My boyfriend is a wonderful man, and I care about him a great deal. He is a heavy drinker. It does not make him mean, but I am bothered about the amount he drinks because I care about him so much. My last marriage failed because I was not able to let go of the same issue, so I am now debating whether I should say anything to him about this. I know that people with drinking problems have to decide to get help on their own. I know I cannot change him, only myself. I have chosen to stay in this relationship because he is a wonderful man and we are very compatible. But my concerns are becoming overwhelming, and I am not sure if it is something I should talk to him about. If I do, how should I approach it?

Jenn

I'm glad your boyfriend doesn't get violent or abusive when he drinks (or when he's sober). But I can understand your concerns about heavy drinking. The possible negative consequences of alcohol abuse or dependence include not only job and relationship difficulties in the present, but also physical diseases and brain damage associated with or exacerbated by long-term heavy drinking.

Alcohol affects nearly every major organ system, especially the gastrointestinal tract, cardiovascular system, and the central and peripheral nervous system. Heavy drinkers can develop gastritis, stomach or duodenal ulcers, liver cirrhosis and pancreatitis, as well as increase their chances of developing cancer of the esophagus, stomach and other parts of the gastrointestinal tract. Cholesterol levels and the heart may also be affected.

Heavy drinking kills off brain cells, and the cumulative effect can be quite severe. Alcoholics can develop cognitive deficits, including severe memory impairment. An especially severe, although relatively rare, possible consequence is Korsakoff's syndrome, in which the individual is almost completely unable to remember any new information. Since alcohol is a central nervous system depressant, drinking can also contribute to or worsen depression and sleeping disturbances.

So as you can see, there are many good reasons besides violence or emotional abuse for an alcoholic to stop drinking. But you're right in that ultimately, the decision to continue or stop drinking is the drinker's, and only he or she can make or follow through on it.

What can you do? One possibility is to attend meetings of Al-Anon, the free community support groups for family and loved ones of alcoholics. You might also explore what in YOUR life and personal choices has contributed to your becoming involved with more than one alcoholic (you mentioned your last husband had a drinking problem). Counseling might also help you examine all these issues more fully.

And you can always tell your boyfriend the truth: You care about him and his physical and emotional health, and so you want him to stop drinking. You could ask him to attend Alcoholics Anonymous (AA) meetings while you're in Al-Anon groups. If he denies he has a problem, you might suggest he see a qualified professional for an assessment and agree to take the results as indication of whether or not he truly has a problem. (Someone in your Al-Anon or an AA group should be able to provide you with the names of appropriate professionals.) If he does appear to have a problem but refuses to stop drinking, then the ball will be in your court, and you will need to decide whether to accept his behavior (while not enabling it) or end the relationship.