If
it hasn’t happened already, sooner or later someone close to
you will experience a problem with alcohol or other drugs. While in
college it may be a roommate, a teammate, a loved one or a friend.
Beyond college it might be a relative, perhaps your father or mother,
an employer, an employee, a future spouse or maybe a son or daughter.
I guarantee that it will happen.
When confronted with this situation, we tend to feel helpless and
hopeless. After all, conventional wisdom states that you need to wait
for the person to hit bottom before he or she will seek help. But
conventional wisdom isn’t always wise, especially when it comes
to alcohol and other drugs. You may not be able to help someone who
has an alcohol problem until that person hits bottom, but you can
raise the bottom!
WHEN
“How do I know if
she is an alcoholic? She now vomits blood, complains of stomach problems
and drinks almost every night until she stumbles home. Sometimes she
even drives home. How can I be sure she is an alcoholic?”
Anonymous
As indicated in the “Addiction” chapter of my book Beer,
Booze and Books...a sober look at higher education, it is difficult
to assess whether or not someone is actually addicted to alcohol.
But, that should not be the question you are asking yourself. If drinking
is causing problems in someone’s life then the person should
be confronted about the drinking. In the situation cited above, it
is obvious that the drinking is causing problems. Is the person an
addict? We do not know—but she definitely needs immediate help.
You don’t need to wait—you shouldn’t wait—until
a more serious problem arises. You don’t need to wait until the
person hits bottom. That’s like saying if you had a friend or
loved one perched on the edge of a bridge ready to jump—ready
to commit suicide—you would allow the person to jump, then run
down to where your friend hit the bottom and pick up the pieces. Consider
this: If not now, when? If not you, who?
Phases of Drinking
Following is a description of the behaviors associated with the phases
of drinking. As you read through it, try to determine what phase you
are in if you drink. You do not need to experience all of the issues
to be considered in a particular phase. You might experience all or
some of those things described in each phase.
Phase 1: (Social Drinker)
- Joe and Jane may choose to drink once in awhile.
- When they do drink, they do not get impaired. Since they do not
drink to impairment, there’s no increase in their tolerance.
- There are no negative outcomes from their drinking.
- They have a take-it-or-leave-it attitude about drinking.
Phase 2: (Social Drinker)
- Jane and Joe enjoy drinking. They drink regularly, perhaps two or
three times per week.
- When they do drink, they usually get impaired. Because they are
drinking to impairment, their tolerance is increasing.
- There are no apparent negative outcomes from their drinking, except
maybe a hangover once in awhile.
- They generally look forward to the weekend so they can “really
let loose.”
Phase 3: (Problem Drinker)
Early Phase:
- Jane and Joe drink regularly.
- They get impaired regularly. Their tolerance is continuing to increase.
- They arrive late for classes and sometimes cut classes due to drinking
and/or hangovers.
- The quality of their school work is inconsistent. They are missing
deadlines.
- They seem to be preoccupied with drinking.
- They might experience a blackout.
Middle Phase:
- Jane and Joe begin to cut classes regularly.
- They become unreliable. Their personal relationships begin to suffer
from disagreements with roommates, teammates and/or friends.
- They avoid situations where there is no drinking.
- They become ill more frequently.
- They experience more money problems.
- They drink in the morning once in awhile to cure their hangovers.
Late Phase:
- Jane and Joe cut classes a week at a time.
- At times their attitudes are belligerent and aggressive or passive
and withdrawn.
- They experience many personal problems with friends and family.
- They have more money problems. Maybe they get a job to support their
partying.
- They may get a DUI violation or encounter serious trouble with school
administration.
- Their academic performance may deteriorate drastically.
Phase 4: (Addicted to Alcohol: Alcoholic)
- Jane and Joe become totally undependable. They experience serious
family and other relationship problems.
- They drink to cure their withdrawal from alcohol.
- They experience serious legal difficulties.
- They get suspended or drop out of school.
- They experience many other negative outcomes.
Can someone consume alcohol and not experience any serious alcohol
problems? As you can see, drinkers in Phase 2 may be doing just that.
They are out drinking, getting impaired yet not experiencing any problems.
But—and it’s a huge but— each time we drink to impairment
our tolerance increases. We know that if we continue to drink to impairment,
our tolerance will continue to increase - it is a biological fact.
As a result, the increasing tolerance moves us eventually to Phase
3 and eventually to Phase 4. (That is why increasing tolerance
is always an indicator of increased risk for alcoholism. The student
who brags about his or her ability to consume excessive quantities
of alcohol is actually revealing, and ignorantly bragging about, his
or her increased risk for alcoholism.)
During
what phase would you confront someone about their drinking? Most well-intentioned
friends or relatives might confront Joe or Jane in Phase 2. And that
might seem to be an appropriate time. However, as much as we would
like to see it, we should not expect them to change their behavior
if they are in Phase 2. After all, they are drinking, having a good
time and are experiencing no apparent negative outcomes. In their
minds, they believe that drinking is harmless and fun—that they
have everything under control. This does not mean we should not say
something to them. Their tolerance is rising, and they will probably
experience problems sooner or later. They need to be informed that
their increased tolerance is an indication of increased risk.
If you confront them in Early Phase 3, there are more concrete reasons
for them to examine their drinking. They are experiencing negative
outcomes, and these can be highlighted as reasons for considering
a reduction in consumption. Also, their tolerance is becoming dangerously
high. They are continuing to come closer to their trigger level for
alcoholism.
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HOW
“This information
was very helpful when I confronted my friend. This could help save
the lives of many college students.”
John S., Keene State College senior
“My friend made it clear to
his girlfriend that he was doing this because he cared about her.”
Ralph S., Franklin Pierce College sophomore
“How can I approach him without getting him upset?”
Anonymous
“I don’t
like seeing my friend hurting herself over and over, but she really
doesn’t think she has a problem. When anyone does say anything
she gets defensive.”
Anonymous
Alcoholism is considered to be the disease of denial.
But the seeds of denial are planted long before the actual addiction.
There are ways to break through the denial. Here are some guidelines
to follow when confronting someone you believe has an alcohol or other
drug problem:
- Be well-informed about alcohol. There are professionals on most
campuses trained to work with students and their alcohol concerns.
Some campuses offer academic courses about alcohol and other drugs.
- Choose your time and place carefully. Confront the person in private
and when the person is sober.
- Expect denial. Most people experiencing problems with alcohol have
developed an intricate web of psychological defenses. These defenses
manifest themselves in the form of denial of the problem.
- Be confident and positive. Indicate you care for the person but
not the behavior.
- Call for help when necessary. Friends, residential life staff, relatives
and/or counselors can be of valuable assistance. In some situations
an organized intervention coordinated by a professional health care
worker may be necessary.
- Get help for yourself. Relatives and friends of people experiencing
alcohol problems also experience their own difficulties. Find help
through your own friends or support groups such as Al-Anon.
- Choose your words carefully. Don’t label the person. Avoid
terms like alcoholic or problem drinker. Simply state that the drinking
is causing problems.
Here’s a framework within which you can present your concerns.
This may make your confrontation more acceptable to the drinker:
“I care ...” Indicate your care and concern for the
person. For instance: “I love you.” “You are my best
friend.” “I care about you.”
“I see ...” Describe the specific behaviors that
concern you. For instance: “For the past three weekends you have
gotten into a fight after drinking.” “You have missed class
every Friday morning for the past five weeks because you were hungover.”
“I feel ...” Describe how you feel. For instance:
“I’m concerned that you are going to fail out of school.”
“I’m worried about our relationship.” “I get angry
when I know I can’t count on you.”
Listen ... Give the person an opportunity to respond.
“I’d like ...” Indicate what you’d like
the person to do. For instance: “I’d like you to go to the
Counseling Center.” “I’d like you to stop coming over
here when you are drunk.”
“I will ...” Offer your support and indicate what
you will do to assist the person. For instance: “I’ll find
out about what professional assistance is available.” “I’ll
go with you to see the counselor.”
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EXPECTATIONS
You can be sure that if you confront someone regarding
their alcohol or other drug use, their immediate response will not
be “Thanks for pointing that out. I’ll go see a counselor
right away.” More often than not the response will be some form
of denial:
Excuses: “I’ve been really stressed out lately.”
“I’m carrying 18 credits and need to loosen up when I can.”
“We lost the game by two points.”
Anger: “Get off my case.” “Up yours!”
Blame: “My boyfriend has been really bugging me lately.”
“I had a tough test today.” “My professors are too
demanding.”
Projection: “Yeah right, well what about you?” “So
what, this is college. Everyone drinks.”
Minimizing: “It’s no big deal.” “I’ve
got it under control.”
If you are serious about helping someone, you need to understand that
success in this situation comes in a variety of forms. Obviously,
if the drinker were to agree with you, seek help and reduce the drinking,
you were extremely successful. Great! There are also other levels
of success. The person may simply agree and decrease the consumption
but not seek professional help. And that might be OK. However, the
person may simply agree but make no changes. Is this failure? No!
Most people in rehabilitation say they sought help because a friend
and/or relatives suggested they seek help. For many of them, it may
have taken up to thirty confrontations before the person actually
sought help. In your situation, maybe you are the first person to
confront the problem drinker, and maybe you are the tenth, but maybe
you are the thirtieth—the person might finally make the move.
At the very least, despite the denial, the person will never drink
again without having your concern echo in the back of his or her mind.
And that helps!
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ENABLING
“My boyfriend had serious
problems with alcohol. But I always tried to make him happy. I always
tried to fix his problems. Thank goodness I stopped doing this because
it only made me feel worse and certainly didn’t really help him.”
Anonymous
“I guess in a sense I was an enabler. I was
always taking responsibility for his actions which I guess made things
worse.”
Carla J., University of Maryland first-year student
A behavior pattern that’s easy to fall into if
you have a friend or relative with an alcohol problem is enabling.
Enabling is the process of removing the normal consequences of drinking
from the drinker. The wife who calls her husband’s boss and claims
he has the flu when he is really hungover is enabling his drinking.
The enabler shelters the drinker from the drinking problems. The drinker
fails to see the drinking as a problem when the enabler provides protection
from the consequences of drinking. The drinker then fails to see the
need for help. Enabling can be defined quite simply as “good
intentions with harmful results.”
Students tend to believe they are helping their friends when they
enable in the following ways:
- Make excuses for the drinking behavior
- Obtain notes from classes missed by the drinker due to her drinking
or hangover
- Lend money for alcohol purchases
- Submit projects for the drinker because she was too hungover to
make it to class
- Buy alcohol for the drinker
- Try to occupy the drinker’s time so there won’t be time
to drink
- Blame the drinking on friends or circumstances
- Drink with the person so you can watch over him when he is drinking
- Vow not to do any of the above yet find yourself doing it again
These may seem like friendly gestures, but they simply contribute
to further drinking. Why should the drinker make any changes if there
are no perceived problems due to the drinking?
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DETACHMENT
“I feel awful for
just giving up on him, but I tried for three and one-half years to
help him and failed in my efforts to do so. I tried to be a good friend
and it seems all I got were huge amounts of frustration.”
Anonymous
“It was very difficult to walk away from someone
I cared about, but it came to the point where it was the only solution.”
Anonymous
There may come a time when you believe you can no longer
associate with the drinker while he or she is using. Only you know
when this time has been reached. It is extremely important that you
let the person know why you are severing the ties of your friendship.
Do not simply avoid the drinker. If you do, he or she will probably
project the problem back onto you. Let the drinker know how you feel.
Use the process suggested above. Then, at some point you may need
to lovingly detach from the drinker if the situation becomes too difficult
for you. Yes, this can be extremely difficult. But what is your choice?
Finally, be sure to leave the door open for the time when the person
may finally agree to seek help.
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