Question: My sister is an alcoholic. Last year we had a family intervention and we all got together a really tried to make her get into some treatment. We even had a place all arranged for her to go to. But it did not work and now she is drinking more than ever before. We do not know what to do. Some of the family want to try again but this time they want to hire a professional interventionist to help us. Others think this is ridiculous and that if it did not work once she is not going to be fooled by it a second time. I do not know what to think. Is it a ridiculous idea to try a second intervention on an alcoholic within a year?

Iona Health Says...:

For a complicated treatment problem, I am going suggest a simple answer. Contact a professional interventionist or interventionist organization and obtain their best professional opinion about the feasibility and effectiveness of a professional intervention after the family failed to assist a family member from entering treatment. Some good websites where you can locate professional interventionists are:

• nadai.us
• intervention911.com
• interventioninfo.org

One spot of hope. It is very common for family to try to get another family member into treatment, informally or formally, using some form of plea bargaining or intervention. These attempts can easily fail. When this happens it is appropriate to refer the family and impaired family member to an intervention professional. I have done many successful professional interventions in hospitals, treatment centers, and in the community after the family has exhausted their hope or best efforts. Please do not give up on your sister. Let the rest of the family know what the professional recommendations are. Your sister can get sober if not in one attempt or but numerous attempts. Her odds are greatly improved if she can obtain some form of treatment which exceeds 180 days. This can be inpatient, residential, partial hospitalization, intensive outpatient, outpatient, and a half way house.

I wish your family, your sister and you every kind of success.

Respectfully yours,

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

Question: My friend has been smoking pot for many years, her family and marriage are falling apart and now she thinks everyone is against her and she feels alone. She recently started sharing her pot with her teenage son. How do I schedule an intervention properly? Several people in her family deny that she has a problem, I think they are in denial about it altogether. How do I help? The husband has cried out for help.

Iona Health Says...:

Your friend could be heavily reliant or dependent on marijuana. Marijuana is often considered a natural and “harmless” plant comparable to tobacco. In my years of providing substance abuse treatment, I can report that marijuana is a highly effective drug which wipes out the user’s feelings and can affect his/her best thinking. Marijuana is a mild hallucinogen and has similar disinhibiting and depressant properties of alcohol. For more information about marijuana, go to these websites:

www.acde.org/common/Marijana.htm
www.ncjrs.gov/ondcppubs/publications/pdf/marijuana_myths_facts.pdf

These are the known dangers of marijuana use:

• Impaired perception
• Diminished short-term memory
• Reduces learning abilities
• Loss of concentration and coordination
• Impaired judgment
• Increased risk of accidents
• Loss of motivation
• Diminished inhibitions
• Increased heart rate
• Anxiety, panic attacks, and paranoia
• Hallucinations
• Damage to the respiratory, reproductive, and immune systems
• Increased risk of cancer
• Psychological dependency

With most substance abuse, significant relationships are affected and often disrupted. Depression, anxiety, and social isolation are common for marijuana users/abusers as they rely more on their use of marijuana rather than their relations with people. In this isolation, the users/abusers do find others who will accept them along with their drug use. For these reasons and more, it is not surprising that your friend’s son is smoking marijuana with his mother. 

The way to help your friend would be for you to talk with her husband and other supportive family members for the purpose of arranging an assessment with a substance abuse professional and/or arrange an intervention for treatment. Planning an intervention would require the identification and participation of any family, friends, neighbors, co-workers, church members, professionals and any others who have a deep concern and knowledge of your friend’s substance abuse and deteriorating behaviors. These individuals would have to agree that your friend has a substance abuse problem, have evidence that her substance abuse has been harmful, and would be willing to ask your friend to go into treatment. Some treatment centers will provide a free assessment of your friend’s substance abuse problem and could offer intervention services, at no or some cost. In some cases, families turn to private professional interventionist(s) to plan and execute the intervention. If your friend’s husband wants to direct an intervention himself, here are some resources: 

http://www.drug-rehabilitation.org/intervention.php
http://www.arctreatment.com/blog-addiction-los-angeles-drug-rehab/how-to-conduct-an-intervention/

The remaining concern I have is for your friend’s son. With his mother modeling the use/abuse of marijuana and providing him with the drug, this son could have devastating effects on the major areas of his life. Without knowing the age of her son, this mother could be contributing to the delinquency of a minor, if he is a minor. This mother could be reported and charged if anyone reported this. Both mother and son could face legal problems for use of an illicit drug, i.e., marijuana, if this was ever brought to the attention of the local authorities. Please do not rule the son’s need for a substance abuse assessment and/or treatment as well. His welfare should be considered as well.

I hope you find this response helpful to your question. If I can help in any way, please feel free to contact me at your convenience.

All the best,

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

Question: I am 14 and I live with my mom who is a single parent to me. We don’t really have much close family except for 2 aunts and 2 uncles who don’t live here in Georgia. My mom has started drinking a lot and I am very worried about her. I have talked to her about how much she drinks but she says that she is fine. Sometimes she is angry with me when I ask if I ask when she is drunk and sometimes when I ask her when she is hangover she says she wants to talk to someone about her drinking but she never does. I want her to stop drinking so much because I am worried about her and because she is not the same person when she drinks. She is hard to live with when she drinks which is all the time now. How can I get her to stop drinking? I do not know if she needs to go to rehab or not but I am worried about that also because I do not want to leave my school and I am not sure if I would be allowed to stay over with my friend for very long. Who should I talk to about this to make her get some help but not someone who is going to take her away from me or anything like that.

Iona Health Says...:

I would like to thank you in advance for having the care, concern and the courage to ask for advice/support or both on an online counseling service. I will do my best to help draw a map for you which may make your choices/options more clearly to you.

You stated that you are a 14-year-old female teenager with a small remote extended family. As a result, your mother does not have close family nearby which can give her support and feedback on her drinking behavior. By you stating that your mother is “drinking too much” suggests that she loses control of her behavior, her drinking, and the effects of the alcohol on you and her. Could your mother be an alcohol abuser or alcoholic? Let’s look at this.

The definition of alcohol abuse is:

Any "harmful use" of alcohol. The Diagnostic and Statistical Manual of Mental Disorders IV describes alcohol abusers as those who drink despite recurrent social, interpersonal, and legal problems as a result of alcohol use. Harmful use implies alcohol use that causes either physical or mental damage. It is also referred to as “binge drinking.” For more information, go to http://alcoholism.about.com/cs/basics/g/alcoholabuse.htm

The definition of alcoholism or alcohol dependency is:

Alcoholism is a primary illness or disorder characterized by some loss of control over drinking, with habituation or addiction to the drug alcohol, causing interference in any major life function, e.g. health, family, job, spiritual, friends ,legal." Bottom line is as soon as your drinking begins to affect any areas of your life, you know that there is a problem. For more information on alcoholism, go to this website: http://www.alcoholism-and-drug-addiction-help.com/definition-of-alcoholism.html.

For a better understanding of the symptoms of alcoholism, go to this website: http://www.alcoholism-and-drug-addiction-help.com/alcoholism-symptoms.html

With alcoholism, frequent is marked by strong denial, a tendency to minimize the problem or seriousness of the use of alcohol and its impact on important areas of your mother’s life; including her relationship with you. The other features of excessive drinking can include depression, low motivation, dishonesty, erratic behavior, mood swings, angry outbursts, social isolation, to name a few. If you are seeing any of these, I can appreciate the crisis your family may be facing.

I think I understand your dilemma of having to think about what kind of medical care or rehab your mother may need to address her drinking, her denial, inconsistent and difficult behaviors. It is not easy to live with an alcoholic or drug addict as you are finding out. As for your question, “how can I get her to stop drinking?” There is nothing anyone can do to make an alcoholic stop drinking. There is much a family can do to help the alcoholic make a decision to address her/his addiction, and consider rehabilitation. In this respect, families often need education and professional help.

First, I would recommend you find support for yourself. There is a group called Alateen for teenagers who have family members whom are problem drinkers. The website for Alateen is:

http://www.al-anon.alateen.org/for-alateen. I would encourage you to go to this website because it a resource for teenagers dealing with alcoholism. In Georgia, there is an Alateen website which has a questionnaire of 20 questions which helps to determine:

1. if Alateen is for you,
2. if someone’s drinking is affecting you, and
3. where Alateen meetings are held in Georgia.
   

If you can’t find a local meeting, there are online meeting that you can attend. For more information, go to this website: http://www.12stepforums.net/teens.html. There is also an online Alateen chat websites: http://chat.alateen.net/

Please do not forget the school counselor or social worker. They are well prepared and versed in working with teenagers whom have substance abuse in the family. If you go and talk with them, they may be able to provide you with additional support.

I cannot recommend rehabilitation for anyone who has not had a formal evaluation for substance abuse by a professional substance abuse professional. The Choose Help website offers a free substance abuse assessment if your mother would agree to participate. Also, her family could be instrumental in supporting her in getting the help her family and she needs. There many programs in Georgia which can assess the seriousness of your mother’s drinking and the level of care she needs (e.g., outpatient, inpatient, and/or residential). However, whatever form of treatment your mother could need, you will need to be provided for. Usually, this concern is addressed when a parent is referred to a treatment program.

This type of situation can be very stressful for teenagers who are working hard in school and growing up. An impaired parent can make this process more difficult. Please consider the resources I have offered your family and you. If you need anything else from me, please do not hesitate to contact me.

Warmly,

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

Question: I'm hoping/praying that our family alcoholic won't ruin Christmas for our family by getting drunk and creating tension and stress. She is in total denial and we do plan a family intervention soon after Christmas, but my concern is how to survive Christmas with the family. I would appreciate any comments or suggestions. Thanks

Iona Health Says...:

Dear Concerned Family Member:

Many families are concerned about how they are going to “weather” through the holidays from Thanksgiving to New Year’s Day. This time period is the peak time for alcoholics to relapse or drink more heavily than usual.

First, your family sounds like it needs immediate support and your family can find that in Al-Anon Family groups. Without knowing your location, I only can direct you to an Al-Anon meeting locator website at:

http://www.al-anon.org/meetings/meeting.html so you can find a meeting in your area. There are also online Al-Anon meetings as well. They can be found at: http://www.ola-is.org/groups/about/index.htm. These are not a substitute for meetings in the community.

Because you identified that the holidays can be marred by tension and stress, it would be great if your family and you could gain some support, learn about how alcoholism affects family members, and to begin to learn about recovery. This often occurs with families who do not have the coping skills or recovery tools to stay in relationship with an active alcoholic whether drinking or not. Alcoholics often feel the dual stress of the holidays and being with their families. How do they cope? By drinking until they feel satisfied, calm, or inebriated.

Do you have a treatment facility or provider ready for your sister’s treatment after the holidays? If so, it may have meetings for families early in recovery. If you look, you may be surprise how many resources for families of alcoholics there are.

From your information, I can see two main choices. One choice would be to spend time with your sister while she is actively drinking, without trying to control it, while “consciously” minimizing your time with her (based on your stress tolerance of her behavior). Secondly, another choice would be to limit or not include your sister and/or alcohol during your family time together. This would be a very difficult choice to make for most families. You have the right and the choice on how you spend your Christmas, with whom, and for how long. Family self-care strategies evolve as the family begins their own recovery which involves emotionally, no relationally, detaching from the alcoholic when in the disease of alcoholism. Al-Anon teaches this.

Often, when alcoholics get out of control it, is often because there is excessive availability of alcohol, enabling by the family, and/or there is too much unstructured time for the alcoholic to use to “act out” with alcohol. Could you consider having family time without alcohol and/or spending “limited time” with you alcoholic sister? Another choice would be to structure your time around specific activities or events which would make it more difficult for her to drink. However, be advised that she could always show up after drinking excessively. Essentially, alcoholics, and/or their drinking, often control their families. In recovery, the family has to learn to separate the alcoholic from the drinking. By the family making healthy choices about what they are willing and not willing to tolerate, how much time they are willing to spend around inappropriate/alcoholic behavior, considering first what they want or need not what the impaired family member wants, framing all their decisions and support on the basis of recovery principles which helps to model and encourage the alcoholic in her own recovery.

I hope your family and you can plan ways you can share the Holidays in a mutually enjoyable way. Remember, you have recovering families in your community who can relate and support you through difficult times with your sister. Best wishes and outcomes for your family and your sister! If you need anything else, please feel free to contact me.

John W. O’Neal, EdS, LPC, MSW, MA, NCC

Question: My whole immediate family and several of my uncles and their families will come to stay at my parents’ place over Christmas. My brother has had a drinking problem for years but things seem to have taken a real turn for the worse this year and he is getting in very heavy with the drinking. I would like to see him get some treatment for his problem but he insists that he doesn’t have a problem and he can get very angry if I bring it up. I think that he is in denial and I think that we need to do an intervention if we are going to have any hope of convincing him to go. I have been reading about interventions and I realize that it is important that we get as many people that are close to him as possible to talk about his drinking and how it has affected them to try to break down his wall of denial. Because of this, l I think that that Christmas, when several family members will be coming in from out of town, makes a lot of sense as the time to go ahead and do this. A part of me though thinks that it is too cruel. My brother has always loved Christmas and the whole holiday and family thing. Am I risking having the intervention not work by combining it with Christmas – with too many other emotions and stuff going on? Should I wait until after Christmas to do it, even though it may mean that some people in the family will not attend? I think if I do wait, some of the people in the family who are not as on board with the idea of sending him to treatment will at least get to observe him and his drinking over that few days and come to understand why we need to do something sooner than later.

Iona Health Says...:

I am sorry to hear that your family and your brother are becoming increasingly affected by your brother’s progressive drinking.

Most heavy substance abusers or alcoholics do not believe they have a problem when-

1. most of the people they know drink similarly to them,
2. other family use alcohol and/or other drugs, and
3. their drinking can be protected by defensiveness, anger, and strong denial.

You are wise to consider using an intervention specialist to help you with your brother and his alcohol abuse/dependency. I used to do family intervention work with several hospitals so I am very familiar with it and their effectiveness to help impaired family member enter into detox, rehabilitation and successful treatment.

Let’s address your question(s) about whether you should do an intervention with your brother at Christmas with other family members. First, I agree with your pros and cons about doing a substance abuse intervention with family members at Christmas. However, I think it would be wise first to-

1. identify a good treatment center for alcoholics,
2. insure that this facility has a good reputation for alcohol detox and rehabilitation,
3. (3) talk with the admissions staff and make a determination if this facility would provide an professional substance abuse assessment for your brother and family,
4. confirm if this facility is affordable and will offer at least 90 days of continued treatment (a combination of detox, outpatient, inpatient if necessary, residential treatment, half -way house, and aftercare),
5. a family program to address the needs and recovery of the family, and
6. whether the facility could provide an in-house interventionist or recommend a local interventionist as part of the treatment strategy.

I would like to offer you some resources. A national resource to identify established treatment centers is Samhsa.gov.

Here is a website to give you information on interventionists and interventions: nationalinterventionassociation.com .

Armed with good information about addiction, alcoholism, addiction as a family disease, intervention, detoxification and rehabilitation, recovery for the alcoholic and family, and relapse prevention would crystallize and assist your family’s decision, and method of intervening, on your brother’s alcohol abuse/alcoholism. My hope is that you find this helpful to you. If you should need anything else from me, please let me know.

Wishing the very best Xmas Season for you and your family,

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

Question: After watching a lot of the show intervention on A and E I can see that bringing in an interventionist has a lot of value, but when I looked into it for our family situation I was surprised to learn how expensive they are, especially since there are traveling expenses that would need to be bundled in to get to us. (no one local performs this service). We are trying to get my brother to agree to get some help for his drinking. He has always resisted any attempts but he has a new baby son now and my parents say they are now willing to stop his financial support unless he goes along with getting some help. This is something they were not willing to do before. These 2 things together make me believe that we have a pretty good shot of having him agree to get the help that he so obviously needs. We have a certain amount of money available that should be enough to get him into a 1 month program that has a 2 month residential follow up program. This program was recommended to us by our doctor. If we spend several thousands on an interventionist we will have more difficulty paying for the treatment. But then again, if we cannot convince him to go at all, then savings the interventionist money doesn’t make a lot of sense. Is it worth it to pay for the professional help or are we best trying it out on our own?

Iona Health Says...:

Let me see if I understand the exact nature of your brother’s alcoholism:

1. Your brother does not recognize that he has an addiction problem.
2. His family recognizes that he is alcoholic, and wants him to go into treatment even though the brother/son does not agree.
3. You think your brother and family could benefit by use of a private interventionist even though your family does not have enough money to pay for your brother’s intervention and treatment.
4. Your father is willing to stop giving your brother, with a new child, any more financial support unless he agrees to go into alcohol rehabilitation or treatment.

Your question is concerned about whether it would be valuable to use an interventionist or handle this situation as a family without professional intervention. I would like to offer you several points which, hopefully, will help you make the best decision about your desire for your brother’s treatment and sobriety.

1. Your brother remains in denial about the exact nature or severity of his alcoholism.
2. Your brother does not agree with his family that he has an alcohol problem.
3. Your father is willing to cut off financial support for your brother as a way to entice him into going into treatment against his will.
4. You have the support of your doctor who has recommended treatment for your brother.
5. You have found a treatment center and program which sounds adequate for your brother’s treatment.
6. You believe that the use of a private interventionist would increase the likelihood of your brother’s agreement to go into treatment.

As for background info, I used to do interventions in a major medical center so I do know how they work and what is involved. Let me share the following:

1. Interventions do not guarantee the success of getting someone into alcohol rehab
2. It can take weeks to months to appropriately organize an intervention.
3. In an intervention, you want every stakeholder to be there and to be prepared to confront your brother’s alcoholism from their knowledge and experience of his drinking, its effects on the stakeholder, the family, and the alcoholic.
4. The idea of an intervention is to “raise the bottom” for the alcoholic so that many of the end stage consequences of alcoholism can be avoided; for example, the loss of his family or health.
5. The central feature of an intervention is that you care about the alcoholic and want him to stop the destructiveness of his alcoholism so you can get him back as the brother you know him to be.
6. You have as many family members, friends, professionals, neighbors, employers, in-laws, etc., as possible in the intervention to give your brother feedback and “break through his wall of denial.”
7. You can not threaten the alcoholic but you can make clear what consequences he can expect from others if he doesn’t adequately address his drinking problem.

The main problem is that your brother drinks but doesn’t recognize or admit he is an alcoholic. Your brother doesn’t see that he is getting ready to lose his family or their support. Whatever is done must be done in a loving manner, or else your brother will be defensive and potentially uncooperative.

You may want to see if there are any drug and alcohol counselors in your area which provide intervention services. This may provide you with some reduction of costs.

If you cannot afford an interventionist, you may want to use someone to serve as a guide for the intervention. Ideally, it would be someone who won’t be intimidated or back down but someone that your brother truly respects. Doctors, ministers, former coaches and teachers have been able to be effective in this capacity. Whatever you do, it is important that it is well organized and that there is a plan to take your brother for admission for treatment immediately after the intervention. If you cannot afford an interventionist, then your choice is to find the best person to lead and organize the interventionist and the parties involved.

Some websites which you may find useful are:

nationalinterventionassociation.com

http://www.hazelden.org/web/public/hff80302.page

http://www.spiritualriver.com/how-to-do-an-intervention/

Additionally, some treatment centers will provide intervention services at no additional cost to the family. Have you checked into this?

I hope this information has been helpful to you in moving you closer to who, where, when, and to what extent your family and you are prepared to do an intervention for your brother. He can recover but needs someone to believe that he can. Please let me know if I can be of further service to you.

Best of Luck to your family, brother, and you,

John O’Neal, Ed.S, LPC