Al-Anon: getting past denial.
It was a booth for Al-Anon, the group for family members, friends, and co-workers of alcoholics. The woman at the booth told me her story and how Al-Anon changed her life, and I was blown away. In fact, I was so impressed that I went back to my private practice and added a question about family history of alcoholism to my incoming patient questionnaire. (Today I would probably phrase it as "family history of problem drinking or drug use.")
From then on, if anyone answered "yes" to that question, I would refer them to Al-Anon. Some patients agreed right away to go to a meeting; others said they didn't see why they should go, because their father died when they were young or their parents divorced, or for whatever reason they didn't think it would help them.
I persisted, and if they still said no, I said, "Well, you don't have to try it, but if you don't, every time you come into my office I'm going to ask you about it, because it's on the problem list."
Many did try Al-Anon. Soon, their visits to my practice decreased. One woman used to come in almost every month with something, and after she started going to Al-Anon, she stopped coming except for her annual checkup. People also seemed happier.
But there was another amazing result. Five people came back and told me that the nonjudgmental nature of Al-Anon gave them the courage to address their own addictions. Four went to Alcoholics Anonymous (AA); one went to Narcotics Anonymous.
Denial can also show itself in other ways. For example, I do rotations at a sexually transmitted disease (STD) clinic. Many patients I see there drink excessively, but don't think they have a problem. They think they're just like everyone else. That's probably true: They drink just like their family and friends do. To them, even a six-pack a day seems normal.
So I say to them, "I'm concerned because you caught this STD through sexual activity while intoxicated. I think your drinking is impacting your health, and it could have been AIDS." But if they don't think they have a problem, they're not going.
But instead of pushing them, I ask if there is a problem drinker in their family. (There always is.) Then I refer them to Al-Anon. Most have never heard of it, or think it's Alcoholics Anonymous. But a number of them are willing to take a referral to Al-Anon.
I give them a handout with a listing of self-help groups and remind them that they can sit in back and just listen, they don't have to say anything, and it's free.
I also suggest to patients that they try four or five different Al-Anon meetings, because each one is different--some are small and some are large, for instance.
Patients might want to try same-sex meetings if they're available; likewise, if patients are gay, they might look for an all-gay meeting.
I think every doctor would find it helpful to their patients to make referrals to Al-Anon. And all health care providers would find it helpful to attend at least one or two Al-Anon meetings themselves, because we all deal with alcoholics.
An open AA meeting is another good idea, because it will be easier to make AA referrals once you are familiar with how the organization works.
DR. EPSTEIN is medical director for the South Bay Area of the Los Angeles County Department of Health Services Division of Public Health. For a listing of Al-Anon meetings, visit www.al-anon.alateen.org.
BY MARSHA EPSTEIN, M.D.
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|Title Annotation:||Alcoholics Anonymous|
|Publication:||OB GYN News|
|Date:||Jul 1, 2005|
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