The NIAAA estimates that in 2012, 17 million adults had what the NIAAA calls an “alcohol use disorder.” (We refer to this colloquially as alcoholism, and that is how I will refer to it for the remainder of this post.) Their estimated split of this number between male and female is 11.2 million and 5.7 million, respectively. Of this massive number, only 1.4 million of them received treatment in 2012; 1 million of those were men.
There are as many ways to decipher and analyze these statistics as there are people involved. About two-thirds of those dealing with alcoholism are men, twice as many as women. About the same ratio holds true for those who seek treatment. One must also consider a couple of variables: 1) There’s no way to know for sure how many people abuse alcohol each year; there are only estimates, and 2) The number of people who abuse alcohol in a year and the number of people who get help in a year aren’t necessarily related, except to show that a very small percentage of people who abuse alcohol are likely to get help.
Why don’t people get help?
I can think of a number of reasons, gleaned from my personal experience with alcoholics, living with an addictive and perfectionistic personality myself, and personal studies in psychology.
Here are only a few, the ones I would consider the most prevalent.
1. They are ashamed. As much as we want to believe otherwise, there is still a strong stigma in society toward alcoholism (and other mental health issues, but that’s another post). To admit you have a problem with something like alcohol, to admit you cannot control something like the consumption of alcohol, means admitting you are human and have weakness. This can be hard enough in itself. But despite the fact that we are ALL human and have weaknesses, there are still people who are judgmental and look at you differently once you admit to being an alcoholic.
Challenge: Consider how you look at people with alcoholism. This can be easier if you know someone who has struggled and is in recovery; but it can be more difficult if you know someone who refuses to get treatment, or whom you’ve seen mean or abusive when in an alcohol-fueled rage. It can also be difficult if you have had no personal experience with a person with alcoholism, because it is so easy to form a personal stereotype against a group of people you personally know nothing about. If you are contributing to the social stigma of shame related to alcoholism, do some research, reach out to others in need, see if there’s something you can do to help rather than blindly judge. It might change your attitude.
2. They don’t realize/think they have a problem. This includes denial. But it can be difficult to discern whether someone is in denial about their problem, or truly doesn’t believe they have a problem. Some might claim these are the same, but I contend that there is actually a fine line, and that it is difficult – often impossible – to determine. Someone who is in denial and/or doesn’t realize they have a problem can be impossible to reach. They will not be convinced by words. My belief is that these are the people most likely to have to hit “rock bottom” before getting help. (I don’t think everyone dealing with alcoholism does.)
3. They don’t want to change. This is NOT the same as denial. This is an admission of a problem and a refusal to change. Why do these people not want to change? I can think of any number of reasons, including fear of the unknown, comfort with the known, and stubbornness. This might be somewhat combined with the denial in #2, in a thought pattern sort of like this: “I know that based on the technical definitions, I probably have a problem. But I don’t need help; I have it under control. And besides, it helps me deal with all the stress in my life.”
A person with alcoholism cannot be forced, coerced, manipulated, or cajoled into treatment. Well, technically they can, but none of those things will result in successful treatment. Treatment will only be effective if the person is ready and willing. If you know someone that you think is dealing with alcoholism, the best thing you can do is encourage them to get help. Be a support to them; offer to attend AA with them; be willing to listen. Get help yourself if you feel the problem is out of control to the point that you cannot safely support your friend. Get help for your friend if you feel they are in danger.
If you are dealing with alcoholism yourself, please seek help. There’s so much I could say about how unhealthy it is, both physically and mentally, but as I’ve stated above, you have to be ready and willing. Nothing I can say will get you to that point; you have to get yourself to that point.
I believe personally that alcoholism results from an underlying issue. Treatment for alcoholism can only be successful if you are willing and able to deal with the issues beneath the surface. Alcohol masks and drowns and hides these issues so that we don’t have to deal with them in the present; but eventually, they will rise to the surface and insist upon being dealt with – if cirrhosis of the liver doesn’t deal with you first.
(**This post could apply to any number of disordered behaviors, particularly those that are related to addiction. I chose to focus on alcoholism because it has been on my mind throughout the writing of Emma’s Story.)