Everyone needs help at some time in their life, and it’s only natural for people to help one another. In fact, when facing a life-threatening crisis, our base instinct is to cry out for help. However, for individuals with alcohol use disorder or AUD, asking for help doesn’t come easily or naturally at all. It certainly didn’t come easy for me.
One of the primary factors that prevented me from seeking help was the stigma associated with alcoholism. I had this attitude that my drinking was some sort of a personal or moral failing, and I couldn’t accept that I was somehow different from other people—that I was an alcoholic.
Sadly, the stigma of addiction is persistent, and people with AUD often feel ashamed that they can’t control their drinking. A study published by the National Institute of Health in September 2016 illustrates the powerful role that stigma plays in preventing people from seeking help. In the study, liver transplant patients were interviewed to determine the reason for their reluctance in seeking outside support for maintaining abstinence. It was found that 62% of those interviewed cited the fear of being labeled an alcoholic as the primary reason for their reluctance.
Another roadblock to reaching out for help is that one may not understand that it’s needed. In my case, there were times when I would stop to question whether or not I had a problem, but inevitably, I would shake those thoughts off and resolve to get everything under control. At the time when I was grappling with this, there wasn’t any such thing as the Internet, so I had to ponder those questions on my own—only to dismiss them in short order and return to drinking. Today, people can instantly and anonymously access information and find answers right at the moment when they have the questions. Maybe you found this website and this article from just such a search. If so, I hope what you read here will persuade you to ask for help. I shall try my best to nudge you gently in the right direction.
Let’s begin with this simple statement. If you think you might have a problem with alcohol; then you probably have a problem with alcohol. If you didn’t, the question would never arise. That’s just my opinion, taken from my own experience. Looking back, if I had asked for help when I first suspected that I had a problem, then I could have saved myself a lot of unnecessary suffering.
No doubt, you probably value science more than my quaint advice, so let’s take a look at the science of addiction. I recommend at some point that you check out this presentation by Dr. Nicole Labor, who specializes in addiction medicine at Summa Healthcare in Akron, Ohio. She does an excellent job of explaining the neurobiology of addiction in a way that is easy for the layperson to grasp. Hopefully, understanding the disease will destigmatize it, and you will come to the conclusion that getting help is the best possible course of action.
When writing about the science of addiction, I will rely on the talk from Dr. Labor as referenced above, William Porter’s book Alcohol Explained, and a publication from the National Institute of Health entitled Complications of Alcohol Withdrawl.
First of all, let’s be clear—Addiction is a disease. It’s a disease of the brain, and it doesn’t matter what substance one uses. Whether it be alcohol, marijuana, cocaine, opiates, or whatever, the disease is the same—it’s addiction. Let’s also be clear that alcohol is a drug, and it’s not unusual for people to become addicted to it. If you are experiencing a problem controlling your drinking, that is a perfectly reasonable reaction for a human being to have. Addiction to alcohol is the result of changes that take place in the brain after alcohol is ingested. How long it takes to become addicted will vary from one person to the next.
People with addiction and that includes those with alcohol use disorder, aren’t weak-willed or in any way different from any other person. It’s in our DNA. The fact is that most people have a gene for addiction. It’s like a switch that needs to be turned on, and what it takes to activate the gene is different for everyone. Some people may have the gene, but never activate it, and therefore, never become addicted.
Dr. Labor points out that there are many different addiction genes, and some people may have several. One person, for example, may have a gene for alcohol addiction that’s activated after two drinks, and another after 200. Still, another person may have a gene for opiates that is triggered after the 40th use. The experience may differ, but the end result is the same. Once the gene is triggered, the brain is permanently changed, and the person can never again safely use alcohol or any other addictive drug.
Addiction, in a nutshell, is a dopamine problem. Dopamine is a chemical in the brain that acts as a neurotransmitter, sending signals to the nervous system to regulate pleasure. Ingesting alcohol or other drugs will increase dopamine levels well above a person’s established threshold, producing the desired effect from the drug of choice. As dopamine levels rise above what’s required, the brain stops producing receptors for dopamine, and this elicits a need for more alcohol or drugs.
This is how William Porter describes it in Alcohol Explained:
Alcohol is an anesthetic and a depressant. This is an accepted medical fact. If we are feeling tired or in pain it will take the edge off this. However, it is also a fact that the human body and mind is not a passive object; it is reactive, and will react to the world around it and to the food and drugs we put into it. The brain has its own store of drugs that it releases into our bloodstream as and when they are required. It will release these in times of stress, hunger, and fear, and will also release them in reaction to external drugs that enter our system. If we regularly take a drug then our brain and body will react to this, and will even act in expectation of this. Indeed, the more often we take an external drug the more proficient our body will become in countering its effects. (William Porter, Alcohol Explained, p. 12)
Drug addiction and this includes alcohol use disorder is a vicious cycle. A person drinks for the sense of ease and comfort that comes from taking a few drinks (thank you Dr. Silkworth), but unbeknownst to the drinker, that relaxed feeling is the result of alcohol suppressing nerve activity in the brain. The brain responds by releasing stress hormones causing a person to feel irritable or anxious. This feeling is quickly relieved by having another drink. In time, the brain anticipates a regular supply of alcohol, and it will begin releasing stress hormones before a person even has a drink. Compounding this bad situation is the additional stress from life-problems people experience as a result of their addiction—stress that is relieved by yet another drink. It’s perfectly natural for the human brain and body to react in this way, but it’s also a trap for an addict.
The only way to escape the trap is to stop drinking and to go through the inevitable withdrawal symptoms. Most people will experience withdrawal from alcohol for about five days. However, one needs to be cautious because alcohol withdrawal can be fatal and many with alcohol use disorder must be medically detoxed. Approximately 10% of those who suffer from alcohol use disorder will experience more severe withdrawal symptoms which include seizures and delirium tremens or DTs. About 5% of people who experience DTs will die from them. For more information about withdrawing from alcohol, you may be interested in reading this brief article published by the National Institute of Health: Complications of Alcohol Withdrawl. If you are going to stop drinking, please see a doctor for an assessment.
If dear reader, you are considering whether or not you have a drinking problem, please take your question seriously and ask for help. Talk to your doctor. You are not a freak of nature because you can’t control your drinking. It’s perfectly normal and nothing to be ashamed about. You are not a defective or broken person, and there should be no reason to allow yourself to feel stigmatized. The people you know who are drinking normally, simply may not have the gene for alcohol addiction or maybe they haven’t drunk enough to activate the gene. Who knows? What’s important is that you do what you must to take care of yourself. Ask for help, and you may quickly find yourself transitioning from despair to hope. You are worthy, you deserve a good life, and it’s definitely within your reach to have it. All you need is a little help.
The next post in this series will cover attending AA meetings and focus on Steps Two and Three, which for me is nothing more than coming to understand that I could be helped, and then deciding to go to AA meetings or any other program or resource where I might find support for my desire to stay sober.