Scott Webb (Host): The month of April is Alcohol
Awareness month, so it's a good time to have on Jim Henceroth again. He's an
addiction counselor with Genesis, and he's going to share the warning signs for
alcohol addiction and his best advice for how we can help a loved one who's
struggling with addiction.

 This is Sounds of
Good Health with Genesis, brought to you by Genesis Healthcare System. I'm
Scott Webb. Jim, thanks so much for your time today. I know that Alcohol
Awareness month is coming up here in April, and it's a good time to do this.
And we've spoken before, so you're kind of an old pro at this. This one we're
going to talk about alcohol addiction and the warning signs and so on. So let's
start there.

Scott Webb (Host): What are the warning signs of
alcohol addiction?

Jim Henceroth, LISW-S, LICDC-CS: For those of us that
work in this field, there's 11 warning signs or diagnostic criteria, and I
don't want to go into any kind of detail with that. It enters the time, but I,
can kind of hit the highlights of them. One of those would be, when a person
drinks larger amounts than they really intend to; so a person plans on having
two beers after work and they end up having six or eight, or maybe they're
going to be home by 6:30 and it's midnight or 11 o'clock. So, longer periods of
time and larger amounts. And another thing that can be kind of a red flag is a
person trying to cut back or control their use, but not being able to really
succeed at that. Another thing would be a preoccupation with alcohol use. And
that involves anything from just, not only just thinking about it, but talking
about it. And also you can factor in the amount of time involved in going to
get alcohol. The amount of time spent using it and then recovering from the
effects of it. So all of that as the disease of substance use disorder
progresses, that sort of stuff tends to take up more and more energy in a
person's life. Cravings or an urge to use, noticing that, having reoccurring
problems at work, school, recreation problems and I'll just kind of throw in
there that there's kind of a myth about work that a lot of people have.

 I find a lot of
people say things like, well, I don't really think I have a problem with
alcohol because I work every day. I just got promoted. I'm working overtime.
Well, in our culture we tend to have a pretty strong work ethic, and a lot of
times work is usually often one of the last things to be impacted by an alcohol
problem. What tends to happen more often or earlier on, is it starts affecting
interpersonal, social, family relationships, and that's another one of these
warning signs. It's more likely to really affect, impact the people we love,
well before it starts creating a problem with work. Another thing would be
continuing to use, but trying to give up or giving up or reducing important
things with the job or recreation or social events. Not being able to do those
things that used to be pretty, a standard part of a person's life. Not quite
having the time or the ability to do that because the alcohol use is squeezing
that stuff out.

Using in dangerous situations, driving, climbing on ladders,
using power tools, that sort of thing, is kind of a red flag as well. And
knowing that it's causing problems, health problems, or psychological problems,
but continuing to use. So for example, if my doctor says, you got to quit
drinking because that's the real reason your blood pressure is so high, or it's
damaging your heart, or your liver enzymes are high, or your depression is
being made worse because of your alcohol use.

And by the way, I mean alcohol is a depressant. A lot of
people don't really think of that. It's kind of counterintuitive because when
it's first used, first consumed, there's oftentimes kind of a lift in mood. It
feels good. But that's a pretty short lived effect, after that is over, then
you start to plunge down into a depressed state if a person has clinical
depression. So that's really, really making things worse. So if a person's
continuing to drink in spite of that sort of thing, that's something that's a
real warning sign as well. Tolerance, increased tolerance, takes a lot more to
get the same effect that it did early on. And then withdrawal, you know, having
withdrawal and with alcohol withdrawal can be things like, you know, feeling
kind of sweaty or increased pulse rate, shakiness, having trouble sleeping.
That's a really common one. You know, nausea, anxiety, agitation, maybe even
seizures or hallucinations. So, having those symptoms occur after drinking or,
the other part of that would be in the same warning sign category would be
drinking to avoid the occurrence of withdrawal. And like I said, that's 11
things I kind of went over there. But, two of those or more occurring over the
course of a 12 month period, suggests that there's likely at least a mild
alcohol use disorder.

 And the more of those
that happen, you know, the more severe the likelihood of the problem is to be.

Host: Yeah, I see what you mean. So at least two over
12 months, and unfortunately, I'm sure for a lot of folks it's more than two,
and I guess, you know, I'm wondering how do we help then a friend or a loved
one Jim, who's dealing with an alcohol disorder. You know, like how do we get
that conversation going? It's not an easy conversation to have. Maybe you have
some suggestions.

Jim Henceroth, LISW-S, LICDC-CS: Well, you're right,
Scott. A lot of people feel kind of uncomfortable doing it and sometimes a
person doesn't want to hear that, that has a problem. But the best way to start
it is well, it's almost easier to say what not to do and what not to do would
be to not blame or nag that person.

 When it comes to a
substance use disorder, the brain gets tricked into believing that it needs a
chemical, a drug to stay alive. So it thinks it needs alcohol to stay alive.
And, if you're creating some kind of defensiveness in a person, their brain is
going to say, well, this is another reason to drink.

You know, I'm going to drink because you're blaming me. So
blaming or nagging usually makes things worse. But it's best to start out with
something like, you know, really showing concern, showing that you care. You've
been thinking a lot about this. So you're thoughtful about it and you bring up
why you're concerned and how that person's alcohol use is affecting you.

 So if I'm doing, I'm
going to talk about how it affects me and if I talk about my feelings
associated with it, it's pretty hard for that person to argue with that
because, well, I'm the expert of how I feel, you know, you can't know how I
feel. So, that kind of helps diffuse defensiveness and has a better chance of
that person listening.

Sometimes, it gets to a point where, you know, even though
you say, Hey, I, I think you really need to get help and you, you need to quit,
and if the person doesn't want to quit or isn't able to, and it's really
creating a problem; sometimes you have to say something, like a spouse for
example, might say I don't think I can handle this anymore.

You know, if you don't get some help, I'm going to have to
leave. And, I've talked to a lot of people, I've worked with a lot of people
over the years, that has been the thing that really got their attention. You
know, I remember one fellow was retirement age. He drank all his life and his
wife finally said, I can't do this anymore. If you don't quit drinking, I'm
going to leave. And he, that was the best thing that ever happened. I wish she
had done that when we were first married and I wouldn't have wasted my life,
you know? If a person does set that kind of limit, you have to be prepared to
follow through because if you don't, you're kind of sending the message that,
oh, I'm going to say I'm going to do this, but if a person keeps drinking, it's
not going to happen. They're not going to leave after all. Only say that if
you're willing to follow through with it.

Host: Yeah, I see what you mean. Yeah. I'm sort of
that way with my daughter and keeping her room clean. You know, if I, if
threaten, if I threaten to take away her phone, I have to really mean it, you
know, because otherwise, children and loved ones and friends in general, if
they know that there's nothing behind it, there's no substance, you don't
really mean it, then it just was not going to have the desired effect, and I
always wonder this, Jim, because you know, I'm able to go out with my wife or
my family and have a beer or two beers and then stop and then drive home safely
you know, and that's that for the night. Do we have any sense, do you have any
sense why some people can't do that? In other words, why do some people have a
problem with this?

Why does it become alcoholism in some and for others, they
can just stop for the night or stop for the week, or the month or the year,
whatever it might be. What is it about some people that it becomes a problem?

Jim Henceroth, LISW-S, LICDC-CS: The big factors
would be, part of it is environmental and part of it is genetic. A lot of times
both of those are really involved. Sometimes one more than the other. But, as
far as environmental factors go, you know, if, if I grow up in a home where
alcohol abuse is normal and I see everybody in my family drinking and they're
drinking in excess and doing unusual things, that's normal to me. I'm going to
jump right in and do that and more likely to develop a problem. And also along
those lines, if that's normal, if that seems normal to me, I'm more likely to
start drinking at an earlier age. And the earlier somebody starts drinking, the
more likely they are to develop a problem. So like people that do prevention,
they really try to do whatever they can happen to prolong the onset of a drug
use because that reduces the likelihood of it becoming an addiction.

So you got the environmental factors. The genetic factors
are pretty strong. So an alcohol problem doesn't run in a family as far as
genetically it does, but the predisposition or tendency to get that problem is
inherited. So basically, chances are, if you have, you know, an aunt or an
uncle or grandfather, a mom or dad, somebody in there, or more than that in the
family that have alcohol problems or sometimes yeah, I heard that my uncle used
to drink, but he quit.

Well, usually people don't quit drinking unless there's a
reason, there's a problem. So if you see that kind of history, that's kind of a
red flag. And for people that do prevention, that's one of the things they look
for with kids is, you know, does anybody else in the family have a problem?

And if they do, point out to them that, hey, because this
runs in your family, your friends might be able to dabble with this or that and
get away with it possibly, but you don't have that great a chance of getting by
without something happening, without developing a problem. So yeah, genetic
factors is, are really strong. Yeah.

Host: Yeah, so genetics, environmental factors, and
people who like yourself, who work to help people with the alcoholism and other
types of disorders and things, how do we find a good fit? You know, I'm sure
there's a lot of trial and error for folks starting programs, stopping out,
dropping out, finding another one, but how best can we try to find a program
like the first time, that really is a good fit that can help us with our
particular disorder, in this case, an alcohol addiction?

Jim Henceroth, LISW-S, LICDC-CS: You want to look for
credentials. Is a program well established? Does it have good credentials? Like
all of our counselors have master's level training. I don't really know of any
place else that has that. There's a lot of programs popping up. And, our folks
have been here for a while. They like it here. See people get better. It's
really rewarding. Our nurses that work here, they have BSNs, bachelor's nursing
degrees. They all have specialized credentialing in mental health or addiction
treatment.

 So it's really
unusual, to see a program that has all of that. I think we're, really making a
difference in our community really.

Host: Yeah, what would be your best advice with all
your years of experience, you know, and knowing what works and what doesn't
work; what's your best advice as we wrap up here?

Jim Henceroth, LISW-S, LICDC-CS: Well, I think the
best advice is to realize that this is a disease. It's a disease of the brain.
There's no debate about that. We know that. The science, the imaging available,
everything says this is a disease of the brain. When it kicks in, it's chronic.
It's there, that's the bad news.

The good news is, it can be treated, it can go into
remission, but you got to have treatment, the right kind of services for that
to happen. And doing it on your own is really tough and a lot of people fail.
They feel guilt, they feel shame. Those are really crummy feelings to feel. And
usually when you feel those, you want to drink more to deal with those
feelings.

So it's just a becomes an endless cycle. So reaching out for
help is real important. There's outpatient program, programming is really
common. For example, we have like a whole range of outpatient stuff here. You
know, three highest level is three hours of a group three times a week,
morning, afternoon. You can work during the day and come in at night or work
during the night, come in during the day. And also knowing that now there's
medications available that really can make a difference, can really make it
easier for a person. I'll just touch on these stuff real quick. If you, you
know, Campral really helps is a medication that really helps with cravings. We
offer that, and, naltrexone is a medication that not just helps with cravings,
but actually blocks the effects of alcohol. So if a person does drink, they
really don't get that high or euphoric kind of feeling. So it's kinda like,
well, what's the point? You know, I don't really feel the need to do this. And
that's also available in an injection form, in a form of Vivitrol also. You get
a shot once a month and it kind of gives you that safety net of knowing that
for the next month, this is going to be working for me.

So, there's some other things too, but that's kind of the, I
guess the big things when you ask that, that really come to mind. It's easier
to treat now than it ever has been, and, people do get better. I couldn't do
this job for as long as I did if I didn't see people get better.

 It's a privilege
honestly, to see that take place and play some kind of role in that. So it
really works. It's great to see people go out and say, boy, I feel like I'm a
better dad now, or I'm a better mom. You know, that's really is a good feeling
to hear that and to see that happen.

Host: Yeah, I think you're so right. You know, it is
a disease and we need to talk about it, and we need to educate and we do need
to recognize. We started today with the, you know, sort of the 11, warning
signs and going through them. And if you're, you or a loved one is, has at
least two of those for a longer period of time, like a year, you know, it's
time. It's time to reach out. It's time to find a program perhaps at Genesis.
Lots of flexibility, you can still work and so on, but it is a disease and it
is one where there's lots of treatment modalities and lots of options available
and compassionate people like yourself and the other folks at Genesis.

So, Jim, always a pleasure to speak with you. Thanks so
much. You stay well.

Jim Henceroth, LISW-S, LICDC-CS: Likewise. Thank you
very much, Scott. Great talking to you as well.

Host: And for more information, go to
genesishcs.org/services-search/behavioral-health. And thanks for listening to
Sounds of Good Health with Genesis, brought to you by Genesis Healthcare
System. If you found this podcast to be helpful, please be sure to tell a
friend and subscribe, rate and review this podcast. And check out the entire
podcast library for additional topics of interest. I'm Scott Webb. Stay well.