“We are taking him to rehab,” she said. I could hear a faint sigh of relief and happiness permeating her voice, which had been distinctly absent for the last few months. I could also hear wind whooshing in the background and a distant trail of her voice, which meant they were already on the road.
“That is great!” I said without hesitation or second thought. Though “great” was an understatement. Was I looking for another term? Perhaps “life-changing” would have been better to say at the moment, but nevertheless, it undeniably was great.
Coping with the effects of a loved one suffering from alcohol use disorder is no easy feat. As medical professionals, it is sometimes innate for us to prescribe recommendations as opposed to tangible treatments. “Doctors orders.” In this instance, perhaps one might effortlessly add into a conversation “you need to cut back on your drinking” or “you need to stop drinking for your health and well-being.” We say these phrases almost instinctively, without consideration of what turned that person to the bottle in the first place. Too often, we fail to consider the support, challenges and failures that come along with a journey towards sobriety.
While no two narratives of an alcoholic are identical, most might attest to the fact that alcohol can change the user in more ways than one. Initially, alcohol was a shield to withstand harsh circumstances in the world. Then, gradually, tolerance and dependence take over and the day is left, unknowingly, with the alcoholic contemplating where the next drink would come from and how it would be obtained. Neuronal connections in the brain are rerouted and detoured around obtaining the substance. Therefore, alcohol not only destroys relationships and professional careers but takes over and creates a new reality for the drinker, beginning with the consequences and aftermath of intoxicated actions. Paradoxically, alcohol may become the repellent and deter those closest to them, something they were potentially dodging in the first place. Ultimately, this leads to a situation that has spiraled out of control, and any semblance of normalcy now appears unattainable.
“So what is the point?” you might be asking yourself. As a medical professional in-training and close observer to an alcoholic’s glass world, I challenge you to think before acting and speaking. Consider the provoking elements and aspects which might have led the person in front of you down a spiral. Stating “you need to stop drinking” to an alcoholic is akin to stating “the sky is blue.” Your patient or loved one knows very well that they need to do something to address their addiction but may be terrified of the consequences associated with a sober life. They may be afraid of disappointing those around them should they relapse or constantly reflecting on the trail of destruction that led them to the moment of putting down the bottle.
This may be where your words and actions are essential. Support. Support not only the obviously downtrodden and wounded person in front of you, suffering from the effects of alcohol and hiding their addiction, but also support those downstream from the wounded working alongside you in this battle. More often than you know, loved ones close to a sufferer of alcohol use disorder take blame for their dependency. The constant replaying of questions in their mind such as “what could I have done differently?” is often interrupted by a record scratch in the form of life’s cruel realities. Therefore, addiction has wide-reaching and crippling effects which must be considered coupled with meticulous planning and treatment in the place of often abandoned recommendations. Lending an open ear to someone’s struggles might be the ounce of courage they need in order to face their circumstances with courage.
As both a medical student and a family member of a loved one suffering the effects of alcohol, I challenge you to consider doing two things when approaching a substance abuse patient, friend or loved one: think and support. Much as you would consider the etiology of congestive heart failure, also consider that of a patient’s substance abuse. Ask the patient, the family, and yourself “how did we end up here and where do we go from here?” Then, while challenging, attempt to understand each perspective and inquire regarding what is needed from you. Another pamphlet, criticism, or empty recommendation may lead to the alcoholic building their wall of defense even higher. Often, patients want to be heard and as medical professionals, we are in a humbling and unique position to change someone’s life for better or worse. You may not consider these items to be a matter of life and death, but you can never really know.