Concerned That a Friend or Loved One Is an Alcoholic?

Alcohol is the most misused substance in our society. Heavy drinking affects not only the drinker but his or her family, friends, work and social environment. ”Just as ripples spread out when a single pebble is dropped into water, the actions of individuals can have far-reaching effects,” as the Dali Lama said.

If you’re reading this, chances are that you are wondering if there are ways you could help that person. Here are five tips to support someone dealing with a drinking problem:

1. Ditch the term alcoholic. It carries a lot of stigma, even today, and the phrase is not productive in having a conversation with another person about his or her drinking. In healthcare, the terms are now alcohol misuse and alcohol use disorder (AUD). We describe an individual who meets the diagnostic criteria as a “person with an alcohol use disorder.” The National Institute of Health (NIH) outlines the criteria for AUD on their website. Notice that AUD lies on a spectrum from mild to severe. AUD is like high blood pressure which can range from mild to severe, rather than pregnancy which is a yes or no question.

2. Get up to speed on how to help your loved one. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has recently released the Treatment Navigator with a great deal of educational information about evidence-based approaches, treatment options, and strategies to help others. I highly recommend reading this online resource. All of it.

3. There is a protocol for folks like yourself called Community Reinforcement and Family Therapy Program (CRAFT). It is effective in both helping a heavy drinker get into treatment as well as in helping you reduce your level of emotional distress. It is recommended by the NIAAA. The developers, Drs. Robert J. Meyers and Jane Smith (full disclosure, friends and colleagues of mine with whom I’ve collaborated over the years) have published a self-help book I recommend, Getting your loved one sober: Alternatives to pleading, nagging, and threatening.

4. Carefully consider how you’re going to talk to your friend or family member. Only bring up the topic when he or she is sober. (I can’t emphasize this enough.) Trying to talk to someone who’s intoxicated risks them overreacting emotionally and responding negatively.

5. Plan and rehearse what you’re going to say. Here’s an example: start with an expression of empathy (e.g., “You’ve been under a lot of stress lately and it’s been a challenge to deal with the pressure.") It’s better to understate the person’s reaction (it’s been a challenge) rather than overstate it. Downplaying the situation will encourage the person to respond more positively. Follow-up with an expression of concern about the concrete negative consequences of that person’s problem drinking: I’m concerned that your drinking to deal with your stress led to the fall you took last night. Emphasize that you prefer being with them much more when they’re sober than when they’ve been drinking heavily and offer to help them deal with what’s driving the problem drinking.

I’m well aware that this process won’t work in some cases. If domestic violence is a concern, then I strongly recommend you work with a counselor who has expertise in treating AUDs with empirically supported protocols like cognitive behavior therapy, motivational enhancement therapy, and medications. See NIAAA’s Treatment Navigator for help finding a qualified addiction therapist near you, and consider SMART Recovery’s Friends and Family resources for social support in your efforts. You can find a treatment center or therapist through the Psychology Today Therapy Directory.