You Can Help the Alcoholic

You don’t know me, but my husband (wife, friend or relative) is drunk and we have pretty well come to the end of our rope and we can’t stand it any longer and we don’t know what to do. What do you suggest …?”

Most of us who have been in the pastorate for any length of time know what it is to receive a call like this and today such calls come more frequently. There are more alcoholics than ever before. Now that the disease has been brought into the open through education, the likelihood of any minister receiving such a call is becoming immeasurably increased.

Few of us any longer hold to the opinion expressed by one pastor of a large city church not long ago: “We don’t have that problem in our congregation.” The good brother, who declared he knew no alcoholics, no longer represents any considerable proportion of the clergy. Today, most of us have witnessed the agony associated with the problem and have known the frustration of trying to deal with it. Somewhere in our experience—if our people believed that they could come to us for help—we have met one or more of the 5,000,000 or so chronic alcoholics who, with their slightly more independent brethren, the 7,000,000 or so problem drinkers, careen their way across our land.

What are we to do about them? That depends on several factors, most of which can be recognized and analyzed: an accurate estimate of the problem of alcoholism, and the condition of the particular alcoholic you are trying to help. Each case is a unique experience, but there are certain rules of thumb.

Evaluation Of The Problem

Most authorities agree that chronic alcoholism is a condition (some call it a disease and the medical profession wishes it knew for sure just what to call it) which leaves the alcoholic helplessly unable to control his drinking. Whether physiological, psychological, emotional or what have you, the fact remains that the alcoholic is under the power of a compulsion over which he has no control by any voluntary means whatsoever. He drinks because he cannot stop drinking. He begs, lies, cheats and steals his way to the next drink because he is in the grip of forces stronger than his will or his imagination, not because he has been refused the truth about his, or his family’s condition.

A readiness to accept this estimate as factual is essential to any help you can give alcoholics. Many pay lip-service to the theory that an inebriate of the chronic variety is helpless, but then they proceed to talk to him man to man as if he has not realized the seriousness of his predicament. They ask him to promise this or that, and tell him that they are going to hold him to his promises. On his part, he insists that he can and will follow their advice. But he never realizes he is as sick as he really is. It is a part of his sickness that you cannot tell him, or expect him to do anything about.

But let us get back to the problem posed by the telephone call at the beginning of this discussion. Your inebriate may be in any of several stages of intoxication, ranging from the heavy drinking preceding actual drunkenness, to delirium tremens at the end, or a heavy hangover on the way back. What can be done will depend on the particular situation. In any case, one who expects to help should have the following information at his fingertips:

a. He should have the names and addresses of one or more doctors who understand the problem of acute intoxication of the chronic variety. It may come as a surprise to learn that an M.D. is no sign that its owner necessarily knows much more than the average layman about the intricacies of alcoholism. This is something about which very little is known by anybody. Even the nature of the “disease” is still an open question. Some excellent doctors simply do not have enough information or experience in this field. This is one reason why many refuse to take alcoholics as patients.

b. Secondly, it is essential to have the address and telephone number of the nearest A.A. group. If that address is in the next town, the distance to it should be no obstacle. But even more valuable than the address of some group would be the names and addresses of men and women who are aware of your genuine interest in A.A. and know your estimate of a given situation is likely to be accurate. You will get cooperation much more quickly if the person you call knows that you understand what to look for in such a situation. Hence, it is really helpful, in preparing for this ministry, to take the trouble to attend a few of the A.A. meetings.

c. It is important to have the address of the nearest institution in which an alcoholic may be placed and the rules governing admission to it, whether it be a hospital, nursing home, asylum or jail. Many hospitals—especially of the general or public variety—will not admit alcoholics. Hence, the county jail may be the only institution available for you at the time. And this is not as terrible as it sounds.

Wherever general hospitals admit alcoholics, it is ordinarily over the signature of doctors who have demonstrated that they know what they are doing and who will guarantee that the patient will not become a problem. I know of several hospitals that will admit alcoholics only for a particular doctor, and then they require that the patient be constantly attended by competent nurses until he is reasonably sober.

Some hospitals catering specifically to alcoholics require that those admitted be fairly sober upon admission. Hospitals offering complete rehabilitation programs will take only those who come voluntarily and who sign a pledge to remain for the full treatment. Such institutions will make little or no effort to keep an inebriate who becomes a problem—an important thing to remember, incidentally, when recommending an institution to the desperate family of a drunk on the crest of a big binge.

But in every state there are one or more institutions, usually operated by the state, to which an alcoholic can be forcibly committed, if necessary, by order of the local superior court and upon the recommendation of one or more doctors. These ordinarily take a patient for a minimum of 30 days and should be considered as last resorts. If the problem is simply one of keeping alcohol away from someone long enough to get him sober enough to deal with, the county jail may often be a good place to put him for a few days. In the county where I live, we have some very understanding public officials who know what to do for an alcoholic coming off a drunk. They will hold one on a minor charge for several days if the family pays the nominal cost.

Armed with the above information, which may be gleaned from druggists, welfare officials, Salvation Army personnel or police headquarters, you are ready to answer your telephone call. When you get there, the alcoholic’s condition will determine what happens next: Is he (or she) drunk or fairly sober at the moment? Is he violent or is he manageable? How long has he been on this particular spree? In short, how bad are the physical effects of dehydration, etc.? How long has it been since he had his last drink, or do the signs indicate that he is beginning to fight his way out of it? How old is his drinking problem? Someone may be looping drunk at the moment yet not be an alcoholic at all. Lastly, but most important of all, does he show any signs whatever of admitting that he needs help—not for the headache of the moment, but for the problem of alcoholism—and is willing to swallow his pride and ask for it?

Rehabilitation

Don’t expect to start right in with rehabilitation when you confront your alcoholic. Don’t expect to do much of anything, in fact, if he is still drunk. Certainly don’t waste your breath talking to him. That can come later when he is thinking more clearly. He may be on a crying rampage and spilling bitter tears all over the carpet, but if he is still intoxicated you simply leave him with the thought that you have something for him that he needs, and you’ll talk about it when he becomes sober. This must constitute the basis of your ministry to him until the situation is ripe for progressive therapy. For his family you have but one word of advice: “Don’t pamper or coddle him.” Love him, yes, but don’t try to protect him from anything (even jail) that will hasten the day of reckoning.

An alcoholic’s drinking can be stopped, but lasting effects will come only when he is cooperating in the program. Thus the goal to work towards is his own sincere admission that he sees himself helpless, and that the stark facts of reality have convinced him, not that he must do something about his problem, but that he cannot do anything about his problem. This is very important. It is an attitude I am talking about, not a promise or even an opinion. You cannot help a person who still vows and declares that he will do better; you cannot help him if he wants to be alone with his shame. You can help him only if—and not until—he is willing to crawl.

A man I once had occasion to deal with illustrates this point. On the day that I have in mind he was not drunk but very sick. He was in the throes of a monstrous hangover following a long drunk. The doctor, a very understanding man, and I were sitting in his room. He had been off alcohol and under medication for about 24 hours. It was only a matter of time before he would be all right, but meanwhile he was having a rough time of it. Did he want to get over the awful taste in his mouth and the gnawing pain in his stomach? Surprisingly enough, he did not. He wanted, instead, to get drunk again. He made it very plain to the doctor and me:

“I want a drink,” he said. “If you don’t give me one I’m going to get one somehow.”

“Don’t you want to clear up your head and get back on your feet?” asked the doctor.

“I’m afraid of the snakes,” the man whimpered.

“But I promised you that you would not have snakes,” the doctor assured him. “The drugs I have given you will safeguard that.”

“Well, then, I just want a drink,” the man hedged.

“You mean you would rather get drunk again than let us help you,” the doctor corrected.

“I don’t mean to hurt your feelings, Doc,” the man said, “nor yours, either,” he directed this last remark to me; “but that is just about the long and short of it.”

It made no difference that his desire to get drunk was ostensibly to relieve the headache, the pain in his stomach and the awful taste in his mouth. So long as he did not want to become sober, and so long as the hell he had been through was not something he would rather escape at any price, there was nothing that either the doctor or I could do for him, unless we were prepared to have him forcibly restrained.

In this particular case, restraint finally became necessary. After 10 more days of drinking, during which he managed to get more liquor either by telephone or in person, we finally had to put him in jail, as there was no family money for hospitalization. In a few days our friend was able to think more rationally, expressed an entirely different desire, and at last got help.

This, then, is the first step in helping an alcoholic. If he is drunk, he must be rendered sober. And he either will want to become sober (which is usually the case) or, like my friend above, he will not. If he wants medical attention, smells offensively, and his case history indicates that he will not come out of his condition in a day or two, the thing to do is call the doctor and, if possible, try to get him to a hospital. If you expect to have him on your hands longer than 30 minutes while taking him wherever you are going, ask the doctor if he would recommend about two ounces of whiskey for him before starting out. Your inebriate may need it if he is still under the influence, or if it has not been long since his last drink (less than 12 hours), but only if you are certain that his dazed condition is due to liquor and not the use of barbiturates. A little drink will guard against the violence that may erupt with less than two seconds’ notice if he is deprived too suddenly of liquid sustenance. The qualification relating to barbiturates is to prevent disaster. Alcohol on top of a stomach full of pills will aggravate the effects of the drug, and you may kill him.

If a hospital is out of the question, then your patient may be treated at home so long as the family realizes that a little firmness and a lot of patience will be required. They have probably been through this before. The doctor will use several of a large selection of drugs, beginning with sedatives that may include healthy doses of paraldehyde or something similar, to encourage sleep and guard against delirium tremens. He then will prescribe vitamins and further protective medication including, perhaps, one of the drug derivatives belonging to the “cortizone” family. Much later he may suggest one of the “alcoholic-allergy” drugs such as antibuse that rather effectively prevents further drinking so long as the patient is taking the drug.

Once the cobwebs have been swept from his brain, an alcoholic enters his second phase of treatment. Here the deciding factor is his desire to remain sober. This is not quite the same problem as the earlier one. Almost every drunk wants to sober up after a few days or weeks on the stuff, but it’s another thing to want to leave the stuff alone after the effects of it are gone. And still another thing to be unashamedly willing to confess that you cannot leave it alone without help.

From this point on, honest differences of opinion exist among counselors in how to proceed. Something must be done, not only to the alcoholic’s habits but to his personality. Sooner or later, in the opinion of many, a vital religious experience must take place, not only for the necessary power to stay sober but also for an adequate, overall adjustment to life. The minister may want to take the alcoholic in hand and attack his problem on the basis he believes will give him a religious experience. A psychiatrist may want to apply his methods of help. And the sociologist may want to improve his environment and his outlook on society.

Personally, while I recognize that an alcoholic must ultimately undergo a revolution in character and personality, and while I believe that this can only be effectively done through a profound appreciation of the meaning and power of the Christian faith, I prefer to leave the first steps to Alcoholics Anonymous. It is my conviction, after considerable experience with alcoholics, that this fellowship offers the best initial help. True, the direct religious approach that bypasses Alcoholics Anonymous sometimes succeeds. Spectacular successes have been registered by devoted persons who, critical of anything less than the highest and most holy, have rejected the rather casual approach of A.A. and have gone straight to the heart of the problem. But I cannot agree with such methods, if for no other reason than the fact that a much smaller percentage are affected by the direct approach of well-meaning but inexperienced people, and too many are frightened away. A.A. has done wonderful things in the treatment of chronic alcoholism. It represents the profoundest sort of reality. It promotes the start of a healthy spiritual vitality, and it is a launching platform from which those who wish to go further can take their departure.

Alcoholics Anonymous

The next phase of the treatment, therefore, necessarily involves A.A. or A.A.’s principles. Since this article is not directed at experts but beginners in the business of alcohol rehabilitation, I will say, unhesitatingly, that this procedure should be followed in every case. A.A. literature should be employed and contact with an A.A. group should be made. Pamphlets will introduce the program and provide illustrations of its effectiveness, and members of any A.A. group will take matters in hand promptly if it is the alcoholic himself who has asked for help. A definite and immediate program of action will follow, and will provide for those periods in the alcoholic’s life between binges and before the craving takes him on another wild ride.

To recapitulate, then, these are the emergency steps in the first stages of alcoholic rehabilitation: 1. Render the alcoholic sober if he is drunk, or provide the means whereby he can be made sober. 2. Put him in touch with an A.A. group if he is ready to ask for help. Meanwhile, the single theme to be pounded into his head from the time he can think clearly enough to understand is the simple message: You can get help when you really want it.

Unfortunately, all efforts to help may not be successful and your alcoholic may promptly fall off the wagon after a few days of shaky sobriety. If so, the whole heartbreaking process will have to be repeated again and again until the daylight breaks through and sunshine floods the soul. Remember, some alcoholics who have conquered their problem were drunk (not simply drinking) 10 years or longer; some have lain in bed too drunk to stand without help four and five months at a time. The story of alcoholism is that simple, that terrible, that “hopeless”—but that full of hope.

Each case, of course, is unique and no pattern for any other. However, one recent experience, which I might relate, illustrates perfectly the principles I have set forth as necessary for recovery. This problem, incidentally, of all those in my experience, was the most easily solved and should not be considered average.

One day a highly distraught, middle-aged man came to see me. It was about his sister who was an alcoholic. Only slightly younger than he, she had been drinking, off and on, for many years. A week or so earlier she had come to town to visit her elderly parents for the Christmas holidays, and the combination of festivities and her own loneliness (her husband had left her some time ago) had proved too much; she had gotten drunk. Evidently it wasn’t much of a binge—just enough to make her very sick. Apparently she had had other times like it, for this one left her much weaker and much sicker than a single, two-day drunk normally would have.

I asked the man whether his sister really wanted to stop drinking. He did not know, but he felt sure she did. The day we talked about it was the third since she had taken her last drink and, according to him, she was quite sure she did not want to get drunk again. The man did not know what to do. I gave him some A.A. literature, including a fine booklet entitled “A.A. for the Woman” and told him to get across to his sister the simple message that she could get help.

The next day the phone rang. A rather fuzzy female voice on the other end of the line asked if this was Dr. Taylor. She identified herself as, shall we say, Mrs. Jones. She had read the pamphlets and was very much interested to know that there were women in the world who had evidently been through experiences worse than hers, and who were now happily sober. But (she spoke with some difficulty) she needed more than anything else right now medical attention, and would I help her get in touch with a doctor. Her parents would not allow her to leave the house for fear she would get drunk. I gave her the name of a doctor who would provide what she needed. She asked me if I would call him. I said no, that she would have to call him herself. Then I excused myself and hung up.

The next day the phone rang again. It was Mrs. Jones. The doctor had come to see her, had given her some drugs and intimated that if she really wanted to stop drinking she could have all the help she needed. She was now calling to find out if I would give her more information about A.A. I told her that I would put her in touch with A.A., and if she wanted help they would come out to see her. She wanted to know if they would give her money to get back home. I said no, and after a few pleasant words I hung up.

She didn’t call again until the next day. Ordinarily any other alcoholic by this time might have gotten drunk again. But Mrs. Jones’ father and mother had guarded her with firm determination, not letting her leave the house and thus forcing her to “tough it out.” Again, she wanted to know more about A.A., and this time I gave her their number. She asked if I would call them for her. I said no, that she would have to call them herself and tell them just what she had told me. We hung up, and about 20 minutes later she called back to say that she had talked to someone at the A.A. club and they had promised to be out within two hours.

I did not hear from her until the next morning. When she called, there was a new note in her voice. She still felt somewhat shaky, admitted that she had almost not made it up the stairs to the meeting the night before, but intimated that her heart was light and her hopes were high. A man and a woman, who had come to see her the afternoon before, had persuaded her parents to let them take her to a meeting that night. She was bubbling over with the experience from which two things stood out in her mind: so many people with problems worse than hers had found peace, and God was wondrously good.

Two Sundays later, a stranger identified herself after the morning service as Mrs. Jones. If this story were fiction, I could say that she looked years younger than her age. She didn’t. But she looked happy. And she is now headed for a new and vital experience with Jesus Christ as her Saviour.

G. Aiken Taylor is Minister of the First Presbyterian Church of Alexandria, Louisiana. He holds the Ph.D. degree from Duke University. He is author of A Sober Faith; Religion and Alcoholics Anonymous and St. Luke’s Life of jesus.

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