Expert: Rebos - 1/3/2006

Question
My Brother has been an alcohol abuser for years now.  He is 36 yrs. old and has recently been acting distant and not himself.  He is not remembering conversations that he has had with me and other family members.  His wife says that he is hiding his alcohol from her and will deny that he has been drinking.  She says that she has her suspicions that he may be drinking before he gets home.  Not that he is stoping at a bar but may be drinking a bottle of liquor and getting rid of the evidence before he comes through the door.  She thinks that he smells of liquor and others agree with her.  I am worried that he is way out of control and want to know what I can do to help him understand that we talk about his drinking because we care and not because we want to nag.  Please give me some direction to take.  Thank you!

Worried

Answer
Good afternoon Gail:

Thank you for your question: Without too much to go on from what you have written in your question, I will try to answer it in a “general” way and hope that it meets with your satisfaction. If you wish to go into more detail about, for example; his family situation, children, problems to date with the law enforcement (if any), rough age, work problems, or even military service, etc you can follow up with another question, if you chose.

Your brother not remembering what he may have done or heard at times (when he is drunk at the time) is called a “blackout”. What is really happening is “alcoholic amnesia”. Each time he has a blackout some brain cells die. The end result can be what is called A WET BRAIN. It's like a prize fighter that gets hit in the head too many times, after a while he is in another world. It is a signpost that he is in serious trouble with his drinking.

Stopping drinking is not a matter of willpower. Alcoholism is a disease. Drinking alcoholically is but a symptom of a deeper underlying problem that he will eventually have to face up to in order to stop drinking for the long haul. Without learning what that problem is, trying to stay away from a drink is known as "white knuckle sobriety", or being on a “dry drunk”. It isn't very long before he will continue to drink again and again no matter how many times he may promise to stop drinking. For any alcoholic there is no such thing as cutting down, drinking only on weekends, changing what they drink, or even switching to “near beer” with 0.5% alcohol. For an alcoholic nothing will work short of total and complete abstinence from any thing that contains alcohol or other mind-altering substances (drugs). Of course the exception is a medical doctor's prescription as long as the doctor understands that he or she is dealing with an addicted person. Unfortunately, all alcoholics must hit their own bottom before they do anything about stopping. I am sorry to say that hitting a bottom for some may mean going as low as a person can go...plus six feet!

It is very easy for those who are close to an alcoholic to become “enablers”. If his wife is enabling him then she should be shown this e-mail. An enabler is a person who allows an alcoholic to continue drinking, primarily by their acceptance of an alcoholic's actions and not holding them accountable for their unacceptable behavior. An alcoholic can sense the ineptness and weakness of an enabler and they continue on drinking because they know that they will be forgiven and if necessary rescued time and time again. If you or your sister-in-law or other concerned members of the family become enablers in a backhanded way you will be giving you're your brother “permission” to drink by the continued acceptance of his unacceptable behavior and his lack of concern as to how you all feel about his drinking. That should be a hint to you that he is faced with a serious drinking problem. What ever the family decides to do, it should be based upon your heads talking and not your hearts. Don't let any of your family's actions appear to be allowing him to continue drinking if you do not want him to drink. Alcoholism is a progressive disease it only gets worse it never gets better on its own. Neither, you or your sister-in-law should EVER make any threats to your brother that you are not willing to follow through with. If you do then you will in a sense be buying him his next drink!

It would be wise for you and your sister-in-law to attend Alanon meetings. If you go to Alanon you will find that your problem is not quite as unique as you may think. At Alanon you would learn how to live with having an alcoholic in your life, and learn the truth about the disease of alcoholism. Alanon is intended to help the concerned non-drinker and not the Alcoholic directly. In order for you to be able to help him you must first learn to help yourselves At Alanon you will meet people who also have an alcoholic in their lives, and that their own lives had become unmanageable as a result of it. Alcoholism is a disease that affects everyone who comes into contact an alcoholic. Alcoholics are not bad people, they are sick people who need help, but they must be held responsible for their actions! You may not be able to do anything about your brother's drinking but you can do something about the problem that has already developed in your lives by having an alcoholic in it. Until you are armed with the right kind of information about the disease your efforts to help him will be for nothing. Alcoholism is deadly and it destroys everything and everyone who comes into contact with it. If you do not have your local Alanon number call toll-free: 1-800-344-2666 (United States) or 1-800-443-4525 (Canada).

It is generally believed, by many in the field of alcoholism, that it is a three-fold disease: Mental, Physical, and Spiritual.

The “mental” part of the illness is not about the crazy things that drunks do when they drink but, it has to do with the “mental obsession” to drink even before the drink is picked up... a pre-occupation with thinking about drinking which is so powerful that an alcoholic must drink, even though they know what the end result will be. The “physical” aspect of the disease is, not that a person is destroying their health, (liver, pancreas, brain damage etc.) but, it is the physical compulsion that sets in after the first drink is downed. The physical compulsion to continue to drink takes over in the form of a deep incessant craving that an alcoholic must continue to drink until some outside incident stops them or they pass out. The “spiritual” part of the illness (which has nothing to do with religion) has to do with the loss of an alcoholic's values, and a willingness to settle for less and less as their drinking continues. It becomes difficult for an alcoholic to determine the difference between right and wrong or good and bad. The alcoholic develops a change in their priorities where drinking becomes more important than health, family, job and friends.

As far as your brother cutting down or changing his drinking habits forget it…it does not work! Never has and never will. Until he “admits and accepts” that alcohol is causing him and the family problems there is little you can do for him. No one can scare an alcoholic into stopping drinking. Cajoling, hand-wringing, threatening, begging and even putting him away against his will, will not get him to stop doing what he has not made up his own mind to do. Don't think that he does not want to stop… he can't stop when left to his own devices. Also, don't be lulled into thinking that he will stop drinking just because he may say that he will. It's not that he will purposely lie to you… but he will lie to himself because down deep he is afraid to stop. Alcoholism is powerful, cunning, baffling and insidious. An active alcoholic's choices become limited to: attending a recovery program like AA, or entering an in-patient detoxification clinic that has an after care outpatient program. He needs some distance between him and his last drink. If he does nothing about stopping then he is destined to die a drunk's death, get involved negatively with the law (if he hasn't already) or end up in a mental institution. I am sorry to be blunt, but I am only stating what you probably already know. I have never seen an alcoholic stop drinking on willpower alone. The disease is too powerful. False pride and fear has a lot to do with anyone not wanting to do anything about a drug and/or drinking problem Below you will find 12 questions that can be used to determine whether your brother is having a problem or not. The questions are normally directed to the drinker, but if you think you know what your brother's drinking pattern is you may find them interesting. But remember, your brother is the only one who can make the decision as to him being an alcoholic or not, “enough” to want to do anything about it.

1. Have you ever decided to stop drinking for a week or so, but only lasted for a couple of days?

2. Do you wish that people would mind their own business about your drinking and stop telling you what to do?

3. Have you ever switched from one drink to another in the hope that this would keep you from getting drunk?

4. Have you ever had an eye-opener upon wakening during the past year?

5. Do you envy people who can drink without getting into trouble?

6. Have you had any problems connected with drinking during the past year?

7. Has your drinking caused trouble at home?

8. Do you ever try to get extra drinks at a party because you do not get enough?

9. Do you tell yourself that you can stop drinking any time you want to, even though you keep getting drunk when you don't mean to?

10. Have you missed days at work or school because of drinking?

11. Do you have "blackouts"? A blackout is when you have been drinking there are periods of time that you can't remember. (Your brother already fits this one).

12. Have you ever felt that your life would be better if you did not drink?

IF YOU ANSWER YES TO 4 OR MORE QUESTIONS then you are probably in trouble with alcohol.

Also, the following is what the National Institute on Alcohol Abuse and Alcoholism suggests when dealing with an alcoholic:

Getting an alcoholic into treatment can be a challenging situation. An alcoholic cannot be forced to get help except under certain circumstances, such as when a violent incident results in police being called or following a medical emergency. This doesn't mean, however, that you have to wait for a crisis to make an impact. Based on clinical experience, many alcoholism treatment specialists recommend the following steps to help an alcoholic accept treatment:

Stop all "rescue missions." Family members and friends often try to protect an alcoholic from the results of their behavior by making excuses to others about their drinking and by getting him out of alcohol-related jams. It is important to stop all such rescue attempts immediately, so that the alcoholic will fully experience the harmful effects of his or her drinking--and thereby become more motivated to stop.

Time your intervention. Plan to talk with the drinker shortly after an alcohol-related problem has occurred--for example, a serious family argument in which drinking played a part or an alcohol-related accident. Also choose a time when he or she is sober, when both of you are in a calm frame of mind, and when you can speak privately.

Be specific. Tell the family member that you are concerned about his or her drinking and want to be supportive in getting help. Back up your concern with examples of the ways in which his or her drinking has caused problems for both of you, including the most recent incident.

State the consequences. Tell the family member that until he or she gets help, you will carry out consequences--not to punish the drinker, but to protect yourself from the harmful effects of the drinking. These may range from refusing to go with the person to any alcohol-related social activities to moving out of the house. Do not make any threats you are not prepared to carry out.

Be ready to help. Gather information in advance about local treatment options. If the person is willing to seek help, call immediately for an appointment with a treatment program counselor. Offer to go with the family member on the first visit to a treatment program and/or AA meeting.

Call on a friend. If the family member still refuses to get help, ask a friend to talk with him or her, using the steps described above. A friend who is a recovering alcoholic may be particularly persuasive, but any caring, nonjudgmental friend may be able to make a difference. The intervention of more than one person, more than one time, is often necessary to persuade an alcoholic person to seek help.

Find strength in numbers. With the help of a professional therapist, some families join with other relatives and friends to confront an alcoholic as a group. While this approach may be effective, it should only be attempted under the guidance of a therapist who is experienced in this kind of group intervention.

Get support. Whether or not the alcoholic family member seeks help, you may benefit from the encouragement and support of other people in your situation. Support groups offered in most communities include Al-Anon, which holds regular meetings for spouses and other significant adults in an alcoholic's life, and Alateen, for children of alcoholics. These groups help family members understand that they are not responsible for an alcoholic's drinking and that they need to take steps to take care of themselves, regardless of whether the alcoholic family member chooses to get help.

I hope that I have not offended you by my directness relative to your question, but alcoholism is a deadly disease. I know of no one who has ever recovered from alcoholism without getting help. Your brother can save himself a lot of time and money by going to AA for his recovery, and I recommend it highly. Remember, alcoholism is but a symptom of a deeper underlying problem that must be recognized (and do something about it) or the disease will progress until your brother  (if he is fortunate) hits his bottom before it kills him, or someone else, he ends up in jail, loses his job, his friends, his family, and most important of all… himself. He's GOTTAWANNA. There is no “good fairy” that is going to come down and tap your brother on the shoulder and make him “all better”. It is going to take a lot of discipline and hard work by him for him to come back to the world of the “living”. However, it is done just “one day at a time”.

I hope that I have given you enough information in my answer to you. If I can be of further service to you please write to me again. Thank you, Rebos.