As of Wednesday, March 19, 2014
DEAR DOCTOR K: My brother is addicted to alcohol. How can I help him overcome his addiction?
DEAR READER: It is so hard to watch a loved one suffer. And addiction surely causes suffering. In some ways, the suffering from addiction is worse than from other illnesses.
One reason is that family members and friends often worry that they might have contributed to the addiction. They worry that maybe problems in their relationship with the loved one drove that person to drink. Hard as it may be to accept, you aren’t responsible for your brother’s addiction.
Another cause of suffering is that many people think addiction is just a personal weakness, a lack of willpower. In fact, it is a disease. Chemicals in your brother’s brain are creating an enormous desire to seek again the pleasure that drinking brings him.
But don’t misunderstand. When I say addiction is a disease, I’m not saying that the disease is incurable. I’m not saying your brother is trapped and powerless to affect his condition, as he might be if he had a cancer spreading throughout his body. With addiction, a person can overcome the enormous desire they feel. It’s just really, really hard, and most people need help.
Behavior change rarely occurs quickly. Most people journey through several distinct phases before attaining their goal. Understanding these phases may help you to know when to step back or step in.
Precontemplation. There is no thought of changing because the individual does not recognize a problem.
Contemplation. The person recognizes a problem but is ambivalent about change.
Preparation. The person has accepted the idea of making a behavior change and begins looking for ways to accomplish it.
Action. The person takes a definitive step. For example, entering a support group for addiction.
Maintenance. Temptation to return to old habits is inherent in any type of behavior change. With addiction, that’s especially true. Brain chemicals continue to cause desire for a long time, maybe forever. Recognizing that lapses can occur and developing strategies ahead of time to get back on track is crucial to quitting successfully.
Relapse and recycle. The person resumes former behaviors. Although discouraging, don’t view this step as a failure. Relapse can help the person recognize triggers and plan stronger coping strategies.
As someone with a loved one who struggles with addiction, here are some things you can do to help:
Speak up. Express your concerns in a caring way.
Don’t make excuses. Don’t make it easier for your brother by lying to protect him from the consequences of his addiction.
Be safe. Don’t put yourself in dangerous situations.
Step back. Try to remain neutral. Don’t argue, lecture, accuse or threaten.
Be positive. Addiction is treatable. Learn about treatment options and discuss them with your brother.
Take action. Consider staging a family meeting or intervention.
Dr. Komaroff is a physician and professor at Harvard Medical School.