Alcohol Abuse

Are there effective online AA groups and sponsors?

Q. Are there effective online AA groups and sponsors?

[The person asking the question is a public figure, concerned about negative publicity and broken anonymity.]

There are good online AA groups.  Most, if not all, have provisions for connecting newcomers with online sponsors.  Any program of recovery is only as effective as the desire of the individual to work at it.  In that respect, an online program is better than no program at all, and no doubt they do the job for some recovering alcoholics and other addicts.  Consider, however, that the purpose of a program is not only to keep from drinking.  Recovery is about unlearning how to be an addict, and learning how better to function in the world outside of AA, NA or whatever program one has chosen.

During our addictions we learn a great many undesirable habits.  We all lie, to ourselves and to others.  We are all thieves.  We may not take material things, but we steal time from our employers and families.  We steal other people’s pleasure in having a clean and sober family member, friend, or business associate.  We steal the time and resources of courts, social services, hospitals, insurance companies and law enforcement — things that are desperately needed by society to accomplish other purposes.  We steal the health of others by causing them stress, causing accidents, and taking up space in doctors’ offices, emergency rooms and other health facilities.

We also develop dysfunctional ways of dealing with other people, with stress, with personal problems, even efforts to enjoy ourselves.  Those of us who continue to function effectively in society still create our own little worlds of quiet chaos — otherwise, why would we be seeking recovery?

When we first get clean, the habits of addiction are still with us.  We have to unlearn them, and learn other ways of dealing with people, the world at large — and ourselves.  In some cases, we have to relearn skills that we’ve forgotten, or get up to date in our fields of expertise.  We have to clean up the wreckage we left behind, and reestablish ourselves in our families and society.  We have a lot to accomplish.

The Twelve Steps are a template — an agenda, if you will — for getting these things done.  They work exceptionally well, at least as well as any other programs of recovery, and better than the majority.  However, they were developed on the basis of face-to-face contact.  Some “solos” have managed to stay sober by letters and (now) email, but the great majority of successful recovery comes from the meeting halls where we interact with others who can guide us.

Sure, some of that can be done online.  This very article is one of the ways that can occur.  But online does not put us in the presence of others.  Online can’t hug.  Online can’t look at our face and tell that we’re having a crappy day, despite our protestations, and call us on it.  Online can’t give us unconditional love — because we need to see that in the face of another human being.  Online can’t tell when we’re full of b.s. — nor can we tell that about the people we interact with online. Online can’t go out for coffee and a chat, or to a picnic, or just be companionable.  We can’t call online at 3:00 AM, the midnight of the soul.  Online can't phone us to find out how we're doing if it hasn't seen us in awhile.  Nor can we do those things online for others.  In short, it’s a weak substitute for f-2-f meetings.

That’s not to say online meetings can’t be helpful, but in my opinion they should not be substituted for the real thing.  Alcoholics and other addicts need contact with people.  We avoided real interaction by keeping ourselves high and detached.  Now we need to do the reverse.  There are meetings for professionals, held privately, to avoid the issues of unethical media who no longer respect our anonymity as they once did.  A call to our local Intergroup office will probably turn up at least one in our area.

“Rarely have we seen a person fail who has thoroughly followed our path.”  Sitting in front of a monitor, regardless of good intentions, is not being thorough.  This is not meant to take anything away from the good people on line, but merely to say that depending on them alone is likely to be a recipe for disaster.

Amateur Night

Sunset 2011

I was outside snapping this photo with my phone, and remembered it was New Year’s Eve, and thus the last sunset of 2011. That got me to thinking about how it would have been, “back in the day.”

I’d have been getting tuned up for the evening by now, slightly tipsy (to the extent that I wasn’t permanently tipsy, there at the end), and making jokes about “amateur night.”  That’s what we called New Year’s Eve, referring to all the drunks who couldn’t handle their liquor, and how dangerous it was to be on the road when they were rushing around looking for that last party where they could ring in the new.  That didn’t stop us from getting drunk, we just stayed home.

Drinking surrounds celebrations in our Western traditions.  I guess other traditions have their own ways of mood-altering to celebrate, and certainly we Westerners have a variety of recreational chemicals to hasten us on our way to “happiness,” but in our society alcohol is overwhelmingly the drug of choice.  We take to heart Ben Franklin’s declaration that “beer is proof that God loves us and wants us to be happy,” and on New Year’s Eve we don’t hesitate to travel other roads to happiness as well.

And you know what?  That’s OK for most of us.  The fact of the matter is that roughly 80% of folks don’t even want to get drunk when they drink.  They get the buzz, relax a little, and then just…stop drinking for the evening.  Those are the folks who walk away from a half-full glass of wine, an unfinished beer, and leave people like me a bit mystified and just the least bit annoyed.  At most any celebration that isn’t held in a bar, eighty out of a hundred of the guests will drink that way, or won’t drink at all.

The rest of us — well, we don’t fare so well.  One of the prime indications of a booze problem is getting more intoxicated than we intend to.  Another is the ability to drink “amateurs” under the table.  Both of those danger signs are well-known.  Despite that, I managed to remain happily unaware for about twenty-odd years.  But that was then.  These days I don’t worry about things like that.  I know that as long as I keep my head in the right place and do the things that have helped me stay sober over the years, I’ll be safe and happy this New Year’s Eve.

As long as I stay off the road, that is.  It’s Amateur Night, but now it’s the other pros that I worry about.

Why are the blood alcohol limits for drivers so low? I can function perfectly well after a few beers.

Q.  Why are the blood alcohol limits for drivers so low?  I can function perfectly well after a few beers.

A. Alcohol, aside from its addictive qualities, also has a psychological effect that modifies thinking and reasoning…. — The American Medical Association, in an official statement issued July 31st, 1964

We now know that having a drink of alcohol inhibits the executive functions of our brains.  The inhibiting mechanisms that control judgement, decision-making, and overall self-control are the first things affected by alcohol.  That’s why we experience that feeling of “freedom” when we’ve had that first drink: the feeling that we can relax, that we don’t have to hold the reins quite so tightly, that enables us to be a little more daring, take a few more risks, makes us more handsome, more beautiful and wittier (at least in our own mind), and that convinces us that we can drive just fine, thank you very much.

The abilities to drive skillfully, operate machinery, and carry out other dangerous activities that require judgement, decision-making and self-control are the very first things that we lose when we drink.  As you can see from the table below, other critical skills aren't far behind.  Combine that with the poor judgement that can make driving seem like a good idea, and we have a recipe for potential disaster.

Blood alcohol limits are set where they are because long experience and tens of thousands of blood tests on drivers involved in crashes and other driving escapades have shown that higher levels greatly increase the potential for trouble.  It’s that simple.  We may believe that we can drive better after a few drinks but, recall that good judgement is the first thing to go.  For a similar reason, the legal drinking age is held at 21, because younger drivers have not yet developed the judgement skills needed to drive with maximum safety, and certainly don’t need further impairment.  (The physical skills associated with driving have nothing at all to do with judgement and emotional stability.)

In the table below, “‘The second column lists behavioral areas by the first BAC at which 50% of the behavioral tests indicated impairment. That is, the point at which the majority of behavioral tests showed impairment. Note that, with the exceptions of simple reaction time and critical flicker fusion, all driving-related skills exhibited impairment by 0.070 g/dl in more than 50% of tests.” [The table was simplified for easier interpretation. The original can be found at the link shown.]



First BAC at Which 50% or More of Behavioral Tests 

Indicated Consistent Impairment

0.100 Simple Reaction Time, Critical Flicker Fusion
0.060-0.069 Cognitive Tasks, Psychomotor Skills, Choice Reaction Time
0.050-0.059 Tracking
0.040-0.049 Perception, Visual Functions
0.030-0.039 Vigilance
0.010-0.019 Drowsiness
0.001-0.009 Divided Attention

In the case of alcoholics and other addicts who use drugs that depress the central nervous system, the risks are multiplied exponentially.  We become impaired even beyond others who have had a few drinks.  The ability of most alcoholics to “maintain” and appear relatively sober to others and themselves is a specific, learned behavior that does not translate to driving and other skills.  We learn to function in spite of being impaired.

There are countries where you can be put in jail for having car keys in your pocket if you’ve been drinking.  Our more reasonable DUI laws can be clearly shown to be not only for you own good but for that of everyone on the road.

What if someone I knew in rehab relapses?

When I was in treatment, I was convinced that all of our little group of roughly 40 would grow old together in recovery.  By the end of three months I had lost track of most of them, and at least one was dead. Twenty-two years later, I know of five who I'm sure are sober, and at least one of those relapsed but made it back.

At a minimum, three-quarters of us in treatment at any given time will drink or use drugs again.  Most of us will do so in the first three months.  That doesn’t mean that rehab doesn't work, or that we won’t eventually get clean and sober, but it does mean that many from a given group won’t make it that time.  Addiction is a chronic disease, and its most obvious symptom is relapse.  However, the things we learn in rehab are not lost, and they help to build the foundation of sobriety.

There is one thing that can’t be overemphasized: no matter what Junior Therapist qualifications we think we got in rehab, we are in no way qualified to get anyone else clean! Someone a few weeks sober trying to “twelve step” a buddy is a well-intentioned trip back into insanity.  Hundreds of thousands of alcoholics and other addicts who failed to believe that fact have themselves joined their friends back “out there.”

The important questions are, first, how do I stay clean and sober, and how can I help the ones who didn’t.  We’ve covered how to stay sober in these pages more times than I care to count.  We stay sober by utilizing all the tools available to us, honestly, thoroughly and to the best of our ability.  We go to aftercare if it’s available.  We live in halfway houses if we are advised to.  We go to lots of meetings.  We get sponsors.  We do service work, hang out with sober friends, and learn to live a sober life.  Hanging out with someone who’s drinking isn’t service, it’s suicide.  (That goes for anyone who’s drinking, not just people we know from rehab.)

We can most help that buddy from rehab by telling him or her we’ll see them at a meeting.  If our sponsor is willing to go with us, we might pick them up and take them to a meeting — once.  We never go alone!  We don't loan them money, spend a lot of time on the phone with them, let them crash on our couch, or do anything else that will make it easier for them to avoid their bottom.  If they get clean again, we follow the advice of those with more sober time about hanging out.  If they don’t become abstinent, we say we’ll see them at a meeting, that we’ll be glad to support them in recovery, but that we can’t afford to hang around with people who are using.

That’s what we do when someone we meet in rehab relapses.  Remember: we have to take care of ourselves first, or we won’t be able to help anyone else when the time comes.  When we’re newcomers ourselves, it ain’t time yet.



Study stirs debate over transplants for alcoholics

CHICAGO (AP) – Some gravely ill alcoholics who need a liver transplant shouldn't have to prove they can stay sober for six months to get one, doctors say in a study that could intensify the debate over whether those who destroy their organs by drinking deserve new ones.

Excessive alcohol consumption costs U.S. nearly $2 a drink, CDC reports

Next time you buy a beer, glass of wine or cocktail, think of paying an extra two bucks for it. That’s about the cost per drink that society pays for excessive alcohol consumption, according to a new study by the Centers for Disease Control and Prevention.Researchers tallied the costs of excessive drinking in 2006 in terms of health care, work productivity and law enforcement, and they found it reached $223.5 billion – about $1.90 per drink.
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Hawaii Big Island study on fetal alcohol, drug exposure

The…group surveyed 2,300 women across the Big Island surveyed over the past three years and found that 1,158 admitted to drinking alcohol or other substance abuse while pregnant, the West Hawaii Today (( reported. There is no known safe amount of alcohol to consume while pregnant.

Alcohol-exposed pregnancy is the leading cause of miscarriage, stillbirth, birth defects and other disorders, said Naomi Imai, child and youth program specialist for the state Family Health Services Division.

Big Island study on fetal alcohol, drug exposure |