When a family member won’t stop drinking: what relatives can do

How do I talk to him about his drinking?

Talk when he is sober and calm, describe what you have seen, and leave the decision with him. Doctors use a similar approach called a brief intervention: open questions, no judgement, and confidence that change is possible.

• Mention specific things: “You missed work twice this month.”
• Ask rather than accuse: “What worries you about your drinking?”
• Offer a choice of next steps, such as a check-up or seeing a doctor together.

You may need to have this conversation many times. Stopping is his decision, which also means his drinking is not your failure. If raising the subject could put you at risk, get advice first.

Can I give him medicine secretly in his food or drink?

No, please do not give anyone a medicine, powder or drops without his knowledge, even if someone has told you it will stop the drinking.

Doctors sometimes use a deterrent medicine that causes a reaction with alcohol, but only for someone who has chosen to take it. India’s treatment workflow lists as pre-requisites a motivated patient, his written consent, warnings to him and the family, and health staff able to handle a reaction. Family can supervise it, but only with his knowledge.

Given secretly, those safeguards disappear:

• He may drink without knowing the risk. Even a small amount of alcohol can then cause flushing, headache and vomiting, and more seriously a fall in blood pressure, an irregular heartbeat or collapse.
• If he becomes ill, doctors will not know what he has been given unless someone tells them.
• Uncommon but serious effects include harm to the liver and nerves, and psychosis, with fear, suspicion and hearing voices. Indian doctors have described psychosis after secret dosing.

The same concern applies to powders or “nasha mukti” packets sold with a promise that they work without the person knowing. Doctors have reported that some contain this type of medicine, at times in higher amounts than would be prescribed, and you usually cannot tell what is inside.

Many families try this out of love and exhaustion, so there is no need for shame. If you have already given something, speak to a doctor today and take the packet with you. If he becomes unwell after drinking, or turns fearful or confused, go to an emergency department and tell the staff exactly what he has been given.

What if he suddenly stops drinking at home?

If he drinks heavily every day, stopping suddenly without medical help can be dangerous. NICE, the UK guideline body, notes that unmanaged withdrawal in severe dependence may lead to fits, delirium tremens (severe confusion) and, in some instances, death.

Early signs include shaking, sweating, restlessness, anxiety, a fast pulse and not sleeping. Delirium tremens typically starts within two to three days of the last drink, so he may seem fine at first. This is why locking him in the house, or forcing him to quit overnight, can put him at risk.

• Encourage him to see a doctor before he stops, so withdrawal can be planned at home or in hospital.
• Tell the doctor about past withdrawal fits or severe confusion, serious physical or mental illness, or other drug use. Indian guidance advises admission in these situations, and when outpatient treatment has not worked.
• If he has already stopped and seems shaky or unwell, get medical help now.

How can treatment start if he refuses to go?

Treatment can start with you, because you can ask for advice before he agrees to anything. Speak to your family doctor, a psychiatrist or a de-addiction service about how to approach him. Some people accept a general health check more easily than a visit about drinking.

When he does go, the doctor will usually take a detailed history, examine him and arrange blood tests, as in a first visit to a psychiatrist. Treatment can include managing withdrawal, counselling to prevent relapse and, if he agrees, medicine.

The Mental Healthcare Act 2017 covers conditions linked to alcohol use, and it protects his say in his own care. Admissions should be voluntary as far as possible, and a decision others think is wrong does not by itself mean he lacks capacity to decide.

Admission without his agreement is limited to serious situations: recent threats or attempts at self-harm, violence or making others fear harm, or being unable to care for himself to a degree that puts him at risk. A psychiatrist and a second professional must each examine him, and he must be unable to make treatment decisions independently. If anyone offers to take him away by force without these checks, ask a psychiatrist or a lawyer first.

What should I do if I don’t feel safe at home?

Your safety and the children’s safety come first, and drinking does not excuse violence. Under the Protection of Women from Domestic Violence Act 2005, domestic violence includes physical, sexual, verbal, emotional and economic abuse. WHO notes that partner violence is unlikely to stop on its own.

Seek help the same day if the violence is getting worse or more frequent, if he has used or threatened a weapon or tried to strangle you, if he has hit you during pregnancy, or if you fear for your life.

Call 112 for any emergency. The Women Helpline on 181 is toll-free, runs 24 hours and operates in 35 states and union territories. One Stop Centres offer police, medical and legal help, counselling and temporary shelter in one place. Child Helpline 1098 works 24 hours a day.

A safety plan can help even if you are not in immediate danger:

• Decide where you could go in a hurry, how you would get there, and whether the children would come with you.
• Keep documents, keys, money and clothes somewhere safe, or with someone you trust.
• Ask a trusted neighbour to call the police or come over if they hear violence.
• If an argument cannot be avoided, stay in a room you can leave easily, away from anywhere there might be weapons.
• Do not get into a vehicle he is driving after drinking, and keep the children out of it too.

Whether to stay or leave is your decision. If you decide to leave, make your plans and go to a safe place before telling him, because telling him first can raise the risk.

How do I look after myself and the children?

You need support of your own, whether or not he ever accepts treatment. NICE guidance asks services to discuss the impact on relatives, give them information and connect them with family support groups. Groups such as Al-Anon exist for this. Ask a treatment team what is near you.

• Tell children, in simple words, that the drinking is not their fault and that stopping it is not their job.
• Keep school, meals and sleep as regular as you can.
• Make sure each child has a trusted adult to talk to.
• Teach older children how to call 112 and 1098, and where to go if they feel unsafe.

If you are a son or daughter reading this, what is happening is not your fault. Tell an adult you trust. If you are under 18 and feel unsafe, you can call 1098.