How to help a friend with a drinking problem

Understanding Drinking Behavior: How Can You Tell if Someone has a Problem?

You don’t have to be an expert to recognize if someone might have a problem with alcohol. Problem drinking behavior can be divided into two major categories:

Alcohol abuse: When drinking interferes with any aspect of daily living. This includes:

Repeated, dangerous drinking that interferes with social, academic, emotional, professional, financial, legal, or physical aspects of a person’s life.

Alcohol dependence ( also known as alcoholism): When someone becomes psychologically or physically dependent on alcohol. It includes four symptoms:

Craving: A strong need, or urge, to drink.
Loss of control: Not being able to stop drinking once drinking has begun.
Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking.
Tolerance: The need to drink greater amounts of alcohol to get "high."

Be observant and watch out for the warning signs of alcohol abuse and dependence. Answering the following four questions can help you find out if you or a loved one has a drinking problem:

Have you ever felt you should cut down on your drinking?
Have people annoyed you by criticizing your drinking?
Have you ever felt bad or guilty about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

One "yes" answer suggests a possible alcohol problem . More than one "yes" answers means it is highly likely that a problem exists. If you think that someone you know might have an alcohol problem, it is important that they see a health care provider right away who can help determine whether a problem exists and plan the best course of action.

Types of Drinking Behaviors

Compare your friend’s drinking habits to those described below. The following list contains examples of common behaviors exhibited by social, problem, and alcohol dependent drinkers. It is not necessary for a person to exhibit every behavior listed to fit into one of these categories. It is also important to recognize that social drinkers do not ordinarily become problem drinkers, and problem drinkers do not necessarily become alcoholics.

A social drinker typically:

Drinks slowly (no fast gulping)
Knows when to stop drinking (does not drink to get drunk)
Eats before or while drinking
Never drives after drinking
Respects nondrinkers
Knows and obeys laws related to drinking

A problem drinker typically:

Drinks to get drunk
Tries to solve problems by drinking
Experiences changes in personality; may become loud, angry, violent, silent, remote, reclusive…
Drinks when he/she should not – before driving or going to class or work
Causes other problems – harms self, friends, family, others
May have blackouts – cannot remember what he or she did while drinking, although may have appeared normal to others.

An alcohol-dependent person or “alcoholic” typically:

Spends a lot of time thinking about drinking and planning when and where to get the next drink
Keeps bottles hidden for quick “pick-me-ups”
Starts drinking without conscious planning and loses awareness of the amount consumed
Denies drinking
Drinks alone
Needs to drink before facing a stressful situation
Goes from having hangovers to more dangerous withdrawal symptoms, such as delirium tremens (“DTs”), which can be fatal
Has or causes major problems – with police, employers, friends or family

How to Talk with a Friend with a Drinking Problem

Talking with someone who may have a drinking problem or has had too much to drink can be a difficult thing. Remember, it is a process. Preparing yourself, getting the proper support you need, and understanding what you can expect from the confrontation can decrease some of your fear and make you feel more confident.

Before the Confrontation

Become informed about the problem.
Examine your own values and attitudes about the problem and about your friend.
Develop a plan to communicate your concern.

Should you be the person to intervene?
Who else should be involved?
What are the appropriate referral sources?

Know the basic facts regarding drinking behaviors and use these facts to substantiate your concern (see below).
Expect to encounter: excuses, promises of behavior change, attempts to change the conversation, attempts to pass the behavior off as “no big thing”.

During the Confrontation

Communicate your care and concern for your friend.
Confront behaviors, not values: state specific examples of problem behaviors.
Do not label or criticize.
Maintain the offensive: don’t let your friend put you on the defensive about your own drinking behavior.
Stick to the issue: the problem is alcohol and the resulting behavior.
Mention choices: the person needs to take action but they have options.

After the Confrontation

Provide on-going support.
Help your friend make and keep referral appointments.
Do not get discouraged if the intervention does not work—if your friend is not ready to make a change there is little you can do.
Get help for yourself if you are negatively affected by the confrontation or your relationship with your friend.

Where can you go for help?

Student Health Services:

Appointments with Betsy Foy, Substance Abuse Specialist. Contact Betsy at 314.935.7386
Appointments with counselors in Mental Health Services. Call 314.935.6666
Appointments with medical staff in Medical Services. Call 314.935.6666

All services are confidential. If requested, these services can be anonymous. Inquiries for referral may be for yourself or someone else.

How can you learn more?

St. Louis Resources

Alcoholics Anonymous “AA” 314.647.3677

National Council on Alcoholism and Drug Abuse, St. Louis Area: 314.962.3456

National Resources

National Clearinghouse for Alcohol and Drug Information 800.729.6686

National Institute on Alcohol Abuse and Alcoholism: http://www.collegedrinkingprevention.gov

Facts on tap: http://www.factsontap.org

Go Ask Alice : http://www.goaskalice.columbia.edu/

Professional

Health Promotion Services provides brochures, programs, and other resources. Contact Melissa Ruwitch at 314.935.7139