My experience with Disulfiram

I’ve been managing my alcohol addiction with disulfiram for about 5 weeks. These are some random thoughts on what it has been like.

  • I’ve felt bullet-proof with regard to temptations to drink. I think in the last 5 weeks I’ve felt a longing to drink once. Maybe it was more like a “yeah, I would have had a drink in this situation”. I almost feel like I no longer have a problem.
  • Being around alcohol doesn’t bother me in the slightest.
  • My first week was fantastic. My mood lifted through the roof. I’m sure it was a combination of freeing my bloodstream of the toxins produced by alcohol, and also a change in my anti-depressants. It was such a high that I was sad to know that it wouldn’t last–I’ve felt it when I’ve quit before, but this time was stronger.
  • I’ve had one or two side-effects that I think I can attribute to the medication. I’ve developed, according to my wife, a persistent case of halitosis that isn’t solved with tooth-brushing and mouthwash. Its possible that this is also a dental hygiene problem since I’ve not been to a dentist in about 9 months, but that will be rectified next week, so I’ll know for sure then. The other thing I’ve noticed is that I seem to have more body odor. I don’t think it is strong enough for others to notice, but I can tell a difference. Now this may be because of other changes in my life (anti-depressants, more exercise, a change in diet), so take this one with a sizable grain of salt.
  • I’ve had one dream about alcohol where I had a single drink, then freaked out about what it would do to me. Fortunately I didn’t vomit in my dream or in real life.
  • Some people report sensitivity to alcohol-based mouthwash and cologne. I’ve used both without incident. I’m no more careful with the mouthwash than I was previously, and haven’t had a problem.

So that’s it. I really don’t struggle with temptation at all and that kindof worries me. How will I handle it when I stop taking the medication? I haven’t yet resolved that issue, and there’s no rush. I just have to be mindful of my ego, and make sure I’m prepared to go it alone when the time comes. Actually, my plan is to be sure I don’t go it alone, and that’s why I’m trying to be engaged in support groups.

Struggling with semantics

Words have meanings. (Deep, I know). Those meanings convey thoughts and ideas. Thoughts and ideas can stick in our brains well beyond the utterance of the words themselves. The connection from word to meaning to idea is so deeply embedded in our brains that we can dwell on something we read, or something someone said, for literally years. This incredible connection is why I can write “juicy lizard farts” you’ll be irritated with me for the rest of the day.

To go the opposite direction, as you have thoughts and emotions percolating in your mind, you’ll likely be feeling an unknown anxiety until you can translate those amorphous blobs into words that most closely convey the meaning of what your you’re feeling. And if I didn’t edit my writing to use the correct word (you’re instead of your) you would get likely get the meaning of my sentence, but because of the incorrect word, your (not you’re) brain would likely do a bit of a hiccup as it searched to fit the right word into the context of that sentence.

In college, I was having a conversation with a professor about one of his research projects. I don’t recall what triggered his comment, but he said something that I’ve been dwelling on for literally decades (paraphrasing): “Don’t let someone tell you that an argument is just about semantics. Everything we say is about semantics. If we cannot agree on the semantics, then we haven’t agreed.”

I struggled with semantics mightily when I was an atheist going to church, and that, ultimately, was why I left. The people were nice, the teachings were wholesome, and the music was beautiful. But I couldn’t get the word “God” to mean anything other than how I understand most people to mean and understand “God”.

“But can’t you just redefine the word in your own mind, and substitute something like ‘universe’ instead?” I tried that. And that works so long as we don’t have any kind of extended conversation that involves the word in question where my meaning and your meaning significantly differ. You need only say “God is doing wonderful things in the world today” for me to struggle with my meaning of God, and this causes a bit of uncomfortable “cognitive dissonance”. (I put cognitive dissonance in quotes because I’m not quite sure that’s the correct phrase. Its the feeling that you get when you’re having a conversation with someone and they use a word or phrase that isn’t perfectly familiar to you and you have to struggle for several moments to figure it out based on context, and that time spent figuring it out is time you can’t focus on the rest of what they’re saying, and its even worse if you just couldn’t quite grok their meaning.)

So this is why I’m still struggling with the idea of going to Alcoholics Anonymous. From what I’ve seen so far, having been to maybe a half a dozen meetings, the people are nice and very supportive. They celebrate every milestone, no matter how small. They volunteer to help and support anyone who asks. They are a great community.

And yet I’ll have to deal with my feeling of “cognitive dissonance” as I struggle with the semantic differences I have with the crowd before me. The first, and most obvious, is the word alcoholic. Pretty much every one of my posts on this topic has been about this struggle. The second is the reference to god/higher power in six of the 12 steps. When I went to a meeting this week, I introduced myself as “Rick, and I struggle with addiction” rather than the much more common “Rick, and I’m an alcoholic”. And when they read the 12 steps aloud, I read my own 12 principles. And then there is the serenity prayer, and its appeal to God for wisdom.

After the meeting, I met a fellow atheist among the regulars. He acknowledged that my struggle is a common one, and gave me some tips for working through it. His higher power were things like “global trade” or “UPS” because “those are way more powerful than I am”. And he told me he used to substitute “Sid” for God because of the letter D at the end. He summarized by saying that he finally acknowledged that all of those struggles were just his attempts to refuse to admit that he really was an alcoholic.  When he had introduced himself to the crowd, he was “Paul, the grateful alcoholic” (not his real name).

In my current emotional/spiritual state, his suggestions felt a bit trite. We had chatted for only a couple of minutes, so its not like I was expecting to be handed some great atheist-brotherhood wisdom. But it did kinda paint the picture that to get the most from the organization, I would have to resolve this internal struggle somehow, because it is clear the organization isn’t going to change for me.

My 12 Secular Principles

A while back, a friend knew about my struggles with the AA 12 Steps, and suggested that I re-write them to be my own. So I have. They are below.

Some quick notes: I rephrased them all in the present tense, since they are likely to be with me for some time. I also got rid of the “higher power” and “God as we understood him” stuff. I’m an atheist and I have a hard time swallowing those words even as metaphors. In several cases, I’ve switch from “God” to “community” primarily because I believe that, as social mammals, we do our best when we help each other. I can make use of that help, and I can be helpful to others.

I’ve also changed the name from “steps” to “principles” because I don’t really think of them as a progression, from one to another. I view them as guidelines for recovery, healing, and growth.

The other point I’d like to make is that I don’t think these principles are magical, or guaranteed to work for me or anyone. I’ve made this translation so that I can go to AA meetings and have an easy substitution for the steps, printed out and ready to remind myself how I want to approach and engage with the community.

Alcoholics Anonymous 12 Steps Secular 12 Principles
1 We admitted we were powerless over alcohol – that our lives had become unmanageable. I admit that I struggle with an addiction that has a negative impact on my life.
2 Came to believe that a power greater than ourselves could restore us to sanity. I admit that I  need help and support to enjoy my life free of this addiction.
3 Made a decision to turn our will and our lives over to the care of God as we understood Him. I seek a community that can help and support me in my efforts to be free of this addiction.
4 Made a searching and fearless moral inventory of ourselves. I document all my behaviors and beliefs which contribute to my own addiction.
5 Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. I acknowledge my behaviors and beliefs to myself and my community.
6 Were entirely ready to have God remove all these defects of character. I admit I am ready to change my behaviors and beliefs.
7 Humbly asked Him to remove our shortcomings. I actively work to change my behaviors and beliefs, replacing them with better behaviors and beliefs.
8 Made a list of all persons we had harmed, and became willing to make amends to them all. I document all of the people that I have harmed through my addiction.
9 Made direct amends to such people wherever possible, except when to do so would injure them or others. I apologize and make amends to the best of my ability to those I’ve harmed through my addiction.
10 Continued to take personal inventory and when we were wrong promptly admitted it. I regularly evaluate my behaviors and beliefs, acknowledging and correcting errors as quickly as I am able.
11 Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out. Through my community of support, I continue to learn how best to live addiction free.
12 Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs. I provide support to others who are struggling in the same ways as I have.

Opposites

Let’s play a quick game of opposites, shall we? I’ll list a series of words, and you try to come up with the opposites. Just go with the first word that pops into your head.

Ready?

  • strong
  • happy
  • fat
  • cold
  • hungry
  • black
  • on
  • light
  • sober

So, if you’re like me, your opposites were weak, sad, thin, hot, full, white, off, dark, and drunk. Is that right? Let’s try a couple more…

  • smoker
  • bulimic
  • suicidal
  • addicted

Those were a wee bit harder, right? I came up with non-smoker, not-bulemic, not-suicidal, not-addicted. Yeah, pretty lame, I know.

I find it interesting that we don’t really have good words to describe people who are no longer smoking, no longer vomiting their food, no longer contemplating suicide, or are no longer addicted to (not-alcohol, not-nicotine) other things. But the word we use to describe people who are no longer drinking is frequently “sober”. I’ve even used the word to refer to myself, with pride even. “I’ve been sober for 6 months…”

But the scary part for me about the word sober is that the contrasted word that easily comes to mind, the word that will run through everyone’s head is “drunk”. I’m sober now. What was I before I was sober? Was I drunk? Not always. Not even a majority of the time. Was I “a drunk”?

I don’t like the idea that perhaps, under some people’s ideas of “a drunk”, I just might have been one. But that would only because I had told you the extent of my drinking habit. But I’m pretty sure that, without these blog posts, if you had asked 100 people who knew me well, if I was “a drunk” that only one would have answered with a tentative affirmative. And that one person is the one who knows me better than anyone else. So, ok, maybe I was “a drunk”.

But now that I’m not “a drunk”, if I tell people that I’m sober, they immediately assume that I used to be “a drunk” and whatever that image conjures up in their head. Then there’s the judgement that comes along with that mental image.

Contrast that with someone who hasn’t smoked in 6 months. Someone in this position might, tentatively describe themselves as someone who “quit smoking” or they might just say “I don’t smoke, or “I’m a non-smoker.” Although you certainly know what came prior to the “quit smoking” phase, I’ll wager the judgement you’d place on them for having previously smoked is way less condemning than the judgement you’d heap on “a drunk.”

“But alcoholism is so much worse than smoking” you may be thinking. And I might be inclined to agree with you. But is the ethanol addict any more to blame for their problem than the nicotine addict? That will likely be the topic of another post.

So although I admit that “sober” accurately describes my state of being for the last several weeks, I bristle at the contrast the word conjures up in the minds of people who know that I’m “sober”.