for Paste Magazine

Addiction is an issue that impacts almost everyone in some way. I’ve been in recovery from alcoholism/addiction since January 2008. During that time, I’ve gone through ups and downs but have fortunately managed to stay sober. I’ll be answering a reader-submitted question about recovery every other week (information on how to submit below). I’m not an expert or mental health professional, just a sober person offering advice based on my experience and the research that’s available. This week, I’m talking

Hi Katie,

My boyfriend, Paul, has a friend (Steven) from middle school who is currently in the hospital, going on a month from cirrhosis/liver failure after decades of severe alcoholism. He is only 30 but has struggled his whole adult life with the disease and is still in real denial. The only reason Paul knows about it is through a mutual friend. Paul has been talking to Steven a few times a week and the whole time they have been talking, Steven never mentioned that he has been in the hospital. According to the mutual friend, if Steven recovers in the hospital, he will relapse without treatment and definitely die. How is it even possible for someone so young to have liver damage from drinking? Everyone involved is positive that Steven will not seek help on his own. Paul and others have tried for years to get him to talk about this and address this, and he will not do it openly.

Does Paul call Steven and tell him he knows what’s going on? Should we try to convince him that he needs treatment? Steven lives in a city several hours away from us and we’ve even discussed showing up at the hospital where he’s a patient. We want to be supportive of him but it’s hard when he doesn’t seem to see the reality of his situation—so much so that he’s not even talking to us about it. Are you just totally helpless if the person won’t take a first step?

From, Paul’s Partner

Hi Paul’s Partner,

I am sorry you and Paul are in this situation; my heart goes out to Steven. Addiction is a real asshole and part of the reason is the impact it has on pretty much everyone in its wake. I have been on both sides of the equation: loved an addicted person and been an addicted person. Each scenario has its own set of challenges but both feel pretty crappy.

We often think of cirrhosis as an older alcoholic’s challenge—and that’s often the case. But a decade or two of chronic binge drinking absolutely can do permanent damage. As all the caveats on this column state, I’m not a doctor and can’t give medical advice. But I can tell you that when I found myself in the emergency room at the ripe old age of 23, I had about a decade of drinking under my belt. When the doctor approached me to talk about the results of my blood test, she informed me that my liver enzymes were at the levels she would expect to see in a heavy drinking, middle-aged male. Fortunately, I had not yet reached the tipping point of cirrhosis and my liver could recover if I stopped drinking immediately. I was lucky. Studies have demonstrated that permanent liver damage (cirrhosis) can occur after less than a decade of alcohol abuse. It sounds like Steven’s doctors believe he falls into this category… (continued)