Mental health articles

What to do for the person with a drinking problem

Most often, health workers treat only the physical illnesses associated with problem drinking.

Unless you treat the drinking problem itself, the person will never fully recover. There are three

stages to overcoming a drink problem:

• admitting there is a problem;

• stopping or reducing drinking;

• remaining sober.

To admit that there is a drink problem is an essential first step. Often the drinker comes to the clinic only because of family pressure. He may deny he has a problem. It is important not to get angry with him. Instead, talk about other issues (such as work and health) and try to get him to make the links between his drinking and its effects on his life. A person who is forced into treatment without accepting that he has a problem is less likely to give up his habit. One way of improving motivation is to help him face his problem by asking him to list all the reasons for changing his behaviour, such as “feeling healthier”, “having more money to spend on other things” and “improving relations with my wife”.

Once the person has admitted that there is a problem, the question to decide is whether she

should stop drinking completely (abstinence) or simply reduce her drinking to the ‘healthy’ limit. There is no simple answer to this. You will need to consider the health and social situation and the history of drinking before you and the person agree on a goal. Abstinence is the preferred goal if:

• the drinking has caused serious health problems, such as repeated attacks of jaundice;

• the drinking has caused serious problems at work or at home, such as violence;

• the person has tried controlled drinking before but has not been successful.

Abstinence is an ideal goal since it is easier to monitor and less likely to lead to a relapse (becoming addicted to alcohol again). Whatever the chosen goal, it must be agreed to by the person, so that the goal is his choice. It will need regular monitoring in the months ahead.

If the person is a heavy drinker (for a man, if he has more than six drinks a day; for a woman, more than four drinks a day), suddenly stopping drinking may lead to withdrawal symptoms.

Advise on how to deal with these symptoms. If a person has more than 10 drinks a day, it is better to refer the person to a hospital where the withdrawal reaction can be monitored more closely.

Tags: drinking