Whenever She’s Not Working, She’s Drinking

lmgrn1 's Loved One drinks alone in the house whenever she's not at work. Her life seems to revolve around it. They're all living together for the forseeable future, and she needs some help with boundaries…

My daughter is a 24 year old health care professional and struggles with what I think is severe alcohol abuse. She's currently working during this pandemic on the front lines. It is a very trying time for many particularly those with mental health/co occurring substance abuse issues. Her work is honestly the only thing keeping her moving in a positive direction.
She moved back home two months ago after a failed relationship with her live in BF, loss of a job and a DUI. We welcomed her home with stipulations that we are a "sober" house. No alcohol will be allowed in the home (nearly impossible to police by the way). She has been caught many times bringing it in, consuming it at night while we are all sleeping, continuing to be in denial about her illness when confronted. She has been hospitalized twice for detox and follow up IOP in the past year. The roller coaster of addiction is alive and well in our home. She is back to the denial phase and believes she can drink in moderation. Read lmgrn1’s full comment here.

Your description of your daughter’s drinking demonstrates what a hold addiction has on a person. Her life, outside of work, revolves around her drinking. She drinks alone. At night. She binges, and yet makes it to work (not all the time, I would presume).

In Learning Module 1, we talk about moderation, the science that exists around it, and its potential for success. In the module, we provide a link to a story of a couple who tried to moderate. In a number of cases, possibly especially so for those of us on this site, moderation has a low probability of working. This is a general statement and each case is certainly different. But the reasoning is that the research on moderation demonstrates that those most successful with this approach are those on the low end of drinking, with a relatively shorter span of time in active addiction. As you describe, your daughter’s drinking is already on the serious end of alcoholism, so moderation is less likely to be successful, according to the research.

However, as we discuss in Learning Module 1, going along with a Loved One’s plan to moderate is also not a bad idea. In a recent post, we described the reasoning for this along with several factors to consider for the family member as they approach such a scenario.

So, yes to moderation: “Giving them the rope” is exactly what we suggest you do when a Loved One wants to moderate. Even consider telling your daughter to try it with your blessing. The chances are very good she will not be able to keep it up but knowing through experience that she can’t succeed with moderation is worth the lesson for her. As everyone on this site well knows, telling a Loved One what is going to work for them, or what they need to do, has a pretty dismal success rate. Setting up a predictable, compassionate and open environment that is conducive to real communication, in which a Loved One is most likely to learn their key life lessons one their own, is always preferable. When we learn lessons for ourselves, they are truly our own.

Moderation done correctly involves supervision by a therapist. Would she be willing to get the support for moderation by seeing someone who could work with her and help her try this with supervision? Online support options are more and more abundant these days. See our list with resources for both Loved Ones and family members here. It is great to hear that you are getting support online during this stressful time. Try to gather a few options you think she might go for in a low moment. If she’s not already connected with a solid therapist who offers online counseling, check out some of the options on our list that specifically offer therapy. 7cups is one that comes highly recommended.

The bottom line is that your daughter is home with you, with nowhere else to go. You then, are living with someone active in their addiction and this isn’t going to change tomorrow. Nor the day after that… Can you and your partner watch Learning Module 1, and come up with a plan that you could accept, that would let her to try a glass of wine with dinner? If you were to open this up, assure yourself that this would be the plan for the time being, taking a cue from the lessons in Module 1. This could certainly start a bender, perhaps not the first or second time, but soon enough. But your focus for now is on letting her try things in a new way, and indeed of shifting the dynamic within your household to attain more open communications.

Negotiating with your daughter so that she can have a glass with dinner will open a conversation with her that will be different than what has gone on before. With the emphasis on working in partnership with your Loved One, you are seeking to talk things out openly and actively solicit her input and participation. It sends the message: okay, you are in charge of your drinking. We are going to support your efforts to take care of yourself. First, we are going to try moderation.

For your daughter’s part, this isn’t about having the first glass at the table and the rest in her room, with bottles of booze hidden in the mattress. This is why we stress the importance of an actual plan with external supports in place. The idea isn’t for her to wing it on her own and hope for the best. But if it does escalate, so be it. Then, in partnership with your daughter, you are candid and open about the conversations about what follows: what comes next? Another program? Talk it through now. You can’t hold her to it in a policing sense, but she will remember having been part of the conversation about what’s next. This is part of the groundwork.

Trying this upfront approach with a truly collaborative conversation style, pushing some responsibility onto her to help come up with a plan alongside you, would be a great start in shifting the dynamic. It sounds like there is ample room to shift things around in your household right now. You’ve mentioned boundaries that you haven’t enforced (which is common, and understandable especially in the midst of the Covid crisis). You are concerned about her drinking in isolation, and you want her to gain the independence to see that she needs treatment. These are all valid concerns.

But please don’t take on the responsibility for her drinking alone because of the rules you’ve set up. This is not your doing. These are patterns she has held for some time. You’re right – she needs to realize that she needs treatment on her own. The CRAFT method is designed to usher our Loved Ones towards this inevitability while simultaneously giving up the power struggles associated with trying to get them to do what you want them to do and on your time frame to boot. A big part of this is stepping back and allowing her behaviors to play out while you remain steady in your stance, ready to step in during those key moments when she expresses a “wish or a dip”. Give yourself plenty of patience and compassion as you also offer these to her along the way. This is extremely challenging work for the family member.

It does sound like the boundaries you’ve set could be revisited, perhaps after reflecting on some of the resources and suggestions in this post, and trying out a few conversations with her to see what you can come up with for a moderation plan. As you feel out the potential for new dynamics with these conversations, it might be easier to start fresh with some boundaries the whole household can get behind. At that point, given the fact that she’s not going to be living elsewhere anytime soon, maybe you take the housing “boundary” off the table and introduce some new boundaries that feel appropriate, with a greater emphasis on collaborating to come up with something that works for everyone. There is room to shift things here. Simple boundaries that are enforced may be better in the long run than more extreme ones which aren’t upheld.

One last thing. We highlight the Sinclair method on this site. The science supporting  the Sinclair method is positive: the drug Naltrexone can help people naturally curtail their drinking. Perhaps moderation is a go, but so is a serious attempt at taking a medication that can help with the drinking. As for the other medications she may not be taking and potentially with the Naltrexone, perhaps you dispense and watch her take it every morning for a while. The drugs should help her want to reduce, as will the moderation efforts, since this is what she is motivated to try.

Good luck with this. Times are very hard for families who have active Loved Ones at home for the foreseeable future. It sounds like you are navigating this well, and you are staying level-headed despite all the chaos around you. It is heartening to hear that you are getting support. We’re glad to be a part of that support system for you. Thank you for writing in with this excellent question.