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Binge Drinking and Diabetes

bottle & phone

I am struggling with the not coming home part with my daughter. We have told her we don’t want her home when she is using drugs and she usually doesn’t come until the next day. I have asked her to let us know if she won’t be home as we worry about her safety. and I go out of my head worrying. But her pattern is to ignore my text or call and not respond until the next day. I understand the letting them experience the let them be out in the world on their own but my adult daughter also has type 1 diabetes and has had some dangerous, life threatening consequences from both low and high blood sugars while drinking. My heart says at least when she is home I know she is alive. I am so afraid that if she is gone for days at these friends’ homes where they are doing the drugs no one is capable of knowing if she is just sleeping it off or is actually having such a low blood sugar that she could go into a coma. My fear is fueled by one episode where she landed herself in intensive care because she drank so much and went into diabetic ketoacidosis. Read the full comment here.

Such treacherous ground you are on. Your daughter is at high risk of hurting herself, mixing alcohol and now cocaine with a health condition such as diabetes. She can do well for months at a time, and then seems to break out in a binge, putting her physical health gravely at risk.

You’ve hit on the central, raw, and painful point in this whole picture — those thoughts like "my child will die if I don’t protect him; my daughter will die if I don’t keep her out of harm’s way; I wouldn’t be able to live with myself if…; at least when they’re home I know they are alive…"

Your daughter recently came to you and said she had a problem with drugs. This is CRAFT at work. This is what we are looking for. You had the list of treatment options ready. What happened when you presented it to her? CRAFT is about putting the immediate environment in place, making it the best one possible, investing time in the things you can control (your communication, your behavior, your help with treatment) and waiting for your daughter to do just what she did: admit she needs help.

She can still say no or she can say yes to treatment, and then not go. In these cases, you maintain your CRAFT stance and set up again. There will come a time she will say she needs help again. Then you’ll pull out the list and say something like: “let’s choose something together. I’ll do anything I can to help you.”

There are limits to what a family can do. A family can do CRAFT, but it is ultimately still up to your daughter. You are shining a light down the road to treatment, you are reducing barriers to her getting into treatment, you are holding out your hand.

You are doing everything you can, despite the fear that when she is away from home, she will drink to the point of diabetic ketoacidosis. You are correct to be worried. When you mix cocaine with alcohol, you do more of both. The cocaine allows you to drink more without getting incoherent. When you add cocaine to a drinking problem it is like adding premium fuel in a car. She will drink more.

These two things are true: she can hurt herself and you can hold your position and keep your arm outstretched.

When she is withdrawing in her room, let her alone. If you are at all concerned about her state of health in the moment, call first responders. When she is home sober, step in and reward.

You are doing CRAFT and I see the signs that it is working. When you are both in a relatively calm mood, the next time you have an opportunity, can you let her know how valuable it would be to you if she could answer your texts the same night, check in with you to relieve your worries about her health, and possibly even make a plan to address monitoring her blood sugar levels when she’s away from home for an extended time? Raising these concerns – but leaving the substance use out of the discussion until the time is ripe for that – in a non-confrontational way, letting her know you want to work in partnership with her to at least address the blood sugar monitoring could be helpful. At least you’d have a chance for her to hear you on this one piece of the puzzle.

In the meantime, set up again. Things can change so quickly and you have done so much of the work needed to create the optimal environment for your daughter to see that she needs help and to get her connected to that help… take some deep breaths and acknowledge how much you have done, and that you can keep doing this. She will ask for help again. Go back over Learning Module 8. Be on the lookout for a wish or a dip, plan out the next conversation about treatment. It has to be a strategic moment, or she will dismiss you. She has come to you once, she will come to you again. In the meantime, look into a civil commitment to see what is involved. Look at the paperwork; get the backup materials the process calls for. You want to cover all the bases you can in this situation, so find out all of the possible external support options available to you. You can also look into hiring an interventionist but they are costly and in general are less effective than the CRAFT method. In the early comparative clinical trials of CRAFT, interventions worked 25% of the time, while CRAFT worked 65% of the time.

This is a terrible place to be for a family. Your description makes it all too real. You are doing what you can. Loved Ones are adults. In the eyes of the law, they are responsible for the decisions they take. As the family, you can learn and behave in the way most likely to lead them towards the right decision. That is CRAFT.



In your comments, please show respect for each other and do not give advice. Please consider that your choice of words has the power to reduce stigma and change opinions (ie, "person struggling with substance use" vs. "addict", "use" vs. "abuse"...)

  1. Thank you for your response, your acknowledgement and support. You asked what happened when we presented the treatment options. She looked at the paper which had all of the options ranging from private counselors, to addictions foundation counsellors who would present the range of supports available here, to help line to a government funded 21day treatment and a private 30 day treatment option several hours away. She thought at that moment she would be interested in seeing an Addictions counsellor. She said she needed to go and be by herself and think of her plan. She left the house about a half hour later texted me and said she was going to be by herself so she could call the helpline. She had taken the paper off the table with her. She then said she would arrange to meet with someone but it wouldn’t be this week as she had a busy schedule at school and the times they gave us to come for intake were during her classes. I checked in with her during the week and asked if I could drop her to the appointment and she said no she would be fine going there herself. This has not happened yet. I don’t want to nag her about it so I backed off. My husband had one further conversation later that week and he said we heard her when she said she wanted to get help and that this week was too busy for her but we worried if things stay busy, going to get help will get harder and harder and that she should make herself and help a priority. If there was anyway we could help her with that we will. I am not certain but I am suspicious she drank last evening not sure about any drugs and she is sleeping most of today. We have already dealt with getting her up to deal with a blood sugar of a 2. We chose to test scan her and when we saw she was so low we turned her light on in her room and said she needed to get up and deal with her blood sugars. We have her leave things on her nightstand to treat lows. We left her room when we saw her get up and treat her low and have not had anymore conversation with her since. I have been looking tonight to make sure I do indeed have all of the external supports in our area available. I will set up again so I can be ready when she comes to us again for help and I like the let’s choose something together. I do find our available options to be somewhat limited in our area of Canada compared to some of the places and supports I hear parents talking about in the discussions. But we do have some and I will have those available to us ready for her. I will review module 8 and keep looking for a wish and dip. At this point, I am not wanting to use an interventionist (I don’t even know if that’s available in our province but I will research that.) Thank you for your feedback and support.

    1. This is a wonderful report. You spoke, she listened. She agreed but as we know, these things don’t happen overnight. You are not pressuring her but remaining near so you can help with the diabetes, a dangerous condition. A blood sugar of 2? I have never heard of such a low where someone was conscious. She is no doubt absorbing everything that’s happening while looking through a lens that leads to recovery. She may not get the help she needs right away but over time there is hope.
      Hang in there.

      1. Thank you gptraveler, your supportive words are helpful and appreciated. It certainly is a one day at a time life but I am happy to say that so far this week has been very positive. I will hold on to these moments and remain hopeful for more and more of them. To clarify mmol/L is the blood glucose values used where I live. In the US it is mg/dl I believe. To convert a blood sugar of a 2 that is equivalent to 36 mg/dl. That is very low which adds to my concern. One way I try and look at it is what would I do if the drugs/alcohol were not part of the equation. And I respond in the same way. When she is sober and more coherent we talk about how dangerous and scary it is to see her in such a vulnerable state and worry we will lose her. I hope one day she will be able to understand that and do some things differently around that. Have a good day and thank you again.

    2. I recall sitting in on a family meeting with my niece and this brilliant psychologist who was treating her and the family. My niece’s mother, my sister, was describing how crazy making it was to see her daughter constantly shift positions about important things, in this case getting further help. In my sister’s eyes, her daughter was lying, saying things just to appease the family.

      The psychologist explained that ambiguity is part of change. My niece was actually telling the truth in the moment, expressing one of the two opposing views, both wanting treatment or not wanting treatment. We expect people to say something, mean it, and do it. But the process of change shows itself in partial ways, with statements that sound contradictory, because in a moment of time, the sentiment expressed is true for them. Read my full response to this family member here:

  2. My husband and I are new to Allies In Recovery and the CRAFT approach. Thank you for this amazing resource. I already do not feel so alone as I work through the modules and read parents comments and questions. I am still so terrified and overwhelmed but determined to learn how to best help our daughter seek support/treatment. Our daughter has had medical issues for 20 plus years and has in the last year been taking a low dose antidepressant. She binge uses cocaine and occasionally drinks alcohol. She started experimenting 6 years ago and has had two times where she came to us and said she wanted to stop and went for counselling. Things appeared to improve but in the last 2 months seems to be escalating again and the worst I have seen. She does have a pattern that indicates her use to us, she will not answer texts, calls and then does not come home until later the next day, sleeps for 2 days or so straight. She rarely has missed work or university. She has one year left in her degree. We have seen her go through a lot of money this past 2 months as she got a student line of credit this past year as she identified that as one of her major stresses last year; taking such a heavy course load and trying to work. She has spent it all, we will not support her in getting any more student loans under these current circumstances. We have paid her tuition up to this point she has paid for her books. She pays her phone bill and car payment but lives at home while attending school. We have noticed things to be getting worse, she has given away shifts at work because she is crashing after using. She has missed a few classes this month which is not been like her. We shared our concerns with her and after this last binge she came home and told us she doesn’t want to use drugs or know why she does and that she wants to get help. We had a list of support options written out for her and said we will be here to support her and are extremely worried about her health and safety. She said she called one of the support lines to speak with someone and she said she was going to set up an appointment with an addictions counsellor. A week went by and she said it will happen but she couldn’t make it work this past week with her busy schedule. She went out last evening and has been sleeping most of today since she got home from work. I am not sure if she used drugs last evening or not. I am working on the reward when not using and withdraw when we suspect she has used. We have always told her we do not want her to come home under the influence and for the most part she does not come home until much later the next day but then sleeps for several days. Other than not attending to her and letting her experience the consequences of sleeping and missing a class or a shift or wasting her day how else can we deal with after she has used? I also am not sure how to handle her saying she needs help and is going to go then so far this past week has not? Is this just to get us off her back or is she really wanting help? How do we communicate around this? I am also seeking any support on how to handle the school piece? I do not want to not continue paying her tuition if it keeps her going and she is managing her grades well as this is a positive. Do we just deal with this issue if she fails something? Do we just let the consequences take care of that? I have read the pieces on school as a reward but I am confused about this. I am as confused about her coming home to come down from her use. Is this a reward? I think in past I was rewarding by giving attention to that and maybe making it too comfortable during, waking her up for school or work for example. I am no longer doing this. I say I am not comfortable watching you like this and I remove myself. Where I am still struggling is my daughter is also diabetic ( insulin dependant). I am sick with worry when she doesn’t come home as to her lack of care for herself or if anyone she is with would know the difference if she was having a low blood sugar that could result in coma or just sleeping it off. There are times where if I don’t go and test her sugars and she has been dangerously low she is not coherent enough to care for herself and treat her diabetes. She has landed in intensive care once because she was not able to care for herself. She was at a music festival with friends and we were away in another province. We had to rush back as she was in poor condition. This fear drives me insane and I am angry with her still about her lack of care and using drugs or alcohol knowing the possible consequences. I feel in a very trapped spot and really do not know what else to do but keep her safe until she is able to do so herself. Sorry this is so long. I feel like I am going crazy watching both of these diseases consume my daughters life and our lives. I am burnt out emotionally and physically.
    I truly would appreciate any support and ideas as I continue to learn the CRAFT approach. Thank you so much.