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Interviewer: You have somebody in your life who is entering the alcohol recovery process or is in recovery and you want to be supportive but some of the things you say might actually be harmful.

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Interviewer: We're talking with Dr. Jason Hunziker, psychiatrist at the University of Utah. Dr. Hunziker, people who are recovering from alcohol addiction, it's a really hard process and they need all the support they can get.

Dr. Hunziker: The choice to go into recovery is a big deal for everyone who does it. It's a very difficult process and it does take a lot of support not only internally but from people in the environment and from systems that help people enter the recovery process. We do have to be careful however what we say to people as they are getting ready to enter that process and as they are in that process so that we can motivate them to stay sober and make this big change in their life.

Some of the things I recommend that we don't say are things like, "Hey you can have just one, and it's not going to hurt anything." That clearly is not going to be helpful to somebody who is telling you that their life has been destroyed by alcohol. That's sets you up for failure in your process and in your program and so that's something that should be avoided.

Interviewer: So what are some other things that people say sometimes that you think are supportive but really aren't?

Dr. Hunziker: Somebody is in the program and you think you're being supportive by visiting them and then you say, "You know I'm glad you're doing this right now. It's a good time for you to do this but one day you're going to be able to drink again."

Interviewer: Really? They say that?

Dr. Hunziker: Yes, and again that is not something that is helpful at all to maintain the sobriety that they're looking for. When you stop, you still have the addiction. You just choose now not to use. And I use the word choose pretty lightly because if it was that easy to quit, everybody would just quit. So they make the decision to everyday get up in the morning and realize that they're not going to use and then go through that day not using even though they still have some cravings, they still have some desires and they still fight that impulse to go get some alcohol.

Interviewer: Okay, what are some other things that people might say?

Dr. Hunziker: Other things people say when they don't realize you don't realize you're an alcoholic at all they'll say, "Wait a minute. I see you go to work every day. You have a job. You're still making money. How can you be an alcoholic?" They think that just because you can function that you're not an alcoholic. But that still does not mean that this does not interfere with other aspects of your life.

Some people will say when you've been in the process for a long time and you've been going to your recovery meetings and you haven't had a drink they'll say, "Aren't you done yet? I mean, you've been doing this for years, shouldn't you be cured already?" There's no cure. I mean the cure is to not drink and the only way to not drink is to get positive support and to be actively making sure that doesn't happen.

Interviewer: Okay, any other things that people might say they think are supportive to a recovering alcoholic but might not really be that supportive?

Dr. Hunziker: Well I think sometimes people want to down play or minimize the alcoholism in the other person's life and so they will say things like, "Well I eat food every day, that doesn't make me addict so how could you be an addict?"

Interviewer: Because those two things are so comparable.

Dr. Hunziker: Exactly, exactly. So clearly our words are very important when somebody has made the decision to go into recovery and we need to choose those words carefully. We don't shy away from having conversations but I don't think we want to interfere and actively seek out information about the alcoholism. If somebody wants to give it to us, great. Let's listen, let's be supportive but if you start asking a lot questions people feel like you're being intrusive and then when you're intrusive it sets them up for failure.

Interviewer: So what are the words and the conversations that you can say to recovering or you should be saying to a recovering alcoholic?

Dr. Hunziker: It's not so much what you say all the time but some of the things that you do. Be available so if they call you in the middle of the night you don't say, "Oh, you're just drunk again" or " Oh, here it goes again." You're supportive, you're available, and you're encouraging them to use you as a support system so they don't go drink. Other things, you stay positive. Keep giving them encouragement all the time because it is a difficult process.

I mean you could imagine if you had to give up something you really enjoyed doing even if you didn't really think it was causing you that much problems. So you want to make sure that you're positive and they get encouraged by you so they will continue to fight the addiction.

Interviewer: So say you know someone who is thinking, who is considering the recovery process, what can you say to them to kind of motivate them to enter it?

Dr. Hunziker: You know I think normally what you want to do is have them think about how this helps them or doesn't help them. If you can say to them, "Okay, let's make a list of how alcohol helps you in your life, and then let's make a list of how alcohol hurts your."

Interviewer: Doesn't help you in your life.

Dr. Hunziker: Exactly, exactly.

Interviewer: Pros and cons.

Dr. Hunziker: And then people can look at that and then you can provide motivation based on the positive feature say, "Look what you can... You want these, you want that, you want this. The only way to get that is to be sober and if you can be sober, good things are going to come."

Interviewer: So any final thoughts that you have about recovering alcoholics, what you should and shouldn't be saying?

Dr. Hunziker: The only thought I have is that if somebody comes to you and says, "I'm contemplating stopping my drug use or my alcohol use." Please refer them to somebody who has a knowledge of recovery, has a knowledge of treatment, their primary care doctor, Alcoholics Anonymous, Al-Anon, somewhere that they can get that process moved from contemplation to full active recovery.

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updated: March 12, 2019
originally published: November 5, 2014

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Interviewer: So Dr. Madsen, I'm curious, physicians, nurses, doctors, when they get sick they can't necessarily take a day off. Sometimes you have to go in.

Dr. Madsen: Right.

Interviewer: For people that are suffering from colds or whatever right now, what are the things that nurses and doctors do to try to keep going that maybe we could do, or to even get better quicker. Is there anything? Is there a magic bullet that you guys know about that you're not telling us?

Dr. Madsen: See, I think you're trying to get free medical advice from me.

Interviewer: Yes.

Dr. Madsen: Because you're sick right now.

Interviewer: Yes, I am. I am. I'm trying. I've got this cough and this congestion that's been going on for a number of days.

Dr. Madsen: But I'm more than happy to offer the advice here, because I went through the exact same thing a couple weeks ago and it is just a miserable thing. And you're exactly right; I have called in sick for one shift in the last 10 years. That's one day of work. So I do everything I possibly can to get through work. And something I deal with on a regular basis is very severe colds. I'm exposed to a lot of people who are really sick and can make you feel really miserable if you catch what they've got.
So the things I do to get through a shift are, number one, I use Tylenol. Acetaminophen is the generic name. I take that one a regular basis and I alternate it with Ibuprofen. I alternate it back and forth every three hours. So that means you're taking each of those, individually, four times a day. You're not overdosing on either one, but it can help a lot with the body aches, the fever, just that feeling of misery you have. And I stay on top of it. I don't wait until I feel miserable. I take the acetaminophen and then I take the ibuprofen, alternating every three hours.

Interviewer: What kind of dosage?

Dr. Madsen: I usually take just a 500mg tablet. You're okay doing 2 of the 325 for the 650 total. And then the ibuprofen I take 600mg, so over the counter comes in 200mg tablets; you're taking 3 of those. For both of these dosing, you will find instructions on the bottle and precautions to avoid overdosing on either of them.

Interviewer: All right. What else do you do, medical professionals?

Dr. Madsen: So the other thing I do, there's the issue with the congestion and the coughing, and that's what can make you feel really miserable. So, typically I'm also staying on top of things and I take a combination of guaifenesin and dextromethorphan. So guaifenesin is a congestion medicine; dextromethorphan is a cough suppressant. And the brand name of that is Mucinex-DM. Again, you can find that as a generic, and I just usually get the generic because it's the same thing. It's half price. I take that also on a regular basis.
Just staying on top of things, morning and night. I think it's just a twice a day dosing on that. Maybe a little bit more. I'd have to look it up. Maybe four times a day, but I take it on a regular basis so I don't kind of get behind the game where I start feeling miserable and then I take it and wait for an hour to kick in.

Interviewer: Yeah. Anything else?

Dr. Madsen: So the other thing I've found is pseudoephedrine. Also known as Sudafed, but again, pseudoephedrine is the generic name. That's one of these things, if I find that these other things aren't cutting it, I take pseudoephedrine and that really just kind of dries my sinuses up. It helps me a lot with the congestion, runny nose. I don't like to take it a lot because personally, it gives me a little bit of a headache, but I usually kind of have it available during a shift if just nothing else is cutting it.

Interviewer: Would you use that on top of everything else we have talked about?

Dr. Madsen: If I'm in a situation where maybe I have taken the guaifenasin and the dextromethorphan and it's been two or three hours, I'm okay with taking it then.

Interviewer: Is there any concern about taking it all these medications? It sounds like a lot of stuff, or isn't it really?

Dr. Madsen: It is a lot of different stuff, but keep in mind these are all different classes of medication. You know, taking all of them can make you feel a bit jittery sometimes, honestly because they can kind of have that effect. The pseudoephedrine can kind of dry your mouth out and with any cold medicine, it's going to make your head a little cloudy. And it's probably already cloudy from feeling miserable from a cold. But they are different classes of medication, so aren't necessarily going to have a cumulative effect with each other.

Interviewer: So you talk a lot about controlling symptoms. Is there anything you can do to shorten duration?

Dr. Madsen: There is some evidence suggesting that if you start taking zinc early in the course of a cold, say within the first 24 hours, that it actually does have an effect. And for years, maybe even physicians have thought, "Well, it's maybe not scientifically based," but there have been several studies that have come out, including a nice review of all the studies that came out about a year ago, looking at zinc based medications. You may have heard of Zicam; that's the brand name. But if you start taking that early on, it very well may shorten the duration of your cold and the intensity of it.

Interviewer: What about drinking lots of orange juice?

Dr. Madsen: Yeah, high dose vitamin C, I've tried to look some things up on that. Personally, I take it, just because I'm like, "It's not going to hurt me, and it may help me." Evidence is a little mixed on it. I feel that personally, it kind of has an effect. Maybe it's a placebo effect. Maybe it's a real effect. Again, trying to look up some studies, kind of a mixed bag on it.

Interviewer: Sure.

Dr. Madsen: But I don't think there is any harm, and it may help.

Interviewer: So that leads me back to another question: Is there anything you do just kind of on a daily basis to help boost your immune system?

Dr. Madsen: Yeah, so on a daily basis, it's funny that you ask that too, especially with the vitamin C question, I take Vitamin C every day because I figure I am exposed to so much junk and so many different types of viruses and illnesses that I'll do whatever. And maybe it helps; maybe it doesn't. It's cheap, it's easy to do, but I do take vitamin C supplements every day.
And of course, the other thing is trying to get sleep. And that's one thing for me, personally, that's a challenge. Just with working night shifts, I find that when I do that, man, a couple days later, I'm really a set up for a cold. But if you're in a situation where you can sleep on a regular basis, and not interrupt your sleep pattern, that's going to help you to stay healthy. And certainly, just exercising. I personally exercise on a regular basis, but I think doing that keeps your immune system up and helps you to hopefully avoid some of these things.

Interviewer: So do you have any concern when you go . . . because there's a lot of discussion nowadays about when you're sick you should just stay home. It used to be, "Oh, I've never been absent a day in my life." But now there's a chance you might spread it to people. In the medical profession that's not an issue, because you said you've had one sick day in 10 years.

Dr. Madsen: Yeah. I mean, if I tried to call in for work, it's just not that simple.

Interviewer: They're going to be like, "Uh, I don't care. You need to come in to work."

Dr. Madsen: They're going to say, "We need you here." I mean, reality is if I'm sick, I'm going to wear a mask. I don't want to spread it to patients if it's really a concern. Unfortunately, that's a big reason people should avoid the E.R. in general. There are just so many bugs floating around there when you walk in the door.

Interviewer: Yeah.

Dr. Madsen: That's why a big thing I always try and talk about is what you can do to avoid the E.R. But certainly anyone who had any immune system compromiser would be a set up for an infection. I'm wearing a mask in that room if I'm even a little sick.

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