Alcoholism: Loved One In Treatment For Alcohol Addiction

The following transcript gives insight on how to deal with a loved one who is in a treatment facility for alcoholism. Family members need to be prepared for everything, even a possible alcohol addiction relapse. This interview is filled with wisdom on this subject.

Interview about the book: “Loved One In Treatment” by Lisa Frederiksen


HospitalHost : Welcome to Perspectives on Healthy Living. I’m your host and we are talking with Lisa who is the author of many a book and her latest one is Loved One in Treatment – for alcoholism, right?

Lisa : Or drug addiction.

Host : Or drug addiction. And now what? Because a lot of people actually feel that the problem is over once the addicted person gets into treatment, right?

Lisa : Right.

Host : But that’s not true, is it?

Lisa : No, no.

Host : So what actually happen?

Lisa : Well, a lot of times, what happens is the family members – there could be a lot of anger getting into depending on the relationship or how long it has taken but then there’s the sense that now …

Host : When you say anger, what do you mean? Angry about what?

Lisa : Anger at the addict/alcoholic believing that they could have done something to stop this and …

Host : Oh, you could have stopped sooner.

Lisa : Sooner, right. If you would have just done and …

Host : Yeah.

Lisa : And there’s a lot of times when many deals – OK, we will do it this way and you don’t do that and if you do this, then that will happen and broken promises and mainly because no one in the family  understands addiction. And so that perpetuates the problem and so anyway, by the time the loved one finally gets into treatment, then you have the family member either anticipating, “Oh, finally it’s over,” and then it doesn’t feel better or they could have a lot of anger and just be like, “Go get yourself fixed and when you’re done, come home.”

Host : Yeah. Come home and apologize.

Lisa : Right, right, right. And there’s a long road ahead.

Host : Well, is part of it because in society in general we don’t accept addiction as a chronic ongoing illness that people think that you could have stopped if you wanted to?

Lisa : Correct. I think that’s a huge part of the problem. There are roughly 23 million people who suffer from addiction and …

Host : In this country?

Angry ManLisa : Only about 10 percent seek help and then compared to 23 million diabetics of which 75 sometimes [0:02:13] [Indiscernible] as high as 85 percent seek help. And there’s different perception of the two diseases and while yes, they’re both diseases, what makes it so difficult is we didn’t understand until just this last 10, 15 years that addiction is a brain disease and because it’s a brain disease, that’s what affects how the people behave, who have this disease.

The other problem too is that along the way, all addict/alcoholics go through a period of substance abuse which is not full-blown addiction and it’s during the abuse stage that that’s when all of the deal making and it’s not that bad because nobody wants to call him an alcoholic/addict.

Host : I know. That is the neighbor.

Lisa : Right.

Host : Or the uncle.

Lisa : Yeah, and then that’s what starts to set up second hand drinking or drugging impacts to the family members or friends who are close to them.

Host : What do you mean by second hand drinking? Is that like second hand smoking?

Lisa : Yes, right. It’s to try to get that same sense of we all appreciate when somebody is smoking that it has an impact on my health or the people in their sphere. But we don’t understand that when somebody is drinking or abusing substances, that that has an impact on those in their sphere too so that’s what the term is hoping to try to illicit that kind of connection.

Host : Oh. Well with second hand smoke, it’s obvious that it affects other people because there’s smoke.

Lisa : Right, exactly. Yeah.

Host : But with addiction, there’s so much emotional stuff. And isn’t there an emotional expression like “You’re blowing smoke”?

Lisa : Yes, yes.

Host : So there’s this emotional smoke that affects other people and that’s what second hand drinking is.

Lisa : You know, the fights with the loved one about, “This is the last time,” or “You wouldn’t believe what you did last night. It was so horrible,” or they come home and you’re trying to judge how much they’ve had to drink or if they’re high.

So you’re watching and then maybe they go to the kitchen and you follow along to see if you can hear or try to catch them or you sit down at the dinner table and maybe dad is having a few more drinks and mom is starting to get anxious and then the children are trying to judge who’s going to blow first and then they just kind of like try to sneak off.

So all of that is having an impact and children for example, they go to their room then and then they start to hear the escalation of the fight upstairs. And maybe they can’t really concentrate on their homework or maybe they aren’t getting sleep and then the next morning they come upstairs or come out of their rooms and dad is being really nice trying to make it up to mom and mom is not taking it. She’s really mad because dad doesn’t understand what he did and that is what we mean by second hand drinking.

Host : Yeah.

Lisa : It’s the impact of the change in the brain, the change in the person’s behaviors. Not only that individual but the way the other people react to that and that dynamic creates an immense ripple effect.

Host : And we don’t talk about that very much. I mean even in the news, you see these stories about heroin addicts and alcoholics falling down and all of that but you don’t see the impact on families. Why is that?

Lisa : I think well because a lot – I think it’s the stigma around addiction, period. So we can barely talk about the addict/alcoholic let alone that the family – that there’s an impact on them.

Host : Yeah.

Lisa : And then because society still believes that once you stop, all is well, then they think that the family should just be well and not realizing depending on how many years that has been going on, that dynamic.

You can only imagine the intimacy or the co-parenting. If it’s a child who has the problem, one parent believing we got to do something and the other parent is saying, “Well, all kids go through this. It will pass,” and that dynamic and then you have the other children in the family and they kind of get lost in the shuffle.

Host : Yeah.

Brain x-rayLisa : Then that’s just in the family members of the alcoholic. Then those people go off to school or they go off to the workplace and they’re looking and they go, “Oh gosh, what does she mean by that look?” or “Listen to her tone of voice,” and they interpret that as meaning you’re mad at them because that’s how they stayed safe at home. They’ve had to hear the sound of the voice or they had to listen for the pop of the can to know, “Here it goes again. This is going to be one of those nights,” or “Oh, he’s on his way to drunk because of the way the key sounds in the door.”

So they take that same heightened sense of awareness of their surroundings into their – and so you go out into society into the workplace and school.

Host : So if you a have a raging  alcoholic, parent, then if somebody yells at work, it impacts you a hell of a lot more.
(Learn how to protect yourself during the mood swings that an alcoholic has.)

Lisa : Because you’re reacting to what you have been conditioned to.

Host : Oh, that’s horrible.

Lisa : And you interpret it as something for you to react to as opposed to …

Host : Taking it personal.

Lisa : … whether it’s really directed at you or not.

Host : Yeah, and you may not even know if it was a little bit of anger or a lot of anger. It’s just you’re hyper vigilantly receiving it.

Lisa : Right.

Host : That’s another part of it is so much of what happens to the family members is surrounding the emotional reactions to the person and this is the hard part is we always look at addiction but it’s this long period of substance abuse. For example, all alcoholics will go through alcohol abuse but not all alcohol abusers will become alcoholics yet the behaviors are the same because the alcohol impacts the brain which then impacts the way a person thinks and behaves and it doesn’t have to be full-blown addiction.

In fact, I think we have a slide that shows – I think it’s a 38-year-old brain of an individual who had 17years of heavy weekend use and a lot of times, we always say, “Oh well, they’re not an alcoholic.”

Host : It’s in the next slide actually.

Lisa : Yeah, they’re not an alcoholic because they don’t – they go to work or …

Host : Right. And so that brain is very impacted.

Lisa : Right.

Host : And that’s just weekend use.

Lisa : Just weekend use, correct.

Host : Yeah. So can we go back to the slide before? And there’s a normal brain. So a normal brain does not have holes in it. ( Check out these articles about Understanding The Alcoholic’s Mind.)

Lisa : No, and this is not like missing brain matter but what the holes show bottom right would be the same image comparing it to top down views, is areas of low blood flow and areas of low brain activity. So giving you the visual that something has to be happening in the brain and helping us better appreciate that these chemical and structural changes that occur with substance abuse change how a person thinks, behaves and acts.

Host : That seems to be the latest innovation in the last maybe 20 years. The National Institute on Drug Abuse, the federal government research wing on addiction has done a lot on understanding how the brain works.

Lisa : Yeah.

Host : And how it does some work under the influence. And has that been useful information?

Lisa : Absolutely. For me, understanding alcohol addiction as a brain disease and why was huge because it let me let go of anger and resentments and …

Host : So you don’t blame them.

Lisa : You don’t blame them because you understand how addiction works and basically, everything we think, feel, say and do is governed by how our brain cells talk to one another and talk to other neurons in the body. That requires what they call a neural network and so addiction or drugs of abuse, alcohol or illegally prescription drugs attack the neural networks in the limbic system in the pleasure-reward center and if a person repeatedly abuses, it causes the brain to change how it wires and how those connections work.

To just back up a minute, when you drink alcohol, it’s not digested the same way as food. It passes straight through to the small intestine and into the bloodstream and it dilutes in water and goes to body tissue with a lot of water, which the brain is one.

So it sits there and you can just picture this depressant substance sitting.

Host : So this is a big vat of alcohol.

Lisa : And it takes about one hour because we only process through the liver. So it takes the liver about one hour to process one standard drink. So if somebody is drinking eight, nine, ten drinks a night, it’s taking eight, nine, ten hours for their liver to process that amount of alcohol.

Host : If the liver is healthy.

Lisa : If the liver is healthy.

Host : Right.

Lisa : So then it sits in the brain and that’s why the alcoholic behaviors change. So not understanding that, that’s why people say they get into fights. They have ridiculous arguments. They drive while impaired because they’re not thinking clearly. It’s not that they thought, “Well, if I have five drinks, I should be able to go drive.” It starts to compromise their judgment. The neural network is responsible for judgment. Yeah.

Host : Right. Whoa! So if somebody has cancer, people have compassion.

Lisa : Right.

Host : When somebody has addiction, people get mad.

Lisa : Right.

Host : And blame you for having the illness. So that’s a tough one.

Lisa : And the part of the …

Host : Including the family.

Lisa : Oh, yes, because what we don’t understand is substance abuse is one thing, causing the brain changes like we showed on that slide. But then why some people cross the line to addiction and others don’t are what they call risk factors and well, let me just touch bases on what makes addiction versus just substance abuse and one of them is cravings. Because when the brain starts to get bombarded, those dopamine neural pathways, what the brain does is the beauty, is it dials down the dopamine which causes it to lose receptors and so then you’ve interrupt – you’ve hijacked the connections for pleasure.

Host : Right.

Lisa : So the person drinks more, trying to get that feel-good feeling and that’s what starts to set up tolerance which is another symptom. Cravings and addiction, craving is five times stronger than the instinctual hardwired desire to eat food when hungry. So that helps …

Host : Unless you’re addicted to food.

Lisa : Yeah, that’s true.

Host : All right.

Lisa : So you help the person understand why an alcoholic will lie and cheat and steal and do whatever they have to do to get their substance because it has now taken control of them. So they cannot – as long as they use their substance, they can never predictably control the outcome. Some days they might, some years they might, but not every time.

So for an addict/alcoholic, it’s tolerance, physical dependence, cravings and then there’s one more.

Host : Withdrawals.

Lisa : That’s part of the physical dependence and then there’s one more – loss of control. Right.

Host : Yeah.

Lisa : They no longer can control how much they drink.

Host : That’s interesting. So when families don’t understand that, they have all this emotional stuff that’s going on.

Lisa : Right.

Host : And you were saying that the families have physical symptoms too.

Lisa : Right.

Host : You know, which is very interesting and people don’t really understand that.

Lisa : Right. What happens to the family members, they get caught in the fight or flight response stress response and that is another …

Host : Yeah, I hate you. I’m out of here …

Lisa : Yeah, yes.

Host : … or I love you.

Lisa : Oh, no or what. And that’s another instinctual, again, hardwire. This is what’s so incredible is that this all impacts in the limbic system and some of these, just we don’t think about it. We don’t think about why we eat. We just do.

Host : Yeah.

Lisa : So the fight or flight stress response system triggers – well, let’s see. It causes a number of reactions. Blood vessels under the skin to constrict to prevent blood loss, should you get cut. It causes the eyes to dilate so you can see better. It causes endorphins to kick in so it blunts pain. It causes the liver to break down glucose so that it adds more energy to where it needs to be.

So back in the day when mankind was evolving, that gave you enough energy to run and get away from the …

Host : The dinosaur.

Lisa : The dinosaur, exactly, or the great woolly mammoth and nowadays, the human species is the only one that can anticipate stress. So we can be in chronic stress in having all those physiological things happening but then we don’t do the running. So they sit and that’s where family members will have …

Host : So the extra glucose, the extra dopamine.

Lisa : Yes. The endorphins, the blood loss from the skin. So a lot of times, family members will present with migraines or depression or anxiety or many physical ailments because the system is constantly being activated but with no expenditure of them.

This is the end of the first video on how to deal with a loved one in treatment for addiction problems. As you can see alcohol addiction is a chemical imbalance of the brain. We will be posting the 2nd part of this video soon. In the mean time be sure to check out the alcoholism audio lessons.

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