Expert: Jan Edward Williams - 10/5/2009

Question
My husband has been an alcoholic in denial for many years and is a heavy drinker from 5pm until he has had his fill, eats, then sleep. This is EVERYDAY. Very seldom he will take a break for a few days, but that only lasts no longer than a week. My question is, when he gets up in the mornings and goes through his day without drinking, is he capable of comprehending a meaningful conversation as a sober person would? He is in his 60's and has been drinking like this since I have known him, for 30 years. I understand that you can't reason with a drunk, but with his history of alcohol in the evenings, can he understand the situation of things during the day while not drinking. He works fulltime during the day and seems normal to others. He never argues with me or is never verbally abusive with me during the day, only in the evenings while he's drinking. Thanks for an answer.

Answer
Hello Martha,
First of all, I understand the pain and consequences you experience from living with an active alcoholic and suggest, if you have not already done so, that you consider attending Al-Anon, the 12 Step Program for persons in a relationship with an alcoholic: http://www.al-anon.alateen.org/ for support. To your question: Is an alcoholic who drinks until drunk every night, and has done so for many years, damaged to the point that he cannot comprehend his situation when not drinking? There are two reasons why my answer is: probably. One is the fact that the alcoholic's brain is affected adversely by such drinking to the point that it is unclear how much he may comprehend; there can be physical damage to the reasoning portion of his brain as well as to the memory portion of the brain. Alcohol and other drugs seriously disrupt the normal functioning of the brain, not only causing dysfunction in the action of “feel good” chemicals (neurotransmitters such as dopamine and serotonin) thereby producing craving and withdrawal problems, but also cause dysfunction in the brain’s ability to process, store, and use information. The second reason why he probably cannot truly understand when you confront him even when he is not drinking, is due to the power of denial in the addictive disease of alcoholism. For many reasons, the alcoholic is truly deluded about the reality of his drinking and how it affetcs him and those around him. It probably would take a significant period of abstinence (not just a week) for the alcoholic to clear up enough to be able to comprehend his problem, and even then treatment and 12 Step meetings may be needed for him to break through the denial. I regret that I must paint such a dismal p[icture, but I am describing the reality of alcoholism. Check out my website for more information, and consider attending Al-Anon. Good luck,
Jan Edward Williams, MS, JD, LCADC
www.alcoholdrugsos.com