Leah K. Walker

It can be very hard to watch a loved one struggle with alcohol use. You may feel scared and confused about how to approach the situation. Getting help sooner rather than later is important and can help prevent further harms to your sibling’s health, well-being, and relationships.1 This article can help you understand more about alcohol use, the signs of an alcohol use disorder (AUD), as well as how to talk to your sibling and help find them treatment. [quote] The words “alcoholic,” “alcoholism,” and “alcohol abuse,” are all outdated terms that can contribute to stigma, which is negative beliefs that may lead to discrimination. Research shows stigma can worsen alcohol use disorder (AUD), prevent people from seeking help, and ultimately leads to worse outcomes. AUD is a chronic disease that people can and do recover from. [/quote] Understanding Alcohol Addiction When it comes to understanding alcohol use disorder (AUD), know that managing it is not as easy as just stopping drinking through willpower. AUD is a chronic, relapsing disease marked by not being able to stop using alcohol despite the negative outcomes alcohol use causes in multiple aspects of your life. But it’s important to know that AUD is treatable, and people can and do recover.3 I Think My Brother Drinks Too Much While only a doctor or a licensed addiction specialist can diagnose someone with an AUD, there are some signs that may mean your brother has a problem with alcohol. These signs include:4 Trying but not being able to cut back or stop using alcohol. Using alcohol in high-risk settings, such as driving. Not being able to fulfill responsibilities at home or work due to drinking. Continuing to drink, despite knowing it worsens a medical or mental health problem. How to Help an Alcoholic Sibling Helping a sibling with an alcohol problem can be challenging, so it’s important to know what you can and can’t control. You can’t make your brother go to treatment or force him to stop drinking. However, you can offer support. This might look like: Helping your sibling research treatment options. Suggesting they talk to a doctor if they won’t talk to you. Going with them to family/group therapy or any other appointments. How to Talk to Your Brother About Alcohol Starting a conversation about someone’s alcohol use is never easy, but there are a few tips that can make it a little better overall. Ideally, approach your loved one while they are sober. Most important, harsh confrontation is not usually a good idea, nor is attacking or ambushing them. What to Say to Someone with Addiction It can be helpful to approach your loved one in these ways:5 Do talk to them when you have privacy and as few distractions as possible. Do start by telling them that you are worried about them and that you are concerned about their drinking. Try saying something like, “I am concerned about you, will you talk with me?” Do listen and acknowledge their feelings. Do offer to help, such as by finding them a treatment program. You can also try asking, “What is the best way that I can help you?” Do stay patient. Change doesn’t happen right away. What Not to Say to Your Loved One It is important to keep the lines of communication open with your brother. It can be helpful to avoid some of these common pitfalls in talking to your sibling about their alcohol use:2,5 Don’t lecture them or say critical things. Don’t make them feel guilty. Don’t bribe or threaten them. Don’t call names or use labels. Remember that labels like "addict" or "alcoholic" can be hurtful. Take Care of Yourself It is important for you to set boundaries for yourself and to remember to take care of yourself while you are dealing with your sibling’s alcohol use. Caring for someone with an AUD is challenging, and it's harder for you to help someone if you are not feeling well mentally. Counseling for you can be helpful, as can going to support groups, such as Al-Anon.6 It can also be a good thing to avoid enabling behaviors, such as: Bailing your brother out of jail. Minimizing the seriousness of the situation. Giving him money that you know is being used for alcohol. Making excuses for them and justifying their drinking. Boundaries are important, too, and this can look like not letting your sibling use alcohol in your home, loaning them money, or calling into work for them. Types of Alcohol Rehab for Your Brother There are many treatments for AUD, which typically involve a combination of talk therapy and medications in an inpatient or outpatient setting. Common approaches to treating alcohol use disorder include:7 Detox is often the first step in treatment. It can help your brother safely manage withdrawal symptoms and get him ready for the next step. Inpatient treatment, where your sibling can stay in a 24/7 program to get around-the-clock support. Outpatient treatment, where your brother could stay home at night and on weekends and get help during the day. Most inpatient or outpatient treatment programs include some form of behavioral therapy, including:7.8 Cognitive-behavioral therapy (CBT), where people in treatment are taught to change their patterns of thinking to help them avoid alcohol use. 12-step facilitation therapy, which incorporates the use of mutual support groups and encourages people to attend 12-step groups. Contingency management, in which people get rewards for following a treatment program. For example, getting free movie tickets for attending a certain number of 12-step groups. The best approach to treatment varies from one person to another. No one type of treatment fits all, and it should be tailored to meet each person’s recovery needs.8 Cost and insurance coverage can also impact program choice. If you are still struggling to get your brother to agree to go to treatment, it is possible to use the CRAFT approach, which stands for Community Reinforcement and Family Training. CRAFT trains family members in communication techniques to help facilitate a family member’s entry into treatment for substance use disorders.9 Getting Help for Your Brother If your brother needs help for alcohol use disorder, there are many options available to get him the help he needs to enter recovery and manage AUD. At American Addiction Centers (AAC), we offer caring and compassionate treatment for AUD. Call us at [phone] today to get started in locating a treatment program that can help your sibling. [vob-aktify-cta title="Does your insurance cover alcohol treatment?" subtitle="Check your coverage online or text us your questions for more information"] [accordion title="Treatment"] Aftercare Alcoholics Anonymous (AA) Alcohol detox Alcohol rehab centers Therapy Frequently Asked Questions (FAQ) [/accordion][accordion title="Alcoholism"] Alcoholism Co-Occurring Mental Disorders Comorbid Health Complications Effects of Alcohol How to Help An Alcoholic Interventions Mixing Alcohol and Other Substances Pregnancy Professions and Alcoholism Relapse Prevention [/accordion][accordion title="Helping someone you love"] Helping an Alcoholic Boyfriends Children Family members Fathers Friends Getting sober Girlfriends Grandparents Husbands Mothers Parents Partners Sisters Teens Wives [/accordion] [sources] Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing addiction in America: The surgeon general's report on alcohol, drugs, and health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. CHAPTER 4, EARLY INTERVENTION, TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS. National Institute on Drug Abuse. (2019, November 29). Words matter: Terms to use and avoid when talking about addiction. National Institute on Alcohol Abuse and Alcoholism. (2021). Understanding alcohol use disorder. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Substance Abuse and Mental Health Services Administration. (n.d.). Starting the conversation: Helping a loved one dealing with mental health and/or substance use disorders. National Institute on Aging. (2017). How to help someone you know with a drinking problem. National Institute on Drug Abuse. (2020, July). Treatment and recovery. National Institute on Drug Abuse. (2018, January). Principles of effective treatment: A research-based guide (third edition). American Psychological Association. (2011). Community reinforcement and family training (CRAFT). [/sources] ...

What is a Sober Living Home? Sober living homes offer ongoing social support and housing for people who are transitioning from inpatient treatment or incarceration.1 They can be helpful for those looking to prevent relapse and maintain abstinence away from their normal environments or homes.1 It is important to note that sober living homes do not offer rehab or any type of formal addiction treatment.1 However, they do strongly encourage attendance in 12-step groups such as Alcoholics Anonymous (AA).1 You generally do not need a referral to enter sober housing; however, people are most commonly referred to this type of facility from the criminal justice system, concerned loved ones, or rehab programs.1 Your length of stay in a sober living home depends on many factors. In some, you can stay as long as you would like, as long as you follow the house rules. Others have specific phases you must pass through in order to maintain your residence.1 As a resident in a sober living facility, you’ll likely have to pay rent, which may depend on whether you have a private or shared room, among other things.1 You may also have to pay some type of fee to help keep the home maintained.1 If you are looking to move into a sober house, it is typical to have to go through an application process similar to renting other properties. While some sober living homes are open to all applicants, there are others that may only accept people who are stepping down from a specific drug rehab program.2 Are Sober Living and Halfway Houses the Same? A sober living home is not the same thing as a halfway house. A halfway house, also called a “community corrections center” or a “residential re-entry center,” is strictly for people leaving prison.3 People living in halfway houses are often serving part of a prison sentence or are in a transitional period after their sentence. They are focused on helping residents re-enter common society after spending time in prison. These centers offer treatment, which some residents may have to attend as part of living there. Sober living homes also differ in that they are not subject to the oversight of state licensing agencies, while the Bureau of Prisons controls halfway houses.1,3 Fee structures for the two types vary, where sober homes have a variety of rent and fee structures, and halfway housing fees are based on residents’ gross income.3 Benefits of Sober Living Homes The type of skills and benefits you can gain by staying in a sober living home include: 4 Developing a social network to reinforce recovery. Being part of a peer groups and having a support network that offers encouragement and hope supports your recovery.4 In addition, being in an environment that is free of drugs and alcohol helps control the triggers that can lead to relapse, such as having family members who drink or use drugs in a regular home. Sober living can involve living with a recovered alcoholic and therefore give you access to peers who are further along in their own recovery who can provide extra support and model behaviors if you are newer to recovery.5 Stable housing. If you are leaving residential treatment, it can be difficult to secure a place to live. This can be due to financial hardships or criminal records. Sober living facilities usually allow people with a criminal record to live there, and they may be more affordable than other housing options. Additionally, those who don’t have a stable home environment that supports sustained recovery may have a higher risk of relapse. Employment and education outcomes. It’s possible that staying in a sober living house can contribute to positive outcomes for employment and schooling, too.5 What to Expect in Sober Living Homes If you enter a sober living facility, you will be expected to follow a set of house rules. These house rules can vary but may include: 1,7 Signing in and out of the sober living home. No drugs or alcohol allowed. Regular drug testing. Completing chores and maintaining a clean environment. Avoiding interpersonal conflict. Must stay at the home a certain number of nights each week, typically 5. Attending 12 step groups. Attending mandatory house meetings. Other things to expect include having a roommate or multiple roommates which can be extremely beneficial living with a recovering alcoholic; however, residents can sometimes pay a higher fee for a private room. Further, to keep the home harmonious, there could be disciplinary actions for physical conflict or other threatening behavior.7 Dependent on the home, this could be something like tighter day-to-day restrictions or even eviction. Curfews are also commonplace.1 In some programs, you cannot have a locked door to your room.7 [self-assessment] Recovery Philosophy Within Sober Living Residences Recovery philosophies for sober living homes vary. In general, sober living residents are expected to participate in a self-help group, particularly AA or NA, and maintain abstinence from all substances.1 Furthermore, each resident is encouraged to support others and “give back” as is described in 12 step programs as key to recovery.1 Residents can lean on one another for support.5 How Much Does a Sober Living Home Cost? The cost of a sober living home varies, based on many different factors. Oftentimes, the only costs are a set fee to help maintain the home, plus rent. The cost of each sober living program will depend on what services are offered, staffing, where it’s located, the value of the home itself, and whether rooms are shared.1,2 Finding Sober Living Facilities Near Me One place to start looking to find a sober living home or facility is a Google search for something such as “sober living houses near me” or “sober house in” followed by your city and state. You can also consider asking peers at 12-step meetings or work with your treatment provider to see if he or she can help get you into a sober living facility. Additionally, Alcohol.org is a subsidiary of American Addiction Centers (AAC), a nationwide provider of treatment centers. We offer sober living facilities at three of our facilities: Oxford Treatment Center in Mississippi. Greenhouse Treatment Center in Texas. Desert Hope in Nevada. Our transitional housing is both for those coming out of higher levels of care and those who may feel their home environment may be triggering, regardless of whether they’ve undergone treatment with us. While amenities and services vary by location, some of the things you can expect while living in our sober living homes are: Separate men’s and women’s apartment-style quarters. Daily transportation to treatment to meetings. Extension of the AAC curriculum. House managers on staff. Chef-cooked meals. Daily gym access. Exercise/lifestyle classes available for anyone in recovery, hosted by The Phoenix. Laundry facilities. Cable TV and phone in each room. Free Wi-Fi. Housekeeping services. Non-smoking rooms. [accordion title="American Addiction Centers (AAC)"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Alcohol treatment near me"] Arizona California Colorado Florida Georiga Illinois Indiana Kentucky Maryland Massachusetts Michigan Mississippi Nevada New Jersey New York North Carolina Ohio Oklahoma Oregon Pennyslvania Rhode Island Tennessee Texas Washington Wisconsin [/accordion][accordion title="Insurance"] Aetna Blue Cross Blue Shield Cigna Humana Kaiser Permanente United Healthcare Veterans [/accordion][accordion title="Detoxification"] Alcohol detox Inpatient alcohol detox Outpatient alcohol detox [/accordion][accordion title="Rehab"] Alcohol rehab centers Alcohol rehab centers near me 28 day alcohol rehab 30 day alcohol rehab 60 day alcohol rehab 90 day alcohol rehab Choosing a rehab center Court-ordered rehab Dual diagnosis rehab Executive rehab Extended care rehab Free rehab High profile rehab Holistic rehab programs Paying for rehab Luxury rehab Mens rehab Nature based rehab Private rehab Residential Rehab State funded rehab Teen rehab Veterans rehab Womens rehab [/accordion] [accordion title="Helping someone you love"] Helping an Alcoholic Boyfriends Brothers Children Family members Fathers Friends Getting sober Girlfriends Grandparents Husbands Mothers Parents Partners Sisters Teens Wives [/accordion] [sources] [1]. Polcin, D. L., & Henderson, D. M. (2008, June). A clean and sober place to live: Philosophy, structure, and purported therapeutic factors in sober living houses. Journal of Psychoactive Drugs, 40(2), 153-159. [2]. National Association of Recovery Residences. (2012, September 20). A primer on recovery residences: FAQs from the National Association of Recovery Residences. [3]. Families Against Mandatory Minimums. (2012, April 24). Frequently asked questions about federal halfway houses and home confinement. [4]. Substance Abuse Mental Health and Services Administration. (2012). SAMHSA’s working definition of recovery. [5]. Jason, L. A., & Ferrari, J. R. (2010, May). Oxford house recovery homes: Characteristics and effectiveness. Psychological Services, 7(2), 92. [6]. Polcin, D. L., Korcha, R. A., Bond, J., & Galloway, G. (2010, March 29). Sober living houses for alcohol and drug dependence: 18-month outcomes. Journal of Substance Abuse Treatment, 38(4), 356-365. [7]. The Sober Living Network. (2012, March 30). Standard for quality sober living homes. [/sources] ...

What is Schizophrenia? Schizophrenia is a mental health disorder, specifically a psychotic disorder, that affects thoughts, behaviors, and emotions.1 There is a very strong genetic component to schizophrenia, involving multiple genes, and therefore this disorder can be passed down from parent to children.3,4 Some other factors may also play a role in the development of schizophrenia, including nutritional deficiencies or being exposed to some viruses in utero, as well as increased stress, puberty, and changes in chemicals in the brain.3,5 Males are usually diagnosed in their late teens or early 20s, while women are diagnosed between their early 20s to early 30s, although mild symptoms may arise years before a diagnosis is made.1,3 Schizophrenia is a chronic and worsening psychotic condition that can be debilitating without treatment.1,3 Symptoms of Schizophrenia The symptoms of schizophrenia can be divided into three categories: psychotic symptoms, negative symptoms, and cognitive symptoms.3 Psychotic symptoms alter how you think, behave, and perceive things. Negative symptoms affect your ability to function and interact with others. Cognitive symptoms impact your ability to take in and recall information and focus.3 Symptoms of schizophrenia include:1,2,4,6 Delusions, or irrational beliefs such as paranoia or believing that someone is monitoring their thoughts. Hallucinations (seeing or hearing things that are not there). Disorganized, incoherent, or rambling speech. Catatonia (repetitive or purposeless movements). Loss of interest or enjoyment in activities or hobbies. Communicating less. Behaving in a disorganized, inappropriate, or bizarre manner. Lessened emotional expression or flat tone of voice. Lack of motivation towards goal-directed activity. Strange thought patterns. Difficulty paying attention. Trouble remembering things. Indecision. Withdrawing from friends and family. Abnormal sleep-wake cycles. Feelings of depersonalization (feeling detached from self) and derealization (feeling detached from surroundings or reality). Lack of insight into having an illness.  Schizophrenia and Alcoholism People who misuse alcohol to the extent that they cannot control their alcohol consumption, despite the negative consequences may be diagnosed with an Alcohol Use Disorder (AUD).2  When an alcohol use disorder and a mental health disorder are present, it is commonly referred to as co-occurring disorders or dual diagnosis.7,8 People who are diagnosed with schizophrenia are more likely to develop an alcohol use disorder or other substance use disorders.2,4 Nearly 25% of people with schizophrenia will develop AUD at some point in their life.4 There are some shared genetic risk factors between the two diseases, although not everyone with one condition will develop the other.4 Since the symptoms of schizophrenia can be highly distressing, alcohol may be used as a means of self-medication.4 Alcohol might be used in an effort to reduce symptoms, lessen side effects of medications, or simply as an escape from their reality.4,5 However, since schizophrenia can impair judgment, thinking, and impulse control, it can also make people with the disorder more likely to develop an alcohol use disorder.6 Does Alcohol Make Schizophrenia Worse? While alcohol can’t cause schizophrenia directly, it can influence the progression of the disease and vice versa.6 The symptoms of either disorder can exacerbate the other, and may lead to worse outcomes for both disorders.4  When people with schizophrenia use alcohol to self-medicate, it can actually make symptoms worse.4,5 Alcohol can lead to exacerbation of schizophrenia symptoms, including:2,4,5,6,8 Aggressive or violent behavior. Depression. Difficulty maintaining employment Greater risk of suicide. Impaired ability to think clearly and make decisions. Increased impulsiveness. Increased risk of homelessness, hospitalization, and legal issues. Not attending treatment. Non-compliance with medication. Worsening hallucinations and delusions. Treating Co-Occurring Schizophrenia and Alcohol Use Disorder It is important to seek medical treatment when you have a co-occurring disorder, not just because alcohol withdrawal can be dangerous, but also to monitor your mental health disorder as you begin your journey to recovery.4,9  When looking for a treatment facility, finding one that is capable of providing specialized treatment for co-occurring disorders is essential.4 This will allow staff to treat the alcohol use disorder in a way that also addresses the schizophrenia in every step of the treatment process.4 (pe3, e7) Integrated treatment for co-occurring disorders, such as alcohol use disorder and schizophrenia, can take place in a variety of settings including:7,8,9 Medically assisted detox. A period of supervised alcohol detox is often the first part of treatment or rehabilitation for AUD. It involves a set of interventions, which often includes medication, that is designed to help you stop drinking and safely withdraw from alcohol. In addition to keeping you stable throughout withdrawal; detox programs help prepare you for additional treatment for AUD.10 Inpatient treatment: You may opt to participate in an inpatient treatment program upon completing detox. These programs offer 24/7 care and can last for a few weeks to a few months, as needed. You will learn skills for remaining sober and address any co-occurring issues you may have. Outpatient treatment: You may engage in psychotherapy, medication treatment, and substance abuse treatment on an outpatient basis. You may take part in a program that you attend daily, or once or twice a week. Therapy and medication commonly play a large role in integrated treatment of co-occurring disorders.4,7 There are therapies such as cognitive behavioral therapy, behavioral skills training, motivational enhancement therapy, and contingency management that have been shown to be effective at treating co-occurring substance use disorders and schizophrenia.3,4 Medications are another important aspect of treatment, and there are many anti-psychotic medications that can be used to manage symptoms of schizophrenia, while some medications used to manage alcohol use disorder can reduce symptoms of schizophrenia as well.3,4 Seeking medical help is an important step on the journey to recovery, especially when diagnosed with a co-occurring disorder such as schizophrenia.3 Withdrawal from alcohol can be dangerous, and many schizophrenia medications require monitoring for effectiveness and potential side-effects.3 Since not all facilities are capable of treating people with co-occurring disorders, it is essential to find a facility that is qualified to provide integrated care for people with co-occurring disorders. For more information about integrated treatment and how to find the right facility for you, contact us here. Sources National Institute of Mental Health. (n.d.). Schizophrenia. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. National Institute of Mental Health. (2020, May). Schizophrenia. Archibald, L., Brunette, M.F., Wallin, D.J., & Green, A.I. (2019). Alcohol use disorder and schizophrenia or schizoaffective disorder. Alcohol research: Current reviews, 40(1), e1-e9. Winklbaur, B., Ebner, N., Sachs, G., Thau, K., & Fischer, G. (2006). Substance abuse in patients with schizophrenia. Dialogues in clinical neuroscience, 8(1), 37-43. Drake, R.E., & Mueser, K.T. (2002). Co-occurring alcohol use disorder and schizophrenia. Alcohol research & health, 26(2), 99-102. National Alliance on Mental Illness. (2020, May). Substance use disorders. Substance Abuse and Mental Health Services Administration. (2021). Substance use disorder treatment for people with co-occurring disorders, advisory. National Institute on Drug Abuse. (2018, January). Principles of drug addiction treatment: A research-based guide (3rd edition). Substance Abuse and Mental Health Services Administration. (2019, October). Treatment options: Types of treatment. ...