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Questions posted in the
The Addiction Forum have been answered by
Steven Adelman, M.D. and by Richard C. Bozian M.D. F.A.C.P. of Harvard Vanguard Medical Group.
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Subject: Re: help for the unwilling (and unwilling helpers) My sister is in her early 40's and has been drinking and smoking for most of her life. She also used pot and other controlled substances but as far as I know no longer does. The problem is twofold, my sister and her husband. My sister finally admitted a few years ago that she had an alchohol problem and we thought that was the beginning of getting over it. She now says a) she's not an alcholic because she doesn't drink every day (the days she doesn't drink she is recovering from being drunk); b) she can quit drinking for a week just to prove she can but she won't be happy, the only time she thinks she's happy is when she's drinking; c) she won't ever go to AA because even if she did quit drinking the last thing she wants to do is listen to a bunch of people talk about not drinking. Her husband unfortunately belives he can convert her to a light drinker. He also smokes but only drinks occaisionally. He tries to convince her to stop after one or 2 drinks and doesn't realize that she just can't, she has no control over that anymore. I told him recently that if he really wanted her to quit then he would have to quit as well so there would be no temptation. He either doesn't understand that or doesn't believe it. A little more history might help. Alchoholism seems to run in the family, many uncles and one aunt as well as my brother have battled it and won (if there is such a thing as winning). I rarely drink (maybe 3 or 4 a year) because I'm afraid I won't be able to stop eventually. Our mother doesn't drink at all for the same reason. She is chronically depressed and on medication at the moment. She has other symptoms like dizzyness and insomnia which are quite likely caused by the interaction with the anti-depressants but she won't believe us on that one. At this point it is starting to strain the marriage and I don't want to see that happen. I don't know what I can do if she is not willing to seek help. Any suggestions on that one or how to convince her husband that he can't get her to just cut back? We have discussed an inpatient detox but that will be very expensive and he is reluctant to commit to that. Personally, I think that may be the only way. Any insights you can provide would be greatly appreciated.
_______ People like your sister who lose control of their drinking and drink to get drunk are NOT candidates for controlled or moderate drinking. They should stop altogether and abstain indefinitely. It is extremely frustrating that what is so obvious to you (that your sister would be better off eliminating alcohol altogether) is not at all obvious to your sister or, for that matter, to her husband. Although they are both manifesting significant denial with regard to the seriousness of her drinking problem, I find it most helpful to assume that someone like your sister probably has some mixed, or ambivalent feelings, about whether or not it is advisable for her to go on drinking. I might ask her to answer the following question: Is there anything that you can imagine occurring to you in the future that would indicate to you that you would be better off stopping drinking for once and for all? If her answer is that she cannot imagine such a situation, then I would probably back off and just repeat this question periodically until she gave me a more positive answer. The only other thing I might do is to let her personal physician know that you believe that your sister has a drinking problem. Many doctors don't know how severe their patients' drinking problems are. Once clued in, it is possible that your sisters' doctor might examine your sister more thoroughly in order to detect some of the many medical problems associated with alcoholism and alcohol abuse. Your sister might be more likely to cut it out altogether if her doctor informs her that she is already manifesting evidence of alcoholic liver disease and that she should not be drinking at all. The bottom line is this: Your sister is not going to stop drinking until she is convinced that she would be better off doing so. Until that time, you should attend Al-Anon meetings, and get to know some other people who are contending with loved ones with serious drinking problems which fail to respond to the help and concern of others. Check out the Drinking Section of my Ask DrSteve web site, which is conveniently hyperlinked below, for additional information about how to approach such situations. Good Luck! Steve Adelman, M.D. (a.k.a. DrSteve)
Keywords: alcoholism, denial, Al-Anon, co-dependence
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