How to Help an Alcoholic Who Doesn't Want Help

There’s that friend or family member who’s maybe known for drinking. Possibly they’ve had a couple run-ins with the law because of it. Maybe they’ve missed work or cut classes due to hangovers. Or, when everyone else stops at one glass, they’ve graduated to emptying the whole bottle. Every single time.

That may prompt some compassionate concern and leave one wondering: how to help someone with alcoholism.

Learn About Alcohol Use Disorder

Before deciding how to help an alcoholic, it’s best to know more about the problem. For 2018, the National Survey on Drug Use and Health (NSDUH) released data on alcohol use, focusing on Americans ages 18 and older. It found:

• 86.3% said they had consumed alcohol at least once in their lives.
• 70% said they drank in the last 12 months.
• 55.3% said they drank in the past 30 days.

That doesn’t mean all those people have a problem. Sometimes it’s really just a glass of wine with dinner or a beer with a buddy.

When it gets out of control, that can be cause for concern.

Take binge drinking, for example. That’s when a man has five or more drinks on one occasion. For a woman, it’s four or more.

Binging is not the same as being an alcoholic, but it can lead to alcoholism, or it can be something alcoholics engage in regularly. NSDUH’s survey found more than one-fourth of American adults had binged alcohol in the previous month, so it’s not exactly a rare occurrence.

An estimated 15 million Americans have an alcohol use disorder (AUD). It’s defined by:

• Strong cravings for alcohol
• Not being able to stop drinking
• Anxiety and irritation when not drinking

When the alcohol abuse is severe, it’s usually referred to as alcoholism or alcohol dependence.

When Is It Considered Alcoholism?

There’s an 11-item checklist of alcohol use disorder (AUD) symptoms. Even a couple “yes” answers point to a problem. They include:

• Drinking more or longer than planned
• Trying unsuccessfully to stop or cut back
• Getting into risky situations during or after drinking (driving, unsafe sex)
• Drinking more to get the same effect
• Drinking despite health problems or blackouts
• Drinking often, or getting sick afterwards
• Drinking even though family and friends express concern
• Drinking even though it interferes with work, school, or home life
• Withdrawing from or giving up loved activities because of drinking
• Experiencing legal troubles from drinking
• Worsening withdrawal symptoms (tremors, nausea, sweating, racing heart, or seizures)

There are many risks that come with alcohol abuse. Besides impairing judgment and leading to dangerous behaviors, it can also raise the likelihood of certain cancers, liver disease, and brain damage.

Too much alcohol also affects the immune system over time, increasing the likelihood of getting sick (especially concerning in the age of COVID-19). Alcohol also gets in the way of nutrient absorption, so some drinkers may experience neurological problems from the lack of certain vitamins. In worst-case scenarios it can lead to memory loss and dementia-like symptoms.

When to Help and What to Say

When bringing up the problem of alcohol abuse, consider what points you want to make. If it helps, practice what you’re going to say so you go in prepared.

Pick the right time and place, ideally when they’re not drinking. Whatever you do — and it can be difficult to resist — don’t argue with them if they’ve been drinking. It’ll fall on deaf ears and could backfire.

It’s okay to express concern, but use statements that start with I, not you. Be careful not to cast blame.

You can say that you’re worried about their health, but stick to the facts. If they drove into a telephone pole and walked away injury free, tell them you’re worried that if it happens again, someone may be seriously hurt. Or worse.

Don’t preach or nag, and don’t use labels such as drunk or alcoholic. Don’t try to guilt them into quitting drinking.

If they’re willing to open up about their struggles, listen with compassion, and offer what support you can.

If they’re being especially resistant, an intervention may be a solid option. During an intervention, friends, family, and coworkers can gather to address their concerns and urge treatment.

Having a professional therapist oversee the intervention can keep emotions from boiling out of control. Therapists may also be able to offer advice on rehabilitation options.

Help may not be accepted right away, but with calm persistence, people may grow willing to angle themselves toward recovery.

Sources

• niaaa.nih.gov – Alcohol Facts and Statistics
• medlineplus.gov – Alcohol Use Disorder
• niaaa.nih.gov – Alcohol Use Disorder
• niaaa.nih.gov – What Are Symptoms of Alcohol Use Disorder?
• cdc.gov – Alcohol Use and Your Health
• medlineplus.gov – Helping a Loved One With a Drinking Problem
• healthline.com – How to Help Someone with an Alcohol Addiction