Reprehensible alcoholic criminal type person

Recently I listened the Playing God episode of the Radiolab podcast. It is a fascinating exploration into the ethics of choosing who gets to live and who gets to die in extreme circumstances. The core of the story is about the events surrounding Hurricane Katrina inside of Memorial Hospital. I encourage you to listen to the whole podcast. It is quite good.

One aspect of the story is that some researchers put these thorny ethical questions to regular people in a town hall meeting. For example, if there were a flu epidemic, and ventilators were required to save people, but there aren’t enough ventilators to cover all the sick, how do you decide who gets a ventilator? Should it be based on years of life remaining? Or likelihood of survial? Or just lottery/luck?

Starting at around 39:35, a participant describes the dilemma:

You’re gonna have like a young pastor. And you might have a reprehensible alcoholic criminal type person, and he might have more years to live. Well  the years of the pastor are gonna be more beneficial to society than the years that this criminal reprehensible alcoholic bad person.

She equates criminal, reprehensible and alcoholic not once, but twice. In her mind, the three go hand in hand.

Don’t get me wrong. I’m not surprised that some people do this. I’m not shocked that some random person in the USofA would think of alcoholic and reprehensible in the same breath. I’m not really annoyed that this person thinks alcoholic is an enhancement to reprehensible criminal to help make her point.

What gets me most is that Radiolab producers let her comments make the final cut. Just imagine if she had said “reprehensible negro criminal type person”, or “reprehensible retarded criminal type person”, or “reprehensible Islamic criminal type person”. I imagine pretty much any other slur would have made her comments unsuitable for inclusion. Remember, this was not a documentary on how people feel about alcoholism, so although her comments helped to illustrate a point, they were also incredibly nasty.

Some may object to my point by insisting that alcoholism is a behavior, but race and mental illness are not. The problem is that it is so much more complicated than that. To start with, alcohol addiction has been seen in pretty much any mammal that has ever ingested the stuff. As a race, those who consume it are almost universally addicted to it. And to think it is a “personal choice” completely ignores all the societal factors that contribute to its consumption.

So the point to this post is two-fold. A) some people equate ‘alcoholic’ with ‘evil person’. B) it is so socially acceptable to people to perform this equivalence, that people hardly notice.

 

Managing addiction

It has been a long time since I’ve written about alcohol, and my struggles with it. For some reason, I don’t like to write about it when I’m “off the wagon”. For several months this year I vacillated between drinking and not with a number of personal reasons for each swing of the sobriety pendulum.

The most difficult part about this past several months has been that I didn’t really want to quit. I knew I was in a “bad place” but I didn’t feel motivated to fully remove my self from the addiction and the temptation. After one night of drinking more than I should have, and half-heartedly hiding it from my wife, I apologized to her in the morning (for what, exactly, I’ll explain below). Her response wasn’t what I was expecting: she pointed out that I had apologized before, but it was starting to ring hollow because I wasn’t actually doing anything with that apology.

I’ve now turned over a new leaf, started a new chapter, or whatever metaphor you like, in how I’m managing my relationship with alcohol. Before I tell you what I’ve done, I feel compelled to convince you (and myself) that I’m not a reprehensible alcoholic.

  • I’ve never been fired (for any reason)
  • I’ve never been arrested
  • I’ve never defaulted on a loan
  • I have $0 in credit card debt, and only 11 years left on my home loan
  • It has been over 20 years since I’ve had a car accident, and that wasn’t alcohol related
  • My personal income places us firmly in the upper-middle class
  • I’m on track to have a comfortable retirement
  • I’ve never had a drink before or during work
  • I’ve never struck, threatened or verbally abused my wife
  • I’ve taught Sunday School
  • I was a Cubmaster and Den leader when my son was in scouts

OK, maybe that crap doesn’t convince you. Perhaps you know that people can have addictions and still be highly functional. Yup, that was me. Highly functional. But then why did I feel the need to quit?

  • I wasn’t fully in control–one drink easily became six
  • I was hiding my consumption from those who loved me the most
  • I wasn’t working at my peak potential
  • I wasn’t parenting at my peak potential
  • I wasn’t husbanding at my peak potential

I had allowed alcohol to take me from being a B+ human down to a B- or C+ human. Still above average. Still not reprehensible. But definitely not the best me I could be. This is what I apologized to my wife for. I knew I wasn’t what I could be, and I was letting alcohol degrade my life.

So, what have I done? I asked my family doc for a prescription and am now taking Disulfiram. This drug will essentially make it so that my body cannot digest ethanol and will therefore reject it violently. If I drink, even small amounts, while Disulfiram is in my body, I’ll vomit and feel like hell for a couple of hours.

“Sweet jesus,” you may exclaim, “you have to take a drug for ‘chronic alcoholism’ to not drink? What kind of reprehensible alcoholic are you?”

I view it as a tool to strongly influence my future behavior. I choose to take the drug when I’m feeling strong in my sobriety. The fact that I’ve taken it then causes a later version of me (still me, but perhaps 12 hours older) to avoid using alcohol to solve whatever problems I thought it might solve. In essence I now see alcohol as off-limits to me. Thanks to me.

You probably have used tools to influence your own future behavior as well. For example, retirement savings accounts are great instruments for making it hard to spend your savings before you reach a certain age. When you are feeling strong in your savings goals, you plop some money in a 401k. The fact that it is financially hard to get that money back makes an older you think of that money as off limits. You could put that money in some other financial instrument (possibly with better returns) but the 401k is a great tool for making sure you don’t spend it too soon.

I’ve now been taking Disulifram for two weeks, and I haven’t felt tempted to drink once. In previous pendulum swings to sobriety, I’ve felt like I’m “white knuckling” it a bit–holding on to try to make sure I don’t screw up. Constantly convincing myself that I need to change and this is how its done. In many ways taking Disulifram has been a relief. My sober me has eliminated the option of drinking for future me, and I’m happy about it.

Before I complete this post, please also know that Disulifram is not my only support. Or, at least I don’t intended for it to be. I’m going to be re-engaging with a couple of support groups, as well as seeking other assistance. And if you’ve read this far into my post, you can be part of that assistance as well. Nothing is required of you at this time, but I may need you to not think of me as reprehensible. I may need you to listen as I struggle with my personal identity in contrast to how our culture blames the consumer of alcohol for the chemical affects of alcohol. I may need you to ask “How are you doing?” when you really want an answer.

Right now, my answer is “Really well!”

 

Dependence

Dependence. We all know what it feels like. There are many things in our lives upon which we are dependent: food, water, air. While those are the obvious ones, we’re also dependent on human connection, sleep, salt,  vitamin D, clothing (in most climates), eye glasses, and many more. I’m not even including the “things we cannot do without” like Instagram, photoboming, Bejeweled, or coffee. Well, wait, coffee just might be on the list.

You know you’re dependent on these things, and you go through withdrawal symptoms when they get low. Hunger is the obvious withdrawal symptom for lack of food, but it frequently can hit us even if we don’t feel physical hunger pangs–we’ll get cranky, tired, irritable–all the things that the Snickers commercials poke fun at. We enjoy those commercials because they point out something obvious–someone in food withdrawal doesn’t always recognize they’re in withdrawal.

And that’s true of many of our dependencies: the withdrawal symptoms aren’t always obvious, even to those of us who are familiar with them.

Caffeine, nicotine, and ethanol are three substances that our bodies don’t actually need, but we readily consume them, and frequently form dependencies on them. And humans aren’t alone in this regard.  I currently have dependence on caffeine, have never experienced nicotine dependence, and have experienced ethanol dependence not too long ago.

Ethanol dependence might be referred to as alcoholism by some people. So if I had alcoholism, you might call me an alcoholic. Or a recovering alcoholic. Or a former alcoholic.

I still internally bristle at the label of alcoholic, and I think that comes from my difficulties with Alcoholics Anonymous. I may write more about AA in the future, but one of the things I dislike about the AA program–not the people in the program–is the “once an alcoholic, always an alcoholic” idea. Another is that the program teaches that alcoholics are fundamentally different from other people. Since alcohol dependence can be induced in non-human animals (this review of methods for accomplishing dependence was written in 1973, so this idea isn’t new) it seems incredibly ignorant and myopic to consider alcohol dependence in humans as something to which only some people are susceptible.

So what is ethanol dependence like? It’s nothing like what you’ve seen in movies or TV shows. The alcoholic caricature is pervasive and wrong. For me, dependence meant that 12-16 hours after my blood stream was free of alcohol, I would start to feel uneasy and a little bit irritable. That’s it. Doesn’t really make for compelling TV does it? To relieve that uneasy irritability, I would have a drink. That drink would taste good and make me feel good, and that uneasy irritability would start to fade. I didn’t want that feeling to return, so I would consume a semi-steady flow until bed time. The hazard, of course, with alcohol is that as more gets into ones blood stream, the harder it is to self-regulate the flow. So sometimes I would have more than I intended–more than was necessary to relieve the uneasy irritability. I never got into trouble as a result of the difficulty in self-regulating, but I can easily see how someone might.

Now you might be wondering, Ah, but how did it start? Isn’t that where the real problem is? Didn’t some defect of character lead you down that road? I would agree with you if alcohol were difficult to obtain. I would agree if I had to harm other people in my quest for alcohol. But if you think I’m deficient of character, then you’ve got to include nearly every other alcohol consuming adult (and that’s a lot of people). It pervades our culture. It’s advertised nearly everywhere, and sold in places that just make no sense: nearly 2% of adults report that in the last 30 days they’ve driven after drinking too much AND we sell the stuff in gas stations and drive throughs! Its everywhere, and one drink does not an alcoholic make.

I’m currently ethanol independent. My body is free of the dependence that I’ve felt several times previous, and I see three possible courses in my future:

  1. Drink when I want, and ride the roller-coaster of dependence up and down, hoping that since I’ve never gotten in trouble before that I won’t in the future.
  2. Drink only in small amounts so as to reduce the risk of dependence.
  3. Abstain from consuming alcohol entirely, completely eliminating the risk of dependence.

In the last five years, I’ve done all three. Only one of these options is safe. Number 1 is risky, and increases the likelihood of ethanol impacting me and everyone in my life. Number 2 can work for short periods, but still has a significant risk that small amounts won’t stay small. Number 3 has as its only downside that I choose not to drink beverages containing ethanol.

So I’m abstaining again, but this time I’m admitting I need help in maintaining my abstinence. AA may play a role, despite my reservations. I’m also looking at LifeRing Secular Recovery and SMART Recovery. If you’d like to join me in ethanol independence, let me know.

Still nothing

A couple of months ago, while shooting the reception of a wedding, I was getting a bit tired and thirsty. I was tired in the ‘my blood sugar is getting low’ kind of tired, so I figured I would get some juice or some pop from the bar. When I walked up to the bar, it was totally vacant–no guests, no barkeep. No worries, sez me to me self, I’ll just help myself. There was a pitcher of what looked like apple cider, so I poured myself a cup, and took a swig.

There was a funny taste to the cider, kinda like the perfume of an old friend, kinda like the the warmth of a departed and much loved pet. It was a taste I should have recognized immediately, but I didn’t. It was there, just on the tip of my tongue, waiting for the right synapses to fire in precisely the right order.

Just as these sensations were registering, the barkeep came from the kitchen and asked if she could help me. “What’s in this?” I asked, pointing to the pitcher that I had used to fill my cup. “Apple cider and rum” she said while holding up the bottle of rum.

Well shit. I don’t drink. I contemplated what I should do next. My face probably turned gray, and the barkeep asked if I wanted just plain apple cider. Yup, and I dumped the cup in the trash. I took the plain cider from her and took a few steps from the bar, and quenched my thirst.

I stood there for a long moment, and wondered how I should react. It was one of those moments where the way forward is actually pretty unclear. How I chose to react was completely within my control. Should I freak out about the 0.1 ounce of rum that had crossed my lips, and sit in the corner with my knees pulled up to my chest? Should I just say “fuck it” and get drunk, because clearly that must have been what I’d wanted by making such an obvious mistake? Or should I just take a deep breath, finish my rum-free cider, and go about doing my job? It really was an interesting few seconds as I contemplated my reaction.

Think about that for a moment–how often do you get to so clearly choose your own reactions?

OK, enough meta-gazing. I chose the last option. I took a deep breath, said nothing to anyone at the wedding, finished shooting the reception, and went home. The next day, I wondered if I would then have to reset some personal timer back to zero. If someone were to ask when was the last time I’d had a drink, would I report the last time I had chosen to have a drink, or would I report this mere technicality? I figured I would go with the former, because what’s important is my choice, not an honest mistake of no significance that was quickly remedied.

So that, my friends, is pretty much the only drama I’ve had with alcohol since I quit around 9 months ago. It continues to be pretty easy for me to not drink, though I do still think about it periodically. This time around, I’m actually expressing those thoughts to my wife. On those occasions where I miss having a few drinks, or if I’m in a situation where I’m hyper-aware of others’ drinking, I’ll confide in her. And that helps. In my ‘one-year-to-prove-to-the-world-I’m-ok’, I didn’t confide in her because I was worried that she would recognize that I wasn’t really going to be OK with starting again after a year. And I wanted to start again, after I proved my point.

I’ve also become worried for my friends who consistently post pictures of what they’re drinking on Facebook. I don’t want to get too analytical about it, but perhaps you’ve heard the phrase (or one similar) “Action expresses priorities.” (Attributed to Mahatma Gandhi) In essence, what you do is more important that what you say. What you do demonstrates more clearly your priorities than any ordered list you scribble down. I think that in the Facebook era you might translate that to “Posts express priorities”. What you post says a lot about you. And yes, I know our culture worships alcohol, but I worry about people who worship it fervently.

Unfortunately, I don’t know how to tell people that I’m worried about their alcohol identity without sounding condescending, or evangelizing. “Honey, you really should stop drinking. I did, and LOOK HOW GREAT I AM”. Yeah, no.

And maybe those folks can handle it in a way that I couldn’t. Sure, that’s a possibility (no sarcasm intended). It’s the outward projection of “look what I’m drinkin 2nite!” that worries me. So anyway, if that’s you and you wanna talk, let me know.

So that’s me. Still dry. Still sober. Still on the bandwagon. Even if I do occasionally miss the perfume of my old mistress.