“When it’s good, it’s good. But when it’s bad…”
If you’ve been living with an alcoholic for any length of time, you’re well acquainted with extreme moods swings. You love this person wholeheartedly, but you can’t stand their often-erratic behavior. You’ve tried everything to help them quit drinking, from dumping their stash to threatening to leave to bribing them with rewards. Nothing works. Somewhere along the line, you figured out treatment had to be their choice. You couldn’t do it for them.
So what can you do? How do you go on living in this relationship, despite feeling exhausted and frustrated?
First, remind yourself it’s not your fault — or theirs. No one is to blame for addiction. It’s the consequence of many factors that include genetics, circumstances and emotional health. In order to get better, they’ll likely need medical help.
All you can do is take care of yourself and your family, intervene when the time is right, and support your loved one as they take their first steps toward recovery.
Alcoholism isn’t the same as enjoying a nightly glass of wine. Alcohol use disorder (AUD) is “a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.”1 While alcohol can be harmless in moderation, many people who struggle with AUD often consume much more than the recommended limit of seven drinks a week for women or 14 drinks a week for men.2
High-functioning alcoholics may even drink in secret and hide their disorder from coworkers and friends. But it’s nearly impossible to hide it from those who share a household. And since only one in 10 addicted individuals seek help for their disorder, many families are left to suffer in silence along with their loved ones.3
How Many People Are Affected by AUD?
The National Institute on Alcohol Abuse and Alcoholism estimates AUD affects approximately 17 million people in the United States.4 A more recent study puts that number closer to 30 million.5 Either way, that’s a huge percent of the population struggling with substance abuse and its harmful side effects.
During their lifetimes, alcoholics may face a host of health complications ranging from digestive issues to reproductive difficulty to high blood pressure and stroke.6 Alcohol is also the third leading cause of preventable deaths in the US, killing an estimated 88,000 people every year.7 Nearly 37,000 people died in 2015 from alcohol-related liver disease alone.
Drunk driving is another deadly consequence of heavy drinking. Sadly, there were enough drunk driving deaths in 2015 — 10,265 to be exact — to account for a fatality every 51 minutes throughout the year.8
People struggling with AUD often have persistent cravings when they aren’t drinking, as well as a tough time stopping after they’ve started drinking. Over time, they’ll develop a tolerance to alcohol, which requires them to drink even more to achieve the same results.
Although alcoholism is often linked to genetics, there are other risk factors involved that can turn moderate drinkers into dependent drinkers. Some of these include:
While your spouse or loved one may be a kind and caring person when they’re sober, drinking may turn them into a totally different person. Unfortunately, emotional or physical abuse often accompanies a person’s intoxicated alter ego.
In fact, of all the reported alcohol-related incidents of violence, two-thirds happen within close relationships.11
That means partners and children are at a significantly higher risk of witnessing or being victims of a violent crime, such as assault or battery. If your loved one isn’t physically or emotionally abusive when drunk, they may be harmful to your relationship in other ways, like spending all their free time at bars, frequently missing work or maxing out credit cards. Whether dealing with physical abuse, angry tirades or other issues within your relationship, the strain can become almost unbearable for you as the “responsible” partner.
Estimates show that roughly 11 million children under the age of 18 have at least one parent suffering from AUD.12 While children of alcoholics are known to have a greater genetic risk of developing the disease themselves, many also grow up to face serious emotional and psychological consequences of their upbringing, such as problems with trust and intimacy.12
Children of alcoholics may also experience challenges later in life such as:
Ultimately, you can’t blame yourself for your loved one’s behavior. Be kind to yourself — you’re hurting, and you probably have a lot of anger and resentment built up from years of disappointment and broken promises. The most important thing you can do now is make sure your family is physically and emotionally safe when your loved one is drinking. After you’ve done that, consider seeking support in the form of private counseling or group therapy (such as Al-Anon). You need a safe place to process, heal and find encouragement.
If you have children, make sure they have someone wise to confide in, like a counselor or family friend. And since their other parent isn’t able to provide for their emotional needs, it’s important you are willing to listen without judgment. Also, be sure you’re making time for fun activities and self-care. Don’t put your lives on hold just because one family member can’t participate.
Maybe you’re having a hard time knowing whether or not to stay in your relationship. You still love your partner, but you don’t love this horrible cycle of unknowns. Often, your friends or family members may be too close to your pain to give you solid advice. Naturally, they want to protect you, but you’re the only one who can make this decision. An objective counselor can help you process and work through your emotions. You can also use the following as ways to set limits and know if you need to leave the situation.
When it’s time to confront your partner about their problem drinking, timing is everything. Pick a time when they are sober and avoid threatening them. Focus the conversation on your feelings and concerns. 15 Express them with a tone that is compassionate and non-judgmental.
Many alcoholics will resist attempts to talk about their disorder at first. They may try to explain their drinking away with excuses like, “It’s not that bad,” and “It wasn’t my fault.” They may even try to shift the focus of the conversation to your flaws.16 Be prepared for this and stay calm. Denial often precedes recovery. You are simply sowing the seeds of change right now. Allow time for them to take root.
While an intervention may sound harsh, it may also be the “push” your loved one needs to finally make the choice to seek help. When approaching an intervention, it’s best to have the individual’s bag packed and a treatment center in mind. This way they are less likely to change their mind after agreeing to go.
It’s also helpful to have a professional counselor or therapist present — and possibly a few close friends who will not overwhelm, intimidate or judge them.
During an intervention, be concise in your statements and don’t lecture. Also be prepared to answer any questions that could ease your loved one’s worries about the treatment process.17 If they are unwilling to go, don’t force them. Treatment works best when the person goes willingly. In time, you can try again.
Once your loved one arrives at the treatment center, he or she will likely be admitted, evaluated by a professional, and then begin detox. In some cases, patients will leave post-detoxification and continue with outpatient therapy, while others remain for residential care. This depends on each person’s specific needs.
Residential rehabilitation typically lasts four weeks and provides a consistent alcohol-free and drug-free atmosphere. This is the best option for anyone who has previously failed at remaining sober with outpatient therapy, as it eliminates triggers and distractions that may normally cause the individual to crave a drink.18It’s worth noting that around 95 percent of an alcohol-addicted individuals experience withdrawal symptoms in the mild to moderate range.19 For this reason, medication-assisted treatment may be a good option to alleviate the unpleasant side effects of withdrawal. Again, doctor and patient can talk about this during the course of treatment.
Your loved one can achieve similar methods of treatment and therapy via outpatient programs. The main difference with outpatient care is it’s less regimented and more infrequent. This allows participants the freedom to continue fulfilling life’s obligations, such as going to work and caring for children. Additionally, outpatient therapy most often includes some sort of support group or group therapy requirement, like attendance to 12-Step meetings.18
In deciding which option is best for your loved one, it’s always best to seek guidance from a professional therapist or doctor who can help your family weigh the pros and cons of each type of treatment.
Many rehab patients — both residential and outpatient — have understandable concerns about remaining sober after treatment. Continued support is recommended through a variety of settings, from religious affiliations and support groups to regular follow-up care at the treatment facility itself. Relapse is something every alcoholic and their family should be prepared for, as rates of drug and alcohol relapse range from 40 to 60 percent.20 If this occurs, it’s important to realize that it doesn’t mean your loved one has failed. With the skills they learned in treatment, they can course-correct and keep moving forward with their sobriety.
You can’t change your partner or loved one. You know that. But if they choose to get treatment, your support will be crucial for them in the long run. After treatment, continue to help them by steering them away from the temptations of alcohol and encouraging them to keep going in the wake of a relapse.
If they are unwilling to undergo treatment right now, that’s not a failure on anyone’s part. Instead, turn your focus to setting healthy boundaries for yourself and your family. Your life is still worth living to the fullest. Be the best version of yourself and, hopefully, they will choose to join you when they’re ready.
Integrated Treatment of Substance Abuse & Mental Illness