My husband is waiting for a pancreas transplant. The team knows that he had an alcohol problem several years ago. Recently, he has started to drink at night to help with his sleep. I do not know what to do. If I tell the transplant coordinator, will they take him off the transplant list?
You have good reason for concern. Stress and other problems can disrupt sleep. But alcohol is never a solution. It will not allow your husband to have a restful sleep. Alcohol disrupts the sleep cycle and is highly toxic to normal sleep. Your husband risks losing control of his drinking. He is fooling himself.
Transplantation will present your husband with several challenges to his physical and emotional well-being. He needs a good working relationship with the transplant staff to best deal with sleep or other problems. The transplant team could learn in another way about his drinking. There is no doubt. Your husband is placing his health and his relationship with the transplant team in jeopardy.
You are in an awkward position. Only you are aware of the problem. But informing the coordinator is not the first approach. You should first consider speaking to your husband. Ideally, let him know of your concern. Insist that he discuss his situation with the coordinator or another person on the team. Remember that they accepted your husband to the transplant list knowing of his previous problem with alcohol. Even if this was not so, the team should respect his ability to confront a potentially serious problem. By working with the team, your husband is more likely to find adaptive solutions to his troubles. Your husband may require treatment specifically for misuse of alcohol. If so, the team must decide if it is best for him to be off the waiting list while receiving this help. It may or may not be necessary.
If you are unable to discuss this with your husband yourself, maybe you could ask a trusted friend or other family member to approach him. What you should not do is ignore his drinking. This is a potentially serious problem. Should none of our suggestions be helpful, you can be sure that you and your husband have a serious problem. You may have to tell him that if he doesn't get help, it is your responsibility to see that he does. If necessary, you may have to approach the transplant coordinator yourself. Although not ideal, it is a better solution than allowing a severe problem to develop.
We have known several applicants with a previous alcohol or drug problem. Their risk of future substance misuse varies and is hard to predict. But regardless, our approach was to meet with the applicant and their support person, preferably somebody who lived with them. We asked them for an agreement. If either became concerned about the applicant's use of alcohol or drugs, they would first discuss it and then always let us know of their concern. This agreement insured that preferably the applicant, but if necessary the support person, would have permission to let us know that they needed help.