Expert: Rebos - 2/26/2007

Question
My sister-in-law is an alcoholic. The whole family is in denial. My husband was one and died because of it at only 54 yrs old. She is in the hospital now having the fluid removed that built up in her belly. I want to get my brother to take her to AA fast - how's the best way to approach him?

Answer
Good morning Nancy:

Thank you for your question. I am very sorry to read about your husband, and you certainly know first hand what‘s in the cards for your sister in law if she doesn’t get help for her drinking problem. Your sister in law may first need some detoxification at a clinic before she tries AA if she is in such bad physical shape. Recovery will sometimes depend on her overall health to get the full benefit from going to AA meetings. If she is in a weakened condition she may need to be watched for convulsions or even a heart attack or stroke if she tries to detox on her own. IS IT POSSIBLE FOR HER TO GO TO A DETOX CLINIC DIRECTLY FROM THE HOSPITAL? Her chances for success will improve greatly. Unfortunately, all alcoholics must hit their own bottom before they do anything about stopping. As you know … I am sorry to say that hitting a bottom for some may mean going as low as a person can go...plus six feet!

Alcoholism is cunning, baffling, insidious and powerful. It has no cure…once an alcoholic always an alcoholic! So to speak…“once you turn a cucumber into a pickle, you can never change it back to a cucumber”. The good news is that there is recovery from the disease and it is accomplished “just one day at a time.” I’m sure that you have heard that saying before. It has been my experience to have never seen an alcoholic recover on their own willpower for the long haul. No one can scare an alcoholic into stop drinking. All the cajoling, hand-wringing, threatening and begging in the world will not get them to stop doing what they cannot do on their own. Don't for one second think that your sister in law does not want to stop drinking… she can't stop when left to her own devices. Don't be fooled into thinking that she will stop drinking on her own just because she says that she will. It's not that she will purposely lie to you… but she will lie to herself because down deep she knows that she can’t stop.

The following is what the U. S. National Institute on Alcohol Abuse and Alcoholism suggests when dealing with an alcoholic. 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!

“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. (End of suggestions)

I don’t want to overburden you with any more details than I have already written. If you have any specific questions feel free to ask me a follow-up. Thank you, Rebos