How To Talk to An Alcoholic

Like most other addictions, dealing with an addiction to alcohol is really difficult for those suffering from it and their loved ones. If someone you care about is struggling with their addiction, it can be difficult knowing how best to help them.

One of the best places to start is by building your understanding around alcoholism and thinking of ways to communicate with your loved one about it. This means that when they are ready to reach out and get some help, you will be better prepared to give them all the support they might need.

This can be a daunting task to plan, but this article will aim to reassure you by providing information on alcohol addiction, effective approaches to communication and importantly, how to look out for yourself in what can be a challenging process.

Alcohol addiction can be intractable and chronic, so it’s only natural that several conversations may be needed to get a person to get help. Your presence and support might help them to make the first steps towards recovery.

Addiction to Alcohol

Many of us enjoy alcohol, in many parts of the world it plays a diverse set of roles from artisanal produce to the social lubricant to holding a religious significance in some religions’ rituals. However, for some, their drinking becomes a problem when they lose control of their alcohol use and feel compelled to drink, even after it has serious negative consequences on their life.

Problematic drinking is a chronic, long term condition and there is no easy cure but certainly, there is treatment that looks to reverse both the physical and psychological dependence that a person may have built up.

When a healthcare professional is making a diagnosis of alcohol addiction, they use the following criteria provided by the International Classification of Diseases version 10 (ICD-10) which is written by the World Health Organization (WHO) ^[1]:

A strong compulsion or desire to drink alcohol
Difficulty in controlling alcohol drinking behaviour
Physiological withdrawal when drinking is stopped or use of alcohol or similar substances like benzodiazepines to prevent withdrawal symptoms ^[2]
Evidence of tolerance where increasing amounts of alcohol need to be consumed to achieve the same effect
Increasing neglect of interests, hobbies and pleasures outside of alcohol due to alcohol consumption itself and the time needed to source more

In order to provide a definite diagnosis, people will need to fulfil at least of these criteria that have been present together at the same time in the previous year. In addition to this, doctors may also consider other factors such as whether the range of type of alcohol being consumed is narrowing, if the person is getting into dangerous situations because of their drinking and are becoming unable to meet responsibilities in many areas of their life.

Only a registered healthcare professional can make a clinical diagnosis of addiction but it can be helpful if you know what to look out for in your loved ones as that might signal a good time to approach them.

Recognising Alcohol Addiction

In addition to the above criteria, there are some physical changed that you might want to look out for if you suspect someone close to you has a problem with alcohol. This could include tiredness, headaches caused by dehydration, sweating, weight changes, bloodshot eyes, sleep disturbances and increasing unsteadiness on their feet.

Their general appearance can change as the person makes less effort in hygiene and appearances.

You may also notice changes in their behaviour such as volatility of mood, outbursts of anger and becoming increasingly uninterested in work and home life. It is common for these behaviours to progress into secrecy and dishonestly as some start being unable to give consistent stories on their activities and whereabouts.

Of course, these behaviours alone don’t prove a problematic relationship with alcohol, but they could indicate that somebody is trying to cover up their issue.

Creating a Plan to Talk

Hopefully, you now have some insight into what alcohol addiction is and how it might be affecting someone you know, both physically and mentally. On reflection and armed with this new knowledge, if you believe that you have identified a problem, the next step is to start planning your approach to the person.

This conversation can be emotionally difficult so having a good plan in place is important to go back to and see where you have formulated your ideas. You might find it helpful to write down the main points you want to get across and understand.

To get started, you may want to consider the following tips:

Explain that you are worried and why e.g. I’ve noticed that you’re not so positive any more, I’ve noticed you are drinking more, and I’m worried about the impact on your health

Express why it causing you genuine concern e.g. I’m sad that we don’t meet up any more as I enjoy our time together, I’ve been getting increasingly worried when you don’t come home

Avoid the use of labels like ‘alcoholic’. Like other mental health conditions, addictions carry a stigma. You can reduce this and help them open up by using non-judgmental language

Keep questions and options open e.g. What do you think is making you drink more? Do you think your drinking is becoming a problem? Would you consider getting help?

Work together to quantify the drinking e.g. Working out how much alcohol the person is consuming can be a good place to start and can help them recognise that they might have a problem. Several easy to use calculators are available such as on the Drinkaware alcohol unit calculator ^[3]

Consider how and where. As mentioned, this can be a difficult conversation to have so chosen a quiet, comfortable place to talk where you are unlikely to be disturbed

In addition to considering the above points and taking some time to reflect on what you want to get across, it is important to take the following steps throughout the entire process of supporting someone with alcohol addiction.

1. Look for Support for Yourself

Again, watching someone you care about struggle with their addiction can take its toll on you, even before you begin to approach them directly. It is important that you are supported adequately throughout the process so you in turn can support the person you are concerned about. Please be reassured that you are not alone in this process and there is a wealth of information and resources out there to guide you.

A good place to start is Drinkaware’s page on what to do if you are concerned about somebody ^[4] and the NHS website ^[6]. If you feel that you are really beginning to struggle, don’t hesitate to get in touch with your local GP or another healthcare provider to get you the help you need.

2. Consider Treatment Options

When you are planning the conversation you will have with your loved one, it might be a good idea to ensure you come with a range of ways forwards to hand. If you can say to them that you’ve already done the research and taken into careful consideration what treatments might be available, the person in question might be more willing to engage.

Depending on individual circumstances, needs and severity of their addiction, treatment can take a wide range of forms, but you may want to consider the following when contacting treatment centres:

Is treatment provided on an inpatient or outpatient basis?
What is the cost of treatment?
Are there any specialised services catering for certain age groups, religions, disabilities, ethnicities, genders etc
Are there educational and employment opportunities?
What sort of psychological therapies be offered?
Will there be medical assistance and prescribed medicines available to assist in the withdrawal period?
Will there be access to alternative and complementary therapies such as art and music therapy?
Are visitors allowed or encouraged?
What options are available for aftercare and support?
What sort of healthcare professionals will be available?

Working out which treatment options and facilities would be most appropriate is challenging and perhaps a daunting task.

3. Participate in Their Treatment

When the person you are concerned about makes the first step towards recovery in deciding to start treatment, consider how you can plan to be involved. Studies have shown that those who have good support networks are less likely to relapse ^[7] so you can definitely play your part.

This might take the form of couples or family counselling ^[8] where you could learn about how you can change your own behaviours to promote your loved one’s recovery, keeping them committed and engaged in the treatment process.

Even if you don’t participate in any formal therapy, just being there for the person you care about can make the world of difference.