Supporting a Loved One: How To Help an Alcoholic on the Path to Recovery

Alcohol addiction is one of the most common substance use disorders worldwide. In the U.S. alone, a 2021 survey estimated that 29.5 million people 12 years and older had an alcohol use disorder (AUD) in the previous year. Difficulties such as relationship issues, economic uncertainties, and excessive work demands push more and more people to use alcohol as a coping mechanism.

While some people struggle with binge drinking or gray area drinking, others become addicted and unable to function in their everyday lives. Knowing someone who is struggling with addiction can be challenging. We often don’t know how to help an alcoholic loved one, especially when they don’t want help. But knowing how to deal with an alcoholic friend or family member is essential to getting them on the road to recovery.

Let’s explore the underpinnings of alcohol addiction and recovery, the health risks involved, and how to help an alcoholic loved one. Then, let’s also look at support groups for families of addicts that can help us feel less alone.

What Causes Alcohol Addiction?

Addiction involves a hijacking of the brain's reward system. Alcohol stimulates the release of dopamine, a neurotransmitter associated with pleasure and reward. This release reinforces alcohol consumption by associating drinking with happiness and relaxation. 

However, as consumption continues, the brain's chemistry adapts. The brain dampens its dopamine response, leading to tolerance — a state in which more alcohol is required to achieve the same euphoric effect. Concurrently, other neurotransmitter systems such as glutamate and GABA, which are crucial for brain function and mood regulation, are thrown off balance, impacting cognition, decision making, and emotions.

But the story of addiction doesn't stop at neurobiology. The psychological landscape is equally complex. People often turn to alcohol as a refuge from distressing psychological states. Stressful life events, persistent anxiety, and depressive disorders can push us towards the numbing effects of alcohol. This maladaptive coping strategy creates a vicious cycle in which someone drinks to alleviate psychological pain, but the drinking behavior ultimately exacerbates that pain.

Complicating matters further, societal stigmas surrounding addiction often lead to shame and isolation, which can discourage struggling people from seeking help. This stigma can perpetuate a sense of hopelessness and perpetuate the cycle of addiction.

Understanding this struggle is essential to knowing how to help an alcoholic loved one. Addiction is not a lack of willpower; it’s a tangled interplay between altered brain mechanisms and the psychological need to escape discomfort. Effective help, therefore, must address both the biological and psychological facets of addiction. Education can foster empathy, reduce stigma, and lead to more effective support strategies for those battling with alcohol addiction.

What Are the Health Impacts of Alcohol Addiction?

Alcohol addiction, also known as alcohol use disorder (AUD), has profound physical and mental health impacts.

Alcohol Addiction and Physical Health

Physically, chronic alcohol consumption wreaks havoc on almost every organ system. The liver, responsible for metabolizing alcohol, is particularly at risk. Several conditions may result from alcohol addiction, ranging from alcoholic fatty liver to the more severe alcoholic hepatitis and cirrhosis, a permanent scarring that impedes liver function. Alcohol also increases the risk of developing certain cancers, including those of the liver, breast, mouth, throat, esophagus, and colon.

The cardiovascular system also takes a major hit. Alcohol abuse is associated with hypertension, cardiomyopathy, and arrhythmias. Moreover, alcohol can lead to pancreatitis, a painful and potentially dangerous condition. Excessive alcohol use also compromises the immune system, increasing our susceptibility to infections and impeding our recovery from illness and wounds.

Alcohol Addiction and Mental Health

Alcohol addiction alters brain chemistry, affecting neurotransmitters responsible for mood regulation. This often results in — or exacerbates — mental health issues such as depression, anxiety, and in severe cases, psychosis. Cognitive functions, including memory, attention, and decision making, can be impaired, sometimes irreversibly. This is seen in Wernicke-Korsakoff syndrome, a debilitating disorder characterized by severe amnesia and confabulation.

Furthermore, alcohol has a significant impact on sleep. Excessive drinking disrupts sleep patterns and diminishes sleep quality, which exacerbates existing mental health problems. The social consequences of addiction, such as relationship breakdowns, job loss, and financial problems, can further compound mental health challenges, leading to a vicious cycle of escalating addiction and deteriorating mental health.

Alcohol Addiction Help: Treatment Options for Recovery

Overcoming alcohol addiction is a multifaceted process involving a blend of therapy, medication, and social support, each addressing different elements of the condition.

Therapy for Alcohol Addiction

Therapy, particularly cognitive-behavioral therapy (CBT), is a cornerstone in treating alcohol addiction. CBT is based on the premise that learning processes play a critical role in developing maladaptive behavioral patterns such as alcohol abuse. Through CBT, people learn to recognize and change detrimental thought patterns and behaviors. They develop skills to cope with drinking triggers and alcohol-free techniques to manage stress. Research indicates that CBT can significantly reduce the frequency and quantity of alcohol consumption, and it’s particularly effective when combined with other treatments.

Medications for Alcohol Addiction

Medications also play a crucial role in treatment. The U.S. Food and Drug Administration (FDA) has approved medications to treat alcohol dependence. For instance, naltrexone can reduce alcohol cravings and the pleasure derived from drinking. Acamprosate helps maintain abstinence by reducing long-term withdrawal symptoms such as insomnia, anxiety, and restlessness. Disulfiram discourages drinking by causing an unpleasant reaction when someone drinks alcohol. These medications can be particularly effective when used as part of a broader therapeutic strategy that includes behavioral treatments.

Social Support for Alcohol Addiction

Social support, whether through formal support groups or informal support from family and friends, is key in helping an alcoholic loved one. This support provides a network of people who understand the challenges of addiction and/or offer encouragement and accountability. The social aspect of addiction support groups can reduce feelings of isolation and help build a supportive community, which is essential for long-term recovery. Having friends and family to lean on can remind a person how valued they are and that they don’t have to go through their struggles alone.

Alcohol Addiction Help: The Potential Outcomes

Each of these elements — therapy, medication, and social support — addresses a different aspect of addiction. Therapy retrains the brain; medication can mitigate the physiological drive to drink; and social support creates a reinforcing community of encouragement and accountability. Together, they form a comprehensive treatment approach that addresses the multifaceted nature of alcohol addiction.

Integrating these approaches increases the likelihood of successful recovery. By providing both the internal tools for psychological resilience and the external resources of medical and community support, people struggling with alcohol addiction are better equipped to navigate the path to sobriety.

How To Help an Alcoholic Who Doesn’t Want Help

Navigating the turbulent waters of alcohol addiction can be even more challenging when our loved one is resistant to help with addiction. Some people grappling with alcohol use disorder may not recognize the severity of their situation or the potential for recovery. This denial or unwillingness is a common and natural defense mechanism, a facet of the disorder itself that seeks to preserve the status quo of drinking behavior.

Helping an alcoholic who doesn’t want help requires patience and a nuanced approach. Research suggests that confrontation is less effective and can even be detrimental. Instead, strategies such as motivational interviewing — a nonconfrontational technique aimed at eliciting behavioral change by helping people explore and resolve ambivalence — show promise. They involve empathy, examining the discrepancy between the person’s goals and their current behavior, assuming a calm demeanor, and reminding the person what they’re capable of.

The journey is complex, but consistent, nonjudgmental support provides so much hope. Encouraging our loved one to engage in related but indirect support mechanisms, such as community activities or therapy for co-occurring issues like depression or anxiety, can sometimes open pathways to addressing the alcohol addiction itself. Ultimately, respecting the person’s autonomy while subtly fostering a supportive environment may light the first spark of willingness to seek help.

How To Help an Alcoholic Loved One 

When dealing with an alcoholic in your life, it’s essential to proceed with compassion and open-mindedness. We want to show the other person that we’re here to help, not to blame. 

If you have an alcoholic loved one, take the following steps to guide them on their road to recovery.

• Educate yourself. Invest time in understanding addiction. Read literature by organizations like the National Institute on Alcohol Abuse and Alcoholism to familiarize yourself with the intricacies of alcohol dependency. You can even read books by people who’ve struggled with alcohol addiction to get a first-person idea of the struggles of the condition. Familiarizing yourself with the nuances of the condition can give you perspective about your loved one’s experience.
• Create a sober sanctuary. Reevaluate your living space (or help your loved one reevaluate their space if you live separately). Remove alcohol from the refrigerator and cabinets, as this can lead to triggers and potential relapses. Get to know your loved one’s triggers so you can help them develop plans for avoiding alcohol. Transform their space into a haven that supports a sober lifestyle, integrating activities that promote wellness and relaxation. For example, you could post positive affirmations around the home or declutter messy areas. Get creative in cultivating a supportive sober space.
• Have open conversations. Engage in open-ended conversations. Instead of dictating the terms of recovery, ask questions that prompt reflection on the effects of your loved one’s drinking habits. Allow them to explain their goals and motivations for recovery. Giving them autonomy empowers them in their recovery process.
• Embrace empathy. Encourage change by expressing empathy and validating your loved one’s emotions. Show them that you understand their pain, and let them confide in you without being quick to react to their statements. Recovery is an emotionally vulnerable time for people struggling with alcohol addiction. With understanding and unconditional support, you can help alleviate their worries.
• Set goals together. Work together to set achievable goals. Whether it's attending support group meetings or pursuing a new hobby, ensure these goals are mutually agreed upon to foster a sense of shared commitment. Use the SMART framework to set and track these goals, and write them down somewhere you and your loved one can visualize progress. Remember that it’s also okay to revisit and revise goals. Recovery journeys aren’t linear, so it’s important to remain flexible. 
• Pursue professional guidance. Many clinical resources out there support alcohol addiction recovery: therapy, medications, inpatient treatment programs, outpatient treatment programs. Help your loved one find therapists or programs specializing in addiction and aligned with their recovery needs and personality. 
• Acknowledge and reward progress. Acknowledge and reward milestones, no matter how small. Establish a tradition of celebrating these achievements in meaningful ways, such as a family outing or a personalized gift. These celebrations can sustain your loved one’s motivation as they continue their recovery journey.

Support Groups for Families of Addicts

It’s essential to care for our own mental health as we support our loved one with addiction. Support groups for families of addicts can be lifelines in difficult times and encouraging places to celebrate victories. There are many options available:

• Al-Anon groups for families. Al-Anon has a prominent presence in the addiction recovery community around the world. It provides support to family members affected by someone else's drinking. Meetings are available in person, online, or via phone.
• Adult Children of Alcoholics (ACA). ACA specifically caters to adults who grew up in homes where parents misused alcohol. It aims to help them process and overcome the trauma associated with alcohol-related childhood traumas.
• Co-Dependents Anonymous (CoDA). CoDA was organized to help people develop healthy relationships, which often involves dealing with the impacts of a partner's or family member's addiction.
• SMART Recovery Family and Friends. This group offers a science-based, secular alternative to traditional 12-step programs. It provides resources for both the individuals struggling with addiction and their families.
• Family support groups at centers for recovery from addiction. Many addiction treatment centers offer support groups for the families of those receiving help with addiction. These groups can foster a safe environment for sharing stories and strategies, creating an atmosphere of much-needed hope and possibility of recovery from addiction. The support structure is often harmonious with the type of support being provided to the person in recovery and may utilize similar concepts and vernacular to facilitate communication.

Alcohol Addiction Help: The Takeaways

While the road to recovery is rarely straight, it’s navigated best with support, patience, and unwavering love. Each step taken towards sobriety, no matter how small, is a victory in the quest for a healthier life. 

It can be frustrating to figure out how to support an alcoholic who doesn’t want help, especially if it’s a loved one. But educating ourselves on the nature of their disease and taking a compassionate approach makes a world of difference. Remember that there are myriad resources out there — and recovery is possible.