In this article you will learn to recognize Alcohol Use Disorder for yourself or a loved one. Then, know how to approach it and where to seek help using CRAFT, the Community Reinforcement and Family Training method. Here, we explain the symptoms, the condition, and where you can turn for help. Read and learn more.
The Definition of a “Problem”
- Missing social, work, or school obligations after a party.
- Regretful behavior.
All of these come with drinking. But are they signs of a drinking “problem”?
By definition, unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems.
If your loved one’s pattern of drinking results in repeated significant distress and problem functioning in his/her daily life, then they likely need professional help. Technically, Alcohol Use Disorder is a pattern of drinking that involves problems with controlling alcohol intake. So, a person has a drinking problem when they are:
- Preoccupied with alcohol.
- Continue to use alcohol even when it causes problem.
- Have to drink more to get the same effect, or
- Experience withdrawal symptoms when drinking is rapidly decreased or stopped.
In this article, we’ll explain how you can approach the problem with a loved one. We’ll also provide you with ideas on the practical ways you can discuss the issue with your family member, friend, partner or colleague who has alcohol use disorder. Then, if you want to know more on how to address the alcohol problem of someone you love, we invite your comments or questions at the end.
Are You Overreacting?
Moderate use of alcohol does not do serious harm to healthy adults. However, many adults who could be diagnosed with an Alcohol Use Disorder have gotten to a point where their drinking causes distress and harm.
You are NOT overreacting about an alcohol problem if drinking alcohol causes your loved one:
- Cravings, or a strong urge to drink.
- Legal or social problems.
- Loss of control or finding hard to stop drinking once they start.
- Physical dependence including withdrawal symptoms.
- Problems at home, school, or work.
- Tolerance, or when more alcohol is needed to feel the same effects.
The Test for Problem Drinking
While you might miss some of the more subjective signs of a problem…the “road test” for problem drinking is really how much alcohol a person consumes. In fact, according to the NIAAA, the National Institute on Alcohol Abuse and Alcoholism and the 2015 Dietary Guidelines for Americans
High-risk drinking = 4 or more drinks on any day or 8 or more drinks per week for women.
High-risk drinking = 5 or more drinks on any day or 15 or more drinks per week for men.
Binge drinking = 4 or more drinks within 2 hours for women.
Binge drinking = 5 or more drinks within 2 hours for men.
You can test drinking patterns on the Rethinking Drinking website.
Benefits of Early Action
Alcohol is often used as a social beverage and people are not showing any clear signs of having problems with addiction. But there may be unrecognized health risks that can lead to serious issues. That’s why early detection is key of eliminating serious alcohol use problems. Here are some signs that can indicate alcohol use has become a problem:
- Drinking leads to health problems.
- Drinking interferes with treatment for a health condition.
- Drinking creates an increasing amount of risk for accident and serious injury.
If you are suspicious whether your loved one’s alcohol use involves these and other risk factors, you seek out an assessment using the Alcohol Use Disorders Identification Test (AUDIT). NIDA share a user-friendly AUDIT assessment here. This is a test approved by major health and medical institutions, including the National Institute on Alcohol Abuse and Alcoholism, and the World Health Organization. It is being added to doctors’ office practices, emergency rooms and other health and services provider settings.
What Can You Do About It?
Unfortunately, unless you’re the one with a drinking problem…you can’t do much about it. You can skip to the next section for help on how to cope in the meantime.
If you’re ready to address a drinking problem for yourself, you can first ask for help from a healthcare provider like your family doctor or general physician. S/He will examine you and ask you about your medical and family history, as well as alcohol use. Your provider may order tests to check for health problems that are common in people who use alcohol that may include:
- Blood alcohol level (This shows if you have recently been drinking alcohol. It does not diagnose alcohol use disorder.)
- Complete blood count
- Liver function tests
- Magnesium blood test
You might also consider talking with someone who has had a problem drinking, but has stopped. That should not bring you under pressure, just make you are aware of the problem you may have and find a way to put it to an end.
To summarize, if you feel that sometimes you drink too much and drinking is causing you problems, or if your family and friends are concerned about your drinking habits, you can ask for help and speak with:
- Your primary doctor
- A mental health provider (psychologist, psychiatrist, or counselor)
- A support group (such as Alcoholics Anonymous, SMART Recovery, or a similar type of self-help group)
NOTE HERE: You cannot change anyone other than yourself. However, you can approach the subject with your loved one.
Planning for Denial
Keep in mind that in such situations, denial is common. Your loved one may not feel like s/he has a problem with drinking. They might not recognize how much they drink or how many problems in their lives are related to alcohol use. Plus, people say the darndest things. Most problem drinkers will have multiple objections to getting help:
- Who will take care of work / the kids / the pets?
- I can’t leave or seek treatment. I have an important meeting on Monday!
- I’m still performing OK. No one else has complained about my drinking.
In cases when denial is profound, professional help can be essential.
Working with a certified interventionist or addiction counselor can help you gather relatives, friends or co-workers to bring drinking habits to light. While you can encourage your loved one to seek help on your own…you might not be as prepared to face the denial as you thought. So, while you can plan an intervention on your own, sometimes it’s best to seek advice from a trained professional.
CRAFT: How to Cope in the Meantime
If you want to cope with a loved one’s drinking, there is help! Some of the more common actions that family members take include:
- Talking with a family counselor.
- Planning a formal intervention with the help of an interventionist.
- Speaking with a treatment center directly.
- Seeking help from groups like Al-Anon.
However, we’d like to introduce a new concept in this article that you may have not heard of. It’s called the Community Reinforcement and Family Training (CRAFT) method. CRAFT is a scientifically based intervention designed to help loved ones to engage treatment-refusing substance abusers into treatment. It was developed by Dr. Robert Meyers, Ph.D. in the late 70’s as an alternative form of interventions.
Basically, CRAFT teaches families behavioral and motivational strategies for interacting with their loved one over the course of 8-12 weeks. CRAFT works to affect the loved one’s behavior by changing the way the family interacts with him or her. In fact, it’s a skills-based program that impacts families in multiple areas of their lives, including self-care, pleasurable activities, problem solving, and goal setting.
At the same time, CRAFT addresses the resistance to change usually seen in alcohol-dependent individuals. This approach teaches families behavioral and motivational strategies for interacting with their loved one. It is designed to accomplish three goals:
- When a loved one is abusing substances and refusing to get help, CRAFT helps families move their loved one towards treatment.
- On its own, CRAFT helps reduce the loved one’s alcohol and drug use, whether or not the loved one has engaged in treatment yet.
- CRAFT improves the lives of the concerned family and friends.
Advice here from the American Psychological Association (APA) on How to Find a Good Therapist. Your state’s psychological association may be another source of potential names. Another way to find a therapist is to ask friends or your physician to suggest someone they trust. You can search online directories for people practicing CRAFT here:
Deciding on goals for yourself and your family is ultimately a personal decision, and is different for each individual. Some people may only be ready to minimize their drinking instead of giving it up entirely, for example.
But, before attempting anything …we suggest that you consult a doctor, a family counselor, or other behavioral healthcare professional to help inform you about your next step. The fact is that alcohol problems can be deep-seeded. They often require multiple attempts towards abstinence. And, some cases of heavy drinking require 24-7 medical supervision, especially during detox.
You don’t need to be strong.
You don’t need to do it on your own.
Reach out for help. It will be there.
Still feeling insecure about addressing a loved one’s drinking problem? Do you have more questions about getting alcoholism help? Or do you have more information about alcohol addiction to share? Feel free to leave a comment below and we will get back to you personally and promptly.