Alcoholism is a disease, but we really don't think so

Miscellaneous and Personal Stuff I Must Share
81

There are already some breakthroughs on that but they aren’t that well publicized. I was in the clinical trials to get Campral (acamprosate calcium) approved for use in the U.S. It has been used in Europe for a lot longer. It isn’t what most people think of as a drug, it is a version of calcium closer to what most people would think of as a prescribed vitamin but the results can be profound and work when nothing else does. I can attest personally that it works quite well for some people. The only drawback that I know is that it can be expensive depending on your health insurance plan.

http://alcoholism.about.com/od/meds/a/campral.htm

There is also Naltrexone which is an opiate receptor blocker. As I mentioned before, alcohol isn’t an opiate itself but it interacts with opiate receptors in ways that aren’t well understood. The opiate pathways are involved in a reward feedback loop and one good theory is that alcoholics have pathways that go haywire when they are exposed to alcohol causing a feedback loop that requires additional drinking to keep them stimulated like they demand.

http://www.webmd.com/mental-health/addiction/understanding-alcohol-abuse-treatment

The only other common drug for alcohol treatment prior to that was Anatabuse that induces an allergic reaction to alcohol in anyone taking it. It isn’t widely prescribed anymore because it doesn’t fix the core problem at all. Alcoholics either stop taking it because they hate it, they drink anyway and then get really sick or they get exposed to alcohol through casual contact (some shampoos and cosmetics for example) and develop a bad reaction through no fault of their own. That strategy just doesn’t work either ethically or psychologically.

Campral and Naltrexone are not perfect but they are a huge improvement even though relatively few alcoholics are even told they are an option (many doctors don’t know much about them either although even family doctors can prescribe them). If you read the cites, there is almost always a reduction in drinking among those that take them and the one year sobriety success rate is over 50% for those that take them and also undergo some type of social therapy. That blows the doors off of anything else out there right now. If you have a friend, family member or are an alcoholic yourself, it is worth talking to a doctor about the fit for these drugs that were rather recently approved to treat the actual cause of alcoholism rather than just try to chase the symptoms or beat certain behaviors over the head.

82

Topamax (topirimate) has been used in the treatment of alcoholism too, if I’m not mistaken.

83

It’s more like, “I will leave you unless you try and get help to stop drinking.” Because getting HELP is a choice. I’m not saying alcoholism isn’t a disease because it is. I’m not saying it’s a moral failure, because it isn’t. But I’m also not defending those who tell someone, “hey, you need to get help, because this is really fucking over our lives.”

Not all diseases are the same. Alcoholism isn’t cancer.

And keep in mind, not all alcoholics are affected the same way – not all of them drive drunk. Some get violent when they drink. Some get depressed. Others get really rude and nasty. Some get really happy and irresponsible. Some get talkative, some just get quiet and moody. Alcoholism doesn’t just affect the alcoholic, either – it affects everyone around them, as well. That was one of the big influences for Prohibition. A lot of feminists saw the effects alcoholism was having on the family, and wanted to stop it. Were they misguided? Yes. But were their observations correct? You betcha. Their solution, however, wasn’t the right one.

84

Do these actually change the brain so as to make someone who does not want to quit can take them & want to quit. So this will really be a way for a way to force people to quit drinking and to have a good outlook, you know, stop depression, eliminate all friends & relatives that don’t think they ever had a problem & will forever be pushing drinks at them. Way cool. I wish I had a ‘trigger’ removal pill in my first years of sobriety.

Do these need to be used to keep that effect? If they drop the meds, will they go back to being alcoholic? Or not have Alcoholism?

Shagnasty said: “there is almost always a reduction in drinking among those that take them and the one year sobriety success rate is over 50%”

Gus ← 50 % who take it make a year or 50% of the 50% ( 25% of the total? ) make it one year?

jtgain said: "Many alcoholics recover. "

No, they are in recovery ( a work in progress ) If they were recovered, they could drink normally. When they die sober & in sobriety, they have then recovered.
Some even believe that if you only drink to excess once every 5 years or so for 40 years and then die sober, that they never really had sobriety. ( IMO, they were not alcoholics but could do this. As I said, it is a good way to live.)

IMO, you have to die drunk to have totally failed. I would not want that way of life or the one with 5 in 40 over the one I have now for any reason. YMMV :stuck_out_tongue:

85

No of course not for your second sentence and beyond. Long-term alcoholism causes all kinds of relationship and social interaction issues but that is beside the point. Those drugs are helping people stop drinking in the first place (which I think you will agree is the very first step) and start rebuilding their lives from there. You need social programs and time for that. There is no pill or medical treatment in the world that can ever fix that in the short-term.

I am surprised that everyone in this thread has agreed so far that alcoholism is a medical condition or a disease. That is a good thing. It really is - full stop in many ways. Hopefully there will be more breakthroughs in treatment in the coming years.

86

Yes, I agree with 98% of everything you have said in this thread and since you have more total sobriety than I do, I **will not disagree ** with success.
A couple of minor things I look or see a bit different but no matter where or how there is progress I am for it… :smiley:

87

Did he make a free, conscious choice to own a car?

88

In regard to “enabling,” people who do this with an alcoholic allow the to continue to drink. You can enable a person with a disease or other disability by doing so much for them, that they never have to so things for themselves. (example: must paraplegics can empty and clean their own catheters, but if they can get someone else to do it do the, a lot of them will). You can burn out caring for someone who isn’t willing to do even the self-care that he or she can do. For a lot of the rest, when it is necessary and overwhelming, there is help.

At any rate. The small things you do do for someone who is disabled and your friend are usually compensated for by the pleasure you get from the person’s company.

The alcoholic who is drinking is like the paraplegic who thinks bathing is to much trouble, and waits for you to get sick of his BO, and do it do it him. The non-drinking alcoholic in recovery, who makes simple requests, like after a party, you have guests take home all the booze, so none is kept in the house, and you buy children’s cough medicine, is being very reasonable, and a better comparison to a person with a disability who takes care of himself.

89

Note – that should be condemning, not defending. Thank you. :smack:

90

What the hell, I’ll weigh in:

There is some research that there is a biochemical basis for alcoholism, at least the “can’t stop once he has had a drink” aspect.

At some intermediate stage of metabolization, ethanol
Is converted to acetone (yes, nail polish remover). In alcoholics further breakdown is delayed by a shortage of the required liver enzyme. Apparently acetone in ones bloodstream produces a strong craving for more, and the alcoholic then drinks till he pukes, passes out, or exhausts the supply.

It is worth noting that alcohol is required to start this. These alcoholics are sincere in their initial intent to “just have one or two to take the edge off” and are baffled and demoralized to find themselves waking up from yet another bender. They really only wanted a little when they started out.

There is a genetic component to this and many Asian and Native Americans (as well as a percentage of us WASPs) will experience this the first time they consume alcohol.

Liver damage due to alcohol or other toxins can also create or exacerbate this situation. I believe this applies to myself. The liver damage does not heal, so the relapsed alcoholic normally only needs a few days or weeks to return to the level of drinking that first took years or decades to reach.
To alcoholics like me that drink as a form of self medicating for anxiety, Alcohol seems like a solution rather than a problem. The shame and scorn heaped on me (including from myself) was just more mental suck that a few drinks could fix. In my case I had to be dry for about six months before I could see what I was doing and why. At the time the only thing is understood was “I need a drink”.

It is not too rare that alcoholics who stay dry through incredible will or aversion training commit suicide. Point being that the drink can be a symptom of an underlying root cause. Beyond stopping consumption, it is important that these be addressed.

Note that all of the above should be read as explain action, not excuse.

I have found AA helpful, but it is far from perfect. I would not choose a 1939 car for daily transportation, nor want to be part of a 1939 marriage, so why the hell does anyone think a 1939 recovery program doesn’t need an update or 10?

91

Yes, but if that were the primary cause, every heavy drinker would become an alcoholic, which, from what I gather, doesn’t always happen. More studies seem to be showing that it’s brain biochemistry that makes for the real difference, as in this one, which showed that–in mice at least–genetic dopamine receptor deficiency leads to changes in how alcohol effects an individual, leading to addiction.

92

Lot of good stuff in the post,

As to this question, AA worked for me. Warts & all. I have been to a meeting or three, conventions & read a lot of stuff about alcohol in 23 years and for me, if any of the changes would have been actually made that so many think should be, I would have probably died.

So, I can not say I would want anything to change. AA allowed me & showed me how to fix the underlying mental problems and all the life long things that helped me become an alcoholic.

If all I did was take a pill and did not want to drink alcohol anymore, no craving for it at all, I would still be a very sick puppy if not a dead one who took a lot of others with me.

If a pill can fix all mental problems, well that would be great. Or would it?

I could then slip you a pill and you could never drink again because you have been fixed. The world may end up going that way but I am lucky in that at my age, I will not have to go with it.

Those who think that they are cured of the disease because they don’t have the symptom, or took a pill for it will very very often think they can go back to drinking. Buried a lot of folks with that idea.

When it comes to AA, if it ain’t broke, don’t fix it.

If you found a different way and get to sobriety and stay there till the end, then you have done the correct way for you and AA will not tell you that you were wrong. It is not a contest no matter what individuals might say. It is about living, not being better than.