In the UK, Macmillan Cancer Support, an organization that provides physical, financial and emotional support to cancer patients, has just launched a fundraising campaign entitled Sober October. The initiative encourages people to stop drinking alcohol or reduce alcohol consumption for a month by giving practical advice to drinkers who decide to join. That those who deal with cancer also deal with alcohol is no coincidence given that there are 200 acute and chronic alcohol-related diseases and 12 types of cancer: from hepatocellular cancer to colorectal cancer to breast cancer. If we add to these data that “there are more than 8 million Italian drinkers at risk – those who exceed the recommended doses: one glass of alcohol a day for women and two for men – and about 700 thousand those in the damage zone who that is, they need a clinical intervention and that we are talking about downward estimates “, as he says Emanuele Scafato, director of the National Alcohol Observatory of the ISS, it is likely that someone who raises his elbow too often is also known to us. Maybe he’s a friend of ours, maybe he’s taking a risk. And maybe we can help him avoid getting into a real addiction, or going into bad clinical adventures.
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It would take a friend
“Friends can do a lot, often they are the ones who turn to dedicated centers to understand how to support the people they care about and who are at risk or in the area of damage – he says. Aniello Baselice, doctor, specialist in psychodiagnosis and psychotherapy, expert in addiction medicine, and member of the national board of the SIA, Italian Alcohol Society – Friends know how to listen with empathy, they do not judge, they make us reflect. They can be more effective than family members, who are often too involved, disappointed, suffering or angry. “
First: observe
But when is the right time to intervene, to make our friend think? “The relationship with alcohol is a personalized relationship, everyone has their own, but it must be said that in the Sert, the drug addiction services, people often arrive who have already passed the risk phase, when there are already professional relational behavioral problems. , and physicists. This is to say that it is important to recognize the problem first, “Baselice resumes. But it is not always easy to understand when the problem is there: alcohol has been a social lubricant for millennia, it facilitates relationships, it is part of our culture and history. What is the limit beyond which it makes sense to intervene? “Of course, you need to have clear parameters – explains the expert – If every occasion is good for our friend to drink, if the amount of alcohol always exceeds the recommended amount (one glass of alcohol a day for women and two for men , ed), if he drinks half a liter or a liter at dinner, and if he drinks between meals, something must be done: if all this happens once and for all it is a stunt, if it is frequent it is a problem “.
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The right time and the right words
Any topic that involves our and others’ weaknesses cannot be addressed everywhere and always: to talk about alcohol you need to choose the right moment “which is not that of a hangover, or of the immediate hangover – adds Baselice – so doing it generates tensions and is hardly effective: it is better to postpone one or more days, when those who have drunk are in the process of reflection. empathic and participatory. One can say ‘I’ve been watching you for some time, I’ve seen how you behave, think about it, I’m worried, I don’t judge you but we reflect together.’ To create a contact you need to stimulate reflections that promote awareness of action in the drinker. questions rather than judgments. Even very simple questions: “Why do you need to drink so much to be happy? Can’t you run out of fuel? Do you remember what you did yesterday?” It may happen that the person denies or minimizes “.
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The fear of offending
It also happens that you delay before addressing the subject with a friend who worries us: you have shame, yes you hope to be wrong, you are afraid of being misunderstood, perhaps sometimes even of offending, perhaps uselessly. “Too often people with alcohol problems enter a recovery path when the oxen have fled the stable, when perhaps there is still no physical dependence, but there are conflicts, absenteeism at work, injuries, fights, intoxication and health compromised – reiterates Baselice – By moving earlier, the transition from low risk to advanced risk could be avoided.
Unfortunately, information on the risks associated with alcohol is not widespread in the general population, nor among family doctors, or among social and health workers. If awareness were more widespread, friends could probably also intervene in a delicate way before it reaches the tipping point. To understand if a person has a problematic relationship with alcoholic beverages, an alcologist is not necessarily required. You don’t need a smock and a desk, just 3-4 right questions are enough “.
The questions to ask
There are two tests, both validated by WHO, the World Health Organization, for the rapid identification of risk: the CAGE test and the AUDIT test. In their short form they consist of 4 and 3 questions respectively. These are not tests meant to be used by friends, of course, but by dedicated personnel. But they give the idea. The 4 questions of the CAGE, for example, are very simple: Have you ever thought recently about having to drink less alcohol? Did you feel guilty about your drinking? Have you ever drank alcohol upon waking up? Have you ever been upset by comments about your drinking style? “And already a couple of affirmative answers can make us think,” says Baselice.
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And centers
If we have been successful and lucky, our friend may have decided to go to a center to deal with his problem or to avoid ending up in it. In this regard, there is the Green Alcohol Telephone of the ISS, Higher Institute of Health, 800 632000, which through telephone counseling interventions facilitates the meeting between the demand of citizens and the supply of services in the area. “Which are different: there are the public services of alcohol and the Sert that often have clinics dedicated to alcohol – explains the expert – And there is a lot of private social. There are networks at national level such as alcoholics anonymous. There are associations non-profit organizations that have reception centers and intervention programs or for individuals or families. There are also self-help groups. The offer is not lacking “.
Never drink in the presence of someone who has stopped
The drinking companions of a former drinker disappear very quickly, those who decide to stop abusing with alcohol tend to marginalize themselves. And here once again a friend can play an essential, social support role. “A friend must be present, propose to go out, to do things together, avoiding consuming alcohol in the presence of those who have chosen not to drink: it is a rule that applies to anyone who enters a treatment program. Dinner must be without alcohol, the non-alcoholic aperitif – The friend continues to be there even in moments of leisure, but his glass of wine is made on another occasion “, concludes Baselice.
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