Alcoholism

Vitamins In Recovery — A Personal Opinion

2013-03-19 16.44.57It isn’t uncommon for me to get questions about nutrition, particularly the role of vitamins in recovery. Let me say at the outset that I have no desire to get into a debate about it. There are huge industries with a vested interest in promoting vitamin therapies, and they use extremely effective advertising to attract people to their products. Many of those folks swear by their various courses of nutritional supplements, and that’s okay. I’m not going to buck the current of billions of dollars worth of merchandising, nor am I interested in changing anyone’s mind.

In most respects, however, I disagree with the concept of vitamin therapy.  In fact, I hold a pretty conservative viewpoint on vitamins, in recovery and otherwise. We evolved to get them in certain quantities, and it's difficult for me to imagine how messing with basic body chemistry is beneficial.  Most experts who are not connected with the vitamin industry agree that there is no point in supplementing heavily unless blood tests have indicated an insufficiency of a particular vitamin, such as vitamin D.

Of course, those who do have an ax to grind, either because of ties to the industry or their own endeavors (books, websites, health food stores, etc.) take an entirely different view. The information here is based on good medical advice, and that’s all I have to say about it.  Most nutritionists agree that we require vitamins and minerals only in tiny quantities, and that what isn’t absorbed literally goes down the drain. I once read a nutritionist’s summation: “Americans have the most expensive urine in the world.”

As addicts, we love the idea of some magical pill that will make us “all better,” but it doesn’t exist. The repairs necessary to recover from addiction will take place with abstinence, a good diet, exercise, rest, and — important to a remarkable degree — fun and relaxation. And it takes time; physical recovery from addiction, including alcoholism, can take up to two years. We feel better long before that, thank goodness, but it can take that long for our brains and the rest of our bodies to get back to something like normal.

However, we addicts are used to getting results fast. It’s no accident that the drugs that are most rapidly addictive are the ones that work the fastest. We think in the short term, and we don’t like to wait — for anything. Good nutrition, exercise and so forth take attention and work, and there’s no instant payoff. That’s our biggest hangup in recovery: wanting the magic pill.

That said, all alcoholics (and most other addicts) suffer from malnutrition to one degree or another. Alcohol prevents the small intestine from absorbing nutrients properly, and interferes with the intestinal bacteria that produce many of the nutrients we need. As a general rule, I believe that absent a doctor’s recommendation most of us do fine with a multivitamin every day with a meal (I take mine with breakfast). Because I have also been diagnosed with a vitamin D deficiency, I take supplements of that as well along with certain mineral supplements prescribed by my physician.

In the case of early recovery, no harm — and much good — can come from taking a high-quality multivitamin in the morning and one in the evening — always with a meal. Vitamins are food, not medicine, and must be digested with other food in order to be properly absorbed.

My personal opinion is that after the first year or so in recovery, people who eat properly and get a bit of sunshine and some exercise along with proper medical care probably don’t require more than a multi a day, and perhaps a mineral supplement if the multivitamin doesn’t provide them.  This obviously doesn't apply to folks who have been told to take certain supplements by a physician.

Of course your mileage may vary.  If it works for you, great! Whether it’s vitamins or the placebo effect, the whole point of recovery is to feel better and get on with our lives.

Remembering Bill C.

This is a lot longer than my usual entry, but that happens sometimes when I get to thinkin' about stuff.  If it doesn't seem to have anything to do with addiction, just bear with me a bit.

I don’t spend much time regretting the past. There are a lot of things I’ve done that, given the opportunity, I’d probably do differently or not at all, but you have to be careful what you wish for. The Law of Unintended Consequences is nothing to mess with.

Today I was thinking about my friend Bill. I met him during a time in my early twenties when I was hanging around the aviation industry. We were drawn to each other by a mutual love of airplanes, flight attendants, and the bars of the Fort Lauderdale area.

Back then there were the usual disturbances and upheavals in Central America, and there was a lot of stuff happening in Africa as well. The company we both worked for had, at one time, some clandestine connections with interests in the Caribbean, and shady characters of some repute still wandered around the small airports of South Florida and the islands to the south. I found this moderately interesting. Bill found it fascinating.

Douglas_A-26B_in_flightA fellow who shall remain nameless, well-known in the aviation community, acquired a Douglas A-26 that had been converted for use as a high-speed executive aircraft. I took one ride in the thing (the guy needed a copilot), noted the amount of oil leaking from one of the big radial engines during takeoff, and deplaned as rapidly and permanently as possible when we landed. Bill’s envy knew no bounds, and his fascination with the former attack bomber increased.

The Douglas languished at the local airplane patch for about a year before a potential buyer appeared. This individual had a reputation for shady dealings involving the transportation and sale of firearms—usually, or so the story went, in considerable quantities. When he showed up and began negotiating for the A-26, Bill saw his chance for glory. [Read more…]

Relapse Triggers — They Don’t Keep Cat Food In The Beer Cooler

Speaking of relapse triggers, it happened that two or three days after I got out of treatment back in 1989, I went to the supermarket to buy some cat food. I was walking through the store, and just for the heck of it I turned down the beer aisle. (That's what folks who work in the field call “testing yourself.”  It's considered to be pretty dumb.) After my stroll down memory lane, I was pleased to note that I hadn’t had even a twinge of a desire for my drug of choice. I was pretty proud.  Yesiree.

The next day, at “day care,” I bragged about it to Ron, my counselor. He looked at me with disgust, and shouted, “You stupid shit! They don’t keep cat food in the beer cooler!

Oops.

I knew enough to understand immediately what he meant, and I never consciously did anything like that again. Some years later, after having worked with Ron at a different treatment center, I had the sad honor of telling that story at his memorial service. Everyone laughed and nodded their heads; they knew Ron, just like Ron knew me.

A big mistake that we alcoholics and other addicts make is believing that we are different; that only we know what’s best for us. In the rooms, we call this terminal uniqueness. The fact is that when it comes to addiction, our similarities are far more important than our differences. That’s because, in all of us, addiction works the same way: it causes certain changes in our brains that alter our priorities and put our drugs of choice first in every part of our lives, and every part of our lives that have to do with obtaining or using those substances become of paramount importance.

Recent studies involving addicts who viewed selected images while being scanned in an MRI revealed that certain stimuli can activate the portion of the primitive brain that controls cravings for alcohol and other drugs.  We relate certain situations and places, along with certain smells, visual and audible cues, to obtaining and using drugs and alcohol. These associations take place in a part of our brain that we cannot directly control, any more than we can control our tendency to flinch at unexpected loud noises.

Walking down the beer aisle won’t always trigger cravings, just as driving past the corner where we used to cop drugs won’t always trigger them. But in all addicts, the wrong combination of trigger, mood, hunger, distress with life and a million other things can cause those synapses to go “click.” Then all of a sudden we’re handing the guy a twenty and he’s dropping a little baggie into our hand, or we’re walking out of the corner store with a bottle of Smirnoff's.

That’s why one of the ideas that we pound into clients’ heads (or try to) is stay away from the old people, places and things until you have some sobriety — preferably, a lot of it — under your belt.  Our families hard-wired our buttons for us, and we can play each other like a cheap barroom piano. Our drinking buddies make us think of those good times (we rarely remember the bad ones), and may themselves not have our best interest at heart. They (and our families) may find that they prefer the old us to the newly-sober variety. And it should hardly need to be said (if it does, we’re in trouble already) that we don’t keep a six-pack or a baggie of blow around “for guests,” or hang around the corner bar because we like to shoot pool.

Simple ideas.  A little rough on the “Me, me, me…I want, I want, I want” part of our addict brains, but really not complicated.  Relapse triggers: If you want to stay on your feet, stay off the slippery places.

Next to People, Places, and Things, relationships and physical stress are the greatest relapse triggers. More about them to come.

Clients’ Questions About Recovery

From time to time we post a few of our clients’ more interesting questions about recovery.

Why do I have to continue this detox?  I am ready to go home.

We are glad that you are feeling better, but that is because you are on powerful medication.  You need further monitoring, until you are off the meds and able to manage without them.

As far as going home is concerned, it is our hope that you will decide to go to treatment instead.  It has been our experience that clients who go back to the old people, places and things don’t do well unless they have a firm foundation of knowledge, some recovery, and are able to take full advantage of available supports. Familiar situations and faces can set off powerful cravings in people who are unprepared.

How do I deal with my baby and wife leaving me because of my addiction?

As we gain sobriety and work on a program of recovery, we learn to deal with problems like this one, and many others as well.

There are only two possible ways of handling this matter.  Either you go back out and use again, continuing the old ways of solving problems that didn’t work so well, or you get clean and sober.

Option number one will certainly be easier, but will accomplish nothing except your eventual death.  It certainly will not help you regain your family and self respect, and will simply add more pain to everyone’s lives.

On the other hand, if you get humble, follow suggestions, and do the things that you need to do for yourself, you have a chance at sobriety.  If you are able to remain sober, you will at some point at least be able to have a relationship with your child, and might actually be able to get the family back together.  Seems to us that the choice is pretty clear.

I would like to know how I get a sponsor.

We find sponsors by going to a lot of meetings, listening carefully to a lot of people, and finding out who is happy, productive, and working a good program of recovery.  Some folks choose “cool” sponsors.  The smart ones look beyond the surface and try to figure out if that person has what it takes to weather the long haul, and whether they can pass it on to others.

Our blogger Bill W. has two full posts devoted to choosing a sponsor, here and here.

How long should you be clean before you can actually go around social events with alcohol?

It seems to us that the issue isn’t so much how long as it is how well prepared we are.  We need to have enough sobriety that thoughts of drinking have pretty much disappeared, along with the nostalgia when we see a beer commercial or drive past a bar.  Beyond that, we need to consider the situation: will it be a gathering when we would have participated heartily and gotten blasted — perhaps a family party or shooting pool with our old buddies — or will it be a situation with less powerful triggers.

Finally, we need to be prepared, and we need to take someone sober with us.  Again, Bill W. has a post here that covers the matter.  Check out his archives for more answers to questions about recovery.

Have a great weekend!

Things Clients Say In Detox — Denial On The Hoof

We thought we would list some of the things that we hear clients say.  You can substitute any drug for any other drug in any statement or comment.  Denial ain’t just a river in Africa, remember?

I don't even know why I'm here.  I'm not an addict.

You're here for some reason.  You didn't just walk in to see what it was like.  Some major problem in your life got you through the doors.  You may as well hang out for a while and see if we can help you with the problem — whatever it is.

Marijuana isn’t addictive, because there’s no withdrawal.

It is true that years ago there was no noticeable withdrawal from marijuana use, but in those days cannabis had only about 1/10th the active ingredients that today’s hybridized varieties have.  Even then, chronic users often had trouble quitting.

Today, there is acute withdrawal that involves irritability, sleeping difficulties, mood swings, loss of appetite and other issues.  We also know that there is a post-acute withdrawal syndrome (PAWS) that  includes depression and cognitive disorders, and that can last for many months.

I'll stop drinking, but I'm still going to smoke a blunt now and then.

Recovery requires abstaining from all mood-altering drugs.  We cannot pick and choose.  All drugs work on our reward system.  Addiction occurs when the reward system loses the ability to make us feel good without the extra stimulation of drugs.  If we continue to stimulate the reward system so that it cannot return to normal, then we will continue to have cravings.

I only drink wine or beer.

All ethyl alcohol (ethanol) affects the human body the same way, and one six-ounce glass of wine, one 12 ounce beer, and one shot of 80 proof liquor all contain roughly the same amount of alcohol.

I only drink on weekends.

It is not important when we drink.  What matters is how much, and why.  If we are waking up with a hangover, which is really alcohol withdrawal, we are drinking enough to cause changes in our brains, even if we only do it two or three days out of the week.  And are we really remaining totally abstinent the rest of the week, or are we having a couple to “relax” each evening?  If that is the case, why do we need alcohol to relax?

I only use (pick a drug) occasionally, so I won’t become addicted.

There are millions of addicts who have found out the hard way that, despite their denial, the occasions tend to get closer and closer together until they have merged, so that we need the drug to be comfortable.  When we are more comfortable under the influence of drugs than we are without them, we are well on the way to addiction.

Alcohol doesn’t bother me; I can drink all my buddies under the table.

Increasing tolerance for alcohol or any other drug is the first sign of addiction.  If we can drink, snort, swallow or shoot more than we used to be able to handle, we’re in trouble.

“I can take it or leave it.”  (I just choose to take it.)

Put it down and don’t touch it for two weeks.  Let us know how that works for you.  Try it again.  Learn anything about denial?

I only have a couple of drinks at home, just to relax.

There is nothing wrong with that, unless we cannot relax without the drinks.  In that case we need to do some hard thinking.  We also we need to look at what we consider a “couple of drinks.”  A standard drink is one shot of 80-proof liquor, one six-ounce glass of wine, or one 12-ounce beer.  “Topping off” is cheating.  So is filling an iced-tea glass with ice and booze and calling it “a drink.”

My whole family drinks like me.

Alcoholism has a strong hereditary component, as do some other addictions.  Need we go on?

The bottom line is this: If drugs, including alcohol, are causing problems in our lives, whether they be hangovers, missing work, “discussions” with our spouses or partners, DUI’s, or any other issues, then they are a problem.  There are no two ways about it.  Either they cause problems or they don’t.  Then the big question becomes why we are continuing to do something that continues to cause us problems.

Now that is a good question — a very good question.

Once An Addict, Always An Addict?

A client asks, “Is it true that ‘once you’re an addict, you’re always an addict?’

“Once an addict, always an addict” is  hurled around the recovery field and among recovering people with considerable abandon. It’s an easy way of describing a pretty complex situation, but it’s misleading to a degree. A far more accurate way of putting it would be “Once you stop using, you have to change the way you live and the way you look at life. If you fall back into thinking and behaving the way you used to, you will almost certainly relapse, and if you don’t you will still be a miserable s.o.b.” To that extent, the addict is always waiting in the wings.

When we began using alcohol and/or other drugs to change the way we felt, we essentially shut down our emotional and social development. Healthy emotions require not only a foundation that is often missing in addicts, but also a clear mind to deal with the many issues, pleasant and unpleasant, that arise in our personal and interpersonal lives.

Since someone who is under the influence of mood-altering chemicals is, by definition, not operating with a clear mind, nothing much useful is going to happen in our emotional development from that time forward. Trauma, such as child abuse, severe injury, parental separation, poor parenting, loss of a loved one and similar things can create the same sort of obstacle to becoming a functional person. Combine the two, as so many of us did, and we end up a real mess.

We can see that sobriety involves a lot more than just quitting drugs. Abstinence is essential to recovery, but by itself only allows us to begin to think clearly. True recovery involves learning how to live without drugs: cleaning up the issues that separate us from others, learning to deal with our emotions, resolving the shame and guilt that always go along with active addiction, and building living skills. These are the abilities that we develop in our recovery fellowships, therapy and spiritual practice. Without them, we have no reason to remain clean and sober.

So — once an addict, always an addict?  To the extent that we practice those skills, and continue to practice them, maintaining an emotional and spiritual condition that will enable us to live a life without drugs, we are insulated from our addictions. However, the other side of the coin is obvious: if we fall back into our old ways of thinking and dealing with life, the addict has returned.

We Are Not Saints — Dysfunction In Recovery Groups

We encounter dysfunction in recovery groups, as we will in any organization of whatever purpose. Because this is sometimes used as an excuse not to participate, we’d like to discuss some of them here.

We need to remember, first of all, that people at AA, NA and other recovery-oriented meetings are not usually there because they are well. They are there to learn skills that will enable them to live without engaging in harmful behavior. The emphasis is on learn. Not everyone learns quickly; some resist, and don't learn much. Some may use their presence in the fellowship to convince themselves that they are okay, and that they have only one problem to address. Unfortunately, some of their “outside issues” have the potential to cause problems within the group.

There are people who may befriend newcomers in order to take advantage of their vulnerability in various ways. Some see the fellowships as a social club, and make no effort to change. (Those folks don’t usually last long.) There are people with control issues who keep running groups when they have many years in recovery, unwilling to pass the baton to younger leaders and support them while remaining out of the spotlight. There are those who are merely annoying — who share frequently and long, and repeat mostly the same things every time. Some folks love to quote the literature but share nothing personal, leaving us feeling preached at, rather than shared with. As the saying goes, “Some are sicker than others.”

I could go on, but that’s not really the point I want to make. My point is this: we gain from our recovery programs according to the effort we put into them, and part of that effort is taking a good look at others and deciding if we really want what they have. We need to look for people who seem as though they are living stable lives, and who behave as though they actually have something to offer besides flash and big talk.

If dysfunction in recovery meetings is really the reason we’re turned off, the remedy is simple: find another meeting. If there is no other meeting, we need to decide if we really want what the fellowship can give us. If so, we need to tuck it up and attend the the annoying meetings anyway, taking the good stuff away with us and leaving the b.s. in the parking lot.

Recovery is a life or death issue. Alcohol and other drugs kill people. If we don’t want to be part of that group, we need to work at becoming part of a different kind. Just as with any other collection of human beings, there will be jerks. But there will also be folks who are genuinely helpful, and — on extremely rare occasions — we may even run across a saint.