How to Help a Loved One Who Drinks Too Much

By Tom Horvath, Ph.D., ABPP

Does your loved one drink too much during the holidays?

Or at any time for that matter? What’s the best way to respond? Here are some general guidelines for navigating this challenging time. Every person and situation is different, so these guidelines are just a beginning. Let’s start with what is ineffective and possibly harmful.

Don’t ignore the excessive drinking.

Sometimes ignoring a problem is sensible, especially if it clears up later on its own. Here we assume it is not clearing up. Like drinking too much, ignoring problems is a short-term solution that masks, or tries to mask, something deeper.

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Don’t tell your loved one what to do or how to do it.

Perhaps the most important fact about addiction recovery is that when you tell someone what to do, they generally assert their freedom to do what they want, or worse, they assert their freedom to do the opposite of what you want. This tendency is known in the psychology literature as psychological reactance. Unless you are sending your loved one into an extremely secure environment (whether or not these actually exist is debatable), without cooperation your “orders” will be over-ridden. You can’t make anyone do anything – you are going to need cooperation.

Don’t bring up the subject when your loved one is intoxicated.

Your loved one may not even remember the conversation. Regardless, approaching the conversation when they are drunk isn’t likely to be effective. They are much less likely to be cooperative or sensible and they may even become hostile.

For a greater chance of a successful outcome, keep in mind the following guidelines regarding what to do:

Do take care of yourself.

Think of the Red Cross’s guideline about rescuing someone who is drowning: help the individual if you can, but it’s not worth both of you going down. Taking care of yourself might include seeking brief counseling or therapy for yourself, to consider your options for self-care and how to respond.

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Do learn about CRAFT (Community Reinforcement and Family Training).

Even though CRAFT is not yet widely known, there are increasing resources for learning this evidence-based approach to helping a loved one change. Even if you cannot find a CRAFT practitioner, the principles of CRAFT may be sufficient to help support change while taking care of yourself. CRAFT is a slow but steady, systematic and effective method for analyzing what is maintaining your loved one’s problematic addictive behavior, and changing those maintenance factors over time.

Do check out SMART Recovery’s free Family & Friends groups.

Even if you don’t have a face-to-face group in your area, online meetings are available. These groups are based on the principles of CRAFT and SMART Recovery. Not only are you likely to learn important ideas for supporting change in your loved one, you will also experience the support of individuals in situations similar to yours.

Do decide when to talk, and possibly make an appointment for it.

“I have an important subject to discuss with you. I want to set aside time to do so. How about ….” In some cases it will be better to start without warning, but at a time when interruptions are unlikely and before substance use begins for the day.

Do prepare what to say.

You are likely to be somewhat tense or worse, angry. Yes, you may have reason to be angry. However, venting your anger probably will not serve your goal (to have a loved one without addictive behavior problems). Whether you are tense or angry or are experiencing some other feeling, preparation is crucial. The sequencing of the following elements of the conversation may vary from person to person.

• Express your love or affection for this individual: “You are the most important person in my life,” or “I care deeply about you and your well-being,” or “our relationship is very important to me.”
• Describe what you have observed: “At Thanksgiving dinner you were intoxicated enough that everyone was trying to ignore you, and then they left early because they were so uncomfortable,” or “we have conversations that you don’t remember because you have been drinking,” or “even though your doctor told you that your health was declining because of alcohol, you keep on drinking and your health is declining, just as she predicted.”
• State why you are bringing up this subject: “I don’t know too many others who would be willing to talk with you about this sensitive subject. I bring it up because I am very concerned about you, and I believe you can change. However, I think you may need a reality check and some encouragement, because you have been slow to change on your own.”
• State your desired outcome: “I want to have holiday meals without worrying about whether you’re going to get intoxicated,” or “I want to have conversations and know you will remember them the next day,” or “I want your health to start improving not declining.”
• State your commitment to assist: “I want to learn from you how I might help you change. Even if it is just listening to your progress, or talking with you when it’s hard for you, or helping you remember the reasons to change, I think I could be of assistance, and I want to be.”
• Ask for a plan: “How much time do you need to think about this situation? It’s been going on for awhile. It is not up to me to tell you how to change. I can help you look for outside help if you want it. There are many types of help available. I think the most important part, though, is you making a decision to change. I’m not going to focus on how you do it, that’s up to you. However, I am going to focus on results.”
• Arrange a follow-up discussion: “I understand you may need some time to think. How about if we talk again tomorrow?”

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Remember the language and actions NOT suggested here.

There is no labeling (“addict” or “alcoholic”), demanding treatment (such as 30 days in rehab), demanding other specific methods, establishing deadlines and harsh consequences, accusing your loved one of being in denial, or angrily confronting your loved one about anything. “Intervention” may look powerful on TV but do you really want a scene like that in your living room? In fact the slower and less dramatic methods of CRAFT work much better. All of the suggestions here are consistent with that approach.

Be prepared to take further steps if needed.

Most people overcome problematic addictive behavior on their own. The suggested conversation you have with your loved one, if carried out calmly and purposefully, can be a turning point. However, you don’t need to wait for change indefinitely. It may soon be necessary to set some boundaries. Keep in mind that setting boundaries means establishing and communicating what YOU will do. Choose consequences that naturally follow from what is happening: “I have given up hope of your moderating your drinking. Your problems are as bad as ever, even though you claim to be moderating. I’m not willing to live like this. If you don’t begin abstaining, the kids and I are moving out” or “We are not having any more holiday dinners here until I see a solid track record of success. I’m not willing to endure that embarrassment anymore” or “whenever you get carried away I’m going over to my mom’s house because you are too unpredictable and it is very painful to me. I would be better off away from you.” With action upon sensible boundaries your loved one’s motivation to change may indeed increase.

If your loved one does decide to seek help, there are many options available, including residential treatment, outpatient, sober living and detox for those in need. If you need help figuring out the next steps to take, give us a call. If we aren’t a good fit for your loved one, we can recommend someone who is.