AddictionsFor someone close55 min read

Helping someone close who drinks

You count the bottles, you invent excuses, you always argue in the evening and never in the morning. This guide explains why the reproach-against-denial stand-off never works, what research has shown to be most effective in getting someone into treatment, how to speak at the right moment, how to stop shielding them from consequences, how to protect the children, and how to hold up yourself.

In short

This guide is for those close to a person whose drinking worries them: partner, parent, grown-up child, brother or sister, friend, colleague. It starts from what research has established: confrontation and surveillance fail, whereas an approach based on changing the behaviour of the person close by — described under the name CRAFT — brings the person into treatment markedly more often, while also improving the health of those around them. It also gives the essential safety information: abruptly stopping a heavy daily intake can be dangerous, and intoxication with loss of consciousness is an emergency.

Topic: Addictions
Who it's for: For someone close
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The programme

This guide is psychoeducational content. It does not replace a consultation. If the person close to you cannot be woken, is having trouble breathing, has vomited without regaining consciousness, or shows confusion, hallucinations or a seizure, call the emergency services immediately and put them in the recovery position, on their side, while waiting for help. Never push a heavy daily drinker to stop abruptly on their own: severe withdrawal can cause seizures or delirium, and prior medical advice is essential — see section 14. In the event of violence, your safety and that of the children comes before everything else: see section 17. Allow fifty-five minutes to read.

1. Before you begin

You know exactly how much is left in the bottle on the shelf. You found the one in the garage. You rang his work on Monday to say he had a stomach bug. Last night you said the thing you had sworn never to say again, he replied that you were making too much of it and that everybody drinks, and you went to bed angry. This morning he was charming, and you did not dare bring any of it up.

This scenario, with variations, is the one playing out in millions of households. It has a remarkable property: it repeats itself identically for years, without ever producing anything.

Three things, straight away.

You are not the cause, and you cannot be the treatment. You did not bring about this drinking, and no amount of watching, no anger, no proof of love will stop it on the person's behalf. That does not mean you are powerless: it means your leverage lies elsewhere.

What you do matters, and it can be changed. Research has shown that by changing the way the person close reacts — what they encourage, what they stop compensating for, what they say and when they say it — the chances that the person will agree to get help go up markedly. This is not a promise: it is a measured result.

Your health is part of the subject. Those close to people who are dependent have anxiety, depression, insomnia and physical complaints more often than others. This guide is not only a manual for helping the other person: it is also a guide for holding up.

Who this guide is for

For you if you live with someone whose drinking worries you, whether or not the person acknowledges it.

For you if you are the grown-up child of a parent who drinks, or the parent of a young adult.

For you if you are supporting someone who has already stopped and started again.

For you if a friend or a colleague worries you and you do not know whether it is your place.

2. What you are living through

This section is about you, and it has deliberately been placed second. Most people close arrive exhausted, and no one has ever asked them how they were doing.

Permanent vigilance

You listen for the door, you smell the breath, you assess the speech on the phone, you count the bottles in the recycling. This watching never switches off, it occupies the mind all day long, and it damages sleep, attention and mood. It is as exhausting as the problem itself.

The double life

You lie to the employer, to friends, to the family, to the children. You cancel invitations, you invent explanations, you arrive on your own saying that he is unwell. This protective lying isolates you more surely than anything else, and in the end it makes you ashamed of yourself.

The anger-guilt alternation

In the evening, you are furious. In the morning, you blame yourself for having shouted. The person, meanwhile, is charming, and you wonder whether you did not overdo it. This swing is the central mechanism by which people close are worn down.

Self-doubt

'Am I making too much of this?' 'Am I being rigid?' 'Everybody drinks, after all.' When the person minimises, denies, or turns the blame back on you — 'if you weren't like this, I wouldn't drink' — it becomes hard to keep a clear reading of the situation. That is a strong reason to keep a written record, as section 6 suggests.

Grieving the relationship

It is no longer the same person: the plans, the conversations, the reliability, sometimes the tenderness have gone. You are living through a loss while the person is still there, and that kind of grief is recognised by no one.

The effect on your health

The work of Jim Orford and his colleagues, carried out in several countries, has described what those close to dependent people go through: prolonged exposure to considerable stress, real physical and psychological consequences, and a glaring lack of support. Anxiety, depression, insomnia, digestive complaints, high blood pressure, rising use of alcohol or medication in the person close themselves: none of this is weakness. It is what happens when a burden lasts for years.

Some good news

The trials that have evaluated programmes for those close show that they improve the health and mood of the person close, independently of what the person who drinks does. In other words: what you are going to learn here serves you, even if nothing changes in the other person.

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Frequently asked questions

Do you have to wait for him to hit rock bottom? No, and it is a dangerous idea that costs years. The data on brief interventions show that change can happen very early, starting from a simple observation, and the approach designed for family and friends has been shown to bring into consultation people who were not asking for it. Waiting for rock bottom means allowing irreversible damage to happen.

Should I hide or empty the bottles? This has never reduced anyone's drinking: the person buys more, drinks elsewhere, or drinks faster. What you can decide, on the other hand, are your own actions: no longer buying any, no longer serving any in your home, no longer offering any at family meals. In a crisis or where there is a suicide risk, safety comes first and anything dangerous is removed.

He says he is going to stop on his own from one day to the next. Is that a good idea? Not without medical advice if he drinks every day in significant quantity: severe withdrawal can cause seizures or delirium, which are life-threatening emergencies. Tell him so without dramatising: 'I am not asking you to carry on, I am asking you to talk to a doctor about it first, because it can be dangerous.'

Should I threaten to leave? A threat you will not carry out teaches that your words commit you to nothing. Prefer a limit that bears on what you will do, that is precise and that you are certain you can apply. And if separation becomes a real option, it is prepared in the cold light of day, with a third party, never on an evening of argument.

He acknowledges nothing. What can I do? Stop trying to prove it to him: the more you argue that there is a problem, the more he will argue that there is not. Change ground: a dated fact, what you feel, a small request, and above all open questions that get him talking — 'what does it do for you?', 'what would be different if you drank less?'.

Is it my fault? No. You did not cause this drinking, you cannot control it, and you cannot cure it. What you can do is change what you do, make treatment accessible, protect the children and protect yourself — and that is already considerable.

What should I tell the children? The truth, in words suited to their age, in three messages: it is an alcohol problem, it is not their fault, and it is not for them to deal with. Stop saying 'daddy is tired' when daddy is drunk: making a child believe that what they see does not exist is what damages them most.

He relapsed after three months. Is everything lost? No. Relapse is a frequent event along the way and does not cancel out what has been gained. What turns a lapse into a full relapse is what happens in the hours that follow — including your reaction. Say once what you have observed, calmly, then encourage a return to follow-up.

Are groups for family and friends any use? Yes, for you: they improve the well-being of participants and break the isolation. On the other hand, they are not designed to bring the person into treatment, and the approach described in this guide achieves better results on that point. Many people close do both, and that is probably the most solid formula.

Can I talk to his doctor without his agreement? Yes, you can pass on what you observe, by letter or in a consultation. Medical confidentiality will prevent the doctor from replying to you, but they can listen to you, and this information often changes the next consultation. Tell your relative rather than doing it behind their back, whenever that is possible.

He is drunk and falling asleep. Should I let him sleep it off? No. Try to wake him; if he does not wake, call the emergency services immediately and put him on his side, in the recovery position, to prevent him from inhaling vomit. Do not make him drink, do not give him coffee, do not leave him on his back and never leave him alone.

How long should I carry on trying? There is no universally right answer. A useful marker: apply these principles seriously, with support, for six months, and take stock again at that point. And bear in mind that this work improves your own health, whether or not the person accepts treatment.

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