Is use after addiction possible--alcohol?

[bcubed]

Look, I know how this sounds. Hell, I know how I'd respond if someone presented these symptoms to me.

Background: SWIM is a 35 y.o. male who has consumed alcohol for 27yrs. SWIM was a periodic binger who escalated frequency of use and wound up moderately addicted 4 mo. ago.

Since then, he's used DXM 3x, LSD 1x, cannabis and salvia numerous x. In the most recent month, he's used opiates 4x. He has been consuming alcohol again for 3mo, but shows altered usage patterns such that:
1. He uses about 15% of his previous habit, by drinking 50% as much 30% as often.
2. He gets unusually high levels of euphoria off 4-6 drinks, which he credits to lowered tolerance.
3. He finds 8+ drinks unpleasant (?!?!?) and does not desire to continue past this point.

Now, the CW is that one NEVER recovers from addiction into non-pathological use, but SWIM's experience is contrary. He's never felt he had to work at avoiding a habit these last 4 mo--specifically post-DXM; it just never materialized. How long must SWIM maintain this level of consumption before he can say with any certainty that he's turned a corner?

As for whether SWIM's being foolish or not: he just doesn't think he can pull off lifetime abstinance from alcohol and that the long-term results might be less favorable if he tried.

[Esmerelda]

There is actually a bit of evidence to suggest that a few people are able to return to more sensible drinking patterns after addiction and even that they are perhaps better suited to that than abstinence. I'd look it up for you now but I was determined to get an early night tonight and don't want to be online for hours!

I don't think swiy should rely on this entirely though - it's clear that it's not the case for most people.

I've actually had a similar sort of pattern to swiy, but perhaps not quite as serious. I was drinking excessively every night for about two years and some degree of physical addiction (although mostly psychological). I now drink about 10 - 14 units a week on average, and some weeks none. Like you I find I don't want large quantities any more. I haven't lost the underlying craving however and I reckon that for me at least things need to keep changing if I'm to avoid getting into trouble again.

If you don't think you can manage abstinence at the moment then perhaps you could try something similar to me. I try to encourage more and more awareness in myself - when I want a drink I don't just get it without thinking, as that's almost a sort of denial. Instead I make an effort to pay attention to what I'm actually feeling at the time. I don't force abstinence but try and recognise the good that comes from having a good stretch of sobriety. So if I've not drunk for a couple of days, I'll add on another day for luck . And so on.... I also challenge myself to not drink on a night when I'd normally have relied on it - say at a party or something. I don't make it mandatory though, as then my rebelliousness kicks in.

I hope this helps a bit. I didn't want to go on about myself - just wanted to say things that I'm finding help me that might be useful to swiy too, as swiy's situation sounds similar.

Oh another thing that helps... my 'hypothesis' for the sort of response you describe to alcohol now, is that although part of the body and mind still has the typical addiction response, there's also a part of that's saying "no fucking thanks! It's not doing me good". You can help that bit to get stronger by doing other things that are good for you. It all seems to happen on an unconscious level but the more good things your body gets the less it will want the crap. At least that's what I've noticed.

I hope you keep posting to say how you're doing.

Good luck

[Pondlife]

Originally Posted by Esmerelda

You can help that bit to get stronger by doing other things that are good for you. It all seems to happen on an unconscious level but the more good things your body gets the less it will want the crap.

That sounds similar to the findings from Bruce Alexander's "Rat Park" study that's detailed in this thread:

http://www.drugs-forum.com/forum/showthread.php?t=37550

[Esmerelda]

Originally Posted by pondlife

That sounds similar to the findings from Bruce Alexander's "Rat Park" study that's detailed in this thread:

http://www.drugs-forum.com/forum/showthread.php?t=37550

That's really interesting. I can understand why people would have been dubious about it, seeing as the process of physical addiction to opiates is well understood and accepted. But it's annoying when people dismiss something without attempting to repeat it. If people believed his methods were unsatisfactory it would have been nice to have seen the same test repeated by someone else.

[imyourlittlebare]

I dont believe that there is evidence to support a claim that you are making esmerelda. My personal theory is there are pigheaded people who will say that you can remain unaddicted to things or be addicted stop and go back without having a problem again. Here is my take because swim has done this with opiates and alcohol and doesnt lie to himself any longer. Swim was an addict. Stopped and went back. He convinced himself he could do it without developing a problem. The problem for swim and all others who do this is it is a FULL TIME JOB to keep yourself unaddicted. You have to constantly and consciously stop yourself from consuming too much or having to many pills each time and it may be upsetting. You become preoccupied with not being addicted and this is sometimes just as harmful. You constantly want more and cant give yourself more knowing you will give in. Swim, along with many, not all, people who do this method either A. quit again for good (highly unlikely because once youve tasted it again you always want "just one more time" which people who are addicted dont understand. let me elaborate further. if you abstain you are free from the drug. if you say one more time and do it and say thats it, its probably not, whether its tomorrow, a month or a year most likely not 100% but darn close, there will be another "one more time" so you are never free. back to the main shiznit) or B. Fall back into old habits because you are constantly being tempted. This is going to get criticism because most people dont like the idea that they dont have control or someone is telling them how they react to a drug. Its the truth. There is no real reason not to abstain except selfishness of the person who wants to feel away. This is in no way an attack on people, just the words of an addict who went through it all and is currently still an addict, on life support with opiates. without them swim would die now. But he loves them.

[Esmerelda]

Originally Posted by imyourlittlebare

I dont believe that there is evidence to support a claim that you are making esmerelda.

Originally Posted by http://www.nih.gov/news/pr/jan2005/niaaa-18.htm

2001-2002 Survey Finds That Many Recover From Alcoholism
Researchers Identify Factors Associated with Abstinent and Non-Abstinent Recovery More than one-third (35.9 percent) of U.S. adults with alcohol dependence (alcoholism) that began more than one year ago are now in full recovery, according to an article in the current issue of Addiction. The fully recovered individuals show symptoms of neither alcohol dependence nor alcohol abuse and either abstain or drink at levels below those known to increase relapse risk. They include roughly equal proportions of abstainers (18.2 percent) and low-risk drinkers (17.7 percent). The analysis is based on data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a project of the National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism (NIAAA).
One-quarter (25.0 percent) of individuals with alcohol dependence that began more than one year ago now are dependent, 27.3 percent are in partial remission (that is, exhibit some symptoms of alcohol dependence or alcohol abuse), and 11.8 percent are asymptomatic risk drinkers with no symptoms but whose consumption increases their chances of relapse (for men, more than 14 drinks per week or more than four drinks on any day; for women, more than 7 drinks per week or more than three drinks on any day).
“Results from the latest NESARC analysis strengthen previous reports that many persons can and do recover from alcoholism,” said NIAAA Director Ting-Kai Li, M.D. “Today’s report is valuable as a snapshot of current conditions and for information about some of the characteristics associated with different recovery types. Longitudinal studies will be required to understand the natural history of alcohol dependence over time.”
Lead author Deborah Dawson, Ph.D. and her colleagues in the Laboratory of Biometry and Epidemiology in NIAAA’s intramural research program released the latest NESARC analysis in an article entitled “Recovery From DSM-IV Alcohol Dependence: United States, 2001-2002.” Based on a representative sample of 43,000 U.S. adults aged 18 years and older, the NESARC is the largest survey ever conducted of the co-occurrence of alcohol and drug use disorders and related psychiatric conditions. The NESARC defines alcohol use disorders and their remission according to the most recent clinical criteria established by the American Psychiatric Association.
The recovery analysis is based on a subgroup of 4,422 adults who met the clinical criteria for alcohol dependence that began more than one year before the 2001-2002 survey. These individuals were primarily middle-aged, non-Hispanic white males. Sixty percent had attended or completed college. More than half had experienced the onset of alcohol dependence between the ages of 18 and 24, and only 25.5 percent had ever received treatment for their alcohol problems.
Dr. Dawson and her colleagues found that the likelihood of abstinent recovery increased over time and with age and was higher among women, individuals who were married or cohabiting, individuals with an onset of dependence at ages 18-24, and persons who had experienced a greater number of dependence symptoms. The likelihood of nonabstinent recovery (that is, low-risk drinking with no symptoms of abuse or dependence) increased over time and was higher among individuals who were married or cohabiting, those with a family history of alcoholism and persons who had experienced fewer symptoms of dependence. The greater the peak quantity of alcohol consumed, the lower the likelihood of either type of recovery. In addition, having a personality disorder was associated with a lower likelihood of abstinent recovery. Treatment for alcohol problems modified some of these effects.
“Alcohol dependence — at least when defined in terms of the DSM-IV criteria — may not preclude a return to low-risk drinking for some individuals,” state the authors. However, they acknowledge, the selective survival of less chronic alcoholics (the fact that persons who recover from alcohol dependence may be more likely to have survived to the survey date) may have inflated the recovery estimate.
When the authors compared their results with findings from the earlier 1991-1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES), they noted a trend during the past decade toward less rapid remission (that is, the absence of alcohol abuse or dependence symptoms) in persons previously dependent. “There are no obvious explanations for why this might be the case. Data from Wave 2 of the NESARC should provide valuable information to address this issue,” they said. The NESARC is a longitudinal study now entering the first stage of followup that should shed light on pathways to recovery.

I wouldn't have said it if there wasn't. I also wasn't suggesting that bcubed take this to mean that such a path is the right one for him. However he has cut down on his drinking significantly and is not craving more. I won't deny that for most people abstinence is the only answer, and I appreciate what you've been through and your wish to help others. But it sounds to me from his post that bcubed is not about to attempt abstinence at this point in his life, regardless of what anyone posts to try and convince him otherwise.

If he's already showing that he can moderate his drinking, a sensible approach might be for him to continue to improve on it, as there is some evidence that a small percentage of people can achieve this.

I was also suggesting that he focus on improving his awareness of his drinking habits and attitude to drink. This way he is more likely to notice if things are slipping or failing to improve further, and more likely to be able to accept it if his current goal isn't working and it becomes obvious that abstinence is what is required.

Reputation Comments on this post:

Very interesting article. I had long suspected that this was the case, but this is the first evidence I've seen

[imyourlittlebare]

Thats a good article. Thank you! I always appreciate someone supporting claims with facts! I didnt realize there were so many! I believe we are in agreement. I just say that it is a fulltime job to control the drinking. I believed it was harder. But possible. If you so like the substance please do. I always enjoy civilized conversation. This is a relief from this one thread where i was flammed off my a&& and this kid just belittled me with opinions.

[Esmerelda]

Thanks for that - I was worried this thread was going to turn into an argument! I've been put off using forums in the past because of the number of people who seem to enjoy pissing others off. From looking at the rules for this place I can see that sort of thing isn't tolerated, but it's nice to see someone obviously wanting to keep things on track and have a proper discussion .

It was actually quite a while ago now that I did any serious reading on this subject but I gather the controlled drinking approach becomes less and less likely to work the higher the level of dependence is. Which is logical. There was one case that was talked about lots, of a guy (I think it was a guy anyway) who managed controlled drinking after 25 years of serious addiction. But I think that's a bit of an exception.

As for Swie - she's had problems with alcohol and opiates (and meth in the past). Alcohol she's got down from two bottles of wine a night to 10-14 units per week, but she's not ignoring the fact that this might not be sustainable and giving up could still be what she needs. Opiates she's on and off but working towards 100% off. There's no real alternative, at least for her. I know what you mean about the full-time battle to remain controlled. Swie has noticed there's not so much of that with alcohol for her any more - especially now that she's concentrating lots on other aspects of her life. But with opiates it's a different matter! It just isn't going to happen. But then the substance is way more addictive.

So it obviously depends a lot on the individual, the substance, and the level of dependence. And that's why self-awareness seems so important. We need to know ourselves and appreciate what's going on, not blunder along in denial! Tis better to be knowingly out of control than out of control and in denial, as acceptance is the key to change and all that.

To be honest, Swie's ultimate goal is to be free of all psychologically/physically addictive substances - she feels they distract her from the truth. But she's not going to beat herself up for not having achieved that yet .

swi-imyourlittlebare has obviously gone through a lot and know what he's talking about - I wish him lots of luck in his journey towards freedom.

Reputation Comments on this post:

Helpful, insightful and informative posting: Keep up the good work

[snapper]

SWIM thinks those with addictions are simply screwed. Total abstinence is a recipe for a severe relapse. SWIM tried AA, NA, drug treatment and found that being clean is a recipe for failure and also a full time job. The sad thing is that there are some people for whom the alternative is death. SWIM has found rotation of substances and depending on those which are least addictive is the best form of harm reduction. SWIM is still alive now and that alone is a testament to success. However SWIM is far from perfect. SWIM still drinks, smokes and uses an assortment of other drugs. However, SWIM uses kratom instead of heroin, occasional RC stimulants instead of coke and meth, and depends heavily on the most benign of all, cannabis. SWIM is able to function, which is more than SWIM used to be able to do when SWIM was less discriminating. Most of those who ran with SWIM before however are dead now.
If the habit will destroy you, you need to abstain. However, substituting a managable habit for a destructive one can help prevent a relapse.

[imyourlittlebare]

i believe that is very true snapper. not so much with drinking and stuff or drinking less. I have posted on multiple threads and posted many articles on how opiates and how as little as a single administeration of morphine begins physiological alterations in the brain that start the addiction process that lasts for life. And the sad thing is there is alot of theory that you cannot reverse any of the brain changes. this is the idea behind methadone maintanence. I perhaps worded this poorly compared to if i was awake so i will be sure to be back later and resubmit a response. but all in all, the theory behind methadone maintenence is that heroin reduces branching in the nucleus accumbus and you can never get it back and thus you cannot experience pleasure or life without this branching. Furthermore, the addiction is engrained in your brain through a process called ltp so your brain physiologically is "on life support" with the opiates and you cant function without them as well as you did before no matter what you do. this is the basis for methadone.

[snapper]

And in this case buprenorphine is a far superior maintenance drug than methadone, which is in SWIM's opinion is simply nasty and even more irreversible. Methadone has its place more for severe end of life pain management. However, as an ex habitual heroin user, SWIM feels that the rewiring of the pleasure centers takes quite a while - on the order of many years - to become permanent. Then the "dry drunk" syndrome irreversibly sets in with abstinence.

[sarbanes]

Absolutely! Don't believe the all or nothing dogma from NA. You do what you want to do, really. Depends on how much you really want something, and how much will power and discipline you can muster. Other factors are how you get clean (taper, or cold turkey). Nothing is impossible, and it doesn't matter if you just began, or are a 10 year addict. Both can become clean again, and then chip on the weekends only, and re-experience those great highs you got in the beginning. You just have to want it bad enough.

[imyourlittlebare]

Originally Posted by sarbanes

Absolutely! Don't believe the all or nothing dogma from NA. You do what you want to do, really. Depends on how much you really want something, and how much will power and discipline you can muster. Other factors are how you get clean (taper, or cold turkey). Nothing is impossible, and it doesn't matter if you just began, or are a 10 year addict. Both can become clean again, and then chip on the weekends only, and re-experience those great highs you got in the beginning. You just have to want it bad enough.

nothing is impossible. I agree. But in all honesty the only surefire way to avoid addiction is to stay clean and that is why they advocate the all or nothing model. Its the safiest for those who ruined their lives before. Most people do not have the self control and mental strength to do what we are talking about. To maintain true control over the drug i believe you would never really be happy with the dose and never quite feel good. Or else if you let it escalate you would become trapped again and fooling yourself as the guise of every other weekend or something. Its a full time job. Not impossible. Although this imposes an enigma. Not saying this is true but its a different way to look at it

"Someone is so addicted and cant be truely addicted again so they focus all their time and energy on the drug to use and not become addicted"

not saying thats right just a thought

Reputation Comments on this post:

i believe you are most correct, esp the 'never quite being happy with the low sensible dose' part

[stoneinfocus]

Well `clean is relative -tryn´ to make it real, compared to what?

As I see it, most of the adolescent would be categorized alcoholics, but then adapt to a normal drinking pattern.

LSD and other psychotropic drugs, like Exctasy have shown to alter use-patterns and prevent addiction patterns of the pathological etiology in users.

In my opinion it is very well possible, after abstaining from a destructoive drug-behaviour, to return to a normal use of a drug, by using the experiences of the former addiction and of other substances, like LSD and Exctasy for getting over it, if they seem to work.

But one should be honest enough to see, when things are going out of hand, which is very difficult with alcohol, because one tends to give a fuck.

Now some doctores will bash me for giving advise to form a polytoxicomania, but it´s not as it might look.

[beentheredonethatagain]

I was clean for over six years , at the time I needed AA and NA , they really allowed me to mature and get past a point in my life to where I had no controll of my addictions. Now I am older and more responsible, I am able to have a beer or two or three, its not a regular thing with me. Despite what I was taught about my addiction doing push ups , well I dont get it, I have made a few mistakes recently due to being loaded, but compared to before , it doesnt compare.

[Fight Club]

I tried unsuccessfully to quit using coke for 4 years while continuing to drink socially. By socially, I mean I never got drunk, usually had 2-3 drinks or split a bottle of wine with my wife.

I resisted 12-step or other support groups that suggested abstinence from all mind-altering substances because I too believed that I could not and did not want to lead a life free from the pleasures of alcohol. You see, my wife and I were wine collectors and foodies, spending a great deal of our leisure time at cocktail and dinner parties, dining out, wine tasting, etc. Most of our social circle was similarly involved.

When I went to rehab in March 2006, a counsellor suggested that even if I did not have problems with drinking, I may want to give it up anyway, since diminshed inhibitions might reduce my ablilty to resist temptation, and cross-addiction was well documented in others. She suggested that I give it up for 90 days (I spent 28 days in rehab; the easy part), and then if I wanted to drink again after that point, to do so. It was hard to argue with her rationale; if drinking wasn't a problem for me, than quitting for 90 days shouldn't be hard, but if quitting was difficult, then maybe I had more of a problem with alchohol than I was willing to admit.

Bottom line, I not only quit for the 90 days, but have not had a drink in 18 months. During that time I had three slips with cocaine, but have always jumped back "on the wagon". For me, abstaining from cocaine, and feeling good about it is far easier now that I have accepted a sober lifestyle.

BTW, I am new on this board, so take it easy on me, OK?

FC

[stoneinfocus]

Great FC an congratiulations for abstaining and counter-acting a cross-linked addiction problem.

I think if you get to know yourself better and find that some habits or other drugs are the key-factor in really forming an addiction, like nicotine is one cross addiction to opiates or alcoholism, or alcoholism goes with cocaine, then one might return to the drug, that one thinks was not the problem and use it, while abstaining from the other drug completely or with a serious time-gap inbetween, like months or weeks or -in your case, years.

[wildbeast]

My guess is that the addicted person needs to find a form of coping with reality without his drug of choice. In most cases anyway. Getting some time dealing with life's issues for a matter of several years.

Is returning to substance use a sure slide back into shitdom? Not always. Not as the 12 step nutcases would always have us believe. However it is an area where a lot of well minded recovered people still choose not to tread.

Alcohol is a poison. That's a fact. Maintenance drinkers are simply doing damage to themselves at a level not usually seen by maintenance opium, tranquillizers or users of other drugs.

Swim found that after completely quitting alcohol she could even medicate as directed with other pharmaceuticals like Xanax or even Oxy Contin without going over the edge. But that is just her physiology and brain at work. Other people have found Xanax and the opiates or opiate synthetics to be very addictive. They would cross over into high tolerances very quickly.

And yet this was never SWIM's experience at all. However it took her a while to get used to the "other shoe" not dropping. People who've done significant 12 step programs may be at a psychological disadvantage for a successful return to chemical use. Or even just prescribed medecines.

The dogma of "We all know what happens to people who stop going to meetings" takes a long time to be cleared from the brain. It's the voice of the beast!

[Paracelsus]

Note that sustained use of tranquilizers, as with alcohol, causes a phyiscal addiction much harder to overcome than that of opiates. When quitting cold turkey from alcohol or sedatives, MANY die if not in medical care. (Sorry for the off-topic, I realize this thread is about psychological addiction)

[imyourlittlebare]

Paracelsus,

oh yeah. its alot harder to get over that physical too. opiates have a much much harder psychological addiction than those in my opinion but there is no disputing the physical. Alcoholics go through hallucinations and seizures. Its scary. Same with benzos. Luckily, that point is semi hard to reach for most. I wonder how much validity there is to the idea of an alcoholics gene? this would almost definetely cross with benzos and all types of alterations with GABA agonists maybe? Because i cannot see swim getting addicted to those things that hardcore. Maybe he lacks a gene?

[Paracelsus]

Genes may play a role in addictions (I know of several alcoholics with alcoholic parents and grandparents and I've read that Native Americans are highly susceptible to alcoholism), but my personal opinion is that we like to blame genes too much, instead of taking responsibility for our own mistakes. Lots of alcoholics (I don't know if it's the majority) have a painful pre-alcoholic past behind them, and got addicted to alcohol in an attempt to drown their sorrow in it.

[imyourlittlebare]

Paracelsus,


but what if those painful pasts are the environmental factors that cause that gene to manifest itself and cause an uncontrollable need for increased GABA agonist activity. I dont know. Maybe more of an understanding of environmental roles in gene manifestation is in order. Like heres an example of that theory being used in a bigger theory. Schizophrenia is a fairly genetic disease. However, there are family members of the sick one that have the same brain changes. However, the one that did get sick was exposed to the flu virus in the womb or used pot and it caused enough of an environmental effect to allow the sickness to manifest itself (there are lots of studies on pot increasing the risk of a person already at risk for schizo to develop it for those who wanted to argue that). Sorry, swim got my computer. He is rambling. He is so far gone off Ritalin he hopes everything he has put up for today makes sense. He will def go back and change it. Or else i will punish him. Those silly pets.

[Pondlife]

SWIM's experience with overcoming tobacco addiction is similar to what beentheredonethatagain has described. I'm not sure how similar cigarette addiction is to alcohol, but I suspect that all psychological (as opposed to physical) addictions have similar roots.

SWIM was a smoker for 12 years, and has now been "clean" for about 15 years.

After the initial cravings had ceased, he often had dreams in which he went back to smoking. These dreams had a strong guilt element, and SWIM would typically wake up feeling real bad that he'd relapsed until he realised that it was only in the dream.

SWIM believed that if he had started smoking again during this period, he would have been back on a twenty-a-day habit in no time. After five to ten years (I'm not sure when exactly), these dreams stopped. SWIM now has the occasional cigarette (maybe one or two a year) but feels absolutely no addiction.

Based on this, there was a period for SWIM after the physical addiction was over where he was still vulnerable. However this eventually passed and he is now essentially back to the same state as before he first started.

[beentheredonethatagain]

question : I hear over and over that some here think that People in the AA & NA programs are nuts or just a cult or what have you, my question is this, I had been to many many meetings in the past and have met alot of people who I know for a fact were on the losing end of addiction, some I had known from the street, these ladies and men are living a new life one of responsiblity to their family and to them selves. they arent robbing and ripping any longer, so what is the key if the program is so bad? these people are completly changed, and I have seen hundreds do it.

[stoneinfocus]

Yeah, that seems to be a possibility, ´cause swim neither gets cravings after cocaine and stims, just thinks it´s a pity when it´s gone, but after nicotine and MJ -and aclohol is a edgy thing, though he´s given it up cpmpletely 14 years ago, except for getting drunk once or twice a month on very little Et(OH), like 4 drinks.

He feels like needing opiates for feeling normal after 4 years of constant pain and sometimes switches with amfetamine, for it gets his work done, which he would else never been able to accomplish, plus he thinks it helps in not getting a rusted mind on opiates and helps with his sex-life, although being pain-free always helps a lot, no matter by what mean.