Updated

David Hasselhoff’s reported hospitalization for a dangerous level of alcohol in his bloodstream, if confirmed, means that he needs a long period of inpatient rehabilitation, followed by more aggressive outpatient treatment, in order to stay sober and stay alive.

According to a report, Hasselhoff apparently at home with his 17-year-old daughter Hayley and had been drinking for more than a day when she called 911, worried that he wouldn’t survive the binge. He’d been hospitalized with a high blood alcohol level back in May, as well.

Alcohol dependence is a notoriously difficult condition to overcome. Getting sober and staying sober can take daily 12-step-meetings, for years. It can take two or four or more inpatient detoxes. I have treated patients who had not stopped drinking after a 20th detox.

What I have learned is that defeating an addiction to alcohol often takes a multidisciplinary and very aggressive approach that can include:

Too many people die of alcohol abuse and dependence because clinicians won’t go to the wall to battle the condition.

A real war means treating any co-existing psychiatric condition, like depression or attention deficit disorder.

A real war means motivating the patient to look at his character. The idea that a person chooses alcohol over his obligations to self and others means that he is unable or unwilling to do the right thing. Lots of therapists don’t want to judge the alcoholic, but judging a man who collapses repeatedly in front of his teenage daughter and makes her worry about him dying is OK by me.

A real war means motivating family members to cease all co-dependent behavior. That may mean telling the alcoholic that he can’t live at home anymore (or at least for an extended period of time), because home isn’t for people who get drunk.

A real war means motivating the person’s employer to submit the alcoholic to random drug tests and to make his employment contingent on his sobriety.

A real war can mean coaching a family through going to court to become the medical guardians of the alcoholic and remove his decision-making capacity over his health affairs. That renders the alcoholic a child in the eyes of the law, allowing family members to hospitalize him for detox when it’s needed, not when the alcoholic likes the idea.

A real war can mean using Antabuse, a medicine that causes anyone who consumes alcohol to become violently ill, vomiting and experiencing terrible headaches (even risking death). Swallowing an Antabuse tablet every morning (while someone watches) will do a lot to take away the urge to drink.

David Hasselhoff seems to be a person who needs everything on the menu. I wish him and his family well. And I wish for all of them a doctor willing to go to the wall and wage war on his illness.