Alcohol

Drinking becomes a problem long before it looks like one from outside, and most people who cut down do it without hitting some dramatic low point first. The most useful thing you can do is stay in the room. People change more often when someone kept talking to them than when everyone backed away.

A licensed clinician is reviewing this guidance and it may change. It is general information, not advice about a particular person. If someone is in immediate danger call 911, and for trained help call or text 988.

Stopping suddenly can be dangerous

Alcohol is unusual in this. Someone who drinks heavily every day can have seizures if they quit all at once, and it can kill. Never push a heavy daily drinker to go cold turkey without a doctor involved. If they're shaking, sweating, confused, or seeing things after cutting back, treat it as an emergency.¹

What helps

Talk when they're sober, and not the morning after — The morning after is full of shame, and shame is often what's being drunk away. A quiet ordinary moment gets much further than a showdown.
Say what you noticed, not what they are — "You've missed the last three Sundays and I've missed you" is hard to argue with. "You're an alcoholic" starts a fight about the word instead of a talk about the person.
Notice the good stretches out loud — This is the heart of CRAFT, the approach with the best evidence for family and friends: make sober time obviously worth having, rather than making drinking cost more. Tell them you enjoyed the evening and you were glad they were there.^{2, 3}
Keep your own life going — This isn't selfish, it's part of how the approach works. In studies, the people doing the supporting got noticeably better in themselves whether or not their person ever went to treatment.³

What tends to backfire

None of these are stupid. Most of them are what caring looks like when it is frightened, which is why they are so common.

The surprise confrontation — The version from television — family gathered, ultimatum delivered — is the most famous approach and one of the weakest. Compared side by side, CRAFT got about 64% of people into treatment; the confrontational version managed about 23%, and Al-Anon-style support about 13%. Worth knowing: everyone doing the supporting felt better under all three, so Al-Anon is doing real good for you. It just isn't what moves the other person.^{3, 2}
Ultimatums you won't follow through on — A threat you don't act on teaches them your words don't mean much. Only say what you'll actually do.
Pouring it away and watching the supply — Controlling access makes you the obstacle, and usually just moves the drinking somewhere you can't see.
Waiting for rock bottom — There's no evidence anyone has to lose everything before they can change, and a lot can be lost while you wait.

What you could suggest

Understanding the situation does not tell you what to actually do. These are things you can offer.

Suggest their regular doctor, not rehab — Most people picture residential rehab and stop there. A normal doctor's appointment is a far smaller step, and it's where medication and options get discussed.⁴
Mention that medication exists — Prescription options such as naltrexone can reduce craving. Plenty of people have never heard this and assume willpower is the only tool.⁴
Offer the SAMHSA helpline — for them or for you — Free, confidential, any hour, no insurance needed, and they'll talk to family and friends too, not only the person drinking.⁵
Suggest a trial run rather than forever — "Try thirty days and see how you feel" is far easier to agree to than "quit," and it tells both of you a lot.
Offer to go with them — To the appointment, to the first meeting, to sit in the car park. Turning up alone is the part most people don't manage.

Questions that are easier to ask than to invent

How have you been sleeping?
What's the drinking doing for you?
What would you want to be different in six months?
Is there any part of this you'd want a hand with?
Would it help if I came with you?
Have you ever tried to cut down before? What happened?
What would you want me to do if I'm worried again?

Words you will hear

Tolerance

Needing more than you used to for the same effect. Usually the earliest sign, and the easiest to explain away.

Withdrawal

What the body does when it stops getting alcohol it's used to — shaking, sweating, sickness, and in bad cases seizures. Medically risky with alcohol specifically.

Harm reduction

Reducing the damage without demanding they quit first — drinking less, drinking more safely, staying alive. Not a lower goal, just a different order.

Help Now is not a crisis line, a counseling service, or a substitute for emergency care. This is general guidance for people supporting someone they care about, not clinical advice about a particular person.