Q: My husband is 33 years old and for the past 2-2.5 years he has become an alcoholic due to a lot of family problems. Recently he suffered a seizure and had severe withdrawal symptoms due to non-consumption of alcohol and was hospitalised for nearly 8 days including 2 and a half days in the ICU. The treating doctor suggested rehabilitation in a de-addiction centre. But my husband has been disagreeing to it saying he will not drink again. The doctor finally said that he has to feel the urge from within to abstain from alcohol and it will be of no use if we forcefully send him to a de-addiction centre. In this case please advise what can be done to get him de-addicted as I do not think he will be able to abstain from drinking on his own for a long time. He feel pain in soles of the feet too. Please advise what I should do to help him? My husband refuses to accept that it is a problem and says he can leave it whenever he wants to but has not left it since 2 years. Please guide us.

A:Your husband is in pre contemplation stage (in denial). The first step is to move him to contemplation stage (ambivalent) then he will accept it! This can be achieved by motivational interviewing and by MET (Motivational Enhancement Therapy). So as a wife you need to have patience. Then talk him into seeing an Addiction Psychiatrist so that he can accomplish the above mentioned acceptance stage. First address his pain and this way he will have therapeutic alliance with his doctor and will listen to his/her advice. There are ways to handle the pain in his feet (it is due to peripheral neuropathy) caused by drinking. Lyrica, Gabapentin are some of the medications that are helpful. The doctor will also be able to start him on Antabuse a medication, which will make him sick if he drinks while on it (if his liver is good). Also Naltrexone along with Antabuse will be a great option. Vivitrol is an option its a monthly injection (Naltrexone Injectable) so that compliance is not an issue. Discuss these options with his doctor. You can do simple things to help him understand why he is drinking by being a friend more understanding than confrontational. Trust him and do not say that you will not be able to do it! Tell him you have the motivation and give him articles to read about alcohol and its complications: as he had withdrawal seizures and delirium tremens and was in ICU. He needs to understand the complications he can end up with due to his drinking. Ask him to go to Alcoholics Anonymous (AA) groups /local groups in a church. If he is not willing to do that, go to these on line groups and have him chat with people who have similar problems and that will give him peer support and he will be able to feel that he is not alone! The key to recovery is trust and encouraging him that he can do it! Always use ‘we’ sentences instead of ‘you’! (this makes it more acceptable than pointing out to him that you are the one who is having this problem). Keep faith and work towards relapse prevention (set up plans if there is a need to drink, who would you call for help? what are the things that you can do? Yoga, meditation, Art of living and other spiritual classes can be considered.