About a month ago I reported on the progress of a farm family dealing with alcoholism. Dan and Darla (not their real names) and their two children have been dealing with Dan’s addiction for several years.

I first wrote about them in October 2013, with their approval as long as I disguised their identities. Their journey has been a traumatic saga described in periodic “Farm & Ranch Life” reports.

One reader recently said: “I’ve been reading these updates for a few years, and each time I get one, I sort of hold my breath that … something has happened to Dan or his family – a wreck, or drinking far to excess, or some such.”

That’s what alcohol addiction does: It challenges our understanding of why some people consume alcohol excessively even when serious negative consequences follow its misuse. Mostly everyone wants to see people “get better.”

Other drugs can have similar damaging effects on addicted people and their loved ones. The current opioid epidemic is one of the unsolved problems that affects many in the United States.

What ultimately assists alcoholics and other drug addicts to make lifetime changes in their reliance on alcohol and other substances? This week’s column provides an update on Dan, Darla and their children.

There is good news, for a change, and hope that Dan’s devotion to changing his life will continue. It’s been two months since Dan had a drink. He had to choose treatment versus divorce and loss of his family after he was drunk for three days straight over the New Year’s weekend.

Darla made him leave their home. Dan entered a 30-day inpatient treatment covered by Darla’s insurance. He is back home and attends support group meetings three evenings weekly, which are 50 miles away from home.

Dan and Darla also attend weekly counseling sessions together with a therapist in the after-care part of his treatment program. Darla said their family therapist (the children also visited him once) has dealt with his own alcoholism and has been counseling others for 15 years.

Dan has changed a lot, Darla said in a telephone conversation last week. Dan told her recently that when he was still drinking and passed out while she was at her job, he would have missed their son complaining of a severe stomachache that turned out to be appendicitis two weeks ago.

Their 8-year old son had an appendectomy just before his appendix ruptured, the surgeon said. And their 11-year-old daughter’s school grades are improving after atypical C to F grades at the end of the previous semester.

For the first time, Darla noted, Dan has confided to her how scared he was of being arrested for DUI, but he couldn’t stop drinking to inebriation. He admitted that breaking four breathalyzers was a “stupid defense” to maintain his addiction. Darla has more hope for Dan, their family and their farming operation than she has had for years – Dan, likewise.

Is this the final step to healing for Dan and his family? Probably not, given what is known from alcoholism treatment evaluations and outcome studies.

On the pessimistic side of what is known, the average number of inpatient alcoholism treatment stints is three. After one or more inpatient program stays, some alcoholics make a lifetime decision to abstain from alcohol, while others continue periodic rehabilitation episodes, only to not succeed in giving up alcohol and to eventually die younger than normal from something related to their habitual drinking.

Spending time in jail following an arrest, or longer incarceration, can be a significant deterrent, but Dan has avoided jail although he was charged once with DUI. Is this an unfavorable prognosticator?

Dan also is not taking anti-alcohol medications such as Antabuse or Naltrexone. How does this factor into his prognosis? Opinions vary about taking these medications.

On the optimistic side of what is known about alcoholism, Dan is addressing other factors in his life that also need repair, such as admitting to Darla and their children that he has to cease drinking for the rest of his life. This is a different stance than he took earlier, when he said needed only to stop excessive consumption and that he could retrain himself to be a social drinker.

Dan is learning to be assertive and to talk, Darla said. He has shared his life story with his support group of men, including other farmers. When he was asked to explain why he was attending the group meetings, he reportedly told them he was addicted to alcohol and didn’t think he could function without it.

Dan also has an advocate whom he can call at any time. Darla said Dan hasn’t yet called his advocate, but he promised he would if necessary. Dan told their family therapist that Darla is his best advocate, whereas previously he blamed her for his drinking.

Is Dan making lifetime changes? Time will tell. Send me your thoughts.

The views and opinions expressed in this column are those of the author and not necessarily those of Farm World. Dr. Mike Rosmann is a psychologist and farmer in western Iowa. Readers may contact him at mike@agbehavioralhealth.com