The person who has someone close who drinks too much has plenty of company. People experiencing alcohol and other drug problems often feel they hurt only themselves. That isn't true. They also hurt their families, friends, coworkers, employers, and others.
Experience shows that for every person with an alcohol or other drug problem, at least four others are affected by their behavior. However, looking at it another way -- as we should -- millions of Americans have a personal stake in helping "someone close" find the way to overcome alcohol problems.
The person who sets out to help someone with an alcohol problem may at first feel quite alone, possibly embarrassed, not knowing where to turn for help. We have preserved so many wrong ideas and attitudes about problem drinking, too often thinking of them as moral weakness or lack of willpower.
You may have learned to better understand alcohol problems and already made contact with nearby sources of services. This does not mean that "someone close" will cooperate at once by going for treatment. Those with alcohol problems may deny they have a problem. They may find it difficult to ask for or accept help.
If there is one thing true about alcohol abusers, it is that, as with all people, each one is different -- different in human needs and responses, as well as in their reasons for drinking and taking other drugs, their reactions to these drugs, and their readiness for treatment.
You are in a good position to help your relative or friend, because you know a good deal about their unique qualities and their way of life. And having made the effort to gain some understanding of the signs and effects of problem drinking or other drug abuse, you should be in a better position to consider a strategy for helping.
Be active, get involved. Don't be afraid to talk about the problem honestly and openly. It is easy to be too polite, or to duck the issue by saying, "After all, it's their private affair." But it isn't polite or consolidate to let someone destroy their family and life. You may need to be persistent to break through any denial they have.
You also may need to let them know how much courage it takes to ask for help, or to accept it. You will find that most people with drinking-related troubles really want to talk it out if they find out you are concerned about them.
To begin, you may need to reject certain myths that in the past have done great harm to alcoholics and hampered those who would help them. These untruths come from ingrained public attitudes that see alcoholism as personal misconduct, moral weakness, or even sin. They are expressed in such declarations as, "Nothing can be done unless the alcohol abuser wants to stop," or "They must hit bottom," that is, lose health, job, home, family, "before they will want to get well." These stubborn myths are not true, and have been destructive. One may as well say that you cannot treat cancer or tuberculosis until the gross signs of disease are visible to all.
The truth is that with alcohol and other drug problems, as with other kinds of acute and chronic illness, early recognition and treatment intervention is essential -- and rewarding.
Be compassionate, be patient -- but be willing to act. Experience proves that preaching does not work. A nudge or a push at the right time can help. It also shows that you care. Push may even come to shove when the person with alcohol or other drug troubles must choose between losing family or job, or going to treatment. Thousands of alcohol abusers have been helped when a spouse, employer, or court official made treatment a condition of continuing family relationships, job, or probation.
You cannot cure the illness, but when the crucial moment comes you can guide the person to competent help.
Treatment attempts to discover the relationship between a person's problematic drinking to their real needs -- an understanding of what they would really strive for it they were not disabled by their problems. One goal is building up their capacity for control which becomes possible in periods of sobriety.
Persons with drinking problems have the same needs as all other people -- food, clothing, shelter, health care, job, social contact and acceptance and, particularly, the need for self-confidence and feelings of competence, self-worth, and dignity. This is where "support" comes in.
What may be needed in most is warm, human concern. The kinds of support given depend, of course, on finding out from the person what they feel they need. Strained family and friend relationships, money troubles, worry about the job or business, sometimes matters that may seem trivial to us, all confuse their file situation and may contribute to their drinking problems.
Moral support in starting and staying with treatment, reassurances from employer or business associates, willing participation by spouse or children in group therapy sessions -- are examples of realistic support.
The long range goal is healthy living for the person and their family -- physical health, social health, emotional health -- an objective we all share.
Three out of four alcohol abusing men and women are married; living at home; holding onto a job, business, or profession; and are reasonably well accepted members of their communities. For those in this group who seek treatment, the outlook is good. Regardless of life situation, the earlier treatment starts after troubles are recognized, the better the chances for success.
Many therapists now use rehabilitation as a measure of outcome -- success is considered achieved when the patient maintains or reestablishes a good family life and work record, and a respectable position in the community. Relapses may occur but do not mean that the person or the treatment effort has failed.
A successful outcome, on this basis, can be expected for 50 to 70 percent depending upon the personal characteristics of the patient; early treatment intervention; competence of the therapists; availability of hospital and outpatient facilities; and the strong support of family, friends, employer, and community.
"It is doubtful that any specific percentage figure has much meaning by itself," says one authority. "What does have a great deal of meaning is the fact that tens of thousands of such cases have shown striking improvement over many years."
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services