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Ask Dr. Bob

QUESTION
My 75-year-old aunt is an alcoholic. After hip replacement surgery and several other related operations, she has not had a drink in over 2 months. Her alcohol of preference is sweet vermouth followed by beer (it used to be scotch). She is now desperately asking for beer. She is physically and verbally abusive and I am afraid she will once again displace her hip because she does not stop lashing around. Is it okay to give her a nonalcoholic beer? I am afraid of triggering her need for alcohol.

ANSWER
From your letter, it seems that your aunt had been dependent upon alcohol or abusing it, and then apparently abstained for two months after hip surgery. Now she is abusive and "desperately" asking for beer, one of her preferred drinks.

We first should make some determination as to the nature of her drinking. Although you do not offer many details, it does sound like alcoholism. Has she ever had treatment, AA or counseling for this? If so, I would certainly ask the advice of previous caregivers.

Giving her nonalcoholic beer, or what some call "near beer," may not be a good idea. In the first place, these are not alcohol free, but generally contain 0.5% alcohol. Considering that most strong beers are 4.0% alcohol, this seems a minute amount, and in fact it is, taking 8 nonalcoholic beers to consume as much alcohol as one strong beer. So what's the big deal, some might ask.

Well, it goes something like this: If she does desperately want (need?) beer, she'll know immediately the difference since she will not feel the "high" or alcohol effect she desires from 1 or 2 or 3, etc., and, of course, will likely become even more agitated. But even more important is the well-intentioned but inaccurate idea of giving her something which looks like beer, tastes like beer, and smells like beer, and expecting it to satisfy someone who has been dependent upon it! In other words, would you advise an addict trying to maintain abstinence/sobriety to substitute a substance that looks, tastes and smells like the real thing? Common sense says no, it most surely would trigger urges for the addicting drug and lead to a relapse. Total abstinence remains the only way to go!

It seems that your aunt might benefit from counseling appropriate to her age and social situation. Why not ask her doctor or other professional about this?

Good luck,

Dr. Bob



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Dr. Bob does not provide specific medical advice or a medical diagnosis for any particular condition described, nor verify the authenticity of any information described in the questions presented. Patients should always consult their physician to discuss any specific symptoms, conditions, or modes of therapy for any particular mental or physical difficulties, diseases or conditions.

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