Expert: Peter L. - 10/31/2011

Question
hello, my best friend has been a alcoholic for the past 10 years. in july of this year he went into hospital because of his drinking. he was in there for around 9 days and when he came out he was a different man !! he was on antibuse. i gave him all the support i could. However he has been off the antibuse for nearly 2 weeks now and last night he admitted he had failed by tex message, then rang me in the early hours of the morning asking for money for a taxi. I SAID NO BECAUSE I DIDNT BELIVE HIM.... maybe i was wrong. What can i do to help him ??? im so concerned but feel like i dont know what to do. if he goes down that road again he will loose his family and everything but he wont listen to my advice.

thanks

Answer
Hi Julie,

Antibuse has been around for quite a while, and has not turned out to be the "silver bullet" its creators may have believed it would be.  People have to keep taking the medication for it to have it's blocking effect.  Often people will simply stop taking it, or when monitored, not tell the truth that they have stopped.  

Nine days of treatment is extremely short for alcohol treatment.  Ideally, he would have come out of the hospital and engaged in inpatient, long-term residential, or intensive outpatient services. All told, to be effective, treatment has to last at least 6 months, and preferably one year.

You have known this man for many years and have witnessed his chronic drinking pattern. Has he attempted treatment before this?  Has he stuck it out?  The question revolves around his readiness.  Why did he want money for a taxi?  Because he was drunk and not able to drive home (assuming he hasn't lost his license due to DWI)?

The only thing you can do to help him is to strongly urge him to get back into treatment. He needs a long-term sobriety plan.  If he doesn't follow it, or is critical of treatment or hesitant to re-engage, he is not in a high degree of readiness for change. This will continue to create enormous frustration for you and his family, but everyone must understand that addictions and those with them are at time exceedingly difficult to break.  There is no way to know at what point there will be a breakthrough, what I call the "magic moment" of awareness where the addict/alcoholic becomes energized and motivated to address their problem seriously.

He may lose his family; sadly, that might be the time he will change.  I've seen this phenomenon many times where the abuser has to be met with an ultimatum.  This is not a bad thing, and often a sign of healthy thinking, where family members and significant others can recognize their need to protect themselves from the negative behaviors of the alcoholic.  

Let's hope he will listen ultimately to at least you, his best friend, as he may trust what you have to say.

Thanks for your question,
Peter