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Worried About A Loved One’s Drinking? Here’s How to Approach It

When someone you love experiences problems with alcohol, it’s not easy to know exactly what you should do about it. You love them and you want what’s best for them. You want to see them live a healthy, fulfilling life. But you’re not sure how you can help. You’re not even sure if it’s your place to say anything or try to stage an alcohol intervention.

If casual conversations haven’t worked, addiction intervention services can guide the family through a structured meeting and a same-day path to treatment.

First, we want to tell you that if you love someone and you’re concerned about them, it’s important to tell them how you feel. Therefore, your first step – when you’re concerned about a loved one’s drinking – is understanding that yes, it is your place to say something. You can’t control how they react to what you say, but you can control you – and there’s never anything wrong with telling a loved one you’re worried about them, you’re there for them, and you want to help them.

Now that we’re clear on that, let’s talk about the drinking. More specifically, about things you already think, feel, or do that are related to your loved one’s alcohol consumption. Have a look at this list and ask yourself if any of these statements apply to you:

  • You spend time and energy thinking about their drinking
  • You make excuses for the amount and frequency they drink
  • When they drink, you feel unsafe
  • When they fail to fulfill their work, school, or family responsibilities, you cover for them
  • You offer support that goes unrecognized or unappreciated – this may be money, or it may be other types of practical support
  • You fear how they may react if you bring up their drinking

If any of those statements are true for you, then it’s time to consider having a serious conversation with your loved one about drinking.

How to Talk to Them/Stage an Alcohol Intervention

The hardest part of this might be gathering the courage to initiate the alcohol intervention conversation. Remember: this comes from a place of love and concern. You owe it to yourself and to them to express your feelings and offer to help in any way you can. You may be nervous, and that’s okay. Marshal your emotions, coax the butterflies in your belly to fly in formation, and take solace in the fact you’re doing the right thing – even if it’s incredibly hard.

Here’s a step-by-step approach that has a good chance of success:

  1. Schedule a time to talk. Avoid bringing up the subject when they’re intoxicated or when you’re emotional. Tell them you have something important you need to discuss with them and prepare yourself to have the talk in a calm, rational manner.
  2. Lead with empathy and love. Make sure the first thing they hear from you is that you love and support them. That’s why you’re having the conversation.
  3. Tell them what you see. Describe – with concrete examples – the aspects of their alcohol-related behavior that concern you.
  4. Listen to what they say. Let them talk. Listen without interrupting. As you lead with empathy and love, also listen with empathy and love.
  5. Tell them what you would like to see. Offer ideas for specific behavioral changes that you think will improve both your relationship and their overall health and wellbeing.
  6. Come up with an action plan. This depends on how the conversation went, of course. If it went well – meaning they heard and understood your concerns and are ready to make changes – then you can help them start their recovery journey to detox.

The most important thing to remember about alcohol interventions is that it’s not a conflict. If things get heated, take a step back. Take a break, maybe take a walk, and pick back up when you’ve had a moment to cool down.

The Next Step: Beginning Recovery

Your goal is to help.

If you see someone you love engaging in a dangerous pattern of alcohol use that damages their physical health, their mental and emotional wellbeing, their work and school responsibilities, and their personal relationships, then the way you help them is by playing a part in initiating behavioral change.

To do that, they need to see the need to change for themselves. That’s why, in your conversation, you offered specific examples of the behaviors that worry you. Whether the alcohol intervention goes well or goes south, there’s one more step you can take: offer access to recovery resources. The best way to handle problem drinking is by seeking professional help at an addiction treatment center or an inpatient rehab facility that offers integrated, evidence-based, data-driven treatment for people with an alcohol use disorder.

You can help your loved one get treatment by arranging an appointment with a therapist, a drug and alcohol counselor, or the admissions staff at a treatment center. If they’re not ready to take that step, then encourage them to seek social support in the community. Programs such as Alcoholics Anonymous (AA) are a good place to start: you can find daily meetings in just about every city and town in the country.

Make a list of meeting dates, times, and locations. Try to get them to commit to going to at least one meeting. Remind them that all AA meetings are anonymous, it’s okay to go to a meeting just to sit and listen, and that everyone is there for the same reason: they want to move past their problem drinking and live a productive, fulfilling, and sober life.

Trauma and Addiction

Trauma can have lasting effects on mental, emotional, and physical well-being. While some people recognize the impact of traumatic experiences, others may not realize how past events continue to influence their thoughts, behaviors, relationships, and overall quality of life.

Research shows a strong connection between trauma, PTSD, and substance use disorders. For some individuals, alcohol or drugs become a way to cope with difficult emotions or trauma-related symptoms, increasing the risk of addiction over time.

This guide explores the relationship between trauma and addiction, how trauma can affect mental health, and the treatment approaches that can help individuals recover from both conditions.

What Is Trauma?

Trauma occurs when a person experiences an event, a series of events, or circumstances as physically or emotionally harmful, threatening, or overwhelming. While some people recover from traumatic experiences with few lasting effects, others may continue to experience emotional, psychological, or physical symptoms long after the event has ended.

Trauma can result from many different experiences, including:

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Neglect
  • Domestic violence
  • Community violence
  • Accidents
  • Serious illness or medical procedures
  • Military combat
  • The loss of a loved one

It is important to understand that people respond to trauma differently. An experience that is deeply traumatic for one person may affect another person differently based on factors such as age, support systems, previous experiences, and individual coping abilities.

Mental health professionals generally recognize three main types of trauma:

  • Acute trauma: Trauma resulting from a single distressing event.
  • Chronic trauma: Trauma caused by repeated or prolonged exposure to stressful or harmful experiences.
  • Complex trauma: Trauma resulting from exposure to multiple traumatic events, often occurring over an extended period of time.

Not everyone who experiences trauma develops post-traumatic stress disorder (PTSD) or other mental health conditions. However, unresolved trauma can affect emotional well-being, relationships, physical health, and overall quality of life. 

How Trauma Can Affect Mental Health

Trauma can affect nearly every aspect of a person’s mental and emotional well-being. While some people experience symptoms shortly after a traumatic event, others may not notice the effects until months or even years later. In some cases, individuals may not realize that ongoing emotional or behavioral challenges are connected to past trauma.

One of the most well-known trauma-related conditions is post-traumatic stress disorder. PTSD can develop after experiencing or witnessing a traumatic event and may involve symptoms such as intrusive memories, nightmares, heightened anxiety, emotional distress, and avoidance of people, places, or situations associated with the trauma.

Trauma is also associated with other mental health challenges, including anxiety, depression, low self-esteem, sleep disturbances, and difficulty managing emotions. These symptoms can affect relationships, work performance, physical health, and overall quality of life.

Some individuals experience feelings of shame, guilt, or self-blame related to their trauma. This can be especially common among survivors of abuse, domestic violence, or other interpersonal trauma. These emotions may make it more difficult to seek help, talk about traumatic experiences, or recognize how trauma continues to affect daily life. 

Without appropriate support and treatment, trauma-related symptoms can persist and interfere with long-term well-being. Understanding how trauma affects mental health is an important step toward recognizing when professional help may be beneficial.

Understanding the Connection Between Trauma and Addiction 

Trauma and addiction are closely connected. Many people who experience trauma struggle with difficult emotions, intrusive memories, anxiety, depression, sleep disturbances, or other trauma-related symptoms. In some cases, alcohol or drugs become a way to temporarily escape or numb this emotional distress.

This pattern is often referred to as self-medication. While substances may provide short-term relief, they do not address the underlying trauma. Over time, repeated substance use can create additional physical, emotional, and social problems while increasing the risk of developing a substance use disorder.

Research shows that individuals who experience trauma are at greater risk of developing alcohol or drug-related problems. Childhood trauma, abuse, neglect, domestic violence, and other adverse experiences have all been associated with higher rates of substance use disorders later in life. However, not everyone who experiences trauma develops an addiction, and not everyone with an addiction has a history of trauma.

For many individuals, trauma and substance use become part of a cycle. Trauma-related symptoms contribute to substance use, while the consequences of substance use often create additional stress, relationship problems, and emotional difficulties. This cycle can make recovery more challenging when both conditions are not addressed together.

Understanding the connection between trauma and addiction can help individuals recognize how past experiences may be contributing to current substance use and mental health challenges. Addressing both trauma and addiction is often an important step toward achieving lasting recovery and improved mental health.

Domestic Violence, PTSD, and Substance Use

Domestic violence is a form of trauma that can have lasting effects on mental health, relationships, and overall well-being. Individuals who experience physical, emotional, psychological, or sexual abuse often face challenges that continue long after the abusive situation has ended. Many survivors struggle with trust, feelings of safety, emotional regulation, and the lasting effects of trauma.

Domestic violence can affect many areas of a person’s life, including emotional well-being, relationships, and the ability to feel safe and secure. These challenges often continue long after the abuse has ended and may contribute to ongoing mental health and substance use concerns. 

One of the unique challenges many survivors face is self-blame. Individuals may incorrectly believe they were responsible for the abuse or feel ashamed of their experiences. These feelings can make it more difficult to seek help, discuss trauma, or access treatment and support services.

Because domestic violence can affect mental health and substance use at the same time, recovery often requires addressing both issues together. Trauma-informed treatment can help survivors process traumatic experiences, develop healthier coping skills, and build a foundation for long-term healing.

Why Trauma Should Be Addressed During Addiction Treatment

For many individuals, substance use develops alongside unresolved trauma and co-occurring mental health challenges such as PTSD, anxiety, or depression. When trauma contributes to substance use, focusing only on addiction may leave important underlying issues unaddressed.

Unresolved trauma can continue to affect thoughts, emotions, behaviors, and coping patterns even after a person stops using alcohol or drugs. Without learning healthier ways to process and manage trauma-related symptoms, some individuals may continue to struggle with emotional distress that can interfere with recovery.

This is one reason many people benefit from dual diagnosis treatment, which addresses both substance use disorders and mental health conditions at the same time. Treating these conditions together can help individuals better understand the relationship between trauma and substance use while developing healthier coping strategies.

Trauma-informed addiction treatment recognizes the impact trauma can have on recovery and helps individuals address both conditions in a safe and supportive environment. By treating the whole person rather than focusing on addiction alone, individuals can build a stronger foundation for long-term recovery and improved mental health.

Treatment for Trauma and Co-Occurring Addiction 

Effective treatment for trauma and co-occurring addiction addresses both conditions at the same time. Because trauma and substance use often influence one another, treating only one issue may make long-term recovery more difficult. Integrated treatment helps individuals develop healthier coping skills while addressing the underlying factors that contribute to substance use.

For some individuals, treatment may begin with medical detox to safely manage withdrawal symptoms and stabilize physical health. Once withdrawal is addressed, treatment often focuses on processing trauma, managing mental health symptoms, and building healthy coping skills that support long-term recovery. 

Treatment plans may include a combination of evidence-based therapies, such as:

Because every person’s experience with trauma is different, treatment should be individualized to address specific symptoms, experiences, and recovery goals. Therapists work closely with individuals to identify effective strategies for processing trauma, managing symptoms, and reducing the risk of returning to substance use.

With appropriate support and treatment, individuals can learn to manage the effects of trauma without relying on alcohol or drugs. Addressing both trauma and addiction together can help create a stronger foundation for long-term recovery and improved well-being.

Recovery Is Possible 

Trauma can have a lasting impact on mental health, relationships, and overall well-being, but it does not have to define a person’s future. With appropriate treatment and support, individuals can heal from both trauma and addiction and build healthier, more fulfilling lives. 

Recovery is often a gradual process that involves addressing the effects of trauma, developing healthy coping skills, and learning new ways to manage stress and difficult emotions. Although healing takes time, many people are able to reduce trauma-related symptoms, stay sober after treatment, and improve their quality of life through consistent treatment and support. 

Seeking help for trauma, addiction, or co-occurring mental health conditions is a sign of strength, not weakness. The earlier individuals receive appropriate care, the sooner they can begin addressing the underlying issues that may be contributing to substance use and emotional distress.

If you or a loved one is struggling with trauma, addiction, or co-occurring mental health challenges, professional treatment can help. Contact The Ridge Ohio to learn more about our evidence-based treatment programs and how we can help you begin your recovery journey.

Insomnia, Binge Drinking, and Cognitive Behavioral Therapy

What is the link between insomnia and binge drinking?

When you ask people about the challenges associated with quitting alcohol, one thing you hear often is “I can’t get to sleep without drinking.” When you ask people who begin drinking again after they try to stop – known as relapse – they often cite insomnia as one of the factors. In fact, research shows that around half the individuals diagnosed with alcohol use disorder (AUD) – formerly known as alcoholism – also have insomnia. Depending on what study you read, the number may be as low as 36 percent or as high as 72 percent.

Whether it’s 36 percent, 72 percent, or somewhere in between, experts agree that insomnia, alcohol use disorder, and relapse are related phenomena. Over the past twenty years, researchers have conducted experiments to try to unravel this relationship, and solve the problem of insomnia-related relapse. Several studies indicate that therapeutic interventions such as cognitive behavioral therapy (CBT), classes on sleep hygiene, and medication can reduce insomnia and help prevent relapse.

A recent study conducted at the University of Missouri-Columbia took a different approach. Rather than analyzing the effect of therapeutic intervention on the behavior of people with insomnia in recovery from AUD, they analyzed the effect of a specific therapeutic intervention – cognitive behavioral therapy (CBT) – on young, active binge-drinkers with a high risk of experiencing alcohol-related harm.

Finding a Path Around Stigma – Insomnia and Binge Drinking

The National Institute on Alcohol Abuse and Alcoholism (NIAA) defines binge drinking as “drinking more than four alcoholic beverages (women) and five alcoholic beverages (men) on one occasion.” This Missouri study focused on people aged 18-30 who reported binge drinking at least once in the month before the study began. The goal of the study was to find a way to reduce the harm associated with excess drinking by targeting the related phenomenon of insomnia without addressing the binge drinking directly.

In an interview with Science Daily, study author Mary Beth Miller, Ph.D., explained the approach:

The potential for insomnia treatment to influence alcohol-related consequences has significant implications for the prevention and treatment of alcohol use among young adults. Given the stigma associated with mental health issues and addiction, it’s crucial to identify other forms of treatment that either influence alcohol outcomes or open the door to alcohol-related treatment.”

The reasoning is rock-solid. Despite decades of awareness efforts and public advocacy campaigns to reduce stigma around alcohol use disorder and the treatment of alcohol use disorder, stigma around addiction and treatment still prevent people with drinking problems from seeking treatment. While we don’t have detailed information about why every person who needs treatment does not seek treatment, we know that a significant treatment gap exists. We also know stigma around treatment contributes to the treatment gap.

To learn more about the treatment gap and stigma, please read our article Alcohol Use Disorder in Adults: The Treatment Gap.

With regards to the effect of CBT on insomnia, and the knock-on effect on alcohol related harms, this Missouri study yielded important results. They indicate Dr. Miller and her team may be onto something important.

The Effect of Improving Sleep on Young Binge Drinkers

The study involved 56 participants who were divided into two groups. One group received five sessions of cognitive behavioral therapy (CBT) for insomnia. The other group received a single session on sleep hygiene. The CBT group received instruction on subjects such as sleep diaries and relaxation techniques. In contrast, the sleep hygiene group received instruction on how to create a consistent bedtime routine and arrange their sleeping space to improve their sleep environment.

Here’s what the researchers found:

  • CBT group:
    • 56% decrease in the severity of insomnia symptoms
    • Moderate improvement in sleep efficiency: more hours asleep in bed
    • Moderate reduction in drinks per week
    • Reduction in negative consequences of drinking
  • Sleep hygiene group:
    • 32% decrease in the severity of insomnia symptoms
    • No reported improvement in sleep efficiency
    • Moderate reduction in drinks per week
    • Moderate reduction in negative consequences of drinking

These results are modest, we admit. However, they contain an easter egg of sorts. The 56 percent reduction in the severity of insomnia symptoms for the CBT group is an important finding. We’ll return to that in a moment. The big picture takeaway is that the idea behind the study – discover a way to reduce alcohol harm that doesn’t involve stigma – showed itself as valid and worthy of further pursuit. Both groups reduced drinks per week and negative consequences of drinking. That’s a positive finding. But here’s where it gets interesting. They did it by addressing their sleeping patterns. They didn’t address their alcohol consumption directly. That’s a new development in the treatment of alcohol use disorder.

Cognitive Behavioral Therapy, Sleep, and Alcohol-Related Harm

Now we’ll talk about the specific data around insomnia. The cognitive behavioral therapy (CBT) group showed a 56 percent reduction in the severity of insomnia symptoms. We see this as an important data point for two reasons. The first is related to relapse. If insomnia is a significant driver of relapse, and CBT for insomnia reduces the severity of insomnia symptoms, it follows that CBT for insomnia for people in recovery from AUD may help them prevent relapse.

Let’s be clear.  The study authors do not say that. But we see that potential in the data.

The second reason is that CBT had a positive effect on the sleeping and drinking patterns of people who are neither in recovery nor receiving treatment for alcohol use disorder. This is another piece of evidence in support of the holistic, integrated model of AUD treatment.

The integrated model advocates treating the whole person. It doesn’t focus solely on the disorder. In the case of these 56 people between the age of 18 and 30 who reported binge drinking at least once in the month before the study, this means that treating an aspect of their overall wellbeing – sleep – had a positive effect on their drinking. It also led to an overall reduction in the number of drinks per week. Finally, it led to a reduction in the negative consequences of drinking.

This is good news and offers a novel entrée to the treatment of problem drinking in young adults. By sidestepping any question of stigma or fear of treatment, it offers young binge drinkers a potential pathway to reducing alcohol consumption. In addition, it may, in the long run, point them in the direction of seeking support for problem drinking, and help them take their first steps toward recovery.

If you need help with the detox process, The Ridge offers an inpatient rehab facility in Cincinnati and the outpatient and partial hospitalization treatments you can enroll in.

Is Alcoholics Anonymous Effective? Stanford Scientists Weigh In

Is Alcoholics Anonymous Effective? 

Disordered use of alcohol is a significant problem for millions of people worldwide, and – because of adjacent factors such as costs to the healthcare system, job loss, violence, and drunk driving – it’s also a significant public health concern.

One of the best-known methods for treating alcohol use disorder is Alcoholics Anonymous (AA). Millions of people around the world use AA for support and guidance as they seek a path to sobriety.

Founded 80 years ago, AA – comprised of the familiar twelve steps, and characterized by the acknowledgment of powerlessness before alcohol – is now a worldwide presence. The organization has local chapters around the globe, and is depicted in popular culture so often that it’s probably the first treatment method that comes to mind for people who want to quit drinking.

But scientists and medical doctors didn’t create AA. The method itself, as well as its underlying philosophy, was developed by two men: Bill Wilson and Bob Smith. They created AA because of their own problems with drinking. Despite these humble origins, millions of people rely on AA year after year to get and stay sober.

Because of this, AA often faces skepticism within the medical and scientific community. How can a method devised by two non-scientists be so effective? Is AA really as effective as its reputation would suggest? Or is it merely a popular approach with unverified or exaggerated results? Is there, in fact, any hard science that indicates AA is a legitimate treatment for alcohol use disorder (AUD)?

The Stanford Study

Scientists at Stanford recently examined those questions in a study that compared AA with other methods of treatment, including motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT).

To conduct the study, Dr. Keith Humphreys – a professor of psychiatry and behavioral sciences – and his colleagues first determined how to evaluate the effectiveness of the methods in question. Alcohol use disorder (AUD) is a complex phenomenon. What outcomes constitute success? And how, for the purposes of the study, would they define the costs of AUD?

The most obvious desired outcome is a change in behavior of the participant seeking treatment. Did AA lead to abstinence more often than other methods? Was it more reliable than other methods? And were there other measurable outcomes to consider?

Increased Abstinence and Lowered Health Care Costs

For the purposes of their study, the scientists decided to focus on measurable data sets to define success. These included:

  • The duration of time that subjects refrained from drinking alcohol
  • The amount they reduced their drinking overall if they didn’t abstain completely
  • Their health care costs

The investigators looked at data from over 27 different studies, with a total of over 10,000 participants, ranging in age from 34 to 51.

The data showed that AA is an effective intervention for promoting abstinence. They also found that the twelve-step method is likely a factor in reduced healthcare costs, reducing the incidence of alcohol-related violence, accidents, and other consequences of heavy or disordered alcohol use.

What Makes AA Effective?

We need more data for a conclusive analysis, but one aspect of twelve-step programs and the AA approach that appears to help people is the meeting-based structure. Dr. Humphreys and colleagues concluded this element of AA is a key to its success in changing behavior.

That sounds simple, but the group approach is based on behavioral science.

AA meetings reinforce social structures that allow members to support each other in all aspects of recovery. These include examining their behaviors, making changes, and creating and sticking to new habits. Humans are social creatures. Social interactions have a profound influence on behavior. Support from peers can range from practical advice, such as simple tips on how to have fun without drinking, to emotional support, to genuine fellowship.

Why does this simple support from ordinary people work so well?

According to the Stanford study, it’s about our development as a species. Humans evolved over millennia to communicate and learn from each other’s experiences. Hearing from someone who’s been there, knowing that they faced similar challenges and struggles – and succeeded in overcoming them – provides a dose of optimism.  Often, it can make the difference between staying sober and relapsing.

A final note: the Standford study showed therapeutic methods such as motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT) worked in treating AUD, too. That supports research that shows a multi-modal approach to addiction treatment – often called integrated treatment and/or holistic treatment – is the most effective path to long-term, sustained sobriety. In fact, most well-regarded treatment programs use the integrated approach. They combine individual therapies like CBT with group therapy, and lifestyle changes, which include diet, exercise, and mindfulness techniques. With the added benefit of community support programs like AA, these full-spectrum, holistic programs achieve the most favorable outcomes for people seeking long-term sobriety.

The Ridge offers the detox process and inpatient rehab facility to help you start your journey towards recovery.

Heavy Drinking, Alcohol Use Disorder, and Marriage

The presence of a drinking problem or an alcohol use disorder (AUD) can cause significant harm to any human relationship, including marriage. Decades of research show that for newlyweds and long-married couples alike, disordered alcohol use such as heavy drinking or binge drinking can lead to a host of negative consequences. In 2009, the journal Clinical Psychology Review published a review of over sixty studies on the effect of alcohol on marriage.

Here’s what the study concluded:

“There is an overwhelming amount of evidence for the conclusion that spousal alcoholism [AUD] is maladaptive, and that heavy and problematic alcohol use is associated with lower levels of marital satisfaction, higher levels of maladaptive marital interaction patterns, and higher levels of marital violence.”

That study lays the foundation for a data-driven, evidence-based understanding of the specifics of how alcohol affects marriage. More recently, a long-term research effort conducted by scientists at the Research Institute on Addictions (RIA) at the University of Buffalo examined the prevalence of alcohol use and its associated problems among married couples in the U.S. They published their research in a series of articles in 2013-2014. While much of their data and conclusions are not a surprise, there are some notable observations that are important for the general public to understand.

Alcohol Abuse Ruins Mairrages

One takeaway from the research on alcohol and marriage is that in a majority of cases, moderate alcohol use does not cause significant problems. Observable and quantifiable trouble appears most often in couples where one spouse or both report heavy alcohol use and/or patterns of binge drinking.

Different Types Of Alcohol Abuse And Their Effects On Marriage

Before we go any further, let’s look at how the experts at The Substance Abuse and Health Services Administration (SAMHSA) and the National Institute on Alcohol Abuse and Alcoholism (NIAA) define moderate, binge, and heavy drinking:

Moderate Alcohol Consumption

  • 1 drink a day for women and 2 drinks a day for men.

Binge Drinking

  • Alcohol consumption that brings blood alcohol concentration (BAC) up to 0.08 g/dl. That means:
    • 4 drinks in about 2 hours for women
    • 5 drinks in about 2 hours for men
  • Consuming 5 or more alcoholic beverages on the same occasion on at least 1 day in the past 30 days.

Heavy Drinking

  • Binge drinking on each of 5 or more days in the past 30 days

Now let’s look at the prevalence of these drinking patterns among married couples in the U.S. This is data reported by the research team at the University of Buffalo:

  • 79% report neither partner meet criteria for heavy drinking
  • 4.0% report both partners meet criteria for heavy drinking
  • 12% report only the male partner meets criteria for heavy drinking
  • 5.0% report only the female partner meets criteria for heavy drinking

Those statistics introduce a consistent trend throughout all the research – yes, all the research over the past several decades – that indicates a gender difference in heavy drinking. According to the data, the male partner in a married couple is more likely to engage in heavy or binge drinking than the female partner. Another notable fact emerges here, as well. The consequences of alcohol use differ when both partners drink heavily and/or have a clinically diagnosable alcohol use disorder (AUD).

We’ll return to that fact in a moment. To read and understand the criteria and risk factors for AUD, please consult this NIAA resource page .

Now let’s take a closer look at the core findings from the research we’ve been talking about.

The Negative Effects of Heavy Drinking on Marriage

The Research Institute on Addictions (RIA) team examined several key metrics: marital satisfaction, domestic violence, aggression, divorce, and the number of positive and negative interactions between married partners.

Here’s what they found:

  • Marital satisfaction
    • Heavy drinking, problem drinking, and AUD in one or both partners were associated with lower marital satisfaction, as compared to marriages where neither partner reported heavy drinking, problem drinking, or AUD.
    • Stronger associations between lower marital satisfaction and drinking problems appeared when the male partner reported the problem drinking patterns.
    • Weaker – but still present – associations were noted when the female partner reported the problem drinking patterns.
  • Domestic violence
    • Alcohol use was identified as a contributing factor in domestic violence for perpetrators and victims
      • Physical aggression is three times more likely to occur when the perpetrator consumes alcohol
      • Physical aggression is twice as likely to occur when the victim consumes alcohol.
    • Alcohol use was identified as a contributing factor in verbal and psychological aggression between married partners
      • Verbal aggression is twice as likely to occur when either the victim or perpetrator consumes alcohol within four hours prior to the reported aggression
  • Divorce
      • Alcohol and/or substance use are among the top reasons identified for filing for divorce:
        • They’re the 3rd most common reason cited by female marriage partners
        • They’re the 8th most common reason cited by male marriage partner
      • Alcohol and/or substance use is one of the most common reasons married couples cite for seeking marriage counseling
  • Interactions
      • More negative interactions than positive interactions appeared in married couples when one marriage partner reported alcohol dependence or AUD.

These statistics clarify – with numbers – the negative effects of alcohol on marriage. Findings like these are helpful when discussing alcohol and marriage, because it’s easy to make blanket statements like “too much drinking ruins a marriage.” Although that may feel true and seem obvious – and is true in many cases – historical research data does not support that statement. It’s also not what the results from RIA studies say.

So, what do the results say?

Different Drinking Habits Cause Problems

We start this section with a heavy qualification. We do not condone excess drinking in any form, for anyone, ever, whether they’re single, married, in a serious long-term relationship, a common-law domestic partnership, or dating. Issues of marriage, divorce, and alcohol and/or substance use and misuse can be highly charged. They’re often accompanied by complex relationship histories. They can be extremely emotional for everyone involved.

That’s why we stick to facts, derived from data, obtained from reliable scientists working in good faith to understand complex topics that have real ramifications for real people in the real world. If you suspect that you or your spouse is battling with drinking problems, its worth taking a look at our latest findings.

With that said, here’s what the RIA researchers found with regards to the following metrics:

  • Marital satisfaction

    • Marriage partnerships in which both marriage partners report heavy alcohol consumption report higher levels of marital satisfaction than marriage partnerships in which one marriage partner reports heavy alcohol consumption and the other does not.
  • Divorce

    • Marriage partnerships in which both marriage partners report heavy alcohol consumption are less likely to end in divorce then those in which one marriage partner reports heavy alcohol consumption and the other does not.
    • 50% of marriage partnerships in which only one partner reported heavy alcohol consumption end in divorce.
    • 30% of marriage partnerships in which both partners reported similar alcohol consumption ended in divorce.
  • Interactions

    • Marriage partnerships in which both partners report having AUD report more positive interactions than partnerships in which one partner reports AUD and the other does not.
    • Marriage partnerships in which both partners report having AUD report a higher ratio of positive interactions to negative interactions than partnerships in which one partner reports AUD and the other does not.

Now you can see why we qualified the data before sharing it. This is tricky territory.

As the study authors say,

“The difference makes the difference.”

The data shows that for marriage partnerships in which both partners have similar drinking habits, those partnerships do not experience the same negative consequences as marriage partnerships in which partners have contrasting drinking habits.

Alcohol Abuse And It’s Effect on Children

Research identifies the presence of an alcohol or substance use disorder in the home as an adverse childhood experience (ACE). ACEs are a form of trauma. They’re a complex phenomenon by themselves. We’ll now offer a thumbnail version of what we think people reading this article should know about ACEs.

Researchers from the Centers for Disease Control (CDC) identify the following ten types of ACEs:

  1. Physical abuse
  2. Emotional abuse
  3. Sexual abuse
  4. Physical neglect
  5. Emotional neglect
  6. Mental illness in the family
  7. Witnessing domestic violence
  8. Divorce
  9. Having a relative incarcerated
  10. Alcohol and/or substance abuse in the home

The scientists who first identified ACEs published scores of peer-reviewed papers on the long-term consequences of ACEs. Taken together, these studies show that when individuals accrue four or more ACEs, they’re at increased risk of experiencing:

  • Impaired neurodevelopment
  • Social, cognitive, and emotional problems
  • Chronic disease, disability, and impaired social productivity

In addition, children exposed to four or more ACEs are at increased risk of engaging in risky behaviors. These include alcohol use, drug use, and early sexual activity. In terms of chronic medical conditions, exposure to four or more ACEs increases the risk of developing:

  • Cancer
  • Diabetes
  • Heart disease
  • Depression

With regards to the negative effect of AUD among parents on their children, the research clearly indicates the presence of AUD – when combined with three or more other ACEs – increases the risk of those children developing a wide range of biological, social, psychological, and emotional problems when they reach adolescence and adulthood.

What Does This All Mean?

That depends on the marriage partnership, the individuals involved in that partnership, and the decisions they make with the knowledge they have.

In short, all this information means different things to different families. Therefore, we can’t tell anyone definitively what this marriage and parenting data means for them.

Does Alcohol Abuse Always End In Divorce

The presence of an alcohol use disorder in a marriage does not automatically mean that marriage will end in divorce. Nor does it mean the partners in the marriage will experience physical abuse, verbal abuse, or a disproportionate amount of negative interactions. It does, however, increase the risk for physical and verbal abuse. That increased risk is more pronounced in marriage partnerships in which the marriage partners have contrasting drinking habits, i.e. marriages in which one partner drinks heavily, and the other does not. In those partnerships with mismatched drinking habits, rates of divorce and negative interactions also increase.

The presence of alcohol abuse in a marriage does not mean that children of those parents will grow up to experience all the negative consequences associated with ACEs, either. It does, however, push those children closer to the threshold at which childhood trauma results in adolescent and adult disease and disability.

But no path is written in stone. Humans are resilient and have the ability to experience and transcend adversity of all types. That includes the trauma associated with AUD and ACEs.

Family And Marriage Counseling In Treatment for Alcohol Use Disorder

Associated with all this data on drinking, marriage, and children is the fact that alcohol use disorder is a chronic medical condition that responds to appropriate treatment. A corollary to that fact is that children who experience trauma can learn to process that trauma with the help of a capable adult – most often a therapist – and mitigate the negative effects of experiencing ACEs.

Therefore, married partners that know and understand the implications of AUD in marriage and parenting have options. If they also know and understand that one, or both, partners in the marriage have an AUD, they can seek treatment and support for the AUD. Evidence shows that an integrated treatment model is effective. Integrated treatment includes individual therapy, group therapy, experiential therapy, and family therapy.

This whole person approach can lead to long-term, sustained sobriety. Married parents with AUD in their partnership can seek support for their children, as well. The trauma associated with parental AUD can be mitigated with the help of a qualified, capable adult. The adults most qualified for helping children work through trauma are professional therapists, as mentioned above.

Get Family Therapy For Alcohol Use Disorder At The Ridge Ohio

The takeaway here is that AUD in marriage can have a negative impact on both individuals in the marriage partnership, as well as any children in the family. But that’s not the end of the story. Spouses and parents can take affirmative, proactive steps to recover from AUD and to help their children process any trauma associated with the AUD. A step toward treatment and support is a step toward empowerment and healing for everyone involved. Seeking support and receiving detox treatment are time-tested methods families can use to author their own narrative, write the next chapter of their personal family story, and rediscover the balance and harmony that the presence of an AUD often disturbs.

The Consequences of Alcohol Use Disorder in Women

How prevalent is alcohol use disorder in women? What are the consequences?

Alcohol use in the U.S. is common. People serve alcohol at parties, commemorative events, and at home. They include it as an option at occasions as diverse as backyard barbecues and executive business lunches. Adolescents experiment with alcohol, college students often make consuming alcohol a way of life, and adults use alcohol to relax, facilitate social interaction, and reward themselves after a hard day of work or play.

Its prevalence – while innocuous in many instances – can also lead to misuse. The 2020 National Survey on Drug Use and Health (2017 NSDUH) shows the following population-level data on alcohol use disorder (AUD) in the U.S.:

  • Adolescents (12-17): 712,000 (2.8%)
  • Young Adults (18-25): 5.2 million (15.6%)
  • Adults (26+): 22.3 million (10.3%)

Quick math tells us that almost 30 million people in the U.S. meet the clinical criteria for AUD, or what most people think of as alcoholism. Further examination of the numbers shows the rate of AUD gradually decreased for all age groups between 2002 and 2017, then increased between 2017 and 2020. However, additional research reveals an increase in the prevalence of AUD in one group over the same time: women.

A study published by the American Psychological Association (APA) in 2014 explores the differences in the development and consequences of alcohol use disorder in women, and how they differ for women and men. This article summarizes that study and discusses its implication for the treatment of alcohol use disorder in women.

Prevalence of Alcohol Abuse in Women Compared to Men

In general, men experience higher rates of AUD than women. Here’s the data:

  • AUD in men: 24.6%
  • AUD in women: 11.5%

These numbers represent a distinct shift, not only over the past 15 years, as indicated above, but over the past 90 years. In the 1930s, data places the ratio of disordered alcohol use for men, compared to women, at seven to one (7:1). When we fast forward to 2017, we see that ratio close significantly: it now hovers around two to one (2:1). If you’re not used to reading or thinking in ratios, what this means is that about a hundred years ago, seven times more men than women experienced problem drinking. Now – or according to data from 2017 – only twice as many men than women experience problem drinking.

That’s a big change. The specific reasons behind the change are beyond the scope of this article, but it’s reasonable to suggest that the increased reporting of rates of AUD for women mirror their increased ability to participate in all aspects of society, from working, to owning property, to securing equal rights and access to a variety of social, political, and cultural activities that were previously denied them, as Supreme Court Justice Ruth Bader Ginsburg observed, “on the basis of sex.”

What is within the scope of this article, however, is identifying differences in the development and impact of AUD on women compared to men.

We’ll talk about those now.

Alcohol Use Disorder in Women: The Negative Effects

Disordered alcohol use causes severe, lasting, and negative impacts for anyone. Men, women, young people, old people – any person who develops disordered drinking patterns risk damage to their brain and body. The latest research tells us two important things: some of the negative impacts of AUD are more pronounced in women than in men, and AUD develops differently in women, as compared to men.

Research indicates the following short-term differences in the effect of alcohol consumption on women, compared to men. Women show:

  • Higher blood alcohol levels when consuming the same amount of alcohol
  • Increased cognitive impairment
  • Increased sedation (sleepiness)
  • Higher levels of impairment (drunkenness)
  • Increased levels of acute, alcohol-related injury
  • Increased risk of sexual assault (as a victim)

Long-term differences in the effect of alcohol use disorder on women, compared to men, include:

  • Increased risk of brain damage and shrinkage
  • Shorter time for brain damage and shrinkage to occur
  • Increased memory impairment
  • Increased cognitive impairment
  • Elevated risk of alcohol-related liver disease
  • Elevated risk of mouth, throat, esophageal, liver, breast, and colon cancer
  • Greater risk of heart disease and cardiovascular complications
  • Increased risk of depression and mood disorders

Pregnancy And Alcohol Use Disorder

Studies also show the negative impacts of alcohol consumption during pregnancy. Risks to newborns of mothers who consume alcohol excessively during pregnancy include:

  • Birth defects
  • Low birth weight
  • Fetal Alcohol Syndrome (FAS), which can cause:
    • Physical deformations
    • Slow growth (before and after birth
    • Defects in major organs
    • Defects in the brain and nervous system
    • Cognitive impairment
    • Social impairment
    • Memory impairment
    • Disrupted emotional development
    • Impaired balance

These elevated risks mean, in a nutshell, that AUD – or simply excessive drinking – has the chance to cause more damage, more quickly, to women than men. The authors of the APA study cited above put it this way:

“AUD appears to be a more severe form of psychopathology in women.”

Alcohol Use Disorder Rehab For Women

There are two more pieces of information we left out – and both are relevant to our discussion. First, following initiation of alcohol use – i.e. their first drink – women develop patterns of disordered drinking more rapidly than men. Second, when women begin drinking during adolescence, the intensity and duration of alcohol use disorder are greater than that found in men who begin drinking around the same time.

Taken together, all this information is critical for primary care physicians, physicians who specialize in women’s health, therapists, psychiatrists, and social workers involved with women’s issues. In other words, anyone directly involved in the health and wellbeing of women should understand the increased physical, emotional, and psychological risks associated with AUD in women compared to men.

Putting this knowledge into action means that medical and mental health professionals can include questions regarding alcohol consumption in any screenings they conduct during regular office visits. These professional caregivers can then act quickly on the information they collect. If women show signs of AUD, doctors and therapists can recommend a drug and alcohol rehab for women and treatment plan sooner rather than later – which can help women with disordered drinking patterns live healthy lives and significantly mitigate the negative short- and long-term consequences of alcohol abuse.

Sources:

https://www.samhsa.gov/data/sites/default/files/reports/rpt35323/NSDUHDetailedTabs2020/NSDUHDetailedTabs2020/NSDUHDetTabsSect5pe2020.htm

Dual Diagnosis and Co-Occurring Disorders

Dual diagnosis, also known as a co-occurring disorder, occurs when a person experiences both a substance use disorder and a mental health condition at the same time. These conditions often influence one another, making symptoms more difficult to manage and increasing the risk of relapse if only one condition is treated.

Understanding how co-occurring disorders develop, how they are diagnosed, and how integrated treatment addresses both conditions can help individuals and families make informed decisions about recovery and long-term mental wellness.

What Is Dual Diagnosis? 

Dual diagnosis refers to the presence of both a substance use disorder and a mental health disorder. These conditions often develop together and can affect one another in ways that make recovery more challenging.

Either condition can develop first. Some people experience mental health conditions such as depression, anxiety, bipolar disorder, or post-traumatic stress disorder before developing a substance use disorder. Others develop mental health symptoms alongside or after prolonged alcohol or drug use. 

In some cases, individuals use alcohol or drugs to manage difficult emotions or psychiatric symptoms, a behavior often referred to as self-medication. While substances may provide temporary relief, they frequently worsen mental health symptoms over time and increase the risk of addiction.

Because addiction and mental illness can share similar symptoms, understanding the relationship between the two conditions is an important part of the diagnostic process.

How Common Are Co-Occurring Disorders?  

Co-occurring disorders are more common than many people realize. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 21.2 million adults in the United States experienced both a mental health condition and a substance use disorder in 2024.

Research consistently shows that people with mental health disorders are more likely to develop substance use disorders than the general population. Likewise, individuals with substance use disorders have a higher risk of experiencing conditions such as depression, anxiety, bipolar disorder, and post-traumatic stress disorder.

The presence of both conditions can make recovery more challenging. Individuals with co-occurring disorders often experience more severe symptoms, higher rates of relapse, and greater difficulty maintaining long-term stability when only one condition is treated.

Despite the prevalence of dual diagnosis, many people do not receive treatment that addresses both conditions at the same time. Integrated treatment approaches help to make sure that substance use and mental health concerns are treated together, supporting better long-term recovery outcomes.

Understanding how common co-occurring disorders are can help reduce stigma and encourage individuals to seek comprehensive care when both mental health and substance use challenges are present.

Common Signs and Symptoms of Dual Diagnosis 

The signs and symptoms of dual diagnosis can vary depending on the specific mental health condition, the substance being used, and the severity of each disorder. Because addiction and mental illness often occur together, symptoms can overlap and intensify one another, making it difficult to determine where one condition ends and the other begins.

Common mental health conditions associated with co-occurring disorders include depression, anxiety disorders, bipolar disorder, post-traumatic stress disorder (PTSD), attention-deficit/hyperactivity disorder (ADHD), and schizophrenia.

Mental health symptoms may include:

  • Persistent sadness, hopelessness, or emotional distress
  • Excessive worry, anxiety, or panic
  • Mood swings or emotional instability
  • Difficulty concentrating or making decisions
  • Changes in sleep patterns or energy levels
  • Social withdrawal or loss of interest in activities

At the same time, individuals may experience signs of a substance use disorder, such as:

  • Strong cravings for alcohol or drugs
  • Difficulty controlling substance use
  • Increased tolerance or withdrawal symptoms
  • Neglecting responsibilities at work, school, or home
  • Continuing to use despite negative consequences
  • Repeated unsuccessful attempts to cut back or stop

When both conditions are present, symptoms often become more severe and persistent. Mental health challenges may contribute to substance use as a way to cope with distress, while alcohol or drug use can worsen existing psychiatric symptoms and interfere with recovery.

Because symptoms often overlap, identifying a co-occurring disorder can be challenging without a comprehensive evaluation. 

How Dual Diagnosis Is Diagnosed 

Diagnosing a co-occurring disorder requires a comprehensive evaluation of both substance use and mental health symptoms. Because addiction and mental illness can produce similar symptoms, identifying the relationship between the two conditions is often an important part of the assessment process.

Diagnosis typically begins with screening for concerns related to both substance use and mental health. If a co-occurring disorder is suspected, healthcare providers conduct a more detailed assessment that may include a review of substance use history, mental health history, medical background, current symptoms, and previous treatment experiences.

A dual diagnosis is established when both a substance use disorder and a mental health disorder can be identified as separate conditions, rather than one condition being solely caused by the other.  Determining this can be challenging because alcohol and drug use may contribute to symptoms such as anxiety, depression, mood changes, or sleep disturbances. At the same time, untreated mental health conditions can increase the likelihood of substance use as a coping mechanism.

For some individuals, a period of sobriety may help clarify whether certain symptoms persist after alcohol or drug use has stopped. However, because waiting for complete symptom clarity is not always possible, treatment providers often begin addressing both conditions when a co-occurring disorder is suspected.

Accurate diagnosis is an ongoing process. As recovery progresses and additional information becomes available, treatment providers can continue refining diagnoses and adjusting treatment plans to support an individual’s evolving needs.

Treatment for Co-Occurring Disorders 

Effective treatment for co-occurring disorders addresses both the substance use disorder and the mental health condition at the same time. Integrated treatment combines addiction and mental health services into a coordinated plan that addresses the full range of an individual’s needs. Treating only one condition while ignoring the other can leave important symptoms unresolved and increase the risk of relapse. 

Individual Therapy and Counseling

Individual therapy helps people understand the relationship between their mental health symptoms and substance use. Treatment may focus on identifying triggers, developing healthier coping strategies, improving emotional regulation, and addressing underlying issues that contribute to both conditions.

Evidence-based approaches such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Motivational Interviewing (MI) are commonly used to support recovery and long-term symptom management.

Medication Management

For some individuals, medication may play an important role in treatment. Psychiatric medications can help manage symptoms associated with conditions such as depression, anxiety, bipolar disorder, or other mental health disorders while individuals work on recovery from substance use.

Medication decisions should be made in collaboration with qualified healthcare providers and monitored as part of an overall treatment plan.

Levels of Care

Treatment for co-occurring disorders can be provided in a variety of settings depending on symptom severity, recovery progress, and the level of support needed. Care may include medical detox, residential treatment, partial hospitalization programs (PHP), intensive outpatient programs (IOP), outpatient treatment, and ongoing recovery support.

Because recovery needs can change over time, treatment plans are often adjusted as symptoms improve or additional support becomes necessary. The goal is to provide the appropriate level of care while helping individuals build long-term stability in both recovery and mental health.

Relapse Prevention and Ongoing Support

Recovery from co-occurring disorders is an ongoing process that extends beyond the completion of a treatment program. Continued support through therapy, support groups, aftercare services, medication management, and recovery planning can help individuals maintain progress and respond effectively to future challenges.

Long-term recovery is often strengthened when both mental health and substance use concerns continue to be monitored and addressed throughout the recovery journey.

Dual Diagnosis Treatment at The Ridge Ohio 

People with co-occurring disorders require treatment that addresses both substance use and mental health concerns. At The Ridge Ohio, treatment plans are designed to address the unique challenges associated with dual diagnosis while supporting long-term recovery and emotional wellness.

Our team works with individuals experiencing substance use disorders alongside conditions such as depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), and other mental health challenges. Treatment may include medical detox, residential treatment, individual therapy, group counseling, medication management, relapse prevention planning, and ongoing recovery support based on each person’s needs.

Recovery from co-occurring disorders is possible with the right support and a treatment plan that addresses both conditions together. If you or a loved one is struggling with addiction and mental health symptoms, learning more about our dual diagnosis treatment program can help you understand your treatment options and begin the recovery process.

My Child’s Father Is An Addict

When we think the parent-child dynamic in the context of addiction, we almost always think about the parent at their wit’s end trying to get help for their addicted son or daughter. The reality is, however, that it’s often the parents of underage and adult children who struggle with addiction and often wind up impacting their children for years to come as a result. Between alcohol addiction and the escalating opioid crisis affecting baby boomers and older seniors, addiction is a public health issue that doesn’t discriminate based on age.

If the father of your child is struggling with addiction, there is a whole other level of urgency you need to observe in your attempt to get them help in order to ensure the safety and long-term well-being of you and your child while getting your partner or co-parent a second chance at life in recovery. Data from the United States Department of Health and Human Services indicates parental alcohol or other drug use as a contributing factor for child removal increased from 18% to over 35% in the last 16 years. At the same time, while there is obviously no guarantee, a commonly cited body of research suggests that children of addicts are eight times as likely to become addicts themselves.

In order to break the cycle of addiction and protect your child from immediate harm, here are some steps you can take to get the father of your child the help they need.

Make Sure You & Your Child Are Safe

You need to be able to help the father of your child from a position of strength and stability. The reality of addiction is that it puts both the addict and the people they love in dangerous situations, and very often jeopardizes their immediate health and safety. Before you can take steps to help your loved one, make sure your living situation is secure and that you and your child have somewhere to go in the event of escalation. Call a friend or family member, if necessary.

“Tough Love” – Consequence-Based Treatment Motivation

While it may seem initially harsh, sometimes the best thing you can do is show the addicted father of your child what can happen if they don’t get clean. Tell the father of your child as calmly and rationally as possible, without exercising judgment, that you simply can’t put your child at risk by allowing visitation until they get clean. It may be necessary to take legal action in this case. Courts may automatically intervene and mandate treatment, depending on the specific circumstances.

Some Of The Signs That The Father Of Your Child May Have A Drug Problem Include:

  • Increasing irresponsibility regarding care
  • Professional or financial problems
  • Prolonged periods of absence or isolation
  • Erratic, risky and potentially illegal nehavior
  • Lying about whereabouts and other things

If your child’s father is exhibiting these physical indicators or any behavioral signs of addiction, it’s time to get them help.

Engage Them Calmly About Treatment

Before things escalate to the point of consequences; however, try talking to the addicted father of your child about the prospect of getting help for both themselves and your child. Offer to help them in their search for care. If they see that they have a partner in this endeavor, and that they can lean on you for support, they might be more receptive to entering treatment. Help can mean anything from assisting in their search for a treatment center by calling or going online to offering to help cover some of their treatment costs through your insurance if they aren’t adequately covered by their own plan. There is no blueprint for this, but as long you are willing to help, let them know.

Get Others Involved In Their Treatment

Even though your child’s safety and emotional well-being may be tied to their father’s recovery, and you have a tremendous personal stake in their progress, this can’t be entirely up to you. Reach out to his family, close friends, and other important people in his life to try and organize a meeting or intervention. An intervention should be led by an experienced, trained, and qualified professional who can keep the process from becoming overtly emotional, assist with making treatment arrangements, and help your group coordinate the logistics of the meeting. It’s important to make treatment arrangements ahead of time to avoid any of the pitfalls of any second thoughts your child’s father may have.

We’re Ready To Help Your Child Get His Father Back

The Ridge has helped thousands of parents just like you start to reconnect your family through comprehensive alcohol and drug addiction treatment. We offer detox programs and an inpatient rehab facility. Whether you and your child’s father are married, separated, or share parentage in any other model, your child deserves to have two parents who love, support, and show up for them.

Resources:

How To Defend Against Prescription Drug Addiction

Prescription painkillers are necessary for people in unbearable pain after an injury or a major medical procedure, but they have a deadly dark side that has more people seeking drug detox programs by the day. Opioid painkillers are extremely easy to become addicted to and introduce people to a life-destroying habit. Every American needs to know the risks these drugs carry and how to avoid getting hooked.

Prescription drugs are more prevalent now than ever. Enough pills were prescribed in 2010 to keep every adult in the country fully medicated 24 hours a day for an entire month. The number of prescriptions for opioid painkillers has nearly tripled from 70 million in 1991 to 210 million in 2011. Unless Americans happened to experience three times more pain that year than they did twenty years earlier, something is wrong with the frequency of these prescriptions. And the statistics for deaths by overdose back that up, too: deaths from prescription drug overdoses more than quadrupled from 4,030 in 1999 to 16,651 in 2010.

Although these drugs have medical legitimacy, it’s essential to remember that they’re still opioids. The euphoric, painless sensation they cause is very easy to get addicted to. The brain will shut down the natural production of pleasure-causing chemicals in response to the unnaturally large amounts the drug causes the brain to release, forcing a person to seek more of the drug. When a person runs out of legally obtained pills, they’ll likely try to buy them through less-than-legitimate means, which can run up to $100 per pill. Many then switch to the much cheaper and much more potent heroin. People in this situation often never would have willingly tried heroin and never thought they’d end up struggling with addiction, especially since the pill that got them hooked wasn’t an illicit substance, but medication recommended by their doctor. With this kind of risk present for literally anyone prescribed an opioid painkiller, education and preparation are key!

So, how can you avoid having you or a loved one fall into addiction if you need a painkiller because of a medical condition? The best bet is to communicate your concerns with your doctor. See if there are any non-addictive, non-opioid methods of dealing with pain. If not, make sure you and your doctor agree on a limited amount of refills and a safe schedule for taking the pills. Consider having a trusted family member make sure that the drugs are only taken at the correct times in the correct dosages. These precautions are especially important since addiction usually begins when people can get their prescription refilled many more times than necessary and start taking the pills for the euphoric high rather than pain relief. If you see anyone starting to abuse painkillers in this way, act immediately and look for an inpatient drug rehab center. Don’t wait for their addiction to get worse.

A less direct action, but no less important, is to be an advocate in your community for safe, effective opioid control. By raising awareness, you’ll force doctors and pharmacists filling prescriptions to be more accountable for their actions, and gain public support for more treatment options for prescription opioid addicts.