The Fork Least Spoken Of


September 8, 2016

fork_in_the_road

 

There is a fork in the recovery path that is very seldom spoken of, almost as if it is taboo. I’m sure some of you will agree that it should remain so, because it is too dangerous, that people who should never consider taking it will be tempted to do so, just at its mention. Some will say I am putting some people at risk by mentioning it, and they’re right. I have friends who have taken this fork, friends who shouldn’t have taken this fork, and died.

However,I know some people are taking this fork or who are intent on exploring this path and I don’t want them to do so without any info or support.

I am talking about the path of drinking again after a long period (years or decades) of abstinence. Put your pitchforks away and hear me out.

Not often, but occasionally I see people move into the MM neighborhood who have been abstinent for years. Many of these new neighbors chose or were encouraged at a young age (late teens or twenties) to join an abstinence based program because they were drinking at a dangerous rate. I’m not saying that these people shouldn’t have joined these programs, we all know young people die every day from alcohol poisoning or alcohol related accidents. These programs save young lives. However, data shows that most people will mature out of their addictions (drug or alcohol) without treatment.

Some Findings from the National Institute On Alcohol Abuse and Alcoholism (NIAAA) Report on Young Adult Drinking (April 2006):

Even though research shows that drinking early in life can lead to impairment of brain function in adulthood, findings also show that not all young people who drink heavily or become alcohol dependent will experience the same level of impairment, and some may not show any damage at all (11). This is because factors such as genetics, drinking patterns, and the use of other drugs also influence risk.”

 

Maturing Out of Alcohol UseAbout 21 percent of young adults met the diagnostic criteria for alcohol dependence or abuse in 2004 (3). Yet as they enter their mid-twenties, studies show that many of those same young adults will stop or moderate their drinking (35).”

 

As I was saying, some people who became members of an abstinent based program in their 20’s find themselves in their late 30’s, 40’s or even older questioning whether they really need to be abstinent. They have matured, they have gained impulse control, and, even more important, they know that life is possible and in many cases damn good without alcohol. They are curious and they want to see, if now, they can enjoy alcohol in a responsible manner. They are well aware of its dangers and they know that they’ve succumbed to them before, so they are cautious, they also know that having a support community is valuable, they learned that before through their abstinent based community. Some of them find their way to MM with its guidelines and tools in search of the answer to their question: Can they now drink in moderation?

 

From Psychology Today, April 8, 2014: Can Alcoholic Ever Drink Moderately: Moderate Drinking May Not Be Possible For Alcoholics

“This question is the backbone of a major debate in addiction research and treatment: can people addicted to alcohol go back to moderate drinking? For years, the answer was assumed to be an unequivocal no: programs based on the 12-Step models dominated treatment and there is no room for “just one drink” in AA.

But now these traditional programs are being influenced by modern research to create new and sometimes very much improved strategies of addiction treatment. We are questioning everything and in the process we’re discovering what works and what doesn’t. This reexamination of the truths we once thought absolute opens the debate on moderation.”

I must insist that you read the article on your own, but to summarize, the article states that the ability to moderate depends on many factors, including the level of your drinking before, the length of time that you drank, and why you drank. Alcoholics cannot drink moderately because of the irreversible damage that chronic drinking has wrought in their brains, decreasing their dopamine levels (ability to feel pleasure), thus becoming addicted brains. And, according to the article, addicted brains will never be satisfied with the amount of drinking prescribed by moderation. However, some “non-dependent problem drinkers” can retreat from addiction to moderate levels of drinking.

Huh?

Again, we come ‘round to what the definition of an alcoholic is and unfortunately there are no clear parameters that pinpoint alcoholism, especially in the early stages. There is no x-ray or scan that shows the “addicted” brain, or, if there is one, most of us are not going to get one. Yes, in the terminal stages of alcoholism there are too many collaborating symptoms and results to ignore a diagnosis of alcoholism, but what about all of us problem drinkers-possible alcoholics that wander around never knowing if we really are an alcoholic or not. It’s not like a doctor can run a few tests and unequivocally diagnose alcoholism as they can diabetes or hypo-thyroidism. According to Katherine Ketchum and William F. Asbury with Mel Schulstad and Arthur P. Ciaramicoli Ed.D., Ph.D., the co-authors of Beyond The Influence: Understanding and Defeating Alcoholism, it is not until the end stage of alcoholism that the characteristics that most of us associate with an alcoholic become apparent.

There is a large gray area when it comes to deciding who is an alcoholic and who isn’t. Because of that large gray area and the inability to diagnose how much damage has been done by our drinking or how “addicted” our brain is, for many years “blanket” concrete rules were applied to all people who admitted to a drinking problem, no matter the severity.

Those rules and theories saved a lot of lives even if they were overreaching for some. Today, with more people reaching out earlier because of the heightened anonymity of the internet, we are going to witness more and more people whose level of drinking does not demand adherence to all of these rules or theories and whose testing of those safeguards is going to show that long held beliefs about dire outcomes are not true for everyone. The dilemma is whether you risk the lives of those for whom bending some of the rules could be hazardous or even fatal to allow others more freedom to find a sobriety that is less stringent.

If you think I’m being over dramatic. I’m not. I’ve lost two friends who decided to drink after years of abstinence, one six years, the other eight. One of them tried time and again to regain her sobriety but could never hold onto it for long. The other, a gorgeous woman, after eight years of sobriety following a bout with alcoholic hepatitis and being told she should never drink again, decided she was ready to enjoy life again and died within three years from a rupture esophageal varices. Bled out.

If you saw these two walking down the street during their abstinent periods, you would never have said, “There goes an alcoholic.” They were two of the most vivacious, energetic women I’ve ever known.

So those dire predictions of what would happen if these women abandoned abstinence, came true.

How do we know? How can we tell someone else that it’s okay if they try drinking again.

We can’t.

It is something that every one of us will have to decide on our own.

So, after throwing you all those bones to chew on, here’s my take on the issue. If you are happy and content in your sobriety-because drinking is not going to fix discontent, you need to figure out why you’re not in love with your life-and feel that you are a point that you could moderate and would like to add an occasional craft beer or winery visit, do your research. Be honest with yourself about your drinking past. Involve your loved ones in the decision. Consult with your doctor and therapist. Then, if you still think you want to try, find a community that supports moderation to walk with you down this path. Don’t ever be afraid or too proud to turn back around.

One comment on “The Fork Least Spoken Of
  1. donna.dierker says:

    NIAAA now defines alcohol use disorder as a spectrum:

    https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders

    A study found that abstinent recovery from alcohol dependence was about as likely as non-abstinent recovery:

    http://www.ncbi.nlm.nih.gov/pubmed/15733237

    But I quite agree this path should be tried with the greatest of caution.

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