Denial in Alcohol Use Disorder I Psych Central

Use of naltrexone for alcoholism represents a “clinical harm reduction” approach rather than an “abstinence or fail” approach characteristic of disulfiram. Knowledge of the impact of AUD on families has led to the development of family-engaged treatments. Considerable research has focused on the development and testing of these family-engaged treatments to foster recovery from AUD. These treatments have focused on the role of the family in the initiation of help seeking, initiation of change, and maintenance of long-term change. The following sections describe and review treatments for affected family members in their own right, and as a way to help effect change in the identified individual with AUD. This is then followed by a review of the array of interventions influenced by cognitive behavioral therapy (CBT) and family systems models.

Michael J. Fox talks alcohol abuse, denial in ‘Still’ documentary – USA TODAY

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Since it is during this stage that relapse or regression to a previous stage of change is likely to occur, preventive strategies are warranted. Kids may also exhibit behaviors such as social withdrawal, risk-taking, and academic problems. Heavy alcohol consumption can also cause malnutrition and vitamin deficiencies which can further contribute to alcohol’s detrimental effects on the brain. In some cases, people may develop alcohol-related dementia or a cognitive disorder known as Wernicke-Korsakoff syndrome. It can also create longer-term impairments that persist even after a person is no longer intoxicated. You spend a lot of time drinking, thinking about it, or recovering from its effects.


Denial can persist for short or long periods and looks different for everyone. However, as addictive behaviors become more disruptive to a person’s life, it can be harder to deceive oneself and others and ignore what is happening. You might also find it helpful to talk with a counselor or therapist who specializes in alcohol use disorder. If you or someone you know is living with alcohol use disorder, there are a number of resources that can help. Each person has a different experience and insight on their relationship with alcohol. While some may have reached a place of awareness, others may still be trying to understand the seriousness of their condition.

why are alcoholics in denial

That is, the future consequences are not weighed in comparison with the present benefits. The benefits of drug use may be clear and immediate, while the costs are typically delayed and uncertain. They tend to prefer drugs because, at the moment of choice, they value drugs more than they value a possible but uncertain future reward (e.g., health, relationships, or opportunities).

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However, the proportions of probands who reported tolerance in the five years prior to interview decreased steadily with each subsequent interview. The key aspect of the tolerance question used here might be the emphasis on the recent why are alcoholics in denial five-year period. It is possible that self-perceived tolerance might be strongest at younger ages when drinking is escalating but might not be as apparent as individuals maintain and decrease the maximum drinks with advancing age.

By Geralyn Dexter, PhD, LMHC

Geralyn Dexter, PhD, LMHC, is a mental health counselor based in Delray Beach, Florida, with a focus on suicidal ideation, self-harm, help-seeking behavior, and mood disorders. Take our free, 5-minute substance abuse self-assessment below if you think you or someone you love might be struggling with substance abuse. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder.

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Despite the hardships of this condition, there are ways to help people with alcoholic denial and alcohol abuse issues. In conclusion, denial of a general alcohol problem by individuals who admitted to multiple AUD criteria items was quite common in the SDPS, despite prodigious maximum drinking quantities. This pattern of denial indicates that greater efforts need to be made to educate our patients and our colleagues regarding what an AUD is and how serious the prognosis can be. For AUD probands, deniers were less likely to endorse several specific criteria that might offer some insights into why they do not consider themselves problem drinkers. The SRE records numbers of standard drinks required for up to four effects including a first effect, feeling dizzy or slurring speech, unstable standing, and unplanned falling asleep.