Dealing With an Alcoholic

Living with, being friends with, and generally dealing with someone who has an alcohol use disorder, also known as alcoholism, can be challenging. An alcoholic can cause a number of issues, from damaging relationships to avoiding responsibilities and even being abusive in some cases. Whether it is a friend, a co-worker, or a close family member, it is important to know how to deal with someone who struggles with drinking, how to help if possible, and when to step away from the situation.

Dealing with an alcoholic includes knowing what to say to offer help and support. There are things to say and ways to say them that are more helpful, and there are actions you may take that are counterproductive. In addition to supporting someone you care about, you also have to take care of yourself. In some cases that may mean leaving or at least distancing yourself from a friend or family member who refuses to accept help or make any changes.

The first step in being able to better deal with an alcoholic is to understand the disease. Although the term alcoholism is still commonly used, the more correct term is alcohol use disorder, a condition that can be diagnosed as mild, moderate, or severe. There are several diagnostic criteria, and these can help an individual understand if someone they live with or care about is struggling with alcoholism:

• Drinking more than planned or intended
• Trying to drink less but failing repeatedly
• Spending an inordinate amount of time thinking about drinking, acquiring alcohol, drinking, and recovering from hangovers
• Craving alcohol
• Not meeting responsibilities or experiencing declining performance at work or school because of drinking
• Drinking even though it causes relationship problems
• Continuing to drink even though it causes or worsens mental or physical health problems
• Spending less time doing other activities in order to drink more
• Drinking in situations that are harmful, like before driving
• Developing a tolerance and needing more alcohol to get the same effect
• Having withdrawal symptoms when not drinking

It is important to understand that this is a real health condition that affects the brain and makes it extremely difficult to stop drinking or to make good choices. A person may want desperately to stop drinking but cannot do so without support.

If you do have someone in your life showing signs of alcohol use disorder, it can be hard to know what to say or do. It is helpful to plan and practice what you want to say. Things can get heated, and it is important to be ready to deliver a clear, simple message in a calm and even way. In planning what to say, remember to be honest but to avoid using blame or guilt to get a point across. Some examples of useful things to say to someone who may have a problem with drinking include:

• I’ve noticed you seem to be drinking more, and because I care about you I’m worried.
• Your personality changes a lot when you’re drinking, and I’m worried you’re going to alienate people by drinking too much.
• I know drinking seems like a good way to cope with problems, but I think it’s just making them worse.
• I would like to help you change or cut back on drinking if you want to try.
• I can help you find treatment for alcohol use disorder if you think you need professional support to stop drinking.
• When you drink too much it affects me in a negative way, and while I know you don’t mean to hurt me, it’s what happens when you’re drinking.
• I think your drinking may be affecting your work, and I would hate to see you lose your job.

There are some important mistakes it is easy to make when dealing with someone with an alcohol use disorder. Some of these should be avoided because they actually enable the person’s drinking, while others are mistakes because they may cause harm to you. Enabling actions are those that passively encourage a person to drink, including:

• Making excuses for someone who has been drinking
• Protecting someone from the negative consequences of their drinking
• Covering a person’s responsibilities when they can’t
• Drinking with someone who struggles with alcohol use disorder
• Helping someone hide their drinking from others

There are also ways of approaching someone with an alcohol use disorder that are counterproductive. For instance, being overly emotional and pleading with someone to stop drinking may only make the situation worse by increasing guilt and shame and the subsequent desire to drink. Preaching, lecturing, acting superior, or bribing someone about drinking are equally unhelpful.

To protect yourself when dealing with an alcoholic it is important to not make decisions that will cause you harm: getting into a car with a driver who has been drinking; drinking with someone and trying to keep up; letting feelings of guilt or responsibility creep in; saying or doing nothing when the alcoholic in your life is abusive, verbally or physically.

Having a friend who is drinking too much is difficult because you don’t want to say or do something that will cost you that friendship. But, as a friend you want to help. Some things you can do to cope with the situation and support your friend include organizing activities you can do together that don’t involve drinking, spending time at your home so you can control access to alcohol, and not drinking in front of your friend.

Bringing up the issue of drinking may seem uncomfortable, whether with a close friend or someone who is a more casual friend. In either case, though, it is important to talk about it. Ignoring an alcohol problem will not help the situation. Risking a friend getting angry with you is worth doing what you can to help and provide support. Every time you speak the truth to an alcoholic, it is a successful intervention.

While helping a friend cope with alcoholism is hard and important, the stakes are even higher with a family member. The same rules apply, however, and bringing it up and talking about the issue in a calm and compassionate way is crucial. When it is a parent, child, sibling, or spouse with an alcohol use disorder, the consequences for the rest of the family can be more serious as compared to having a friend who drinks too much. In this situation it is important to try to help and support a loved one, but also to care for your own needs.

If you are living with an alcoholic, avoid blaming yourself for the issue or taking it personally. These are common but unhelpful responses. It is also important to let your loved one feel the consequences of their drinking, so don’t clean up after a drinking binge or cover his or her missed responsibilities. Also be sure to take care of your own health, getting counseling if you have mental health issues, learning and using healthy coping strategies for stress, and making healthy lifestyle choices like eating well, exercising, and getting enough sleep.

Ultimately, a person who has a drinking problem has to be willing to try to stop and to accept help or nothing will change. Everyone has different limits, but know yours and know when it’s time to leave a relationship or even the home if necessary. A sensible limit may be when a family member refuses to get help after many offers of support or when a person’s drinking causes them to become abusive.

It may be easier to walk away from a friendship than a family member, but in either case there may be a time when dealing with the situation is no longer viable. You can always return to the relationship if and when the person decides to get help, but until then you have to consider your own needs and health, which sometimes means extracting yourself from the situation.

Knowing how to deal with an alcoholic is not a skill that anyone is born with, but it comes from experience and learning more about this disease. It is important to be supportive and caring, to face the problem head on instead of avoiding it, and to also know that your well-being is also important and that you may need to walk away.