CarolD

Hi Everyone....
Things to ponder while you are considering
if recovery is for you.

These are excerts from the book by Milam & Ketcham
"Under The Influence"

There is also a sequel
"Beyond The Influence"

Thanks to the OP
SR member GreenTea
for this valuable service work...

CarolD

Under The Influence

Page 21
1.
Once in the blood stream, alcohol is distributed throughout the body in simple diffusion. Its small and relatively simple molecular structure allows it to pass right through cell membranes and mix in the entire water content of the body. The brain, liver, heart, pancreas, lungs, kidneys, and every other organ and tissue system are infiltrated by alcohol within minutes after it passes into the bloodstream.

Alcohol's immediate effect on the brain is most unusual. The brain is usually protected from chemicals and drugs by an electrical-chemical filter system known as "the blood/brain barrier," which makes sure that only very simple molecules such as those of oxygen and water can pass through. The simple molecular structure of alcohol allows it to penetrate this selective screen and gain easy access to the brain and its extension, the spinal cord.

Consequently, alcohol has immediate and profound effects on behavior. At low doses, alcohol stimulates the brain cells, and the drinker feels happy, talkative, energetic, and euphoric. After one or two drinks, the normal drinker may experience some improvement in thought and performance. As the BAL rises, however, the amount of alcohol in the brain also rises, and alcohol begins to disrupt the brain's electrical and chemical circuitry, causing complicated behavior changes.

With large amounts of alcohol surging through the brain's labyrinthine passageways, the central nervous system cells can no longer function normally. The brain malfunctions, and the major visible effect is a change in the drinker's psychological and emotional state. After several drinks, the normal drinker may begin to show signs of intoxication. He may become emotionally demonstrative, expressing great joy, sadness, or anger. He may also begin to show signs of motor incoordination, staggering slightly when he walks, knocking his drink over as he leaves the table, or slurring his words. If he continues to drink, his vision may blur, and his emotions, thoughts and judgement may become noticeably disordered.

When blood alcohol concentrations reach very high levels, the brain's control over the respiratory system may actually be paralyzed. A .30 BAL is the minimum level at which death can occur; at .40 the drinker may lapse into a coma. At .50 BAL, respiratory functions and heartbeat slow drastically, and at .60 most drinkers are dead.



Page 22
1.
The body, in the meantime, is doing its best to eliminate alcohol. Small amounts are eliminated in the urine, sweat, and breath, but the primary site of alcohol elimination is the liver, which is located behind the ribs on the right side of the body. This vital organ is responsible for numerous life-sustaining processes, including the control and elimination of drugs and chemicals which are toxic to the body's cells and the conversion of various nutritional substances into materials which can be used in the life processes of cells -- processes such as eliminating wastes, making repairs, and creating new cells.

The process of elimination begins as soon as alcohol enters the liver. An enzyme called alcohol dehydrogenase (ADH) attacks the alcohol molecule, quickly removing two hydrogen atoms to create a new substance called acetaldehyde. Since acetaldehyde is a highly toxic agent which can produce nausea, rapid heart beat, dizziness, headache, and mental confusion if present in the body in large quantities, the liver quickly initiates the second step in the elimination process.

It employs another enzyme with a similar name, aldehyde dehydrogenase, to transform acetaldehyde into acetate. Acetate is then converted to carbon dioxide and water and eventually eliminated from the body. During these two steps in alcohol oxidation, a great deal of energy is released. In fact, with ordinary rates of alcohol metabolism, almost the entire energy needs of the liver can be satisfied. Most of the acetate is passed into the blood stream and oxidized to carbon dioxide and water in other organs. The energy produced in these reactions contribute to the energy needs of the entire body. In the alcoholic, up to two-thirds of the body's total energy needs may be satisfied by substituting alcohol for other foods. This explains why alcoholics often neglect eating for several weeks at a time.

The conversion of alcohol into acetaldehyde and acetate is an efficient process in most drinkers. The liver works at maximum efficiency, converting alcohol at the rate of approximately one-half ounce per hour, until all the alcohol in the body is broken down and its energy released to the cells. The liver is then able to return to its other duties.

If alcohol is present in the body in large amounts for long periods of time, however, the liver must work constantly to break it down and flush it out. The liver's preoccupation with alcohol results in the neglect of its other duties and, as a result, toxins accumulate and nutritional functions are disrupted. The health and vitality of the body's cells, tissues, and organs begins to suffer.

GreenTea

The following posts are taken from the original "lost thread"...

GreenTea

{Posted By GreenTea}
So that's what's happening inside your body and how the alcohol gets metabolized. Notice how every cell in your body is affected and how the liver gets preoccupied away from its other duties.

{Posted By 2Dayzmuse}
I'm amazed at how I never developed any permanent liver damage. I'm very, very lucky in that...

GreenTea

{Page 25}
If it were not for these stimulating effects of alcohol, most people would soon lose interest in drinking. In fact, when alcohol's sedative effects begin to take over after several drinks, the pleasure and excitement of drinking are gradually cancelled out, and the average drinker simply stops drinking. A built-in deterrent to overdrinking seems to be working in most drinkers, somewhat like the natural deterrent to overeating which most people have, although the mechanism is different. The average person enjoys sweets, for example, and will eat a candy if it is offered. Some people will eat two or three, and a few will gobble down the whole box. Most people, however, will feel sick if they eat more than a small amount of concentrated sweets.

Likewise, the average drinker is unable comfortably to drink more than a few beers, a glass or two of wine, or several mixed drinks. The benefits of drinking are usually available only with low doses of alcohol, and when sedation begins to override the stimulation, the average drinker ceases drinking. Another deterrent is the toxic effect of several drinks in the normal drinker -- the nausea, dizziness, sweating, and other unpleasant sensations.

The point at which alcohol's stimulating effects are overshadowed by the sedative and toxic effects varies from drinker to drinker. For some people, one drink is the limit. Others can drink four, five and more drinks and still experience alcohol's stimulating and euphoric effects. Alcoholics develop an increased physical resistance to alcohol's effects (called "tolerance"), and some can drink many times more than nonalcoholics while continuing to behave as if they were on their first few drinks. Thus alcohol remains stimulating and pleasurable for alcoholics even after they have drunk amounts which would cause nonalcoholics acute discomfort.

For alcoholic and well as nonalcoholic drinkers, however, alcohol's stimulating effects will eventually be erased with continued drinking. After several drinks -- again, depending on the initial tolerance of the drinker -- the average person will begin to experience a slowing down in his mental and physical reactions. He may not be able to grasp the thread of a conversation; his reflexes will be somewhat delayed, his speech slurred, and his gait unsteady. As he continues to drink, the alcohol increasingly depresses the central nervous system, and sleepiness, mental sluggishness, and physical incoordination intensify.

Only rarely, however, will a normal, nonalcoholic drinker take in enough alcohol to lose consciousness. This is fortunate, for alcohol taken in large enough quantities to cause unconsciousness is dangerously near the amount needed to paralyze the respiratory center, shut off the breathing aparatus, and kill the drinker. As an anesthetic or pain killer, therefore, alcohol is inferior because it numbs the senses only at extremely high, nearly lethal doses.

GreenTea

{Page 27}
Alcohol, then, belongs in a category somewhere between the habit-forming and addiction-producing drugs. The WHO labelled it "intermediate in kind and degree" between the two categories of drugs, but even this label is inaccurate.

The fact is that the effects of alcohol simply cannot be generalized for both alcoholics and nonalcoholics.

For most drinkers, alcohol is not addictive; yet for the minority who are alcoholics, the criteria for true drug addiction are fulfilled; an increased tissue tolerance to the drug, a physical dependence on the drug with physical withdrawal symptoms, and an irresistable need for the drug when it is withdrawn.

The only way to clear up the confusion is to label alcohol a selectively addicting drug. It is addictive only for those individuals who are physically susceptible.

{Page 29}
Alcohol's energy "kick" is therefore its most beneficial and potentially its most deadly characteristic. As normally consumed, alcohol is usually in the body in small amounts and for relatively short periods of time, and its effects are therefore temporary. Furthermore, in small amounts, alcohol's benefits are noticeable and the penalties non-existant; the cells receive a quick jolt of energy, the hearthbeat accelerates, the brain cells speed up their communications, and the drinker feels euphoric and stimulated. The chemical causing these pleasurable effects is easily eliminated in an orderly and efficient manner, and the body then returns to normal activities. The brain cells quickly recover from their alcohol bath, the liver cells return to their everyday functions, nutritional materials once again flow in adequate proportions and amounts to the cells, and waste materials are efficiently eliminated.

In large and continuous amounts, however, the penalties of drinking far outweigh the initial benefits. The drinker is taking in so many calories from alcohol that he will automatically require fewer calories from other, more nutritious foods. Alcohol also disrupts the cells' ability to take in and use nutrients from other foods. It interferes with the absorption of various vitamins from the gastrointenstinal tract, inhibits the absorption of numerous amino acids, and increases the loss of certain vitamins in the urine, including thyamine, pyridoxine, and pantothenic acid. As a result, even if an alcoholic is eating well, alcohol denies him the full nutritional benefit of what he eats. Put another way, alcohol literally robs his body of those substances which are essential for life. Thus all alcoholics develop malnutrition regardless of what or how much they eat.

GreenTea

{Posted By GreenTea}
I remember how much I was drinking when I was out there, and how often too. I would have had to have been placed in the "large and continuous amounts" category.

{Posted By ibhmn}
Thanks

Very informative! I wish I had read this years ago. Thanks for taking the time to share it with us.

{Posted By CarolD}
The information in "Umder The Influence" is what
convinced me to seek sobriety.
I highly recommend it to any who question their drinking.

I read it in '89 and never drank again...

Thanks so very much for the excerpts.

{Posted By bob123}
Wow... count myself very lucky reading that

GreenTea

{Page 33}
At some point, however, the drinking patterns of both groups begin to diverge. The alcoholic starts to drink more, and more often. He does not want to stop drinking once he has started. In the later stages of his drinking, he may keep a six-pack of beer in his desk drawer or a pint of whisky in the glove compartment. He may stop regularly at the corner tavern for a few quick ones after work. He may gulp his first drink or switch to martinis or straight whisky.

The alcoholic appears to be using alcohol to solve his problems. His drinking appears to be an effort to drown his depression, forget work or marriage difficulties, obliterate loneliness and insecurities, and ease mounting tensions.

The reality, however, is very different from the appearance. In reality, an abnormal physiological reaction is causing the alcoholic's increasing psychological and emotional problems. Something has gone wrong inside.

{Page 34}
In other words, while psychological, cultural, and social factors definitely influence the alcoholic's drinking patterns and behavior, they have no effect on whether or not he becomes alcoholic in the first place.

Physiology, not psychology, determines whether one drinker will become addicted to acohol and another will not. The alcoholic's enzymes, hormones, genes, and brain chemistry work together to create his abnormal and unfortunate reaction to alcohol.

{Page 35 & Others}
(I'm going to grab a few things here and there starting on page 35)

Acetaldehyde, the intermediate byproduct of alcohol metabolism, appears to be one of the major villians in the onset of alcoholic drinking. The trouble probably begins in the liver ...

... found that the same amount of alcohol produced very different blood acetaldehyde levels in alcoholics and nonalcoholics. Much higher levels were reached in alcoholics. Lieber theorized that this unusual buildup of acetaldehyde was caused in part by a malfunctioning of the liver's enzymes.

... took this acetaldehyde difference in alcoholics one step further. His studies confirmed that, in alcoholics, the breakdown of acetaldehyde into acetate -- the second step in alcohol metabolism -- is performed at about half the rate of "normal" i.e. nonalcoholic metabolism. It is this slowdown in metabolism which apparently causes acetaldehyde to accumulate.

... Heredity is clearly implicated in these studies ...

In summary, addiction to alcohol may, in part, be traced back to a liver enzyme malfunction which results in a buildup of acetaldehyde throughout the body. In the brain, these large amounts of acetaldehyde interact with the brain amines to create the isoquinolines. These mischievous substances may trigger the alcoholic's need to drink more and more alcohol to counter the painful effects of the progressive buildup of acetaldehyde.

... Accumulated evidence clearly indicates that alcoholism is hereditary ...

... The weight of evidence clearly links alcoholism to heredity ...

Goodwin's studies provide compelling evidence that alcoholics do not drink addictively because they are depressed, lonely, immature, or dissatisfied. They drink addictively because they have inherited a physical susceptibility to alcohol which results in addiction if they drink.

Furthermore, this evidence has profound implications for treatment. While it may be possible to teach the problem drinker how to drink in a more responsible way, the alcoholic's drinking is controlled by physiological factors which cannot be altered through psychological methods such as counseling, threats, punishment, or reward.

In other words, the alcoholic is powerless to control his reaction to alcohol.

{Page 48}
Because the early alcoholic shows no sign of disease, the logical but wholly mistaken idea persists that alcoholism begins only when the drinker does suffer from drinking and does show some deterioration in physiological functioning, such as severe withdrawal symptoms, personality disintegration, or inability to control his intake.

Before these visible symptoms appear, most people assume that alcoholics and nonalcoholics experience precisely the same physical reaction to alcohol. In fact, they do not. The alcoholic reacts physically in an abnormal way to alcohol, and his disease begins long before he behaves or thinks like an alcoholic.

The reactions or adaptations of the body's cells to alcohol remain hidden in the early stages of the disease, but they are nevertheless happening. In months or years, the cells will have been so altered by alcohol that the alcoholic's behavior and thought processes will be affected. Then the disease will no longer be hidden, and the alcoholic will clearly be in trouble with alcohol.

In the early stage, however, the disease is subtle and difficult to recognize. It is characterized by adaptations in the liver and central nervous system, increased tolerance to alcohol, and improved performance when drinking.

GreenTea

{Posted By GreenTea}
A lot of that certainly rings true for me -- how about you?

Its almost like discussing, "... its not a matter of if -- its a matter of when"

Its interesting to see the point being clearly made that using alcohol carries a different set of experiences for an alcoholic versus a nonalcoholic, even in early stages of use. Perhaps heredity determines the use thresholds at which these experience sets start to diverge.

As I've stated elsewhere, I know that my body has changed over the years due to my drinking habits. I can feel the difference between having a few beers 'way back when I first started, as compared to if I would have a few beers now. I don't just mean tolerance differences -- those out of control feelings of craving once I started -- "... gotta get another beer! gotta get another beer! ..." -- are downright scary.

I'm glad that I don't ever have to go back to that!

{Posted By NEEDTOBESOBER}
Very good information, after reading that I am surprised I don't have any liver damage, when I went to the doctor to talk about my drinking problem, when prescribed Campral , the doc did tests on my liver and the results came back that there was nothing wrong w/ my liver, I was so relieved.

{Posted By janeeyre}
Green Tea,

Thank you so much for posting these excerpts! I've had that book on hold at our local library for months (still waiting for it...) but I can see it's worth going out and buying a copy.

There seems to be a ton of excellent information in this. I've read bits and pieces in other books, but never so much in one place.

Jane

{Posted By GreenTea}
I'm glad everyone is enjoying these excerpts. By all means, please find a way to get a copy for yourself -- I'm reading from a Bantam Books paperback version marked US$7.99. The ISBN number is 0-553-27487-2. The UPC code is 76783-00799.

I'm doing these excerpts under "fair use" guidelines in an effort to inform and encourage discussion.

GreenTea

{Page 49 & Others}
In the onset of alcoholism, adaptation is central. Alcoholics initially experience physical stress whenever they drink. Their enzymes, hormones, and numerous chemical processes are thrown out of balance by alcohol, and the normal ebb and flow of materials into and out of the cells is upset.

To counteract this confusion, the cells make certain changes in their structures. These adaptations gradually allow the cells to work smoothly and efficiently even when alcohol is present in the body in large quantities. In fact, the alcoholic's cells become so competent at using alcohol for energy that they choose alcohol over other energy, or food, sources.

... Gradually alcohol attacks the cells, destroying their delicate chemical balances, eating away at the membranes, and deforming the cell innards ...

The critical point, however, is this: the preliminary adaptation begins before the alcoholic starts drinking heavily and, in fact, causes the heavier drinking. Adaptation does not occur because a person drinks too much. On the contrary, when a person starts drinking more, and more often, and the pattern persists, he is displaying one of the first symptoms of alcoholism.

... A viscious cycle begins when the alcoholic must drink more to maintain a level of alcohol sufficient to override and block the devastating effects of the rising level of acetaldehyde. This is the basis of the alcoholic's "physiological imperative" to keep drinking once he starts that is regularly mistaken for a psychological compulsion to drink ...

GreenTea

{Posted By hoobie}
Thank you for posting this!

My therapist has been talking to me about the "alcoholic liver" and how she thinks I have one. I argued that since there is no test to prove that I metabolize alcohol differently than regular people and that all my blood panels turn out fine, that she can't "prove" that I'm an alcoholic.

She said that my cravings, drinking alone, drinking frequently, and high tolerence for someone my size is proof enough.

anyway, its helpful to see this in writing and really try to understand it psysiologically.

GreenTea

{Page 54 & Others}
... Researchers conclude that large and continuous doses of alcohol stimulate the cells to adjust the structure and thus the functioning of their membranes. The cells now welcome alcohol and adjust to its toxic aftereffects. As a result, the cells are able to cope with increasingly large doses of alcohol; they become, in other words, tolerant to alcohol.

If the alcoholic continues to drink in large quantities, however, the toughened membranes are continually battered and gradually damaged by alcohol's poisonous aftereffects ... The results are catastrohpic ... The destruction of cell membranes is linked with many of the conditions which afflict alcoholics in the late stage of their disease, including severe withdrawal symptoms, such as convulsions, hallucinations, and delerium tremens, and damage to the heart muscle (alcoholic cardiomyopathy).

The ability to tolerate large amounts of alcohol can develop over a period of weeks or years, depending on the individual. Some alcoholics experience a subtle gradual shift from normal drinking to a drinking pattern of increased frequency and stepped-up amounts over a period of many years. Most alcoholics, however, experience a more immediate change in their tolerance level and are able to drink more than their friends and show less impairment soon after they first start drinking.

Tolerance is actually responsible for the alcoholic's continued and increasingly large intake of alcohol. In fact, an increase in the amount and frequency of drinking is the typical symptom of a developing tolerance to alcohol and one of the first warning signs of alcoholism.

When the alcoholic become tolerant to alcohol's effects, he is responding to changes which are occurring inside him. He is not responsible for initiating theses changes. He is not even conscious that these changes are taking place.

{Page 58 & Others}
Something completely different happens when the early-stage alcoholic drinks. Alcoholics in the early, adaptive stage of their disease also show improvement of functioning as the blood alcohol level begins to rise. But unlike the nonalcoholic, this improvement continues with additional drinking.

Even when blood alcohol remains at fairly high levels -- levels which would overwhelm the nonalcoholic, causing him to stumble, stutter, and sway -- the early alcoholic is often able to talk coherently, walk a straight line, or skillfully maneuver a car. Only when the alcoholic stops drinking and his BAL descends, does his performance deteriorate -- and it does so very rapidly.

Most alcoholics discover "maintenance drinking" early on in their drinking careers, and they learn ways to protect themselves against the disasterous drop in blood alcohol level ... "... keep a bottle in the car to maintain him until he gets home ... pick a tavern closer to home and gulp a last drink just before leaving ..."

Maintenance drinking is not gluttony or irresponsible drinking, but a protective device whereby the alcoholic delays the drop in BAL until he is safely off the road and back in bed. By drinking continuously but never overdrinking, he attempts to hold on to the benefits of drinking while forestalling the penalties.

Tragically, the alcoholic can only temporarily control his drinking behavior. Over a period of years, the cells' dependence on alcohol becomes more firmly entrenched until, at some point, the alcoholic no longer has a choice. He needs alcohol to function, and he suffers terribly when he stops drinking. The benefits of adaptation are gradually overshadowed by the penalties of deterioration.

GreenTea

{Posted By GreenTea}
Yeah, that works -- up until the point where you DO start overdrinking, and you start doing it every time.

I also learned elsewhere that an increase in tolerance can be generated by overdrinking -- kind of like "exercising that drunk muscle". I wonder if the "tolerance" line has gotten pushed so far up that it doesn't have anywhere else to go anymore, resulting in the overdrinking happening every time whether drinking continuously or not.

I've certainly had that proven to me over and over again!

GreenTea

{Page 67 & Others}
The hangover can be excruciating for the non-alcoholic, but it becomes much worse for the alcoholic in the later stages of the disease. As one expert put it, "[Hangovers]... are so extreme for the alcoholic that they really should have a different name. No normal drinker would recognize them as what he has."

The source of the physical and mental pain of the alcoholic hangover is, to repeat, the state of hyperactivity in the central nervous system caused by the withdrawal of alcohol. The cells, which are accustomed to the presence of alcohol and dependent on it for energy, stimulation, and sedation, become agitated when it is suddenly not available. The cells' distress is experienced by the alcoholic as the headache, eyeache, dizziness, nausea, and anguish characteristic of the hangover, ("anguish" is an older term than "anxiety" and refers to both mental and physical pain or suffering -- "anxiety" refers only to psychological conflict or tension).

Alcoholics feel physically wretched during a hangover, but they also feel deeply and profoundly ashamed. From past experience, they know better, but they got drunk anyway -- why? Ignorant of the powerful workings of the addiction, the alcoholic can only blame himself. Remorse, self-loathing, and guilt therefore go hand in hand with the throbbing headache and queasy stomach ... "... the emotional pain which accompanies them -- the guilt, anxiety, self-accusation, the sense of hopelessness and despair ..." ... a very real and very painful physiological disorder.

The increasing misery of the alcoholic hangover is directly caused by the drinker's physical dependence on alcohol. As this goes by and the alcoholic drinks more, and more often, the withdrawal symptoms -- experienced in those minutes, hours, or days without a drink -- become more severe. He begins to feel shame and remorse when he repeatedly fails in his efforts to stop drinking or control his intake. He cannot make good his intentions to drink as everyone else does, and this personal failure causes great guilt and despair. The alcoholic believes that he should be able to control himself by a sheer force of will. He does not know that the physical addiction is in command of his every thought and action and subverts his persistent efforts to control it.

... The alcoholic's most cherished values -- his honesty, integrity, self-discipline, even his love for his family -- are repeatedly overthrown because he cannot reliably predict or control his own drinking behavior. Any normal human being would feel disgust and self-loathing at this seemingly pathetic inability to exert control and exercise will power; and so does the alcoholic, who may be normal in every respect except his reaction to alcohol.

The alcoholic's guilt, depression, self-loathing , and despair are therefore understandable reactions to a bewildering and mysterious inability to stop the ravages of drinking. Neither the alcoholic nor those around him know that his cells have become abnormal, for the physical dependence and cellular addiction have worked inside him for months or perhaps years, invisible and unnoticed. No wonder the alcoholic believes he is weak-willed and pathetic. No wonder many of the people who observe his behavior believe that he is psychologically unstable, self-destructive, and perhaps suicidal. Without an understanding or knowledge of his addiction, they have no way of knowing that the alcoholic's irrational behavior is beyond his control.

GreenTea

{Posted By GreenTea}
There's a lot more in the book, and I strongly recommend finding a copy somewhere for yourself. I'm about to give away my current copy (again) to a friend later today, (I should just buy two at a time!).

Anyway...

So, if you're wondering whether you're an alcoholic or not, you might ask yourself what kind of hangovers do you experience? Have they ever changed over time? If they have, when did their natures start to become different? What were your drinking patterns then compared to now?

Its as if the protracted (PAWS) withdrawal is like one extended hangover until your cells start to function right again. So just one more, last, long, hangover and its all behind you -- no more hangovers after that ever again!

I think it took me about two weeks total before the main physical stuff worked its way through. At that point, all the mental stuff started up and I began to remember why I drank so much. I've been working through that with God's help (my HP), and life is starting to look a little more liveable these days.

I noticed last week that its been a little while since the last time I felt like "having a few pints" or stopping at a pub to "hang out". My spare time doesn't have to be spent like that -- I can find other things to do even if its just taking a nap. Reading and posting here at SR between meetings is another example! (I suppose I'll have to tackle them dishes soon too).

I am glad that I don't ever have to go through one of those horrible hangovers or deal with the withdrawal crap ever again! ... I can keep all of that behind me -- I don't ever have to do it again if I don't want to, and that's at least a choice I CAN make. Today is day 71 and life is getting better.

I hope these excerpts and commentary are helpful if you are thinking about your relationship with alcohol. If nothing else, hopefully its been informative.

{Posted By GreenTea}
I know that book has always been pretty accurate as regards my own experiences. I'm still looking forward to reading its sequel "Beyond The Influence".

One of the things that strikes me is how the cellular changes have been occuring and that newly acquired "problem drinking" is only the "latest" manifestation of it.

Most people in the recovery community regard alcoholism as a disease, or as an allergy, or at the minimum as a syndrome or condition. The point is that everyone agrees that there's something different with an alcoholic compared to a nonalcoholic as regards alcohol use. The physiological perspective works for me, largely in part because it seems to match so well with my personal experiences (I know which side of the fence I've crashed through).

If I read correctly, it may be possible to measure an actual physiological difference by monitoring the acetaldehyde levels between alcoholics and nonalcoholics during use. Its as physical a sign as someone turning blue during an asma attack (and just as desired, I'm sure).

{Posted By Arura}
WoW ((GT)) , opened my eyes to a lot of stuff there matey ...Thanks for the exerts, from the book. Much apprictaited...!

Thanks for the food for thougth...!

{Posted By 2Dayzmuse}
As far as the allergy aspect goes, I would become flushed and break out in red blotches all over my body within a few sips after drinking.

{Posted By Lastbinge}
Interesting reading Greentea......the part from page 67 about the hangovers fit me to a "T".

I like you am glad I have experienced my last one. I'm not too far behind you in time "dry"...52 days and I thank God to have made it and to have no urges to ever drink again. I read here on SR about peoples cravings and their....for lack of a better word I'll use sorrow, about not ever being able to drink again due to their alcoholism.

I am thankful to not have the cravings and I certainly have no "sorrow" about never tasting another drop of alcohol, the thought of drinking again turns my stomach, likely because of the pain I have been through in numerous detox withdrawals over the span of my 30 some year drinking career.

Thanks for posting the excerpts from this book

Scott

{Posted By ibhmn}
GreanTea,

Kudos for all your work typing and bringing us these insights. It sure makes me want to buy the book now.

I hope google grabs hold of many of these posts and enlightens many to become SR members--and new book owners. (I found SR by googling anxiety and something else that I can't remember.)

These posts are so educational that I think this thread should be a sticky for new members. Anna and Carol, what do you think?

{Posted By GreenTea}
I'm very glad people have found this topic to be informative, and hopefully helpful. The name of the book again is "Under The Influence" and I highly recommend it.

The last time I went out drinking, I broke out in handcuffs!

GreenTea

{Page 108 & Others}
(Sorry it took me so long Carol, and THANKS for the sticky!)

The middle-stage alcoholic has probably been having blackouts from time to time. Blackouts are a very distinctive feature of alcoholism, and one symptom that clearly distinguishes alcoholics from non-alcoholics. The events which occur during an alcoholic blackout are not forgotten; they are simply not stored or are imperfectly stored in the brain. There is nothing there to be recalled later.

During a blackout, the alcoholic may be functioning normally and aware of everything that is happening around him. He continues to talk, walk, eat, drive a car, conduct a business deal, or make love to his wife. Yet on sobering up, he has no memory trace of what occurred during a certain time period -- it could be a minute, an hour, or even several days. In the early stages of the disease, blackouts are relatively infrequent, but as the disease progresses, they occur more often and last for longer periods of time.
It is not difficult to imagine how frightening blackouts can be. The alcoholic may wake up in the morning with no recall of the events of the previous evening. He gets out of bed, afraid to inspect his clothes -- did he get sick? Then the question occurs to him: "How did I get home?" He looks out the window, fearful that the car will be missing. He does not remember driving home.

The car is there, and he has another, even more frightening thought: "Did I hit something or someone?" He runs outside and looks at the front end. He searches the seats for clues to help him piece the lost time back together. Humiliating thoughts race through his mind: "Did I disgrace myself? Will my friends talk to me? How can I find out what happened when I am too embarrassed to admit that I don't remember?"

Blackouts can be so frightening that they make the alcoholic question his sanity. For the first time he may realize that he is in deep trouble with alcohol. Despite his increasing problems, however, the middle-stage alcoholic rarely considers giving up drinking...

GreenTea

{Posted By GreenTea}
Boy, I can certainly relate to all of that!

I guess I was a highly functional drunk right up there until the very end. Its amazing what you can accomplish when you're walking around out cold. This brings "state-dependent learning" questions into issue, too. What's even more funny is when you start being able to recognize "blackout states" in your drinking buddies.

Blackouts... I'm not missing those! And yeah, they are scary. Its also sometimes referred to as "time travel" or "teleportation", (one second its midnight at the pub, the next second its noon in your bed).

I don't know sometimes which is worse... Waking up not remembering what happened and having to glean it all from everyone around you, (they all remember, and they all know that you don't). Or waking up, and after a few minutes, recalling something really bad that did happen, (yes, now that you remember the nightmare, it really was for real -- welcome back to life!). -shudder-

I personally have "woken up" driving down the road with the sun coming up and no clue where I was at. (So what do you do in a situation like that? Find a gas station, go use the bathroom to take stock of yourself, wash your face, buy something to drink -- good time to check the cash, if any, in your pocket -- fill up, look at the headline on the newspaper to check what day it is, ask the guy if you can use a map and please show me where we are right now? What time is it? If he asks where you're trying to get to, tell him truthfully wherever you live -- its almost like training for time travel field work!)

Anyway... Those "what about the car?" feelings were some of the worst. And to think that by the end there, I was doing that to myself about three or four times a week. I would actually pray on the way to the place asking for forgivenenss and protection, hoping that I wouldn't do something too stupid by morning and that I'd get home okay, (just like a sitcom, everything back to normal again by the end of the show). At the end there, I knew something was wrong, and I started praying for help.

Seriously, what other activities do we do where we know ahead of time that we will have occurences of "running on automatic" and "lost time"? ... UFO chasing? ... General anethesia? ... Sleeping? ... What else? ... Amazing what we put ourselves through, and what we get used to dealing with.

I'm glad I don't have to go through any of that ever again.

{Posted By CarolD}
As I lived in a city...driving was not an issue.

Blackouts?? I mistakenly thought all drinkers blacked out.

I eventually trained myself for them..

I was a bar hopping drunk...I would take the personalized
matchbooks from places...
then the next morning I knew where I had been.

I far too often needed to ask the dreaded morning after query...

"What's your name again, Honey?"

Once sober,,,no more blackouts!

{Posted By WEE DEE}
This thread has been fantastic for me Green Tea - definately gonna buy that book (hopefully tomorrow)!!!

Blackouts became a big thing for me in the last 2 years. Like the text said earlier - no matter how I tried there are things that are gone forever.

In a blackout I lashed out verbally and abusively at people. Apparently I tried to kick my boss down some pub stairs - I strongly denied it at the time. But as I've got sober I'm not so sure. I was lucky to keep my job. Probably because she was drunk too and couldn't say for definate.

Those blackouts are one of the main things that have kept me sober. I dread the thought of lifting a drink again and the possibility another blackout might engulf me. Too horrible to contemplate.

I've heard people talk about this book but never really paid to much attention. I wish I had.

Thank you - you've certainly strengthened my resolve to stay sober!!!!

Take care.
D.xxx

{Posted By WEE DEE}
Oh Carol - me too.

I ended up marrying the last guy whose name I had to ask!!!!

Now there's a deterent not to drink if every there was one.

D.xxx

{Posted By Chy}
Great, great thread GT!

{Posted By Zephyr}
Thanks for posting the info on blackouts. I was looking for that specifically. I was a blackout drinker from an early age. Towards the end it got really bad. I was drinking to keep from dealing with my dysfunctional family. I knew that sober I would never harm my kids. When I would wake up from a blackout I was always fearful that I might have hurt them. Thank God I never did. I am also thankful that I don't have to try and piece together the night before anymore, check the caller ID to see who I talked to, wonder if I went out in the front yard naked, etc. Sober is good.

{Posted By SuperDave}
Thanks GT
I'm new to SR and now I know i've come to the right place. I can identify in myself almost all of the characteristics mentioned from the those excerpts. Pretty informative and scary stuff.

{Posted By midgetcop}
I was lucky in that I didn't often experience blackouts...I'd usually only get them if I drank something harder than beer, such as a lot of wine or hard liquor. But when I DID have them....it scared the bajeezus out of me! I found mainly that my memories of the night-before would be hazy, and I would forget conversations I'd had, and I'd usually forget going to bed (or passing out, more accurately). Not sure if that fully constitutes a black out.

GreenTea

{Posted By dave65}
i'm reading that book right now, it's nearly 1.30 am here in the uk and i havn't had a drink for the first time in ages and i can't sleep, the bit in the book about malnutrition is very true for me as i've always been a fit guy but when i'm drinking i end up weak and loose weight.

{Posted By KJJ}
there's so much good , informative info here and i'll read and re-read,explains my lows in the morning with no alcohol, i tried coffee to get the energy and that doesn't work, i've heard about honey and orange juice in the morning, i have both at home sooo..giving it a try KJJ

{Posted By nolonger}
Green Tea - thanks so much for posting all this. I'm going to go get hold of the book itself.

{Posted By ay100}
I will get that book too. GreenTea thank you very much for those excerpts, although knowing most of the information , this thread became a rude awakening to me.

May God help me I am kicking this habit!

{Posted By MLALOK}
Trying to get inside the head of my dead Alc man. Trying to understand what he was going through, and why he had to do and hide it all. SO terribly sad, such a clever and wonderful man, who loved me so much, but hid this terrible disease from me and all who loved him.

GreenTea

{Posted By GreenTea}
Personally, I find no conflict. The two complement each other well, in my opinion.

The physiological perspective advocated by the book only takes you so far. "When the hardware isn't broken and is running right, then suddenly the software starts to work a whole lot better".

You have to remember the devastation that occurs as described by the book. The damage happens on not just a physical level, but on a physiological one as well. The deterioration occurs physically, mentally, emotionally, and yes, spiritually too.

Simply "getting off the sauce" is only the start. Repairing the physical damage is the next step, (and hopefully it still is repairable). At that point you're left with life staring you in the face (like it always was) and you have few tools with which to cope. Psychologically a peson is a mess from the roller coaster ride through hell that they've been putting themself through, and if you were like me, then you were left emotionally bankrupt and spiritually wretched.

What coping skills a person had are either underdeveloped or very rusty through lack of use. I know for me its true that I was turning to alcohol instead of facing my life or its problems. As this progressed, I turned to alcohol more and more, until alcohol became my primary "coping mechanism".

For me, I think a lot of the mental obsession after the physical detox and withdrawal (those horrid first thirty days), was based on the "familiarity" and the "ease of use" of alcohol as a coping mechanism. It was a lot easier (and more fun in the short term) to just go get drunk again instead of facing things. It finally hit the point where I was doing that four to five times a week. Sure I knew something was wrong and that I was trapped in a beer bottle, but by then I simply did not care.

Back to your question, my point is that simply not using alcohol is only the start. In AA-speak, this state of being physically sober, but emotionally all raw, psychologically twisted, and spiritually empty is known as being a "dry drunk". About the only thing that's changed at that point is that you aren't using alcohol -- you're still feeling, thinking, and behaving like a drunk.

On occassion, people have heard me say the following... My psychological issues are what got me STARTED on my drinking career. But it was the developed alcoholism that KEPT me in my drinking career. Further, the alcoholism also perpetuated and magnified my psychological issues which gave me an excuse FOR the drinking career.

Note that I originally turned to alcohol as a way of coping with my life. I don't KNOW that once I started I was immediately an early stage alcoholic or if that came later after I had been at it for a little while -- the threshold is set differently for everybody, I think... for some its very low, for some its very high, for most its somewhere in the middle.

Once I DID become an alcoholic though, then the reason I drank had little if nothing to do with my life issues. At that point, I drank simply because I WANTED to drink. I drank because it was fun. I drank because I was a drinker. I drank because I felt good. I drank because I felt bad. I drank because it was a day of the week that ended in "Y". This is how I spent most of my drinking career (middle stage) and protecting that "right to drink" was very important.

Note too that the disease hid behind my psychological and life issues, using them, feeding them, shaping them, sometimes even creating them, causing them to grow so that I wouldn't notice how prevalent the alcoholism had become. Even when I did finally notice, I was so mentally, emotionally and spiritually messed up that I didn't even care anymore.

As the disease progressed, the craving effects became stronger. No where in my life is this more true than during those final two months when I was locked into that death spiral with alcohol. I had progressed to the start of the late, deteriorative stage.

All during that time of my drinking career, I was turning more and more to alcohol as a coping mechanism. This is a result of the disease aspect. As the craving effects increase, you exercise your use of alcohol more and more, until it *becomes* your primary coping "skill" and the others fall to the wayside. "Alcohol ruled my life" and "the bottle was drinking me".

The physiological perspective alone won't provide you with the coping skills needed to face your life. It can explain what is going on physically, help you to stop the deterioration and repair it, provide some relief mentally and even help to stabilize your emotions to an extent. But it won't teach you how to deal with those emotions once you start feeling them again! And it won't teach you how to cope with life on life's terms. Understanding the physiology helps you to understand what is going on, and how you got to where you're at, but it is ONLY A START! It gives you a fighting chance.

If you'll notice, in the 12 Steps, alcohol is only mentioned once. Read the Steps carefully and you'll see that its outlining a set of skills for coping with life. Its a guide for how to change from being a dry drunk to being a fully functioning, healthy human being as God intended you to be. Leading a sober, healthy, happy, satisfying life in accordance with God's Will is not only the goal, but its also the reward. Furthermore, its also the process -- leading your life that way makes its easier TO lead your life that way, because you become better at it with practice, (as with anything else).

Its been said, "...first I replaced God with Ego... then I replaced Ego with Alcohol..." ... Replacing the alcohol with ego gets you back to being a dry drunk again. Replacing ego with God gets you to being sober, healthy and happy.

The "character flaws" that you're refering to aren't a case of "...here are the reasons I used to drink..." I KNOW why I used to drink. I drank because I am an alcoholic. "Under The Influence" describes the mechanisms of that for me very well, especially as regards the progressive nature of the disease. It does an excellent job for me of explaining the why and how of where I found myself -- the steady decline over time, the denial, the personality disintegration, craving, PAWS, psychological and emotional roller-coaster, etc.

The character flaws, in my mind anyway, fall into two categories... First there are the ones that were there before I started my drinking career. Seeking a way to cope with these flaws and their effects, I tried alcohol as a method. They didn't "make me drink" -- they only caused me to seek ways of coping with them. I found alcohol and it was good, so I adopted it as a coping mechanism.

You can guess how well that worked out. Even after years of practice -- in some cases really intense focused practice -- alcohol wasn't very effective as a coping mechanism for them. Now that I'm no longer using alcohol, those particular flaws are still there, and they still need to be dealt with, (although by now they may have grown some).

The other category of flaws are those I've picked up along the way. Gifts of my alcoholism, they have been left behind like so much discarded camouflage. They are the results of increased dependency and chemical tolerance, unprocessed emotions, and skewed thought patterns resulting from the deterioration and disintegration brought on by the disease. They too need to be dealt with and unlearned. The amends are about cleaning up the damage, setting things right and moving on with forgiveness.

There's a reason people use the term "soul sick". My disease left me with a large spiritual hole in my heart and in my life. My personal relationship with my Higher Power -- God -- fills that hole and heals it.

My response has gone a lot longer than I had intended -- I didn't mean for this to be such a long post. I hope it make sense.

For me there's no conflict about it whatsoever. "Under The Influence" helped me to see what was going on with my life. It helped me to recognize and understand what was happening and what the disease was doing to me, and what to expect when I stopped using. It really clarified for me my relationship with alcohol and brought home for me the fact that the disease will always do its best to try to kill me, no matter what, all the while whispering into my ear how much of a good friend it is, (talk about a snare).

AA takes it from there. "...So you've stopped using alcohol... NOW what are you going to do? Sit there in your misery, bleeding over everyone while chewing on those white knuckles?"

You don't have to. There is a better way. And you are NOT alone!

GreenTea

{Posted By GreenTea}
Amazing how the veil of denial lifts, isn't it? And how the light from a different perspective helps you to see the truth of what has been happening.

For the longest time, (for me anyway), the last thing I would admit was that alcohol, my "friend" and "comforter", was actually doing its best to kill me and to make me thank it for doing so.

How much of my life would have been different if I hadn't been clinging to the lies alcohol was feeding me? But no longer...

YOU ARE NOT ALONE!