Two years ago I reported for the first time how “Dan,” a farmer in his early 40s, was in a drunken stupor at least three evenings per week, when “Darla,” his wife, came home around 8:00 p.m. from her job as a nursing supervisor.  Their two children, then 4 and 6 years old, usually were “on their own” when their mother arrived home. 

If Darla awoke Dan to ask him about matters, she could smell alcohol on his breath, but he denied he was drunk, even though he was glassy-eyed and couldn’t walk straight.  When Darla contacted me, I recommended that she purchase a breathalyzer to measure Dan’s alcohol consumption.

If nothing else, the breathalyzer took the determination of Dan’s inebriation out of Darla’s hands.  Dan destroyed the first breathalyzer Darla purchased and refused to blow into the replacement device, or did so under protest, claiming the results were inaccurate. 

He pronounced he would “cut back” on his own and didn’t need anybody’s help.  He detested the breathalyzer, but he needed its objective feedback so he couldn’t avoid facing his growing reliance on alcohol. 

Over the next 20 months Dan had increasing difficulty managing his temper and often got drunk at family events.  Nonetheless, he didn’t “bottom out.”

In early March this year, the date of my last column about Dan, he had been arrested for “driving while intoxicated.”  Dan refused my advice that he needed intensive inpatient treatment to make lifestyle changes, to manage his behavior and relations with people and to not rely on alcohol for anxiety relief. 

Dan proclaimed he was different than most people, including his father who formerly drank heavily.  Dan said he could make necessary behavior changes without anyone’s advice.  He refused to attend Alcoholics Anonymous meetings but he began seeing a psychologist of his choice every other week. 

One afternoon this past May I received an almost incoherent text message from Dan that he was in the Emergency Department of his local hospital.  He was getting his scalp stitched together after having fallen.  I contacted Darla, who drove to the hospital.

When Darla arrived at the hospital it was immediately apparent to her that Dan was inebriated, as we had suspected.  His blood alcohol concentration was .41, five times the legal limit to drive. 

Dan yelled at hospital staff that Darla caused him to drink; he wanted to drive his truck home.  The county sheriff was called to the Emergency Department and wouldn’t allow Dan to operate his vehicle.  By the time Darla got Dan home, he had passed out and she let him sleep in her car until he came into their house on his own.

Dan was remorseful when Darla called the next day.  He agreed to see his counselor the following day, with Darla present for the first time. 

The meeting with Dan’s psychologist helped them figure out a treatment plan.  Dan agreed to attend two support group meetings weekly, to see his psychologist twice each week and take naltrexone to manage alcohol cravings.

Naltrexone is used to reduce opioid and alcohol dependence.  The combination of naltrexone, counseling and support meetings doesn’t work for everyone, but this treatment plan allowed Dan to remain out of inpatient treatment so as to finish planting corn and soybeans.

Dan doesn’t take naltrexone anymore but he sees his counselor weekly, sometimes with Darla, and he attends support group meetings twice weekly.

Dan acknowledges he is an alcoholic who drank to quell self-doubts, to help him say things he couldn’t otherwise say to his parents and to Darla when sober, and to “not have to think.”  When Darla called recently to report on how things were going, she said Dan “acts like his old self.”

He makes supper for the kids and her when she has to work late.  Their crops look better than they have for several years, Darla says.  He has not consumed any alcohol for the past four months. 

People can be secretive and resist others telling them how to change, especially when the main “tool” they rely on to deal with feelings of inferiority, anger and worry is unavailable, like alcohol in Dan’s case.  Dan is acquiring skills to express his feelings appropriately and gaining personal confidence. 

It isn’t certain if Dan will continue managing himself productively.  Most people addicted to alcohol relapse once or twice before learning how to make permanent lifestyle management changes. 

Dan said he is an exceptional case, for about 20 percent of alcoholics consume small amounts daily for its health benefits.  Dan, and Darla hope he will eventually be able to consume a glass or two of wine or beer daily, but no more than that. 

Will Dan regulate his alcohol consumption hereafter?  We’ll see. 

I thank all who contacted me to suggest recommendations regarding Dan.  You offered useful advice, usually derived from your own experiences, and which I passed along anonymously.


Dr. Rosmann is a psychologist/farmer who lives near Harlan, Iowa.  Contact him at: www.agbehavioralheavioralhealth.com