Alcohol

Jimmy quit drinking back in 1999.  He had been a heavy drinker since late adolescence—before he married his high school sweetheart.  Rita had fallen in love with his happy-drunk cheerfulness. He liked beer; she liked Chardonnay. After five years of marriage, however, Rita decided she “wanted to be a grown-up.”  She quit, but Jimmy kept it up. Her perspective about Jimmy’s drunken cheerfulness changed as well—she now saw it as immature and irresponsible.

“How can he keep spending so much money on beer, when he has two children and a mortgage?” she would ask herself. The resentment inside grew a little stronger every day.  Over the next fifteen years of marriage, Rita threatened to leave many times.  She stayed in the marriage however, hoping that he would see how unhappy she was and change.  The arguments would start every night when he pulled his first beer out of the fridge. Her agenda was always, “stop drinking!” His agenda was, “You can’t make me.”  Two days before their twentieth anniversary, Jimmy came home from work to find that Rita, the kids, their clothing, the furniture were gone. The only thing left in the house was the refrigerator and the twelve-pack inside.

Jimmy drank the twelve-pack and then checked himself into Detox.  He was in Detox five days, where he was introduced to Alcoholics Anonymous.  After Detox, he went to Rehab at a Partial Hospitalization Program (PHP) The PHP met six days a week, 8 hours a day for a month.  Family sessions were a part of the rehab, and by the end of the month, Rita and the children were back in the house.  Jimmy attended AA every evening for 90 days and had a sponsor.  He attended at least twice weekly for two years, at which time he thought he had too much to do to go to meetings.

Jimmy was able to stay sober for the next year—except for a couple of times, when he had a few beers over the weekend.  But the third time he relapsed, he went on a binge. He drank until he got drunk. He hid the beer cans in his garbage can at work. He could not, however, hide that he was drunk—not from Rita, and not from the cop who pulled him over as he drove down the interstate.

His first DUI, in 2002, cost him Ten Grand, by the time he paid his ticket, legal fees, and increased insurance rates.  He went back into Detox for two days, back to rehab at the Partial Hospitalization Program, and back to AA.  Rita was so angry that she refused to go to the family meetings this time.  Jimmy could tell she was angry and that made him mad. Three months later, Jimmy relapsed again.  He told everyone it was Rita’s fault that he relapsed because she didn’t trust him.

The struggle to recovery from Alcohol or Other Drug Dependency (AOD) frequently involves years of sobriety with intermittent relapse and need to start over in treatment. Relapse brings feelings of shame to the person who relapses and frustration and anger to their family. The Alcohol or Drug Dependent person or his or her family often feels like giving up—and many do.

Treatment for Alcohol and Other Drug Dependency is effective—in spite of the possibility of it requiring several starts.  People who recover often have family, friends, and sober support groups who are willing to make an extensive investment in the recovering person.  Very few people are able to recovery on their own, without strong support.

The first step in recovery is identifying if you or someone you love is dependent on alcohol or other drugs.  The medical definition of “dependency” or “addiction”, according to the American Psychiatric Association (DSM-IV) and the World Health Organization (ICD-10), include meeting any three of the following criteria:

Tolerance. Has your use of drugs or alcohol increased over time?

Withdrawal. When you stop using, have you ever experienced physical or emotional withdrawal? Have you had any of the following symptoms: irritability, anxiety, shakes, sweats, nausea, or vomiting?

Difficulty controlling your use. Do you sometimes use more or for a longer time than you would like? Do you sometimes drink to get drunk? Do you stop after a few drink usually, or does one drink lead to more drinks?

Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?

Neglecting or postponing activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?

Spending significant time or emotional energy. Do you spend a significant amount of time thinking about using or how to not get caught?

Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever tried to quit or cut down on your own, but couldn’t?

Jimmy demonstrated all seven criteria of dependency. He required four episodes of treatment before he was able to enjoy five years of sobriety. He lost two jobs, had three DUIs  (one of which involved some jail time); and was separated from Rita for over two years before he finally was able to consolidate his recovery skills into maintaining a five-year sobriety.

What did Rita do when Jimmy tried to blame her for his problem drinking?  How do moxie spouses and family members react when their loved with Alcohol or Other Drug (AOD) Dependency—or any other mental illness—try to guilt them into allowing the problem behaviors to take them or the family as emotional or financial hostages?