Alcohol and You.

Alcohol is a drug, a medicine, an antiseptic, a poison, and a solvent. It is flammable, boils at 172.4 degrees (F), and dissolves in fat and water. It's a huge part of our culture: the alcohol industry spends over $5 billion on advertising and promotion every year!

 

Is alcohol good or bad for you? 

It is true that there are known health benefits of consuming small or moderate quantities, but if you already have had problems then think about the likelihood of developing a heavy drinking habit. Heavy drinking is always unhealthy! Alcohol damages all of your organs. It is the third leading cause of preventable deaths in the US, is a factor in over a third of traffic deaths and half of boating deaths and drownings.

 

Do you have a problem?

You've probably already experienced some negative effects of alcohol, directly or indirectly.

Here are some questions you can ask yourself:

*                  How often do you drink alcohol? 

*                  How much alcohol do you drink when you are drinking?

*                  Are you sometimes unable to stop drinking once you start?

*                  Have you failed to do something that people expect of you – work, relationship, friends, family – because you were drinking?

*                  Have you had times that you couldn't remember what you did the night before after you'd been drinking?

*                  Has your drinking ever harmed you or someone else?

*                  Has anyone mentioned that they are concerned about your drinking?

 

If your honest answers to any of these questions worry you, it's time to think about changing your behavior.

 

Just the facts:

*            Beer is 4 - 6% alcohol, wine coolers are 5 - 6%, wine is 10 - 14%, fortified wines (sherry, port) are 16 - 24%, distilled spirits are 40%, and a few distilled products are up to 75% alcohol. A drink contains 100 - 150 calories, so heavy drinking can replace a lot of your daily food intake, leading to poor nutrition, or add to weight problems.

*            It takes about 1 drink per 40 lbs. of body weight per hour to make your blood alcohol 0.08%, which is legally drunk in California. This is based on a standard drink of 1 beer, 4 - 5 oz. of wine, or 1.25 - 1.5 oz. of hard liquor (heavy drinkers typically increase the content of "1 drink" of hard liquor by 50 - 100%). You can get just as drunk on beer, wine, or spirits.

*            It is easier to ingest alcohol if it is sweetened (the alcohol industry knows this, marketing wine coolers and similar flavored stuff to young people).

*            It gets into your bloodstream faster on an empty stomach or if the beverage is carbonated, and more slowly if you eat dairy products or fatty foods beforehand. That doesn't reduce the alcohol in the bloodstream, it just slows down how fast it gets there.

*            Men have more of an enzyme that breaks down alcohol before it gets to the stomach, so it is true that women are somewhat more affected by alcohol than men of equal weight.

*            Your body metabolizes about 1 drink per hour, no matter how big you are. Once the alcohol is in you there is nothing you can do to get it out of your body faster. Caffeine may wake you up, but you're still drunk.

 

How much alcohol harms you?

First of all, the presence of ANY alcohol in your system is illegal if you are under 21. (1) And a police officer can arrest you for being legally drunk even below the legal limit if you are, in the officer's opinion, impaired.

 

At 150 lbs., if you have three drinks in two hours you may be legally drunk and would probably get a DUI.

At 100 lbs., two drinks in two hours.

At 200 lbs., four drinks in two hours.

No matter what you weigh, if you then drink one drink per hour you will stay legally drunk. People aren't very safe drivers when alcohol is leaving their bodies, even if they are 'legal', so your driving may be impaired even when your blood alcohol level is below 0.08%.

 

Drinking hard liquor is especially risky, because the amount in a 'drink' is often more than the standard measure. Adding fruit juice makes it easier to swallow and drink faster, so wine coolers, mixed drinks, and punch are especially risky.

As you drink, your ability to rationally refuse more drinks diminishes. You are less and less able to make reasonable decisions about your behavior—including drinking, drug use, sex, and whether or not you can drive safely.

 

Blood alcohol of 0.5% is usually fatal. Almost impossible to do with beer or wine, it is usually caused by rapidly drinking hard liquor. But it can be done over the course of an evening of taking shots, even alternated with 'soft' alcohol.

Half a liter of hard liquor (about 16 oz.) can kill a 100 – 125# person.  A liter can kill a 200 - 250# person. Your body has a strong tendency towards self-preservation, so you will likely vomit as you approach toxic levels of alcohol. But smoking pot reduces the 'gag' factor. That was a factor in the death of a college boy in Davis, California. He was celebrating his 21st birthday, and did "21-for-21" after smoking pot. He consumed about 3/4 liter over a few hours and died in the presence of the friends who had been encouraging his drinking. So we can guess he weighed between 150 – 200 #.

 

 Death can also be caused by choking on vomit while unconscious. If you haven't vomited while still conscious, you are likely to pass out at about 0.3% blood alcohol, and if you end up on your back your life can be in danger. Pushing someone who has passed out over onto his or her side or face can prevent choking, but be careful--if they awaken while you are doing this they may become very agitated or violent because of their drunken disorientation.

 

The long term effects of alcohol abuse are serious. It damages virtually every organ in the body, especially the liver and pancreas. It is linked to cancers, heart disease, sexual problems, and suppresses the immune system. It makes it harder to quit smoking, and people who are drunk often engage in other risky behaviors. And the average cost of a first offense DWI, including fines, fees, attorney costs, alcohol classes, increased insurance, and more, comes to thousands of dollars!

 

Ok, that's enough of the scary stuff.

 

Further Reading:

 

Here is a link that lists some of the many negative consequences of heavy drinking: http://www.ncadd.org/facts/problems.html

 

Here's a complete tutorial about the chemistry of alcohol: http://www.chemcases.com/alcohol/alc-01.htm

 

Here's an online test you can take to assess your problem: http://drinkerscheckup.com/

 

More information about drunk driving costs: http://www.maddorangecounty.org/cost.htm

 

Here is a chart and some information about drinking and driving: http://www.california-drunkdriving.org/levels/

Note that you can get a DUI for blood-alcohol levels below 0.08% if your driving is impaired in the opinion of the officer.

 

Here is an online blood alcohol calculator: http://www.intox.com/wheel/drinkwheel.asp

 

Here's an article about the college student in Davis who died of alcohol poisoning after a "21 for 21":

http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2000/04/05/MN28956.DTL

 

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Why do some people develop an alcohol habit?

A child whose parents are heavy drinkers OR who have always been abstinent is much more likely to drink heavily than one whose parents drink moderately. A boy whose father and grandfather drink heavily is many, many times more likely to drink heavily--one statistic I have seen is 900 times more likely than other boys.

 

Whether this is due to genes or environment--or both--is a subject of debate. We do tend to model our behavior on what we've seen growing up. If there's an 'alcohol culture' in your family, you may find it harder to change your lifestyle than if you saw a lot of moderate drinkers and well-adjusted non-drinkers when you were growing up. Planning for those family gatherings where 'everybody' is drinking is a common topic on recovery forum boards. It can be helpful to discuss these situations with others.

 

Do you have family members who are or were heavy drinkers? Does substance abuse seem to 'run in your family'? It may seem that you're hard-wired for drinking. But remember, you are not a statistic: you make choices. If you can recognize the consequences of developing an alcohol habit, focus on the benefits of not drinking, and practice for situations where you are likely to be offered alcohol or drugs, those choices are easier.

 

 We tend to go from using to abusing alcohol along a pattern:

*            experimentation;

*            social use;

*            habituation (regular, usually daily, drinking);

*            chronic drinking.

 

But this is not an inevitable progression!  

Of special concern to teenagers and young adults is 'binge drinking', which is episodic heavy drinking, usually with intervals of abstinence (and remorse!). It is common among college students, most of whom just grow out of it. But it can be the start of habituation and chronic drinking.

 

Many people who are habituated to alcohol seem to function fine in their daily lives, including people you love and respect. But when alcohol becomes an important part of your daily life, or you have intentionally gotten drunk more than once, it's time to take an honest look at your habit.

 

What is happening in the body and brain when we develop an alcohol habit?

The 'benefits' of drinking are euphoria, a feeling of well-being, and – for many of us – a temporary ability to forget about things that cause us to be emotionally upset.

We may gradually start to ignore or deny the negative consequences: hangovers, loss of memory or blackouts, fights, self-harming behavior. 

Meanwhile, "neuroadaptation" is occurring where the brain tries to compensate for the damage to normal functions that the alcohol causes as it disrupts our neurotransmitters. With repeated use, it is harder for the brain to get back to normal and we go through withdrawal when we quit. In fact, getting drunk, being drunk, or being hungover begins to feel like "normal."

 

Are you an alcoholic?  Is alcoholism a disease?

Defining chronic alcohol use as a disease was a major step forward in public acceptance of new treatment methods. Previously alcohol abuse was viewed in moral terms, with heavy class overtones in how it was dealt with. Lower class drunks were thrown in jail; upper class people had "a drinking problem." The rise of modern medicine, and the young field of psychology, changed the focus to the medical consequences of heavy use. Understanding the brain chemistry of substance abuse is still an emerging and very interesting area of science.

 

But there is no broadly accepted definition of the term "alcoholism,"  so it can be a problem trying to define if you are one. To most people it means chronic drinking, binge drinking, or any use of alcohol that has significant social, personal, or health consequences. The label is not important. It's your behavior that matters.

 

What is "denial"?

Denial is when you understate your problem, or overstate your progress towards change. Denial is not the same as "ambivalence," which is simply a mix of feelings about whether change is necessary. Nearly everyone who decides to quit drinking or using drugs is ambivalent about it, because the drugs provided some benefits. Recognizing the harm they are doing may take some help from others, since we are pretty good at rationalizing our behavior. But it's normal to be ambivalent. Just don't let your mixed feelings paralyze you and keep you from making healthy choices!

 

Should you quit drinking completely?

One of the first things you're going to decide is about continuing to drink 'moderately' or at all.

Most people who have been heavy drinkers have a pretty loose definition of that term. Moderate drinkers don't drink every day and don't drink to get drunk. Moderate drinkers don't feel that alcohol is a necessary part of events or activities. They don't obsess about it, plan in detail to have it around, or miss it intensely if it's absent.

 

Some useful guidelines: a moderate female drinker drinks an average of one drink daily; a moderate male drinker drinks two. They might not drink every day. A heavy drinker drinks more than that, and usually drinks daily.

 

It's difficult to drink moderately after we've drunk heavily. Our brains and bodies get accustomed to heavier doses. If we've been drinking heavily for a long time, it's really easy to slip back into a pattern of daily heavy drinking if we drink at all. One drink just reminds us of what we liked about it, and we end up wanting more.

 

So you'll probably find that abstinence is actually an easier commitment to make than moderation. It's much easier to say, "I don't drink" than to say "I only drink this much." What decision will you make? What is in your best long term interest? Our choices about drinking and drug use often involve choosing our long term interests over short term gratification.

 

Further Reading:

Alcohol and your brain: http://www.utexas.edu/research/asrec/drugs_m.html is just one web site with information on drugs and neurotransmitters.

 

What is "moderate drinking?" Moderation Management, a self-control group, defines moderate use as follows: "For women: Do not drink more than 3 drinks on any day, and no more than 9 drinks per week. For men: Do not drink more than 4 drinks on any day, and no more than 14 drinks per week." http://www.moderation.org/otherlim.shtml

Many, perhaps most, people who have a drinking problem find it very difficult to drink moderately. We tend to re-define "moderate" as "less than we drank last time."

 

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What do I do about my problem?

You can consider a recovery group.

 If you are drinking daily, or get drunk intentionally every so often, or if drinking is interfering with your life in any way, you may decide that you have a problem with alcohol and want to seek help. All of the alcohol recovery groups believe that you should abstain from drinking, but they take different approaches to how and why you should do so.

 

The disease concept of alcohol use was combined with a strongly spiritual approach to treatment in Alcoholics Anonymous.

AA is the oldest, largest and best-known recovery organization, and despite the spiritual/religious basis it is heavily used in our legal system (this is periodically challenged as a violation of church and state). A DUI is likely to result in a sentence that includes mandatory AA meetings, and people aren't likely to challenge that when jail time is the alternative.

 

AA is the original and best-known "12 Step" program. Interestingly, the disease concept was not an original part of AA, mentioned only in passing in the 'Big Book' that is their basic text. It is a program of rigorous spiritual change, and AA members usually define alcoholism as a 'spiritual disease'. Much of the quasi-medical disease stuff has been added on by modern recovery programs, which involve intervention, rehab, lots of meetings. This is often reinforced by repetition of the dire consequences of continuing to drink or do drugs. Hazelden is one of the older 12 Step programs of this sort.

 

12 Step principles are that alcohol abuse is a disease that is invariably fatal, that abstinence is the only cure, that you admit that you are powerless over alcohol, you call upon a higher power for help in achieving abstinence, and that you regularly attend meetings to get the support you need. One big advantage: AA meetings are available just about everywhere.

 

Newer recovery organizations reject the disease concept of alcohol use.

In the 1970's, the limitations of 12 Step programs were becoming apparent to many people. Although there have always been women in AA, as a group it was heavily male—particularly the founders and the early members. In 1976 Women for Sobriety was formed to provide a different approach which focuses more on self-affirmation and emotional development.

There are two secular (nonreligious) groups based on cognitive behavioral science. Rational Recovery uses a technique where you learn to argue with your own 'addictive voice' and persuade yourself not to drink. SMART Recovery uses techniques where you learn better ways of coping with upsetting emotions, and learn to dispute your thinking patterns that lead to drinking. SMART, in particular, uses principles from Cognitive Behavioral Therapy (CBT) and Rational Emotional Behavioral Therapy (REBT).

 

Both of these groups use a more scientific approach than AA. They work by helping you choose not to use drugs by identifying the reasons and avoiding the triggers to drinking/using. A big difference is that you--not a higher power, not a group--are responsible for your own recovery. Both programs have online information, and SMART Recovery has an extensive schedule of online meetings.

 

Many people like the group meetings and peer support that AA provides, but don't like the religious aspects. In spite of what AA members may say, it comes across as a religious group: many meetings open and close with Christian prayers, and there are lots of references to god. So two groups were formed primarily to have secular (non-religious) meetings: SOS and LifeRing.

 

Which programs work?

Information on the effectiveness of the different groups is hard to come by. Any recovery group can be effective for people who have acknowledged that they have a problem, are motivated to quit, and can accept the basic principles of the organization. Anyone can benefit from the support provided by other members of a group.

 

You can try quitting on your own.

It is an interesting fact that the majority of people who quit abusing alcohol do so on their own, perhaps demonstrating that it really is a matter of personal motivation and choice. They may seek support from family and friends, but don't join any particular organization--they decide to quit and "simply" stop drinking. George W. Bush is a good example: he says that he drank too much wine one night, as he had at times in the past, and that Laura Bush "gently" encouraged him to quit--so one day he did.

 

People who belong to recovery groups will often find it hard to believe that people can quit without a specific support group. They don't believe they can quit on their own, and may not believe anybody can. The fact is, we vary in where we find the power for change. Some people like groups, others value their individualism. There's a simple quiz you can take to determine where your 'locus of control' is—that is, whether you are more likely to find the power for change from within (internal locus) or from another source such as god, church, a group, etc. (external locus). Here is one link to the quiz:

http://www.psych.uncc.edu/pagoolka/LocusofControl-intro.html

 

It is not better or worse to have an external or internal locus! It just might be a good predictor of how likely you are to find peer support or an organized group's recovery structure useful.

 

Your choices and your future.

 

The habits you take on in your late teen years become deeply engrained by the time you are in your 20's. Seeking a high can become an end in itself, and can crowd out other activities and interests.

Do you know people like that? Friends who are choosing to use drugs and alcohol regularly, and who may also be making poor life decisions -- about relationships, who they hang out with, about their futures?

 

You can still like those people and care about them, but you probably can't help them change the directions they are taking. You can certainly be there with facts and support if they talk about it.

 

But it may be necessary to avoid drinking/drugging friends when you quit, at least for a while, and they may not like that. It's hard to stop being a drinker or stoner when you're surrounded by that mentality. Successful sobriety involves making some lifestyle changes, and changing who you hang out with may be one of those changes.

 

Planning for those situations – what you're going to say and do – is really crucial. Peer pressure is real and difficult to deal with. So think about doing what actors do: they have scripts and they memorize their lines. Know what you're going to say when someone urges you do drink or do drugs. It's amazing how often people get stoned or drunk 'without meaning to' because they weren't ready for the situation.

How you're going to spend your time is really important. Drinking and getting stoned are pretty passive activities, and we tend to have a lot of nervous energy when we quit. Fill your time. Identify the times you used to use, and make plans for what you're going to be doing.

 

If you choose to use alcohol or drugs again, it isn't a moral failing or the start of a progressive disease. It's just an unhealthy choice. Is there someone who you trust that you can talk to about why you made that choice? It might be useful to talk about what beliefs and emotions your decision was based on, and how you plan to deal with it next time. Peer support can be incredibly useful, and that support is available online. A habit can be hard to break, but it can be done. Your past does not have to predict your future.

 

Think back a year or two. Where were you emotionally? What can you do now to be more content and happier a month, six months, a year from now? Are there people in your life who you think are models for comfortable, well-adjusted behavior? What do they do that you can apply to your own life?

 

Let's say you've quit drinking and using drugs.  It was uncomfortable at first, but not intolerable.  Now think ahead a year or more. If sometime in the future you are plagued by doubt, depression, or anxiety, and things seem hopeless, you can look back on this time in your life when you pulled yourself up, took care of yourself, and developed confidence, poise, and peace of mind. There may even be others you can help.  It really is easier to deal with life with a clear mind. I'm not saying sobriety will make you happy. It'll just make it easier to make and achieve your goals. 

 

Further reading:

 

About recovery groups:

Alcoholics Anonymous: AA says that their organization welcomes atheists and agnostics. Decide for yourself! Read the 12 steps of AA here: http://www.recovery.org/aa/misc/12steps.html

 

 Rational Recovery: "RR was founded in 1986 by Jack and Lois Trimpey in response to the lack of choice in the field of addictions. At the time, there was no choice other than the 12-step, spiritual healing program of Alcoholics Anonymous. Lack of choice in recovery styles is still a serious national problem, but RR has become well-known as a viable and widely available alternative to addiction." http://www.rational.org/

 

SMART Recovery: teaches self-reliance rather than reliance on a higher power. Views addiction as a complex maladaptive behavior rather than as a disease. Encourages you to recover and move on with your life. Does not use the labels "alcoholic" or "addict." Does not have a "sponsor". Holds meetings which are discussions rather than a series of monologues. Evolves as scientific knowledge evolves.  http://www.smartrecovery.org/

 

 The importance of your language:  http://www.skysite.org/primer/exchange.html gives examples of absolute words and their alternatives.

 

Links for more information about various recovery groups:

 

The groups:

*                  SMART Recovery                               http://www.smartrecovery.org

*                  LifeRing Secular Recovery             http://www.unhooked.com

*                  SOS - Secular Organisations for Sobriety        http://www.secularsobriety.org

*                  Women for Sobriety                         http://womenforsobriety.org/

*                  Rational Recovery                               http://www.rational.org

 

 

Information and analysis about addiction treatment, social policy, and harm reduction:              http://www.peele.net/

 

Some variations on 12 Step programs:

Agnostics AA:                                      http://agnosticaa.org/

Pagan approach to 12 steps:           http://members.aol.com/JehanaS/recovery.html

Christian recovery sites:

http://www.celebraterecovery.com/message.asp

Alcoholics Victorious: http://www.alcoholicsvictorious.org/12-steps.html

Interpretation of the 12 Steps from a Jewish perspective:

http://www.a-1associates.com/AA/jacs_journal_2.htm

Buddhist version of the 12 steps: http://www.geocities.com/b12steps/index.html