how soon can I take leave from a new job for in-patient alcoholism treatment?

by Alison Green on November 24, 2025

A reader writes:

This month, I started a new job that offers excellent benefits, including a policy stating that employees who “self-identify” on an addiction issue can take time off to get help without penalty. As a high-functioning untreated alcoholic, I’m very grateful for this, but unsure how to navigate it. (Kudos to all the authors of personnel policies out there who wrote language like this. Sincerely, those folks need to know how grateful some employees are for those clauses! Thank you! You are helping people!)

Here’s the situation: I’ve had a long-term drinking problem and know in-patient treatment would finally help me address it. Out-patient didn’t stick, and in-patient programs have told me I’m “not bad enough” to deserve a bed, but that’s subjective, and I really want the help. I’m going to go eventually. I’m going to get well and turn my life around, and I have a good job and mortgage to go back to. I’m worthy of real treatment, I say partially to convince myself this is okay!

My dilemma is about timing. I’m fresh on the job, and I’ve been working hard to establish myself. My new boss even described me as “indispensable,” and that is the reputation I want to keep. I’d love to be transparent, but I also don’t want to jeopardize the trust I’m building or seem unreliable so soon after starting.

When is it appropriate for a new employee to “self-identify” and use medical leave benefits for something like addiction treatment? Should I wait six months? A year? Or is it better to be up-front as soon as I’m ready to seek help? I would go tomorrow if I could. This job is so important to me, but I’ll keep sweeping my problem under the rug as long as no one hints it’s observable.

(And I literally have to have a half a beer before work and another on lunch to keep the shakes at bay, it’s that bad. I drink 7% ABV beer.)

P.S. I have found AA unhelpful, please don’t try to coerce me into it like everyone else. If AA was going to help me, it already would have.

The only responsible answer is to go now. If your health depends on it, you have to go now. If you’re drinking and driving or doing anything else that puts you or others in danger, you have to go now.

And addicts are notorious for misjudging how much danger they’re really putting themselves and others in — especially when they’ve been high-functioning for a long time — so I don’t see how there’s any answer here other than to go now.

But I understand what you’re asking, so in the most practical terms: does the policy indicate that you need to have worked there for a certain amount to time before you’re eligible for this leave and the associated job protection? FMLA protects your job for up to three months per year when you need time off for medical reasons, but it doesn’t kick in until you’ve worked there a year. Even if this job doesn’t explicitly lay out a similar waiting period, is it worded as “the company may give time off for treatment without penalty” or “the company will give time off for treatment without penalty”? Legally there’s a difference in how binding those each are. I’d like to think that a company that recognizes the importance of making it possible for people to seek treatment isn’t putting caveats on it like that, but you’re essentially asking how protected you’ll be, and that’s a relevant part of the answer.

In addition, if your employer has 15 or more employees, you may also be protected by the Americans with Disabilities Act because you’re seeking treatment, and there’s no waiting period for that to kick in.

You could also talk to HR about exactly what would be shared with your manager. Ideally they’d only be told that you’re out for emergency medical leave, without details beyond that.

But I’ll tell you this: if I had a new employee who had been doing well (well enough for me to have already called them “indispensable” a month into the job!) and they needed leave for in-patient treatment, I’d be glad they were taking it and I’d be glad my company offered it. It might be aggravating to try to get their work covered for that period and I might feel blindsided by it (they just started so we thought the work was covered now), but I’d no more hold it against them than if they suddenly needed to be hospitalized for any non-addiction medical issue. Frankly, that would be true even if they weren’t kicking ass at the job — but the fact that they were would make me extra glad that they were getting treatment so they could come back and continue the work. It would be a complication but not a disaster.

Go get treatment.

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  1. Ask a Manager* Post author

    Keep in mind the letter-writer isn’t looking for input on the specifics of their recovery plan (nor is this site an appropriate place to advise on that); they’re asking for advice on the workplace part of the question. Thank you.

  2. Justin*

    Yeah it’s a medical issue, and if a new employee was diagnosed with cancer or some such, I guess they could be mean about it but they wouldn’t judge. So, take care of yourself!

    1. Cmdrshprd*

      I agree with most everything you said, but I do think as a society in general there is still much more of a stigma on addiction issues versus something like cancer and people thinking people who have addiction issues brought it on themselves. Some people might judge, so wanting to keep the specific issue undisclosed is understandable.

      It is tough, another one of those issues where things/stigma won’t necessarily get better if don’t disclose and allow it to seem more common place, but at the same time understandable for people to not want to disclose and deal with the risks.

      1. Justin*

        No no no I was not saying to disclose! I was saying that if they tell their supervisor etc it’s a serious medical issue they’ll do alright.

      2. BridgeofFire*

        It really is unfortunate. One of my favorite Mitch Hedberg (RIP) quotes from his stand-up routines nails it, IMO. “Alcoholism is a disease, but it’s the only disease you can get yelled at for having. “Dammit, Otto, you’re an alcoholic!” “Dammit, Otto, you have lupus!” One of these doesn’t sound quite right.”

        2. Glenn*

          Totally agreed… except it’s not so much the only example. I would say lots of mental illnesses are also in this bucket, to some extent. Including all sorts of other addictions and substance abuse disorders, but not just those.

            1. Rainy*

              I have so many personal examples of this exact thing, you would not believe.

              Anytime someone says “X is the only health condition it’s acceptable to be blamed for” it is *definitely* not.

    2. Anon for this*

      I’ve learned from AAM that the less said the better. Honestly, for everyone.
      My husband died after a short illness.
      Because…
      yes, he died from cancer.
      Yes, it was lung cancer.
      Yes. He smoked.
      From the time he was 12.
      And yeah, that’s why.
      It even lists “smoking” on his death certificate.
      He tried EVERYTHING. I started smoking so he could quit with ME.
      He couldn’t quit.
      But I say lung cancer and people are going to have feelings about it.

      1. The Rise and Fall of Sanctuary Moon*

        God, that is awful. I’m so sorry your husband passed away. I’m also really sorry that people are having their feelings at you in such an inappropriate way about smoking. They have no right to make your grief harder. Virtual hugs from an internet stranger if you want them.

      2. someone anon*

        I am so sorry for your loss, and so sorry you have to deal with people making it into an opportunity for self-righteousness.

        1. Not Tom, Just Petty*

          Thank you and everyone for reading and understanding. And I hope my husband and Mitch Hedberg are laughing together now.

      3. I don't know Star Trek*

        One of my dance teachers had non-hodgkins lymphoma–she was about 22 or so when she was diagnosed. Did chemo and beat the cancer! But, it left her with what she described as “holes” in her lungs, and she needed a double lung transplant and was on oxygen. She didn’t get the transplant, and passed when I was in high school, right before Christmas. My grandparents were in town for their annual visit and my mom was taking my sister and I to a vigil at my dance studio for her, and when my grandpa asked how she died and I said “she didn’t get the lung transplant she needed in time,” he said she shouldn’t have smoked in the first place. She never smoked, but when most people hear “need a lung transplant” they automatically assume the person smoked, and that somehow makes them less deserving of care/treatment/etc.

        My condolences on your loss.

        1. Susannah*

          What a sad, tragic story. I’m so sorry.
          I have a theory about this – that people aren’t (only, or purely) judgmental, but that they are afraid and trying to convince themselves that THEY will never have to face a particular illness. So, thinking – oh, I don’t overeat, I don’t smoke or drink to excess, I don’t play contact sports, whatever – and so someone who suffers from alcoholism, cirrhosis, lung cancer or diabetes – well, that’s THEIR fault.
          Somewhat related: when I was reporting in a war zone, and we had colleagues who were injured/captured or worse because they went into an area with mines or shelling, we’d be horrified and sympathetic, but then people would start saying things like, oh, I KNEW not to go into THAT era, or whatever. It’s not even that people were blaming thie colleagues who were in danger or worse – it’s that they wanted to convince themselves that they were not in the same danger.
          But we can all get sick. An inconvenient truth.

          1. small canadian*

            thank you, this is actually a really helpful point. I will remember it next time I’m about to get defensive about comments like that.

      4. Elizabeth West*

        I am so sorry.

        As a recovered nicotine addict who knows how difficult it is to quit, you will get no judgment from me. Only *hugs*

        1. Skipper*

          My mom was diagnosed with COPD when she was in the hospital with a broken leg. When I tell people, their first question is if she smoked. I think sometimes it’s unthinking people wanting to show how smart they are, that they know something about how lung disease can happen. And some of them are judgemental jerks. So now I just say “no, she never smoked” – because it’s none of their business, and they don’t get to judge my mom. I know of at least one other person who stopped smoking many, many years before they got sick, and they still got sick. If someone is in that category OR if they weren’t ever able to stop, they still don’t need to be judged.

          I’ve learned the hard way that I never know who will have inaccurate and judgemental ideas about stuff – lung cancer, ADHD, etc., so until I know someone well, I don’t talk about that stuff. I really don’t need to feel unnecessarily defensive about my life.

          1. Skipper*

            Just remembered about my close friend who died of chirrosis. Yes, she had issues with alcohol, but it’s always more complicated than just one thing. I think compassion, not judgement is what is called for. I maintain that she died of loneliness and not being able to manage the many difficult things that life threw at her. I miss her so much, and it’s been years. I often want to tell her things that none of my other friends would respond to the same way.

            1. Annon for this*

              Thank you for saying this and appreciating the whole person that she was. Too often people with addictions are defined by that single aspect of a complex person.

          2. MM*

            People want to reassure themselves that because THEY aren’t doing the bad thing, that scary fate won’t–can’t–happen to them. They do this at the expense of literally anyone else, all the time. This includes people who probably consider themselves generally compassionate people who are sympathetic to people’s varying circumstances and so on. You experience it constantly when you’re chronically ill and/or disabled. They instantly want to know what you did to deserve it (they don’t put it in those terms, but that’s what it boils down to) so they can retreat to their illusions of imperviousness and stop having to confront how fragile and mortal every human body really is.

      6. Rainy*

        I am so very sorry for your loss.

        My first husband finally quit smoking for good after a disabling stroke. That’s what it took for him to quit, and while I do think that quitting prolonged his life, he still died from the stroke, it just took more years than it might have otherwise done. The more I learn about addiction, and nicotine addiction specifically, the more I think that we don’t actually understand much about it at all.

      7. Mid*

        My grandmother started smoking in the second grade (age 8 or so), because reps GAVE KIDS CIGARETTES on the playground. She never had a chance at that point. She hated it, she was ashamed of it, she tried her best to hide it and to quit, but she literally grew up addicted to smoking. Smoking is intentionally designed to be addictive, it’s deeply unfair to blame people for having trouble quitting. No one deserves cancer, or COPD, or any other side effect from smoking, or to be shamed for it.

    3. MCMonkeyBean*

      If a new employee had a cancer diagnosis certainly no one would judge–but unfortunately a lot of places don’t have health insurance that starts immediately on hire.

      I think that’s similar to the potentially complicating factor here. Ideally OP could go get the treatment they need right away, but if this is a benefit being offered by the company then they probably do need to talk to someone in HR and find out if there are any kind of timeline stipulations on when this benefit is available to them.

      I hope OPs is able to go get the help they need ASAP!

  3. Grumpy Daddy*

    Agreed you should get treatment now, but if you can run this by an employee-side employment attorney first, you can make sure you’re protecting your job. I definitely understand not wanting to lose that in this economy and at this time in your life.

    1. Anonym*

      Very wise – get guidance from an expert on how to navigate this. The attorney can guide you on the basis of both their expertise and the specifics of your situation and the company’s policies.

      You deserve treatment (and well-being!) and you deserve the best possible support while getting it.

      1. Not Everyone Can Wear Sandwiches*

        Agreed. An expert that is connected to you rather than the employer can analyze the exact legal meaning of the words.

    2. ArtsNerd*

      Yeah, I was going to comment to warn that LW might be too new to know whether they can trust benefits-on-paper, and that there might be retaliation or other weirdness for taking advantage of your benefits or even legal rights. (Have run into that for other issues in multiple workplaces.)

      But AAM is right: this is not something to wait-and-see about. Even **if** your employer ends up being weird about it, your life, health and the safety of everyone around you are far more important.

    3. Ellie*

      I wonder if OP’s company offers any kind of EAP program. If there’s counselling available, that should be OP’s first stop and they will be able to advise on when the leave can be taken and what that looks like.

      Put it this way OP – right now you are doing well. No-one knows about your addiction, and it hasn’t affected anything work related yet. Your boss thinks highly of you. But that could all change in an instant. You admit that you’re drinking every day. How long will it be before you have an accident, or fail a breathalyser, or slur your words, or someone smells alcohol on your breath at 9 in the morning, or you go on a bender and come in late, or not at all. How long can you keep all that up? Because as soon as you start to slip, that goodwill you’ve built up may disappear. Isn’t it better to get ahead of all that, and seek treatment now? What if your boss does get upset, but the in treatment program works, and you stop drinking? Is that not worth it?

  4. Dryjanuary9yrchamp*

    As someone who left to go to treatment, and came back to no job (I was an assistant at a two person company), I can tell you it was 100% worth it. If your company can facilitate it, even better. I actually had the woman who I worked for reach out to me the other day, 9 years later, to tell me how proud she is of me and how highly she thinks of me. So it is hard, really really scary but it’s not the end of the reputation you have built. I’m wishing the best for you!!!

    2. Slow Gin Lizz*

      That’s wonderful! I mean, not about losing the job, but I’m glad she still thinks so highly of you. Congratulations!

    3. Grumpy Elder Millennial*

      Well done for making the difficult choice to take care of yourself and for doing the work.

      1. Dryjanuary9yrchamp*

        I can say that when I made the decision to go, like really decided that today’s the day and put it in motion, that was the most at peace I had felt in a while. If the LW feels remotely the same way, my advice is ride that momentum while it’s there.

  6. Yup*

    I’m just going to say kudos for prioritizing yourself and your health and life, and for recognizing this program is ideal for you, as well as thinking about how it will affect your employer and your position. Go, go, go of course. But also know you should be very proud of yourself for all of this. Best of luck – everyone is rooting for you.

    1. Llama Energy*

      Wanting to echo this. OP is being very brave and should be very proud of themself, and I hope the program is helpful.

  7. TheErstwhileLibrarian*

    As someone closely related to a high-functioning alcoholic, all I can say is it’s better to go now, because it will become a serious issue much faster than you think it will.

    Thank you for being willing to seek the treatment that will work for you. You have all my best wishes for recovery, healing, and peace for yourself and the ones you love–I’m pulling for you.

      1. hypoglycemic rage (she/her)*

        As the daughter of an alcoholic who is also now deceased, I cosign this cosign.

        Huge props to you, OP.

    2. Family member*

      Hear hear.
      In hindsight a loved one was a functioning alcoholic, but I never saw it. He was SO dependable, SO consistent in caring for others. But then he got into his 60s, his liver quit working, and he did treatment but kept having setbacks, then died of complications from cirrhosis. He was an AMAZING man. But I look back and wonder if he had been a little more “selfish” in getting treatment earlier in life if he could have continued being amazing for another few decades.

    3. Ama*

      Yes I have seen the consequences in my own family of alcoholics that couldn’t recognize they needed help so you are already doing so good just to get to that point! I will be thinking positive thoughts for you.

    4. Kammy6707*

      This comment. My husband’s skin and eyes turned yellow, his stomach was huge and bloated but his body lost all fat and muscle (stomach issues from drinking kept him from eating – he threw up all the time). I thought I was going to lose him. Your body has a breaking point.

  8. MK*

    I am not sure I understand: OP says ” in-patient programs have told me I’m “not bad enough” “, so how can they control the timing, when they aren’t even considered eligible for these programs? Is this for the eventuality when they will reach a point bad enough to be hospitalized, and wants to be prepared to discuss it with their employer?

    1. Kaitlyn*

      I’m assuming this is funded vs unfunded treatment, but now that private benefits cover it, the “bad enough” issue is moot.

      1. bamcheeks*

        OR LW is engaged in magical thinking which allows them to believe there is a solution out there, that they will definitely take, one day, when they’re ready, when the circumstances are right, not yet, because for obvious reasons they can’t go yet, for now they’ve got to keep drinking, but they will, one day, definitely.

        I hope it’s not that, and I really, really hope LW can make the call today and start changing today.

        1. But Of Course*

          Yes, it’s definitely “magical thinking” to want to be able to use your benefits to seek treatment and to have a job when you come back so that you can pay your mortgage, rather than the kind of practical risk analysis most people engage in at some point, the one where you have to decide whether the risk of losing your job is worth disclosing a condition, or reporting harassment, or telling someone what you think of them. Seems really rude to decide you and you alone know what’s going on for the LW!

        2. Hydrator*

          I don’t think we have enough info to assume that? If LW is excited because a new job puts inpatient treatment in reach, that’s kind of reasonable. And the difficulty of LW’s immediate circumstances is real, though it doesn’t need to be prohibitive.

          Anecdote alert! I struggled for years to stop, trying and failing, until somebody on a support site mentioned short-term inpatient detox. The light went on, and I was certain that was The Answer — but I couldn’t do it right away. So my idea could easily have been discounted as magical thinking, etc. But in my case, when I went, it WAS The Answer, and I’ve been sober for nearly five years.

          That said: LW, I’m with Alison. Go. This burden can be lifted, and there are much better days ahead for you.

          1. bamcheeks*

            Yeah, I hope so! I’m not trying to rain on LW’s vibe, and getting to the point where you can say “I am an alcoholic and I need to stop drinking” is a huge step that many people never get to. But equally, many people also don’t get past that step, and “I will stop drinking, but not yet, because the stars haven’t yet aligned in exactly the right way” is one of the things people tell themselves to justify continuing to drink.

            I absolutely don’t claim that I know which LW is, but I also believe that nobody knows for sure which they themselves are until the day they do actually stop. I hope it’s the latter but — you don’t know until you take the step.

            1. metadata minion*

              I realize addiction is way more stigmatized than cancer, so this isn’t intended to equate our situations, but just as a data point on “hey, turns out I need serious medical treatment right after starting a job” — right before I started my current job, I got a call from the doctor saying that the results came back from the specialist and we’re so sorry, it is actually cancer and you need surgery. Luckily for me, it was very early stage and the actual Oh No Cancer aspect of it wasn’t a big deal. But it was still nontrivial surgery, when I was still doing things like setting up my new health insurance.

              And my employers, who are generally awesome people, said “oh dear, we’re sorry to hear that; let us know what we can do to help!”. And I got the surgery and am doing fine and my job is also doing fine. In a way, I think it actually makes it easier when you haven’t been there very long, because there just hasn’t been the time to get involved in really complex projects that it’s going to be a pain to put on hold.

          2. Not Everyone Can Wear Sandwiches*

            I think we can be safe in assuming that an insurance issue, resolved by getting different insurance, can make treatment possible where it wasn’t before.

            What insurances will cover can vary vastly between systems / plans within the system. My assistive devices used to be covered and now they are not.

        3. Productivity Pigeon*

          I think that is a bit harsh based simply on the information in the letter.

          It might be excuses, it might not. If LW hasn’t had insurance coverage, how do you suggest they should’ve been able to access in-patient rehab?

          1. Radioactive Cyborg Llama*

            +1. The idea that the LW should have taken advantage of the beneficent American health care system before this is a little out of touch. They’ve literally tried other options.

        4. wounded, erratic stink bugs*

          Maybe, but writing in to ask for advice on how to determine when the circumstances are right suggests that they genuinely are on the path to doing this. It’s a hard path and I commend them for it!

        5. C*

          This is a pretty uncharitable reading of the OP’s post. They sound like they’ve done some thorough analysis of their state and desire for treatment, so it’s especially unhelpful to second-guess their reasons, particularly with such an undermining angle.

          1. bamcheeks*

            I don’t think it is undermining or uncharitable, but I apologise to LW if it sounds it. I just meant it as a recognition that that magical thinking and self-deceit thinking are a huge part of what alcoholism is: it’s not a judgment on them as a good or a bad person, it’s just how addiction works. To me it seems much more undermining not to name the fact that addiction works like that.

        6. wanda*

          Some complications of alcohol withdrawal are life-threatening. If this person is enough of an alcoholic that they get “the shakes” if they don’t drink for a few hours, it’s probably a good idea for them to have medical supervision to detox. That is something you need to plan for.

          1. Teapot Connoisseuse*

            This. Very much this. My husband saw what happened to a friend of his who did this without medical supervision.

        7. JSPA*

          LW has literally sought out in-patient care, and been stymied by lack of insurance to cover it, and by not qualifying for unfunded care because they’re not quite losing life or organs (yet), and is saying they’d be ready to go tomorrow, if it won’t destroy their career. So while your screed is no doubt true of many people, it is strangely off base and needlessly accusatory, when pointed at the writer of this letter.

        8. D*

          I don’t know; I had a family member get court-ordered in-patient rehab, and the rehab then told him that he didn’t NEED in-patient, he could do out-patient rehab!

          He then proceeded to drink during the entire period, then got refused into the in-patient rehab center routinely because he was drunk and they couldn’t let that affect the other patients.

          Sometimes rehabs SUCK.

      2. Dulcinea47*

        I’m very curious as to whether this is true. Just b/c the employer encourages people to take time to get treatment, doesn’t mean the insurance is going to agree to pay for inpatient treatment. But maybe it does?

        I’ve seen way too many people who really needed mental health/substance abuse help just get kicked out of care as fast as possible due to insurance to take it for granted that any in patient care would be covered.

        1. Lifelong student*

          Absolutely agree with this consideration re insurance. Insurance loves to deny coverage for things- even sometime when recommended by medical providers if the insurance company wants other (cheaper) alternatives tried first. Also- “self-identify” would probably not satisfy FMLA or ADA rquirements. Explore all the pitfalls before going public.

        2. RegBarclay*

          That’s what I was wondering – the letter focuses on being able to take time off, but surely it being covered by insurance and OP being able to get a spot are the more important parts of the equation?

          Maybe since the new employer spells out that people can take time off for this it’s an issue that’s important to the people in charge and they prioritized good coverage for recovery, etc in their insurance.

      3. Ellie*

        That’s what I assumed. When we suspected that my daughter had a learning disorder, they told me that on the public system, she would never get diagnosed, let alone treated. There was a minimum 6 year waiting list, but she was not ‘bad enough’ to move up and would never make it to the top. So we paid for it out of pocket and the whole thing got handled within a few months. Ironically, since we paid for the diagnosis, she now qualifies for some public interventions.

        Health systems everywhere are in crisis. They likely do not have the funding to help anyone who does not require immediate hospitalisation. But if you can pay for it, there is always a way.

      4. MCMonkeyBean*

        Yeah, I took this to mean like “not bad enough to be covered by insurance” or something but now the company will cover it so they can get the help they need.

    2. ferrina*

      I was wondering if there were waitlists for in-patient programs. If so, get on that waitlist now. Take your bed when it’s offered. Don’t delay necessary medical treatment.

      2. Enai*

        Yes, ferrina is right. And I’ve never heard of any evidence-based, administered by certified providers mental health treatment that didn’t have a waitlist a mile long.

    3. Anon for This*

      Very straightforward answer—programs such as this will usually do a phone screening/intro call before you even get to an in-person clinical admission. This is where they tell you that without insurance it’ll cost you $10,000—or whatever. (Source: I made a bunch of these calls.)

    4. Anonymous22*

      Also, speaking from experience, such evaluations are a bit flexible and can be modified. I was sent to an inpatient program and on the final intake interview admitted to when I’d last been drunk. I REALLY wasn’t functioning well, desperately wanted in, and thought that well, I was pretty sober right then, so, what did it matter when I last drank. It seemed logical at the time.

      That particular program didn’t take people they thought might best attend an outpatient program and/or community groups while maintaining their daily lives, but also didn’t take people who couldn’t maintain at least a minimum period of sobriety. There was a separate detox facility and in theory once you got out of there, your brain was straight enough to handle the next step in treatment.

      The man doing the final intake interview let me in anyway. That program – and a lengthy period of outpatient work afterwards – probably saved my life.

      I second the comments saying that LW probably needs immediate help even more than they realize they do. Your brain lies to you, and you don’t understand that’s what’s happening because the lies feel right.

      1. Steve*

        The way we word things can have interpretations we don’t always understand. I say this specifically about a friend who had serious mental health issues and went to the hospital a few times for help. The first couple times when they asked about my friend’s health he responded that everything was mostly okay – because in that moment, in a hospital, he was feeling better. Because of this they pushed him out. As soon as he left the hospital he felt unable to cope with his health. After a couple of these a friend of his with experience said to answer all the questions with the feelings he has when he’s not in the hospital. On the next visit those responses set off different flags, he got into an evaluation program for mental health diagnoses, he got a new and correct diagnosis, got treatment, and now he’s been healthy for a decade.

        I know OP’s situation is different, but I wrote my friend’s situation to flag that we don’t always have a good system for deciding what data points are best for treatment. Even fairly simple and routine medical questions like “How much pain are you in from 1 to 10, where 10 is the worst pain you can imagine?” can vary widely. Thankfully, despite my giving a low number, an ER doc sent me on for further testing and I had my appendix removed the same day. I was comparing to my limb being chopped off without anaesthetic, so my stomach pain felt relatively reasonable!

        OP should be mindful that most health questions have answers that vary for an individual over time, and maybe answer the questions based on how they are on their worst days and not on their best.

        1. Rainbow Unicorn*

          Tangent: pain scales based on “the worst pain you can imagine” or “the worst pain you’ve ever experienced” are awful. Both imagination and prior experience vary widely. And that’s before getting into some people being more sensitive to pain, and rightly thinking “the average person wouldn’t be able to feel this at all, but I know something is wrong because this part of my body shouldn’t feel like this.”

          Pain scales based on impact on functionality (e.g. “the pain prevents me from [task]”, “the pain distracts me from [task] [performance measure if you have one]”, “the pain makes it hard for me to sleep”, …) are better, but still not perfect. They still don’t capture personal experience and self-knowledge, but at least they don’t lean on imagination or prior experience for their baselines.

          And make sure to include lingering effects! “If I [task] I’ll be sore for the next day / I’ll be winded / I won’t be able to do [other task] for the next week” is important information.

          (Signed, someone who’s had to stay in an allergist’s waiting room for several extra hours after an allergy test due to tiny itches away from the testing patch with instant starts and stops. No regrets on staying under supervision to be safe, but my doctor and I are pretty sure that was from single molecule detection of the positive control moving around my body and occasionally latching onto other histamine receptors. Anyone who properly understands how biological half-lives work will tell you that medications do generally work that way but conscious awareness of such tiny amounts is insanely rare. Hence, doctors seeing me as a “rainbow unicorn” patient.)

    5. treatment center employee*

      It really is subjective sometimes, just like LW says. At one center you might be just below the threshold of what warrants admission to their program, at another you’d be just above. It is definitely worth it for someone to keep calling places and seeing if it’s the right fit even if one place told them they weren’t quite “bad enough.” I wish it wasn’t so complicated to find the help you need, but sometimes it is.

  9. Insert Pun Here*

    OP, I knew someone like you—high-functioning, great at their job, wholly dependent on alcohol. Please, please get treatment as soon as you can. The job will be there when you finish, or it won’t. The person I knew is dead now and that’s forever.

    Good luck. I’m rooting for you.

    1. Anon for this*

      I knew someone like this too. Her death was caused by lots of factors but alcoholism may have played a role. The pain of her loss will never ever go away.

      OP, sending you so many good wishes, and kudos on your bravery and clear vision. The people who love you are lucky that you are focused on getting better. It sounds like you have a life you value–you are worthy of real treatment so you can get back to it!

  11. Moira's Rose's Garden*

    OP, a few things here:

    1. In case it is helpful to hear: AA is a great support for many people recovering from biobehavioral illnesses – which is what addictions are. But much the same way only a small minority of other kinds of biological illnesses would respond only to managment with a support group, AA *by itself* will not be sufficient treatment for the LARGE majority of people, and many many others find different support models more helpful.

    2. There

    1. Moira's Rose's Garden*

      Argh! Sorry, hit post:

      2. There are a lot of really good medications out to help now, and inpatient can be a great start.

      3. Please also talk to your treatment team about intensive outpatient support in your treatment plan.

      Your having insight into this is a huge step in your favor, but please know this isn’t about willpower, it’s about working to find the right mix of known therapies *that will work for you*, just like not everyone responds to the same anti-hypertensives or cancer treatments!

      Good luck, this internet rando is pulling for you, really!

      (I know there is disagreement on the point, but “addict(s)” as a noun carries a lot of stigma. Context really matters, as does self-claiming, but avoiding using stigmatizing language when offering support is generally recommended by the treatment providers and literature evidence I find most compelling & persuasive.)

      1. Slow Gin Lizz*

        I remember hearing maybe a decade or so ago, maybe longer, that there was a medication that had been developed that was extremely effective in helping people overcome their substance abuse issues but that it hadn’t been approved or wasn’t widely available specifically because SO MANY people (or insurance companies? or doctors? I don’t remember) have such a stigma against addiction and believe that it’s simply a weakness of character and that addiction should only be overcome by hard work on the part of the person who has the issue. I was so enraged by this belief; in so many cases addiction is caused by situations out of the person’s control – it really is a disease, so why not treat it as such???? And additionally, why should this kind of recovery be harder than it needs to be if we can help patients ease their symptoms and treat their disease more effectively?

        I hope your comment is telling me that these medications are now more widely available, right?

        1. fhqwhgads*

          I don’t know if what you read about was GLP1s, but I’ve read things indicating GLP1s are effective at treating additions, not just treating diabetes, and not just for weight loss (or sleep apnea… or high blood pressure).
          So if that’s what you were thinking of, well, they’re available, but are they covered by insurance? It depends. A lot of the time no.

        2. treatment center employee*

          Just piping in here to say I wonder if you’re thinking of medication assisted treatment (MAT) like methadone, suboxone, etc? It’s been around for longer than 10 years but I think it’s gained more attention in recent years. Inside the substance use treatment field it’s seen as a useful aid for treatment and reaching recovery, something frequently used. Outside the field, with the general public who isn’t familiar with addiction, I still see some stigma for the reasons you mentioned, like using a medication to aid your recovery is a crutch or something rather than a useful tool we have at our disposal to treat a disease. But I think, just like a lot of things, people dislike what they don’t understand.

        3. Sparrow*

          Thinking good thoughts to OP and finding the program and medical support that works for them.
          For anyone else reading this who is curious, there are medications that have evidence specifically for alcohol use disorder – naltrexone (as a pill or monthly injection) and acamprosate (and a distant third disulfram or Antabuse), as well as many adjunctive therapies. GLP1s are promising but the large studies (&FDA labelling and insurance coverage…) aren’t there yet. If you or a loved one is struggling with alcohol, please talk to your PCP about them. I’m a PCP and prescribe them often. If your PCP is not comfortable, ask for a referral to an addiction specialist

    2. Brooklynlite*

      I completely disagree with point 1. Sure AA has worked for some people, but it isn’t based in science, often religious in nature, and focuses on an outdated understanding of addiction. If LW needs a support group as part of their treatment plan, I would suggest something that isn’t AA.

      1. Slow Gin Lizz*

        I think you and Moira actually agree, as I think that what Moira is basically saying is that AA can be helpful for some people but that it’s not a failing on OP’s part that it didn’t work for them, because it doesn’t work for a lot of people.

      2. Tio*

        I read point 1 as more about being affirming that AA is NOT the right choice for everyone and there are other options rather than a plug for it

        1. WeinerDog*

          I read it as endorsing AA specifically, in tandem with other treatments. I can’t get behind AA either. I believe the people who said it helped them, but if you have trauma in your past, steps 3 and 4 can actually be really bad for you, and AA is not designed to treat trauma. It was also designed for men specifically and hasn’t been updated since.

          1. Brooklynlite*

            My take as well. There is nothing “great” about AA in my opinion. (Although obviously I support anyone who finds it meaningful in their recovery, and I had a family member that used AA with success.)

            1. Really, I'm Fine*

              These are some pretty far fetched takes on AA. just went to a meeting that discussed the beauty of NOT having to be religious to get sober through the steps. Half the people there were women. The work in steps 4 & 5 are often done in tandem with outside therapy, something that healthy AA members encourage. Funny how Brooklynite says there is nothing “great” about AA but says they know someone who used it successfully. The fellowship has been alive and helping people achieve sobriety for over 75 years. it’s not for everyone, the same as any other option, but it works for and has worked for millions of folks– sometimes when nothing else did

  13. Madame Desmortes*

    Good luck, OP. Getting treatment now can help you and everyone around you toward a better life. I want that for you! Speaking as the adult daughter of a high-functioning alcoholic, I want that for them too!

    All the best to you. I want you to be free of this, whatever that looks like for you. Please update us when you can.

  14. H.Regalis*

    LW, I wish you the best of luck with your treatment. I hope you are able to get into an in-patient program that works for you.

  15. Seashell*

    If you haven’t done so, talk to a primary care doctor or psychiatrist about your options. There may be medical treatment that can help, and you may need detox in a hospital.

    Also, just because outpatient treatment or AA didn’t work in the past doesn’t mean they might not help in the future. Keep an open mind, as it often takes multiple tries to get sober.

    Hope you’re able to get the help you need ASAP!

    1. Friendly Office Bisexual*

      I’m in the addiction and prevention field. AA is not an evidence-based treatment and has strong religious connotations. Many people swear by it, but just as many have found it very unhelpful for a lot of reasons. (For example, AA/NA takes a firm stance against any form of medication-assisted treatment.)

      I don’t think we should be telling people to keep an open mind to it any more than we should be telling them to keep an open mind to going to church.

      Outpatient treatment *could* make sense in the future, but I think we should take LW at their word that they need a higher level of care right now.

      1. iyss*

        Yeah, I’m very happy for people who have been helped by AA, but I hate how often people treat it as the only option. It is totally reasonable for people to say “I tried it and it’s not for me.”
        If for whatever reason OP can’t go in-patient right now, I do think out-patient might be worth another shot in the meantime.

    2. Tobias Funke*

      I can’t believe it only took three comments. Please have some respect for OP. They’re the expert on them.

    4. LeSigh*

      LW: Please don’t bring up AA.
      Commenter: OK but…

      Can we please take the LW at their word? We have no idea how often they tried the program, but it sounds like they did and it wasn’t for them.

    5. Scoops Troop*

      OP specifically said don’t try to strongarm them into AA and here you go doing it, well done on ignoring their request and not answering their actual question related to their job.

    6. Anon Psych*

      Speaking as *a* psychiatrist (and not *your* psychiatrist) AA is not for everyone. It works for some and not for others, and pressuring people to keep trying something that doesn’t work is not appropriate and actually has it’s own harm. I have my own deeply mixed thoughts about AA. I have patients telling me it saved their life–which, great! But I also have patients who decline potentially life-saving, evidence-based interventions because their AA group is giving them the message that all they need is willpower, accountability, and more AA. Or that their recovery doesn’t “count” if they’re “relying” on something else. Bah!

      If someone’s in my office, and they tell me, “AA doesn’t work for me,” I go, “Ok, what was it that didn’t work for you?” And then–imagine! I LISTEN to them and RESPECT their experience and then offer several other options (inpatient! brief withdrawal management stay! outpatient! cbt-based group! mindfulness-based group! individual! naltrexone! acamprosate! gabapentin!) There is SO MUCH HOPE and so many options for people with addictions. AA is not the be-all and end-all.

  16. Spicifer*

    Best of luck to you on your journey, OP. Recognizing you have a problem and taking steps to fix it is huge. Most people in your shoes don’t get to that point. If you believe in-patient treatment will help you, I think it’s a matter of finding the right facility who will take you now.

    For what it’s worth, my cousin is an alcoholic and went to an in-patient facility after 3 months at a new job. It’s what she needed to do, and she’s been sober for over a year now. And she’s still at that same job a year and a half later.

    I hope your employer will support you in your journey, and I wish you success in healing.

  17. mollybdenum*

    Disclaimer: I am not LW’s psychiatrist and this is not medical advice. LW could also consider an intensive outpatient or a partial hospitalization if he/she has been told they aren’t “bad enough for inpatient” (a concept I loathe) – both to get some treatment they may not have tried before and avoid the double whammy of missing work and paying out of pocket for addiction treatment – or worse “outing” self at work, dealing with negative repercussions, and still not accessing care. PHP and IOP are intermediate levels of care in between outpt/AA and inpatient, and often are staffed by either the same people or coworkers of whoever runs the inpatient or residential treatment program. IOP = intensive outpt, depending on organization 2-3 hours 2-3 times a week, sometimes in evenings or outside of normal work hours. PHP = partial hospitalization, usually 5-8 hours/day M-F; both have added benefit of patients going home and facing their fridge and the drive past their store every day and having to deal with that stressor with immediate support the next day (frequent cause of relapse after inpt – we make promises to ourselves we can’t keep in the real world). Depending on when and where OP last accessed outpt, there are several meds that may or may not have been tried (GLP1s for addiction are new within the last year or so – help some with cravings but not the physical dependence described, which unfortunately is what OP needs to focus on to be deemed medically appropriate for care).

    1. amoeba*

      Yeah, or you could have a combination of both? A good friend of mine just did a (medically assisted) inpatient stay, which wasn’t long at all – I believe 10 days? He then got a place for an additional month in partial hospitalisation, and also help to find support for continued outpatient treatment afterwards.

      1. mollybdenum*

        Yes, you can often step up or down levels (the best programs have support to do so). Residential with evening groups is another good option – many people need some sort of “getting treatment while engaging in stressors” for sobriety to stick. I’m glad to hear your friend is doing well.

  18. No Tribble At All*

    Please, please go get treatment ASAP. OP, you said you need another beer at lunchtime or you’ll get the shakes? If it were anything other than drinking, you’d see that it’s a medical crisis — say you weren’t able to get a drink one day, you could absolutely crash yourself and need to be rushed to the ER. You’re riding a bike that’s going downhill too fast. If you wobble at all, you’ll fall off. Treatment will help you put the brakes on the bike so you can slow down safely.

    Best of luck <3

      2. raincoaster*

        They’re a pretty good indicator of a serious problem. They are literally the warning that seizures are the next step.

        Detoxing from alcohol without help can be fatal. I am glad LW is seeking professional help.

      3. amh*

        Alcohol withdrawal if you are a heavy drinker (which the shakes might point to) is absolutely a medical emergency.

        1. Lisa B*

          Absolutely. This is the reason liquor stores were allowed to stay open during pandemic shutdowns here. They really, really didn’t want a bunch of people flooding ERs in severe alcohol withdrawal.

        2. kt*

          Just adding my cheering you on, LW! It’s really, really impressive that you’re thinking about this, and I wish you all the best in your recovery!

        3. hypoglycemic rage (she/her)*

          my dad tried to do this once – I think his dad talked to him about quitting cold turkey, I assume not knowing just how bad he was. I think my grandpa thought he could just power through and would be good in a few days.

          it ended up with him being so disoriented that he crashed and fell into my room from the hallway at like 2am, hitting his head on my bookshelf and also injuring his back. my mom could barely get him off my floor and had to take him to the ER and they got him to detox safely.

      4. Anon for this*

        I am curious, and reading all the comments, I am learning a lot. So I am asking, academically not as a gotcha thing, what are the shakes?
        When I read “the shakes” I thought OP meant he was going into DTs which can kill a person. Is this a different thing?
        Thank you

        1. Ally McBeal*

          Yes, DTs is also known as the shakes. The person commenting that DTs are not a medical emergency is almost certainly not a doctor, addiction specialist, or someone who has a close loved one dealing with alcohol addiction.

        2. Amh*

          I am not an addiction specialist, but I’m the child of someone who died from withdrawal (so died from alcoholism in general): my understanding is the shakes and DT are both part of alcohol withdrawal. Someone with the shakes from withdrawal could very easily end up with the DTs depending on how heavily they drink.

        3. Keymaster of Gozer (She/Her)*

          Muscle cramps basically. Those and the cold sweats were the worst part of me coming off various addictions. And there’s a big part of your brain that’s telling you to go out and get the one substance you know will make you feel better and fighting against your own brain can cause extreme anxiety and shaking.

      5. 1607 days sober*

        I was hospitalized twice for alcohol withdrawal. The shakes are just the start. Believe me, it’s a medical emergency.

      6. Wishful Fishing*

        The shakes are the warning sign of a pending medical emergency the same way that an itchy throat is a pending sign of anaphylaxis. If not treated, it will become life threatening.

        But boy howdy did you just show everyone how little you knowm

        1. Radioactive Cyborg Llama*

          Maybe you know about DTs but you don’t know allergies. Allergy symptoms do not inevitably lead to anaphylaxis, including itchy throat. I’m tired of this myth that allergies are only “real” if you die from them. That is not at all the case.

          1. Wishful Fishing*

            Buddy, I’ve got allergies. I’ve lived this reality every day since I was 3 years old. Not all allergies are fatal, but if someone who was exposed to an allergen tells me their throat is itchy you better believe I’m treating it as anaphylaxis because that shit happens fast.

            And it’s the same with the shakes. Maybe it won’t progress to full blown DT and withdrawal, but the odds of it are high and the consequences are severe.

          2. Arrietty*

            Feeling shaky doesn’t always lead to a medical emergency caused by alcohol dependency, but when some is an alcoholic withdrawing from alcohol it’s a pretty fair bet. Likewise, if someone has an anaphylactic allergy to something and they just ate that thing, a tickle throat is highly likely to be a sign of anaphylaxis.

      7. Productivity Pigeon*

        Alcohol withdrawal is definitely an emergency and not something you can weather at home.
        If LW goes into withdrawal if they don’t drink for a few hours, they need professional help.

      8. Chirpy*

        The reason liquor stores were deemed “essential retail” during Covid lockdowns in 2020 was specifically because the medical system wasn’t going to be able to deal with every alcoholic suddenly being forced to detox on their own and the resulting spike in alcohol detox related medical emergencies. “The shakes” are serious.

      9. Anon MD*

        Yes they are.

        They absolutely must NOT get worse. Ideally, the alcohol withdrawal shakes would be treated. Alcohol and benzodiazepine withdrawal can be fatal. This is why people are found dead in the “drunk tank” or when well meaning family members force a “dry-cation” or the person themselves goes out camping in the woods to force “becoming clean.” Untreated severe alcohol withdrawals kill people. And the withdrawals get worse each and every time.

        Listen to your bodies. Many people with alcohol addiction try to cut back on their own. If anyone here is struggling with alcohol addiction, please be careful and ask for help. Please do not go cold turkey on your own and without having access to withdrawal treatment. I cannot stress this enough.

        There can be long term tremors associated with long term alcohol misuse. However, those are very different and it does not sound like what the OP is discussing.

      10. Amateur Limguist*

        This is a wild take. I’ve seen people here downplay a lot of very serious situations (e.g. ketoacidosis), and I’m never sure why that happens.

      11. NP*

        “ The shakes, while not very fun, are not an actual medical emergency at all.”

        Yes, they are. People can and have died from them. This is dangerous misinformation.

    2. Alexis Moira Rose*

      Responding just to say, yes, “shakes” are a very urgent medical issue because they are a symptom of alcohol withdrawal! Alcohol withdrawal can be very dangerous and life-threatening.

    3. irritable vowel*

      Agreed, and also – OP, if it provides additional motivation, it is almost certainly observable to others if you’re drinking beer before work and during lunch to get through the day. Most people who drink alcohol to that extent give off a noticeable odor – I don’t mean on your breath, but exuding from your skin. Anyone who has a person in their life with this addiction will recognize it. I wish you all the best in your treatment.

  19. CzechMate*

    Just coming to say that I’m sorry it’s been such a saga for you to get the treatment you need and I agree that you should do what you need to do now.

  20. iyss*

    There are lots of people for whom AA doesn’t work! Let’s take OP at their word here. It is not evidence-based, it isn’t compatible with everyone’s religious or spiritual beliefs (or lack thereof), and it doesn’t work for everybody.

    3. tinybutfierce*

      Thank. You.

      I’m nearly 10 years sober and stopped going to twelve step meetings about two months after cutting out drinking. It just wasn’t for me for a variety of reasons and figuring out my own personal roadmap to recovery was far more beneficial for me than sticking to a specific program because people thought I “should” or “had to”.

  21. Anon for now*

    My new employee took a leave of absence for cancer treatment soon after starting. This is no different, you’re undergoing medical treatment.

    1. Em from CT*

      Exactly! Sure, it might be a hassle for the employer to find temporary job cover—but if there’s one thing I’ve learned from reading AAM, it’s that business continuity planning like this is part of a manager’s/company’s job. Cancer happens, diabetes happens, bereavement leave happens. Life intervenes.

  22. Friendly Office Bisexual*

    Good luck LW, you’re worth getting treatment! It sounds like you know how severe the issue is and you know you need to take this time off.

    And I say this not to shame but just to encourage a perspective shift, I would call it a very dysfunctional type of “high functioning” to need alcohol before work and at lunch. It’s the kind of homeostasis that can’t actually be sustained in the long term without significant harm to yourself and/or others. The analogy I’d use is like holding together a broken desk with a few chewed-up pieces of gum, lol. It might work for a certain period of time but eventually disaster will strike. Go get the desk fixed!

    1. My Cabbages!*

      This reminds me of a true story I heard today on a podcast if a building that had built using a miscalculated load, and one day after years of use it suddenly and completely collapsed.

      From the beginning, its weight was too high for the supports, but somehow it kept standing.

      Until, suddenly, it didn’t.

  23. Jules the 3rd*

    No advice, just… best of luck to you. Good on you for recognizing a problem and wanting to solve it. That’s hard.

  24. Elle*

    Unbelievable that they were denied inpatient treatment if they are so addicted that they go through withdrawal symptoms if they don’t drink.

    1. tinybutfierce*

      Recovery centers/rehabs, like much of the medical industry in the U.S., have a lot wrong with them systemically; a big chunk of that is refusing to take patients if they can’t afford the astronomical (and frequently overpriced/predatory) costs.

    2. Harper the Other One*

      Sadly, a lot of programs have such long wait lists that if you can hold a job/maintain day to day life, even by the skin of your teeth, they have to prioritize the person who can’t. EVERYWHERE needs more funding for mental health and addictions treatment.

  25. pomme de terre*

    Best of luck to OP in seeking treatment.

    I’m guessing if the OP works somewhere that has excellent benefits and a carefully worded statement about self-identified addiction, it is probably for a big, well-resourced organization (so there are people to absorb the work) and perhaps in a profession that is prone to addiction issues.

    I had a buddy who worked for a Big Law firm and realized she needed treatment and screwed up her courage to ask for help and navigate FMLA, etc, and when she went to HR they were like, “You think you’re the first lawyer ever to deal with alcoholism? We do this all the time. Here’s the form. Good luck.” For her it was validating (and funny) that her Big Scary Thing was someone else’s Tuesday. It made it feel less big and less scary.

    2. Another One*

      I remember realizing before I went to law school (when working as a paralegal) that alcoholism is a huge issue in the legal field, which made sense to me given that amount of alcohol consumed at every office event.

      The (legal) bars at the time were starting a big push for lawyers to get self-identify as needing help before it was a real problem.

      1. FishOutofWater*

        A huge percentage of the local bar association’s programming is focused on identification and treatment of substance abuse problems. HUGE. They have a whole division devoted just to this.

    3. ursula*

      This really reinforces LW’s point about the benefit of companies with these friendly policies writing them openly into policy manuals!

    4. small canadian*

      had a similar experience asking for assistance with stress-related medical leave (I work in the software industry)… validating and also bleak!

  27. Corvidia*

    I hope you get what you need as soon as possible, LW. All best wishes.
    I’m sure we’d all be glad to hear an update from you in the future.

  28. Keymaster of Gozer (She/Her)*

    As a former alcoholic, and former manager, I’d say to adopt a different state of mind. You have a serious medical problem (if you’re getting withdrawl shakes I KNOW how horrible those are and how BAD a sign that is) that could be fixed by treatment.

    Take the morality etc. out of it. I wouldn’t care if someone had been working for me for a month or 20 years – if they need serious medical help then I’ll do everything I can to help them get it.

    It’s like if you had a serious bout of mental illness (which I also have experience with) and being inpatient would save your life. Both are stigmatitised unfairly.

    Go get the help, don’t put it off. And I wish you all the healing in the world. It was a long road for me to stop drinking alcohol but I’ve been teetotal for over 10 years now. The medical professionals I dealt with (I was also coming off some much nastier stuff) were very, very good.

    1. Keymaster of Gozer (She/Her)*

      Oh and, in both cases (the detoxing and the depression going out of control) I just told my manager that I had an urgent medical issue that would be fatal if left untreated.

      1. Alexander Graham Yell*

        Keymaster, thank you so much for including the specific language you used. I think while many of us would want an employee to do what they need to for their health, it can be terrifying to figure out how to bring it up. This language is so true, and not in the “I mean it’s technically true but…” way. OP, you have a medical issue that could kill you if you’re not able to get this treatment. You have a chance to get it now, take it as soon as you can.

      2. Rainbow Unicorn*

        Keymaster, thank you for sharing your experience with both compassion and honesty. Not only are your comments here useful to the OP, they’re a great example of what it looks like to avoid sugar-coating or softening one’s words for the recipient’s benefit.

    2. Me, Myself and Fries*

      Well said. Best wished to OP. Also, don’t assume that the before work and lunch beer aren’t, or can’t be detected by new, great job.

    3. Jean (just Jean)*

      Keymaster, this internet stranger wants to compliment you on your strength in overcoming an enormously difficult problem. Your comments are always useful and compassionate. I will screenshot your answer today to remind me that it’s possible to face down and solve whatever problem I think is un-solvable. It may take lots of time but it can be done. And now I’m wobbling back to continue my own imperfect efforts to face and solve my own personal monster challenge. Internet hugs if you want them, or a handshake or a respectful bow.

    4. Amateur Limguist*

      Seriously. Earlier in the year someone had a severe illness and was hospitalised. My boss tried to lay down the law that he was not to come back to work until X date, but he popped up in meetings and wouldn’t simply stay off until he got better. She had me report to her if he was in an external meeting (which are a bit more stressful than internal meetings) and after one instance of that in a team meeting he got the hint and stayed off for a bit longer.

  29. Anon for This*

    OP, I’m pulling for you so hard. You do deserve help! It doesn’t have to be “that bad.” (God, why do medical professionals do this? I had a nurse tell me one time I probably didn’t need treatment for depression because “you’re smiling, it can’t be that bad.” Joke’s on her, I promptly burst into sobs because it was that bad.) You know you need to get better, and that’s what matters. Huge huge kudos to you for doing it.

    As one addict to another (hi, former high-functioning alcoholic, here) please know this: there are as many paths to sobriety as there are addicts. Do what you need to do. I needed four years of countless “day ones,” intensive outpatient treatment, medication support, and concurrent anti-depressant prescriptions. Some people need AA. My aunt needed science-based SMART Recovery meetings and permission from herself to eat as much candy as she wanted as long as she wasn’t drinking. So do what you gotta do.

    The other thing is—I actually lost my job when I took leave to get the intensive outpatient treatment. Oh, really it was I got put on a PIP after coming back and they decided “not to renew my contract,” but functionally it’s the same thing, right? And I still, one hundred percent, with utter and absolute conviction, will tell you that it was worth it to me. Sure, I wish I hadn’t lost the job; I’d probably be in better financial shape right now. But if that’s the price I had to pay for sobriety, I’ll pay it, because sobriety has enriched my life ten thousand times more than that job ever did, and even though I’ve been sober for two years now, I still wake up literally every single day and feel grateful for the life I have now that I’m sober.

    I join you in your appreciation for the HR professionals who make this possible. Thank you, truly, to everyone who writes those policies.

    Sending you huge internet hugs.

    1. Slow Gin Lizz*

      Hugs and thank you for sharing! I have quite a number of people in my family with alcohol use disorder and most of them never tried getting treatment for it, so I’m always very impressed and heartened by those who get to recovery and stay there. The one family member I know of who did go through treatment also fell off the wagon at one point but then got back on it and has been sober ever since, so I know how hard it can be to stay sober. I love your sentiment that your life is so much better now that you are sober, that’s wonderful.

    2. Grumpy Elder Millennial*

      Giant internet high-fives to you, Anon. It sounds like you traveled a very difficult road to getting sober. But you did it and you’re still doing it.

      Also, I hope that nurse has the day she deserves.

  30. Law H*

    I’ll offer that it’s worth checking with the treatment program about when they’ll be able to take you. I connect with these programs sometimes for work and often they may not be able to take new patients for a month or multiple weeks. So good to know what that timeline is and factor that in to your communication plan with work. Good luck, I hope a year from now we’re getting an update about how great things are going.

    1. Ragewalker*

      I second this completely! Having your name down somewhere (or a couple of somewheres) can help with the communication with work like Law H said, and give you a bit of a mental boost that you are doing something to get the process rolling.

  31. Do these bananapants make my bum look big?*

    OP, I look forward to the day when you look back on this post and say “why did i wait a single moment to get help” because your life is so much better.

    Also, on the timing question, which do you think is preferable to your employer: you going to HR TODAY and asking to go on leave, or losing an indispensable employee because they were found to be drinking on the job? I love that Alison went into more detail, but her initial answer is still the best one: RIGHT THE HECK NOW.

  32. tinybutfierce*

    As someone who’s almost 10 years sober from alcohol, I just want to give the OP all the support for knowing they need help and actually seeking it. And thank you, Alison, for your empathetic and supportive response.

    1. Anon for This*

      Amen. Alison, I think you’re the manager many of us wish we had—and a wonderful example of how to be a human modelling empathy and kindness. <3

  33. Syzygy*

    LW, congratulations on recognizing what you need to do, and taking steps towards getting there. Your life is important! You deserve to get the help you need! I hope that a year from now we get an update from you. Wishing you all the best.

  34. PickleJar*

    I have a couple of longtime friends who tell themselves (and others) that they are “high functioning” alcoholics. They are not.

      1. Junior Dev (now midlevel)*

        To me it seems useful to point out to OP that their self-assessment may not be accurate. I have other mental health problems (not substance abuse) and a big thing I struggle with is recognizing when my perception of a situation is not in line with what others see. It could be useful to OP to know that their problem may not be as well compartmentalized as they are telling themselves.

        1. Grumpy Elder Millennial*

          Sure, but what’s the purpose of making that point? How does it translate into practical advice for the LW who a) recognizes they have a problem and b) is intent on seeking help?

    2. Married to an alcoholic*

      That may be your own experience, but it is not relevant nor helpful to respond to the LW like that. If you are implying that it is not possible to be successful at work and generally function well in day-to-day life while at the same time dealing with serious addiction issues, then that is categorically untrue.
      If you mean that any addition is unhealthy and will progressively become worse without treatment, well the LW already knows that and is seeking treatment!
      Good luck LW!

    3. Keymaster of Gozer (She/Her)*

      As a former alcoholic can I just say that this kind of coment is EXTREMELY unhelpful. It’s like going to someone with an eating disorder ‘you think you’re hiding this but you’re not’.

      1. LizB*

        Right. Shame and stigma don’t actually make someone’s medical condition vanish. Addiction/ED are compulsive behaviors – it’s not as simple as “oh gosh, I didn’t realize everyone could tell I was sick, now I’ll just stop being sick!”

  36. Sad Sister*

    Hey OP,
    My twin sister died at 38 from her alcoholism. It was a slow spiral from being a high functioning six figure salary VP to being laid off from her job to doing ok to dead in 3 years. Her overall disease progression took less than 8 years.
    She had family support, access to outpatient treatment, access to inpatient treatment, and support from caring friends.

    I sincerely hope your job will be supportive of you but I encourage you to get help BEFORE your body begins to shutdown. Liver failure is a truly awful way to go.

    Proud of you for recognizing that you need inpatient, go for it—-you’ll be glad you did.

    2. smeep248*

      My brother was an addict/ alcoholic for 30+ years. The only thing he was using during the last years of his life was alcohol and he died at 48 from liver failure. I have now been sober for over 7 years. Get the help you need as soon as you can. It is SO worth it.

  37. 1607 days sober*

    It’s never a great time to go to rehab but it’s always the right time.

    I went for inpatient alcohol addiction treatment in the summer of 2021. I had been at my firm for several years, but we’d lost a big client at the end of the prior year (not our fault – internal politics on their end), the attorney I’d been working for had a huge ego hit and ended up leaving the firm that spring. He didn’t take me with him, and I could have very easily been cut loose – we were experiencing an overall downturn in work due to the COVID slump – but one of the other partners had always liked working with me and had offered to bring me on to his team. Years of depression, anxiety, self-medicating, and high functioning alcoholism finally caused me to bottom out. I don’t drive and took public transportation to work so I’d long been drinking in the morning (as well as at lunch and from my special bottle in the late afternoon) but I finally got to the point where I just couldn’t leave my house anymore. I emailed in sick a few days in row, had a huge fight with my husband, and finally had to admit that my life had become unmanageable. I called our HR manager, sobbingly confessed everything, and told her I needed to go to rehab. We’re a small firm so we’re not covered by FMLA but the partners agreed that my health was a priority, and they agreed to a two month leave of absence. Making that call was the hardest thing I’ve ever had to do. I’ve never been more afraid – of losing my job, my family, my friends, all the respect I’d earned over the years, of being judged as worthless by everyone – but I also knew I was not going to be able to keep living the way I was. I was hollow and really had no reason to keep going on. Rehab was my only hope.

    If you’re working at a place that has a policy about giving someone with addiction issues time off for help then they want to help you. They want you to get better. I would not be surprised to find out if they’ve been touched by addiction and know first hand how necessary this lifeline could be. Please talk to HR and get yourself in treatment. It will be hard – the conversation, the aftermath of that conversation, the treatment, the first days back in the office. But your life is hard now and it will get better.

    1. LookAtMeI'mTheManagerNow*

      Fantastic comment. I have been on the other side of that call, hearing that an employee who didn’t qualify for FMLA needed to go to rehab. I agreed with HR that we should give it to them anyways, because it’s the right thing to do.

      Tomorrow is day 1608.

    2. Watching the detectives*

      You are incredible, 1607 days sober. Making that call took guts and I bet every day of recovery has taken guts too. I hope you feel proud of yourself deep in your bones, like knowing you faced down the devil.

  39. Lalapants*

    LW, kudos to you for recognizing the problem and making a plan to deal with it.

    FWIW I work at a company that has similar values/benefits. We had a coworker who started end of Oct, suffered a bad injury end of Dec, and while he was initially only supposed to be gone 8-12 weeks, he had complications and was out nearly 6 months. Our manager/company didn’t have to keep him (as he wasn’t eligible for FMLA) but they did, and they worked hard to make sure he was able to get paid during that time as well. So there are good companies/managers out there!

  40. Elizabeth*

    Listen to your body and take the leave now. It’s not at all the same situation, but I finally took medical leave to recover from long COVID (after almost a year of “just pushing through it” and getting worse and worse because I wasn’t convinced I “needed” time off and none of my doctors were particularly supportive) and it was one of the best things I’ve done for myself. And, my performance at work (unsurprisingly) improved when I came back!

    Listen to that part of you that says you “really want the help.” It’s okay to prioritize your own needs and your own health over doing well at work (although it sounds like you’re doing great despite your alcoholism!) Ideally this workplace will support your medical leave, and you can come back stronger; but even in the worst case scenario, getting treatment will still improve your life, your well-being, and your capacity to handle whatever you come back to – whether that’s rebuilding your reputation at this job, or (very worst case) having to find a new job.

  41. Long time listener*

    OP, I am rooting for you. I am 2 years and 4 months sober, and sobriety has been wonderful for me, one of the best things I have ever done for myself, along with marrying a great human or getting a college education. Sobriety is transformative, all for the better. But it is not just transformative as regards alcohol— it changes things across your life. You will have to, in your sobriety, choose sobriety over other things you want. (i.e. a drink, 10 drinks, i.e. what people think of you, lack of judgement in a workplace, appearances to your boss, etc.) In sobriety, your sobriety has to be first, take precedence, over other important things in your life, because it is the bedrock of your ability to have a life at all. In my sobriety, I have often needed to work less than I would like to meet my career goals, for instance, so that I can exercise or go to bed early or go hiking or swimming, to keep the sobriety front and center and to quiet the urge to drink. This has had a small professional cost, but not nearly as high a cost as it would have had if I had kept drinking. (It is also a cost that I can manage daily, instead of a spectacular unexpected catastrophe caused by drinking.) Sobriety is a transformation of your life to choose yourself, a healthy you, and learn how to stay healthy, and to develop a daily practice of knowing yourself, and of keeping your routines and programs of sobriety in place. And wow, is it worth it. Go to treatment, Poster, work your program, believe in yourself, put your sobriety first. We are rooting for you, you deserve this. It is hard, but the sober world is here for you, and it is so, so much better on the other side.

    2. Grumpy Elder Millennial*

      Well done, Listener, for doing what you need to do to get and stay sober.

      Your comment reminds me of something that Justin Hawkins (of The Darkness) has said a number of times. He had to put his sobriety as his number 1 priority for 10 years. As as you said, it’s a series of choices, made day after day, and the thing to do is to make the choices that will keep you from drinking.

      1. Long time listener*

        <3 Many thanks to you both, and to Allison, who gave the perfect advice here. This comments section is a testament to what a beast alcoholism and addiction is, how destructive it can be to families and sufferers, and also to how tremendously healing recovery is and can be. I have so much gratitude for the recovery workers, the meeting old timers, the researchers, and all those beautiful souls out there who create and maintain the wide world of sobriety. Happy holidays to all! (Or complicated// sad holidays, that is okay, too! xoxo)

  42. MigraineMonth*

    This letter has real “Go get your dog” energy, and I am here for that!

    LW, this is a wonderful convergence of someone who needs treatment and is willing to make the difficult changes to their life required by treatment and a humane benefits policy that provides that treatment.

    You deserve to get this treatment and take back control of your life. Go ASAP!

      2. Slow Gin Lizz*

        Oh wow, I’d completely forgotten about those letters and even just reading their titles is choking me up.

    2. DancinProf*

      Clearly, when Alison says “Go get X,” it’s a sign that an OP is in pursuit of a truly righteous cause. I immediately thought of “Go get your dog,” then reflexively got a little misty-eyed. Now looking forward to what I hope will be a heart-warming and tear-inducing update from this OP!

    3. Guacamole Bob*

      I was thinking this, too – I really hope that “go get treatment” can join “go get your dog” in the collection of AAM letters with life-changing positive updates down the line. We’re all rooting for you, OP!

      1. Amateur Limguist*

        Absolutely. My boss has been supportive on a couple of minor personal things. She encouraged me to start swimming and even found a couple of pools local to me that she thought would be quieter than the main public pool for someone a bit shy, and she also said that if I couldn’t find anyone to help bring my rescue cat home she’d ask around.

        I didn’t need either assistance directly but her comments encouraged me to go beyond my comfort zone and get back in the water and she allowed me a flexible afternoon to go and meet the cat, although I did take a day off to go and get her with my mum so I could play around with her guilt-free when she got home.

        Supportive colleagues and bosses are worth their weight in gold, and I would also encourage LW to take advantage of this generosity as soon as she can.

  43. Another One*

    Just- all the kudos for you for (1) acknowledging that alcohol is a problem for you that isn’t going to get better on it’s own and you need something more in depth and (2) yeah, AA isn’t for everyone.

    There is a reason there are multiple treatments out there. Having the courage to say “I need help” is massive and really hard. And acknowledging the kind of help and what hasn’t worked? That’s a huge step.

  44. Education Mic*

    A lot of jobs have a specific probationary period (at my job it’s three months) during which it’s much more difficult to fire someone. I would look into that too and just make sure it won’t create issues. Even if HR was ok with it, would their boss be able to say “OP did nothing this month, I’m letting them go” and there would be fewer checks and balances from HR due to still being in that period?

  45. AnonThisTime*

    Public service announcement: people who go cold turkey from long-term heavy drinking can die from withdrawal effects. Medical assistance of some kind is necessary for detox, do not go from daily to zero on your own, a step-down period is required at the very least.

    The OP clearly knows this, but I didn’t until I learned about it during alcohol treatment and so so many people don’t that it was worth spelling it out.

    It does at least make getting insurance coverage for alcohol detox a little easier since it’s medically necessary for a life threatening condition (and probably because a hospital bill for intensive ER care from trying to detox at home would cost the insurance more).

    OP- good luck, I’ve been in a similar place and made it through with proper medical care (12 years recovered now). Even then I relapsed a couple times during my program until we found a treatment combo that stuck for me. I hope you get the help you need, and your employer doesn’t make life any harder than it needs to be for you.

  46. B. Mariner*

    Hi, therapist-in-training here. I’m just going to add some details about what different levels of treatment look like – LW may or may not know this, but its also good information to share around.

    First off, when looking at addiction treatment, you have to be very careful about where you go. There’s not much regulation on the term “rehab” and a lot of places that have no business being rehabs market themselves as such. There’s a John Oliver video on this if you want to learn more, but basically, make sure the place that you’re going is full of people who are licensed for addiction treatment, is focused on actual empirically supported therapy*, has good reviews, and has sufficient medical resources. If you have a trusted therapist already, they may be able to help refer you, but even thats a bit of a dice roll if your therapist doesn’t specialize in addiction and doesn’t know the ins and outs of local treatment programs.

    *As a note, although it takes up a huge percent of the cultural consciousness of what addiction treatment looks like, AA is *not* empirically validated. That doesn’t mean it doesn’t work, but they have expressly chosen not to study efficacy. They claim it is for privacy reasons, but I’m somewhat skeptical as many other therapies have been studied, and they all have similar concerns around privacy. Of course, many people do find AA helpful, but its a highly specific and fairly religious program, and there’s nothing to suggest its superior to other validated addiction treatments. For example, it’s a subject of hot debate whether you need to be completely abstinent to be in recovery or if you can still drink/use in moderate and controlled amounts. AA falls firmly on the side of complete abstinence, but actual research is mixed on what works best for in the broader population – some people do better with complete abstinence, while others do better knowing they can participate in some drinking while still maintaining control. Again, still heavily debated, and I’m very far from an addiction specialist, I’ve just had a few days of class on the subject.

    As for levels of treatment, there’s residential, inpatient, partial hospitalization, intensive outpatient, and outpatient. Residential and inpatient are sometimes used interchangeably, but generally, residential implies a longer-term stay, while inpatient could be a shorter term. Inpatient has a high level of control over what the patients do, which can be necessary in some cases, but can also cause its own negative outcomes, especially if someone is involuntarily committed. It may be necessary, but inpatient can be a huge imposition on your basic rights and freedoms. If you voluntarily choose to go to impatient, it’s less likely to be a bad experience because you have more control over which facility and have a feeling of agency in the decision, but the lack of control can be a barrier for many people. In this case, LW will almost certainly need some kind of inpatient to start at least, since alcohol withdrawal has very serious medical complications if someone is physically dependent like LW. Going “cold turkey” for someone who is truly dependent can be literally deadly, but there are a lot of medical treatments available and can be done safely in a hospital setting. This is also why I included “sufficient medical care” as a requirement for a good rehab, though there’s other reasons too.

    Next, there’s partial hospitalization programs (PHP), also known as day treatment programs. These are 5-7 days a week for 6-10 hours a day. You spend your nights at home, but still get most of the resources of inpatient treatment. This is good option for a lot of serious mental health issues because you get intensive care, but its less of an imposition on your social life and still has a feeling of autonomy. It’s also less financially burdensome, as you don’t need facilities with beds and showers or round-the-clock staffing, and there may be breaks for meals. Depending on the situation, PHP may be used as a step down from inpatient, when someone still needs intense care, but doesn’t require constant monitoring.

    Intensive outpatient (IO) is the next step down in intensity, 3-5 days a week, for about 3-5 hours a day. This can be a good option for people who either want or need to remain active in their job but still need significant treatment. Or, it can be good for someone who is only partially responding to outpatient treatment and just needs a little more support and face time with their therapist/therapy team. Also used as a step down from PHP

    Outpatient can technically include PHP and IO, but usually it’s used to refer to once or twice a week one hour sessions. It’s what most people think of when they think of “going to therapy.” You can still go to outpatient therapy for very serious issues and get good results, and its usually the most accessible form of therapy. Once someone is in a good place, they might go every other week or even once a month, or may stop seeing their therapist regularly and only make appointments if they have a new concern arise.

    All of these are “real treatments,” to use LW’s phrasing, but the best intensity really depends on the person and the situation. You can improve in all of these treatment programs, but it might take a lot longer – it would take 49 weeks of weekly outpatient to get the same number of face hours as a week of PHP, and a lot of minutes every session are spent going “so how was your week,” and transitioning in and out of the session. The unfortunate reality is that there aren’t enough beds for all of the people who need it, unless you can pay exorbitant fees, so the qualifications for “bad enough” might be “currently and actively a danger to themselves and the people around them” vs “just” doing permanent damage to their bodies, spending all of their money, and damaging their personal relationships. In a just world, there would be a bed for everyone who wants one, and I sincerely hope that LW is able to find a reputable inpatient program as soon as they are able. It sounds like your job will be understanding, but even then, your health is the most important factor if you are able to afford it.

    1. Rainbow Unicorn*

      Thank you for this! Clear and compassionate medical information, including explaining terms, is important.

  47. ItsGonnaBeOK*

    High-functioning anxiety disorder over here, that put off going to therapy or getting medication because I had too much on my professional plate and didn’t want the stigma of being “crazy” at work. Then I spiraled out of control, culminating in trying a medication without doing research on it… and it made me suicidal. Then The Thing I’d been worried would happen eventually happened — I went to a psychiatric ward for 5 days. It was absolutely the best reset I could have. And I confided in the people that needed to know, told others it was an emergency medical emergency (because it was), and my job/my health/my everything was better. But I could have prevented it if I had admitted I had a problem and took the time for myself earlier. Best of luck to you OP, you’re going to be OK.

  48. East Coast Girl*

    Hi OP – popping in, in solidarity, to say AA wasn’t the right fit for me either. In early November, I celebrated 14 years of sobriety and the majority of that has been without AA.

    In my opinion, it’s so important to recognize what doesn’t work for us and continue to be willing to try different approaches. Best wishes to you, you’ve got this!

  50. mn_mp*

    I thank you for sharing OP. It has come to the point if I am wondering whether I need treatment or some sort of help, but always questioning “if it was bad enough.” This made me realize it doesn’t have to be bad by someone else’s metrics, just bad enough that I want to change. Good luck on any future treatment.

  51. Bicycle*

    Sending you internet hugs and good wishes, OP. A close family member did in-patient recovery 3 times in 2024, once with police involvement. Addiction is no joke and I think most people need help to recover. My loved one is now sober for 11 months and I wish the same for you!

  52. PinkUnicornClub*

    OP if you are feeling guilty about taking leave at an “inconvenient time,” try to remember that spiraling due to untreated alcoholism is WAY more “inconvenient” for much longer for everyone in your immediate vicinity than committing to treatment! The earlier you can do it the better off EVERYONE will be, including your colleagues and boss and family and everyone who values you. Best of luck to you.

  53. ThinMint*

    Good luck to you OP! Sending you well wishes that, whenever the timing, this is all that and a bag of chips! Here’s to recovery!!

  54. happy red panda*

    I’m not an alcoholic, but I had a domestic violence situation happen early in my career which resulted in a number of mental health issues. Finally there was one night that I wound up in the ER and was given two options: either start intensive outpatient program (IOP) behavioral health treatment tomorrow, or the hospital would seek a court order and force me to do a totally inpatient program. I chose the IOP.

    I was only maybe 4 months into my first office job ever when that happened. I took FMLA, came back to work maybe 3 months later. In all that time, I’ve never gotten flack for going on leave right after starting the job. Mental health and addiction are medical issues – work on you when you need to, not when it’s convenient for the company!

  56. Slow Gin Lizz*

    I just wanted to say to OP that I 100% agree that yes, you’re worthy of real treatment. You absolutely deserve to get well, and with that mindset I’m certain that you will finally make it happen. Best of luck!

  57. CubeFarmer*

    Could the company legally decide to terminate if LW is still in a probationary period? That said, I feel like that almost shouldn’t matter to LW: there are other jobs, there’s only one you.

    Best of luck with treatment.

  58. Binge_Drinker*

    Kudos to you, OP for admitting you have a problem and need help. It took me far too long and *almost* losing everything to admit I had a problem. I wasn’t like you, exactly; I didn’t drink daily and didn’t have to drink to get through the day, but I was a binge drinker. It took me too long to realize I can drink zero, or I will drink until I black out once that button is pushed. But because I “never missed work” and “never had hangovers” and “never had a DUI” and never THOUGHT there was an impact, I lived in denial for years. Finally when my spouse said, “you have a drinking problem and we need to address it,” after my initial anger and defensiveness, when he laid out all the times I forgot the night before, what I’d said, what I’d promised people to do, and then let them down, etc.. it sank in. It’s hard! Drinking is so ingrained with social behavior! I commend you for knowing you need in patient help because I couldn’t have done it alone, either. Good Luck and hoping you can start the new year on the path to sobriety.

  59. HR Exec Popping In*

    Great advice has already been given. As an employer, I will add one more thing to take into consideration on timing of going into treatment. It is always better to seek treatment before the need for such treatment becomes an obvious performance or behavioral issue at work. As a manager, I would be thankful that you recognize the issue and are seeking help. That is much preferable to someone starting to implode on the job and the company needing to intervein. Which in my past experience will happen eventually.

    So please prioritize yourself and your reputation and get into treatment ASAP.

  60. Chairman of the Bored*

    I’d recommend LW be very careful with what info they specifically give their boss so as to not give them occasion to look at this as a safety problem, if applicable.

    If I were the supervisor in this position I would be infinitely helpful and understanding *unless* I found that LW had been drinking before operating any sort of vehicle/machinery or similar equipment; even hand tools.

    If I found out about anything along those lines my new mission would be to ensure that LW leave and never come back; I have zero (0) tolerance for people doing industrial/mechanical type work after any amount of alcohol.

  61. HiddenT*

    A couple months ago I saw the local premiere of the play “The White Chip”, which was a semi-autobiographical story of the playwright’s struggles with alcoholism. On top of being a poignant (and funny!) show, it talked about how AA is flawed.

    One of the things that shocked me to learn was that part of the reason so many people relapse in the first few months is because, biologically, your brain will withhold dopamine until you feed your addiction. If you can make it to the 3-month mark, your brain will finally start producing dopamine on its own again. The playwright talked about how his “higher power” (in AA speak) is science, so knowing the scientific basis of recovery was what finally made it so he could break that cycle for himself.

    I wish the best for you, OP, and I highly recommend you look up the play and the foundation he’s started in connection with it.

    1. Rainbow Unicorn*

      What a validation and a light at the end of the tunnel that must have been. Both to know that there is a biological reason for feeling so wretched and compelled, and to know that it would change if he held out for 3 months. “It gets easier gradually after 3 months” is a lot less scary than “it’s going to be exactly this hard every day for the rest of your life”, especially with all the “no such thing as a former addict” messaging.

  62. HR Person Here*

    HR person here.

    I am very familiar with policies similar to what you describe. My current company has the same language in their policy. however, in the US, self-identification is not required in orfer to use the benefits.

    There is nothing to stop someone from taking advantage of the benefits (as they should!) and going for inpatient treatment. This is also covered under our short-term disability program as a medical issue.

    Before self-identifying to a new employer, I think you should do some checking into the actual policy. I cannot imagine that your medical plan and short-term disability plan would not cover this if you simply applied for it on your own.

    Good luck.

  63. Cat Lady in the Mountains*

    Focusing just on the work-related piece of this – if this is a benefit your company offers, HR should be well equipped to guide you on how to use it in a non-judgmental way, assuming they have a super basic level of competence. I’d start there – both because that leaves you the option to not share anything you don’t want to share with your manager or team, and because you will almost certainly get more useful and practical information from them. (Managers often don’t have a ton of detail about implementation of benefits like this.) You can always ask those questions in a theoretical way, like “how would someone use this,” if that feels better to you. And just asking questions about it doesn’t commit you to using the benefit on any particular timeline – it’s just information-seeking at this point.

    As for whether to tell your manager or others – I’d go by what you know of them. Are they generally reasonable, kind, fair, and aligned with the company’s benefits-related values? If so, they’re likely to be supportive of you using this particular benefit. I’d keep what you share at a big-picture level without revealing a lot of details (like about drinking during lunch), just in case some specific detail does have a specific work-related impact that raises red flags for them. As a manager, whenever someone on my team is going through medical stuff I prefer not to know a lot of detail because it protects them from any biases I may not even realize I have.

  64. Abe Froman*

    I don’t really have anything to add to Allison’s excellent advice. Just want to say that I’m rooting for you, OP. I hope you can do what you need to get healthy.

  67. You matter*

    OP – You’re indispensable to the world, to all of us even if we’ve never met. Please take care of yourself first.

  68. GreyMatterbutReallyColorful*

    As someone who has loved addicts – I am so proud of you, LW! Always put your health and well-being first. Wishing you a successful recovery.

  70. NCA*

    My dad was a high functioning alcoholic….until he wasn’t. He lost his job with the dot com bubble and that cascaded the issue. For him it was to cope with undiagnosed ADHD and depression that he didn’t feel he could go to a doctor for, and AA also didn’t help him. I lost him about 13 years ago, in my 20s, due to liver failure. Please please please go take care of yourself, and sooner rather than later.

  71. Popinki*

    This can’t have been an easy decision to make, and I’m glad you made it. I have no advice, but this internet stranger is rooting for you.

  72. Eirishis*

    As a recovering alcoholic (sober 19 years) – go now. Go today. Knowing you have a problem won’t solve it until you have the tools and support network to replace the booze in your body, mind, and self-image. Even if – and I sincerely hope it doesn’t – it ends up costing you this job. Your life is more valuable than the job.

    As head of HR at a place with a policy like what you have described – we have a 30 day “extended medical leave” policy for people in situations like this who aren’t yet FMLA eligible. We do have a 90 day work requirement, though.

    But again – go now. If your workplace and manager are as you perceive them to be, they will support you.

    Good luck. You may not need to hear this, but I did when I was where you are: you are not a bad person, even if you have done things you believe are bad. You are a sick person who needs to get well. You CAN get well. There are people who want to help you and support you when you walk through the door.

  73. Not Marion, but the Librarian*

    Like so many others, OP, I wish you all the best and hope the job and the treatment opportunity are everything you need in this moment.

    Alison, in a world, well, country actually, that is trying its hardest to dehumanize everyone, thank you for being a shining example of compassion. Would that all managers would take a page from you.

    Now, if you’ll excuse me, my office is a little dusty.

  74. Anon for This*

    Alison, feel free to moderate/delete this comment if you feel it is inappropriate. But since there has been some sharing of resources in the comments, I want to note that the r/stopdrinking subreddit has been an incredible source of support on this topic for me and many many other people. I have always found the AAM commentariat to be kind, thoughtful, and supportive (just look at this comment thread!) and SD has the same kind of non-judgemental, caring support and community.

  75. Project Manager*

    OP, go get the help you need, and then report back to us with an update so we can celebrate you; you’ve got a lot of strangers cheering for you!

  76. BigLawEx*

    Go now. I was sitting/laying down? in recovery at a hospital outpatient room recently. I’d been there for a colonoscopy. The person in the bed next to me…. I could hear behind the curtain and the doctors suggested he’d waited to late to stop drinking, and not only could they not perform whatever surgery he was scheduled for, he was likely at the end of his life because his liver was at 10% functionality. He had so much regret. I felt really sorry for him.

    As the child of a high-functioning alcoholic, who is in and out of sobriety…please do what’s best for everyone, but especially you–now. I do second the advice to run it by an employment attorney, though.

    1. Irish Teacher.*

      And I want to give the opposite side. My uncle recently told my brother that at some point my grandmother had been told she had to give up drinking or she would be dead in three months. I never knew that before, but I did know that she was in a very bad state health-wise when I was in my final year at college (to the point I was looking up policies for missing exams due to bereavement because I really didn’t believe she’d last the next few months).

      Well, she took it seriously and she lived until 93. If you saw the photos taken at her 80th birthday, you wouldn’t have given her a chance of getting to 83, let alone 93.

      So yeah, agreeing with everybody who say to go as soon as possible.

  78. Grumpy Elder Millennial*

    LW, I hope it’s not weird to say that this internet stranger is proud of you for recognizing you have a problem and that you need help to handle it. That’s no small thing. And a lot of people don’t get to that point. You absolutely deserve to get the help you need. We’re all pulling for you.

    I hope that your new employer will be cool about what you need to get and stay sober. I’d be hopeful, given what they have written in their policies! It sounds like the company is one that recognizes that addiction is a disease and that people with addictions deserve to get help without penalty. The fact that you’re already “indispensable” is also a great situation. The company will presumably be even more invested in keeping you around.

    One thing I’ve read in several of the comments from those with lived experience is that they did lose the jobs they had, but that it was entirely worth it to get sober. I certainly don’t want to diminish the consequences of losing a job, especially these days. But that has to be balanced with the consequences of not getting sober. There are consequences to your health; you can’t feel organ damage while it’s happening, just the outcomes when things have gotten bad. There’s also the question of how long you can balance on this knife’s edge. Yes, you’re functioning now, but how long is that going to last?

    Go get your treatment, LW. Make the calls today. There is never a perfect time to seek treatment (e.g., in 6 months, you’re a key part of a project team and leaving could be disruptive), so the best time is NOW. We’re all cheering for you.

  79. LizB*

    Best of luck to the LW, and huge props all the other commenters posting who are on sobriety journeys as well! I’m so glad you’re all taking care of yourselves.

  81. timeisacircle*

    Please take care of yourself. the advice given is exactly correct. Now is the right time. As an HR person myself, I would strongly advocate for any employee, no matter how long their tenure, to be given the opportunity to get treatment. A good inpatient program has helped many a person get a new sober lease on life. For many, the only way to do it is to get a job with health insurance that will cover it. Good for you for working hard to be a reliable employee.

  82. Liz the Snackbrarian*

    As a sober person who got in patient treatment, go now. You deserve to be healthy and sober.

  83. Rose is a rose is a rose!*

    A close relative is 14 years sober, and it took two rounds of in-patient detox (paid for by her employer) and a heck of a lot of coffee and ice-cream for her to get to a place of sobriety. She had an alcohol-related Incident at work (not vehicular, thankfully) that led to the first round of detox, but she did keep her job – a very large company with good benefits and a strong union. I’m sharing this to say, OP, that if your company has this policy that presumably they do want people to avail of it, and that the sooner the better, before you have an Incident on the job that
    may be hard to recover from. Good luck to you!

  84. Nik*

    OMG, please go now. Your health and life could depend on it more than you realize. My sister was the same way as you describe. She developed Wernicke–Korsakoff syndrome, was hosptialized, in a nursing home facility for a while, and now still has severe memory issues.

  85. My Stars*

    LW I am so proud of you for continuing to fight even when the outpatient and peer group efforts didn’t work out. I used to work in a residential treatment environment where my patients often worried about leaving work for 30 days. I encouraged them to think of it like this: if you had a cardiac event today and went to the emergency room, and if they told you we need four weeks in the hospital to get you stabilized and strong enough to get to the next level of recovery, you would say, “well that’s terrible timing and my work is not going to like hearing it, but I don’t want to die.” Why is this different? A physical dependency to alcohol at the level you describe, needing to start out the day with it just to function, is deadly without medical support.

  86. anon for this*

    this one really hit me hard.

    i have mental health issues that have gotten pretty bad over the past couple years. i rarely get through a day without at least some brief flare up of suicidal ideation (mostly passive lately but it was getting worse than that before i left my old job 7-8 months ago)

    i often feel like i am white knuckling it through my first year at this job because i’m entitled by policy to considerably more job protections after i pass that mark. but reading this and the comments, i wonder if that’s what i should be doing

    1. Also anon for this comment*

      I’m so sorry to hear. If you feel it’s getting worse, then yes you should get treatment. You could try outpatient first, like a PHP or IOP – I really benefited a lot from going to a PHP during a bout of bad mental health, even without active ideation. It’s not worth seeing how long you can hold your hand over the stove. Your mental health and well-being are worth getting treatment for, just like any other medical issue.

    2. Anon for This*

      Getting my mental health treated was the best thing I’ve ever done. Seriously. I can’t tell you if now’s the time, or if you should wait—but for me, it was, if not quite the difference between life and death, definitely the difference between a life of despair and a life of joy. A lot of the advice about how to phrase the request for leave to treat a medical condition can apply to mental health just as much as to alcoholism.

      I wish you so much luck.

  87. Alexandrine*

    As the child of a highly-functioning alcoholic, if you’re ready to seek help now, do it now!

    You should not feel guilty about taking care of a serious and life-threatening medical need.

    (My father died of liver failure last year, after spending almost seven years in the terminal phase of cirrhosis. It was not pretty, and he had to medically detox for a few days in ICU when he first went terminal. He was not able to stay sober for very long after that medical detox, and lived for most of his last seven-ish years continuing to drink and decline. He had spent decades dependent on alcohol and could never truly bring himself to believe that he hit bottom, so he never stopped drinking for long stretches.)

  88. FunkyMunky*

    nothing to add, just popping in to say good luck and I hope you get all the help you need! you can do it!

  89. Cats*

    “and know in-patient treatment would finally help me address it. Out-patient didn’t stick, and in-patient programs have told me I’m “not bad enough” to deserve a bed, but that’s subjective, and I really want the help. I’m going to go eventually”

    Oh boy.

    Okay, first off: you’d need to find an inpatient program that:
    1–is willing to take you
    2–actually has beds available
    3–would be covered by your insurance/work/whatever.

    I’m going to be honest here. As the relative of more than one untreated alcoholics (living and dead), a lot of what the LW has written sounds very magical thinking. It sort of seems like the LW is hinging ALL their responsibility to get sober on whether or not an in-patient program will take him. So if (when) he can’t find an in-patient program, he never has to actually put effort towards getting sober. Just keep knocking back that half a drink before work and another one during the day, only it’s going to increase to 2 drinks throughout the day, 3.5 drinks, etc.

    If you’re at all behind the wheel of a car while you’re microdosing Bud Light, LW, then you NEED to get yourself into any program that will take you. Even if it’s an out-patient program. I’m also the relative of someone killed by a drunk driver—that is a hell you don’t want to inflict on other people. You don’t have to do AA (it isn’t for everyone and that’s ok but people don’t want to admit it), but you have to do SOMETHING.

  90. Emma*

    My brother hit six months sober this week, after taking a leave of absence from his job (at the company I also work at) earlier this year. He presented it as a serious but resolvable health issue without going into details, and they were supportive, and even though he was pretty high functioning, it’s also been very clear to them since he came back that he’s been much more reliable and productive, in ways that they’ve commented on. It was extremely worth it, and I wish you all the luck in your own recovery.

  91. nnn*

    I absolutely agree with everything Alison and others have said to the effect of “Go get treatment.”

    The rest of my comment here is for if you’re still not feeling that you can just go get treatment without checking in on whether it’s an appropriate time or you fear the stigma of saying that you’re seeking alcoholism treatment. If you’re not having these feelings, you can skip the comment.

    If you’re still not feeling confident that you could just go get treatment, a scripting option would be to ask your boss something like “When would it be appropriate for me to schedule medical treatment that might require X weeks of recovery?” If you feel the need to say more: “This treatment will almost certainly improve my ability to do my job, but I don’t want to jeopardize the trust I’m building or seem unreliable so soon after starting by taking this time off inappropriately early.” Without explicitly stating what the treatment is, act as though it’s something like carpal tunnel surgery.

    What will almost certainly happen is your boss will say “OMG, don’t delay something important! Get it as soon as they can book you in!”

    Then you have permission.

    Again, you don’t have to do this. You are absolutely allowed to just go get treatment without going through this subtly-ask-permission-but-not-really dance.

    But if you find you’re stuck or still not being brave enough, this can be a way to get permission.

  93. Properlike*

    My husband’s colleague was a high-functioning alcoholic who quickly became low-functioning, got fired for it, then died soon after. He felt guilty for a long time that he didn’t recognize the signs and urge him to get treatment.

    The world’s better with you in it, OP. There will never be a better time than RIGHT NOW. Looking forward to your update!

  95. Jane contributes nothing to the conversation*

    Good luck, OP! There are thousands of us out there who have been and are in your shoes. If you are ready and willing to go, start treatment now. Everything will fall into place with your job.

    Sober life is awesome. <3

  96. Susie*

    I really hope to see an update in the future from this LW! This is a massive step having identified the problem, and being ready to get help. That motivation can shift with addiction so I hope the LW has the full support in going right away. If the LW is caught drinking on the job, they could jeopardize their standing with the company, so more of a reason to get the help they need. Best of luck.

  97. anon manager*

    I join the legions here cheering you on, LW! I fully agree with Alison’s advice. Also as a c-level manager who has hired a lot of people, I’d want you to take the leave and take care of your health. I would not judge you negatively for doing it early in your employment and would be glad the company benefits could make someone’s life better.

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