At least one time per week in my experience of working with clients and counseling there is a common question asked, “How can I get help for my loved ones drinking and drug usage?”. These are the common questions of concerned family members, friends, and significant others. Across the country millions of family members struggle with dealing with a family members' drinking or drug usage.

In my counseling of family members, friends, significant others and alcoholics/ addicts, the struggle comes in choosing the best approach for dealing with drinking and drug usage. What usually works is when the family or support system is able to view this as a family disease. The drinking or drug usage affects the family or support system as well as the individual who is drinking or using.

Usually might plan with the family members is to educate about signs and symptoms. Family members are usually aware of signs and symptoms. The symptoms can affect both the drinker/user and/or the family or support system. Signs and symptoms can vary from behavior/social changes, personality changes, physical changes, to medical problems. Overall, the concerned person is informed this may be gradual or rapid. If it is gradual they usually are not able to notice the symptoms as easily.

An example of a behavior/social change is someone who used to be very socially active with family members, friends, and the community, decreases activities or will stop them completely. This can happen abruptly or over a period of time. Once again if this is over time the family members may not notice the symptom as easily.

Another symptom is personality changes, which sometimes is also described as an emotional change. The personality change or emotional change which family members report to me more often than any other is a fun loving easy to get along with person changing to the most irritable or moody person that they have known. The person will react to situations in an aggressive manner either being verbally, emotionally, or physically aggressive or abusive or all three.

Over time, a family member or support system will notice physical changes with the drinker or drug user. The most common response in this area is hygiene, such as not bathing, showering, shampooing as the person used to in the past. Also others have noticed a change in the person's appearance. They may look bloated or have a drastic weight loss.

Medically speaking, other changes may occur such as cardiac problems, high blood pressure or mental health issues. In addition, with the drinkers and drug users they may have problems with liver functions. The symptoms may have a long-term effects and need to be addressed as quickly as possible.

First and foremost a family member or support persons best defense for dealing with a loved one's drinking or drug use is to seek help for themselves first. There are many avenues to address the issue. An integrated approach I have used in my practice for years is an individualized plan for each client I see. Some options are seeking individual counseling, family counseling and group counseling. In the community, become active in twelve step support group such as Al-Anon. also, various churches in the Quad Cities offer spiritual based programs for significant others.

The overall theory in my practice is that you need to help yourself first and the drinker or drug user may or may not join you in this endeavor. This is line with twelve step support groups focus on detachment with love and acceptance of the significant others inability to change the loved ones drinking or drug use behavior. The bottom line is the only person you can change is yourself.

Various studies by Robert J. Myers, Ph.D. (2002), with the Butler Center Research - Hazelden Foundation, have found that significant others of drinkers or drug users need a combination of services. The combination of services includes individual, family and group counseling along with a twelve step support group such as Al-Anon . There was more success with engaging the drinking or drug user into treatment.

The goal is to allow significant others the tools to address their needs as well as assist and loved one into treatment. Significant others are able to work on the typical response they have had in the past and what are present day appropriate responses to the drinker or drug user. The results show the significant others using the combination of services were anywhere from 58.6% to 76.7% more successful and engaging the drinker or drug user into some type of treatment.

Counseling options for the drinker or drug user, depends on the extent of the usage as well as all the signs and symptoms, which were previously discussed. This is individualized for each person. The standards have been set to determine the appropriate level of care for each individual. The level of care is determined after completing an assessment with a professional. These levels of care can be from the least intensive to the most intensive level of care.

The first level of care would be a community twelve step support group. The next level with the individual counseling, possibly with family counseling. Moving on from there would be intensive outpatient groups from nine to fifteen hours per week. Day treatment involves the person going to groups during the day hours and to their home at night to sleep.

If a drinker or drug user has medical issues related to usage, a stay in a hospital based program to address the detoxification issues is the next level of care. An inpatient stay involves a person staying in the hospital 24 hours a day. This is to allow monitoring of medical issues. The length of stay varies for individuals based on medical issues, support systems, their environment at home and the costs.

Another level of care is long-term care of such as three to six months in a residential setting to address recovery issues. In this environment the individual usually does not leave the facility but addresses issues daily via groups and individual sessions.

A halfway house allows individuals who have been maintained sobriety to live there. They may be struggling with the environment they live in the need to live in a sober environment. The plan is to work in a job and attend groups so many hours a day at the halfway house and in the community.

Overall as you spend the holidays thinking of family or friends and if you have concerns about loved ones drinking or drug usage the best approach is to take care of yourself first. This means focusing on yourself and deciding your best options. If you would like to seek assistance by using an integrated approach please feel free to contact me at my office.