Question: I drink because it makes me feel better and if I don't I just feel depressed. I think I need medication but when I told my doctor how I feel he said I needed to cut down on my drinking before I should try medication because it could be the drinking that is making me feel depressed. The thing is without drinking I feel so bad that I never can make it more than a couple of days without drinking It s a catch 22 situation. The drinking is making me feel bad but I feel so bad I need to drink to feel better. Should I find another doctor who will prescribe me the medications?

Iona Health Says...:

From your first statement it appears that you don’t like how you feel with or without alcohol. The feeling you have identified is depression. Have you considered seeing a mental health professional who can guide your treatment; including medications. The additional benefit would be to have an alcohol abuse assessment to determine if you are using alcohol to medicate your depression, and/or additional problems, or alcohol abuse. Taking a drink to help you avoid feeling bad could be considered a sign of alcohol dependency. This symptom is referred to as alcohol withdrawal which suggests you don’t function normally without alcohol. Try to get an assessment and counseling which could help you manage your drinking and depression enough so that you can stop this drinking cycle.

I am not surprised that your doctor does not want to prescribe anti-depressants while you are drinking. After working with a number of psychiatrists, I have never found one who would prescribe medications if alcohol or other controlled substances are being used. If there is any problem with the medication, while using alcohol, it puts the doctor as a huge liability; especially if he knows you are using alcohol, a depressant, as well as taking prescribed medication.

The standard practice is to address any kind of substance abuse before taking on any mental health issue, like depression. Going to another doctor, or doctor shopping, would not be considered ethical, because no doctor should prescribe you medications if you are drinking alcohol; often a more immediate treatment problem. I recommend you take immediate action to address your alcohol use before you address your depression.

In my best opinion, you need to have a substance abuse assessment, plan to stop using alcohol, get into the appropriate level of care and treatment, and lastly address the source of your depression with a mental health/substance abuse professional.

Respectfully yours,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: My son has borderline intellectual capacity. He has an IQ of about 70. He is 25 now and he is living independently with some financial support from us and he is working as a bagger at a local supermarket. He has started to get a taste for alcohol, which is something he never really had when living at home. His employer is a personal friend of the family and he called me yesterday to say that my son is starting to show up for work obviously hungover and smelling of alcohol. He notified us as a courtesy and he was very apologetic when he said that unless things changed for the better that he would have to let my son go. I can see this spiraling out of control unless we get ahead of it. I have tried talking to my son but I don’t think he gets the severity of the situation. Is there some sort of program we could get him into for people that are at risk of alcohol problems with diminished intellectual capacity? I am sure his boss would agree to give him a leave for a couple of weeks so he could go and get some help if that’s what would be best.

Iona Health Says...:

Your proactive stance with your son’s probable substance abuse is a wise and prudent course. Substance use, abuse and dependency are on a continuum and your son’s use of alcohol cannot be accurately determined without an assessment by a substance abuse counselor. Researching this issue, I was able to indentify one treatment center which specializes in treating substance abuse individuals who have IQs as lower as 50. I feel certain that if you contact this program, Cottonwood Treatment Center, in Salt Lake City, Utah, they can discuss all of your son’s treatment options and the best place for him to participate in treatment.

Another article, from the Substance Abuse and Mental Health Services Administration (SAMSA), discusses the treatment challenges and treatment options for persons who are developmentally delayed and have a substance abuse problem. When considering options for your son, please read this SAMHSA article.

Another excellent resource that you might consider for an appropriate substance abuse assessment and/or treatment in your state can be found at this website.

Another option would be to contact the Substance Abuse Department of your state’s Mental Health Division. The staff, at this division, are usually informed of most programs in your state and can recommend programs which might better serve your son and your family; if it turns out that he is abusing alcohol.

Lastly, your best bet would be to talk to your son and express your concern about his recent alcohol use and your desire to have this condition assessed by a substance abuse professional. A local substance abuse professional can access all of the available resources in your area for people who are developmentally delayed or borderline intellectually functioning with alcohol abuse problems.

I hope this information will give you the direction that you may need to assist your son at this time. If you need anything else from me, please do not hesitate to contact me.

Respectfully,

John W. O’Neal, Ed.S., MSW, MA, LPC, NCC

Question: If I have blackouts when I get drunk most of the time does that mean I am becoming an alcoholic. I am in my senior year of high school and we have parties most nights during the summer vacation. I never feel like I need a drink but we get wasted most nights anyway.

Iona Health Says...:

Let’s discuss the primary cause of alcohol-related blackouts. The primary cause is drinking too much alcohol too quickly. Usually, when individuals have blackouts, it is recommended that they see a medical professional and medical treatment. An excellent article “What Happened? Alcohol, Memory Blackouts, and the Brain,” written by Aaron M. White, Ph.D., a research professor in the Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, offers a clear explanation how alcohol is the “sledgehammer” in the toolbox of recreational drugs. To better understand the serious and profound effects of alcohol and alcohol-related blackouts have on the brain and its functioning, go to the National Institute of Alcohol Abuse and Alcoholism website and read this excellent article. This website can be found at:

http://pubs.niaaa.nih.gov/publications/arh27-2/186-196.htm

The risks and rapid progression in teenage alcoholism are widely known and have enormous health implications for teens. For more information about this, please go to these websites:

http://kidshealth.org/teen/drug_alcohol/alcohol/alcohol.html

http://pubs.niaaa.nih.gov/publications/AA67/AA67.htm

The current research shows that the younger the age of a person when he begins drinking the more likely he is to have an alcohol dependency problem during some time in his life. Individuals who begin drinking under the age of 15 are at high risk for alcohol abuse and/or dependency. If you are drinking daily, drinking too much in short a time, having blackouts, I would confidently state you are very progressed in your alcohol abuse. Be very careful because it is your health which is at risk. My recommendation is that you talk with an adult you trust, tell him or her, about the extent and effects of your excessive drinking. See if you can see a counselor who can have you assessed for alcohol abuse or dependency. The sooner you take action, the better your outcome results will be.

I would like to acknowledge you for your courage in seeking out the professional opinion of an addictions counselor. You have made the biggest step. Now, you must take the next step by getting evaluated and treated for a medical condition; known as alcohol abuse/dependency.

If I can be of further assistance to you, please do not hesitate to contact me. I have supported many teens in making new decisions about their lifestyles and substance abuse. I know you can turn this destructive practice around.

All the best,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: I have early stage heart disease and my doctor says I need to quit smoking and drinking. I know the smokes are killing me so I cant make any more excuses but quit but I did not know that drinking beer only was bad for my heart. If I cut down and I only have 1 or 2 beers every day isn’t that supposed to be a good thing for my heart. I think it would be much easier for me to have 1 or 2 a day rather than not be able to have any at all. I have been drinking about 12 a day for a while.

Iona Health Says...:

The American Heart Association (AHA) warns that any miniscule benefit received, like a slight increase the HDL cholesterol (good cholesterol) from alcohol consumption does not merit its use when there are many vegetable and fruit sources for increased HDL. Its recommendation is that if you have a heart condition, currently are drinking, you should only drink moderately. What is moderate drinking? According to the AHA, moderate drinking for men is no more than two drinks per day and for women no more than one drink per day. The AHA reports that excessive alcohol consumption has been associated with high blood pressure, increased caloric intake, diabetes, obesity, heart failure, stroke, cardiomyopathy, cardiac arrhythmia and sudden cardiac death. In other words, the rewards are low for consuming alcohol, and the risk can be high.

My question is “Why are you going against the medical advice of your doctor?” Do you think you doctor is not giving sound medical advice. Drinking 12 beers per day could constitute alcohol abuse, if not alcoholism. Have you ever tried to stop or decrease your consumption before? If you decide to reduce your alcohol intake to two beers per day without any problems, may mean you are only a heavy drinker. But, it you can’t “control” your intake to two beers per day, you may need to consider being alcohol dependent or in strong denial.

Since this is your life, we are considering, I would encourage you to discuss your drinking plans with your physician. If there is any possibility that you could be alcohol dependent, you may want to consider an alcohol and drug evaluation by a substance abuse professional. The only prominent idea which stands out in your inquiry is this: “you don’t want to give up alcohol completely even when drinking alcohol puts your health at risk.” What is drinking this idea?

My hope is that you will consider how your drinking could have impact on your heart disease. If I can be of further help, please let me know.

Respectfully,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: Are there any issues with a vegan diet for a person who is coming off a long bout with alcoholism? I am about to receive my cousin to come stay with us on our organic farm. We are all vegan here so he will also eat that way. He intends to stay for a long while while he recovers his health. I know that alcoholics can have some particular vitamin deficiencies so I want to be sure that our diet here, which is healthful for an average person, will be up to his nutritional needs.

Iona Health Says...:

According to About .com Health’s Disease and Condition and its Medical Review Board, it defines moderate drinking to be one alcoholic drink for women per day and two alcoholic drinks for men per day. With moderate drinking, the risk for auto accidents, others accidents, high blood pressure, stroke, violence, suicide, birth defects, and certain cancers can be raised. There is some evidence that one drink per day can elevate the risk for breast cancer. Heavy drinking and alcoholism opens the doors for more complicated medical problems to include, liver disease, hepatitis, obesity, and diabetes; to name a few. What implications could this have for a choosing a diet which could restore an alcoholic to healthiness and wholeness? For more information about this, please go to:

• http://alcoholism.about.com/cs/nutrition/a/aa000605.htm
• http://www.holistichelp.net/alcoholism.html

Many treatment centers are addressing the nutritional deficiencies with their recovering alcoholics; such as Accelerated Recovery Centers in Atlanta, Georgia http://www.iwanttostopnow.com/. Recovery centers and substance abuse professionals recognize that alcoholics and drug abusers suffer from serious malnutrition and poor eating habits.

Alcoholics Victorious makes suggestions for the Recovery Diet for alcoholics. The guides for the Recovery Diet are:

1. Use the USDA's Food Pyramid as a guide to prepare well-balanced meals.
2. Eat 3 snacks and 3 meals per day
3. Drink decaffeinated coffee and herbal teas to decrease caffeine
4. Eat fresh fruits and vegetables
5. Eat foods made of whole grains
6. Eat more beans and grain products, limit the amount of red meat eaten. Red meats are harder to digest
7. Eliminate or keep to a minimum foods that contain sugar and caffeine
8. Be aware of hidden sugar in cocoa, condiments, and over the counter medications
9. Be aware of caffeine in over the counter and prescribed medications

Composition of the Recovery-friendly Diet:

• Protein - 25%
• Carbohydrate - 45%
• Fat - 30%
• Total calories 2,000

Sample Meal Suggestions:

• Breakfast - oatmeal muffins, pancakes, quiche, omelet, yogurt
• Lunch - Sandwiches, salads, soups
• Dinner - Soups, chowders, rice & beans, chicken and vegetables, tortillas, lasagna with vegetable
• Dessert - Yogurt, fruit, oatmeal cookies, custard

A Note on Vitamins

Because drugs and alcohol deplete the body of vitamins and minerals, multi-vitamin/mineral plus B supplements can be especially helpful.

Vitamins and dietary supplements should be taken with meals for optimum absorption.

Source: 

Nutrition In Recovery by Margaret Soussloff, M.S. & Cara Zechello, R.D., Massachusetts Food Banks and Maria F. Bettencourt, MPH, Massachusetts Department of Public Health

________________________________________

I do recognize that the USDA’s food pyramid does not reflect the vegan diet and lifestyle, since vegans do not use any animal products or byproducts; such as eggs, cheese, yogurt, milk, etc. However the food pyramid can be used to a limited extent, minus meat and dairy. For your information, there is a vegan pyramid at: http://www.happyvegetable.com/nutrient-check/vegan-food-pyramid/

The main problem with a recovering alcoholic eating vegan is that most alcoholics are protein deficient. One of the challenges of the vegan diet is to find alternative meat protein sources and Vitamin B-12. Here is a resource called the Vegan Detox diet which has many suggestions for vegans who want to rebuild their bodies and meet their body’s nutritional needs at: http://www.livestrong.com/article/127471-vegan-detox-diet/. The idea of treating alcoholism nutritionally is not new as purported by the book, “Seven Days to Recovery”.

The vegan diet is wonderful for those who have adequate food sources and good balance in their diet. However, for someone who has primarily been drinking alcohol and tries to go on a vegan diet, not vegetarian diet, could promote failure. Perhaps, your cousin could start with a vegetarian diet and consider vegan later. A vegetable-based diet has been known to significantly reduce cravings for alcohol to its credit. A vegetarian diet could be more adaptable and could more easily provide your cousin’s nutritional needs than a vegan diet. There is a vegetarian food pyramid so you can compare it to the other two pyramids listed above.

I am impressed that you would seek outside opinion and information about diet for your recovering cousin. This level of sensitivity and care for another will be more supremely important than diet. I have little doubt that with your resources, openness, and care for your cousin, there will be much difficulty. You are right to consider there could be adaptability problems for your cousin who has discontinued an alcohol-centered lifestyle for a vegetable-based diet and lifestyle.

Try to include your cousin in any plans for addressing his dietary needs to further his success. I hope this information which be found to be useful. If I can be of further assistance to you and your cousin, please let me know.

Sincerely yours,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: I'm trying to get some help for my son he is addicted to alochol and he is living on the streets of baltimore I'm looking fgor a state funded rehab for him please help me

Iona Health Says...:

Please know that I understand the frustration, the fear, and worry associated with a son or other relative engaged in progressive alcoholism. Since your request was for resources in Baltimore, Maryland for state-funded alcohol rehabilitation, these are resources I have identified:

John Hopkins Medical Center www.hopkinsmedicine.org/psychiatry/specialty_areas/substance_abuse/

Another resource which may be more appropriate is:

Healthcare for the Homeless

Substance Abuse Services

111 Park Avenue

Baltimore MD 21201

Phone: (410) 837-5533

Web Site: www.hchmd.org

I think this resource would know all of the available substance abuse services for homeless men in the Baltimore area. From your request, it seems like you are strongly affected by your son’s homelessness and alcoholism. I would recommend that you find a local Al-Anon meeting at: www.marylanddc-alanon.org where you can get support for yourself, a greater understanding of alcoholism, and knowledge of the family’s role in supporting recovery in a family member. By attending meetings yourself, you stand a greater chance of being able to talk to and support your son from a place of knowledge and experience.

If I can be of further assistance to you in this or another matter, please do not hesitate to contact me as soon as you are able. I wish your son and you a speedy and successful recovery from the devastating effects often found in alcoholism.

Respectfully yours, 

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: I am in my last year of high school and am on a trip with some friends. We have been drinking beers every night. I start drinking at about 1 or 2 and I will have 15 or 20 beer by the end of the day. I am usually pretty heavy but this week has been a lot even for me. I am starting to get this really painful stomach feeling that is difficult to explain in the morning after drinking beer. After a few beers it usually goes away but the next day it gets worse. I have had this before when I drink a lot a bunch of days in a row. I am 17 and have only been drinking for about a year so I don’t think I can have hurt my liver yet. None of my friends gets the same way as me but I probably drink more than them. How come drinking is starting to make my stomach hurt so much? Is it something I need to be worried about?

Iona Health Says...:

The first thing you brought to my attention was your increased tolerance to alcohol. Drinking daily with friends and beginning with 1 or 2 beers then continuing to drink until you have consumed 15 to 20 beers by the end of the day. This self-report suggests heavy drinking minimally and possibly alcoholic drinking. This does not mean you are a confirmed alcoholic but it does mean that you could be abusing alcohol, addiction or not.

It is the excess of alcohol consumption that can cause stomach pain or alcohol gastritis, or inflammation of the lining of the stomach. Commonly reported symptoms of gastritis are:

• Pain or discomfort in the upper abdomen. This is the most common of the gastritis symptoms.
• Nausea and vomiting. The vomit may differ in color depending on the severity of the gastritis.
• Belching. Belching usually either does not relieve the pain or relieves it only briefly.
• Loss of appetite.
• A bloated feeling, feeling as if you have just drunk A LOT of water.
• A burning sensation at the top of the belly.
• A bad taste in the mouth.
• Diarrhea (For more information go to: www.the-alcoholism-guide.org/alcoholic-gastritis.html)

Medicines are not effective in reducing gastritis. The most effective treatment of alcohol gastritis is to (1) moderate your use of alcohol or (2) to completely stop your use of alcohol. The symptoms of alcohol gastritis will return if excessive use of alcohol is resumed.

I would encourage to decrease your use of alcohol or stopping your use of alcohol entirely so you can reduce/eliminate your symptoms of alcohol gastritis. It might be a good idea to consult with your doctor and let him or her know how you have been using alcohol and have your diagnosis of alcohol gastritis confirmed or denied.

If you find it difficult to stop using alcohol, you may want to have a substance abuse professional evaluate your current level of alcohol abuse. You can also have a free assessment for alcoholism by going to our website, www.choosehelp.com.

I hope this information is useful to you. If I can be of service to you now or later, please contact at your earliest convenience.

All the Best,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: I have a drinking problem that I can sort of control but which mostly controls me. I go through these back and forth phases of not drinking and binge drinking. What I do is quit drinking and get focused on getting in shape and doing better at work and being a better dad and being a more spiritual and mindful person. I do this for a while and after a couple of weeks I start feeling really great, much better than I ever feel when I am drinking. And then after a while I am feeling so great and there will be this reason to have a few glasses of wine or an old friend will come through town or whatever and I will end up having a few drinks. And then a few days later I will have a few more drinks and then it will just escalate until I am drinking between 6 and 12 beers every night. Once I am in a drinking phase I get obsessed with thinking about drinking and I will be thinking about getting and drinking beer all day long. Because my family knows about my battles with drinking I am also obsessed about hiding my drinking so they don’t know how much I am really having. After a while, things will get bad enough that I will quit drinking again and tell my wife that I am done with drinking again. I know myself very well and this cycle has repeated itself enough times that I know it’s like a pattern I can’t break free from. I am on my first day of not drinking again today after a health scare that I thought was related to drinking but wasn’t – but since I am in my 40s and have been drinking for decades, it very well could have been. I really want to break free from this cycle and stay sober for good. I have been to AA meetings before and I did not like them. I can easily quit for a few weeks or even months so I don’t think I need rehab. I just don’t know how to keep myself from slipping up a month or two down the road. How can I stop myself from repeating this pattern of my life?

Iona Health Says...:

I think you already recognize that in many ways you are fine father and a spiritually minded individual who cares for his family. These descriptors describe your character, not your medical condition or dis-ease. The struggle I sense is in your strong effort to try to control or hide your alcohol consumption.

Alcoholism is a life-threatening disease. What prevents many people from recognizing alcoholism is for a variety of reasons. First, most people do not like to think they cannot control a behavior or substance and are uncomfortable feeling controlled by externals, like alcohol. Secondly, many people do drink and can drink till intoxication, but do not show a loss of function. They go to work, to school, and fulfill most or all of their obligations. However, the difference between heavy drinkers like these and alcoholics is loss of control over their drinking. This loss of control includes, but is not limited to, a loss of control over how much is consumed in one setting, the amount of money spent on alcohol, the amount of time spent planning or acquiring alcohol, having to hide drinking or the amount of alcohol consumed from others, etc. Hence, I would like to draw your attention to common signs or symptoms associated with alcoholism:

You might have an alcohol problem if you experience three or more of the following alcohol-related symptoms within a year:

1. Not being able to quit drinking or control how much you drink
2. Needing to drink more to feel the same effect
3. Feeling sick to your stomach, sweaty, shaky, or anxious when you stop drinking
4. Spending a lot of time drinking and recovering from drinking
5. Giving up other activities so you can drink
6. Trying to quit drinking or cut back, but not being able to
7. Continuing to drink even though drinking causes you problems
8. Trying to hide your drinking from others
9. Having blackouts, where you don’t remember what happened while drinking
10. Having friends and family be concerned about your drinking

For more information about this, go to: maketheconnection.net/conditions/problems-with-alcohol

If you continue to have doubts about alcoholism, I would recommend you take an alcoholism screening test by Alcohol Screening Organization at alcoholscreening.org. This is a free test which indicates whether or not you test out as an alcoholic, based on your age, sex, and drinking patterns.

You asked what you can do to address this problem. Although I have offered resources, I still think your best move would be to consult with a substance abuse professional who can properly assess your drinking and making treatment recommendation for you, based on your drinking, level of motivation, history of alcohol abuse, family issues, and community/medical resources available to you. Since you did not like AA, you could also augment any treatment with attendace at recovery groups such as Smart Recovery or Rational Recovery meetings. Smart Recovery and Rational Recovery are alternatives to Alcoholics Anonymous. I do want to assure you that alcoholism is a progressive disease which will get worse if unattended by recovery resources or medical treatment. I encourage you to take action, get an assessment, and then consider your treatment options, if necessary.

I wish you every success in your search for answers for this common and treatable problem. If I can be of further service to you, please do not hesitate to contact me.

Respectfully, 

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: Is menopause ever a cause for excessive drinking. My wife is going through menopause right now and she is having a hard time with things. She is getting a lot of the usual symptoms like the hit flashes and sweats and she is also very emotional and sometimes, to my mind, she is not acting very rational. She is also drinking a lot more than she ever has before. She always liked to have a glass of wine with dinner and maybe a couple on the weekends but now she is getting drunk more than a couple nights a week, When she gets drunk she is much more likely to have an emotional ‘meltdown’ and it is very hard on me, but especially hard on our two high school aged kids. They know what she is going through and they’re good kids and they are trying to be sympathetic but they are also too often the target of her irrational anger and it’s hard for them to know how to handle this well. If she was acting like this a few years ago I would have been encouraging her to seek some help but as it is right now I know that her moodiness can be explained by the hormonal fluctuations. Is the drinking something that is also being caused by the menopause? I am kind of hoping this thing is just going to run its course soon enough but if the drinking is getting of control and it is not associated with the menopause then maybe I should encourage her to get some help. I have already tried just asking her to drink less and that didn’t go very well.

Iona Health Says...:

You are right in your rightful suspicion that menopause has been documented to be correlated with excessive drinking, mood swings, erratic changes in behavior and personality. I am going to refer you to some websites which can give you more specific, concrete examples and information for gaining a deeper insight into the relationship between menopause and excessive drinking. These websites are:

• http://www.goodtherapy.org/blog/women-hormones-menopause-alcohol-abuse/
• http://www.jrussellshealth.org/alcmeno.html
• http://www.gynob.com/menopause-and-alcohol-abuse-in-women.htm
• http://www.non12step.com/articles/treatment-for-women/88-menopause-and-alcohol-abuse-another-overlooked-element-in-womens-alcohol-treatment

For the more visually and technically oriented, I would like to offer you an excellent video which addresses the complexities between menopause and alcohol abuse. This video can be found at http://www.ehow.com/video_4400912_the-effects-alcohol-menopause.html

As you will discover, sudden changes and fluctuations in a woman’s hormones can cause problems in clear thinking and moodiness. Alcohol use/abuse can ease the severity of this discomfort when women experience the stress(es) of the lives along with the onset of menopause. For many women, this life change is the first time, they have abused alcohol to self medicate themselves from the uneasiness associated with hormonal changes. One of the articles above notes that heavy drinking can hasten the onset of menopause up to five years. An unexpected factor discovered by some researches was a link between heavy drinking and cancer; specifically breast cancer. This research should grab the attention of most menopausal women who drink and who would like to prevent cancer. 

As you can see, your wife is suffering from a medical condition which she is trying to treat herself. I would highly recommend that she consult with her doctor and discuss the problems she has been having. Your wife or you need to be frank with the physician and let the doctor know that she has been using alcohol excessively since she began menopause. Additionally, she may need to consult with a substance abuse program which considers “contributing factors” to her excessive drinking, not automatically apply the “disease model” and assume her main problem is substance abuse or early stages of alcoholism.

If your wife does not receive some medical help, I do not predict your family, your, or her situation will significantly improve. Therefore, I hope the information I have provided you will provide some assistance and guidance in this troubling situation.

If you need anything else from me, please let me know at your earliest convenience.

All the Best,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: I drink every day. I got very drunk a couple of nights ago and then I got a panicky surprise phone call in the morning from my ex wife to go get our son from school. He had fallen at morning recess and they needed a parent to take him for x-rays since they thought he had a broken ankle. I went to the school to pick up my son and then they asked me to wait while they coordinated his homework with is homeroom teacher. I thought it was a bit weird to have to wait but my son was not in pain when he did not stand on the leg so I obliged. 10 minutes later a police officer walked into the principal’s office and I was asked to take a breath analyzer test, which I failed with a 0.085. I was very surprised but I guess I was still drunk from the night before and I must have really smelled of booze which is why they called the police instead of letting me take him in my car. I probably didn’t look too great either. They threatened to charge me with DUI and child endangerment but in the end because I was there in an emergency and because I had only been drinking the night before they let me off with a warning and I had to walk home. My ex wife had to come from work to take our son. All in all it was one of the most humiliating and degrading days I have ever experienced. And my son saw it all and now my ex wife is saying that she won’t allow me to see my son for a while. And the worst thing is I was feeling so bad about it all that I stopped off on the way home and bought a bottle of rye. I have been drunk ever since. My car is still at the school and I am too ashamed to go and get it. I am going to lose my kids unless I stop drinking but I just don’t know how to do that. It is noon right now and I am staring at a bottle and trying hard not to take a drink but I think I am about to have one. If this isn’t rock bottom I don’t know what is. I am ready to stop drinking but I don’t know how to do that. What’s the first thing I need to do?

Iona Health Says...:

First, I would like to acknowledge the embarrassment and pain you have encountered as a result of your recent encounter with your son, your son's school, the police, and your ex-wife. When someone starts to lose things, or people, they love as a result of alcohol abuse or alcoholism, it can become very painful, hard to manage, and has been referred to as "hitting bottom." From this request, I sense that your children may be more important to you than your relationship with alcohol. If this is accurate, then there is hope for you and this painful situation if you take action.

Although you gave good reasons for your high alcohol content, it must have been readily obvious to the school personnel that you were under the influence of alcohol. Often when there is alcoholism or other addictions, the tendency is to use minimization, justification, and pure denial about the real problem. I do hear some minimization in your description of your alcohol problem. However, are you an alcoholic or do you simply abuse alcohol? I would recommend that you take an alcohol screening test at http://alcoholism.about.com/od/tests/l/blquiz_alcohol.htm or The Michigan Alcohol Screening Test. Please note there is a free assessment offered on the front page of http://www.choosehelp.com.

I strongly recommend that you determine the extent of your alcohol problem, how and where it can be best treated. For example, you will have to undo ambulatory detoxification or inpatient detoxification to avoid the potential dangerous effects of alcohol withdrawal syndrome. For more information on alcohol withdrawal symptoms, go to http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001769/.

If it is determined that you need treatment, then depending on your financial and employment situations, you would need to find a treatment program in your community. There programs in community mental health agencies, private agencies and hospitals.

This type of decision is better made with the help of a substance abuse professional. If possible, I would ask you to seek an assessment from a local substance abuse professional and find what local resources are available for substance abuse treatment.

I hope this information becomes useful to you and your family. Disrupted family relations, due to substance abuse, can have devastating effects on children. By taking responsibility for using alcohol excessively and as a coping mechanism, you may be able to protect your children and restore their important relationship with you, as their father by obtaining an assessment and treatment.

If I may be of further service to you, please contact me. I wish you and yours all of the best.

John W. O'Neal, Ed.S, MSW, MA, LPC, NCC