Re-learning to drink: a long overdue update

First of all, apologies to anyone who has followed or read my earlier posts on my experiences of ‘re-learning to drink’. So here’s a quick one to say how its been going…

First of all, things have been fine although I remain incredibly busy which is why its been too long here. But drink-wise, I’m not drinking problematically despite my past alcohol dependency. Presently I typically drink a few times per week on average, and on most occasions within the guidelines (3-4 units). If more, it’s never more than double them, which is the government’s rather technical definition of ‘binge drinking’. Of course this is a long way off the 20 or 30 units I would regularly drink in my early twenties.

As previously explained, my concern then with returning to drink after many years of abstinence was the possibility of slipping back towards dependency. Before starting this experiment of sorts, I knew that wouldn’t happen overnight, but perhaps in 3, 6 or 12 months I would have a good inclination of the chances. In researching controlled drinking as fact or fiction, the main criticism that resonated was that it may be possible for a while, but the controlled drinker always ends up dependent again. Most of the studies don’t seem long-term enough to decisively disprove this. But at nearly 12 months in, that doesn’t feel a real risk for me right now.

Nonetheless, in times of stress I have felt an urge to drink, and a social occasion without alcohol is not so appealing as one with it. Having said that, once drinking  it doesn’t feel all that special, though certainly pleasant. So, whilst I do look forward to drinking, surely that’s as much because I look forward to weekends and socialising as much as the mild effect of alcohol itself. Or so I believe. If I’m busy or need to drive somewhere on what might otherwise be a drinking occasion, that’s not a big issue. In the past I sought drunkenness whenever possible; now I seek ‘responsible drinking’ as part of an available social occasion or weekend.

Nonetheless, I’ve by no means decided that I am proof of “controlled drinking being possible”. It’s far more complex than that, and my position at present is that for some, whose lives are stable and have addressed the reasons they became dependent in the first place, drinking again may be possible. But, for most formerly dependent drinkers, certainly those who have had more severely developed dependency, abstinence is undoubtedly the best and safest option. From my research, experience and many conversations, it seems to me a general premise that the greater the level of dependency, the less likely successful controlled drinking will be possible. As previously explained, I felt that because I stopped ‘early’, had a long period of abstinence, and significantly changed my life circumstances, I had a good chance of drinking without destruction.

So our life circumstances are key. Without good health, good use of time, general happiness or other important wellness factors, anyone’s chances of problem free, non-addicted behaviours are reduced. For now, touch wood, this often cruel thing called life isn’t treating me too bad. If that changes, I’d be worried about continuing to drink.

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Are the recommended guidelines ‘nannying’?

It was recently announced that the recommended guidelines for ‘safe’ drinking are to be reviewed - a move which has been welcomed by both the usually opposing health and industry groups. With it though came a Daily Mail article shrieking about the guidelines being another example of the nanny state, and a barrage of other mis-truths about alcohol and society.

Personally I feel the guidelines are important, but equally so is how the Government and health groups use them. There may be a fine line between providing information and patronising people if they choose not to use it. If people don’t want to reflect on their drinking they won’t, so there’s no point forcing it. But I don’t accept that by simply providing a guideline on ‘safe’ consumption or offering people advice is any way ‘lecturing’ in itself. This is where journalists at times misconstrue things which in turn foster the very problems they hype about.

Take the Mail article. Firstly it refers to the guidelines as “limits” – not an uncommon mistake, but semantics are important here. ‘Limits’ suggests a legal implication (like a speed limit), and that we don’t have a choice. The guidelines are there to help us make an informed decision about our own drinking – should we choose to. I’m not denying there aren’t challenges in conveying units and guidelines, but to turn making information available on an important health matter into an argument for excessive state intervention seems entirely baseless.

The article further misuses information to argue a political case for less nanny-statism; for instance saying that “only 6  per cent of cancer deaths in the UK every year can be attributed to alcohol”, whilst ignoring many other higher levels of alcohol implicated deaths such as liver or hypertensive disease. In typical Daily Mail fashion, the article points the finger of blame at the unemployed; “Most people who have jobs and family duties do not over-indulge”. The stats actually show that it is those in senior professional roles that most often drink above the guidelines, and most people with alcohol dependence are still in fact in work.

Towards the end, the article concludes “Instead of lecturing the great majority with dubious drinking limits, the authorities need to find ways of reforming those binge-drinkers.” It offers no suggestion as to how the Government should actually ‘reform’ these ‘binge drinkers’. Instead it suggests “individuals should take charge of their own destinies”. Funnily enough, that’s exactly what I thought I was doing when I used to pride myself on getting wasted. I wasn’t aware of the guidelines back then, but if I was, perhaps I would have reflected on my drinking a little more before it became quite so problematic.

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Re-learning to drink? 3 months in…

Three months ago I tentatively began to drink again after many years of abstinence. I have explored why I felt this might be a possibility for me when for many with past dependency this would be a bad idea. Here’s a brief update on how its going.

Certainly my new experimental relationship with alcohol has been at the forefront of my conscience, carefully weighing up my instincts, the evidence and words of friends and colleagues. When I started, I was sure it would not be until at least several months in before I had an inkling as to whether it was going to work.

At present I feel confident to say that – so far – I am succeeding in non-problem drinking. But it is certainly too early to describe myself as ‘recovered’. Indeed I may never feel this an appropriate term – anyone with past dependency may only ever achieve ‘controlled’ rather than normal drinking. In addition, there are a few issues which might raise some legitimate causes for caution.

Over the last 3 months I have been drinking on average twice per week, usually a couple of lower strength (4%) beers. There have however been exceptions; one in particular where I felt moderately intoxicated, and another where I did not feel imbibed but drank more than on other occasions, but over a longer social event. The vast majority of my drinking occasions have been moderate and harm free. Two have been pushing the boundaries and left me feeling ambiguous about the implications.

Many people would argue that occasional sessions of mild drunkenness or exceeding the (fairly low) guidelines are a part on “normal” drinking.  However “normal” is not something a former problem drinker might consider themselves capable of. I am at present pleased that on the whole I seem capable of a moderated approach, though am cautious that as time passes, I may test and blur these boundaries until the regularity and amount I drink creeps up. And with that could come a range of health and social risks. And my greatest fear – re-occurring psychological dependency.

Overall though, I feel so far so good. But of huge importance is that I never forget my past problems in controlling my alcohol use and the consequences of that. Complacency could easily spell trouble as times passes and self-preserving fears dispel. We should always keep a close eye on our lifestyles and any self-rewarding behaviours. The more in tune we are with these the greater the chance we have of nipping a potential problem in the bud.

I wish to highlight that I feel controlled drinking is in most cases not the best option those with past dependency. I have explained here why I felt I was able to attempt controlled drinking.

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Re-learning to drink? One month in…

One month ago I ended eight and a half years of abstinence with a single drink. That one weak  beer though was a long contemplated, carefully planned and controlled occasion. Since then I have drank 6 times, each time not more than 2 drinks or 3 units. In consumption terms, I have been a perfect moderate drinker, but the key question is can it last? Am I in the process of re-learning how to drink, or back onto a slippery slope with only one inevitable outcome?

Perhaps the answer is neither – alcohol dependence is not determined purely by consumption or genetics, so my wider life events and choices will inevitably influence what happens. If an unexpected traumatic event comes out the blue, as in life sometimes happens, my emotional state and ability to rationally control my behaviour would be likely to suffer. But assuming my circumstances remain stable, what is the effect of again inducing alcohol’s reward effects onto my brain? The changes and recovery potential for a once alcohol dependent brain is a little known science.

On the surface, my recent drinking occasions have been uneventfully normal. Reassuringly I have not felt particularly compelled to ‘keep going’, despite certainly enjoying the mild but pleasurable effects. A good start so far. On the other hand, I have been regularly thinking ahead to the next drinking occasion in a way few ‘normal’ drinkers probably would. Though I am anxious this could be some indication of a craving, I believe these thoughts are more induced by the personal significance of these occasions and the careful planning to ensure my drinking remains controlled and dispersed by alcohol free days.

My strategy for controlled drinking so far has been simply to stick to the recommended guidelines, not to drink to get ‘drunk’, and have only a few drinking occasions per week. Its working so far, though I have already contemplated whether I can revise these boundaries in the future. If things go steady, and loss of control doesn’t appear imminent, then wouldn’t the odd binge drinking session be ok? Possibly, but probably not to be tried any time soon. What about drinking more regularly, allowing myself to drink most nights of the week rather than only a few? That for me may be the true slippery slope. Instinctively, the more regular the drinking occasion, the more the door is opened to dependence.

It is then perhaps where and why I drink that has preoccupied me most over the last month. A month ago I felt the safest way to drink was at home, as part of a Friday or Saturday evening unwinding. Now though I’m not so sure. Drinking should largely be a social activity, something we do with friends, not to help us deal with stress or negative emotions. My past heavy binge drinking was problematic, but it was the regularity of it that probably led to emergent dependence.

Perhaps the best way to ensure we avoid developing a problem (asides from keeping an eye on how much) is by honestly asking ourselves what our motivations are to drink. At present, I wish to enjoy the social benefits of drinking, the taste of a nice drop and the subtle relaxing effect it brings. But if the reasons begin to shift back to the past, I must immediately re-evaluate. Drinking motivated by wanting to ‘let go’ or escape, quench a psychological thirst or craving, or deal with underlying problems are surely signs that alcohol use is becoming problematic.

Want to assess your own drinking? You can do an online self-assessment here which is based on the validated AUDIT alcohol screening tool. For further UK help and advice see here or call Drinkline anytime on 0800 917 8282.

Image credit: Evgeni Dinev / FreeDigitalPhotos.net

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Will I drink again… recovery or re-lapse?

“Will I drink again?” was the perhaps ambiguous conclusion to my last post.

Over the last year or so I have been considering attempting ‘controlled drinking’. By this I mean harm-free drinking, most importantly for me without any re-emerging dependence. If I succeed by learning to drink ‘responsibly’ and without problems, some may believe I was never an ‘alcoholic’. Others will say this is consistent with evidence that it is possible to return to ‘normal’ drinking following former problem drinking (including in some cases dependency). I accept I may later regard any failed attempt at controlled drinking as a re-lapse.

Either way, I am in no way suggesting that anyone in recovery attempt controlled drinking on the basis of my experience; if at all. Abstinence is the only 100% safe option and the evidence for successful controlled drinking in former problem drinkers is to some degree under-developed. What seems clear is that the more serious one’s level of past problem drinking, the more appropriate an abstinence goal appears for successful recovery. In addition, prolonged periods of abstinence are also important for ‘former alcoholics’ that have reportedly succeeded in normal drinking. So ultimately, why should a formerly alcohol dependent person ever put themselves at risk by drinking again if they have succeeded in abstinence? I’d expect for most it is not a risk worth ever taking.

In fact I failed in a sustained attempt to moderate my drinking after first recognising my difficulties nearly 10 years ago. But that circumstances were so very different then, environmentally and personally, it is not surprising I did not succeed. My attempts to cut down were without professional guidance, in a drinking centred environment where I had not learned other coping skills. It now seems quite apparent why I came to realise that not drinking was the only way I could avoid my drinking problems at that time. Abstaining provided a clearly defined line – no drinks was no drinks whichever way you looked at it, whereas ‘just a couple’ all too easily became many more.

Nearly a decade later, most of it sober, I have increasingly felt that I could now drink in a controlled way. There is no single reason I can point to, though my circumstances are entirely different. I have a fulfilling and active life in which social pressures to drink are limited. Years ago I felt angry and troubled which was I believe was linked to a strong desire to get drunk. Today I feel happier, more emotionally secure, and somehow like I could enjoy one drink without craving for another. This isn’t a professional judgement, just an instinctive and I believe honest assessment. Most importantly, I feel ready to accept that if I attempt controlled drinking but feel dependence creeping back, I would accept that drinking is not an option for me.

Below are the two key reasons as to why I think controlled drinking may be achievable for me.

  1. Whether we call it alcoholism or dependency, there is evidence to show that a minority of those who recover from serious alcohol problems later achieve controlled drinking. The research is perhaps limited, but it is there, as far as I am aware most comprehensively collated in the book ‘Controlled Drinking’  (Heather; Robinson, 1980). The book finds that the greater the level of dependency, the less likely controlled drinking may be achievable. The length of abstinence and significanct shifts in social circumstances also seem important factors in determining the likelihood of recovered control. Essentially it argues that the notion of alcoholism as an irreversible condition has been proven false.
  2. Whilst there is undoubtedly a genetic component to the risk of developing alcohol problems, alcohol dependency cannot be accepted as only biologically determined. Arguments against the disease model present significant aspects of ‘alcoholism’ as socially learned behaviours. This has been most persuasively set out in the influential book ‘Problem Drinking’ (also by Heather & Robinson, 1997). A key premise of the book is to redefine alcohol misuse and addiction as a wider scope of ‘problem drinking’ behaviours. It aims to reconstruct some of the simplistic misconceptions that appear to surround the subject of problem drinking such as the often narrow and flawed perceptions of alcoholism and its causes. From this perspective and my own thoughts, I am as yet unconvinced that I am, and therefore always will be, an ‘alcoholic’. If I fail in any attempt at controlled drinking, I may still be inclined to reassess.

In considering the theory of alcohol problems as socially learned and the evidence of normal drinking in former alcoholics, I stand in relatively good stead to succeed. Perhaps most significantly, that I never reached a stage of severe (or physical) dependence. I have clear recollections of thinking ‘if I don’t stop now, it will be increasingly hard to do so if I continue drinking’. I had instinctively recognised mild dependence and stopped before it developed. Therefore in scientific terms, that I never developed severe dependence is a key factor in the likelihood of success. That I have been sober for many years, reconstructed my social life and improved my overall mental well-being are also undoubtedly significant. On the downside, some family history and early onset of harmful drinking do not favour so well as indicators of likely success.

Nonetheless, the last time I drank I had no intention of it being for good. That I haven’t had a drink for over 8 years was down to my own recognition that I felt it was best for me not to do so, as the risk of dependency felt present. Many things have now changed and I feel confident that I have a good chance to re-learn alcohol use without developing problems. I may be wrong, but I unless I try I will always wonder. Will I drink again? Yes… but carefully.

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Contemplating a problem: an early reflection

This blog is to help me explore my own relationship with alcohol, and perhaps resolve whether I was, or still am, ‘an alcoholic’. This is partly why I previously explored alcohol dependency as the preferable term for ‘alcoholism’. Here’s an early reflection.

Whilst grateful for the opportunity to go to university, I must admit it was mainly for the chance to leave home and have a good time. Fortunately I also recognised the importance of the academic opportunities, but for the most part study was an inconvenient aside. My focus was on the there and then, so as a sociable but somewhat emotionally volatile 19 year-old, drinking surrounded all that I enjoyed.

During my adolescence I had become an increasingly enthusiastic beer drinker, but it no longer delivered the drunkenness I craved for a good night. A large bottle of Jack Daniels, some brandy and rum were the most important items I unpacked on my first day in university digs.

I’m now quite ashamed of much of much of what I so drunkenly did in that first year of ‘study’. Ironically, many of those reckless actions were at the time things I was proud of, and brought me some degree of reverence amongst like-minded peers. I grasped onto a laddish ‘binge-drinking’ culture and made it my own. It gave me an identity through which to achieve both release and hedonism. A life without drinking seemed dull and pointless. Partying, casual sex, unplanned drug taking and crippling hangovers are arguably par for the course for many outgoing youngsters. But that my dis-inhibited behaviour included numerous fights and one incident of drink-driving remain deep regrets.

It is perhaps an indication of the cultural embededness of ‘binge drinking’ that the risks to others I at times posed had no effect on my drinking behaviour. But during that year of particularly vociferous drinking, one occasion stands out as the trigger for contemplating that perhaps… I had a problem.

I can remember many things about the night of a good friend’s birthday (as good a reason as they come). Caution – the final reason won’t please the squeamish too much. Despite it being some 10 years ago, I clearly recall the frustration of trying to get drunk that night. The event started with a typical ‘pre-loading’ session before hitting the bars. But despite no lack of supply and my increasingly determined efforts, I felt frustratingly sober for most of the night. Returning to the house, I refused to be beaten. With more shots, shared with anyone that was able to join me, eventually I began to achieve the effect I had craved.

The hangover after such a session had reliably become a splitting headache and some unhappy insides. Painkillers were handy for alleviating the head pain, but I was about to receive a worrying shock. Reluctantly emerging late in the afternoon to use the toilet, I sat slumped on the seat and anguished the pain in my stomach. When I stood up and looked down there was blood. I stared motionless, anxiety creeping in, and began to repeat to myself “What am I doing?”.

This was certainly not the last time I would drink, but here started an important process of reflection and recovery. But I am still left with one key question unresolved. Will I drink again?

I hope to use this blog to help me explore my relationship with alcohol as problematic or not, past and present. I will share more about where I have been with alcohol, where I am now, and where I may go, and welcome any comments. Ciao for now!

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Alcoholic, binge, or sensible? Part 1

Broadly speaking you will fit into one of these three categories, though you may well not like the description. In fact you’d be right not to, they are all spurious if not misleading terms.

When it comes to discussing types of drinkers, we are faced with a proverbial minefield of misleading, confusing and awkward set of terms. The issue for those who need to ‘correctly’ identify drinkers into categories is that the most common phrases are often the most unhelpful. To start, I would question whether encouraging ‘sensible drinking’ could be likely to induce a counter-effect. To those of us that like a good jolly, could being told to be ‘sensible’ in one’s supping could sound provokingly dull to the point of inducing the opposite response?

More exciting terms like ‘binge drinking’ or ‘alcoholic’ certainly catch the ear and probably conjure up some vivid images. But in many cases neither terms are helpful or well-defined (try asking a group of friends what they mean). Labelling someone ‘an alcoholic’ is clearly unfavourable due to its loaded and negative connotations. An important point to note is that in medical terms, ‘alcoholism’ is not recognised by most health authorities (such as the World Health Organization). What we are actually referring to is ‘alcohol dependence’. Admittedly, it doesn’t roll off the tongue so well, but on reflection it should be clearer to clarify what we’re actually talking about.

Alcohol dependence broadly means a strong desire to drink coupled with a difficulty in controlling its use. Common factors identifying dependence are not confined to physical problems like withdrawal or tolerance. Feelings of guilt, remorse or relationship or life problems amongst regular drinkers will often indicate dependence. More broadly, addiction is commonly characterised by the continuation of a harmful behaviour, despite negative consequences.

Where am I going with all this? I would say that most of those within the estimated 1.6 million dependent drinkers have seemingly regular lives and so fall way off mark of what people tend to perceive as ‘an alcoholic’. Most have probably not contemplated the thought of being ‘alcohol dependent’, not least because they have a job, a family, friends etc.  But importantly they are more likely at a stage of early or mild dependence, and should respond well to brief behavioural treatment or support. Many in fact will successfully recover on their own or without professional help – should of course they themselves accept a change is for the best. *Note that anyone with more severe dependence must seek professional help before cutting down – severe alcohol withdrawal can be fatal.

We should therefore avoid using the term ‘alcoholic’ where possible, unless perhaps someone chooses that term themselves such as a fellow of Alcoholics Anonymous (AA). Whilst many people’s perception of ‘alcoholism’ may be sufficiently similar to the criteria for severe alcohol dependence, language is all important. Alcoholism has evolved predominantly negative connotations which, with the intriguing exception of its use within AA, are counter-productive for those trying to overcome alcohol dependence. However it should not sound so stigmatizing.

Many people will arguably have an ‘addiction’ (another tricky term) of some sort in their life; tobacco, compulsive eating, caffeine (debatable), a pricey gambling habit… or a few drinks too often. In today’s stress-filled world, no-one should feel ashamed to find themselves becoming dependent on something along the road. When someone does recognise an early problem, they should feel supported and empowered to change. If not, feelings of guilt or shame are more likely to induce denial and the problems may worsen. The language of ‘alcohol problems’ is therefore instrumental.

On a final note, we should recognise that the majority of ‘alcohol problems’ are not caused by the small minority of dependent drinkers. Soon we’ll explore ‘binge drinkers’, and perhaps why not to tell them to drink ‘sensibly’…

Ciao for now!

Want to assess your own drinking? You can do an online self-assessment here which is based on the validated AUDIT alcohol screening tool. For further UK help and advice see here or call Drinkline anytime on 0800 917 8282.

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