Ask an Addict: Is it Possible to Help Someone Who Won’t Admit They Need It?

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This article is not meant to diagnose or provide medical advice—that responsibility lies with physicians. The author is not a licensed medical professional.

Addiction is an issue that impacts almost everyone in some way. I’ve been in recovery from alcoholism/addiction since January 2008. During that time, I’ve gone through ups and downs but have fortunately managed to stay sober. I’ll be answering a reader-submitted question about recovery every other week (information on how to submit below). I’m not an expert or mental health professional, just a sober person offering advice based on my experience and the research that’s available. This week, I’m talking about if and how it’s possible to help someone who won’t admit they’re struggling with addiction.

Hi Katie,

My boyfriend, Paul, has a friend (Steven) from middle school who is currently in the hospital, going on a month from cirrhosis/liver failure after decades of severe alcoholism. He is only 30 but has struggled his whole adult life with the disease and is still in real denial. The only reason Paul knows about it is through a mutual friend. Paul has been talking to Steven a few times a week and the whole time they have been talking, Steven never mentioned that he has been in the hospital. According to the mutual friend, if Steven recovers in the hospital, he will relapse without treatment and definitely die. How is it even possible for someone so young to have liver damage from drinking? Everyone involved is positive that Steven will not seek help on his own. Paul and others have tried for years to get him to talk about this and address this, and he will not do it openly.

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Does Paul call Steven and tell him he knows what’s going on? Should we try to convince him that he needs treatment? Steven lives in a city several hours away from us and we’ve even discussed showing up at the hospital where he’s a patient. We want to be supportive of him but it’s hard when he doesn’t seem to see the reality of his situation—so much so that he’s not even talking to us about it. Are you just totally helpless if the person won’t take a first step?

From, Paul’s Partner

Hi Paul’s Partner,

I am sorry you and Paul are in this situation; my heart goes out to Steven. Addiction is a real asshole and part of the reason is the impact it has on pretty much everyone in its wake. I have been on both sides of the equation: loved an addicted person and been an addicted person. Each scenario has its own set of challenges but both feel pretty crappy.

We often think of cirrhosis as an older alcoholic’s challenge—and that’s often the case. But a decade or two of chronic binge drinking absolutely can do permanent damage. As all the caveats on this column state, I’m not a doctor and can’t give medical advice. But I can tell you that when I found myself in the emergency room at the ripe old age of 23, I had about a decade of drinking under my belt. When the doctor approached me to talk about the results of my blood test, she informed me that my liver enzymes were at the levels she would expect to see in a heavy drinking, middle-aged male. Fortunately, I had not yet reached the tipping point of cirrhosis and my liver could recover if I stopped drinking immediately. I was lucky. Studies have demonstrated that permanent liver damage (cirrhosis) can occur after less than a decade of alcohol abuse. It sounds like Steven’s doctors believe he falls into this category.

There are a few adages about addiction; one of those states that if a person doesn’t want to get sober, no outside person can make them. This is basically true. But it’s also true that people who are pushed into treatment without being “ready” sometimes get sober. I think it’s more accurate to say that someone must want to stay sober. Getting sober is hard but staying sober is harder. It’s not harder forever, but at first it definitely is. So Steven’s loved ones may be able to force him into treatment but only Steven is ultimately responsible for the success of his treatment.

Are you well within your rights as people who love and care about Steven to go make your case? To beg, plead and cajole him to get treatment, to save his own life? Only you know the answer to that, but it sounds like you think you are. And I wouldn’t blame you if you did. I don’t know what Steven’s situation is like but it sounds like he has a network of concerned loved ones. If that’s the case, people have likely tried the begging and cajoling before. That’s not to say you shouldn’t take that approach, just that you might consider an alternative—especially considering Steven hasn’t told you and Paul directly about the situation.

I understand why Paul feels awkward about approaching Steven about the situation, considering he heard about it from a third party, but I think being honest and straightforward is the best option. If I were Paul, I would reach out to Steven and say, “hey, I heard through X person that you’re in the hospital. I’m so sorry to hear it, what can I do?” Then, I’d put real suggestions behind that offer for help. Offer to research treatment options, travel to the hospital on weekends, whatever he needs. (It might go without saying, but anything you offer to do, you should be prepared to actually follow up and do. So don’t, like, offer to take him to Fiji or something). And then it’s up to Steven to take it or leave it.

When I was drinking, my lying stemmed from two places: denial and shame. Actually three places: denial, shame and a desire to not get in trouble. But mostly denial and shame. Anyone who knew how much I was drinking would judge me for it. And I was already so ashamed of myself.

Treat Steven as you would if you found out he had late stage cancer, or another disease that doesn’t have any stigma associated with it. You can be open about how sorry you are that he’s sick without getting into why he’s sick. You’re there to help. If he’s interested in treatment programs, the Substance Abuse and Mental Health Services Administration is a good place to start. You can make the case to him about why you’d like him to go that route. Ultimately, however, he’s the one who gets to decide how he wants to treat his addiction.

I’m glad Steven has you and Paul for support.

From, Katie

Paste contributor Katie MacBride is a freelance writer and the associate editor of Anxy Magazine. Her work has appeared in Rolling Stone, New York Magazine and The Establishment. Every other week she will answer one recovery/addiction related question posed by our readers, based on her experience. Email questions to [email protected] with Ask Katie in the subject. By emailing, you are agreeing to let Paste publish your email. Emails may be edited for length.