How to Talk to Someone About Their Alcoholism

Approaching someone about their alcohol use can be daunting. You may worry about how to bring up the topic, whether you will offend them and how they might respond. Still, if you suspect that a loved one’s drinking has spiraled out of control, addressing the issue can be a crucial step toward helping them find the support they need. Knowing how to talk to an alcoholic about their alcoholism involves understanding the nature of alcohol use disorder (AUD), recognizing its signs, choosing appropriate language and offering meaningful encouragement.

This article provides practical guidance on how to discuss alcoholism in a constructive and compassionate way. We will look at the diagnostic criteria for AUD, the common signs of harmful alcohol use, effective and supportive ways to start a conversation and what not to say. We will also outline specific steps you can take to help your loved one while taking care of yourself. Finally, we will review alcohol treatment options and recovery resources that can provide hope and healing.

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What Is Alcohol Use Disorder (AUD)?

Alcohol use disorder (AUD) is a medical diagnosis characterized by the inability to control or stop drinking despite negative consequences. In past years, healthcare professionals often used the terms “alcohol abuse” or “alcohol dependence.” Today, these concepts are combined into one overarching diagnosis: AUD. This designation acknowledges that problem drinking exists on a spectrum ranging from mild to severe. Regardless of its severity, AUD can interfere with health, relationships and daily functioning.

An important aspect of AUD is that it is not a moral failing or a simple lack of willpower. Rather, it is a chronic disease that changes how the brain responds to alcohol, influencing a person’s emotions, behaviors and thought patterns. Sometimes, those struggling with alcohol feel shame, guilt or confusion about why they can’t just “stop.” Learning about AUD can help you approach your loved one with empathy rather than judgment or blame.

It is also important to note that AUD usually coexists with other mental or physical health concerns. For example, someone with depression or anxiety may drink to self-medicate or cope with emotional pain. Over time, these drinking habits can become ingrained. Alcohol use can be both a symptom and a driver of deeper problems, making professional help especially important.

Alcohol Use Disorder Diagnostic Criteria

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria used to diagnose alcohol use disorder. Generally, meeting two or more of the following criteria within a 12-month period indicates that an individual may have AUD. The more criteria a person meets, the more severe the condition:

1. Drinking more or for a longer period than intended.
2. Wanting to cut down or stop drinking but being unable to do so.
3. Spending a lot of time drinking or recovering from the effects of alcohol.
4. Experiencing cravings, or a strong desire or urge to drink.
5. Failing to fulfill major responsibilities at work, school or home because of drinking.
6. Continuing to drink despite problems in relationships caused or worsened by alcohol.
7. Stopping or reducing participation in important social, occupational or recreational activities due to alcohol use.
8. Using alcohol repeatedly in physically hazardous situations (e.g., driving under the influence).
9. Continuing to drink even though it’s causing or exacerbating a physical or psychological problem.
10. Developing a tolerance to alcohol, requiring more to achieve the same effect.
11. Experiencing withdrawal symptoms when the effects of alcohol wear off (e.g., anxiety, shakiness, sweating, nausea).

If you notice that your loved one meets multiple criteria from this list, it may indicate a more serious issue that warrants professional attention. However, do not rely solely on self-diagnosis. Encourage them to seek a medical or mental health evaluation for a full, accurate assessment.

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Signs of an Alcohol Use Disorder

Spotting the signs of alcohol use disorder can be challenging, especially if someone goes to great lengths to hide or deny their drinking. However, certain indicators often emerge that suggest a person’s drinking has crossed a dangerous line. These can include:

• Increased Frequency or Volume of Drinking: They may start drinking earlier in the day, drink more often during the week or consume larger quantities in one sitting.
• Behavioral Changes: Irritability, mood swings or episodes of anger and aggression can become more frequent. You may also notice that they become withdrawn or secretive, especially about where they’ve been or why they missed an appointment.
• Neglect of Responsibilities: A person with a developing AUD may frequently miss work or school, show up late or neglect household chores and family obligations.
• Social Problems: You may see a decline in the quality of their relationships as conflicts around alcohol become more common. They might also choose to isolate themselves from friends or activities that do not involve drinking.
• Physical Symptoms: Redness in the face, shaking hands, sweaty palms, gastrointestinal problems and poor personal hygiene can all point to alcohol-related health issues.
• Hiding Alcohol or Lying About Drinking: People with an AUD sometimes stash bottles in secret locations or mislead loved ones about how much they’ve been drinking.
• Using Alcohol to Cope: Relying on alcohol to handle stress, sadness, anxiety or boredom can be a strong sign that a pattern of addiction is forming.

While any single one of these behaviors might not confirm an AUD, a combination of them can be concerning. If these signs are persistent and worsen over time, it’s important to address them promptly and provide support.

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What To Say to an Alcoholic

When you decide to have a conversation about your loved one’s drinking, thoughtful preparation can help. Framing your words in a non-confrontational, compassionate manner sets the tone for productive dialogue. Here are some guidelines for what to say:

1. Begin With Empathy and Concern
   Start by expressing genuine care for their well-being. You might say, “I’m worried about you and I love you. I’ve noticed some changes in your drinking, and I want to make sure you’re okay.” Emphasizing love, concern and support from the outset can help the person feel less defensive.
2. Use Specific Observations
   Rather than making vague accusations, focus on concrete examples. For instance, “I noticed you’ve been late to work several times recently because of hangovers,” or “I’ve seen you get upset more quickly when you’ve been drinking.” Highlighting specific behaviors can help them see the impact of their actions on their life and those around them.
3. Express Willingness To Listen
   Conversations about addiction should ideally be a two-way street. Show that you want to hear their perspective: “I’d really like to understand what you’re going through. How do you feel about your drinking?” This approach opens space for them to share their feelings, fears or reasons for drinking.
4. Offer Validation
   A person with an AUD may already be battling shame and guilt. Let them know you see their struggle: “It seems like you’re dealing with a lot, and I know this is hard.” Recognizing their challenges can mitigate defensiveness and encourage honesty.
5. Encourage Professional Help
   Even if someone acknowledges their drinking problem, they might feel unsure about where to turn. Offer resources or suggest seeking professional treatment: “I’d be happy to help you find a counselor or a rehab program. We can look into options together.” Sometimes, making the initial steps feel more manageable can persuade them to get help.
6. Keep the Lines of Communication Open
   End the conversation by reaffirming your availability: “I’m here for you whenever you’re ready to talk or if you need someone to lean on.” Consistent support can make a difference, especially when your loved one is hesitant about treatment or worried about stigma.

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What Not To Say to an Alcoholic

Just as certain phrases or attitudes can help a conversation about alcoholism go well, others can undermine it or cause harm. Even with the best intentions, words can trigger shame, anger or defensiveness. Avoid the following pitfalls:

1. Using Shaming or Accusatory Language
   “You’re such a drunk,” “You’ve become a loser,” or any personal attacks focusing on their worth can exacerbate shame, pushing them away rather than motivating them to change. Instead, stick to describing behaviors and consequences rather than labeling the person.
2. Ultimatums Without Follow-Through
   Threatening someone with consequences like, “If you don’t stop drinking, I’m kicking you out,” can be risky if you are not prepared to follow through. Empty ultimatums can erode trust. If tough boundaries are necessary for your own well-being, make sure you are willing and able to uphold them.
3. Minimizing Their Experience
   Comments like “It can’t be that bad,” or “Everyone drinks once in a while,” can make them feel misunderstood or dismissed. Even if you’re trying to reduce their shame, minimizing the severity of their drinking can discourage them from seeking help.
4. Making It About You
   Avoid turning the conversation into a lecture about how their behavior inconveniences or embarrasses you. While it’s important to share how their drinking affects you, the primary purpose of the discussion is to encourage treatment and healing, not to assign blame.
5. Expecting Immediate Agreement or Gratitude
   Because alcohol addiction alters how a person thinks and behaves, they may not respond positively the first time you confront them. Insisting they thank you or agree to everything you say on the spot can backfire. Recognize that meaningful change usually requires multiple conversations and consistent support.

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Other Supportive Steps

After having an initial discussion, you may be left with many questions: “What now? How do I keep helping without enabling? How do I care for myself in this process?” The following four steps can guide you toward being supportive while also protecting your own well-being.

1. Get Support

Reach Out to Professionals
You do not need to tackle this alone. Therapists, counselors, addiction specialists and interventionists have training in how to speak with someone struggling with alcohol. They can offer advice tailored to your unique situation.

Involve Trusted Friends or Family
Enlist the help of individuals who also care about your loved one. However, ensure that everyone is on the same page about how to communicate respectfully and effectively. Contradicting one another or presenting mixed messages can confuse the person with an AUD.

Consider Support Groups
Groups like Al-Anon or SMART Recovery Family & Friends can offer resources, workshops and emotional backing. Listening to others who’ve experienced similar challenges can help you feel less alone and better equipped to set boundaries and communicate effectively.

2. Practice Self-Care

Set Emotional Boundaries
Caring for someone with an AUD can be emotionally exhausting. It is crucial to recognize your limits and take steps to maintain your own mental health. Practice stress-management techniques like mindfulness, journaling, exercise or therapy.

Avoid the Trap of Enabling
Enabling occurs when you protect your loved one from the consequences of their actions. For example, calling in sick for them or giving them money when they’ve spent their paycheck on alcohol. These actions, although well-intended, can inadvertently allow them to continue harmful behaviors.

Remember You Have Needs, Too
Whether you’re a spouse, parent, sibling or close friend, your life doesn’t revolve solely around your loved one’s drinking. Keep up with hobbies, maintain friendships and prioritize your career, physical health and emotional well-being. You can be compassionate without neglecting yourself.

3. Set Up Treatment Options

Research Available Programs
Look for rehabs, counseling services or support groups in your area. The Recovery Village Cherry Hill at Cooper, for example, offers evidence-based treatment for alcohol use disorder in both inpatient and outpatient settings. Having a list of potential treatment options can make it easier for your loved one if they decide they’re ready to seek help.

Speak With Treatment Providers
Before you approach your loved one with suggestions, talk to these programs or providers yourself. Ask about insurance coverage, how to begin the admissions process, typical treatment timelines and what family support looks like. This can empower you to answer some of your loved one’s initial questions about treatment.

Present Options in a Non-Pushy Way
Rather than demanding, “You have to enroll right now,” say, “I’ve looked into a few places that could help, and I’m willing to go over the options with you whenever you’re ready.” Emphasizing choice can reduce resistance and encourage cooperation.

4. Get Involved in Your Loved One’s Treatment

Attend Family Sessions
Many rehab programs encourage family participation through educational sessions, counseling or workshops. These sessions help you learn about addiction, set healthy boundaries and improve communication patterns within the family.

Stay Involved
Recovery is an ongoing process that doesn’t end when a person leaves rehab. Encouraging them to attend follow-up appointments, supporting their involvement in 12-step or other peer support groups and helping them build a healthy lifestyle can make a difference in sustained sobriety.

Practice Patience and Realistic Expectations
Recovery often involves setbacks and relapses. While relapse is never guaranteed, it is not uncommon and doesn’t mean that treatment failed. If relapse occurs, continue to offer support while reinforcing the importance of professional guidance and healthy coping strategies.

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Recovering From Alcohol Addiction

Alcohol addiction can be difficult and potentially dangerous to recover from on your own. Severe alcohol withdrawal can be deadly, so heavy alcohol users should not attempt to wean off alcohol without the help of a professional medical detox facility. Alcohol addiction treatment will begin with a detox period that focuses on managing any uncomfortable or severe withdrawal symptoms that arise. After detox ends, patients begin a rehab program that teaches them how to cope without alcohol and maintain sobriety.

Detox and rehab can take place in inpatient or outpatient settings. Outpatient treatment is best for mild alcohol addictions, and it allows patients to attend doctor and therapy visits while still living at home. Inpatient treatment is best for moderate to severe alcohol addictions or people who have relapsed. Inpatient treatment involves living on-site at the detox or rehab facility, an approach that keeps patients in a healing environment and allows for better monitoring and treatment.

The Recovery Village

The Recovery Village Cherry Hill at Cooper provides a full continuum of care, from medical detox and inpatient rehab to aftercare. We are here to help you and those you love recover from addiction and begin a healthier, alcohol-free future. Contact us to learn more about alcohol addiction treatment programs that can work well for your needs in recovery.