Excessive alcohol use leads to 88,000 deaths every year, and is the third leading cause of lifestyle-related death in the United States. Alcoholism and alcohol abuse can lead to chronic diseases like hypertension and atrial fibrillation, and other serious health consequences such as stroke, cancer, and dementia. It leads to car accidents, drownings, falls, and shootings.
Even when alcohol abuse doesn’t lead to death (which it almost always does when left untreated), alcoholism can cause a range of mental and social problems, including anxiety, depression, and suicide, as well as professional and financial problems due to job loss, legal trouble, and more. Alcoholism can break up marriages and drive children away from their parents. It can damage every aspect of a person’s life.
Most people suffering from drug and alcohol abuse refuse to see the risks or consequences. They live in denial, with a litany of reasons they can recite as to why they don’t need or shouldn’t get treatment.
High Functioning Alcoholics
Especially adept at denial are the high functioning alcoholics. These addicts tend to blend more easily into their environments, drinking for years, even decades, with few people realizing there’s a problem—and the alcoholic certainly isn’t going to admit to it.
High functioning alcoholics almost never miss work, they get their kids to school and soccer practice on time, they participate in clubs or sports and can be quite successful in one or more areas of life. From the outside, high functioning alcoholics have their lives together. But alcoholism is a progressive disease, and sooner or later, all alcoholics suffer serious consequences stemming from their addiction.
In the meantime, high functioning alcoholics often secretly live in a state of extreme stress, doing their best to balance their addiction with maintaining their image and fulfilling responsibilities. They may work hard all day at work, then at quitting time on most days, if not every day, they head to the nearest bar or liquor store and quickly settle into drinking. They are incapable of having just one drink, but they can usually hold their liquor well, so it isn’t always apparent when they’re drunk. They also rarely get hangovers—or at least not obvious ones.
When forced to go to dry parties or when they run out of alcohol, the high functioning alcoholic becomes uncomfortable, nervous, irritable, anxious and moody. This is their brain and body’s reaction to not having access to the substance they’ve become dependent upon.
Denial comes very easy to high functioning alcoholics because they have experienced very few outward consequences of their alcoholism. If anyone questions their drinking habits, the high functioning alcoholic can point out that they just got promoted at work, that they’ve never missed a dance recital or PTA meeting, that they’ve never had a DUI, and that they run three times a week. Therefore, they say, they cannot be an alcoholic.
Excuses Alcoholics Make to Avoid Addiction Treatment
Lying to yourself and others, and making excuses about addiction, are symptoms of alcoholism, high functioning or not. Here are 13 of the most common excuses alcoholics make to avoid addiction treatment:
1. Everybody drinks.
To the alcoholic, it seems that everyone drinks, because this is their reality. They always socialize with other drinkers and avoid events and activities that prohibit drinking. They may even feel that people who don’t drink are stuck-up, no fun, or untrustworthy.
2. There is nothing wrong with me.
As long as the alcoholic insists that everything’s fine, then there is no problem to be treated. This denial is another aspect of addiction, functioning to protect the addictive behaviors.
3. I’m not hurting anyone.
Alcoholics are often quick to claim that their drinking doesn’t hurt anyone, or at least not anyone but themselves. Their disease has made them unable to see the many ways that their alcoholism impacts everyone who cares about them.
4. This is the last time.
There is no need to seek treatment if I’m never going to get drunk like that again, right? At the moment, this claim can seem completely true. They don’t realize that alcoholism has created actual structural and chemical changes in their brain’s reward pathways—changes that have trained them to be alcoholics.
5. I need to work.
While technically true for most people, not all forms of addiction treatment will require a recovering alcoholic to miss work. Residential substance abuse programs can be great, but so can Outpatient programs that provide treatment during after work hours or on weekends. Many companies support addiction treatment, and the right to rehabilitation treatment is usually protected by state or federal laws like the Americans with Disabilities Act, and the Family Medical Leave Act.
6. I can’t afford treatment.
Yes, there are fancy, celebrity-filled rehab programs that cost more money for a month than most people make in a year, but there are many excellent low and no-cost programs all across the country. Also, thanks to the Affordable Care Act, addiction treatment has been designated as an essential health benefit that most insurance plans are required to cover.
7. I don’t have time for treatment.
Pretty much all Americans are busier than they’d like to be, but alcoholism is a devastating, progressive disease that will wreak more havoc on life the longer it is left untreated. Getting addiction treatment should be an alcoholic’s top priority. Besides, healing alcoholism tends to provide alcoholics with a whole lot of additional time and energy they didn’t have before treatment.
8. I deserve a few drinks with a job/family/marriage like mine.
In the United States, most people view alcohol as a reward for doing well, working hard, or enduring difficulty. Alcoholics usually feel that they’ve “earned” a drink. Of course, they almost never stop at just one drink, and they tend to “earn” the right to drink nearly every day for a variety of reasons.
9. I can’t ____ without drinking.
Some alcoholics have talked themselves into believing that they need to drink to speak in public, to socialize, to write, to paint, or to play music. They feel blocked or frightened without drinking, and even falsely believe that alcohol enhances their abilities. Once they are past the withdrawal phase of treatment, recovering alcoholics often start to realize that they can do anything without drinking, and that they do it much better while sober.
10. I’m not an alcoholic because I don’t drink half as much as my father/my friend/that guy passed out at the end of the bar.
The truth is, when playing the comparison game, an alcoholic will always be able to find someone who appears to be worse off than themselves. However, just because so-in-so lost their job, their home, and their wife because of their drinking, doesn’t mean that a high functioning alcoholic doesn’t also have a problem. There is no hierarchy when it comes to addiction. If you are an addict, you need and deserve addiction treatment.
11. My only problem is all the judgmental people around me.
Alcoholics quite often blame others not only for seeing a problem where there is none but for creating a problem. They believe that they wouldn’t drink so much if everyone would just get off their case for a while. Of course, this isn’t true. The alcoholic will never run out of reasons to drink. Alcoholics may also be extra-sensitive to being judged, as addiction can bring out paranoia in many people.
12. I can quit whenever I want to.
Many alcoholics sincerely believe or at least pretend to believe, that they can quit drinking anytime they want to. They don’t want to yet. However, the truth is that very few people can quit drinking without some form of professional help.
13. I can’t handle detox.
It’s natural for alcoholics to be intimidated by the thought of going through detox—they’ve likely experienced withdrawal symptoms when they haven’t had a drink for a while, and they know that sobering up completely will be worse. Also, substance abuse treatment programs have some resources, from medications to counseling to lifestyle changes, that can reduce withdrawal symptoms and make detox much easier.
Denial is Dangerous, and Acceptance is Key
The only thing that denial protects is the alcoholic’s drinking habits. Refusing to admit there is a problem leaves people vulnerable to the chronic, progressive nature of alcoholism. Even high functioning alcoholics who have successful businesses and happy families are doing damage to their bodies and brains. They are also at great risk of accidents that could harm themselves or others.
Accepting the fact of one’s alcoholism is the first step to overcoming it. It is also the first step to forgiving oneself for not being perfect, and to recognizing that everyone needs help sometimes.
How to Break Through Denial and Get Someone into Treatment
Addiction transforms people into someone new by actually restructuring their brains. Denial is a common side effect of this. There are, however, some proven ways to get through to alcoholics in denial so that they either seek out or allow themselves to be led into treatment. Contrary to some popular myths about addiction, treatment for alcoholism is equally effective whether the patient came up with the idea or was pressured into it.
Whether or not you stage a formal intervention, there are some conversational tips that can help you break through an addict’s denial.
- At some point in a discussion about alcoholism, your loved one will contradict themselves. This is an opportunity—not to throw the contradiction in their face, but to get them to see it for themselves by gently urging them to clarify what they said and explain how both things can be true. Avoid accusatory language, and understand that you might not get through the first time the topic is discussed.
- A valuable statement to use in any discussion of addiction treatment is “I don’t understand.” It’s easy to offer the knee-jerk response of “I know,” or “I get it,” when discussing your loved one’s experience with alcoholism, but this is not helpful to them, and for the most part, it isn’t true. Addiction is a disease that alters how people act, think, and view the world. It impacts all aspects of their life. Acknowledge your loved one’s unique experience, and don’t try to pretend that you know exactly what they’re going through. If you want to show them that you sympathize, acknowledge them by saying that you see the pain they’re in, or that you feel for their suffering.
- Another useful phrase in these kinds of discussions is “you’re right.” Alcoholics are used to people telling them that what they’re doing is wrong and that they, themselves, are wrong, while inside, they believe their drinking is justified. They are also used to feeling judged. Despite the many advances in addiction science, there is still a profound stigma associated with alcoholism. For these reasons, alcoholics are always primed for a fight. By telling them they are right and acknowledging that they’ve been doing the best they can, you disarm their defenses and open the door to change.
- Speak in first person. It is all too easy to use accusatory language (such as “you don’t care about me”) but speaking with “I” is much more effective (e.g. “I feel as if you don’t care about me when you are drinking”).
Preparation is also Key
It’s best to prepare for these kinds of discussions in advance. While it’s understandable that arguments about drinking will crop up unexpectedly when you love an alcoholic, it’s better to wait until you have a cool head and clear thinking to try and convince someone to enter into treatment.
Try writing out how you feel in a letter, or rehearsing what you want to say out loud. Anticipate things your loved one might say or do and come up with useful responses before you need them.
Preparing yourself ahead of time will also allow you to confront the issue with warmth and love, as well as with firmness, presenting your case as effectively as possible.