Witnessing the stronghold alcohol has on a loved one’s life hurts. You may feel exhausted, helpless, and frustrated. Your intentions are good, but you may wonder whether what you’re doing is helping them or even unintentionally making things worse. This guide is for you: the parent, partner, sibling, friend, or other loved one on the outside trying to figure out what to do next.
You cannot make another adult stop drinking, but that doesn’t mean you can’t help. You can learn how to help someone with a drinking problem by recognizing behaviors that are concerning, starting important conversations, and providing support without enabling. They may have alcohol use disorder (AUD), but only a qualified healthcare professional can make that diagnosis.
In this guide, we will help you understand those things, as well as what treatment options are available, how to respond to emergencies, and how to take care of yourself along the way
If you or a loved one is experiencing a substance use or mental health crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline. You can also use the Crisis Text Line. Simply text HOME to 741741 to connect with a crisis counselor. If there is an immediate medical emergency, go to the nearest emergency room or call 911.
You can also call SAMHSA’s National Helpline at 1-800-662-4357 [1]. It’s free, confidential, and available 24/7.
Recognizing When Drinking Has Become a Problem
When is drinking a problem? Diagnosing someone based on observation alone is impossible. However, these patterns are worth paying attention to [2]:
- Drinking more than intended
- Struggling to stop or cut back
- Drinking to cope with stress
- Hiding drinking
- Drinking first thing in the morning
- Becoming angry or defensive when the topic of drinking comes up
- Drinking despite serious problems caused by alcohol use, like relationship conflict or legal issues.
AUD doesn’t look the same for everyone. A person doesn’t have to regularly pass out or drink every day for alcohol to be causing serious harm. If you’ve noticed these signs in a loved one, it’s never too early or too late to offer help.
When It's an Emergency
Alcohol-related emergencies are real. That’s what makes this so stressful for loved ones. Knowing when to get emergency help is just as important as knowing how to have a supportive conversation. Two situations that require particular attention are alcohol poisoning and severe withdrawal.
Alcohol poisoning
Alcohol poisoning happens when there is so much alcohol in the bloodstream that areas of the brain responsible for basic life-support functions begin to shut down. Signs include [3]:
- Nausea
- Vomiting
- Lethargy
- Slurred speech
- Slow heart rate
- Slow breathing
- Mental confusion
- Seizures
- Clammy or pale skin
- Extremely low body temperature
- Unresponsiveness or trouble staying conscious
Alcohol poisoning is extremely dangerous. If you suspect alcohol poisoning, call 911 immediately. Don’t assume the person can “sleep it off.” Stay with them while you wait for emergency services.
Severe alcohol withdrawal
When a person who has been drinking heavily over a long period suddenly stops, it can cause withdrawal. This can be potentially life-threatening. Symptoms of life-threatening withdrawal include [4]:
- Confusion
- Shaking
- Tremors
- Anxiety
- Agitation
- Heavy sweating
- Hallucinations
- Paranoia
- Headaches
- Hyperthermia (high body temperature).
- Fast heart rate or tachycardia
- Seizures
- Delirium tremens (see below)
Unmanaged alcohol withdrawal can become delirium tremens (DTs). This can involve agitation, delirium, severe confusion, fever, hallucinations, and seizures [4]. If severe withdrawal symptoms occur, seek emergency medical care or call 911.
How to Talk to Your Loved One About Their Drinking
Talking to someone you love about their drinking can be difficult. You may rehearse what you want to say over and over and still worry that you’ll say the wrong thing.
- Use observations over accusations or labels. Focus on specific behaviors and explain how they affect you. “I” statements are helpful because they can feel less accusatory. Focusing only on what the person is doing wrong can cause them to become defensive.
- Timing matters: Avoid initiating sobriety conversations while the person is drinking or intoxicated. Choose a time when you’re both calm, rather than bringing it up during an argument or immediately after an incident.
Here’s a quick example of effective vs. ineffective communication:
Rather than: You’re an alcoholic! Get help now.
Try: I’m concerned about how much you’ve been drinking recently, especially after you had to go to the hospital because of it last weekend. Can we talk about this?
Rather than: You don’t care about anyone else and how this affects them.
Try: I felt worried after you passed out last night and I couldn’t wake you up right away. I’m worried about what’s happening.
Bringing up the topic carefully doesn’t mean your loved one will respond well. Denial, anger, and minimizing their drinking are common. An initial negative reaction doesn’t necessarily mean the conversation had no impact. When exploring how to help people with drinking problems it’s important to remember that it often takes more than one conversation before someone is willing to consider change.
If you believe that the person may become confrontational, prioritize your own safety rather than continuing the conversation. And if informal conversations repeatedly haven’t worked, and you feel stuck, professional guidance from an addiction counselor, therapist, or interventionist may help you decide what to do next.
What About a Formal Intervention?
The confrontational “ambush” interventions like those portrayed on television aren’t the only approach. One evidence-based alternative is CRAFT (Community Reinforcement and Family Training) [5].
CRAFT uses nonconfrontational, motivational, and behavioral strategies. Family members promote change without losing themselves. This method teaches family members how to communicate more effectively with their loved one, encourage healthy behavior, and take care of themselves.
If conversations about drinking repeatedly haven’t led to change and the situation is serious, an addiction counselor can help you know what to do next.
Supporting vs. Enabling
Fear can shape how you respond when a loved one struggles with alcohol. Sometimes the things you do because you love them can unintentionally reinforce the drinking pattern. This is called enabling. Enabling can be difficult to recognize. That’s because it usually comes from love and fear, not a lack of caring. Some common examples of enabling a loved one with AUD are:
- Giving money that will likely be used for alcohol
- Covering up consequences caused by drinking
- Fixing financial or legal problems caused by drinking
- Not following through with threats or boundaries
- Calling in sick to work for them when they’re too drunk/hungover
- Making excuses to family members, friends, or their employer for their behavior
Enabling often comes from a place of love. You are trying to protect your loved one. While these actions may reduce the immediate crisis, they can also shield your loved one from the natural consequences of their choices.
This is where supportive behaviors come in. Supportive behaviors can include:
- Being concerned without covering up the problem
- Following through on reasonable boundaries
- Getting support or therapy for yourself
- Being honest about your concerns
- Allowing natural consequences to occur (when safe to do so)
- Offering to help find treatment without taking responsibility for whether they accept it
Support and rescue aren’t the same thing. You can love someone while recognizing that you cannot manage their drinking for them.
Loved ones of people struggling with alcohol may also find support in Al-Anon’s concept of “detach with love” [6]. It means loving someone without taking responsibility for their decisions. No longer softening consequences for your loved one doesn’t mean that you are abandoning them. You are separating your love for them from responsibility for their decisions.
You stop trying to protect them from every consequence of those decisions. If you recognize enabling patterns in yourself, it can be helpful to get support for yourself.
Understanding Alcohol Treatment Options
When figuring out how to help someone quit drinking, educating yourself about alcohol treatment can help you understand what’s available. This allows you to have a more informed conversation if your loved one becomes willing to seek help. You don’t have to choose treatment for them.
Here are some treatment options for alcohol problems [7]:
- Medical detox: Supervised treatment for people who need medical withdrawal management. Cornerstone does not provide detox, but people who need it can receive withdrawal management before entering ongoing treatment.
- Residential/inpatient treatment: Structured care and 24/7 support while residing at a treatment facility.
- Outpatient treatment: Treatment that takes place in a community setting. A person continues to live at home.
- Behavioral therapies: Therapies like CBT (cognitive behavioral therapy) and motivational interviewing can help people change patterns related to alcohol use and build recovery skills.
- Medications: FDA-approved medications such as naltrexone, acamprosate, and disulfiram may be used as part of treatment for alcohol use disorder [8].
- Mutual-support groups: Examples include AA (Alcoholics Anonymous) and SMART Recovery.
- Virtual IOP: A virtual IOP program can provide intensive treatment through a computer-based platform while allowing someone to continue living at home. At Cornerstone, virtual IOP includes therapy, psychiatry, medication management, family therapy, case management, virtual primary care, and peer support.
- Partial hospitalization programs: A PHP provides a higher level of structure for someone who needs more support than a weekly therapy session but does not require 24-hour residential treatment.
What’s best varies from person to person. Medical history and alcohol use history and patterns influence how intensive care levels should be.
A primary care provider or SAMHSA’s treatment locator can also be a low-barrier place to start. Ultimately, the goal is to find evidence-based treatment that your loved one is willing and able to engage with.
What If Your Loved One Refuses Help?
When coming up with a plan that addresses how to help someone with a drinking problem, you have to understand that you cannot make another adult want help. That can be hard to accept when you’re watching someone you love be negatively impacted by their drinking. This doesn’t mean that there’s nothing you can do.
Readiness to change usually develops gradually and may change over time. Instead of taking responsibility for changing them, you can focus on what remains within your control:
- Maintain boundaries
- Keep expressing concern without nagging
- Avoid enabling
- Seek support and self-care for yourself
Some states have laws allowing involuntary treatment or commitment in limited circumstances [9]. Requirements vary greatly by state and may involve situations in which someone poses an immediate danger to themselves or others. If this becomes relevant to your family, speak with an appropriate clinical or legal professional about the laws where you live.
There aren’t any “right words” to make someone choose recovery. You can stay honest, keep your boundaries, and remain willing to support treatment if they become ready.
Supporting Recovery for the Long Haul
Getting treatment is the first step, but it isn’t the end. Here’s how you can continue supporting your loved one during recovery:
- Be patient as they adjust to recovery
- Respect treatment appointments and recovery activities
- Keep alcohol out of the house
- Acknowledge milestones
Understand that relapse can happen. If this happens, more care may be needed from treatment teams or support systems. It doesn’t mean that treatment has failed or that recovery is impossible.
It’s also common for family relationships to require healing. Feelings of resentment and other issues don’t automatically disappear when alcohol use stops. Family therapy may help family members address these patterns and build healthier ways of relating during recovery.
Final Thoughts: What You Can and Cannot Control
Watching someone you love struggle with alcohol can be heartbreaking. But your job isn’t to fix someone else.
You can be honest, set and maintain boundaries, offer support, and resist the urge to protect them from consequences. It’s also important to take care of yourself.
Your next step may be to call SAMHSA’s National Helpline, research treatment, attend an Al-Anon meeting, or simply have a calm conversation with your loved one [10]. Start with the step that’s more accessible to you now.
If your loved one may be ready for treatment, Cornerstone Healing Center can help you understand what level of care fits their needs. Verify your insurance and call our team to get started.
Explore Options for Alcohol Addiction Treatment
Get in touch with our team to learn how we can help your loved one recover together.
Need immediate help? Reach out to these resources.
SAMHSA’s National Helpline: Call 1-800-662-4357 to learn more about treatment options.
988 Lifeline: If you or your loved one is experiencing a mental health or substance use crisis, call or text 988.
Emergency services: If there is an immediate medical emergency, call 911.
Frequently Asked Questions
How do I help an alcoholic who doesn't want help?
To help someone who doesn’t want help start by expressing concern, avoid enabling behaviors and offer to help them find treatment.
What's the difference between supporting and enabling an alcoholic?
Enabling protects someone from natural consequences. For example, this might be bailing them out of jail after a DUI. Support helps someone access recovery while allowing them to remain responsible for their choices. An example of support would be driving a loved one to a treatment appointment.
How do I talk to someone about their drinking without making them defensive?
Choose the right time when they are calm and not intoxicated. Focus on specific behaviors. Don’t label them. Try using “I” statements, such as “I’m really concerned with how drinking is affecting your physical health.” This communicates concern without starting with an accusation.
What are the signs of alcohol withdrawal that need emergency care?
Severe confusion, extreme agitation, hallucinations and seizures are all signs of an emergency. Severe alcohol withdrawal can be life-threatening. People with heavy, long-term alcohol use should seek medical guidance before abruptly stopping alcohol. If you notice these signs in someone, contact 911 (in the United States).
Can I force my loved one into rehab?
Some states have involuntary treatment laws. The requirements vary from state to state, but often a person must be a danger to themselves, a danger to others, or gravely disabled. If you are concerned that a person may be in immediate danger contact 911 if it’s an emergency. You can also reach out to a qualified clinical professional or a lawyer about the laws and options where you live.
What treatment options are available for alcohol use disorder?
Treatment depends on the person’s needs and other factors, like whether they have other co-occurring disorders. It may include medical detox, outpatient treatment, residential or inpatient treatment. Other options include behavioral therapy, FDA-approved medications, and mutual-support groups.
How do I take care of myself while helping an alcoholic family member?
A good first step is to seek help or support for yourself. Therapy, family support programs, and groups such as Al-Anon can help you care about your loved one without making their recovery your responsibility. Also, set clear boundaries that you can stick to.
