The Truth (and the BS) About Alcohol
There is little truth in what we are lead to believe about alcohol. The biggest BS is that it is physically and mentally harmless. The kernel of truth that it does “facilitate” coping with life (briefly and ineffectively) is drowned (no pun intended) by the consequences and the aftermath. Questions people ask, “Why do I feel so lousy after a “fun” night of heavy-ish drinking?”, and “Why do my relationships keep falling apart?”, reinforce the idea that any short-term enjoyment is temporary and fraught with long-term negative outcomes.
There’s a long list of reasons, arguments, and excuses the alcoholic provides as an explanation for his or her decision to continue drinking. The following is only a partial list.
• I am not hurting anyone but myself.
This is a standard statement by alcoholics based on denial of the fact that their addictive behavior is indeed causing harm to others, including their family members. They believe it is their life, their body, and their right to drink.
• Everyone drinks.
Alcoholics will proclaim that drinking is a universal practice and that they’re no different than anyone else who enjoys a cocktail. Alcoholics may proclaim that they don’t drink nearly as much as other people do.
• I don’t have a problem with alcohol, so the problem must be you.
Denial again, but this time an attempt to shift the blame to the other party. This offensive strategy aims to disarm the loved one who objects.
• I need to drink.
Citing job stress or constant family demands as a clear need to relax by using alcohol, alcoholics attempt to garner support for the comfort that “only alcohol can provide.”
• You knew this when you married me.
Alcoholics attempt to justify drinking as some sort of inherent trait that was clearly visible when the partner decided to marry them. In other words, “accept me as I am.”
• I work every day, so I am not an alcoholic.
High functioning alcoholics will point out the ability to succeed in their profession, work out at the gym, and participate in parental duties, stating that they couldn’t do those things if they were “true alcoholics.”
• I can quit drinking whenever I want.
Probably the most common excuse of all is the claim that they have control over their drinking and can quit at will.
• Drinking is part of my job.
When alcoholics are confronted about their need for treatment, the thought of quitting is so frightening that they may state their livelihood depends on and must involve social drinking.
• There is nothing wrong with me.
Denial of the physical toll that drinking is taking on them, alcoholics will proclaim that all is well, ignoring the distended gut, puffy face, red-rimmed glassy eyes, and other physical signs of deterioration.
• I don’t have time for treatment; I will handle it myself.
A classic excuse used by busy professionals who cite time constraints as the reason they can’t go in for treatment. Utter denial of the power of addiction is exposed when they emphatically state they can handle recovery on their own.
• Everybody drinks.
To alcoholics, it seems that everyone drinks, because this is their reality. They always socialize with other drinkers and avoid events and activities that prohibit drinking. They may even feel that people who don’t drink are stuck-up, no fun, or untrustworthy.
• There is nothing wrong with me.
As long as the alcoholic insists that everything’s fine, then there is no problem to be treated. This denial is another aspect of addiction, functioning to protect the addictive behaviors.
• I’m not hurting anyone.
Alcoholics are often quick to claim that their drinking doesn’t hurt anyone, or at least not anyone but themselves. Their disease has made them unable to see the many ways that their alcoholism impacts everyone who cares about them.
• This is the last time.
There is no need to seek treatment if I’m never going to get drunk like that again, right? For a moment, this claim can seem completely true. In reality, alcoholism has produced actual structural and chemical changes in their brain’s reward pathways—changes that have trained them to be alcoholics.
• I need to work.
While technically true for most people, not all forms of addiction treatment will require a recovering alcoholic to miss work. Residential substance abuse programs can be great, but so can outpatient programs that provide treatment after work hours or on weekends. Many companies support addiction treatment, and the right to rehabilitation treatment is usually protected by state or federal laws like the Americans with Disabilities Act, and the Family Medical Leave Act.
• I can’t afford treatment.
Yes, there are fancy, celebrity-filled rehab programs that cost more money for a month than most people make in a year, but there are many excellent low and no-cost programs all across the country. Also, thanks in part to the Affordable Care Act, addiction treatment has been designated as an essential health benefit that most insurance plans are required to cover.
• I don’t have time for treatment.
Many Americans are busier than they’d like to be, but alcoholism is a devastating, progressive disease that will wreak more havoc on life the longer it is left untreated. Addiction treatment should be an alcoholic’s top priority. Besides, healing alcoholism tends to provide alcoholics with a whole lot of additional time and energy they didn’t have before treatment.
• I deserve a few drinks with a job/family/marriage like mine.
Most people view alcohol as a reward for doing well, working hard, or enduring difficulty. Alcoholics usually feel that they’ve “earned” a drink. Of course, they almost never stop at just one drink, and they tend to “earn” the right to drink nearly every day for a variety of reasons.
• I can’t ____ without drinking.
Some alcoholics talk themselves into believing that they need to drink to speak in public, to socialize, to have fun, to write, to paint, or to play music. They feel blocked or frightened without drinking, and even falsely believe that alcohol enhances their abilities. Once they are past the withdrawal phase of treatment, recovering alcoholics often start to realize that they can do anything without drinking, and that they do it much better while sober.
• I’m not an alcoholic because I don’t drink half as much as my father/mother/my friend/that alky passed out at the end of the bar.
When playing the comparison game, alcoholics will always be able to find someone who appears to be worse off than themselves. However, just because so-in-so lost their job, their home, and their wife because of their drinking, doesn’t mean that a high functioning alcoholic doesn’t also have a problem. There is no hierarchy when it comes to addiction. If you are an addict, you need and deserve addiction treatment.
• My only problem is all the judgmental people around me.
Alcoholics quite often blame others not only for seeing a problem where there is none, but for creating a problem. They believe that they wouldn’t drink so much if everyone would just get off their case for a while. Of course, this isn’t true. The alcoholic will never run out of reasons to drink. Alcoholics may also be extra-sensitive to being judged, as addiction can bring out paranoia in many people.
• I can quit whenever I want to.
Another famous excuse. Many alcoholics sincerely believe or at least pretend to believe, that they can quit drinking anytime they want to. They don’t want to, yet. However, the truth is that very few people can quit drinking without some form of professional help.
• I can’t handle detox.
It’s natural for alcoholics to be intimidated by the thought of going through withdrawals and detox—they’ve likely experienced withdrawal symptoms when they haven’t had a drink for a while, and they know that sobering up completely will be worse. They ignore that substance abuse treatment programs have resources, from medications to counseling to lifestyle changes, that can drastically reduce withdrawal symptoms and make detox much easier.
Whenever an alcoholic is ready to acknowledge the truth about his or her drinking as being inherently harmful to the self and others, it may be at the point where the damage begins to show.
It is never too early or too late to stop drinking altogether, or to stay sober if you have already quit.
Repeated Use of Alcohol Can Cause Long-term Changes in the Brain
When a person drinks alcohol repeatedly, it takes more drinks to become intoxicated. This means that the person has developed tolerance to alcohol. Tolerance is a consequence of two changes in the body.
First, with repeated use of alcohol, the targets (i.e., GABA receptors) for alcohol adapt by decreasing their number. Now, it’s harder for alcohol to produce its effects. Interestingly, one effect that does not show alcohol tolerance is death. In fact, our biological defense mechanisms promote “passing out” from too much alcohol to protect against death. Unfortunately, drinking too much too fast increases the BAC to a lethal level, bypassing tolerance.
Second, liver cells respond by making more enzymes to metabolize alcohol. The increased metabolism means there is less alcohol in the body. In both of these situations, the person will drink more alcohol to try and achieve the original effect. These cellular adaptations and the development of tolerance are key to the progression to addiction.
Researchers have shown that repeated episodes of binging and drinking to intoxication substantially increases the risk of alcohol addiction (now called alcohol use disorder).
Once the person is addicted to alcohol, he/she no longer has control over drinking. The loss of control and craving that ensues when the alcohol isn’t available are due to changes that take place in the brain.
One serious change that can result from repeated drinking is shrinkage of the brain. The shrinkage is probably due to a loss of neurons (grey matter) and glial cells (white matter), the other major type of cell in the brain. The shrinkage happens especially in areas of the brain that are important in learning and memory, such as the cerebral cortex and the hippocampus.
Source: Duke University Medical Research
Naturally, all this means that there will be serious changes in behavior, emotional stability, relationships, and physical health. Who’s okay with that?
What Is An Alcoholic?
An alcoholic is known as someone who drinks alcohol beyond his or her ability to control it and is unable to stop consuming alcohol voluntarily.
Most often this is coupled with being habitually intoxicated, daily drinking, and drinking larger quantities of alcohol than most.
In general, an alcoholic is someone who suffers from alcoholism.
Alcoholics Anonymous defines this as “a physical compulsion, coupled with a mental obsession to consume alcohol,”in which cravings for alcohol are always catered to, even at times when they should not be.
A particular concern for women
Because of metabolism, a generally smaller physique, and the way alcohol is processed by the female body, women are more susceptible to the negative effects of alcohol.
In women, its effect is much faster, i.e., it takes less alcohol to cross over the line of being legally drunk.
Warning Signs You’re an Alcoholic
The following are ten warning signs of alcoholism that might help you answer the question, “Am I an alcoholic?”
- Drinking alone and in secrecy.
- Losing interest in other activities you once found enjoyable.
- Alcohol cravings.
- Making drinking a priority over responsibilities or relationships.
- Alcohol withdrawal symptoms.
- Extreme mood swings and irritability.
- Feelings of guilt associated with drinking.
- Having a drink first thing in the morning.
- Continuing to drink despite health, financial and family problems.
- An inability to stop or control the amount of alcohol consumed.
A simple screening test
A popular screening tool is CAGE, a questionnaire that measures the intensity of a drinking problem.
There are 4 questions in this screening questionnaire, and if you answer “yes” to at least half (only 2) of those questions, then your drinking patterns could be an alcohol use disorder and you should consider seeking help from an addiction professional.
The 4 CAGE questions are:
1. Have you ever felt you should cut down on your drinking?
2. Have people annoyed you by criticizing your drinking?
3. Have you ever felt bad or guilty about your drinking?
4. Have you ever had a drink first thing in the morning to steady your nerves or get over a hangover?
According to CAGE questionnaire advocates, regardless of the answers to those four questions, if your drinking is negatively impacting any area of your life, regardless of how much alcohol you drink, such warning signs should be addressed by an addiction professional.
If you or your loved one have a problem with alcohol, give me a call at (678) 554-5632 to set an appointment (either at my office location or online via telehealth) for an evaluation and a referral to a specialist or treatment center, or send me the appointment request form, which you will find here on my website. I look forward to working with you!