My friend has started drinking a lot more than she used to and sometimes blacks out from it—how can I talk to her without her getting angry at me? I'm afraid to say anything because I drink too and I don't want to be a hypocrite. What can I do?

Your concern about your friend is understandable, as the research shows that drinking increases the likelihood of injury, assault and unwanted sexual advances, and significantly impairs judgment and academic performance. It also causes a plethora of health-related problems such as liver disease, heart disease, high blood pressure, and increases a woman's chances of developing breast cancer.

Chances are, your friend will get angry at you for calling her out about her drinking, as one of the primary characteristics of someone with a drinking problem is denial. In order to deny her problem, she has to deflect attention from her own actions, and that means she will make you the bad guy so as not to have to look at herself. But it is equally plausible that you could be doing just that right now, focusing on your friend so as not to have to look at yourself.

So I want to suggest that you look take a hard look at your relationship with alcohol first. There are many online sites that you can go on to do a self survey to determine if you have a drinking problem and to what extent; there are many sources of support available for those who want help. You may not be ready to take this step yet, as your question shows that you are not at the point where you identify your drinking behavior as problematic.

Readiness is key, both for you and for your friend. Until one is truly ready to admit that she has a problem, it's unlikely that she will be receptive to feedback from others.

Sources:
www.collegedrinkingprevention.gov
www.physorg.com
www.righthealth.com
www.alcoholscreening.org
www.aa.org

Your concern for your friend sounds totally reasonable. Her escalating use of alcohol is a clear indication that her use of alcohol is abusive and out of control (even if she doesn't get physically ill or black out each time she drinks). Regardless of your use of alcohol, it is fair to open a discussion with your friend. If she sees that you are coming from a place of concern rather than judgment, she will be less likely to react with anger.

Probably the best time to discuss this would be the day after a night out, when the consequences of her drinking are fresh in her memory. Ask her if she is feeling okay because you are worried about how sick she got the night before. If she can't recall the details of her night's drinking, let her know what happened, even things that may have been dangerous or embarrassing, to help her understand your level of concern.

Hopefully, she will be receptive to your concern, even if she does not see it as a problem for herself. If she too is worried about her use of alcohol, you might suggest she speak with a counselor or her physician for further assistance. If she reacts with anger to the discussion, just remind her that you are only concerned because you care about her and then back off. She may need more time to recognize her problem on her own. At the very least, if you raise the issue with her, she will know that if she does want to talk, you are there to listen.