Concerned about a loved one's drinking? An expert explains signs to look for and how to talk about it

People who drink frequently may be "gray area" drinkers

While some are choosing not to drink this holiday season, for others it can be a time of excess — sometimes to the point where loved ones become concerned. 

Alcohol use disorder, or AUD, falls on a spectrum of mild, moderate or severe, and is characterized by an "impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences," according to the National Institute on Alcohol Abuse and Alcoholism. It encompasses conditions often referred to as alcohol abuse, alcohol dependence or alcoholism.

So, how can you tell if a friend or family member may need help? Vanessa Kennedy, director of psychology at Driftwood Recovery, says some of the criteria for alcohol use disorder are red flags to look out for, including:

  • Tolerance to alcohol, where the person needs to drink more to achieve the desired effect
  • Withdrawal symptoms such as sweating or tremors
  • Cravings to drink
  • Difficulty cutting back
  • Problems meeting social, home or work obligations
  • Health, mood or relationship problems
  • Physically hazardous behavior when drinking

"Denial often comes with the territory when a person falls into a high-functioning or mild to moderate category of severity because their behavior may fall into a gray area and might be seen as largely socially acceptable," Kennedy says, but adds, "even high-functioning alcohol problems affect certain areas of the person's life and health in detrimental ways."

If you're thinking of sharing your concerns with someone, there are a few things to keep in mind:

Timing matters: It's typically better not to start the conversation while the person is intoxicated, Kennedy says.

"The best way to approach and talk to someone who is in denial about their alcohol problem is to talk to them when they are sober and to lead with love," she suggests.

Avoid judgment: "Try to avoid attacking their character or judging them, but rather express your emotions and concerns directly," she says, suggesting that you can express your intentions by saying something like: "I feel worried and anxious when you drink too much because I do not want you to miss out on celebrating the holidays with the grandkids." 

Set boundaries if necessary: Kennedy says you can make your boundaries clear by saying something like: "I am so concerned about your drinking that I do not want to enable the behavior, so I am not going to buy alcohol for you or cover for you when you avoid family gatherings."

In order to help navigate the sensitive nature of the topic and any possible defensiveness, you may also opt to have the conversation with a professional involved, she adds.

Safety first: But sometimes there's a good reason to speak up while someone is still intoxicated: Safety — for themselves and others, including if they become belligerent, erratic or pass out.

"You may need to redirect (them) with other people supporting you to keep the person and others safe," Kennedy says. "This may look something like ensuring that they do not drive, keeping them calm and giving them a place to rest, eat and rehydrate if possible."

If you or a loved one is experiencing a problem with alcohol, help is available via the Substance Abuse and Mental Health Services Administration Helpline at 1-800-662-HELP.

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