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.
Dr Zayan Al-Falasi, psychiatrist
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 those around the person — described under the name CRAFT — brings the person into treatment markedly more often, while also improving the health of those who apply it. 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
- Languages
- FR · EN · DE · IT · ES · ZH · AR
Français · English · Deutsch · Italiano · Español · 中文 · العربية
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 come before everything else: see section 17. Allow sixty minutes to read.
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What the rest contains
- 3. Understanding dependence from the outside
- 4. The reproach / denial stand-off: what does not work
- 5. What the research says
- 6. Taking stock: observing and measuring
- 7. The family approach: the principle
- 8. Choosing the moment, and the words
- 9. Reinforcing what is going in the right direction
- 10. Ceasing to protect from consequences
- 11. Setting limits you can hold to
- 12. Proposing treatment at the right moment
- 13. If the person accepts, if they refuse
- 14. Withdrawal: what someone close needs to know
- 15. Alcohol-related emergencies
- 16. The children
- 17. Violence and getting to safety
- 18. Your health and your exhaustion
- 19. Groups for family and friends
- 20. Relapse
- 21. Particular situations
- 22. When nothing changes
- 23. When to seek help, and what to ask for
- 24. Six weeks, step by step
- 25. Frequently asked questions
- 26. Key points
- 27. Sources and foundations
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 brought anyone's drinking down: 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? It depends on his condition. If he wakes when you call him and is breathing normally, you have a choice: stay close to him, or sleep in another room after checking that he is sleeping on his side. If he is heavily intoxicated, hard to wake, vomiting or breathing poorly, do not leave him alone. If he does not wake or is breathing poorly, 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.
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.