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Outcomes of substance abuse treatment vary

Outcomes of treatments for substance abuse are difficult to predict and also are difficult for the people affected by the substance abuser to deal with. This is the 10th report about Dan and Darla, a farm couple and their two children, a daughter who is 13 and a son who is 9 years old. As usual, I have not used their real names or revealed identifying information.

My first description of their circumstance was published in October 2013, but Dan's problems with alcohol and other aspects of his life began well before then. The most recent report was in early December last year.

My role has been to consult periodically with Darla since she first contacted me seven years ago and more recently with Dan as well. I have not provided professional services to them, but I have advised them and shared feedback with them that readers of the Farm and Ranch columns have sent me.

Dan admitted that he was a lifelong alcoholic in June last year when he relapsed after three months of sobriety. His belligerent demeanor changed when both children challenged their father to never drink again and to be honest.

Dan continues in counseling with a competent therapist, but not AA; he has learned to stand up for himself and to not have to fortify himself with alcohol in order to verbalize anger. He operated the farm that he and Darla are purchasing from his parents efficiently last year; he now also helps with household chores such as cooking, cleaning and ferrying the kids to their activities.

Their crop yields were well above average last fall. Although market prices have been less than favorable, the farming operation broke even for 2018. With Darla's income and health insurance, the family can make their loan payments and still have enough to live on modestly.

Last fall I wrote that Darla kept wine in the house to serve guests and to occasionally have a glass herself, and with Dan's approval. Several readers expressed concerns that Darla kept wine in the house and that others consumed alcoholic substances when around Dan.

Some people wondered if Darla is subtly setting up her husband to relapse. Most said Darla should get rid of any alcoholic drink in the home in order to eliminate a temptation and to show her support of her husband's reform.

I shared these concerns with Dan first and then Darla. Dan said he doesn't object to his wife and others drinking in his presence.

Drinking alcohol is his problem, he said, and he can't blame others for his circumstances. He added that it's OK if he drinks a soda or something else that isn't alcoholic while other people consume alcoholic beverages.

Darla confirmed that she and Dan had discussed the issue thoroughly and that they consulted Dan's therapist for advice. Dan's therapist pointed out that Dan has to live in the real world in which some people consume alcohol or other addictive substances, but he has to manage only his own behavior.

If Dan consumes an alcoholic drink, he knows and accepts that he is flirting with danger because he won't be able to stop drinking until he is inebriated. He said he tells himself that getting drunk would worsen his life and the lives of his family.

Worst of all, Dan could lose contact with Darla and their children because they wouldn't allow him to live with them if he drinks alcohol, Dan said. He wants their love and respect, he added, and he knows many people he cares about much would also suffer if he resumes consuming alcohol.

Although nearly all that has happened lately seems positive to Dan and his family, long-term studies of abusers of alcohol indicate subsequent periodic trials with drinking by the alcoholic.

The first resumption of drinking is usually within the first year of sobriety. Dan "made it" only three months. Now he has accomplished a full year of abstinence from alcohol, in spite of having it around him.

The average time between the first and second resumption of "trying" by the alcoholic to see if he/she can drink ever again is three years. If the addicted person becomes inebriated again, then faces consequences and resumes abstinence thereafter, usually it is for the rest of his/her life.

The typical addict chooses to refrain from drinking ever again or to entering a recurrent pattern of substance abuse and treatment stints or incarceration until the addict dies. It's a tough path with choices that the alcoholic must make, unless science comes up with a better cure for alcoholism.

I am grateful to Dan and Darla for keeping me in their loop and sharing their "journey" with others. Hopefully, others can learn from them.

Dear readers, please share your feedback and recommendations. Thank you to those who have shared your thoughts and experiences.

Mike Rosmann is a Harlan, Iowa, psychologist and farmer. To contact Rosmann go online to: www.agbehavioralhealth.com.

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