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Alcohol Addiction

Alcohol Addiction

Alcohol addiction. It’s difficult to find anyone in the U.S. that has not felt its impact, either by witnessing its devastating effects on a family member, neighbor or coworker – or through their own personal struggles. The damages are frightening. According to the National Institute of Alcohol Abuse and Alcoholism, an estimated 88,000 people in the U.S. die each year from alcohol-related causes. And, unfortunately, alcohol abuse and dependence is on the rise. A recent study published in September 2017 by the Journal of the American Medical Association found that in the first decade of the 2000’s, alcohol use disorder (AUD) rose nearly 50 percent in the U.S., resulting in 12.7 percent of the nation’s population (one in eight adults) meeting the criteria of AUD.

There is hope, however, in the form of treatment. Today, professionals have an arsenal of weapons they can rely on to fight back against alcohol addiction, including specialized medications, residential and outpatient treatment programs, individual and group therapies, 12-step programs, and a range of support services. The bottom line is that long-term sobriety is possible. It all starts with asking for help.

Expert

David Tews
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Alcohol addiction. It’s difficult to find anyone in the U.S. that has not felt its impact, either by witnessing its devastating effects on a family member, neighbor or coworker – or through their own personal struggles. The damages are frightening. According to the National Institute of Alcohol Abuse and Alcoholism, an estimated 88,000 people in the U.S. die each year from alcohol-related causes. And, unfortunately, alcohol abuse and dependence is on the rise. A recent study published in September 2017 by the Journal of the American Medical Association found that in the first decade of the 2000’s, alcohol use disorder (AUD) rose nearly 50 percent in the U.S., resulting in 12.7 percent of the nation’s population (one in eight adults) meeting the criteria of AUD.

There is hope, however, in the form of treatment. Today, professionals have an arsenal of weapons they can rely on to fight back against alcohol addiction, including specialized medications, residential and outpatient treatment programs, individual and group therapies, 12-step programs, and a range of support services. The bottom line is that long-term sobriety is possible. It all starts with asking for help.

Signs of Alcohol Addiction

The problem with alcohol addiction is that many alcoholics live in a state of total denial of their alcoholism, even when its presence is obvious to everyone around them. If you’ve ever wondered whether someone you love has an alcohol problem, first of all, it’s likely that they probably do. If you’re still not sure, consider the following signs and symptoms:

  • Drinking alone/secretly: For most people, drinking alcohol is an activity normally shared with others while enjoying a good meal or watching the big football game at home. Drinking alone or while hiding it from others, however, may indicate the presence of dependency. There’s usually nothing wrong with an occasional drink when alone, but when it becomes a habit, that may be the sign of a problem.
  • Lying about drinking: Denial of a drinking problem is common among alcoholics, and inherent in that denial is lying – both to oneself and to others. If you catch someone regularly lying about his or her drinking, there may be a problem.
  • Drinking at inappropriate times and in inappropriate places: Drinking, particularly to excess, at work, after a doctor’s warning, or – more frighteningly – before getting behind the wheel, is likely the sign of an alcohol abuse problem. Likewise when the drinking happens at inappropriate times, such as first thing in the morning.
  • Ability to handle more alcohol than before: The human body has an amazing ability to adapt to all sorts of things a person does to it, and that includes the excessive consumption of alcohol. If a drinker finds that he or she can – or needs – to drink more than before to obtain the same desired effects, that may be a sign of a developing alcohol addiction.
  • Withdrawal symptoms: As with other addictive substances, an alcoholic may experience any number of unpleasant experiences if he or she stops drinking, including irritability, nausea, tiredness, anxiety, inability to sleep, loss of appetite, trembling, and shakiness.
  • Trying and failing to quit: The conscious attempt to stop drinking may be, in itself, an indication of a drinking problem. Failing in the attempt to stop is likely a strong indicator of alcohol addiction.
  • Signs of depression: While not all people with depression drink, alcohol and depression often travel together.
  • Inability to control the amount of drinking: This one is simple. If someone can’t stop drinking once he or she starts, that’s a clear sign of an alcohol addiction problem, especially if it happens every time the person drinks.
  • Friends and family express concerns about the person’s drinking: It’s not uncommon for someone to point out to a friend or loved one that he or she is drinking too much at a particular occasion like a social event, for example.But if family members or close friends are regularly expressing concerns about someone’s alcohol consumption, then it’s probably time to seriously consider acting on those concerns.
  • Blackouts and short-term memory loss: Forgetfulness, particularly in the short-term, can be a sign of alcohol addiction. Regular losses of consciousness, or “blackouts”, are a sure sign that something serious is amiss. And they may very well be related to a drinking problem.
  • Drinking to relax (relieve stress and anxiety): Everyone experiences stress in their lives, and how that stress is dealt with varies from person to person. If an individual’s primary stress reliever of choice is most often – or always – alcohol, then there may be a problem.
Is Alcoholism Genetic?

Is alcoholism hereditary? According to the National Institute on Alcohol Abuse and Alcoholism, researchers have identified various genes that may contribute to alcohol addiction and other addictive or compulsive behaviors. The Institute notes that your DNA is only one factor, however: environment can have a major impact on whether one turns to alcohol. Readers who already know alcohol abuse tends to run in their families can prepare for the possibility that they too could have an alcohol addiction, thereby avoiding circumstances that might encourage dangerous choices and finding healthier ways to deal with stress and sadness.

How to Help Someone with Alcohol Abuse

If someone you love has a drinking problem, you’re likely to want to do anything and everything you can to help get them to stop. The problem is that how to help. You may be afraid of adding to the problem by saying or doing the wrong thing. Or you may be concerned about angering your loved one by broaching the subject. You may even be uncertain as to whether your loved one’s drinking amounts to an actual problem that needs addressing. This section focuses on those concerns so that you can provide the best help possible to your loved one in need.

An alcohol addiction problem isn’t always readily apparent, even to those in closest contact to the addict. If you suspect that someone you know may have a drinking problem but you’re not quite sure, start with the signs of alcohol addiction listed above. Other signs to look for include neglecting family and/or work responsibilities, troubles with personal and professional relationships, legal problems, changes in friends and acquaintances, and physical indications such as shaking, trembling, weight loss, and changes in dress and/or cleanliness. If you recognize one or more of these signs, there’s a good chance the individual has, or is well on the way to developing, a serious alcohol problem.

One more thing. If you still aren’t sure that someone you love has a drinking problem, you may want to simply ask them. Sometimes all it takes is a concerned friend or family member bringing up the subject to get a person to admit they have a problem.

Talking to someone who abuses alcohol can be difficult. Denial of the problem is a feature of alcoholism, and highly-functioning alcoholics are very good at hiding their drinking. That shouldn’t stop you from talking about it, though. A life may depend on it.

Below are a few tips to help toward a successful conversation:

  • Plan ahead: It’s best to have a clear idea of what you intend to say beforehand. Start by educating yourself a bit on alcohol addiction: its symptoms and consequences. When you have the facts at hand, you’re more likely to be persuasive.
  • Speak to the person only when he or she is sober: You’re more likely to have a more receptive audience for your message when the listener is thinking clearly.
  • Avoid lecturing and being judgmental: The hardline approach rarely works. Don’t accuse the person of being an alcoholic or demand he or she seek treatment. Don’t criticize. Better to state your concerns and suggest that the individual speak with a professional. By the way, pleading doesn’t help, either.
  • Don’t just talk, listen: Be prepared to consider the drinker’s point of view. Don’t interrupt when he or she is talking. People are more likely to receive your message if you’re receiving theirs.
  • Be ready to offer a referral for professional help: You might also want to offer to go with your loved one to meet with a doctor or treatment counselor.

Most of us have a general idea of what an intervention is. Interventions may be informal or formal. Informal interventions are often unplanned, and typically involve a very small number of participants gathered to express their concerns regarding the intervention subject’s drinking and provide encouragement for the subject to seek help.

A formal intervention is planned in advance, normally involves a larger group of participants than the informal intervention, and is led by a professional interventionist. Formal interventions are highly structured, follow a specific format, and are conducted with the specific goal of convincing the subject to agree to enter treatment immediately following the intervention. Participants share their concerns for the subject’s wellbeing and establish the consequences that the subject will face if he or she refuses treatment. Formal interventions are most often carried out in a “last ditch effort” to get the subject into treatment after other attempts have failed.

One of the best ways to aid someone with a drinking problem is to locate alcohol rehabilitation centers and other services in their area that may be able to provide treatment and support. Doing so shows your concern for your loved one’s wellbeing, and eliminates one more excuse he or she may use to avoid getting help on their own. A great place to start is with the Substance Abuse and Mental Health Services Administration (SAMSHA) National Helpline at 1-800-662-HELP (4357). The hotline is a free, confidential information service that provides referrals to local treatment facilities, community-based organizations, and other support programs. The service is available 24-hours-a-day, year round, and information is given in both English and Spanish. SAMSHA additionally provides its Behavioral Health Treatment Services Locator, an online search engine with information on treatment facilities throughout the U.S. Another helpful resource is the American Academy of Addiction Psychiatry’s Practitioner Database.

In addition, every state has its own agency to help residents find resources to fight alcohol addiction. Visit your state’s official website for more information. Other non-governmental resources for finding help include Alcoholics Anonymous, Al-Anon, SMART Recovery, Women for Sobriety, Celebrate Recovery (Christian-based support), and Jewish Alcoholics, Chemically Dependent Persons and Significant Others (JACS).

What to Expect from an Alcohol Treatment Program

Alcohol rehab is offered in a number of forms and lengths. For some, an outpatient program will be appropriate. For many others, however, treatment will come in the form of a 30 day or longer stay at an inpatient residential treatment facility. The first steps in treatment consist of admittance and assessment, followed by withdrawal from the alcohol through a detoxification process (see below).

Following detox, treatment in a 30-day program will typically consist of daily individual and group therapy sessions, 12-step (or alternative) program meetings, and periodic appointments with a physician. Additional activities normally include homework assignments, exercise and recreational programs, and wellbeing activities like yoga and meditation. Patients can expect three full meals a day, and short breaks for personal time between therapy sessions and other structured activities. Patients are required to remain on-premises throughout the program’s duration, although supervised off-premises activities may be included. Once the program is completed, the patient will receive a final assessment and individualized written aftercare treatment plan.

  • Detox: Withdrawing from Alcohol
  • Visiting Someone in Rehab
  • Addiction Therapy: Participating in Treatment
  • Regardless of whether the program involved is inpatient or outpatient, the first step for anyone entering alcohol rehab is withdrawal from the alcohol itself. The sudden withdrawal from alcohol addiction results in a tremendous shock to the addict’s body that results in a range of unpleasant and possibly life-threatening symptoms. Therefore, alcohol withdrawal should never be attempted at home.

    Medically-supervised alcohol detoxification typically takes several days to complete from the time the alcoholic takes his or her last drink. The patient typically experiences a number of symptoms throughout the process, including fever, nausea, vomiting, shaking, sweating, anxiety, irritability, confusion, and poor appetite, among many others. Severely addicted patients may experience delirium tremens, or DT’s, which can be dangerous or even fatal. Some symptoms may take several weeks to fully resolve. Fortunately, medications can be used to lessen the severity of symptoms and provide for a safe detoxification process.

  • Visiting a friend or family member in an alcohol rehab program is normally allowed and, in most cases, encouraged by the treatment facility. So, if you are invited by your loved one, strongly consider going. Bear in mind, though, that patients in recovery are going through a very difficult time, and are likely in a fragile emotional state. It’s important to keep conversation during the visit positive and encouraging, and free from any judgments or old, negative family business. Most importantly, be sure to follow the facility’s visitation rules to the letter. Don’t try to sneak anything in. And definitely don’t visit if you are currently abusing alcohol, or any other substance for that matter.

  • An essential element to recovery success is the active involvement of families in the alcoholic’s treatment and recovery process. That’s why most rehab centers incorporate family and/or couple’s therapy into their treatment programs. Family therapy sessions can be conducted in-person at the patient’s treatment facility or by teleconference when distance precludes on-premises visits. In some cases, families will attend therapy sessions absent the presence of the recovering loved one.

    The benefits of family therapy in alcohol addiction treatment are numerous:

    • It invites the family to become active participants in the patient’s recovery process.
    • It helps to educate family members about alcoholism generally and the specific issues surrounding the patient’s drinking.
    • Most significantly, it helps to resolve issues within the family dynamic – including those regarding trauma, enabling, and substance abuse by other family members – that underlie the patient’s alcohol addiction.

Life After Alcohol Rehab Programs

The road to alcohol addiction recovery begins with admitting the problem and getting treatment, but it doesn’t end with the initial treatment period. The recovering alcoholic will need the continuing support of friends and family to stay sober. Here’s what loved ones can do to help:

  • Encouragement: Support begins with encouragement: to remain sober, to continue attending meetings and participate in sober activities, to develop healthy eating habits, to exercise, etc.
  • Patience and acceptance: Recovery takes a long time and will come with setbacks. Showing patience and providing support without judgment is essential. This is particularly true when it comes to relapse. If your loved one relapses, understand that relapse does not mean failure, but is a common element of recovery to be dealt with. Be positive, don’t judge or shame, and encourage your loved one to get back to sobriety as soon as possible.
  • Alcohol-free environment: Provide the recovering alcoholic with a substance-free environment, both at home and elsewhere. And nothing will help more than friends and family maintaining their own sobriety.
Find Personal Support

Dealing with a loved one with an alcohol addiction takes a toll on the health and wellbeing of everyone around them. It’s important, therefore, for loved ones to remember to take care of themselves throughout the recovery process. Be sure to stay in touch with your own friends and family, and to share your feelings with them. Consider seeking help from a therapist or counselor. There are also a number of support groups specifically for friends and family members of alcoholics and addicts, such as Al-Anon, Adult Children of Alcoholics, SMART Recovery Family & Friends, and Co-Dependents Anonymous (CoDA). Remember, you can’t help your loved one unless you take care of yourself first.

Q&A With an Alcohol Addiction Expert

David Tews Ed.D, LCPC, CADC Executive Director Banyan Recovery Center – Chicago
David Tews Ed.D, LCPC, CADC Executive Director Banyan Recovery Center – Chicago

David Tews, Executive Director of Banyan Recovery Center in Chicago, has been in the helping profession for over 20 years. Dr. Tews has worked in a variety of settings specializing in the treatment of substance abuse disorders. He has taught addictions and other mental health courses at local colleges and universities, and currently serves on the Illinois Advisory Council on Alcohol and other Drugs, advocating for those in need of substance abuse treatment.

  • What do you see as the biggest challenges to getting someone you love – a family member or friend – to go into alcohol addiction treatment?

    It’s probably going to mean a lot of sacrifice for the family members. Let’s say the person with the alcohol problem is the breadwinner. That might mean that person is not going to be bringing home a check or will have to leave work while in treatment. The spouse is going to have more burdens and more sacrifices to make. Now this sounds sort of counter-intuitive, but I would say that the struggling individual and their loved ones would like the treatment to be the least intensive as possible. They would like [the alcoholic] to just quit and go to AA, or maybe just go to detox and then come back home. Then they realize at some point that it’s not working and that more intensive care is needed. So, if you look at the big picture and say that getting the loved one to actually go into treatment means that the family, the employer, all have to make sacrifices – I could see those as real challenges.

  • Sometimes it’s the alcoholic that is the last to admit they have a problem. Would you say that’s true?

    Absolutely. That’s the bottom line is the person wanting help. What do they call it now? Precontemplation, right? We don’t say denial anymore, we say precontemplation. Self-reliance, that notion, especially in our society, that I can do it on my own. I don’t need outside help. I don’t need to ask for help. If I do, it’s a sign of weakness. Yeah, those are all significant barriers that we face. Underlying mental health, as well. In many cases, the alcoholism might be masking an underlying mental health issue. That can also be a barrier to the person admitting they have a problem because if I admit to having a problem with alcohol, and alcohol is treating my anxiety, that means I’m going to have to face my anxiety issues.

  • What are some of the most common mental health issues that you see as co-occurring with alcohol addiction? What about alcohol and depression?

    Anxiety, depression. We’re also seeing more and more PTSD. Not necessarily related to war veterans, but related to childhood sexual trauma.

  • You mentioned at the beginning of our talk that you have seen an uptick in alcohol. What is the percentage of clients at Banyan that come to you with an alcohol problem?

    Our current percentage is 32 percent alcohol use disorder.

  • What do you think is causing the uptick?

    [One] thing with alcohol is that it’s sort of flying under the radar. It’s a behavior that has become so socially accepted and encouraged that we’re just seeing more numbers of people saying, “Uh-oh, maybe I have a problem.” So, yeah, I would say that the opioids are sort of leveling off and alcohol is going up. And what a challenge that people in our society are facing when they have an alcohol use disorder. I mean, you can’t watch TV, you can’t walk out of your door, you can’t go to the grocery store. It’s everywhere.