What is your opinion on "once an addict, always an addict."

Great Debates
21

[QUOTE=WhyNot]
…

I think some people have the same relationship to drugs, including alcohol. No matter whether or not they had their last drink an hour ago or a decade ago, they will still have the tendency to abuse drugs. They will always be addicts or alcoholics, nevermind their current level of consumption. It’s a mental, and perhaps physiological, state-of-being, not a description of an activity.

I also believe, however, that not everyone who abuses drugs or drink is an addict. There are indeed people who go through a period of self-medication or recreation and need treatment to stop. But some of them may quite legitimately be able to resume moderate use later in life. I think it’s these people to whom AA does a great disservice to.

The problem, of course, is that you don’t really know if you’re an addict or not until you try moderation and it fails.
[/QUOTE]

I think it’s risky to assume that an addiction is temporary.
Sure a shock (such as a bereavement or loss of career) may cause you to e.g. drink far too much. However, even once the unhappiness is sorted, you may now be physically addicted.

22

I really think AA is responsible for this. Try to tell someone that you were an alcoholic but now you’re not and that you can go out for a couple drinks without sliding back, and the common response is “You weren’t really an alcoholic, you just drank to much” (I think there’s a name for this)

I drank for years, way too much and constantly. Several years after the shakes and etc. stopped, I had a beer. It didn’t taste all that good and I didn’t immediately slam a 12er. A year or so later I had several beers and still managed to not get blotto. 12 years after I quit drinking, I can still moderate my consumption.

My name is Bobo, and I’m an ex-alcoholic. (Let’s not discuss smoking tho)

23

[QUOTE=Bobotheoptimist]
“You weren’t really an alcoholic, you just drank to much” (I think there’s a name for this)
[/QUOTE]

“Cluricaun”

24

[QUOTE=Cluricaun]
“Cluricaun”
[/QUOTE]
:smiley:

I was thinking “No true Scotsman”, but I like yours better.

25

Everyone else has touched on other parts of the OP quite nicely, so I’m going to address this part. IMHO, your aunt is doing what’s working for her and it’s not hurting you one little bit. Therefore, again IMHO, it’s jerkish to argue the point with her.

26

[QUOTE=diggleblop]
But how is being fat a symptom and not a problem? A symptom of what?
[/QUOTE]

It’s a symptom of an unhealthy relationship with food, if not an outright full-blown eating disorder.

Slightly off on a tangent here–I am not an alcoholic or a drug addict but I am a recovering anorexic. As with recovering alcoholics who are working their recovery, I work my recovery too. I know my triggers, and much like hlanelee who posted that even one drink is too much, if I choose to indulge any of my known triggers, then I will be headed down the skeletal path.

So IMO your analogy doesn’t work for eating disorders either.

27

[QUOTE=glee]
I think it’s risky to assume that an addiction is temporary.
[/QUOTE]

Right, that is what I meant by: “The problem, of course, is that you don’t really know if you’re an addict or not until you try moderation and it fails.” Even after the physical addiction is dealt with through detox and medical support, the question still remains for most people - am I an alcoholic? The only way, I think, for those who think they’re aren’t to learn the truth is to try moderation, but you’re right. It’s very risky. If you (general you) have things too valuable to lose, like a family or a job you love, it’s probably not worth fighting your ignorance in this particular area. Assume you’re a forever-addict and act accordingly.

28

It’s a slippery slope thing. People who have been fat are on the slope in two ways. First there’s the habit of overeating, possibly the craving to overeat, which has been mentioned.

In addition to that, there’s the physiology. When you overeat, first your fat cells fill and then your body makes additional fat cells. When you diet, your body empties the fat cells. They don’t go away, at least not for years. Any time you backslide, they’re there waiting to be filled. And it takes less energy to do that than to make more fat cells, so the fat goes back on more efficiently the second or third time.

I have known people who had the stomach surgery and either didn’t lose the weight they were expecting or eventually put a significant amount of it back on, because the surgery won’t help if you don’t stop overeating. You have to learn to say no to the craving and no to anyone who urges you give in to it. Anyone who says, but you’re not fat now, have a little slice, should be slapped. Anyone who says, but you’re not fat now, don’t talk about yourself that way, it makes me uncomfortable, may not deserve a physical attack, but it’s not helping.

29

Fixed title, and moving thread from IMHO to Great Debates.

30

I guess I should mention that I don’t think everyone will be able to drink in moderation after breaking the cycle. AA works for some people, self loathing (or pride) works for others. It’s just the notion that no one can get over it that I take issue with. Probably not a good area for experimentation, in many cases.

31

I believe it is true at least for me and the vast number of other alcoholics I have known and how AA generally represents it (unfortunately). Alcoholism runs so deep in my family that it is ridiculous especially when counselors have had me fill in a genetic chart for such a thing. My mother is one of the only non-alcoholics out of the bunch and I never really grew up with most of the relatives in question. I absolutely swore that it would never happen to me and I basically left my family for good at age 18 when I went to college.

One thing that was readily apparent right away was that I had an extreme tolerance for alcohol even though I had never drunk much before. I hooked up with hardcore drinkers as friends and we played drinking games most nights. I was soon assigned a handicap of drinking 3 drinks for every one 1 the next closest guy took. It didn’t take all that long before I could drink 30 drinks a night or more every single night until most other people were passed out. I would then drive some of them home. It sounds bad but alcohol didn’t affect me like most people and I could drive semi-safely and I never got a DWI despite being stopped a few times for other things. This went on for years and one day I felt a switch “flip”. That day, I cried and realized that I could never go back and I only had a couple of paths to take and neither was good.

It wasn’t so much mental as a physical feeling like I absolutely had to drink all day, every day and that is what I did except when I was at work and that was the time I felt like pure hell. I did not get hangovers and the liquor bills were many hundreds to over $1000 dollars a month and I kept that minimized by either not drinking at bars or having a twelve pack before I went so that other people wouldn’t notice the extreme consumption although it usually came to that anyway.

I believe it the “flipped switch” theory for me and many others. Alcoholism is about as close to demonic possession in the material world. I am sure some drug abuse is the same although I have never done those but alcohol has the advantage of being everywhere. Some part of your brain wants to destroy you and literally and ultimately kill you. That is a scary problem and it is hard to fight. At some point, the medical tests start to become frightening to the doctors and you have to go for more and more tests while wanting to stop while this addiction rages inside you literally hijacking your body and brain to destroy you.

I made excuses at one time about what I could do about it but it is all lies. My academic background is in psychopharmacology and I new what was going on intellectually every single day and I couldn’t stop it. All I could do was to flip the off switch and never get close to it again or the process will pick up right about where I left off.

32

I think it’s important to make the distinction between someone who may have a true addiction to drugs or alcohol and one who uses substances to cope with depression, bipolar disorder or some other psychological problem.

I used to drink, but I have abstained for almost 15 years. I largely drank to cope with undiagnosed bipolar disorder and PTSD; once I got help for these, the compulsion to drink went away. I still don’t drink, but that is more of a lifestyle choice than a desire not to “relapse.” I don’t like the out-of-control feeling that alcohol gives me, so I just don’t use it. It’s not that big a deal. It’s not something I have to be vigilant about. I just don’t drink.

Robin

33

I believe this model of addiction is derived heavily from the Alcoholic’s Anonymous paradigm of addiction, and I’m not sure it’s entirely accurate. I’m certainly not an expert in addiction, but I’ve studied it a little. And while I’m certain that many individuals relapse very easily upon any exposure to alcohol once they’ve been rehabilitated, there’s evidence to suggest that many people manage to drink responsibly after rehab. I dug up this abstract very quickly–


[Quote=Schutte et al. 2003]
Older former problem drinkers (n = 447) were prospectively followed for 10 years and compared to lifetime nonproblem drinkers. RESULTS: Of former problem drinkers, 31% (n = 141) died over the 10-year interval, a rate 1.6 times higher than that of lifetime nonproblem drinkers. Among surviving former problem drinkers, although relapse was relatively uncommon (11%), a less severe drinking history, heavier baseline alcohol consumption, and lower baseline income were associated with relapse. The majority (63%) of former problem drinkers who successfully achieved sustained remission continued to drink alcohol, though at levels below those consumed by older lifetime nonproblem drinkers (n = 339). Stably remitted problem drinkers who were abstinent (SRAs) generally reported more severe drinking histories, greater functioning and life context deficits and more help seeking than did stably remitted problem drinkers who were nonabstinent (SRNs). Although SRAs and SRNs both experienced improvements in functioning over the 10-year interval, they continued to experience financial, health-related and life context deficits relative to older lifetime nonproblem drinkers.
[/quote]

This would seem to support that really heavy alcohol use is correlated with an inability to responsibly drink after treatment, but I’m not sure how they’ve operationalized things and I don’t have access to full text. It also suggests that actually the majority of former problem drinkers (whatever that means; I really need to see the methods) manage to drink okay after treatment! I’ll see what else I can dig up; one article’s never enough.

34

My twelve stepper friends all know that I did a lot of drugs, for a lot of years, and had a lot of trouble stopping it. Now, the fact is that most of the drugs I did were hallucinogenics, not opiates. (I hate downers, and can’t stand folks who do them either.) Whether or not true addiction is possible with pot is a argument that very few people have the biomedical credentials to argue rationally. It doesn’t matter to me, It took me ten years after I quit buying pot to quit smoking it. I don’t want one, thank you.

But, (and here is where the AA mafia gets really torqued up with me) I drink, every time I want a drink, and as much as I want to drink. Long ago, before drugs, I got drunk a lot, and had some troubles because of it. But, now days, it is not a problem, and hasn’t been since the first time I got stoned. See, alcohol is a downer. I hate downers. So, the amount I actually want to drink is one drink, sometimes two, and if it’s a long social thing, maybe three, but probably not. And I do this once or twice, every two or three years.

Now speed and cocaine are exactly what I like in drugs. Except I was lucky enough to meet speed freaks, and crack heads before I ever tried those drugs. No thanks.

So, once an addict always an addict is a gross oversimplification. But, if a gross oversimplification keeps you from screwing up your life, then by god, oversimplify!

Sometimes you just take drugs, sometimes the drugs take you.

Tris

35

[QUOTE=norinew]
Everyone else has touched on other parts of the OP quite nicely, so I’m going to address this part. IMHO, your aunt is doing what’s working for her and it’s not hurting you one little bit. Therefore, again IMHO, it’s jerkish to argue the point with her.
[/QUOTE]

I agree that she’s obviously doing what works for her (or what she thinks works for her; maybe she’d be sober even if she didn’t think of it that way for all I know) and that it’s important to allow people their own style and their own approach since we can’t ultimately know the unique nuances of how they process things mentally, emotionally, and physiologically.

I think it’s harsh to say he’s being a jerk though. It seems to me that he feels she may be locking herself into a mindset that isn’t necessary to maintain sobriety and that may be hurting her self esteem in other ways that are equally important, potentially, insofar as the quality of her life is concerned.

Doesn’t mean he’s right, but I think the intentions can be honorable if you think someone is operating on a delusion to try to argue them out of it.

36

A second cite–

[

](http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=3597795&ordinalpos=10&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum)
(bolding mine)

An older study, and not ironclad evidence that former alcoholics can go back to habitual drinking, but it looks like many former alcoholics won’t be completely sunk by a signle drink.

37

[QUOTE=Guinastasia]
This thread is why my blood just boils when people deny that alcoholism is a disease. Wanna meet my family and find out?
[/QUOTE]

I don’t mean to be inflammatory, so please excuse this question: why? Sometimes alternate models of substance abuse and dependence are useful, aren’t they? I don’t think it detracts from the fact that alcoholism can ruin people’s lives, nor do I think it means people are weak or immoral because they end up with alcohol dependence.

38

I usually fall off the wagon on the 4th of July,dont ask why,I just dig the 4th…

My being an alcoholic has nothing to do with how long I have abstained or can stay away.It has more to do with my complete inability to drink like a sane person,ever.
The last time I drank I wound up in the hospital and blew a .513 and the doctor was amazed that I was still conscious,let alone lucid.He also informed me that .6 is comatose or dead.
It usually starts with"Its the 4th, Ill just drink tonite with the fellas." It usually ends with me on the couch 3 or 4 weeks later going through severe withdrawls,my whole body shaking and gripped with anxiety/fear and depression.

Dreading the inevitable nightmares, shakes,days of dry heaving unable to eat and minor seizures (when I can sleep). Ive been doing this since I was 16 and am now 37. (I once told a good friend “If I fall asleep and start twitching dont be alarmed,it happens”-I didnt wanna use the word seizing,he’d a freaked out)

Ill never be able to drink ‘normally’ no matter how long I abstain. How do I know this? Not because AA tells me so (Im not a member but have been and am very familiar with the program)I know because I’ve tried.
I have a feeling that I could type till my fingers fall off and you would never understand ,thats OK I dont expect you to fully understand and I hope you never do.
Having said all that do you think that’d keep me from drinking on the next 4th of July? probably not, we’ll see…
Why would I call myself something that has a negative connotation?.. Its true

39

I’m not doubting you. Again, it’s pretty clear that a lot of people have that reaction. But there’s evidence to suggest that some people recover from addiction and are able to drink at least occasionally without relapsing. At the same time, some people drink very heavily but don’t seem to develop a dependence.

AA has helped, by their claim, millions of people. I think the popularity of the disease model has largely fallen out of their good work, and if subscribing to it helps you, that’s awesome. I will go on record saying that I think there’s legitimate objections to be made against the disease model of addiction, but that it’s still really useful for treatment for a lot of people. As long as people find it useful and are able to use it to fight their alcoholism, I think there’s value to it. That’s all.

40

I am a recovering alkie.

I know lots of alkies. We run in packs* to scare the normies. Well, not really, but it’d be fun. Actually we go to A.A. meetings for the most part.

So far I have not met an addict or alcoholic who has been able to go back to using his or her drug of choice successfully. The last guy I know who tried had ~12 years clean and sober. He decided to drink again. I missed his funeral because I had to work. He died about three months after going back to drinking. He had a seizure. And an insanely high B.A.C level at his time of death.

I have, however, met problem drinkers who have been able to control their drinking. And this is where it gets weird. I hung out with people who drank as much as I did and were not alkies. They were problem drinkers but it seems that they could choose to regulate their drinking while I couldn’t. They could, and did, successfully regulate their drinking. They would have problems in life caused by drinking (DUI, pissed off friends/family, late for work, etc) but when they decided to cut down or stop they could do it while I couldn’t. I know a couple of them can drink in moderation now and have no problems.

What is the difference between me and them? I don’t know. I do know, however, that I am an alcoholic and if I drink again I will end up exactly where I was when I stopped drinking. I know this because I tried it way too many times. Every time the exact same thing happened. One drink led to many which led to bad things. There is no reason to assume that if I were to try drinking again the outcome would be any different.

Slee