Expert: Rebos - 3/1/2007

Question
Before I began, I would to apologize for the length of my story.
I have a 35-year old female cousin who has been drinking for 3 years.  She left her home and left behind her two children and husband.  It began when she found out her husband was having an affair. She also says her husband was psychologically abusive. Her children to not have any contact with her at all.  She claims she has called but they do not pick up the phone and they claim their mom has never called. I mostly believe the children, because she does not show any “motherly” expression about her kids, not even at Christmas time.  She was laughing and giggling and did not bother to pick up the phone to call her kids…and she was not even drunk that night!
She moved from Chicago to Houston and is currently staying with one of my aunts.  We asked to come here hoping we would be able to help her.  She is drunk practically every day.  She has been admitted to the hospital because she has thrown up blood.  She drinks 3-4 bottles of vodka daily.  She has gotten fired from jobs because she presents herself drunk.  We have asked her to admit she needs help so she can go to a rehab center for professional help.  After 6 months, she finally accepted.  However, the center told us she did not meet the criteria to be admitted because she did not have withdrawal symptoms and that she only qualified for outpatient treatment (which has failed to attend in the past).  My cousin’s mom, in her desperateness, asked the counselor to reconsider because her daughter needs help.  It turns out that my cousin lied about her drinking.  She indicated that she only drank “once in a while”.  We do not know what to do.  My aunt has asked her to leave because it has become to much for her family to deal with on a daily basis. Her kids are afraid of my cousin, to the point that they sleep with my aunt and uncle.  But my cousin will not leave, she only locks herself in her room and totally ignores everything people tell her.  How can we help her?  My aunt has kicked her out various times and I fear one of these days they will get her stuff out of the house and she will have no place to go?


Answer
Good afternoon Mayra:

Thank you for your question. My answer may be somewhat generic however, since your cousin (as are all alcoholics) an addicted person. You say that your cousin refuses to leave her aunt’s house…your aunt may want to consider calling the police and having her removed as trespassing on her property. It may be a way for her to get into a detox clinic if the police bring her there!

Stopping drinking is not a matter of willpower. Alcoholism is a disease. Drinking alcoholically is but a symptom of a deeper underlying problem that your cousin 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 she will continue to drink again and again no matter how many times she may promise family members that she wants 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 0.05% 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! Your cousin may be one of those poor souls that cannot get honest about the problems that alcohol is causing her and her family.

It is very easy for those who are close to an alcoholic to become “enablers”. If her family is enabling her (as was her aunt) then all of them should take to heart what I am writing to you. 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(s) and they continue on drinking because they know that they will be forgiven (and if necessary rescued time and time again). If you or other concerned members of the family become enablers in a backhanded way you will be giving your cousin “permission” to drink by your continued acceptance of her unacceptable behavior and her lack of concern as to how you all feel about her drinking. That should be a hint to you that she is faced with a serious drinking problem. What ever the family decides to do, it should be based upon their heads talking and not their hearts. Don’t let any of your family’s actions appear to be allowing her to continue drinking if you do not want her to drink. Alcoholism is a progressive disease it only gets worse it never gets better on its own. Neither, you or others in the family should EVER make any threats to your cousin that you are not willing to follow through with. If you do then you will in a sense be buying her, her next drink!

It would be wise for you and your family to attend Alanon meetings. If they or you go to Alanon you will find that your problem is not quite as unique as you may think. At Alanon you and other family members 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 all of you to be able to help her 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 cousin’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 all armed with the right kind of information about the disease your efforts to help her 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... as your cousin doing to her children. 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 cousin thinking that she may be able to cut down with her drinking, forget it…it does not work! Never has and never will. Until she “admits and accepts” that alcohol is causing her and her family problems there is little you can do for her. No one can scare an alcoholic into stopping drinking. Cajoling, hand-wringing, threatening, begging and even putting her away against her will, will not get her to stop doing what she has not made up her own mind to do. Don't think that she does not want to stop… she can't stop when left to her own devices. Also, don't be lulled into thinking that she will stop drinking just because she may say that she will. It's not that she will purposely lie to you… but she will lie to herself because down deep she 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, and/or entering an in-patient detoxification clinic that has an after care outpatient program and a half way house program. She needs some distance between her and her last drink, and learning to have some discipline in her life. If she does nothing about stopping then she is destined to die a drunk's death, get involved negatively with the law (if she hasn’t already) or end up in a mental institution (if she hasn’t already). 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 have a lot to do with her not wanting to do anything her drinking problem.

There is no one method used in the recovery of alcoholism that works for everyone, and there is “no cure” for the disease of alcoholism. If you take a cucumber and turn it into a pickle, you can never change it back to a cucumber again...“once an alcoholic - always an alcoholic”. There are recovering alcoholics and there are active alcoholics. That being said, alcoholism is not a moral issue. It is considered a disease by the American Medical Assoc. and there is no shame in being an alcoholic the shame is in doing nothing about it!

Unfortunately, AA or any other method that an active alcoholic may try to use to recover does not always work for those who need it, but will always work for those who want it. Your cousin needs a detox, some in house counseling and probably an extended stay at a halfway house.  I know that she was hospitalized for bleeding and that should be enough for her to qualify for a bed in the detox clinic. However if her health has deteriorated it would be wise for her not to stop “cold turkey”.

From its earliest days, AA has enjoyed the friendship and support of doctors who are familiar with its program of recovery from alcoholism. Doctors, better than any other group, are in a position to appreciate how unreliable other approaches to the problem of alcoholism have been in the past. AA has never been advanced as the only answer to the problem of alcoholism, but the AA recovery program has worked so often, after other methods have failed, that doctors today are frequently the most outspoken boosters of the AA program. The AMA has stated that AA membership is still the most effective means of treating alcoholism. In AA’s words they say, “Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with them selves. There are such unfortunates. They are not at fault; they have seemed to have been born that way. They are naturally incapable of grasping and developing a manner of living that demands rigorous honesty”.

Very simply, AA is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is “a desire to stop drinking”. There are no dues or fees for AA membership, and it is not allied with any sect, denomination, politics, organization, or institution. AA can be found in the yellow pages of the phone book.

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 on willpower alone. After the detox clinic and aftercare in a halfway house… your cousin can save herself a lot of time and money by going to AA for her long term recovery. I recommend it highly. Remember, alcoholism is but a symptom of a deeper underlying problem that must be recognized (and for her do something about it) or the disease will progress until she (if she is fortunate) hits his bottom before it kills her, or someone else, she ends up in jail, becomes totally un-employable, loses her friends, her family, and most important of all… herself. She’s GOTTAWANNA. There is no “good fairy” that is going to come down and tap her on the shoulder and make her “all better”. It is going to take a lot of discipline and hard work by her, for her to come back to the world of the “living”. However, it is done just “one day at a time”. If you feel that an intervention is in order then go for it but make sure that you have a professional run the intervention that is familiar with alcoholism.

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.