Many can provide a dramatic representation of the threat to the patient's health. For example, if there is evidence of brain atrophy on a computed tomography scan and there are abnormalities on a detailed mental status examination, seeing the scan after the examination is a powerful inducement for the patient to seek treatment. Liver damage and the potential for the development of varices and hepatic failure, aggravation of osteoporosis, the devastating damage to a woman's fetus, and the progressive lowering of a man's serum testosterone with resulting gynecomastia and impotence are strong threats to the patient. Whenever the patient protests or shows anger, it is important to remind the patient that the physician is acting only out of concern and that a defensive reaction usually confirms the existence of the problem. The physician can also state that the goal is to attack the disease, not the patient.
Families can also effectively apply pressure by confronting the patient.
A meeting should be planned so that all family members can be present. At this meeting, members should express their love and concern for the patient and their desire that alcohol not claim him or her as another victim. Most important to this approach is the presentation of a unified front, not in blaming the patient but in firmly stating the fact that alcoholism is a disease, which has resulted in specific adverse repercussions for both the patient and the family. At this meeting, the family presents the patient with a plea to acknowledge the destructive effects of alcoholism and asserts full family support for the patient throughout a treatment program intended to achieve sobriety. Because keeping a job is a powerful motivation for a patient to get well and stay well, employers may be in the most powerful position to help an alcoholic.