Six strategies for hosting a substance abuser.
It’s the nightmare scenario for anyone who’s ever hosted a holiday gathering: A guest who happens to be a loved one drinks too much or indulges in illicit drugs and behaves boorishly, flipping the festive mood of the party from “ho ho ho” to homicidal.
What can you do in that situation? What are your options if you’re hosting a substance-abusing adolescent or adult child, a sibling, a cousin or another close relative not only for a party or dinner, but for several nights over the holidays?
A Challenging Season
“The holidays can be fraught with worry and fear and panic about what’s going to happen when a loved one drinks too much or abuses drugs,” says Beth Kane-Davidson, director of the Addiction Treatment Center at Suburban Hospital in Bethesda, Maryland. “Most Americans know someone with a substance abuse disorder,” she says. “During the holidays, we need to be on guard to handle binge-drinking situations.”
Tens of millions of people in the United States suffer from alcohol abuse and addiction, and their conditions affect their families and other loved ones. A study published in June 2015 in the journal JAMA Psychiatry found that 32 million adults struggled with a serious drinking problem the previous year. And about 27 million people used illicit drugs, mostly marijuana, according to the 2014 National Survey on Drug Use and Health.
Whether the holiday guest struggling with alcohol or drugs is visiting for a few days and nights or just for one event, here are strategies you can take to try to ensure the season isn’t ruined or defined by an active alcoholic’s or addict’s behavior:
1. Set expectations before the visit or event. Hosts should keep in mind that they are in control of what goes on in their home, and not cede that authority to any guest, Kane-Davidson says. Be specific in spelling out boundaries on such issues as arriving to an event on time, not drinking or using drugs, and dressing and behaving appropriately.
Let the loved one know that if he or she violates the rules, they will be asked to leave. If the person is staying at the host’s home for a few days, make it clear he or she will be asked to find alternative lodging if they break the rules, so they don’t ruin the holiday for everyone else, says Anita Gadhia-Smith, a psychotherapist who practices in the District of Columbia and Bethesda, Maryland. “You don’t have to host people who are alcoholics or drug addicts just to be polite or people-please,” she says.
2. Emphasize safety. Some guests will drink excessively or abuse drugs even if they’ve been told such behavior won’t be tolerated. “Things can start out well and disintegrate quickly,” Gadhia-Smith says.
If your guest drinks heavily at a gathering or is clearly impaired from drug use, don’t let him or her get behind the wheel. If they’re staying at a hotel, arrange for a taxi or other car service to take them there. If they’re staying with you, let them know when they have sobered up that they broke the rules, and though you love them, they have to find another place to stay.
3. Make your home alcohol- and drug-free. If you’re hosting someone who’s drinking excessively or abusing drugs, get rid of whatever alcohol or prescription drugs you have in your home. You can keep the substances in the home of a trusted friend or relative, or place prescription drugs in a locked box hidden from easy view.
You can also host alcohol-free parties and instead serve nonalcoholic beverages like apple cider, Gadhia-Smith suggests. Plan fun activities such as non-drinking games like charades, “Taboo” or “Pictionary.”
4. Limit the drinking time. If you know a house guest or someone coming to your party drinks excessively, offer nonalcoholic beverages and snacks instead of alcoholic drinks during the cocktail hour before dinner.
This will make it harder for your problem drinker friend to indulge, says Constance Scharff, research director at Cliffside Malibu Treatment Center in the Los Angeles area. People who don’t drink or only imbibe socially won’t mind and may even find it a relief, given the amount of drinking that goes on during the holidays, Scharff says.
5. Consider meeting the substance abuser in a public place. This strategy is a form of “portion control,” Gadhia-Smith says. “It allows you to limit your exposure to toxic people,” she says. “Portion control is good not just for eating.”
Gathering in a public place, like a restaurant, provides structure that can help cut down the odds of an alcohol- or drug-fueled debacle occurring. “It gives you a beginning, a middle and an end,” Gadhia-Smith says. It gives loved ones of the person struggling with substance abuse the opportunity to leave at a time of their choosing, which may occur at any moment with a substance abuser. “Sometimes things start out great and deteriorate quickly,” she says.
6. Encourage your loved one to get help. When you talk to your guest or visitor about your expectations, make it clear you care for their well-being and hope they think seriously about getting help. “You can talk about the need for getting help and plant the seeds,” says Dr. Joseph Garbely, medical director and vice president of medical services at Caron Treatment Centers, which has facilities in Pennsylvania and Florida. Experts disagree on the utility of trying to stage an intervention during the holidays – it may not be an optimal time to try to persuade the substance abuser to go to rehab, Garbely says. An intervention requires a lot of planning and would be difficult to arrange during the holidays, he notes.
But for some people struggling with alcoholism or drug addiction, the holiday season can be the best time for an intervention, Kane-Davidson says. “It is a time when loved ones and people who are important to the person are gathered together – it might be that the favorite sibling or childhood friend could be the exact ingredient to finally persuade the person to get help. Remember, addiction does not take a holiday.”