Sunday, August 16, 2009


Non alcoholics literally never think they have a problem with alcohol. They don't have to control their alcohol or drug use because it's never out of control. Certainly no one is concerned about their drinking or drugging. That's what the first two questions of the CAGE screening test refer to. If a person is concerned about their drinking or others suggest they cut down, 8 out of 10 of these people will definitely have a problem with alcohol.
The World Health Organization recommended a year of abstinence if there was a problem. Further, if a person couldn't go a year abstinent then they definitely had a problem with alcohol and abstinence was the best recommendation.
Alcoholics Anonymous recommends Abstinence for life. Narcotics Anonymous and Cocaine Anonymous and Marijuania Anonymous all make the same recommendation.
There is this idea of "Controlled drinking" and it's most commonly the first step to finding the motivation to quit drinking completely. Most alcoholics have in some way tried to control their drinking by limitting the number of drinks or switching from spirits to beer or some such thing. This may slow down the roller coaster but it rarely works and never really stops an alcoholic from drinking in excess. Eventually the alcoholic will return to abusive drinking. But as one AA said, you don't have to ride the garbage truck all the way to the dump, you can get off anywhere along the route.
It's the first drink or drug that sets one up physically and mentally to have the craving for more drinks even if it's not that first drink that one time. But in contrast to what the alcoholic thinks it's the first drink not that last that does the damage.
More than 70% of people after 3 years of abstinence if they try to return to controlled drinking will return to alcoholic and abusive drinking. At 5 year of abstinence 50% appear to be able to return to controlled drinking without returning to abusive drinking for a matter of a year or more. The other 50% however return to abusive drinking but it's rare that they with thier experience of abstinence return to their previous level of drinking. Vaillant's and other's research showed that after 5 years of abstinence it was more likely that a person never identified as having an alcohol problem would have serious social problems secondary to alcohol use than that person who had been abstinent. There are further studies that show that at 7 years of abstinence if individuals return to controlled drinking only 30% will go on to abuse alcohol. This suggest that abstinence itself is a healing process. However 15 year follow up studies show that those who remain abstinent are healthier and more successful than those who return to controlled drinking. Not only that but they may indeed surpass the projected trajectory of success in work, relationships, and well being of their original cohort. Abstinence appears not only to be curative but also to induce superior functioning. AA members with more than 5 years of abstinence and membership were shown early to be twice as successful across the board as their original cohort.
Abstinence works. It's the gold standard. The whole recovery movement with it's various alternatives is riding on the coat tails of the successful abstinent pioneers of AA. Indeed it's the AA members with continued sobriety whose lives are the model of recovery that have caused society to give alcoholics and addicts the second and sometimes more chances. The millions of recovered members of AA have shown by their example that the disease of alcoholism and addiction is treatable. Once considered a fatal illness without any hope of treatment millions of members in AA and other 12 step abstinent recovery programs have proven that this is not the case. The original Big Book of AA was called a Way Out and it certainly is that for those people who can be honest with themselves, admit their problem and follow the 'simple' program of Alcoholics Anonymous. Abstinence works. "Controlled drinking" is usually a 'glum affair' in marked contrast to the 'happy, joyous and free' experience of abstinence that is so much a part of the fellowship of AA.

1 comment:

bobbi said...