It is not news that alcohol misuse is a major public health problem. In fact, it is the third leading cause of preventable death in the United States. The National Council on Alcoholism and Drug Dependence estimates that 95,000 people in the United States die each year from the effects of alcohol. NIAAA (National Institute on Alcohol Abuse and Addiction) describes alcohol abuse as an impaired ability to stop or control it’s use despite consequences. They estimate nearly 15 million people in the United States suffer from this (9.2 million males and 5.3 million females). It is considered a chronic relapsing brain disorder and only approximately 10% get treatment.
I would often get the question from patients about what is considered “unhealthy drinking.” A male drinking more than 14 drinks per week (or more than seven drinks per week for a female) is “at risk.” Research suggests an even simpler question: “How many times in the past year did you have five or more drinks for a male, four or more for a female in one day?” An answer of one or more needs further evaluation. One alcoholic drink includes 12 ounces of beer, 1.5 ounces of liquor, or 5 ounces of wine.
Let’s change gears. There is another group of people profoundly affected by alcohol. It is the friends or family members of the drinker. If there are 15 million problem drinkers in the United States, and there is, let’s say, an average of two or more people for each affected, well, you can do the math. The number of families impacted is staggering. Mine was one of them. In 1983, Janet Woititz wrote Adult Children of Alcoholics. She broke through the barrier that the disease of alcoholism is confined to the drinker. She identified that addicts are surrounded often by people who want to believe them, and as a result, unknowingly become part of the disease pattern. I think many of us are tempted to quickly try to fix a “problem” so that we do not have to feel the pain or the discomfort. Often this leads to frustration and is not helpful.
I would like to introduce three “A” words: Awareness, Acceptance, and Action. These describe a technique that many behavioral health therapists teach about how to approach challenging situations in life. This certainly applies to the families of problem drinkers.
Awareness: Slow down long enough to fully understand and perceive the situation. Take time to give conscious attention to what’s going on. Be mindful in the moment and alert to all aspects of the situation. Pay attention to the challenge and how you feel about it. Put the situation under a mental magnifying glass for greater clarity and insight.
Acceptance: I call this the “it is what it is” step. Being open, honest, and transparent about the situation helps reduce the feelings of shame. Accepting is not condoning.
Action: For many of us “fixers” we jump to knee-jerk solutions. Thoughtfully consider your choices, including (and this sounds radical!), how you feel about it. You do have a choice.
Resisting the impulse to “do something,” and thoughtfully considering what actions to take is powerful. One of those actions you can take is self-care. Being connected to someone struggling with the disease of alcoholism can be overwhelming. If you are depressed or stressed, it can be very helpful to seek help from a counselor or therapist. You can also participate in a program that’s designed for the friends and family members of alcoholics, such as Al-Anon.
There’s one more word we should discuss. It does not start with the letter A, but it is worth noting. Codependency. It is a word we often hear but may not completely understand. I didn’t.
The best definition I have seen for codependency is a pattern of prioritizing needs of a partner, spouse, family member, or friend over your personal needs. Think of it as support that’s so extreme it becomes unhealthy. You can love someone, want to spend time with them and be there for them…without having to direct or manage their behavior. You feel empowered by being the helper and they become more and more dependent on you. Bottom line: stop offering solutions and trying to “fix” the people you care about, especially when you are not asked.
I will finish with four other words you come to understand when you stop the dance with the active alcoholic. In this case they all start with the letter “C.” You soon realize that you did not cause it, you cannot control it, and you cannot cure it…but you can certainly complicate it.
References and Resources