When a loved one shows signs of alcoholism, it’s easy to feel overwhelmed by questions, such as:
- Is my loved one abusing alcohol?
- Will your loved one accept help or deny the problem?
- What treatment services are available?
- What’s the best way to ensure that your friend or relative gets the right kind of help?
This guide will help you answer some of these questions to best move forward with getting help for your loved one.
What Is Alcohol Use Disorder?
Alcohol use disorder (AUD) is a chronic and relapsing condition that is diagnosed by professionals using a set of 11 criteria (shown below). These criteria come from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Meeting 2 or more of the criteria in a 12-month period indicates the presence of an alcohol use disorder. The more criteria met, the more severe the disorder. 1,2
In 2018, an estimated 11 million adults 26 years or older in the U.S. met criteria for an alcohol use disorder in the previous year. Over 3 million young adults between 18 and 25 had an AUD in the same time frame. The disease touches adolescents and teens as well, with more than 400,000 youths between 12 and 17 having an AUD that year.18
Detecting the Signs of Alcoholism
If you’re worried about a relative or other loved one, look for some of the diagnostic criteria of an alcohol use disorder:1
- A loss of the ability to set limits on drinking (how much or how long).
- Repeated attempts to quit drinking or to cut back without success.
- A great deal of time spent in getting alcohol, drinking, or being hungover.
- Cravings, or a strong desire to drink.
- Continued drinking despite relationship conflicts.
- Drinking interferes with professional, social, or domestic obligations.
- Important or interesting activities are given up in favor of drinking.
- Frequent intoxication in situations where it could be physically hazardous (such as driving).
- Continued drinking even when it causes or worsens physical or mental health problems, or results in blackouts.
- Increased amounts of alcohol are needed to achieve the same degree of intoxication (i.e., tolerance).
- Withdrawal symptoms arise when alcohol use is stopped or reduced.
As starkly pronounced as some of these signs and symptoms may be, in some cases, individuals may overlook or downplay the significance of them when considering whether or not a problem is present because drinking is such a common social practice. If your loved one is showing the signs of an alcohol use disorder, they may need the help and support of others, including addiction treatment professionals, to stop drinking.
Potential Causes of Alcoholism
Alcoholism is a complex condition that is not caused by a lack of willpower, but by a combination of contributing factors, including:3-8
- According to the National Institute on Alcohol Abuse and Alcoholism, up to 60% of a person’s risk for developing an alcohol use disorder is a factor of individual genetic variation.
- The home environment: Parental alcohol abuse, poor parental connectedness, low levels of parental emotional support, and sibling alcohol use can all impact a person’s risk of alcoholism.
- Personal trauma:A history of childhood trauma (such as child abuse or neglect), as well as experiencing trauma in adulthood — such as military combat, sexual assault, or homicide — have been associated with an increased risk of alcohol abuse. In fact, the U.S. Department of Veterans Affairs states that up to 75% of individuals who have survived abuse or violent trauma develop problems with alcohol use.
- A co-occurring mental illness:Substance abuse very commonly co-occurs with mental illness. In fact, according to the 2014 data from the Substance Abuse and Mental Health Services Administration, roughly 39% of all Americans with a substance use disorder have a co-occurring mental illness. In some cases, people may drink in an attempt to alleviate certain symptoms associated with their mental health issues, although doing so may actually worsen their condition over time.
Of course, not every person who experiences mental illness, trauma, or other risk factors for alcoholism will go on to abuse alcohol. The disease of addiction is complicated, and it’s not possible to predict with total accuracy who will be impacted.9
Alcoholism is a chronic, progressive, and multifaceted disease. As alcohol use disorder itself is quite a complex condition, oftentimes so too is recovering from it. It is not just a matter of deciding to put the bottle down—very often, professional treatment is needed to get and stay sober.9
Talking to a Loved One About Their Drinking
Convincing a loved one to get help can be extremely challenging. Denial is common among people struggling with alcoholism, and it may take many attempts to get your loved one to accept that they need help.10 When talking with a person who has a drinking problem, the most effective approach is usually to be as objective, caring, and nonjudgmental as possible. Confrontational approaches like those seen on television may alienate the individual instead of bringing them closer to treatment and may even result in violence.11,12
When talking to a loved one:11,12
- Schedule the talk for a time when your loved one is sober. Trying to get your loved one to calmly hear your concerns and consider recovery may be far too difficult when they are intoxicated. Tensions may also run higher when alcohol is involved.
- Find creative ways to get your loved one to visit a doctor. You might be able to incentivize your loved one to go to a doctor’s appointment, where they may be persuaded to access some form of treatment. Offer to go with them.
- Express your concerns lovingly. Tell your loved one you’re concerned about their health, and try using “I” statements (e.g., “I feel scared for your health when you drink”) to convey your feelings about their drinking. Avoid lectures or pleas.
- Provide examples. During your conversation, stick to facts and provide specific examples of ways your loved one’s drinking has had a negative impact.
- Don’t use guilt, bribes, or threats. Your loved one is in charge of the decision to get help. You can offer support and ask that they consider it, but you cannot control them. Continuing to offer support while also setting boundaries on what you’ll accept is the best you can do.
Above all, remember that alcoholism is a disease that should be treated with as much compassion and understanding as any other serious medical condition. It can be extremely frustrating, even frightening, to watch a loved one abuse alcohol despite the obvious harm to themselves and the people they love. But an effective alcohol treatment program can help prevent further harm and get your loved one back on the path to a healthy, rewarding life.13
Finding an Alcohol Treatment Center
When you think of addiction treatment, you might default to inpatient rehab; however, there are many different types, or levels, of care in the continuum of substance abuse treatment.14
Often, people start out in a very intensive level of care and then transition to a more flexible outpatient program that offers relatively more independence and autonomy.15 Outpatient rehab programs offer many of the same services and therapies as inpatient treatment centers, but they give people the opportunity to live in the community, attend work or school, and take care of family obligations at the same time.
Stages of Alcohol Recovery
As a person gets help for an alcohol use disorder, they will often go through several stages of treatment. Most often, the first stage is medical detox because alcohol withdrawal may be dangerous or in some cases life-threatening.16
Treatment may then focus on behavioral therapies and skills training in an inpatient or outpatient environment (or both).
Once treatment is complete, the person will be in the maintenance stage which may involve minimal hours of outpatient therapy, moving to a recovery residence, attending regular AA meetings, or taking other steps that help support recovery.
In some cases, after the detox stage, additional medications may also be used to decrease continued drinking behavior in those with AUD. Such medications include acamprosate (Campral), disulfiram (Antabuse), and naltrexone (Vivitrol). The use of these medications may extend into the maintenance stage, as well.
Types of Alcohol Treatment Programs
As a person moves through treatment, they may participate in one or more of the following levels of care:14,15,16
- Medical detox: In this phase of treatment, medical staff manage the patient’s withdrawal symptoms with medications and supportive care. This phase also includes helping the patient make the transition into either an inpatient or outpatient program for continued recovery work.
- Inpatient/residential alcohol rehab: People enrolled in inpatient programs benefit from the supervision and structure of a live-in treatment environment with no access to alcohol or drugs. These programs tend to incorporate individual counseling, support groups, family therapy, 12-step meetings (AA/NA), and other services such as case management.
- Partial hospitalization programs (PHPs): Sometimes called “day treatment,” patients in a PHP attend 4-6 hours of therapy per day while living at home or in a sober living residence. In some cases, the structure and routine of a PHP helps people transition (or step-down) from rehab to life in the community in a safe, supportive environment.
- Intensive outpatient programs(IOPs): The IOP represents a step down from the partial hospitalization program, with even more flexibility than the PHP provides. Patients still participate in recovery activities for several hours per day many times per week, but they may live at home, work, and take care of family at the same time.
- Outpatient treatment: People who participate in more standard, relatively less-intense levels of outpatient treatment may attend therapy 1-2 days per week and live at home.
Together, these programs form a spectrum of services that support long-term sobriety. Greenhouse Treatment Center provides this full continuum of care, offering all levels of treatment in one place so that patients don’t have to bounce around between treatment providers as they progress in their recovery.
Recovery from alcohol abuse does not happen in a matter of days and is not just a matter of completing a 30-day stay in a program. Alcoholism treatment is often a multistep process that demands time, effective therapies, and the support of friends and family. But the time and effort that go into recovery from alcoholism will pay off in the form of improved physical health, stronger personal relationships, and a more positive outlook on the future.
Questions to Ask an Alcohol Treatment Center
Making that first phone call to an alcohol treatment center may feel intimidating. This list of questions will help you structure your conversation with an admissions counselor and find a program that meets your loved one’s needs.
- What are your credentials and accreditations?
- What therapies and alcohol treatment services do you provide?
- Who are the professionals who make up your treatment team?
- What accommodations and amenities does your facility offer?
- Do you offer support and therapy for family members?
- Do you provide aftercare planning and services?
- What forms of payment do you accept?
- Do you offer transportation to your facility?
- How soon can my loved one get into treatment?
Ideally, finances wouldn’t be the major concern for those seeking treatment for alcoholism, but in reality, paying for recovery can be a stressor for those who need help. In many cases, however, paying for treatment may be less of a barrier than you think. Many programs offer financing, loans, or other ways to offset the burden of paying a large sum upfront.
For individuals with limited financial resources, options do exist in the form of:
- Publicly funded detox and rehab programs.
- Sliding scale payments (adjusted cost based on financial need).
Outpatient programs tend to be less expensive than inpatient programs, as well.
Many health insurance plans will also cover substance abuse treatment. For questions, you can contact the treatment center or call the number on your insurance card. For your convenience, Greenhouse also provides a free insurance benefits verification.
The Alcohol Treatment Intake Process
The intake phase is a critical step in the early stages of alcohol treatment. A thorough intake assessment and evaluation will ensure that the course of treatment adequately addresses the patient’s needs. During an intake evaluation, staff may ask about the patient’s:17
- Medical history.
- History of alcohol use and withdrawal.
- Abuse of any other drugs.
- Previous detox attempts.
- Treatment history.
- Mental health history.
- History of personal trauma or abuse.
- Sources of social support.
This information helps the treatment team identify the right level of care for the patient and create a personalized care plan for recovery. Greenhouse Treatment Center’s Admissions Navigators can discuss the right treatment plan for your loved one and how quickly they can get into treatment when you call 972-848-0221.
- National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for Alcohol Problems: Finding and Getting Help.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol Use Disorder.
- National Institute on Alcohol Abuse and Alcoholism. (2003). Alcohol Alert.
- Psychosocial Factors in Alcohol Use and Alcoholism.
- Brady, K.T., Back, S.E. Childhood Trauma, Posttraumatic Stress Disorder, and Alcohol Dependence. Current Reviews, 34(4).
- S. Department of Veterans Affairs. (n.d.). PTSD and Problems with Alcohol Use.
- National Alliance on Mental Illness. (n.d.). Mental Health by the Numbers.
- Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50).
- National Institute on Drug Abuse. (2018). Understanding Drug Use and Addiction.
- UNC School of Medicine, Bowles Center for Alcohol Studies. (n.d.). Alcoholism and Alcohol Abuse.
- S. National Library of Medicine. (2019). Helping a loved one with a drinking problem.
- National Institute on Drug Abuse. (2016). What to Do If Your Adult Friend or Loved One Has a Problem with Drugs.
- National Institute on Drug Abuse. (2015). Addiction Science.
- National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
- Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.
- Columbia County Adult Treatment Court. (2008). Intake Form.
- Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.