“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.
- 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.
- 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.