An AA Explanation of Cravings - Acetate and Alcoholism as an Allergy


Written by Barefoot Bill L. Barefoot Bill is a revered Alcoholics Anonymous (AA) speaker and an alcoholic. Here he writes here about alcohol cravings from the perspective of AA. There is no one right way to recover. AA proposes complete abstinence and working the "12-Steps" as a means to recovering from addiction.

This is an explanation of addiction cravings founded on the teaching and the book of Alcoholics Anonymous written in 1939. Despite some antiquated language, science has proven the concept sound all these years later.

This is an explanation of addiction craving founded on the teaching and the book of Alcoholics Anonymous written about 70 years ago.

The Phenomenon of Alcohol Craving: The Case for Total Abstinence

The Big Book on page xxiv (The Doctor’s Opinion) says that an alcoholic has an “allergy to alcohol.” An allergy is an abnormal reaction to any food, liquid, or substance. If nine out of ten people have one reaction and one out of ten people have a different reaction, then the reaction of the one out of ten is abnormal.

It also says on page xxvi that “the action of alcohol on an alcoholic is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker.” (A phenomenon is something that you can see but can’t explain.) “These allergic types can never safely use alcohol in any form at all.”

Then on page 22, “We know that while the alcoholic keeps away from a drink, as he may do for months or years, he reacts much like other men. We are equally positive that once he takes any alcohol whatever into his system, something happens, both in the bodily and mental sense, which makes it virtually impossible for him to stop.” This includes substances that contain alcohol like mouthwash, cold remedies, some chocolates, food prepared with alcohol, etc. Your body doesn’t know if you are having a drink or taking Nyquil for a cold, it only senses alcohol and begins to process it.

It also says on page xxviii that, “all the different classifications of alcoholics have one symptom in common: they cannot start drinking without developing the phenomenon of craving. This phenomenon may be the manifestation of an allergy which differentiates these people, and sets them apart as a distinct entity.” Dr. William D. Silkworth, M.D. who at that time had nine years of experience specializing in the treatment of alcoholics and drug addicts, wrote this in the late 1930s. He called it a “phenomenon of craving” because at that time there was no way to study metabolism. Since then, science has proven his theory as correct.

The following is an explanation of what happens when alcoholics put alcohol into their bodies, and how it is a completely different experience compared to non-alcoholics. No wonder why non-alcoholics can’t relate and make statements like, “Can’t you just stop after one or two drinks?” It shows why alcoholics can use their willpower against everything except alcohol.

What Happens When Alcoholics Take Alcohol: The Role of Acetate in Alcohol Cravings

Alcoholics make up about 12% of the population. The body of the alcoholic is physically different. The liver and pancreas of the alcoholic process alcohol at one-third to one-tenth the rate of a normal pancreas and liver.

Now as alcohol enters the body, it breaks down into various components, one of which is acetate. We know now that acetate triggers a craving for more acetate. In a normal drinker, the acetate moves through the system quickly and exits. But that doesn’t happen in an alcoholic. In alcoholics, the acetate of the first drink is barely processed out, so by staying in their body, it triggers a craving for more acetate. The alcoholic then has a second drink, now adding to most of the acetate of the first drink, and that makes them want a drink twice as much as the normal drinker. So they have another. Then, having almost three times the craving as a normal drinker, they have another.

You can see from that point how alcoholics have no control over how much they drink. The craving cycle has begun and they have no choice but to keep drinking. Once the acetate accumulates in their body, and that begins to happen with only one drink, they will crave another. And how many times does an alcoholic think it would be nice to have just one drink to relax, but has many more? Now you see why. And this can never change.

How the Progressive Nature of Alcoholism Plays a Part

On top of that (like so far it’s not bad enough), alcohol is a poison because it destroys human tissue. The two organs that alcohol damages the most are the liver and the pancreas. So the more the alcoholic drinks as time passes (or doesn’t drink, because the liver and pancreas also deteriorate naturally as we age), the less their body is able to processes the acetate. That is why alcoholism is a progressive, fatal illness.

Bill W. says on page 30, “We are convinced to a man that alcoholics of our type are in the grip of a progressive illness. Over any considerable period, we get worse, never better.” Pretty revealing, huh? It explains many things I never before understood.

But if you think about it, we never have to deal with any of this if we don't put alcohol into our bodies in the first place. So the main problem of the alcoholic centers in their mind and in their spiritual condition. My mind tells me it’s okay to take the first drink and doesn’t see that what I’m about to do is harmful (otherwise known as the obsession or powerlessness), and if I’m not spiritually fit I can’t stand being sober because it’s too uncomfortable (otherwise known as unmanageability). Coincidentally, the 12-Steps deal directly and effectively with both.

So that’s what it means to be an alcoholic – I can’t handle drinking and I can’t handle not drinking.

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