Often, when a person is experiencing an alcohol use disorder, other people in the family may currently, or in the past, have also experienced one. For this reason, a family may not be entirely unfamiliar with the signs of an alcohol use disorder. The real challenge may in fact be taking action that can help the affected person to recover.
Signs of an Alcohol Use Disorder
WebMD identifies numerous signs associated with alcohol abuse and addiction. There is a quick distinction that should be made between symptoms and signs. A person who abuses alcohol will experience psychological and physical symptoms, whereas an onlooker would see signs. Symptoms and signs are related, but they are not symmetrical. For this reason, at least when alcohol abuse is in its early stages, a person may not show any outward signs. For instance, a person could feel nauseous but, short of vomiting, may be able to hide this symptom from others.
Some signs of alcohol abuse or addiction that a concerned person may notice include the following:
- The person experiencing the abuse or addiction demonstrates poor performance at work, school, home, or in the social sphere of life. This can include not doing well on work tasks, school tests, or assignments, or being uncharacteristically late or not showing up for things.
- The person may engage in risky behavior, such as driving while intoxicated.
- The person may uncharacteristically be getting into trouble with the law for one or more reasons, such as fighting, driving while drunk, or stealing.
- The person may have an existing health condition or develop a new condition that alcohol abuse is making worse. Though the person is aware of this, they continue to drink.
- The drinking is causing interpersonal problems (e.g., with family, colleagues, or classmates). Though the person is aware of this, they continue to drink.
- When the person stops drinking for an extended period (in some cases, just a few hours), uncomfortable withdrawal signs emerge, such as sweating and shakiness.
- The person is seen drinking an increasing amount over time. This is a sign that the person is experiencing physical tolerance to alcohol, which is a natural biological response to repeated consumption of alcohol.
- The person is spending a lot of time drinking compared to other activities.
- The person may drink alcohol first thing in the morning.
- The person may consume alcohol for hours or drink alone.
- When questioned about drinking, the person makes excuses.
- The person drinks in secret or buys alcohol at different shops to avoid being noticed. This can also be a sign of feeling shameful about the drinking, which is a sign that a person has lost control over the behavior.
- The person stockpiles alcohol to ensure there is no problem with supply.
- The person may show physical signs of alcohol abuse, such as weight loss due, most likely, to malnutrition.
A person who is concerned with a loved one’s drinking can learn more about symptoms by looking at a screening tool. Though the tools are designed for the person who is drinking, they open a window into what the person’s daily life may look like.
The National Council on Alcoholism and Drug Dependence provides a nuanced alcohol abuse screening tool on its official website. The tool reflects some of the most common psychological, social, and behavioral factors involved in alcohol abuse.
Ways to Help Someone with an Alcohol Use Disorder
There are numerous ways that a concerned person can help someone who is experiencing an alcohol use disorder. While there are affirmative approaches, such as staging an intervention, there are also numerous things a person should probably not do.
According to the National Clearinghouse for Alcohol and Drug Information, the following are some actions that will not likely prove very helpful in getting a person to accept help:
- It isn’t usually helpful to threaten, punish, bribe, or preach to a person who is experiencing an alcohol use disorder.
- Emotional appeals may go nowhere and may only end up amplifying any feelings of guilt the person is experiencing.
- It’s not a helpful practice to make excuses for the person or try to make them believe that everything is going to be fine when that’s not realistic for the situation. For example, if a person is driving while intoxicated, it’s a very dangerous situation so everything isn’t fine.
- Taking control of the person’s responsibilities may end up making them feel worthless, and it can also provide greater opportunity for drinking.
- Helping the person to hide the problem, such as throwing out bottles of alcohol, will likely only help to perpetuate the drinking.
- It is best to speak with the person about the issue when the person is sober. Talking to a person while drunk can lead to fights.
- It is a bad idea to drink alcohol with a person who is dealing with an alcohol use disorder.
Addiction is an insidious disease, and it can warp even the best intentions. For this reason, it is difficult to think about helping a person without first thinking about how to help oneself and the role one may be playing in the abuse. A family member of a person with an alcohol use disorder may be experiencing a disorder known as co-dependency.
Codependency survivor Melody Beattie is a bestselling self-help author on the topic (books include Codependent No More and Beyond Codependency). Speaking broadly, codependency happens when a person, in response to another person’s behavior, takes on the role of ultimate caretaker. Codependent people are often loving and compassionate, but these qualities contribute to them being unable to live their lives because they focus on serving someone who is not getting help for an addiction or other behavior.
Codependency has an unfortunate spin: The codependent person can enable the person with the addiction in avoiding professional help. One of the ways to break free from codependency (and it is a process that may require therapy and considerable personal effort) is to recognize that one is not solely responsible for another person. There is professional help available.
An affirmative step a person can take to get help for someone with an alcohol use disorder is to have an intervention. An intervention can be as informal as a conversation, or it can be a formal intervention that is led by a professional interventionist.
It can be difficult for a person to talk about alcohol abuse or addiction with a loved one. According to the Partnership for Drug-Free Kids, there are some must-dos when it comes to talking to someone (adult or child) about addiction.
- It is best if the person with the drinking problem is sober at the time of the talk.
- The person who initiates the talk and all others present must be sober.
- The environment must be suitable (e.g., private and quiet), and there must be sufficient time available for both (or more) people to have a dialogue.
- The person leading the conversation can emphasize that it is motivated by love, care, and concern.
- Provide a list of behaviors that demonstrate the alcohol use disorder. This list can be used to express concern about the drinking, such as how it increases the risk of getting into accidents and physical harm.
- It is critical to keep the discussion open and nonjudgmental.
- If the affected person refuses to participate or denies a problem, ask if the conversation can be revisited in the near future.
A formal intervention embodies the spirit of an informal one, but it is more structured. Mayo Clinic provides guidance on what to expect from working with a professional interventionist when planning and staging an intervention.
The following are some key steps:
- The concerned individuals make a plan, which includes reaching out to a professional interventionist. A rehab program of interest may have a referral, or loved ones may contact the Association of Interventionist Specialists.
- Collect information about a rehab program. A formal intervention always includes the goal of getting the person help immediately. For this reason, rehab admission plans need to be in place. In this way, the group is able to offer the person in need the opportunity to go to rehab, and the group is able to immediately deliver on that offer.
- Gather the members of the meeting. Each person involved in the intervention will contribute to the process. This step will involve taking care of the administrative tasks, such as where and when the intervention will occur.
- Define consequences. The philosophy of interventions includes each member spelling out the consequences for the affected person if they do not accept the offer to go to rehab.
- Each member will write a letter to the affected person explaining their concern, requesting that they go to treatment, and naming the consequences if they do not.
- The professional interventionist will lead the discussion and serve as the moderator. If the person accepts treatment, the interventionist will help get the rehab plan started. This can include physically taking the person to rehab for admission.
- The interventionist may recommend that key members of the family or other loved ones get help from a therapist as they are likely experiencing psychological and even physical distress as a consequence of the addiction. This is also a way of helping the person in recovery as it helps to ensure that they will not go back to a dysfunctional family dynamic, which can be a trigger for relapse.
A group of concerned people could, feasibly, stage an intervention with the steps above without hiring a professional interventionist. One concern, however, is that a neutral party will not be present, and the person who needs help may feel the group is ganging up on them. It can also be difficult for a family to maintain calm if they are both guiding and involved in the intervention. The point is, however, that there are different options for an intervention. Generally, interventions run by professionals are more successful.
Supporting the Recovery Process
It is well observed that addiction is a family disease. One the one hand, family can play an instrumental role in the development of a family member’s addiction (e.g., being part of a traumatic event, such as child abuse or divorce). On the other hand, family can also play an instrumental role in healing the addiction. The way this is achieved is not simply by each member focusing on and supporting the person who is in recovery for alcohol or drug abuse. Rather, the individual family members can work on their own personal transformation or get help for issues that are disrupting their enjoyment of life.
Depending on the rehab program, family therapy may be included in the curriculum. Family therapy helps the family unit to improve its interpersonal dynamics, which can be transformative for the group and individuals. Typically, family therapy will start after the person in recovery has made progress.
Family therapy can help the family to come up with a new system that is conducive to healthier living. It can also help the family to understand the reality of what life will be like after the person exits structured treatment, including supporting the person in aftercare efforts. For example, the family may come up with a practical plan for helping the recovering person to attend local Alcoholics Anonymous meetings (because, for example, the person has lost driving privileges due to the alcohol abuse). The important point is that therapy can give a family the opportunity to work through the emotional and practical aspects of life during and after treatment.
Many rehab centers also offer family days. These are typically social days and may include a main activity like a barbeque. The goal is to help the family stay connected and enjoy their time together. Family participation may be especially important when a person is in a residential treatment plan. Ongoing interaction with family provides the recovering person with a vital link to world outside of rehab. Improving family relationships can help to make the transition from rehab to home smoother. It also gives the recovering person and the family opportunities to work out issues, so they don’t come up when the person is first back at home, a period during which the person needs to feel safe and secure.
A family’s efforts can go a long way in helping their loved one not only avoid relapse, but also build a stable and fulfilling drug-free life. A rehab program addresses the addiction and provides the person in recovery with the skills and tools needed to create a sober social network. Not every person in recovery may have the benefit of a concerned family, but for those who do, working together can help to bring about changes that last for a lifetime.