How should families deal with substance abuse during the holidays? A Q&A with Dr. Sam Ball
With the holiday season right around the corner, many families affected by substance abuse are dealing with a big question: Should I serve alcohol when one of my guests has a drinking problem?
The holidays are a time of gathering with the people you love and celebrating. Food, gifts, parties and alcohol often play a big part in these celebrations. Though these times are filled with joy, they can also come with added stress. Tensions between family members can run high. Someone struggling with alcoholism can be at especially high risk for relapse. To get some advice and direction in how to navigate this situation, The Buzz talked to CASAColumbia’s President and CEO, Dr. Sam Ball.
Q: I am having a holiday party and considering serving alcohol, but I invited a family member with a serious drinking problem. How should I plan for this?
A: It depends on many factors, but let me just mention a couple. First, does this family member accept that they have a problem with alcohol? Are they open to discussing it? Second, are you close to them? If you answered yes to these questions, then speaking directly with them about their drinking plans and sharing any concerns or expectations you both have is most appropriate. If a direct conversation is not possible, then discussing the situation with whoever is accompanying them about your concerns and expectations is more appropriate. In either case, it is important for you and any co-hosts to talk beforehand and make sure everyone is on the same page about how to respond should a situation arise. Disagreements among concerned family and friends about what to do when something bad happens exacerbates the stress and may make things worse. A decision about someone being asked to leave, being driven home, or taken to the hospital has little chance of working if the opinions don’t align.
Q: If I serve alcohol and see my family member drinking, should I intervene?
A: Yes, but how you intervene depends on your pre-party planning and discussion. I highly discourage a “let’s hope she doesn’t drink too much like last year,” approach and then making rash decisions if she (and others at the party) becomes intoxicated. People go to great lengths planning all the details about holiday parties and should spend as sufficient time discussing how to respond to an intoxicated person as they do about what drinks to serve. Think about the planning that goes into accommodating someone who has a serious medical reaction to nuts or other food. Alcoholism is at least as serious and life threatening of a problem as a serious food allergy.
Q: Is it insensitive for me to serve alcohol when a family member has alcoholism? Am I putting them at a high risk of relapsing?
Another highly individualized decision that requires family discussion. One of many important considerations is whether the person with alcoholism is still actively drinking versus how long they are in recovery. If they are still drinking and you and others have decided to have alcohol available, then it is a matter of minimizing harm by not allowing them to drive, monitoring their impairment, and getting them home safely. If they have only been in recovery for a short time, then a discussion with them about their preferences with regard to the availability and prominence of alcohol is appropriately sensitive. With that input and in discussion with others, you as the host may decide to only allow wine with dinner and not allow drinking throughout the party, open access to the bar, or coolers on the porch, for example. For people who have been in recovery for many years, they may no longer wish to be a main reason for altered drinking customs. However, it never hurts to check in with them about their preferences from time to time. Even people in long-term recovery can have relapses and stressful times of the year can increase this risk.
Q: If I am the person in the early stages of recovery from alcoholism, what are some tips for avoiding relapse?
If you are hosting the event, you are in charge. I strongly recommend that you make this an alcohol-free gathering and ask that no one brings wine or other alcohol with them. If you have made people aware of your struggles and wishes and they still protest this, you should ask them not to come. If you are a guest at someone else’s event and the host knows of your problems, you can ask what level of accommodation you and they feel comfortable with. If you are unable to have that discussion and are worried about alcohol being present, I would recommend finding a reason to decline the invitation.
Everyone is different, but in general the more prolonged, visible, and excessive the drinking is at an event, the greater the risk of relapse for someone with alcoholism. If 12-step meetings are a part of your recovery program, I highly advise you to attend them very regularly, especially during the holidays. If you have not attended them, this would be a great time to check them out. Not only may you get some ideas about how to handle family gatherings or celebrations around the holidays, but the joy you experience being with people who are truly grateful for their recovery and each other may be the perfect kind of holiday spirit to imbibe.
Samuel A. Ball, Ph.D. is the President and Chief Executive Officer of CASAColumbia.