you are being physically threatened, ensuring your safety and that of any children involved, must take priority.

Make changes in your own life. Take some time to do things that you’ve always wanted to do ‘ perhaps some activities that you’ve put off for a long time. Start doing things for yourself. Try joining a club or group and getting together with other people.

It may seem like strange advice to go and do something else when your family is facing a crisis. However, if you have outside interests and time away from the person drinking, you will be able to cope more effectively with the family problems caused by their drinking.

You can’t force someone to change their drinking habits no matter how much you love them, but you can make changes in your own life. Changing your behaviour is likely to have an impact on the person drinking. By getting on with your own life, and not protecting them, you are helping them face up to the problems that result from their choice to drink. You are helping them to take more responsibility for the way they feel and act.

Where can I turn for support?

Talk with a friend: It may help to discuss the problem with a friend. Talking about how you feel may help clarify your thoughts and work out what you’re going to do. It may just help to get things off your chest. It is easier to talk with someone you trust and are comfortable with. They may already be aware that something is wrong. They may have been in a similar situation themselves. People are usually very willing to help a friend, however, they often have to be asked.
 
Talk with a professional: Talking with someone outside your daily life, such as a professional counsellor, can be another useful option. Counsellors have talked with many people in similar situations, and can help you to explore ways to deal with the problem. You will find professionals experienced in dealing with alcohol problems at your local community health centre or an alcohol and drug treatment agency.
 
Self-help groups and other support: Some people join self-help or support groups to share their thoughts and experiences with other people who are facing, or have faced, similar problems. There are several types of self-help groups for family and friends and each can have a different style. You might want to go to several different meetings before you choose one that’s right for you.

There is no need to deal with alcohol issues alone. For information, counselling, advice, services available and other assistance, contact your state alcohol and drug telephone information service.

Treatment options

A number of different treatment options exist for a person seeking help for an alcohol problem. Some aim for the user to achieve an alcohol-free lifestyle, while others aim to stabilise alcohol use at a reduced, safer level. Some employ individual counselling techniques, others use group therapy, while still others use chemical agents to assist with withdrawal or maintenance.

A combination of treatments is often recommended to address the physical and psychological complexities of alcohol dependency, including withdrawal treatment and follow-up counselling.

Counselling

There are different forms of counselling available. Some operate on an outpatient basis with the person attending regular counselling appointments. Others may be used in combination with other treatments as part of an inpatient residential treatment program. Some individuals may find one style of counselling more effective than other styles. Therefore, it may be worthwhile investigating other counselling options if one ‘style’ is not suitable.

Withdrawal

A doctor or a drug counsellor can assist in identifying the most appropriate treatment and also the most suitable environment for withdrawal.

If it is agreed that home withdrawal is the most suitable option, there are certain preparations that can be made so that your home is a supportive environment. This includes making your home alcohol-free and ensuring that the person going through withdrawal will not be negatively affected by non-supportive people.

Home withdrawal services are available in some areas. This includes regular home visits and providing medication and support. Prescribed medications may be used to reduce the severity of some withdrawal symptoms, however, it will not block the symptoms completely.

Before a person attempts to withdraw from alcohol at home, seek the advice of a doctor and/or an alcohol and drug counsellor. It may be appropriate to discuss alternative methods such as withdrawal at a residential service.

It is important to remember that withdrawal may not be successful with the first attempt. With each attempt a person can learn more about themselves and their relationship with alcohol. This experience can be used to help a person progress with future attempts. Staying off alcohol is difficult for many and this is where counselling can help the person to learn strategies that will help to avoid relapses.

For help and further information regarding treatment options, contact the drug and alcohol telephone information service in your state/territory.

Supporting someone in treatment

Supporting a person as they undergo treatment can mean providing both emotional and practical support. Establishing and being clear about what your support includes (and does not include) will help everyone involved to understand what they can and cannot expect from one another.

This support may include:

  • supervising their medication during withdrawal;
  • encouraging the person to develop supportive networks and to place themselves in positive environments;
  • assisting them to learn stress-reducing activities, such as relaxation techniques, looking at things in a different way etc;
  • talking with them ‘ understanding what they are going through and what type of support they find most effective;
  • encouraging them to attend counselling and to accept support;
  • helping them to maintain motivation by regularly reviewing their achievements and the reasons that they are in treatment.
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