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

[nameless]

[QUOTE=sleestak]
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.
[/QUOTE]

That’s the thing. What’s the definition of an addict? What defines an “alkie?” Problem drinkers =/= alcoholic… because they didn’t go to AA? Surely, that shouldn’t define someone as an addict or not. I mean not all people with alcohol dependence disorders seek treatment. But then again looking in the literature today, I found a few articles that grouped people who seek treatment vs. those that don’t, and there’s actually differences in their long term prognosis–here’s one of them–

[Quote=Elal-Lawrence et al. 1986]
Controlled drinkers were more likely to be continuous drinkers, were not likely to have attended A.A. or to have abstained for a significant period of time, were likely to have relatives with a drinking problem, to have been motivated to seek help by a friend or a relative and to be less discriminating about the social drinking environment. Relapsers were more likely to be unemployed, to have a history of A.A. attendance and to have had a short period of previous abstinence. They were most likely to have liver damage and therefore advised to abstain. The results were interpreted as suggesting that outcome is likely to be influenced by the subjects’ cognitions, by past behavioral expectations and experience of abstinence, as well as having the freedom of a choice of goals for recovery.
[/quote]

(bolding mine)

So it seems logically (to me anyway) not really a useful definition of alcoholic… but apparently it might correlate with some interesting factors. And it does sort of make sense when you think about it, that people seeking treatment might be differently susceptible to the effects of alcohol than those that aren’t. Whether that is sufficient to classify them as an addict… I don’t think so.

For what it’s worth, the DSM-IV doesn’t use the word “disease” (although it does use “disorder”) and it lists substance “dependence” and substance “abuse” disorders, (as well as substance “withdrawl” syndromes) but not substance “addiction” (at least not in my copy )

[Tony_Montana]

[QUOTE=diggleblop]
How do you feel about this mentality? In my opinion, I don’t think it’s very encouraging to call someone who has worked so hard to stay clean for __ number of years an “addict”.
[/quote]

If someone still has to work “so hard” to stay sober after __number of years what does that say?

When I see people introduce themselves in movies like, “hello, I’m Paul, I’ve been clean for 14 years and I’m an addict.” it makes me cringe. Because that person ISN’T an addict any longer.

My addiction to alcohol will always be there,even if the alcohol isn’t. Are you speaking from personal experience here?Are you an addict?

It’s like a fat person who loses all their weight still saying they’re fat.

There’s no physical or chemical addiction there.Not a valid analogy

Or a bank robber who has served his time saying, “Hi, I’m Tom, I did 20 years for armed robbery and I’m a bank robber.”

Not analogous

To me it’s saying that a person never changes.

The alcoholism part of me never will change,doesn’t mean that the rest of me cannot.

Why would you call yourself something that has such a heavy and negative connotation?

Thats just the way it is. I’ll never be able to drink ‘normally’. I don’t go out in the middle of the street and broadcast it at the top of lungs though.

The same goes for alcoholics. My aunt hasn’t had a drop in 20 years and she still calls herself an alcoholic. I always argue and tell her that she ISN’T a fucking alcoholic anymore.

Why would you do such a thing,and why does it bother you so much?

This is one of ideals the twelve step program that I disagree with, in fact, there are many.

I know Im an alcoholic and always will be regardless of how long I abstain from alcohol. I know this from my own life experience.Not from some book in some AA meeting.

This is just one that I can’t grasp.

I have met many 'non-alcoholics who couldnt grasp my ‘addiction’.I could talk till I was blue in the face and they’d never understand.

It’s totally discouraging the EX-addict and I also think it subconsciously does something to the self esteem of the EX-addict. Which is why I think so many go back to doing drugs.

The only thing that bothers me about being alcoholic is that I can’t have a drink with the fellas.It doesnt lower my self-esteem one bit.I dont know why others would relapse and wouldn’t be so presumptuous as to think I do.

These programs teach people backwards

So are you suggestion that AA or NA should begin by telling the addict or alcoholic: “Today,you are no longer an addict”

[norinew]

[QUOTE=9thFloor]
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.
[/QUOTE]

You’re right in that I could be being harsh saying he’s being a jerk. I don’t know the tone or content of their conversations. I certainly haven’t heard her side of it.

However, this line from the OP (bolding mine):

I always argue and tell her that she ISN’T a fucking alcoholic anymore.

comes across as jerkish. Now, it’s certainly true that print on a screen isn’t nuanced the way speech is. Maybe as he says this, he’s smiling a crooked little rueful smile, and shrugging his shoulders. That’s just not the way it’s coming across to me. If he always argues, if he always insists that she stop referring to herself as “a fucking alcoholic” because (in his own words) it makes him “cringe”, that seems like jerkish behavior to me. She’s found what works for her, she’s doing it, and she’s not hurting anyone by doing so.

As I said in my first post, this is only my two cents, and probably isn’t worth more than that .

[villa]

[QUOTE=diggleblop]
Or even ex-smokers walking around stating that they are smokers.
[/QUOTE]

Actually, I always did. For the seven years that I gave up smoking, I always described myself as a smoker who no longer smoked. Now I am a smoker who smokes once more, but I hope soon to return to non-active duty.

[nameless]

[QUOTE=Tony Montana]
There’s no physical or chemical addiction there.Not a valid analogy
[/QUOTE]

That just isn’t true. Fat is a chemical. All of the components in the fat metabolism pathway and the hormones that deal with eating are chemicals. Physical changes occur in the body and brain when eating that might resemble the ones that take place during substance abuse. Why is it so hard to believe that they might affect the brain’s reward system in a similar way as alcohol?

It’s different, but that doesn’t make it not as good of an analogy. A better argument would be: being fat is not like being an alcoholic because animals will satiate on food but not on cocaine (for example).

[Nutty_Bunny]

I can understand the reasoning of many addicts to call themselves addicts in order to keep it in mind, so they (we) don’t slip up, but in my experience, I relapsed more while I was attending NA meetings. If I’m in an environment where people are talking about drugs, I’m like Pavlov’s dog–except instead of a bell, it’s the mention of narcotics (vicodin) that get me salivating. It was much more difficult to stay clean when all I talked about was trying to stay clean.

So, I agree that “once and addict, always an addict”, but I don’t self-identify as an addict. I know that if I were to take one pill, I’m headed down the wrong path again, but I won’t label myself. It’s what works for me.

[Tony_Montana]

[QUOTE=nameless]
Why is it so hard to believe that they might affect the brain’s reward system in a similar way as alcohol?

[/QUOTE]

So if Im reading this correctly you’re saying that fat has a direct and immediate profound effect on the neurotransmitters serotonin (5HT), dopamine, and GABA (gamma-aminobutyric acid)?

[nameless]

[QUOTE=Tony Montana]
So if Im reading this correctly you’re saying that fat has a direct and immediate profound effect on the neurotransmitters serotonin (5HT), dopamine, and GABA (gamma-aminobutyric acid)?
[/QUOTE]

You forgot to abbreviate dopamine (DA)

That’s not really what you were claiming before. What you claimed before was–

@Tony Montana

There’s no physical or chemical addiction there.Not a valid analogy

The upstream pathway implicated in fat-related reward, the time course of fat-related reward, and the magnitude of fat-related reward are all variables which differentiate fat-related reward from drug-related reward. Of course. I won’t dispute that. I will disupte that fat doesn’t affect the reward circuitry in a fashion that is very similar to drug reward.

Maybe not immediate, or particularly direct, but yeah, I’d say fat activates the brain’s reward circuitry, or else we wouldn’t eat.

[QUote=Fulton et al. 2006]
Leptin is an adipose-derived hormone that acts on hypothalamic leptin receptors to regulate energy balance. Leptin receptors are also expressed in extrahypothalamic sites including the ventral tegmental area (VTA), critical to brain reward circuitry. We report that leptin targets DA and GABA neurons of the VTA, inducing phosphorylation of signal-transducer-and-activator-of-transcription-3 (STAT3). Retrograde tracing combined with pSTAT3 immunohistochemistry show leptin-responsive VTA neurons projecting to nucleus accumbens (NAc). Assessing leptin function in the VTA, we showed that ob/ob mice had diminished locomotor response to amphetamine and lacked locomotor sensitization to repeated amphetamine injections, both defects reversed by leptin infusion. Electrically stimulated DA release from NAc shell terminals was markedly reduced in ob/ob slice preparations, and NAc DA levels and TH expression were lower. These data define a role for leptin in mesoaccumbens DA signaling and indicate that the mesoaccumbens DA pathway, critical to integrating motivated behavior, responds to this adipose-derived signal.
[/QUOTE]

Adipose is fat, for those keeping track at home. All drug reward feeds through the nucleus accumbens (abbreviated in this paper as NAc) shell, and is at least in part mediated by increased dopaminergic release there.

From the text of the article–

The hypothesis that decreased NAc dopamine signaling leads to increased feeding is compatible with the finding that obese humans have reduced central D2 receptor levels (Wang et al., 2001) and that administration of DA agonists to ob/ob mice normalizes hyperphagia (Scislowski et al., 1999 and Bina and Cincotta, 2000).

These researchers observed reduced dopaminergic transmission in NAc in ob/ob mice (which are leptin deficient). So it’s clear that fat and dopaminergic transmission are connected in some way. Furthermore, they cite articles that suggest the reward system in obese individuals is different from individuals who aren’t (specifically, it seems like they’d be more resistant to satiation). But you’re certainly correct that being fat is different (again, animals generally satiate in response to food but don’t satiate in response to certain drugs). But to claim that fat doesn’t cause chemical changes in the reward system or that it can’t be “addicting” is false IMO.

[mswas]

The problem with this mentality is that it encourages a person to identify with their addiction. Their addiction is part of them rather than an affliction that can be healed. With addiction its all about attitude. You don’t get over your addiction until you stop being an addict. Generally addiction is a substitute for some other need that is not being fulfilled, often love. If you can fill the need that is being substituted for then the addiction holds less sway.

No one who has AIDS says, “I am AIDS.” so why, “I am an addict”?

[Tony_Montana]

Ok nameless
How about if I say that being fat is not like being an alcoholic because animals will satiate on food but not on cocaine.
What do you say to THAT??! Uh huh I thought so…

wow,your last response generated 4 “reply to post” emails from SD.Is that from the edit function?

[fifty-six]

I am getting super close to ten years of sobriety. I consider my self an alcoholic and an addict. Here is why.

Cocaine, speed, crack, shooting up, heroine, inhalants, pills, alcohol, LSD and other hallucinogenics are what I consumed on a regular basis for ten years.

In ten days I will be ten years sober.
For the last twenty years every day of my life has been about getting or using, quiting or recovering, form drugs and alcohol. It is still as much a part of me now as when I was using.

It has become a part of my identity.

I wish to have a new identity but I can’t seem to shake this one. It is not due to AA. I don’t go. It is not because I call myself an alcoholic or addict. I rarely say that. It is just that it still consumes me.

10 FUCKING YEARS!!! sober and it still takes a large part of my thought.
I often state that when I turn 65 I will start using again. Coke and drinking mainly. I have caught myself driving and longing for the day, muttering to myself. Ahh… only thirty years to go.

[Guinastasia]

[QUOTE=nameless]
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.
[/QUOTE]

I guess it’s more the people who call addiction a “weakness”, and that people need to just suck it up, and have self-control. That’s all. I guess it was just losing my aunt that really makes it a sensitive subject for me. She was my godmother and my favorite aunt. And even now, I’m getting teary-eyed thinking about it. I’m not looking for sympathy. Just saying how it makes me feel.

I tend to be over protective when it comes to my family.

[jackdavinci]

meh. It’s no more or less accurate than any other label. It’s more accurate to say “I have an addiction” or “I’m abusing drugs” than “I’m an addict”.

I guess the real issue people are getting at though is - if someone has had a problem abusing the object of their addiction and quit the said object, does that mean that they will never be able to casually come in contact with it without succumbing to abuse again? I think it boils down to a tautology - people that are able to do something casually without abusing it aren’t defined as addicts. People that can’t are defined as addicts.

But it’s really a more general case of that anything one does becomes habitual. If you are used to enjoying 6 drinks at a time, it’s likely to be harder to learn to enjoy just 2 drinks in a sitting (a new habit) than just not drinking at all. I’d say it would work the opposite way to some extent - someone who is used to enjoying one or two drinks for a light buzz probably wouldn’t feel comfortable starting to drink hard. Mixed of course with the fact that the scale is one sided - you can always have more, but you can’t have less than nothing - so any new behavior is likely to be in the direction of excess (except in the case of going totally opposite and becoming compulsive about healthy habits).

Sure, it’s possible for someone to have an addiction abuse problem, and than later become a casual user without ever succumbing to abuse again. There’s just a lot of selection pressure against the phemomenon making it less likely than other scenarios.

[Moirai]

Just my opinion, of course…

I still refer to myself as a drunk and a junkie, even though I haven’t touched a mood-altering chemical in almost 17 years. I will always be an alcoholic, even if I never drink again. The underlying condition isn’t ever going away. Same goes for my myriad of drug addictions.

At the core of my being, I know I can never drink like a non-alcoholic. Nor can I recreationally use drugs. I am cool with that.

But I do not reserve the right to drink at some point in the future. I know it’s a bit controversial, one day at a time and all that, but everybody I know who reserved the right to drink or use later on did it. And I’m not going there, thankyouverymuch.

[diggleblop]

I don’t even know where to begin with your nitpicking. But I’ll try. My responses are in black.

[QUOTE=Tony Montana]
If someone still has to work “so hard” to stay sober after __number of years what does that say?
That says that they’ve worked hard to stay clean, what is it supposed to say? Staying clean is staying clean. It does not mean they are an addict any longer.

There’s no physical or chemical addiction there.Not a valid analogy
Addiction is addiction, be it food, sex, talking or drugs. It is a valid analogy, sorry.

Not analogous
**Again, yes it is. **

The alcoholism part of me never will change, doesn’t mean that the rest of me cannot.
**Good for you, but that’s YOU. If the alcoholism part of you never changes, then why aren’t you still drinking? If you’ve quit drinking, then you’re no longer an alkie, sorry.
**
Why would you do such a thing,and why does it bother you so much?

**Because a person who no longer drinks and calls themselves names that has terrible connotations has low self esteem. Alcoholic, druggie, addict are all terrible names and calling yourself that when you are no longer one is stupid. PLain and simple. Answer #2: I do it because I care. **

I know Im an alcoholic and always will be regardless of how long I abstain from alcohol. I know this from my own life experience.Not from some book in some AA meeting.

Then you might as well start drinking again (though I hope not and I’m rhetorically trying to show you my point). If you’re going to live with that connotation of being an alcoholic, might as well play up to it. I mean, why not, you’re calling yourself one.
**
I have met many 'non-alcoholics who couldnt grasp my ‘addiction’.I could talk till I was blue in the face and they’d never understand.
**
It’s not about grasping your addiction, nice try with the twist there, but I’ve been debating on boards too long to fall into that one. I’m talking about calling yourself an alcoholic while not even drinking any longer. You knew what I was talking about. Twist with someone else, my friend.
The only thing that bothers me about being alcoholic is that I can’t have a drink with the fellas.It doesnt lower my self-esteem one bit.I dont know why others would relapse and wouldn’t be so presumptuous as to think I do.
**
Again, calling yourself an alcoholic does lower your self esteem. You just admitted that it bothers you in one way or another by saying you can no longer do it. You just proved my whole point. See, if you were to say that you are no longer an alcoholic, not being able to go out drinking wouldn’t bother you one bit. **

So are you suggestion that AA or NA should begin by telling the addict or alcoholic: “Today,you are no longer an addict”

**Uh, yes. Maybe not at the beginning if the “treatment”, but definitely at the end of the program. YOU ARE NO LONGER AN ADDICT. Yeah, that might actually give people hope. **

[/QUOTE]

[Tony_Montana]

:sigh:
Ok you asked me my opinion,I gave it to you. Ill point you towards this linky here. And here’s a New England Journal of Medicine Linky.You can’t see all the text in the NEJM link (registration req) but theres enough to get the gist. There should be contact info on both sites,perhaps you could tell the good Doctors at the NEJM about your miraculous epiphany.

-TM

[Dangerosa]

[QUOTE=norinew]
You’re right in that I could be being harsh saying he’s being a jerk. I don’t know the tone or content of their conversations. I certainly haven’t heard her side of it.

However, this line from the OP (bolding mine):
comes across as jerkish. Now, it’s certainly true that print on a screen isn’t nuanced the way speech is. Maybe as he says this, he’s smiling a crooked little rueful smile, and shrugging his shoulders. That’s just not the way it’s coming across to me. If he always argues, if he always insists that she stop referring to herself as “a fucking alcoholic” because (in his own words) it makes him “cringe”, that seems like jerkish behavior to me. She’s found what works for her, she’s doing it, and she’s not hurting anyone by doing so.

As I said in my first post, this is only my two cents, and probably isn’t worth more than that .
[/QUOTE]

Here is my problem.

Most alcoholics in recovery I’ve talked to would LOVE to drink - and they feel that if they were social drinkers, they wouldn’t - they would be out of control. To them, saying “I’m an alcoholic” is what they say - to themselves - over and over and over and over again to keep from having that one drink - just that one.

And, most of the ones I’ve run across have had a really hard time admitting that they were alcoholics, and then deciding to do something about it. It isn’t a label they wanted.

To tell someone like that “you aren’t an alcoholic” translates to them as “you can drink” - the thing so many of them want so badly. You aren’t doing them any favors by implying that they can drink. (Granted, SOME people can go from being heavy drinkers, maybe even alcoholics - to social drinkers - but if THIS person can’t, well, I think erring in support of not drinking - even if the label isn’t perfect - is better than not supporting it).

[Moirai]

Posted by digglebop-

Because a person who no longer drinks and calls themselves names that has terrible connotations has low self esteem. Alcoholic, druggie, addict are all terrible names and calling yourself that when you are no longer one is stupid. Plain and simple.

Only your opinion, my friend, and one that is not shared by many (if not most) alcoholics. You do not speak for me- my self-esteem rocks. In my case, your statement is dead wrong.

Please don’t presume to speak for anyone but yourself. Thank you.

[Qadgop_the_Mercotan]

[QUOTE=EJsGirl]
Only your opinion, my friend, and one that is not shared by many (if not most) alcoholics. You do not speak for me- my self-esteem rocks. In my case, your statement is dead wrong.

Please don’t presume to speak for anyone but yourself. Thank you.
[/QUOTE]

Quoted for Truth.

[WhyNot]

[QUOTE=EJsGirl]
Only your opinion, my friend, and one that is not shared by many (if not most) alcoholics. You do not speak for me- my self-esteem rocks. In my case, your statement is dead wrong.

Please don’t presume to speak for anyone but yourself. Thank you.
[/QUOTE]

'zactly.

digglebop, have you tried asking your aunt why she uses that label, instead of telling her she’s stupid for using it?

Generally speaking, I don’t argue with people’s self-identifications simply because it’s rude. The one exception I can think of was when a woman I’ve known very well for 10 years suddenly started expressing a desire for gender reassignment surgery. While I didn’t argue with her about her new label for herself, I did ask her about it. Based on her answers, I did suggest that perhaps she was simply too limited in her internal definition of “woman”, and expanding that definition to include herself might be easier and more useful than labeling herself a man. After a few months of pondering, she agreed with me, much to the relief of her husband and two daughters!

No one wants to hear that they’re stupid or wrong. Try a discussion instead of an argument and you might find out some interesting things about your aunt.

So, while I don’t think once an addict, always an addict (unless we “No True Scotsman” the definition of addict to mean only those who are always an addict), I certainly wouldn’t contradict any individual who labels themselves an addict.