Young Adulthood – From 18 to …

Generally speaking, a person is considered a young adult when they attain the age of 18. They’re not 21, which is legal drinking age, and they’re not still children. They definitely have a mind of their own, no doubt honed during their often-tumultuous teenage years.

The age of young adulthood spans from 18 to 23 or 28, depending on which expert you consult or which intervention and rehab program for young adults you’re looking at.

There are some individuals who may have achieved the chronological age that society deems means they should be capable of making informed choices about their lives, yet they may be hampered by years of abusing substances and engaging in other risky behavior.

So, consider that young adults, in the context of drug and alcohol intervention for young adults, ranges from the age of 18 to 28.

Intervention – Some Basics

What is an intervention? Who needs it? When should you consider it for a young adult in your family, or for your close friend or loved one? Here are some answers.

In essence, an intervention for drug or alcohol abuse is a strategy that’s designed to interrupt or halt the course of what otherwise would be the progressive – and often fatal – illness of chemical dependency, or addiction.

If you’re reading this with any thought of trying to get some immediate help for your loved one, it’s not being disloyal or cruel to strongly consider an intervention. Why? The fact is that young adults who are exhibiting symptoms of drug and alcohol abuse will be the first ones to deny that there’s any problem at all. They will voice vehement objections over getting help for a perceived problem, and may even go so far as to question your love for them.

Most likely, the young adult with the substance abuse problem is incapable of recognizing what is, in fact, a reality: they have a chemical dependence. Since he or she can’t see that there’s a problem, there’s no reason on earth to pursue getting help. And it’s highly unlikely that the individual will just stop using alcohol or drugs (or both) just because you bring it up and express your concern. Maybe the usage will cease temporarily, but it won’t last.

It can’t, because once a person is dependent on chemicals, their body and brain craves it beyond all reason. Your loved one who is age 18 to 28 uses chemicals as a way to cope with life’s problems and associated stress when, in fact, much of this may be caused by the use of substances themselves.

Considering that your loved one has a distorted view of reality, trying to reason with him or her most likely won’t work. But you can’t just stand back and allow such self-destructive behavior to continue, can you? To do so would be unconscionable. The only way to break through the distortion is to have reality presented in such a clear and informed way that it cannot be denied.

This is accomplished through drug and alcohol intervention. And the best intervention is conducted by a trained professional.

Intervention – Who Needs It?

Next, let’s look at who needs an intervention. What should you look for to give yourself peace of mind that an intervention is, indeed, what your young adult loved one really needs?

While there are any number of questionnaires about drug and alcohol use freely available on the Internet, at various treatment sites, on 12-step self-help groups such as Alcoholics Anonymous and Narcotics Anonymous, here is a sampling of questions that you can review. For alcohol and drugs, read through the following and see how much of it applies to the young adult you suspect has a problem with substances:

• Is there any family history of alcohol or drug problems? This includes close relatives such as parents, siblings or grandparents.
• Does the individual use alcohol or drugs on a consistent basis? Is this person often the last one to leave the bar, closing the joint?
• Does the individual have a reputation as being the “life of the party,” a “real party animal,” or someone who really enjoys drinking and drug use and looks forward to occasions to indulge?
• Have you, or someone else close to the young adult, ever complained about or worried aloud over the person’s drinking or drug use?
• Does the prospect of not having access to or being able to use drugs or alcohol cause the individual to be angry or anxious? Think about an occasion where such substances would not be available, such as a church function, or other gathering where no alcohol is served.
• Does this individual gulp down drinks so as to get high quicker?
• Have you noticed a change in the individual’s pattern of behavior with respect to alcohol and/or drugs? Does he or she drink or do drugs alone, switch off substances, use more or use more often now than in the past?
• Does the young adult have episodes where he or she can’t remember what happened while drinking or doing drugs?
• Has the individual been arrested for DUI or DWI?
• Does the person continue to drink, long after others have “called it a night” or stopped drinking in the interest of safety, knowing their limits? Does he or she keep on using drugs or alcohol, even though it’s clear that the limit has been reached?
• Do you hear apologies over what happened while the individual was drunk or high on drugs, or regrets and assurances that he or she will clean up their act?
• Has the individual tried to stop drinking or doing drugs, but the hiatus only lasted a short time before it began all over again?
• Does he or she appear guilty over use of drugs or alcohol, become angry or defensive if you mention your concern?
• Have you noticed the tolerance of the young adult has increased? In other words, does it seem as though the individual is able to drink or use drugs more than he or she did some time ago, say five years?
• How often does this individual suffer blackouts – periods where he or she can’t remember anything at all that happened during the time of drinking or drug use?
• Have there been difficulties at work or at school, such as frequent absences, poor work performance, missing deadlines, complaints from others about behavior, attitude and appearance?
• Does he or she frequently drink or use more than intended?
• Have you noticed the young adult has the shakes, is nauseated, complains of a terrible hangover, or appears depressed, anxious, moody or paranoid when sober?
• What about illnesses that may be related to alcohol or drug use, such as persistent vomiting or diarrhea, broken blood vessels in the nose or cheekbone area, no appetite, glassy eyes, high blood pressure, liver disease, pneumonia, hepatitis, seizures, pancreatitis, gastritis, cirrhosis, delirium tremens (DTs), or heart palpitations?
• Has the young adult suffered serious loss as a result of alcohol or drug use, such as getting fired from a job, losing a driver’s license, alienation or separation from a loved one, loss of financial security?
• Has the individual been hospitalized or gone to the emergency room for injuries, trauma, or accidents sustained as a result of drinking or using drugs?
• Has the young adult expressed the desire to commit suicide? Has he or she ever had hallucinations after drinking or doing drugs, exhibited paranoia, become extremely fearful or anxious over seemingly nothing?
• Is the personal appearance of the individual noticeably changed? Does he or she neglect to bathe, wear wrinkled or dirty clothes, no longer exercise, or refuse to see a doctor even when there’s an obvious medical condition that needs attention?

The answers to these questions may point to early, middle or late-stage addiction of the young adult. In any case, answering yes to five or more of them is a reasonably accurate indication that an intervention may be appropriate for your young adult loved one.

How to Arrange for an Intervention

Once you determine that an intervention is in the best interest of the young adult, the next step is to make arrangements for it.

Many people are uncertain how to go about finding an interventionist. This certainly isn’t anything to be ashamed of. We only tend to find out about such things when we really need them.

One way is to start with the family doctor and ask for a recommendation. Maybe you know the parents of another young adult who went through an intervention prior to going into treatment. If that worked out well, you might explore working with that interventionist or at least giving the individual a call to ask the kinds of questions you naturally have.

Treatment centers are another logical first step, since they may be able to provide counselors to help with an intervention for a young adult. There are also third-party professional interventionists for hire. These are people who have been thoroughly trained in how to do an intervention.

Always be sure to check out the professional interventionist or intervention service. You want an interventionist with exceptional credentials, sterling references and a great deal of experience, specifically with doing interventions for young adults. Check out the Association of Intervention Specialists to find a professional interventionist, all of whom are board registered interventionists and adhere to the AIS Code of Ethics.

Why not just perform the intervention yourself? For one thing, unless you’re a professional drug and alcohol interventionist, you aren’t properly equipped to handle the emotional aspects of the intervention. You may be swayed by tears and angry outbursts, feel a sense of shame or guilt about confronting your young adult son or daughter. Worst of all, you may back down and allow your son or daughter to continue behaving as before.

With a professional interventionist present, however, you can be assured that the meeting will take place according to evidence-based procedures. There will be a pre-meeting for family members and possibly close friends where everyone meets with the interventionist to go over what will take place during the actual intervention.

During the intervention itself, the interventionist’s sole purpose is to get the young adult to acknowledge that his or her abuse is a problem and to accept and be willing to go into treatment. During the meeting, family members and close friends read aloud statements that they have prepared ahead of time, telling the young adult how his or her drug or alcohol abuse has impacted them, and that they are here out of love for the individual and only want him or her to get the treatment they need.

It’s also critically important that the young adult realize that there will be no more enabling of the drug or alcohol abuse by family members. Excuses will no longer be tolerated and there will be no further support unless and until the individual accepts treatment.

Once the individual agrees to go into treatment, the intervention is over. Arrangements for admission to a drug or alcohol rehab facility should already have been made and the interventionist often accompanies the individual directly to the facility. There’s no downtime, no delay to give the person an opportunity to back out. The time to act has come.

Remember that if an individual is 18 or older, treatment cannot be forced upon him or her, unless it is the result of a court order, usually as part of a sentence. Even so, if your young adult agrees to go into treatment during the intervention, you’ll want to have the treatment facility arrangements already made. If you dally, needing to find the facility and make the necessary arrangements, you will lose the momentum of the moment. That’s definitely not the way you want to go if you’re serious about getting help for the young adult.

What Are the Prospects for Recovery?

Since recovery is the ultimate goal, the reason you’re thinking about drug or alcohol intervention for the young adult, it’s important to keep the long view. Look upon the professional intervention as an important and integral first part of the healing process from drug or alcohol addiction.

Of course, one time in rehab for drug or alcohol abuse may not be sufficient to overcome chronic addiction. Your young adult son or daughter may relapse, requiring further counseling or treatment one or more times in a rehab facility or private counseling. This does not mean the original rehab was a failure. It only means that there may be more time required for your son or daughter (or other close family relative or friend) to understand the disease of addiction, learn more about how to recognize triggers and learn and practice coping strategies for dealing effectively with cravings and urges.

Participation in 12-Step groups such as Alcoholics Anonymous, Narcotics Anonymous or other self-help groups is also strongly encouraged following completion of drug and alcohol rehab.

With continued support and encouragement from family and peer support groups, your young adult will have a much better chance of maintaining sobriety and living a more fulfilling life. Don’t shortchange your son or daughter who may be in trouble with drugs and/or alcohol, thinking that they’ll be able to overcome this formidable hurdle alone. The time to act is now if you believe there is, indeed, a problem. It is undoubtedly the most loving thing you can do to get your young adult son or daughter off drugs and alcohol and on the way to a happy and drug-free life.

Considering everything, ask yourself again: Is now the right time to get your loved one, family member or close friend aged 18 to 28 drug and alcohol intervention for young adults? If so, the sooner you get involved, the sooner the young adult will be able to begin the healing process.

Recognize the Opportunity

Sure, it’s natural to lament what you did or didn’t do as parents to warn your children about the dangers of drugs and alcohol. What you should have done is have early and frequent discussions about how damaging substance abuse can be, even prescription drugs used for non-medical purposes. What you should have done is establish family rules about no drug or alcohol use and clearly communicate them to your children. What you should have done is to keep the lines of communication open, listen to your children, and support them when the going gets rough or they’re subjected to intense peer pressure to experiment with drugs and alcohol.

But, even if you did do those things, that doesn’t mean that your teen might not fall prey to drug and alcohol abuse and addiction. Early experimentation often leads to more frequent use which then can become abuse and finally dependence or addiction.

No use to cry over what might have been. Now is the time to recognize that you have an opportunity, once you first spot the telltale signs of drug or alcohol use. You can take steps to address this problem right here and now and get the appropriate help for your teen.

What is that help? It is in the form of a teen intervention.

Telltale Signs of Drug or Alcohol Abuse

Before we discuss the specifics of a teen intervention, it’s a good idea to recap some of the common signs, those telltale and unmistakable signs, that your teen is fooling around with drugs or alcohol. Maybe your teenager doesn’t exhibit all the signs, but does show a good number of them on a regular basis. That’s enough for concern and alerts you that there is, indeed, a problem with abuse going on here.

There are general signs of drug and alcohol use and more specific symptoms of abuse relative to certain types of drugs or alcohol in general.

General signs include the following:

• Grades drop dramatically. You’ve been accustomed to seeing a certain level of performance with your child, but suddenly your teen starts accumulating lower grades, even failing grades, in school.
• Skipping school becomes a frequent occurrence. It may begin with tardiness, an inability to get up in time to go to school and then progress to outright skipping classes completely.
• Mood changes become a regular thing. When your teen begins to display crying jags, or becomes depressed and moody to the point of days on end, this is a sign that there’s more going on than just typical teen emotions. Something’s out of whack.
• Your teen starts foregoing usual activities. Let’s say your teen loves being involved in after-school activities, playing in the band, taking part in sports, music or other activities. Then, one day, you notice that he or she isn’t doing any of these things anymore. Whatever your teen once enjoyed doing no longer is part of everyday activity. That’s not a good sign.
• You notice your teen’s appearance has changed. Teens aren’t always the most immaculately groomed, but if you start to see that your child’s hygiene starts to suffer, or that there’s a dramatic weight loss or gain, or your teen adopts unusual fashion changes, this is a signal to pay attention to what else may be going on with your child.
• Friends suddenly change. Your teen has had a number of regular friends, pals he or she has hung around with for quite some time. Then, as if out of the blue, they don’t come around anymore. Maybe they’ve been replaced by new friends, some whom you’ve never met or even that your teen won’t introduce you to. What’s happened? There may be something to do with the new friends’ behavior involving drugs and alcohol that you need to be concerned about.
• Money goes missing from the home. If your teenager is getting deep into drugs and alcohol, it takes money to finance this behavior. When money or valuables go missing from the home, this is a telltale sign that the money is being used for something that your teen doesn’t want you to know about. It could very well be drugs or alcohol.
• Your teen exhibits secretive behavior. Every teen guards his or her privacy, but if your teen locks himself or herself in their room and doesn’t come out for hours, gets irate if you enter without knocking, or takes an inordinately long time to come to the door if you knock or call, it just might be a sign that there are things your child is keeping from you.
• Your teen starts being hostile or aggressive. Sudden angry outbursts or outright aggressive behavior toward you or other family members is a definite warning sign that drugs or alcohol use may be going on.
• Motivation is lacking. When a teen is involved in drug or alcohol use, he or she will often become listless, not caring to do much of anything, certainly nothing that requires pursuing goals or exerting effort to achieve. That is, unless the goal is scoring drugs or alcohol. If your teen is abusing substances, this is one of the only things that may get him or her motivated.
• Your child can’t seem to remember things. Forgetfulness is another general telltale sign of drug or alcohol use. Once in a while is normal for every teen. After all, they’re going through a lot of changes. But if your teen can’t remember on a regular basis or seems to “forget” important things like assigned household tasks or family rules, there’s something wrong.
• Your teen’s sleeping habits change. Maybe it’s a gradual change that you begin to notice or it could occur suddenly and without warning, but if your child’s sleeping habits dramatically change, this is a sign that should be concerning to you. Either sleeping much too long or not sleeping well or at all is a sign of trouble.
• Your teen seems depressed. Depression, a state that persists for weeks without letup, is not a good sign. It could be a telltale sign that drugs or alcohol are in the picture.
• Your teen seems overly anxious. Certain drugs make the user extremely anxious, even paranoid, especially when the high wears off. Any frequent or prolonged anxiety is a trouble sign that could have something to do with drugs or alcohol or both.
• Something just doesn’t seem right about your teen. Maybe you can’t pinpoint exactly what it is, but you do know your child and you feel instinctively when something doesn’t seem right. If it doesn’t seem right, it probably means it isn’t right. Drug or alcohol use could be at the bottom of it.

Teen Intervention

What is teen intervention? Simply put, it is the coming together of family and friends, often with the guidance of a trained interventionist, to get the teen to the point of admitting he or she has a problem with drugs or alcohol and accepting treatment.

Some parents prefer to begin with a candid conversation with their teen about drug and alcohol use, particularly if the parents have witnessed several warning signs that their teen has been using substances.

But some teens have already progressed to an out-of-control behavior state where well-meaning parental discussions no longer have any impact. Often the only way to get through to your teen is through a professional intervention.

Early Teen Intervention Can Help Prevent Years of Addiction

Does a teen intervention seem like overkill? Do you think that an intervention is only right for skid row bums or stone alcoholics or drug addicts who’ve been arrested for DUIs, incarcerated for petty crimes, got fired from numerous jobs, lost their homes or families as a result of their substance abuse? If you think that, you’d be wrong.

The statistics about early drug and alcohol use among adolescents and teens are startling. Research studies have shown that the earlier a child begins experimenting with alcohol and drugs, particularly if it occurs before the age of 15, the more likely they are to go on to full-blown drug or alcohol use later in adulthood. They are at greater risk for addiction.

So, the earlier that your teen who has been abusing drugs or alcohol has an intervention that is handled in a professional manner, the sooner he or she – assuming that treatment is accepted – can get the help needed to be able to overcome the substance abuse.

According to some experts, there are four phases of drug or alcohol addiction that apply equally well to teens. Stages one and two are where teens experiment with and use drugs or alcohol in a social setting. During stage three, teens arrange their life around their drug and alcohol use and everything else goes by the wayside. In stage four, all the teen thinks about is getting high, and scoring drugs for the next high. Not surprisingly, intervention and treatment work best if they occur during the first two stages.

Don’t be fooled by your teen’s insistence that there’s nothing wrong, that he or she just tried drugs or alcohol once, or that they’ll never do it again. If they’ve exhibited several of the telltale warning signs of drug or alcohol abuse, they’re already deeply involved. You can’t take their word for it, because it’s not their brain that’s talking. It’s the drugs. Teens, just like adult substance abusers, will deny they have a problem. Some studies have found that most teens won’t seek help for a drug or alcohol problem until they’re in their 30s. By that time, however, their chemical dependence, which began while they were in high school, is problematic. In other words, it’s tougher to overcome substance abuse that’s become entrenched.

Even if your teen doesn’t want to go into treatment, as parents you can insist that this happens. Just because your teen may be against treatment doesn’t mean that he or she can’t benefit from treatment. A study at the University of California Los Angeles showing treatment outcomes among methamphetamine addicts who had been legally pressured into treatment was not dramatically different from those who entered treatment without any pressure.

What we, as parents, can take away from this is that the important thing is to get teens with substance abuse problems into treatment. How they feel before they go into treatment is not the determining factor over whether or not they’re helped by treatment.

How to Find a Teen Interventionist

If you’re at your wits end and nothing you’ve tried thus far has worked out with getting your teen to stop using drugs or alcohol and put some healthy behaviors back into his or her life, now may be the time to go for a teen interventionist. The question then becomes, how do you find one?

You could start with the family doctor and ask for a recommendation. Maybe you know the parents of another teen who went through an intervention prior to going into treatment. If that worked out well, you might explore working with that interventionist or at least giving the individual a call to ask the kinds of questions you naturally have.

Treatment centers are another logical first step, since they may be able to provide counselors to help with an intervention. There are also third-party professional interventionists for hire. These are people who have been thoroughly trained in how to do an intervention.

Always be sure to check out the professional interventionist or intervention service. You want an interventionist with exceptional credentials, sterling references and a great deal of experience, specifically with doing teen interventions. Check out the Association of Intervention Specialists to find a professional interventionist, all of whom are board registered interventionists and adhere to the AIS Code of Ethics.

What to Expect in the Teen Intervention

There’s more to the teen intervention that simply the family and the interventionist sitting down with the teen. There’s pre-intervention planning and work, the actual intervention, getting your teen to the right treatment facility that specializes in treating teens with substance abuse problems, monitoring the treatment and developing an after-care program. Some recovery experts recommend that parents choose an interventionist with case management experience.

During the actual intervention, there will be a lot of open discussion, tears and brutal honesty, as well as tough love on the part of family and close friends. Your teen may at first be outright hostile, resentful, or even try to run away, either literally or by distancing himself or herself emotionally. This is quite normal behavior during a teen intervention. In any case, whether the person for whom the intervention is being conducted is a teen or an adult, this is a highly-charged emotional time.

It is also a crucial time for your teen. It may be the best chance your teen has to get the help that he or she so desperately needs but doesn’t know or believe it yet.

The ultimate goal of the teen intervention is that your teen accepts and goes into treatment. The best scenario is that the interventionist or other “escort” literally accompanies your teen to the treatment facility, ideally a residential drug and alcohol rehab facility that specializes in treating teens with substance abuse problems. Many times transportation this is by car, although in the cases where the treatment facility is in a distant city or another state, a plane or train trip may be required. The reason why it’s best for your teen to immediately go into treatment is that this is striking while the iron is hot, so to speak. Once your teen says, “Yes,” the object is to get your teen into treatment.

Delay can cause all sorts of other perceived obligations or obstacles to get in the way. You don’t want that. Although it may be stressful to see your teen go through this experience of an intervention and your heart naturally goes out to your child, the absolute best thing that you can do for your teen is to remain steadfast in both your support and demand that your teen go into treatment.

Think of teen intervention for drug or alcohol abuse as the first step on your teen’s road to recovery. Healing does take time and your teen will need your unwavering support and encouragement as he or she begins a new life of sobriety.

Be ready to intervene with the help of a professional interventionist who can conduct a safe and effective teen intervention to start the process of recovery for your child. It is undoubtedly the most loving thing you can do to get your teen off drugs and alcohol and on the way to a happy and drug-free life.

What are some of the signs that we should be on the lookout for? How do we know when and if an intervention for our elderly loved ones is appropriate or necessary? Let’s look at this issue in a little more detail.

Clever Deception

We already know that our parents have a keen sense of privacy. They’re also pretty adept at keeping things secret that they don’t want others to know about, including us. It should come as no surprise, then, that our parents may cloak their growing abuse of alcohol and drugs, including prescription drugs and maintain an outward demeanor that everything is just fine.

Should there be slight glimmers of misuse of various substances, often our parents will cleverly cover it up by saying they’ve just got a bug or engaged in a little too much celebration. No big thing, they may say. There’s nothing for you to worry about.

That’s just about the time when your radar should sense that there might be more to the situation than your parents are letting on.

It isn’t that your parents want to lie to you, at least, not in most cases. But if they’ve become dependent upon drugs or alcohol, or any combination thereof, they may not be able to help themselves. Telling a falsehood becomes necessary in order for them to be able to continue their surreptitious consumption of drugs and/or alcohol undetected.

So, while we can forgive them their outright lies, this doesn’t mean that we should allow the situation to continue.

But how do we know if there really is a problem? Maybe it is true that they’re only drinking now and then, or took prescription medication in conjunction with alcohol only once. On the other hand, the problem may already be quite severe. In fact, only about 37 percent of substance abuse cases are recognized in people over the age of 60, compared with 60 percent among those under the age of 60.

The only way we can be less than clueless is to know and watch out for warning signs of drug or alcohol abuse.

Warning Signs of Prescription Drug Abuse in the Elderly

It’s easy to dismiss certain signs of prescription drug abuse in the elderly as just normal aging. Forgetfulness and irritability are two common behaviors that often go hand-in-hand with advancing years.

Here are some of the typical behaviors that are associated with drug abuse, including abuse of prescription medications. If any of them are present, it may be time to think about an intervention for your elderly loved ones.

• Changes in sleeping patterns – including sleeping too much or inability to sleep
• Changes in eating habits
• Poor personal hygiene
• Inability to concentrate
• Unexplained chronic pain
• Unsteady gait, tendency to fall frequently
• Lapses in memory
• Sadness, depression or irritability
• General loss of interest in life and activities that used to bring enjoyment
• Increased isolation from family and friends
• Has bottles of tranquilizers on hand and often takes the medication at the least sign of any disturbance

Before launching into a confrontation with your loved one, however, it’s a good idea to know a little more about what your elderly loved one may be dealing with. First of all, take an inventory of the prescription medication your loved one is taking.

Does your loved one take a drug that has addictive potential, such as benzodiazepine or opioid painkillers? These are drugs such as Valium, Xanax, Librium, OxyContin, Dilaudid, Demerol, Vicodin, Lorcet and others. If so, any deviation from taking it exactly as the doctor ordered, including how much to take, how often to take it and for how long, could be problematic.

What sometimes happens is that an elderly person doesn’t think he or she is getting the expected benefit from the medication and doubles up on the amount taken, or takes it more often than recommended. It’s also easy for older adults to forget that they’ve already taken the medication, if they don’t use a pill minder or organizer. And combinations of medications, perhaps prescribed by different doctors who aren’t kept informed of other medications your elderly loved one takes, can also be harmful. Interactions, side-effects and complications can ensue.

It might be time to accompany your elderly parent or loved one to the doctor and ask about the possibility of prescribing a safer alternative drug. This is especially important if your loved one has a past history of addiction.

Remember that it isn’t ever advisable for a patient to just stop taking a medication that the doctor prescribed for them. So, while you may be concerned about your older loved one’s misuse of a variety of prescription drugs, he or she may have become addicted to one or more of them. Quitting cold turkey is not only difficult, but can be extremely dangerous or even fatal. Withdrawal symptoms, such as seizures, for example, in the case of addiction to benzodiazepines, mean that safely detoxing from the drug needs to be carried out under the supervision of the doctor or a medical professional, often in an inpatient rehabilitation facility.

Warning Signs of Alcohol Abuse in the Elderly

Abuse of alcohol is dangerous for everyone, regardless of age. But it can be especially dangerous for older adults. Medical experts say that older adults usually need less alcohol to become intoxicated than individuals who are younger. An older person stays drunk longer due to the fact that the human body processes the alcohol more slowly with increasing age.

Older adults may have vision or hearing problems, or both. They may also have reaction times that are considerably slower than they once were. This means that use and misuse of alcohol can exacerbate these problems, causing more incidents of falls, alcohol-related vehicle crashes, as well as other types of accidents.

When an older adult mixes alcohol and prescription medications or over-the-counter (OTC) drugs, the results can be dangerous or even fatal. And the fact is that as adults get older, they are more likely to be prescribed multiple medications for a variety of medical conditions, everything from high cholesterol and high blood pressure levels, to diabetes, blood, lung or other illnesses.

Watch out for the following signs that may indicate alcohol abuse in your elderly loved one. Note that some of these warning signs are similar to or the same as those for prescription drug abuse.

• Increased incidents of falls
• Inability to make it to the bathroom in time, a condition known as incontinence
• Increased headaches and/or dizziness
• Poor personal hygiene
• Changes in eating habits, for example, not eating enough or eating poorly
• Increased problems with money or finances
• Losing touch with or ignoring family and/or friends
• Thoughts of suicide
• Mood swings, frequently feeling sad or depressed
• Seems more hostile than usual or more resentful
• Loss of interest in activities that previously were enjoyable
• Difficulty in focusing and making decisions
• Worsening memory
• Feeling anxious most of the time
• Drinks alcohol despite warning labels on prescription drugs
• Often appears intoxicated, slightly tipsy, exhibits slurred speech
• Suffers from shakes and tremors
• Drinks in solitary, hidden from others
• Is drinking more than before
• Has drinking rituals, like drinking before, during or following meals, and is upset when this ritual is disturbed
• Suffers from alcohol-related health problems
• Often hides empty beer and liquor bottles or surreptitiously attempts to dispose of them
• Makes excuses to keep beer and liquor in the house
• Has the smell of liquor on his or her breath, attempts to disguise it with mouthwash or by chewing gum
• Falls asleep during conversations
• Calls you at odd hours or in the middle of the night

If any of the abovementioned warning signs are present, it doesn’t automatically mean that your elderly loved one is abusing alcohol. Some of these are warning signs that accompany other health problems that adults may have as they age. Some behavior changes are the result of stress, which may have prompted a sudden increase in alcohol consumption as a means of coping.

In addition, retirement, if recent, the loss of a spouse or other loved one, loss of the family home, and being recently diagnosed with a disease can all trigger substance abuse, whether that substance is alcohol or drugs or both.

Getting Help: Arranging for an Intervention

After careful analysis of the situation with your elderly loved ones, if you determine that there’s good reason to be concerned about drug or alcohol abuse, the first thing to do is to have a frank and loving conversation with your loved one about what you have observed.

This may not go as you had planned, however, due to the fact that your elderly parents may deny that a problem exists, promise to quit drinking and/or taking too many drugs, or ask you to mind your own business. You should not give up in the face of resistance, though, since the life of your loved one could depend on his or her getting professional help.

Maybe you will be able to convince your parent to see his or her doctor and you could accompany your loved one for the visit. This isn’t always practical and your parent may refuse to either go to the doctor or to allow you to come along. Again, it may be considered an invasion of privacy, a desire to remain independent, or a denial of any problem, or all of these.

What should you do if problems continue to exist and your elderly loved one refuses to get help to correct them? Consider an intervention by a professional.

Why not do the intervention yourself? For one thing, unless you’re a professional drug and alcohol interventionist, you aren’t properly equipped to handle the emotional aspects of the intervention. You may be swayed by tears and angry outbursts, feel a sense of shame or guilt about confronting your elderly loved one. Worst of all, you may back down and allow your loved one to continue behaving as before.

With a professional interventionist present, however, you can be assured that the meeting will take place according to evidence-based procedures. There will be a pre-meeting for family members and possibly close friends where everyone meets with the interventionist to go over what will take place during the actual intervention.

During the intervention itself, the interventionist’s sole purpose is to get your elderly loved one to acknowledge that his or her abuse is a problem and to accept and be willing to go into treatment. During the meeting, family members and close friends read aloud statements that they have prepared ahead of time, telling the loved one how his or her drug or alcohol abuse has impacted them, that they are here out of love for the individual and only want him or her to get the treatment they need.

It’s also critically important that your elderly loved one realize that there will be no more enabling of the drug or alcohol abuse by family members. Excuses will no longer be tolerated and there will be no further support unless and until the individual accepts treatment.

Once the individual agrees to go into treatment, the intervention is over. Arrangements for admission to a drug or alcohol rehab facility should already have been made and the interventionist often accompanies the individual directly to the facility. There’s no downtime, no delay to give the individual an opportunity to back out. This is striking while the iron is hot, so to speak.

When looking for a professional interventionist, search for one that is board registered and certified by the Association of Intervention Specialist Certification Board (AISCB).

Prognosis for Recovery

Look upon the professional intervention as an important part of the healing process from drug or alcohol addiction. It is true that older adults, over the age of 55, often take longer to recover, and they also often need greater support during treatment, but it is also true that their overall long-term recovery success rate is higher than any other age group.

Remember, age sometimes does have its benefits. While your elderly loved one may have been quick to dismiss that there was a problem with his or her alcohol abuse, once they enter treatment and commit to sobriety, they often embrace their new sober lifestyle with gusto.

Of course, one time in rehab for drug or alcohol abuse may not be sufficient to overcome chronic addiction. Your elderly loved one may relapse, requiring further counseling or treatment one or more times in a rehab facility or private counseling. This does not mean the original rehab was a failure. It only means that there may be more time required for your elderly loved one to understand the disease of addiction, learn more about how to recognize triggers and learn and practice coping strategies for dealing effectively with cravings and urges.

Participation in 12-Step groups such as Alcoholics Anonymous, Narcotics Anonymous or other self-help groups is also strongly encouraged following completion of drug and alcohol rehab.

With continued support and encouragement from family and peer support groups, your elderly loved one will have a much better chance of maintaining sobriety and living a more fulfilling life. Don’t shortchange your parents who may be in trouble with drugs and/or alcohol. The time to act is now if you believ

But when we’re talking about addiction of one of our family members or loved ones, or even one of our close friends, we may be losing more than just an opportunity. Our failure to act may be one of the worst decisions we’ve ever made.

Let’s look at some scenarios and see how our failure to act could be so detrimental to another’s life – and our own.

Escalation of Serious Negative Consequences

Addiction isn’t a straight-line path for everyone. Some individuals can “carry on” for years as high-functioning alcoholics or confine their drug use to surreptitious forays and cloak their growing dependence using a variety of subterfuges, distorted half-truths, and outright lies.

There does come a time, however, when it all starts crashing down. The lies have escalated to the point where the individual can’t even keep track of them anymore. Friends, family members, loved ones and employers catch the person in first one, and then another and another falsehood.

Pretty soon, it’s more than just deception and lies that are happening all too frequently. The individual, who has by now become dependent on alcohol or drugs, begins to have difficulty sticking to schedules, frequently loses track of time, and gets into a series of consequences that escalate in their seriousness.

Naturally, the person who is addicted doesn’t see anything wrong. It takes almost total loss of everything the individual holds dear for the realization that he or she is addicted to really sink in. And by then, there may very well be the loss of a job, home, financial ruin, health consequences, and estrangement from family and loved ones.

When an addict goes untreated, it only gets worse. At the end of the line, when all is lost, sometimes the individual decides that taking his or her own life is the only solution.

This is a deadly consequence of putting off an intervention that you know is necessary. No, you can’t force the addict to get treatment, but you can certainly offer your support and encouragement, along with the help of other friends and family members and possibly a trained interventionist.

It’s certainly something worth considering. But let’s take a look at another scenario where putting off an intervention could prove to be a deadly decision.

Abuse Results from Continuing Addiction

It’s not easy being a parent even in the best of times. It’s also tough to be a loving spouse or partner in times of crisis. But add in addiction and the prospects for a healthy family atmosphere just gets murkier.

When one family member is an addict, either to alcohol or drugs, or gambling or compulsive sexual behavior, workaholism or compulsive spending – or a combination of these – going over the line and becoming abusive to family members and loved ones is all too common. The more the addict feels cornered or threatened or is running out of options and excuses, the greater the risk that he or she will start taking out frustrations and anger on those nearby.

It’s just too easy to lash out, first verbally and then physically. Cruelty to spouse and/or children in the household is certainly not inevitable, but it happens so frequently as to be statistically significant.

And abuse leads to psychological and physical damage in those who are abused. In many cases, an abused child grows up to be an abuser to his or her children and spouse as well. In this regard, the consequences of foregoing an intervention could be extremely damaging to the persons closest to the addict.

Even if your loved one, family member or close friend hasn’t yet resorted to physical violence and abuse, it may only be a matter of time. Addiction changes how the individual is able to process what’s going on, interferes with rational thinking, increases aggression, and results in poor decision-making.

Why allow such a heartbreaking outcome to occur – when you could take the time and make the effort to stage a potentially lifesaving intervention?

Financial Difficulties Intensify, Putting Children at Risk

Let’s face it: Addiction costs money. As a person sinks deeper into addiction, what may have started off as casual drinking or doing drugs has propelled the individual into a vicious cycle of drug-seeking, using, coming off the high, and starting the process all over again. By the time the person is completely hooked, seeking, using and seeking takes over his or her life.

It also costs a great deal of money. Besides the cost of the drugs (or alcohol, or gambling, or any other type of addiction), there are the ancillary costs to be taken into account. Days lost from work, a cut in pay due to poor work performance, loss of a job, court costs, fines, money to pay for lawyers, medical bills – all these add up to wreak a tremendous toll on the family’s financial situation.

Something’s got to give. It may be that the mortgage or rent falls into arrears. The utilities go unpaid. Necessary medical and dental expenditures are put off, including those for minor children living in the household. Food becomes scarce. Clothing is worn, left dirty. Personal hygiene is untended to.

Still, without an intervention and treatment, the addict won’t curtail his or her self-destructive pattern of behavior.

But it’s not just the addict that suffers. Worst of all, the children in the family are being neglected by one or both parents as a result of addiction. Suffering more than just physically, the children are being put at a great risk for psychological and emotional damage.

Hoping against hope that this isn’t the case, or couldn’t possibly be the case, with your friend or loved one just won’t cut it. If you even suspect – and you know by now whether you do suspect addiction or not – you owe it to the addict, yourself, and any person who’s in daily close contact with that individual to encourage an intervention and ultimately get treatment for the addict.

Fatalities or Injuries as a Result of Driving Drunk

No one likes to think about the consequences of a loved one or family member driving drunk, getting into an accident, and causing injuries or death to others. But the fact of the matter is that the more often someone who’s inebriated or drugged gets behind the wheel, the more likely it is that sooner or later that individual will cause an accident – with potentially fatal results.

Consider the facts. According to the 2010 National Survey on Drug Use and Health (NSDUH) from the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2010, an estimated 22.1 million persons aged 12 or older were classified with substance dependence or abuse in the past year. Of these, 2.9 million were dependent on or abused both alcohol and illicit drugs, 4.2 million had dependence on or abuse of illicit drugs but not alcohol, and 15.0 million had dependence on or abuse of alcohol but not illicit drugs.

The survey also inquired about driving under the influence of alcohol or drugs within the past year. The answers reported were also alarming here, with 10.6 million persons aged 12 or older saying that they had driven under the influence of illicit drugs during the past 12 months, and 11.4 percent reporting that they had driven under the influence of alcohol at least one time during the past year.

It doesn’t take a mathematician to figure out that the potential for tragedy is everywhere on the roads and highways of this country each year. With the largest concentration of illicit drug and alcohol use among those aged 18 to 25, it also stands to reason that this age group is even more likely to become involved in a motor vehicle accident while under the influence.

Remember, it only takes one time driving drunk or under the influence of drugs to result in a tragedy that the individual will never be able to erase. Ironically, the person who causes such accidents usually, but not always, survives. Nevertheless, the ramifications for looking away when someone you know or love decides to get behind the wheel after drinking or drug use could be something that haunts you forever.

If you feel anything for this person, do everyone a favor and make the decision to do an intervention. To not get involved, to just go your own way, could be the most deadly decision you’d ever make.

Deterioration of Health with Life-Threatening Results

Watching someone you care about deteriorate before your eyes isn’t a pleasant experience. While you certainly aren’t God and can’t prevent some medical conditions or unforeseen accidents from happening, when the deterioration is due to addiction of one sort or another, what you need to know and remember is that unless the addiction is treated, the individual’s health is only going to worsen over time.

Addiction is a progressive and often fatal disease. It isn’t something that just goes away.

Depending on the addiction, here are some of the potential life-threatening medical conditions that occur over time.

Alcoholism – Excessive drinking can cause potentially serious problems, including:

·        Accidental serious injury or death

·        Certain cancers, including breast cancer, cancers of the mouth, pharynx, larynx, esophagus and liver

·        Cirrhosis of the liver

·        Fetal alcohol syndrome and other health problems in an unborn child

·        Heart muscle damage (alcoholic cardiomyopathy) leading to heart failure

·        High blood pressure

·        Pancreatitis

·        Stroke

·        Sudden death (if the person already has cardiovascular disease)

·        Suicide

Heroin abuse – Long-term use leads to addiction and may also result in the following:

·        Abscesses

·        Arthritis and other rheumatologic problems

·        Bacterial infections

·        Clogging of the blood vessels leading to the kidney, liver, lungs or brain

·        Collapsed veins

·        Infection of heart lining and valves

·        Infectious diseases, such as HIV/AIDS and hepatitis B and C

·        Liver and kidney diseases

·        Lung complications (including pneumonia and tuberculosis)

Meth abuse – Long-term use (sometimes even short-term use) leads to addiction and may also result in the following:

·        High blood pressure

·        Palpitations

·        Rapid breathing

·        Over time, constant fluctuations can cause consistent blood pressure problems, cardiac damage and artery blockage.

·        Rapid increase in heart rate and body temperature leads to risk of sudden stroke or heart attack

·        Spontaneous brain hemorrhages

·        Aneurysm ruptures

·        Enlargement of the heart

·        Compromised immunity

·        Liver damage

·        Lung disease

·        Dental disorders, “meth mouth” conditions of rotting teeth and gum disease

·        Psychosis, including hallucinations, paranoia and mood disturbances

About Staging an Intervention

With the previous list of possible long-term medical consequences as a start (it is by no means complete), it is clear that once a loved one, family member or friend is addicted, he or she needs help of a professional nature. But what, exactly should you do? We’ll take a look.

As already stated, a person who has become addicted is very adept at denying that there’s any kind of a problem. Since they don’t believe that they have a problem, or they have convinced themselves and others that they don’t, they’re not likely to ask for help on their own. That’s where friends, family members, and even co-workers come in. At this point in time, it’s up to you as a group to persuade the individual to get help.

Getting started in staging an intervention is not all that difficult. It just takes some planning and a commitment to see it through. All that an intervention is this: a carefully planned process during which family and friends, teachers, clergy members, or others, including a trained professional interventionist, come together to confront an individual about his or her addiction and ask him or her to accept a treatment plan. If the intervention is directed by a professional interventionist, the arrangements for the addicted individual to go off to treatment have already been arranged. As soon as the person agrees to go into treatment, he or she is escorted to the treatment facility by the interventionist.

Of course, not every intervention involves the use of a professional interventionist. Family members and friends may be able to pull off a successful intervention, but there must be a great deal of research and planning that goes into it before the intervention is undertaken. Remember that a poorly planned and executed intervention will likely not result in your loved one, friend or co-worker agreeing to go into treatment. If you don’t have everything in order, and stand united in your determination that the addict gets treatment, it could result in an even worse situation.

Does this mean that an intervention is too much trouble for you to get involved in? Do you think that it’s better to let the situation remain as it is? That would be a lost opportunity, indeed. Do not put off an intervention because you fear your loved one, family member, friend or co-worker will turn away from you, hate you, or reject you. When confronted about addiction, the addict is very likely to exhibit a range of powerful emotions, from hysteria to anger to denial to threats, tears and walking out the door.

That doesn’t mean that staging an intervention is not worth the trouble. Do your research. Find out where you can get help to arrange an intervention. Be thorough. Be persistent. Find the support you need to get the ball rolling.

One more thing about hiring a professional interventionist: Your goal should be to hire one with a proven record of getting highly resistant individuals into treatment. After all, the addict desperately needs help in order to overcome his or her addiction. Wishing won’t make it so, nor will threats, anger, tears or long silences. Take advantage of this opportunity to get your friend, co-worker, loved one or family member the help he or she needs to get his or her life back in order and on the road to recovery.

But how does an employee stage an addiction intervention for the bigwig in the corner office? Can you say something without putting your job on the line? According to the experts at Promises Treatment Centers in Los Angeles, there are few options for walking this fine line.

Interventions for Bosses

The Direct Appeal

Because of the power dynamics, a casual conversation about a boss’ drug or alcohol problem isn’t typically advisable. But if you care about your boss’ well-being or are concerned about your job or the future of the company, ignoring the problem won’t improve the situation, either.

“If the employee has a solid, long-standing relationship with their boss, a sincere expression of concern and a polite and compassionate appeal for them to get help may make a difference,” says Dr. Greg Skipper, the Director of Professional Health Services at Promises drug treatment center in Los Angeles, who was helped into recovery, in part, by a concerned employee many years ago.

Of course, a direct appeal comes with a certain level of risk, which many employees are reluctant to accept, particularly in a tough economy.

Human Resources

Most companies have policies in place for handling drug or alcohol problems in the workplace, and some have employee assistance programs, built-in support systems designed to help employees address problems that impact their personal and professional lives. Start by speaking with a human resources representative about the procedures in place. Be sure to find out whether complaints are kept confidential.

Professional Assistance Programs

Certain fields have professional assistance programs that accept referrals when a doctor, lawyer or other licensed professional shows signs of drug or alcohol addiction. Many of these programs are able to maintain the anonymity of the individual submitting a report and are highly successful in getting an addicted professional into treatment.

Professional Interventionist

In the absence of an employee or professional assistance program, the employee may enlist the services of a professional interventionist who specializes in interventions for executives. A neutral third party may be able to help you formulate a plan for speaking with your boss or get the appropriate parties involved.

The Boss’ Supervisor

Another possibility is making an honest expression of concern to the boss’ supervisor or another executive. Interventions are often most effective when the person confronting the addicted executive is in a position to use the threat of job loss as leverage to help get them into drug rehab.

“It requires very high management to have that first conversation,” Dr. David Sack, CEO of Promises, told BNET.
As you prepare to discuss your concerns, whether with HR, an assistance program or a supervisor, start a log that documents problematic behaviors, including:

• Frequent absences from work or tardiness
• Complaints from clients or co-workers about missed appointments, lack of preparation, or unreturned emails or phone calls
• Illogical behaviors that may range from overly enthusiastic to hostile
• Requests for cover-ups
• Deteriorating health or hygiene

The log should include the date, place, description of the behavior and names of other people present.
Roughly 75 percent of adults who use illicit drugs are employed. Even though they manage to maintain their employment, bosses who are dependent on drugs or alcohol still need help to recover from addiction. If it isn’t your voice they hear, make sure they hear someone’s.

The qualities of a "teachable moment" are complicated, said Emily C. Williams, research project director at the VA Puget Sound Health Care System and corresponding author for the study. "On one hand, it may be the first time that a patient realizes that their drinking is responsible for a very serious illness or event requiring acute hospital care," she said. "On the other hand, there are people who continue to drink heavily despite knowing the consequences associated with it. For the former group, hospitalization may serve as a strong impetus of change whereas, for the latter group, hospitalization may be met with a neutral attitude (or worse) toward change."

This is an important issue to address because of the large number of patients and substantial healthcare resources that are involved, added Daniel Kivlahan, director of the Center of Excellence in Substance Abuse Treatment and Education at the VA Puget Sound Health Care System, and associate professor in the department of psychiatry and behavioral sciences at the University of Washington.

"Most providers in inpatient medical settings will see patients similar to those sampled for this study, and we need more evidence about better ways to recognize and address the clinical needs of this diverse group of patients," said Kivlahan. "Hospitalizations need to be considered part of the continuum of integrated healthcare with implications for post-hospital follow-up, rather than isolated events."

Researchers recruited 341 adult medical inpatients from a university medical center (242 men, 99 women) — who self-reported "risky drinking" during the previous month — based on their initial hospital screening. Participants were then enrolled in a randomized trial of brief alcohol counseling, and interviews were conducted at enrollment as well as three months after hospitalization. Information on five measures of physical health was gathered, and compared to two outcomes: abstinence and number of heavy drinking days three months later.

"We found that among inpatients with unhealthy alcohol use whose drinking is less severe — those not dependent on alcohol and those reporting low levels of problem perception — alcohol-attributable illness may serve as a strong catalyst of changes in drinking," said Williams. "As such, alcohol-attributable illnesses could become a focus of hospital-based brief counseling interventions.

"This study provides an important alert to providers that they should not assume that patients recognize a link between their alcohol use and their alcohol-related medical diagnoses," said Kivlahan. "Although most patients may be aware of this link that is typically obvious to providers, a small subset of patients may benefit from having it addressed directly during the hospitalization."

Both Williams and Kivlahan noted the relevance of these findings for helping providers recognize a need for conversation about ways to improve hospital-based brief interventions for patients with unhealthy alcohol use.

"This study offers suggestions regarding the content of hospital-based brief interventions," said Williams. "If physical health is important to the patient, and they see the connection between physical health and their drinking, counseling interventions that make sure to include covering such topics could make the interventions more effective. Also, if the patient links his/her drinking with his/her physical health, they may be willing to follow-up with care in settings where medical and alcohol care are integrated, which could lead to improved outcomes."

"For clinicians, it is worth noting that most of these patients at risk due to unhealthy alcohol use did not have alcohol-attributable medical diagnoses, and only 15 percent had such a diagnosis listed as the primary reason for admission," said Kivlahan.

"Further, even though more than one in five reported abstinence at a three-month follow-up, this was not reliably associated with self-reported worse health after other explanatory variables were considered. Thus, we can see that medical hospitalization is not a sufficient factor to eliminate heavy drinking for many patients. We need to replicate these results under circumstances more similar to clinical practice and with larger samples in the subgroups of interest."

Science Daily reports that in the first evaluation of its kind, the study published in Addiction found that problem drinkers provided access to the online screener www.CheckYourDrinking.net reduced their alcohol consumption by 30% (six to seven drinks weekly), rates that are comparable to face-to-face interventions. This result was sustained in both the three- and six-month follow-up.

Problem drinking is a major cause of preventable deaths in Canada as well as morbidity, trauma and violence, yet many of those who struggle with problem alcohol use will never seek treatment. A recent general population survey indicated that 81% of problem drinkers in Canada have Internet access, and about a third indicated that they would be willing to seek intervention via the web.

Brief Internet-based interventions for problem drinkers are promising, and fill a gap in the services available to problem drinkers, according to principal investigator, Dr. John Cunningham Senior Scientist with the Social and Community Factors in Prevention Research Section, CAMH.

"An unfortunate reality is that many problem drinkers do not seek treatment. While getting help from a health care professional is ideal, there are barriers to access such as concerns about stigma, a desire to handle problems on one’s own, or simply because treatment is not readily available—online interventions can help reduce these barriers by allowing people to seek help in their own homes,” Dr. Cunningham said.

By analyzing self-report data, the website provides problem drinkers with a report that compares their alcohol intake to the national average and informs them of the physical and health risks associated with their drinking patterns. The report also calculates the amount of money spent on alcohol annually and how much of their time is spent under the influence each year. Safer drinking guidelines are also provided to website users.

"The Check Your Drinking online screener provides participants with a wealth of information about their drinking, its consequences, and how they compare to others," said Dr. Cunningham. "When presented these facts in a non-judgmental manner, participants are able to re-evaluate their drinking and may be motivated to reduce their alcohol consumption."

A comparison of the effects of two interventions on DWI recidivists with alcohol problems found that one—Brief Motivational Interviewing (BMI)—was more effective. Results will be published in the February 2010 issue of Alcoholism: Clinical & Experimental Research.

"Traffic crashes contribute more to morbidity in teenagers and young adults than any other cause, and DWI contributes to about a third of the overall toll," explained Thomas G. Brown, assistant professor in the department of psychiatry at McGill University and principal investigator for the study.

"In dollar terms on a yearly basis, total estimated loss due to DWI is estimated at five percent of the gross national product of Canada. This is a staggering figure, associated with a huge amount of personal suffering and loss, and is all the more tragic given that DWI is preventable,” Brown said.

Sandra C. Lapham, senior scientist and director of the Behavioral Health Research Center of the Southwest in Albuquerque, New Mexico, said the problem is equally huge in the United States.

"Approximately 1.5 million people are arrested in the U.S. each year for this crime," she said. "About one in three to one in five convicted offenders will repeat the offense, and repeat offenders are more likely than other drivers to cause alcohol-related crashes."

"While probably the majority of drivers who are arrested and ultimately convicted for DWI will take appropriate measures to not drive again after recent use of alcohol and drugs, so-called DWI recidivists contribute to a disproportionate amount of the carnage occurring on our roads," said Brown.

"As well, many recidivists do not participate in the DWI evaluation and remedial programs that are an obligatory part of regaining their licenses in most jurisdictions. Unfortunately, there is relatively little research about these individuals’ characteristics and the measures that could be taken to reduce their risk, as most research is conducted with drivers who are participating in intervention programs."

Brown and his colleagues divided 184 male and female recidivists with drinking problems and not currently engaged in DWI intervention into two groups: 92 (86 men, 6 women) received a 30-minute BMI session, a brief but powerful psychosocial intervention where the client was encouraged to review personal reasons for change; 92 (79 men, 13 women) received a 30-minute "control" intervention, where the client received information about the hazards of excessive drinking related to health and DWI. Outcomes measured at six- and 12-month follow-ups included percent of risky drinking days in the preceding 6 months, biomarkers of alcohol abuse, and alcohol abuse-related behaviors.

"The drivers we studied may be among the most dangerous drivers, what some authorities call ‘hardcore drunk drivers,’" said Brown. "We figured that an intervention tailored to their specifications would have to be very brief, something that could be applied opportunistically, say at the time of a court appearance. Our results indicated that BMI, compared to the control procedure, was superior in reducing by around 30 percent the number of risky drinking days for up to a year after receiving the intervention. A risky drinking day is when an individual drank enough on a given day that he or she would probably be impaired if they were to drive shortly after."

As for why the BMI intervention was more effective than the control intervention, Lapham responded: "We all have inner conflicts, but these conflicts between how we act and how we would like to be are sometimes not obvious to us. BMI techniques expose these conflicts and allow the person to be more aware of how their harmful alcohol use is at odds with their self image; in other words, how their behavior sabotages their own personal goals for the future. Some interventions try to lead the person into setting goals developed by the therapist, whereas BMI allows the person to fashion his or her own agenda: uncover their own reasons, and motivations, for changing, and set their own goals."

"What is new here is that this may be the first published report of a beneficial effect of a very brief version of MI with individuals who are not in a clinical setting, not particularly motivated to reconsider their drinking (as an individual in an emergency room following an injury might be), and who are generally considered to be hardcore drunk drivers. Nonetheless, the results underscore how, in the right hands, even very brief psychosocial interventions can have important and enduring effects in individuals who are often seen as impervious to change,” said Brown.

He added that encouraging the DWI offenders to participate was rather easy: offering a monetary incentive of about $70, which not only illustrated the power of "immediate positive rewards" but also seemed like a reasonable investment in the name of public safety.

"We need to remember that these repeat offenders reported…drinking 23 to 24 drinks per week, indicating a need to cut down on drinking for both health and public safety reasons," said Lapham.

"The take-home message here is that brief interventions—which can be administered in a health-care provider’s office during a routine visit, and in a variety of other settings—can be very effective tools for helping people change their harmful drinking patterns, changes that can persist for long periods. That said, the most important comparison has not been done yet. The authors are following up to determine what changes, if any, occur in the drinking and driving arrest statistics over time, and whether re-arrest rates will differ between the two groups."

Singer Janet Jackson reportedly tried to stage an intervention for her brother Michael in 2007, two sources close to the Jackson family told CNN. Britney Spears’ family intervened in 2008 through the court after a judge in her custody case cited her for “habitual, frequent, and continuous use of controlled substances and alcohol.” Her father, Jamie Spears, was granted temporary conservatorship over her.

An article in CNN suggests several ways to intervene, noting that interventions can take many forms. Experts say that simply suggesting that a drug addict make an appointment for professional help may work.

Patrick Hart, an intervention specialist in Seattle, Washington, said that speaking openly in a compassionate tone and without judgment is an effective way to approach an intervention. He said that the addiction or other problem should be viewed as an illness that deserves professional care.

“Do not expect an addicted loved one to simply stop within their own right,” Hart said. “Offer specified help.”

Another form of intervention is a more formal, direct approach involving family members and close friends. It’s best to hire a professional interventionist for these meetings. Before the meeting, the interventionist meets with family members and friends to get a history of what has happened.

Loved ones will often explain in writing that they are involved in the intervention because they love the addict, and then detail the ways the addict’s behavior has hurt them or concerned them. For example, if the person is married, his or her spouse may not permit him or her back into the home. If the person is living with family, the relatives may warn that he or she won’t be welcome back.

Before the intervention, the interventionist will help the family create specific consequences if the addict does not agree to go into treatment, and the interventionist will talk with the family about the possibility of the addict running away.

Dr. Bankole Johnson, chairman of psychiatric medicine at the University of Virginia, said it’s best to treat the addiction as a medical problem and stress the physical consequences of it. According to him, simply telling a person that he or she has a problem with alcohol or drugs is often not as effective as saying, “You seem to be having difficulties with your sleeping, or you seem to be having difficulties with your breathing.”

In most states, treatment for addiction cannot be forced by family members of friends—that’s where the legal system comes in. However, it is very difficult to prove in court that a person is not able to manage his or her life because of an addiction.

Different states have different laws, but a conservatorship—when someone takes legal charge of another person’s decisions—is only granted if a person is a threat to other people or to themselves, Johnson said. Generally, he said, the person has to commit a crime such as driving while intoxicated before the legal system gets involved in ordering treatment.

But sometimes the very threat of police intervention is enough to prompt an addict to treatment, said Dr. Marvin Seppala, chief medical officer at Hazelden Foundation.

Experts stressed that family members and friends should not wait until the person they’re concerned about “hits rock bottom” before attempting to get help from a professional.

“Very rarely does someone wake up in the morning and say, ‘I want to change,’” said Mike Loverde, who was addicted to prescription painkillers eight years ago and now is the director of program services at the Intervention Services Inc. branch outside Chicago.

1.) Hire a professional interventionist. Evidence shows that a successful intervention should be directed by an intervention specialist who has been trained in drug abuse intervention techniques and has a track record of intervention success.

2.) Base the intervention around a “happening” in the life of your loved one. This could be an instance when he or she was caught stealing something or lying, a big fight regarding substance abuse with family members, or perhaps if he or she was arrested for driving under the influence. Evidence shows that immediately following events like these, the individual is usually more willing to admit needing help.

3.) Make sure your loved one is not using during the intervention. If possible, choose a time and place where you are certain he or she cannot obtain drugs or alcohol. If there are any signs of recent drug or alcohol use, you may need to reschedule the intervention.

4.) Be extremely patient. Your loved one will most likely yell, scream, argue, and deny everything that’s being said during the intervention. Remain patient and know that the interventionist will handle any conflicts that arise.

Studies show an intervention success rate of 90 to 95 percent, but this depends on the interventionist and the commitment of family and friends to confront the addict.

You may experience resentment from your loved one after the intervention, even if he or she agrees to enter into treatment. If this happens, try to remain positive and keep thinking of the ultimate goal: your loved one’s recovery.

Also keep in mind that an intervention is only the first step in your loved one’s recovery, as he or she must now go through detox and therapy and change their lives in order to remain sober.

It’s imperative for you and other close friends and family members to attend support group meetings and group therapy with your loved one. Family counseling and support groups such as Al-Anon can help keep you strong while your loved one starts his or her journey to recovery.