Alcohol consumption is a socially accepted phenomenon that has in fact been part of a large number of cultures since ancient times. However, many people consume excessive and prolonged alcohol consumption over time and end up becoming dependent on this substance: we are talking about alcohol dependence or alcoholism.
This situation has serious repercussions for the subject, and can cause serious health problems or even lead to death. It is something dramatic that many families observe in one of their members, not knowing how to act. How to help an alcoholic? In this article we are going to discuss a series of general guidelines that family and friends may find relevant and useful in addressing the topic.
Alcoholism is considered addiction to alcohol, that is, the acquisition of both physical and psychological dependence on the consumption of spirits that is generated due to the acquisition of tolerance towards its consumption. The body needs larger quantities of the substance to notice the same effects, while its absence generates powerful symptoms typical of a withdrawal syndrome, such as dysphoria, agitation, seizures and other types of alterations. It is consumed in such a way that a large amount of time is invested in obtaining alcohol or other activities or relevant areas of life are neglected or deteriorated.
We are faced with a situation in which the subject loses control over consumption, which is much greater than intended and is carried out despite the knowledge of possible aversive consequences for both him and his environment. However, it is common that there is a desire to stop consumption and one or more attempts may have been made to do so (unsuccessful). Despite this, they usually deny the existence of a dependency.
Uncontrolled and frequent consumption of alcohol can have dramatic consequences, which can cause liver cirrhosis, fatty liver or even kidney dysfunction. Damage to these organs can be irreversible and lead to the need for a transplant or even death due to the destruction of said tissues. The alcoholic is frequently intoxicated, and the presence of blackouts and loss of consciousness is common. In some cases the subject can reach alcohol coma or even death due to cardiorespiratory arrest.
Behavior is also altered, and can range from aggressiveness to extreme passivity, and it is not unusual for risky behavior to occur while intoxicated. Socially, they may suffer abandonment from their environment or cause great suffering to those around them.
Families and close surroundings usually do not know what to do to deal with the problem, often blaming the subject or pretending not to know or justify their behavior. But such behaviors do not help the patient but in fact can complicate her condition. That is why below we will review some guidelines to help an alcoholic, both to make him see his problem and to facilitate its solution.
1. The environment must recognize the problem
First of all, although it may seem logical, the first step to take into account is not justify or ignore the behavior and excessive consumption of the subject with alcoholism The subject who suffers from this disorder or disease (not a vice, something important to keep in mind) consumes alcohol that is dangerous and has a large number of short and long-term consequences. This fact, as well as the fact that it is a disease or disorder and not something that the subject does for the sake of doing and over which he has total control, must be understood and comprehended by those close to him.
It is important to take this point into account, whether the subject is able to identify and recognize their problem or whether they are not aware of it.
2. Approach the topic in a moment of sobriety
An aspect that also appears logical, but that can be difficult to take into account when the subject arrives drunk and with irrational behavior, is to discuss the topic at a time when the subject is sober. Discussing the topic while intoxicated will not have the same effect the subject is not in a position to reflect, and can easily forget what was said or an aggressive response on his part is even possible.
3. Adopt a helping position and not blame
It can be easy for the frustration and pain caused by the condition of our friend, partner, family member or loved one, or their behavior or perceptible lack of intention to change, to push us to blame them for the situation. This fact does not help the subject, but can generate reactance and the existence of conflicts that in some cases can even push the affected person to drink more to avoid discomfort.
It’s not about pretending that nothing is happening, but about address the issue directly but adopting an empathetic attitude that allows approaching the topic in a proactive and collaborative way. It is also important to keep in mind that you should not be condescending or start from a position of superiority, something that will also generate reactance.
4. Watch how you communicate
Linked to the previous point, we must take into account that we are facing a very complex situation. It is necessary that we can express our feelings regarding the situation that our loved one is experiencing being useful that we include ourselves in the sentences.
Concern, if it exists, should be expressed and it is often helpful to mention some of the behaviors that you find worrying. Express yourself with empathy and try to seek dialogue, asking the reason for some behaviors without being excessively demanding.
5. Maintain some degree of control
The subject with alcoholism is someone with profound difficulties controlling alcohol intake, this loss of control being the most defining aspect of this disorder. Although it is not about exercising continuous control over every gesture you make, it is advisable to maintain a certain control over your situation. One of the ways to do this is through money management, in such a way that you can control the amount that the subject carries and what is spent, and even on what depending on how. It is true that the person can obtain money from other sources or even be invited, but this management is very useful and limits the possible purchase of alcohol.
6. Avoid exposure to stimuli that generate the drinking response
Human beings are used to doing certain things in certain places. While it is possible to drink anywhere, prevent the alcoholic from being exposed to situations or environments that facilitate consumption It is very useful. For example, bars, clubs or parties are environments where the consumption of alcoholic beverages is common.
Also, don’t drink in front of her either. This would make the subject think about alcohol and at the same time send a contradictory message: I want you to stop drinking but I do drink.
7. Take into account the possible role we play in addiction
Generally when we talk about alcoholism we tend to think of the subject in question as the one who has the problem. However, sometimes the environment itself favors or has some type of role that makes it easier for the subject to resort to consumption. We have an example in the aforementioned blaming, in situations of abuse or abandonment or even in excessive paternalism.
8. Go to professionals
Alcoholism is a serious condition, a chronic disorder whose existence can endanger the life of the sufferer This is why it is essential to go to some type of professional in order to treat the different elements that condition and maintain alcohol consumption. In extreme cases, it can be very useful to go to a detoxification center (in some cases it could be be required even at the judicial level, although it is advisable to make them understand the need to attend).
In this sense, it is advisable to be interested and actively participate in therapy, in such a way that one learns to relate to the subject and the symptom and acquires guidelines for action in addition to providing social support to get out of a situation that, at least , hard. It is also very useful in making the subject reflect and motivate the change.
Simply recognizing alcoholism is already a very difficult step for someone with this disorder. AND the process of stopping consumption is long (important: it should not be stopped suddenly unless there is medical monitoring due to the possible emergence of potentially fatal withdrawal syndromes, such as delirium tremens) and complex, having to treat different aspects, both behavioral and cognitive. Social and environmental support is a good prognostic factor and a stimulus to progress in treatment.
10. Encourage him to attend support groups
Alcoholics Anonymous is an association created with the purpose of serving as a support group to solve alcoholism problems and generate recovery, while allowing that the subject meets others who have gone through the same situation In these meetings the person will be able to freely express those elements and aspects that he does not want or can tell us about his experience and contrast his experience with that of others.
12. Pleasant activities incompatible with drinking
One way to help a loved one quit drinking, or to maintain changes with treatment, is to explore and engage in enjoyable activities that are not compatible with alcohol consumption. It’s about learning to have fun without being drunk
13. Relapse prevention
This is a fundamental aspect in all addictions. Treatment may be successful, but the existence of different stressors or situations can cause a relapse into alcoholism. That is why, as is already done in therapy, we take into account the need to work on prevention with elements such as those in the previous two points.
And from therapy?
The above refers to ways to help the alcoholic from the family or friend context, with social support towards withdrawing from alcohol being one of the most important elements to maintain and generate the perception and motivation for change. But Also in psychological therapy different methods are used to help the alcoholic stop drinking alcohol, in addition to controlling the craving or craving for consumption. In fact, it is important to be able to attend therapy, given how much is at stake.
Roughly, Therapy focuses first on gaining awareness of the problem in cases where this does not exist, to subsequently reflect on the pros and cons of drinking behavior, reinforce the motivation to change and act through various technical programs (which include the approach to community reinforcement, marital therapy and couples, signal exposure therapy with response prevention, contingency management, training in coping and social skills, controlled drinking programs) and finally maintain these changes with relapse prevention programs.
During treatment, techniques from very diverse theoretical aspects can be used, the most common being cognitive-behavioral, systemic and humanistic. It is also common for substances such as disulfiram to be used during treatment which generates unpleasant effects on the body by interacting with alcohol in such a way that its consumption acquires an aversive red color.
