Alcoholism Case Study: Rebuilding a Life Torn by Addiction
Patient Information:
Age: 45
Gender: Male
Background:
Aviral (name changed for privacy) is a 45-year-old construction foreman living in suburban Thane. A father of two and married for 18 years, he was well regarded by colleagues for his dependability and work ethic. As a second-generation blue-collar worker, Aviral was raised and nurtured in a modest, working-class home. No stranger to hard work, he relished the ability to support his family and made every effort to show up every day until alcohol took over.
History or Cause:
Aviral's drinking started casually in his mid-twenties, as a few beers after work with coworkers and slowly transitioned into a daily occurrence. A transition from casual drinking to chronic dependency did not occur from day to week to night. Moments in time transpired between each event.
At 39, a regional economic downturn resulted in losing his 14-year job, which caused a hit to Aviral's self-worth. Aviral, who developed his identity around productivity and taking responsibility, felt as though he had lost his sense of purpose. At first, drinking allowed him to "take the edge off" and helped him to sleep, but as time went on, it began to serve as a crutch for whatever was stressing him, whether it be financial problems, fights at home, or hopelessness
At 41 years old, Aviral drank over a litre of vodka daily. The consequences came fast and hard.
- Three DUIs in 18 months.
- failed two job interviews because he was drunk.
- Liver pain, fatigue, and persistent nausea.
- Getting further away from his kids every day.
- He was emotionally abusive to his wife while drinking.
After collapsing at home with gastritis from alcohol, he ended up in the ER, where a hospital counsellor began the process of referring him to an inpatient treatment centre. Aviral agreed—not exactly out of hope, but because he had run out of places to fall.
Diagnosis:
Aviral was reviewed through a full intake process that included blood work, psychiatric evaluation, and self-assessment measures.
Medical Evaluation:
- Increased liver enzymes (AST, ALT)
- Signs of fatty liver with early fibrosis
- Nutritional deficiency (thiamine, folic acid)
Psychological Tools Used:
- AUDIT (Alcohol Use Disorders Identification Test): 34 (severe risk)
- GAD-7 (Generalised Anxiety Disorder): 16 (moderate to severe anxiety)
- PHQ-9 (Patient Health Questionnaire): 19 (moderate to severe depression)
Diagnosis:
- Primary: Severe Alcohol Use Disorder (per DSM-5)
- Comorbid Conditions:
- Generalised Anxiety Disorder (GAD)
- Persistent Depressive Disorder (Dysthymia)
- Generalised Anxiety Disorder (GAD)
- Persistent Depressive Disorder (Dysthymia)
- Generalised Anxiety Disorder (GAD)
- Persistent Depressive Disorder (Dysthymia)
Treatment:
Approach:
Aviral is being treated using the bio-psycho-social model, which incorporates the physical detox, the psychological reasons for his drinking, family issues and concerns, and social reintegration. The programme relied heavily on evidence-based treatments and was trauma-informed and sensitive.
Program Outline:
1. Medical Detox (Week 1):
- 1- Medical Detox (Week 1): Conducted in a clinical setting and included 24/7 medical monitoring.
- Administered orally, lorazepam (the recommended choice of benzodiazepine) is used to address seizures and tremors.
- Administered thiamine, folate, and electrolyte replacement therapy.
- Once acute withdrawal had stabilised, transitioned to PO naltrexone (to reduce cravings).
2. Inpatient Rehab (Weeks 2–8):
- Cognitive Behavioural Therapy (CBT): Conducted daily one-on-one sessions, focusing on identifying cognitive distortions like "I'm no good unless I have a job" and "my family would be better off without me".
- Dialectical Behaviour Therapy (DBT): Helped Aviral in building emotional regulation skills to manage resentment and guilt.
- Motivational Interviewing (MI): Used to explore Aviral's own reasons for change (his children became a central theme).
- Group Therapy (AA Model): Daily peer-led sessions provided accountability and peer support.
- Family Therapy: Initially, Aviral's wife resisted attending; however, after a week after working with Aviral, most of the respective issues could be identified. Established biweekly sessions. Trust, boundaries, and communication are re-established.
3. Nutritional and Physical Rehabilitation:
- Customised nutrition program to address nutritional deficit
- Gentle cardio and yoga to promote blood circulation and thought clarity
4. Vocational Rehabilitation:
- Sessions with a career coach to identify flexible self-employment practices
- Support in the resume building and trade license renewal, as well as building confidence
Therapy Sessions in Detail:
- Cognitive behavioural therapy (CBT) sessions: These started with journaling exercises and tracking cognition. Aviral began wrestling with memories related to shame and failure and learnt to challenge the internal narrative of “disappointment”.
- Dialectical behaviour therapy (DBT) tools used: Each week included mindfulness meditations, distress tolerance exercises, distress tolerance skills, and especially “opposite action” exercises (doing the opposite of what you want, e.g., instead of isolating, you engage with a group).
- Group work: Aviral became a more verbal component of the group by week three, notably helping new members feel at home.
- Family therapy: Most notably, Week 5 was when Aviral's wife said, "We're starting to see the man we married again," which became Aviral's anchor.
Improvements/Recovery Timeline:
Week 1-2:
- Physical withdrawal symptoms equate to being managed.
- Emotional state: shaky and fluctuating between guilt and despair.
- First sober sleep cycle re-established.
Week 3-4:
- Identified triggers (stress, boredom, self-loathing).
- Panic episodes went from daily to weekly.
- First joint session with my wife.
Week 5-6:
- 80% reduction in cravings reported.
- Took first responsibility as a group therapy assistant.
- First unsupervised phone call with happy tears of children.
Week 7-8:
- More than 60 days sober.
- Regained 6 pounds of healthy weight.
- Started making birdhouses for a creative outlet.
- Applied for part-time handyman jobs.
Post-Rehab (Month 3-6):
- Joined the local AA chapter.
- Started leading the Sunday men’s group at church.
- Started doing small home repair jobs.
- Had my first sober Christmas with family in nearly a decade.
- Continued counselling (1x individual, 1x family weekly).
Jagruti Rehab Treatment’s Impact on Aviral’s Life:
Aviral found more than simply sobriety; he found peace. He operates a small handyman service with three consistent clients. He makes money honestly, sleeps well and wakes up with purpose for the first time in years.
Emotionally, he is feeling "human again". He still experiences episodes of anxiety, but they are not dictating his life. His depression has decreased to the extent where he smiles as often as he likes, without alcohol dulling those smiles.
Aviral's marriage is still a work in progress; however, it is replanted in mutual respect and a shared commitment to bettering themselves. Aviral's children (now tweens and teens) find him a good listener when they seek counsel, and they enjoy his sober and patient presence.
Family and Community Impact:
Aviral's wife remarked that his transformation is "like watching a ghost come to life." His children describe him as "funny again" and "actually there".
The family attends Al-Anon and family therapy monthly and will often see some of the other couples that Aviral has inspired. They have made recovery a collective act of rebuilding.
By putting Aviral's story into the broader community context, he continues to be a lighthouse. He volunteers at a homeless shelter twice a month and speaks of his path with individuals still stuck in the fog. He works with newly sober men in their first 30 days, which he calls "the deepest trenches".
The Final Thought
Jagruti Rehab’s alcoholism case study demonstrates how complicated, awful, and incredibly reversible addiction can be. Aviral's story is not about a miracle; it is a story of iterative, compassionate, multi-disciplinary care at the right time and with rare sincerity.
Addiction can be a disease, not a character flaw, just like heart disease or diabetes, and addiction will not go away without medical care and lifestyle change.
What Aviral shows us, with each sober sunrise and with every repaired relationship, is that redemption is always available. It is not easy. It is not fast. But it is real.
And, most importantly, worth it.
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Jagruti Rehabilitation Centre is a leading facility specializing in mental health, dementia, and addiction recovery. The team of psychiatrists, psychologists, and caregivers is committed to empowering individuals on their journey to recovery.
