How to help an Alcoholic or Addict

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There is no one anywhere who is not capable of recovering from substance addiction. It is a good idea to involve the person's doctor early on for health supervision. Please note that withdrawal from alcohol can be dangerous: see "Alcohol Withdrawal, DTs, and Seizures" (Click Here). The following excerpt explains the process of becoming mentally ready to accept help, and then describes what we should do to help a loved one caught in alcoholism or addiction.

At risk of sounding clinical or like I’m trying to shoe-horn all of us into one mold, I break down the mental readiness for accepting help for addiction-alcoholism into four “phases.” In medical terminology we call this projection of how a disease plays out its natural history. To be sure, everyone is an individual and has their own story. However, I think my concept of the natural history of readiness for recovery from alcoholism-addiction holds up quite well for most of us. See what you think, I’d appreciate an email with any comments you may care to share. Most people who find themselves drinking or using drugs, or gambling, or stuck on some addictive behavior too much are able to shake themselves off, walk away from it, and never look back. However, those of us who can’t – true alcoholic-addicts – follow a remarkably similar path, which I have broken into four phases. These are:

Phase 1: This begins when we realize that our substance use has become abnormally frequent, and we are seeing the beginnings of it being detrimental to our health, family, job, and well-being. We are having arguments at home over our drinking or using and our behaviors around it. We are noticing that we are covering up for things we messed up or neglected to do. We are not willing to stop our drinking or using; even if we could stop at this point we would not. We become annoyed when people talk about our drinking or using. We try to get them off our back by hiding our substance use and telling them that we’ll stop, even though we have no intention of doing so. We are starting to choose our substance over people and things, as we are willing to endure frayed relationships, sagging job performance, loss of hobbies and activities, and material loss for our substance. We are developing tolerance to our substance. We begin to be attracted to other people and places that support our substance use. We are getting physically sick from our substance use. Cognitive dissonance (see "What is Cognitive Dissonance, and Why Does it Keep Me Addicted?"  Click Here) is getting noticeably uncomfortable. We sense that we are somehow becoming a different person, doing things we previously would have considered selfish and stupid.

Phase 2. This begins when we reach the point where we do want to stop, but we think we can do it on our own. “I got this,” “I can stop: I’ve done it before,” “as of Monday I’ll stop” becomes our mantra to concerned family and friends. We really mean it when we say these things. We believe that will-power and determination will do it. Everything becomes “tomorrow." Tomorrow is when we’ll deal with the bank problem, fix the broken garage door, have that talk with our boss, take the kids to the movies. And we believe it every time we say it. Even though we are going to great lengths to hide our alcohol or drug use, it is well known to everyone around us. Family and friends are repeatedly trying to get us to talk to the doctor, go to rehab, go to A.A., but we come up with every reason, every excuse not to. We still don’t believe we need any help. Our alcoholic-addict pride, and our insane thinking are in full swing. We still believe we have power over our substance. Even if we did follow their requests and seek help we wouldn’t accept what was offered, because we still need to keep that door to our substance open, and we still think we can do it our way, on our own. We would only pretend to seek help to get our family off our back.

At this point we are trying – over and over and over again – to control or stop our drinking or using. But it has to be our way: on our own with us in control. We are still looking for the easier, softer way. "I'll just drink on weekends," "I'll switch to beer, or weed," "I'll cut back my using," "I won't drink or use until after work," are our new plan. Each new low makes us swear off the drugs or alcohol, and we mean it. Sometimes we do stop. It will last a day or two, sometimes a week or more, but we always end right back where we started. Despite all our failures, we still cling to the belief that we can do this on our own. We are under the spell of the insanity of our disease.

We are losing things from our life, and we will continue losing them as long as we remain in this phase of our disease. Marriage, job, money, house, drivers’ licence, access to our children, all progressively fall away. If we don’t get out of this phase we will end up finding ourselves homeless, edging toward “jails, institutions, and death.” We are having serious health problems. We are sick all the time. If we don’t get out of this phase we will die.

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Phase 3. Those lucky enough will enter this phase of our disease before they have lost too much. We are in this phase when we are finally desperate enough to seek and accept help. This is what is referred to in the Twelve Steps as “hitting our bottom.” The crucial ingredient to entering this phase is described in the Big Book: “We learned that we had to fully concede to our innermost selves that we were alcoholics [or addicts]. This is the first step in recovery. The delusion that we are like other people, or presently may be, has to be smashed” (page 30).

At this point we will find ourselves being funneled toward detox, an in- or out-patient rehab program, or a program of recovery like a Twelve Step program. Our doctor, friends, family, whomever we go to for help will want us to do this. There is still one barrier between us and recovery at this point: surrender.

Once we surrender ourselves to help, and give up our need for control, we find sobriety. Surrender or die.

Phase 4. This phase is not part of our disease unless we fail to find sobriety in Phase 3 and give up trying. We have tried rehab, Twelve Step or other programs numerous times but have always found ourselves back drowning in our substance. This phase begins when we finally give up, and accept that we will ride our disease to the end. This is where we find the Wernicke-Korsakoff syndrome, advanced liver cirrhosis, alcoholic cardiomyopathy, psychosis, and other advanced physical consequences of our disease. This is where we find those living on the fringes of society, who look and act like outcasts. This phase of our disease is uniformly fatal. However, there are still those who escape the grave and find sobriety if they finally become willing to surrender themselves to the solution.

If a friend or loved one is caught in addiction or alcoholism we must be aware of these phases, because if we push for sobriety and treatment in phase 1 or 2 we will have little chance of success and will only alienate our loved one.

There are barriers to recovery (Click Here) that are common to many alcoholics and addicts. Prominent among these is a feeling of being overwhelmed (Click Here) that is specific to addictions. Having an understanding of these important parts of the mind-set of someone caught up in addiction is very helpful. If they feel understood they are much more likely to connect with help. However, they say that only an alcoholic / addict can understand, and there is truth to that. But, an effort to undertsand them rather than saying "why don't you just stop" goes a long way.

There is a major impediment that is characteristic of alcoholic-addicts to accepting advice or help from family or friends, especially if they are not alcoholic-addicts themselves. If we are too close, we are not in a good position to help them break free. Our advice tends to be offered repeatedly and quickly becomes viewed as "nagging," pushing our sick loved one away. Besides that, one of the hallmark symptoms of alcoholism and addiction is the ability to masterfully manipulate family and friends, so that when these people think they are helping their sick loved ones, they are actually enabling their drinking or using. This is especially the case when it comes to giving material support. When we are too close to the person, we lose perspective and objectivity. Besides, unless we are an alcoholic or addict in recovery we really don't know what we are dealing with. So, it is best to let an outsider who is an alcoholic-addict in recovery become involved.

A friend with more than twenty years in recovery from drug and alcohol addiction found himself with a teen-aged daughter who had followed his earlier path of addiction. She came to him for help. Even though he had more than twenty years of recovery experience and had helped many other alcoholics and addicts into sobriety during his time in A.A., he knew he wasn't the one to help her. He brought her to a Twelve Step meeting, introduced her to the first female he saw, and then left. He knew that if he tried to help her himself that he would try to be her father and her sponsor, and tell her what to do. He knew this wouldn't work, and he was correct. His daughter is now five years into her own recovery, by the way.

The best thing we can do for people in the throes of their disease is to recognize what phase of their illness they are in, and resist our overwhelming desire to push them to “just stop.” We need to understand their frame of mind even though it may be foreign to us. I hope that reading this book will enable us all to do that famously. Then we need to involve an outsider who knows what he or she is doing. I suggest calling the local A.A. number and asking for help. They will send someone over who will extend the hand of help in a way that addict-alcoholics can identify with. If they are not ready to accept help, the A.A. caller will back off, but will make sure that sick loved ones know that help is there when they are ready.

Once loved ones have accepted help, now is the time for family and friends to throw their support openly behind them. Allow them to set the tone, and the pace. Get in touch with their sponsor or councilor with any questions. It means a lot to an addict-alcoholic in early recovery to know that family and friends are there for them. Keep the conversation light, they often are far from ready to discuss their situation, allow them to set the pace and drive the subject of conversation. Easy does it.

When we back away from the situation, our addict-alcoholic loved ones are surprised by our understanding, and relieved by our restraint from pushing them toward something they are not ready for. We can’t will these people into recovery, but we can understand them and gain their trust. Once they are ready, it is time to get them better.