Alcoholism --
An incurable addiction

By THOMAS RUE

Alcoholism is a disease that is chronic and progressive and, if not arrested and treated, fatal.

According to the American Medical Association, "It should be approached in much the same manner as are other chronic and relapsing medical conditions. The aim is then viewed as more one of control than cure. Abstinance is sought as the primary objective."

The alcoholic is medically disabled by an addiction to alcohol.

The addictive cycle involves an exchange of short-term relief of pleasure for long-term pain. Other symptoms include obsessive thinking, increased tolerance to the drug (alcohol), loss of control of one's life, and various forms of damage to ones' health and lifestyle.

Shifting the blame

Alcoholics tend to blame other people for their condition. This is one of the many forms that the defense mechanism known as denial takes. Actually, no one is responsible for an alcoholic's relapse but him- or herself.

Family therapy can help significant others accept the permanency of the disease and explore the roles they play in creating opportunities in which which a relapse is likely to occur. No one is the cause for an alcoholic's drinking, but families (and workplaces) are dynamic systems with interlacing networks of relationships and behaviors that can reinforce the illness. Psychological mechanisms, or pattersn of behavior, ingrained in the alcoholic by years of experience may lead to the initiation of a relapse.

While others may participate in a dysfunctional cycle, it is the responsibility of no one but the alcoholic if he or she picks up the bottle and resumes drinking or abusing other drugs. Friends can empower the alcoholic to live a more adaptive lifestyle by not allowing the shifting of responsiblity for the alcoholic's drinking, and by not participating in denial themselves. This is often difficult.

A drunk drinks for no other reason than that he or she is compelled to do so by the illness. Period. It's not the wife's fault, the boss's, the nosy neighbor's, or anyone's other than the alcoholic's.

Accepting responsibility

For his or her own good and the good of society, the alcoholic/addict must be held responsible for behavior while drinking. For example, being caught driving while intoxicated (DWI) leads to a variety of consequences, including being justly branded as a criminal. DWI endangers not only the alcoholic, but innocent motorists and pedestrians as well.

Often a life-shattering event like an arrest is what it takes to start an alcoholic on the path to recovery. In this sense, being arrested and convicted can be a blessing. But sometimes even this is not enough to cause a drunk to "hit bottom" and give up drinking. Even a 28-day inpatient counseling program is not a cure-all for a lifetime of drinking. Alcoholism is a problem that never goes away, until death.

Some so-called recovering alcoholics continue to drink on the sly, lying to their closest companions, even after being convicted and ordered to abstain and to engage in treatment. For this reason, probation officers and counselors are often authorized by courts to take random urine samples to test for the presence of alcohol or other drugs.

Denial, rationaliszation and blame-shifting are chronic symptoms among alcoholics. So don't be fooled. "Emotional stress" is not an excuse for drinking. If an alcoholic is unable to deal with a stressful job, for example, she or he might be well advised to seek more suitable employment.

Relapse prevention

Relapse occurs whenever an alcoholic resumes drinking. One drink leads to another. Very quickly the person finds him- or herself in circumstances similar to those before recovery began. There is no such thing as a cured or recovered alcoholic.

A relapse often commenses with a stressful life change. When stressors are not recognized and unpleasant emotionsl go unacknowledged, a breakdown in behavior and social structure begins, leading to a loss of control and good judgement. At this point, the alcoholic's view of the world will begin to shrink. Such acute degeneration is often followed by resumed drinking.

The only way for an alcoholic to prevent a relapse is to break this cycle before picking up that first drink. This can be done by seeking support from a trusted friend, sponsor or counselor whenever stress arises. Alcoholics can remain sober by permitting the methods of such proven programs as Alcoholics Anonymous fill the existential void left by the loss of alcohol as a means of coping.

Dry Drunk Syndrome

Persons experienced in working with alcoholics recognize certain warning signs that a relapse may soon occur. Because alcoholism is a permanent disease that affects personality, these warning signs can be seen in the alcoholic's behavior even when he or she is sober.

The term "dry drunk" applies to the alcoholic who, having undergone a successful period of sobriety of any duration, has not effected positive changes in behavior and attitude, or has reverted to old attitudes and ehavior.

Indicators of a "dry drunk" lifestyle or attitude may include one or more of the following:

Grandiosity, or an exaggerated sense of self-importance and the relative unimportance of others' feelings or rights.

Judgementalism, in which the alcoholic is prone to make striking value judgements -- ususally in terms of what is "good" or "bad" about other people or about themselves.

Intolerance, leaving no room for delaying gratifications of personal desires or accepting legitimate differences.

Impulsivity, related to intolerance, whereby the alcoholic is heedless of the ultimate consequences of his or her actions.

[A contributing editor to The River Reporter, the writer is a National Certified Counselor who lives and practices in Monticello, New York.]

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