PAWS

A Reader Writes About Her PAWS Experience

I got this letter a few days ago. It so closely parallels the article on the Sunrise Detox blog about sugar addiction, and has such a clear outline of the lady’s experiences in early sobriety, that I thought it would be good to publish it here, along with my response. Perhaps some of you folks will be able to relate. The letter is edited for readability and to preserve anonymity, and is being published with the permission of the writer.

I had absolutely no acute withdrawal symptoms when I stopping drinking. In fact, quitting was so easy I never lasted more than 3 months before. I used to do these “stop drinking” bouts twice a year for the last 5 years to cleanse but admittedly, looking back it was because I had a problem with alcohol. It's been over 100 days now. I quit on January 1st.

I'm 46 and I have been drinking since 17. I was a heavy drinker who was always sensitive to alcohol. I could handle booze until I was 40, when I started drinking a bottle of wine nightly. For me, who was small, that was way too much. No one thought I was having a problem because I was drinking alone, hiding at home.

I had no withdrawal but I seem to now have classic PAWS. [Post-Acute Withdrawal Syndrome – Ed.] Where I used to have mental acuity and a really fast mind, I'm now super confused and tired. My first month was complete rage. I was so bloody angry, where did it come from? I seemed to be intolerant and have no censure about telling people off. It's almost comical.

In a sense it relieves me, I can finally not be polite. I used to be so polite and sweet and nice but chronically depressed as a drunk. I'm now angry, which in my book is better than depression. (Can you believe it, I was sure booze didn't create depression because when I stopped for a month before, I was not less depressed. But now that I’ve accumulated over 4 months and am no longer depressed, I SEE that it was alcohol. I just so wish I had got that realisation sooner…so many years wasted!)

Thankfully, the rage has subsided. I deal with frequent headaches, but my most annoying PAWS symptom is sugar craving. I was on a NO CARBS diet for 8 weeks and it helped, but it was too austere to be a happy place (I'm all about extremes) so I'm back to a good diet, meditate daily, do yoga, I'm doing wonderfully except for the sugar cravings. When I feel like drinking like mad, I allow myself the sugar rush. I guzzle a spoonful of molasses or maple syrup, and you know what? It helps me greatly. My only question is, will it ever diminish? It's a sugar craving exactly like when I have PMS — the exact same urge to have sugar with immediate brain POW relief. So since I don't abuse sugar at all except a daily dose of dark chocolate (1 square) or a tablespoon of maple syrup, i think it can't harm me that much. Better than alcohol.

I don't mind that PAWS takes time. In a way it makes me grateful, it reminds me that I'm weaned from my poison. I'm just happy it's not 1 year for 1 year of booze because I would be in pain for the next 25 years.

Thank you so much for your kind presence. I find that you are very present to us. In spirit, in listening.

“Ruth”

Hi Ruth,

Don't worry about the sugar for now. Next time you go to your doc, request that she order an A1C test to evaluate the way your body is handling glucose. For the time being, stick with the method you've found. You might try smaller amounts of sugar or — perhaps better — some more complex carbs to see how that works. I'm concerned about blood sugar spikes and bottoms, especially in connection with the rage.

Ah, the rage. Hardly surprising that it has surfaced now that the booze is gone. Booze helps us stuff all manner of things, powerful feelings first among them. At some point you'll be ready to take a good look at things in the past that are causing it, perhaps via a 4th and 5th Step, or with a good therapist. For now, don't sweat it, but you will need to explore those issues eventually. (If that caused any kind of reaction besides, “Oh, okay,” it's proof of the premise. Denial ain't just a river in Africa.) If things get too tough, buy an aluminum baseball bat, find some poor undeserving surface, and whale away at it for a bit. Good upper body exercise, too.

How much we drank has less to do with PAWS than how long we drank and how our tolerance for alcohol developed. Along with tolerance came changes in our brain, as our bodies attempted to adapt to the altered levels of neurotransmitters (NT's) caused by the stimulation of the alcohol and/or other drugs. These are permanent changes that involve receptor sites and other minutia. As a small woman, you got the full treatment. Because women produce less of the enzyme that metabolizes alcohol (ethanol dehydrogenase), it stays in your bodies longer, at higher levels than it does in men. Being small merely exaggerated that. More effects for the money is about the only benefit there.

Put simply, PAWS is the symptoms our body experiences during the period when the brain and other bodily systems are returning to an approximation of normal. They include all the things that you mentioned, some others that you didn't, and sometimes depression. Not everyone expresses the same syndrome, but your list fits right in.

PAWS usually lasts for from 8-10 months to two years, depending on a broad range of variables. There is no way to avoid it, but following the suggestions in the article can ameliorate many of the effects, and just knowing that it will gradually get better is a morale booster, too. Expect some swings: good days and worse days, with the good slowly increasing. It's frustrating for us addicts, because we're used to mood changes on demand, but this is better.

Trust me.

Follow the hypoglycemic diet suggested, and stay away from fad and “cleansing” diets. They have no real validity, regardless of how artful the presentation. Remember that those folks are trying to sell things; there's no profit in simple, good nutrition. Recovery is about reality, and there's some for you right there.

Keep on keepin' on!

Bill

Antidepressants In Recovery — Just Another Drug?

Depression is not uncommon in the first year or so of recovery. Some people manage to avoid it entirely, but many of us experience it to one degree or another. That’s because sometimes the ability of our brains to produce the chemicals that make us feel good has been damaged by the alcohol and other drugs, and it takes time for the necessary repairs to take place.

Unfortunately for many of us, the drugs that we used masked underlying problems.  For example, roughly 65% of alcoholics are known to suffer from pre-existing emotional problems, most of them brought about by imbalances in brain chemistry.  Those folks usually find that the removal of the drugs brings out the underlying conditions, often severely so.  Thus, the idea that all we have to do is stop drinking and straighten up is often — sometimes tragically — not the case at all.

Whatever the case, if we end up feeling that we’re worthless, that life is not worth living, and that it’s just not worth the effort, that’s bad. Depression kills people every day — far more than it should, because in most cases it’s treatable.  The problem is that, in some cases, it worsens so rapidly that the time to begin effective treatment can be quite short, so it doesn't pay to wait around.  If you're feeling depressed to the point of not caring about your life, see a doctor.  Right now!  If you're having thoughts — even casual — of self-harm, then you're already in crisis.

Many folks have been on antidepressants, felt that they didn’t work, and stopped taking them. Most antidepressants take from three to eight weeks to have their full effect, and sometimes in the early treatment period they seem to have no effect at all. Combine that with an addict’s conviction that taking a pill should make us feel good right now, and you have a good chance that the patient is going off the meds before they have a chance to help.  Others have found relief, and stop because they believe they're cured.  AD's are not like antibiotics.  They cure nothing, they simply reduce the effects of the depression and allow us to function.

Not all antidepressants work for all patients, and if we toss one before it has a chance to work, we run the risk of missing the one that was right for us. Second, and perhaps more important, is the fact that sometimes the medication was beginning to work and we just didn’t notice. In that case, if we quit suddenly, we can experience a rebound effect that throws us straight into deep depression.

This brings us to the big point we’d like to make here. Depression is nothing to fool with! There is an unfortunate attitude among some of the laypeople in the recovering community that antidepressant medications are just another drug. That is emphatically not true!

Antidepressants (ADs) are not the sorts of drugs that most recovering people mean when they say drugs. They are not addictive, in the sense of creating tolerance and cravings for more. They will not interfere with recovery by preventing our bodies and brains from repairing themselves — in fact, they assist in the process. They do not alter our mood, except for the better, and they do not interfere with our judgement. They do not trigger the addictive process, and they do not make our lives unmanageable.  Quite the opposite: antidepressants in recovery can lift the weight of the world off our shoulders, and contribute to our recovery by giving us the ability to be enthusiastic about it and enjoy its rewards.

The greatest danger of antidepressants is the danger of not taking them when we need to. Depression can not only lead to self-harm in its more severe forms, it can keep us from seeing the gains we are making in recovery, putting us at increased risk of relapse.

That said, there are some downsides. In some people, ADs affect the ability to feel and express emotion. Some have other side effects that can vary with the particular medication. However, none of these are as dangerous as suicidal thoughts or acting out, or as harmful to recovery as a relapse because “Life sucks, so I might as well just use.” And, as mentioned earlier, going off an antidepressant without a physician’s guidance can have devastating results. Any undesirable side effects should be discussed with a physician.  It may be necessary to change a dosage, or switch drugs, but do not stop on your own!

We're not recommending that recovering folks run out and look for a doctor who will prescribe antidepressants, nor are we offering them up as some sort of magic pill. What we are trying to get across is that we need to listen to the experts, and we need to be careful about making medical decisions that we aren’t qualified to make.

For some of us, antidepressants in recovery can be a tool, but they are not the whole answer. The answer, as always, comes from remaining abstinent and learning how to live without addictive drugs through therapy, support groups, and an organized program of recovery, but it makes sense to utilize all the tools if we need them, especially if failure to do so can kill us.

Important Note: This article should not be taken as, nor is it offered as medical advice. You should consult with your personal physician or a specialist, as appropriate, before considering the use of, or ceasing the use of, any medication.

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.

How Long Do Cravings Last After You Stop Using?

“I still have strong cravings to use, so my question is, does it get easier with time and treatment, or will I feel like this forever?”

The cravings that you feel should moderate soon.  It would be nice to be able to give you a simple yes or no, but you need to know a bit about what addiction actually is before you get our answer.

Drugs (including alcohol) make us feel good by imitating or increasing the levels of chemicals in the brain that act on the brain’s reward center. Different drugs do it in varied ways, but the overall effect is to overstimulate that part of the brain that gives us pleasurable sensations.

When over-stimulation occurs, our bodies try to bring things back into balance by reducing the natural production of those chemicals (neurotransmitters). Often, when the drugs wear off, we feel uncomfortable until the natural production of the chemicals resumes. We call this period of withdrawal a “hangover.”

With continued presence of the drugs, the body takes further steps: it begins to increase the number of receptor sites for the specific neurotransmitters in order to use up the surplus. Because of this, continued drug use causes “tolerance.” We need more of the drugs to fill up those extra hungry receptors, and we begin to feel uncomfortable when we don’t have them present in our bodies, or if they are present at too low a level. The process of addiction has begun.

Further drug use doesn't only increase the receptor sites. In its attempts to bring things back to normal, the brain slows production of the natural neurotransmitters. That means that when we stop the drugs, there are insufficient natural neurotransmitters, and we feel cravings and other symptoms of acute withdrawal. These vary, depending on how the drugs affected us to begin with, but they are generally the opposite of however we felt when we were using.

These feelings are most acute during the time the drugs are leaving our bodies, and begin to subside within days. However, the fun isn’t over. As George Carlin said, “Just because the monkey’s off your back, it doesn’t mean the circus has left town.” We will continue to feel discomfort until the body has shut down the extra receptor sites so that they are no longer begging for drugs, and until the natural production of neurotransmitters has resumed. This can take several months, and is referred to as Post-Acute Withdrawal.

Many authorities believe that the extra receptor sites just shut down, and don’t go away. They believe that they can easily be re-activated if drugs are reintroduced into the body.  That certainly seems to fit what we observe in real life.  That’s why we recommend abstinence. In most addicts, any drug use seems to slow and soon reverse the recovery process.

Because of this continued potential for discomfort, if we don’t take care of ourselves physically and mentally during the post-acute period, our risk of relapse is high. However, the discomfort tends to come and go, with good days and bad. Eventually the good days become more common, and the bad ones tend to occur less often and with reduced discomfort, until things are more-or-less back to normal.

You can most certainly look forward to a time when you no longer have the cravings, and those that you have will begin to ease off within a few more days. If you stay clean, eventually the discomfort will disappear entirely. Naturally, as addicts we want to feel better immediately, but it doesn’t work that way. We spent months or years getting our bodies used to drugs, so it’s hardly surprising that it takes quite a while to get over the effects.

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.

Questions In Early Sobriety

I want to share a letter I recently received from a guy in early sobriety, along with the response I gave.  The letter is SO typical of the cares and worries of people in early sobriety that I think most folks will be able to relate.  I edited a bit for brevity, believe it or not.  So…

Hey Bill,

I talked with you once before  when I was about 43 days clean. Today is day 68 and don’t get me wrong I am happy so far.

I have been exercising quite often, mostly running and some weight lifting in the days past, but I still have trouble sleeping at night; I have to wait till like 3 a.m to be able to fall asleep and then I sleep like a hibernating person. At times anxiety comes and attacks me just as depression sets in. From what I have read and researched it seems to point to p.a.w.s. I just really want to be back to normal and never touch the stuff I used to.

Even deep down inside I feel tremendous strength and confidence that I won’t go back to using, some people I know tell me not to be fooled by this deception. I know you have a lot of experience with your own sobriety so I am hoping things will eventually get better for me.

Every day that passes I realize how nice it is to just be alive in the moment even though I have lost everything I have ever owned to this drug. People I have known for ages have distanced themselves, acting as tho they have never known me. I will admit this does hurt, but I try not to let it get to me. Someone once told me that the day we start being clean is the day we start growing emotionally.

Never in my life would I ever think I would be sitting behind the screen typing this and actually counting the days that go by. I count each and every day because it serves me as a reminder of the time I have dedicated towards fighting this disease.

All I want to ask you Bill is if things will eventually get better because depression seems to always be around the corner. There are days when I am happy for most of the day and then there are those times when everything seems dull.

Peace, love and happiness. Take care.

Joe

Hi Joe,

Good to hear from you again, and congratulations on the 68 days and 136 nights!

Sorry you’re having trouble sleeping, but that’s pretty normal in early sobriety. You feel draggy, but rest assured that no one ever died from lack of sleep — at least not when they’re able to “sleep like a hibernating person” once they fall off. It sounds like you’re suffering as much from a disturbance in your sleep pattern as from actual lack of sleep.

Try limiting heavy exercise and caffeine to mid-afternoon at the latest. That may help. Also, never force yourself to stay awake. If you get sleepy during the evening, forget about TV or that book. Go to bed. Sometimes a little discipline on the waking side is all it takes. If you can’t sleep, get back up and do something: eat a light meal or snack, low on carbs with a bit of fat and protein (peanut butter on crackers works well for many) and then read or do something non-stimulating until you think you can sleep again. Lying in bed awake just accustoms you to lying in bed awake.

Your mood swings, likewise, are pretty typical. As long as the depression doesn’t become severe, or last for more than a day or so at a time, I wouldn’t be too concerned. Your brain is adjusting to an entirely new balance of neurotransmitters, and your dopamine production is almost certainly still below normal. As long as you’re not having thoughts of worthlessness, life not worth living, etc., you’re likely just going through normal swings. They will become less severe over time, as your brain chemistry slowly returns to normal.

HOWEVER, if the depressed feelings get worse than just feeling blue, you need to take them seriously and talk to a doctor. You might need an antidepressant for a while. Antidepressants won’t interfere with your recovery.

On the other hand, watch out for antianxiety drugs. The most popular ones are benzodiazepines (Ativan, etc.) and they are poison for recovering addicts. They will prevent your brain from recovering properly, and are highly addictive in themselves (regardless of what your doctor may think). Trust me: I spent three weeks in medical detox for benzos. If you need medication for anxiety, there are plenty of non-addictive alternatives. Mainly, though, you need to keep to your program of healthy living and meetings.  In most cases the anxiety will ease off as you begin to feel more comfortable in your recovery.

Your friends are right: overconfidence has killed many an addict. Relapse is a recognized symptom of addiction, and it can happen to anyone, even us old-timers. I know plenty of people with 10+ years who have relapsed — almost always because they got overconfident and stopped doing the things that kept them sober to start with. Don’t get too confident; it leads to carelessness.  That said, as long as you're working a program and doing what you need to do, you needn't worry.  Just remember that recovery is a process, not an event.  It's a sliding scale, and sometimes it's more slippery than others.

The person who told you about emotional growth is correct as well. If our emotional development wasn’t interrupted by some sort of trauma before we started using, it was most certainly brought to a screeching halt when we began getting high regularly. Then when we get sober — and just when our nerves are at their most jangly — along come all those suppressed emotions that we haven’t learned to handle. It can be unnerving, to say the least. This, too, shall pass. Therapy helps, as do the steps of the program. So does experience living clean and sober.

Recovery takes time, Joe. We spent years messing up our brains and (to a degree) our bodies. Because we’re addicts we expect immediate results when we stop using, just as we got them when we used, but it takes our bodies months to get back to something like normal. That’s what PAWS (Post-Acute Withdrawal Syndrome) is — the period of healing. It takes time, but it does get better.

Hang in there, and

Keep on keepin’ on!

Bill

From A Drunk Who’s Ready To Dump Alcohol

On a different site, I often get comments and letters from folks with questions about alcohol and their recovery.  The one I'm reproducing below, along with my answers, was especially interesting.  Since the writer gave me permission to use it, in the hope that it might help others, I answered with publication here in mind.  As they say around the Interwebs, “I hope it helps!”

Bill: Dear Joy,

Thanks so much for writing, and for your thoughtfulness in specifically making your letter available to others.  It is so long, and so chock-full of commentable (word?) material, that I’m departing from my usual format of simple Q&A and will address each paragraph or so as they come.

Joy: I’m a 38 year old female with a long history of being a drunk. I started drinking in college and it was often binge drinking. After college, I continued to drink, sometimes binging, but usually mostly on weekends. I was in a bad relationship for 2 years and drank more often than that. Then my relationship after that was better, but I still drank. This was still weekend binges and sometimes during the week as well. My next relationship was with a non drinker, so my drinking was cut way down, but that was only for a year. Then for the next 2 years (about age 26-28), I was more of the weekend binge drinker with sometimes some drinking during the week.

Then from 28-38 (now), I’ve basically drank every night. My boyfriend of a decade is also a drinker. The first 5 years it was mostly beer (5-6 a night), with some hard liquor on the weekends. Some weekends I would drink more than 5-6 a night. Then I developed a wheat allergy (so bloated and horrible stomach and digestion problems, as well as infections), and switched to vodka about 5 years ago. I also have a history of bladder and yeast infections. I would have 6 or 7 shots a night, pretty much nightly (often mixed with club soda because it’s without calories). Sometimes I would take 1 or 2 days off and felt even worse, so started drinking again. I continued to have bad digestion and stomach problems, but not as bad and the bloating went away quite a bit. But I continued to have infections, and almost 4 years ago was sick with one for 2 months. They think it was my colon. No antibiotics worked and I got a yeast infection in my mouth. I should also mention I had infections even as a kid (ear and acne) and was frequently on antibiotics. So that history mixed with the booze equals disaster.

Bill: Your progression down the road to alcoholism closely parallels my own, except that it took me about another five years to catch on to the fact that I had a problem. That’s not unusual, BTW. Alcohol damage progresses more rapidly in women, because you don’t produce as much of the enzyme that breaks down alcohol. Your BAC rises faster, and the drug stays in your system longer.

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