Once an alcoholic, always an alcoholic?

Great Debates
202

Your insistance on the cured aspect is rather odd. Do you question if diabetes is a disease because there is no cure? There are a whole shit load of diseases out there that cannot be cured but can be managed. How about bi-polar or schitzos?

I’d call an alkie cured if they could drink successfully. When I say successfully i mean the ability to drink without all the negative concequences. In fact if someone asks me if they are an alkie, my response is simple. I tell them to try controlled drinking. If they can successfully limit the amount and how often they drink then there is no problem. If, on the other hand, they cannot stop drinking or get shitfaced every time they drink then they probably have a problem.

The medical aspect of alcoholism is getting clearer all the time. The genetic link has been pretty well proven through twin studies. They are working on understanding the brain chemestry involved.

Treatment is another issue. So far the best option seems to be A.A. and counseling. I’ve posted links to the studies in multiple threads (on a side note, I could have sworn you participated in a pit thread on this subject where I linked to the latest research). Sadly the recovery rates are low across the board.

None of this, btw, absolves an alkie of responsibilty for their actions. Ultimately it is up to the alkie to admit the problem and find a way to manage it.

Slee

P.s. I.posted this from my phone and apologize for any typos…

203

Not really, since that is basically what this thread is supposed to be about. Your second paragraph, btw, pretty much answers the question.
That stuff about my thinking that it must not be a disease because it has no cure is nothing more than projection.

204

I guess if someone is ‘cured’, they are able to go through the rest of their lifes, spiritually fit and reasonably happy without ever again suffering consequesnces from drug abuse or obsessive behaviour.

If someone tells me they are cured, I am not going to argue with them, or try to convince them they are not cured.

If someone were to offer me a pill, a surgical procedure, a one-shot-and-you-are-done-cure, well that would something. I would probably be all over it. It would give me a lot more free time.

But if someone did this, and 3 years later are drunk in the bar again and doing the same shit they were doing before, does this mean the cure wasn’t really a cure?

Some cures are not found, and probably will never be found. And we know this. Some diseases go into remission for reasons we have no clue about. When someone goes into remission for cancer, do we say they are cured? We don’t really. We say they are ‘cancer-free’ or ‘in remission’. Doctors can perform surgery and remove tumors. Do we call them cured of cancer? Are we every really suprised when cancer reappears in someone who has had it? It is tragic, but not suprising. And someone who has had cancer *will always *be on the lookout for it again. Wouldn’t you be?

205

I think some of this debate centers around when the disease is present in the individual; if indeed “disease” is what alcoholism is. Does one suffer from alcoholism before ever taking a single drink? Or does the subsequent damage to one’s life and inability to control one’s drinking after one has begun using alcohol signify alcoholism? In other words, is it the measurable effects of the use/abuse of alcohol that determine alcholism or is it biological?

It would seem that it is becoming more and more clear, both scientifically and socialogically, that the answer is the latter. Sure, an alcoholic can “dry up” and abstain from ever taking another drink again, but, as many have pointed out here, they are forever nasty and unhappy. And as spooje has pointed out, the need is still there.

206

Keep in mind that many will be able to do this for a certain, limited period of time–let’s say, a month or two–in order to “prove” they don’t have a problem to their family and/or friends. Then, they start to increase the amount and frequency, gradually at first, and often secretly. Eventually, they’re back to their previous problematic drinking pattern, or maybe even worse.

207

I am not the only one who came to that conclusion. If you say something and multiple people come to a conclusion you did not mean, maybe you ought to rethink what you are saying.

For example, silly shit like this:

Take your statement and change alcoholic to diabetic. Does this mean that there are no diabetics out there?

As far as whether or not ‘Once an alcoholic, always an alcoholic’ is falsifiable, that is a tricky question. From my experience (which is of course anecdotal) the answer is yes. Of the 4 alcoholics I know who were in recovery and went back to drinking in the past year*, 3 are dead and one has disappeared. One died in a drunk driving accident. One had his liver fall out. One did a murder suicide. The other gal disappeared and no one knows where she went. She had a good job and a house. My guess is she will turn up in jail or dead soon.

According to the medical studies I have read the body does not change the way it processes alcohol once someone quits. The damage is done and once a drinker picks up again the body responds as though they had never quit. This is a physical issue, not a mental issue. I’d hunt up the cites but I am tired of posting the same shit over and over again.

Slee

*Note, that is for the past year. It’d take me a long time to add up all the people I’ve known who died after returning to drinking since I got sober. Watching people die does get old…

208

So looking at alcoholism from a disease-model, in a purely hypothetical situation, an alcoholic who (for whatever reason-forced, etc.) never took that first drink to begin with would still suffer from the disease of alcoholism. Or, more broadly put, the disease of addiction. That “hole”, as I believe spooje referred to it as, would still be there, regardless of whether or not one fills it with alcohol.

209

According to Chick (1982), there have been former alcoholics who have recovered from their alcoholism by modifying their daily routine. Some were able to recover by only having a few drinks (drinking moderately). Of course, there are some who had to abstain from drinking any alcohol. It depends on the individual. To answer the question, some alcoholics do recover. Recovery is possible and some alcoholics get to the point where they can drink moderately (after they recover from their alcoholism). However, it is also true that some people do not recover from alcoholism.

210

Well done, Spooje !

211

Exactly.
I recall my husband’s first 6 month

s of sobriety were nearly as bad as him being a drunk.
He was a first class A-hole when he initially became sober, and he had to live his life without that soft friendly fuzzy blur provided by his daily self medication.
He ate sugar non stop for 6 months as well. This is very common I hear.
Not drinking was the easy part.
Being happily sober took some effort and a whole lot of coaching from others who loved him enough to tell him when he was full of shit. Which was often.
I love that man. He’s my hero today.

212

No doubt that long-term overuse of alcohol damages ones brain. But AA and other advocates of the disease-theory contend that alcoholism is a disease one is born with; not a disease caused by alcohol-induced brain damage.

213

I acknowledge that you state this is your opinion, but may I ask: what makes you think that you will die as an addict? Is addiction a disease or a self-imposed term applied because of past behavior?

If the former, then how do you know a cure for this disease won’t be discovered tomorrow? If the latter, then I suppose you can choose to consider yourself an addict because of past behavior, and decide that you shall always consider yourself an addict until the day you die. Nobody can take that away from you and you can label yourself whatever you like. Of course, you can also choose to remove the label, too, should current behavior warrant it.

I suspect you hold the former to be true–that addiction is a disease. I don’t think anyone would voluntarily choose to consider themselves an addict forever and ever, no matter what, unless they truly believed that it was an involuntary pathology–a disease. So if a cure is found for your disease will you still call yourself an addict?

214

I just wanted to pop back in here. Thanks to all those who took time to post such thoughtful things, it is appreciated.

However, I find this whole drinking, and being an alcoholic at the same time to be a very fine line. Take for instance, the analogy that’s been used, “if you start drinking and can’t stop, you’re an alike”. Well what about for those who can do it “sometimes?”

Admittedly, I’ve drank and got out of control countless times. So I have a problem. But this whole weekend at my cousins wedding I drank and kept it under control. No blackouts, trouble, anger… Just drinking like a normal person.

In my opinion, it goes back to your state of mind as well as surroundings and alcohol simply acting as an amplifier. I’m surrounded by friends and family who I love and trust. Also, I don’t want to embarrass myself in front of people I know. Alcohol is just a social lubricant.

In a bar, not so much. You’re surrounded by mostly random people. You have social anxieties and fears that increase and alcohol just seems to throw everything into a tailspin. Alcohol is an escape.

But how can somebody with a problem control it sometimes?

215

So you admit that external pressures can influence your behavior while you’re under the influence. What you haven’t told us is how much you drank at the wedding vs one of your worse nights. Or was the difference that the wedding reception was during daylight vs at night?

Maybe what you are noticing is that when you have fun, you don’t feel the need to act out, and when you are not having fun, you substitute a loss of control (potential for embarrassment, etc) for the stimulation of interesting company. Don’t you think that you could have had just as much fun at the wedding not drinking at all?

All that aside, have you given any consideration to the suggestions around forcing yourself to drink less via monetary controls, strict rationing, or making better decisions (about top-shelf booze vs rotgut)?

216

Addiction as a disease. Or if you prefer, addiction as a state of being.

I know for a fact, from past behavior, what happens when I use a drug. Any drug. But addiction is not the drug, but what makes me obsess about it and crave it. And what sometimes leads me to obsess and crave is series of situations involving low self esteem, alienation, fear, self-centeredness, etc… Now, when I work a program (going to meetings, working steps, talking with my sponsor, prayer and meditation, being of service) I can live a good life that resembles that of of non-addicts. If I do not, and there have been times when I haven’t, it can get ugly.

Type 1 Diabetes (which I also have) is a good analogy. As we know, there is no cure for Type 1 Diabetes. But it can be managed with the proper regimen. (Remeber, the regimen is not insulin alone, but also diet and exercise and proper medical care) If someone follows that regimen, they can live a long, full life. If they do not, and try to eat sugar like it is going out of style and think they can just shoot enough insulin to take care of it…well, it gets ugly. Often someone in this state doesn’t know how much their health is in danger till it is almost too late. (Sadly, I speak from experience here also)

So every day, I am addict. But everday I get to choose if I am going to work a program or not.

So about the cure. That’d be real nice. But what you would have to cure is the low self esteem, sense of alienation, fear, self-centeredness, etc… What would this cure look like, I wonder? Probably a regimen of pills that work on brain chemisty anf the pleasure center. Now, if I had to take these pills daily, indefinately, is that a cure? Or just maintenance of a disease. And if it is maintenance, would I be better off than I am now?

In all seriousness, I do not know.

217

I have a hard time seeing threads like this and not popping in with my two cents. I think addiction is a disease, and those with personal experience either because they themself know the struggle, or someone they are close to does, perhaps understand it to a degree other people do not.

That said, my main reason for coming in is to say that I think addiction treatment is woefully inadequate, and the fact that everyone has pretty much told the OP to go to his AA meetings is evidence of that. There are a small number of people who have some amount of success with AA and other 12-step programs, and I certainly wouldn’t deny that or take it away from them. If it works for you, great, but let’s not pretend it’s successful enough that it’s appropriate to prescribe it to anyone and everyone with addiction issues.

The statistics differ, but the success rate of AA seems to be about the same as that of people who attempt to stop drinking with no outside help at all.

But I’m pretty excited to find that there are more drugs being shown to have success in treating alcoholism. And I’m always going to be more inclined to go with science over prescribing “higher power” and daily meetings for the rest of your life (where they literally repeat the same exact shit every day). So I feel like this stuff needs to be shared when this discussion arises.

There are some different drugs that are having a decent amount of success with regard to alcoholism, and naltrexone has shown promise:

Here’s an article about naltrexone and topomax being prescribed for alcoholism:

http://articles.cnn.com/2009-04-15/health/addiction.cold.turkey.pill_1_naltrexone-alcoholics-topiramate?_s=PM:HEALTH

An article about a drug called baclofen:

ScottyMo, I don’t know if you are an alcoholic, or if you’re just a young guy who gets carried away drinking and will chill as you get older. Whatever the case, it sounds like this is a good time to perhaps refrain from drinking until you figure out what the truth of the matter is for you. I hope you’ll talk to your doctor about this, in addition to (or instead of) the AA meetings.

Good luck!

218

For myself, my definition of alcoholism is, I cannot with any confidence predict when a drinking event will turn out badly. Looking back, the wedding went OK for you; could you have predicted that in advance? In my case, I cannot.

219

Indygrrl - Naltrexone works fabulously as a crutch, the alcoholic can drink and not become impaired.* While all these drugs are a great help, they don’t replace therapy or counseling. They don’t teach the alcoholic how to manage their lives minus the alcohol.
*This is how I saw it used.

220

I’m aware of that, but according to that model, someone who is born with alcoholism and never in their life drinks–perhaps someone born in a devote Muslim culture, for example–will never exhibit the phenotype. Such a person neither will get into trouble with alcohol nor will need a “cure” for it. For such a person, the question in the OP is moot, isn’t it?

However, with the disease-theory, isn’t the idea that once that person born with the genotype for alcoholism gets to experience the effect of ethanol on the neurotransmitters which normally trigger dopamine, etc., that person will increasingly seek contentment through the alcohol, as the natural means of contentment are disabled with increased consumption. Maybe not a lot, at first, or maybe only on the weekends at first, like the OP, but as it progresses, the alcoholic is different from other people because s/he requires the ethanol (or other drug) more and more to achieve even a normal, natural ease of mind.

221

I am jealous of any disease/condition where a daily meeting of support and fellowship can offer help.
I wish like hell I did not need to take drugs to manage/control MY terrible, awful disease.
I hate these fucking pills. Prednisone keeps me alive for now, but may kill me in the end.
If I had a choice … prednisone or daily spiritual meetings ???
Hmmmmmmmmmm.
I’d go to meetings and repeat the same shit every day.
Hell, I’d go twice a day … Perspective is “sobering”.