While most people with a friend or family member with alcohol use disorder (AUD) mean well, it can be easy to inadvertently say something that hurts more than it helps.
In fact, even calling someone “an alcoholic” rather than “someone with alcohol use disorder” can be problematic, because it can lead to a loved one feeling defensive or stigmatized; the term “alcoholic” also downplays the fact that AUD is a health condition that can be treated and lead to recovery.
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Although terminology might seem minor, it can play a major role in how your words are received. With the goal of showing support and having productive, compassionate conversations, here are five things to avoid saying when talking to someone with AUD — and what to say instead.
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1. Your Drinking Doesn’t Seem That Bad, Maybe You Just Need to Cut Back
This comment appears to offer reassurance that someone with AUD doesn’t have behaviors that seem especially problematic, but it’s actually harmful because it downplays the condition, according to Matt Glowiak, PhD, a licensed clinical professional counselor and the chief addiction specialist at Recovered, an organization that provides resources for mental health and addiction treatment in New York City.
“Someone can have alcohol use disorder and still be functional in terms of balancing work, family, and everything else,” he says. “We cannot dismiss an alcohol use disorder because people appear to be productive.”
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Saying their condition “isn’t that bad” also fails to acknowledge that alcohol use exists on a spectrum from low-risk drinking to AUD, and you don’t know where the individual might land on that continuum.
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Assuming someone is on the less-severe end of the spectrum where they’re still able to exert considerable control can be dismissive.”Alcohol use disorder of any severity is a big deal,” says Dr. Glowiak. If it was as easy as ‘cutting back’ or ‘stopping at any time,’ they would have likely done that a long time ago.”
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What to say instead: “I know you’ve recently spoken a bit about some challenges with alcohol. I’ve found some resources that might help if you’re open to exploring them together.”
2. Why Can’t You Just Stop?
This is one of the most common comments that those with AUD hear, according to Katherine Pannel, DO, a psychiatrist specializing in substance use disorders, and president of the Mississippi Psychiatric Association, in Oxford.
“This can make someone feel unworthy, weak, or ashamed,” she says. “It can also make someone with AUD feel like a failure if they’ve relapsed or have had multiple attempts at sobriety.”
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The question implies that recovery is a matter of willpower, and is a simple choice. In reality, it’s a medical condition that’s defined by a hampered ability to stop or control alcohol use despite negative consequences on relationships, work, and physical and mental health. In fact, AUD is considered a brain disorder that can lead to long-term changes that make people more vulnerable to relapse.
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Framing AUD as a personal failing isn’t “tough love;” it will simply show someone with AUD that you don’t know the nuances of the condition, says Dr. Pannel.
What to say instead: “I may not know what you’re dealing with, but I care about you and I’m here for you. How can I help and support you?”
3. You Don’t Care About Anyone or Anything but Alcohol
This statement is problematic because it implies someone with AUD is unaware of the consequences of their behavior, or that they’re being stubborn in continuing to drink — but in reality, they may be using alcohol as a coping mechanism or numbing agent, says Glowiak.
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“Most people with alcohol use disorder have had a desire or made multiple attempts to quit,” he says.
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“Often, getting to the point of an alcohol use disorder indicates use as a maladaptive coping mechanism where one is trying to mask the pain of something else such as a [co-occurring] mental health … disorder, trauma, low self-esteem, or another issue.”
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Being told “you don’t care” adds to the shame someone is likely experiencing with AUD, he says. Ultimately, this feeds into a negative reinforcement cycle, in which the person drinks to cope with the emotional pain of their shame, negative comments perpetuate shame, and the cycle continues.
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What to say instead: “Overcoming addiction is one of the most challenging things anyone can face. I want you to know I love you and always want what’s best for you. Let me know how I can best support you through recovery.”
4. Can’t You Have Just One Drink?
Whether it’s a champagne toast at a wedding, a beer at a ball game, or a glass of wine at Thanksgiving, alcohol is often part of a celebratory atmosphere, and this question seems to be encouraging — like you want the person with AUD to feel included. But it can come across as highly disrespectful, says Glowiak.
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“For individuals with this condition, it may feel nearly impossible to stop at one drink,” he says. “If you truly care about them, you’ll respect their wishes not to drink, and you won’t make them feel like they’re missing out if they don’t join.”
One drink doesn’t make relapse inevitable, but it’s certainly one of the factors that can contribute to lower chances for recovery.
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On the other hand, a supportive social network that doesn’t revolve around drinking has been shown to be protective against AUD relapse, which means showing support in these types of situations can be particularly important for someone dealing with the condition.
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What to say instead: “What can I get you to drink? We have plenty of options, including sparkling water, soda, juice, or coffee. Let me know what you prefer.”
5. You Don’t Look Like an Alcoholic
In addition to using the problematic term “alcoholic,” this comment implies that someone with AUD has a certain appearance or set of behaviors that sets them apart from others, says Pannel.
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“This can be hurtful and demoralizing,” she says. “It also conveys a lack of support and encouragement because you seem to be dismissing what the person with AUD is trying to tell you about their recovery.”
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People with AUD already struggle with guilt and shame, she says.
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Acting as if you don’t quite believe someone when they tell you about their disorder can lead to shutting down communication and making them feel less supported. What they need instead is empathy without judgment, which Pannel says fosters trust, and is more likely to spark discussion.
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What to say instead: “Thank you for telling me about what you’re going through, I’m proud of you and your bravery. I want to understand what you’re dealing with, so please let me know if I say anything that seems like I’m not getting it.”
The Takeaway
- When talking to someone with alcohol use disorder, comments you think are helpful might actually be harmful, and could negatively affect communication and trust.
- Trying a “tough love” approach of being aggressive can easily backfire since those who struggle with this condition tend to feel guilt and shame, and these comments can make those feelings worse.
- Communicating with empathy and openness and without judgment can go a long way toward showing support and building trust.
