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The biochemistry of of craving and relapse?

Old 02-07-2016, 07:27 PM
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The biochemistry of of craving and relapse?

Hi,

This is my first post here.

I had my first experiences with alcohol and marijuana when I was 9 years old. There was a lot of drinking and drugging going on in my home. I drank myself into a black out when I was 9, and used marijuana frequently to sleep. My drinking got more heavy and regular after 7th grade. I drank and did some hard drugs with abandon and was pretty much on the way to dropping out of school. Due to a traumatic experience with hard drugs, I ended up getting clean and sober when I was 15, without the help of any 12 step program (that's how scary it was).

Thankfully, I managed to make a normal life for myself. Aside from some binge drinking in college, I didn't abuse drugs or alcohol.

Then, in my late 20's, I began to have cravings for alcohol. (Technically, in Big Book terms, this would be an "obsession"; however, I experience this as a very physical craving.) Usually it happened when I was under significant stress. It has come and gone over the years and I usually just white-knuckle my way through it. On one occasion my cravings collided with a bottle of wine I came across in my mother-in-law's refrigerator, but I managed not to repeat the experience.

Now, in my early 50's, I am having a major episode of cravings. I've really been feeling more at risk of using alcohol again. I have been discussing it in therapy and have started going to AA and am getting support and so forth. I really have trouble identifying myself as an alcoholic because, after all, it's not like I've been actively drinking like many of the people who come to AA recently sober (or in the process of getting sober).

A kind of "ah hah" moment came to me when I read an article called "Relapse and Craving" on the Bill Moyers on Addiction site. It does describe that an addict can experience bouts of "profound" cravings many years after having gotten sober. The article discusses this phenomenon as a major risk in relaspsing. I've heard it said that alcoholism progresses even when you're not drinking. Like, when you're abstinent, your disease is out there on the lawn doing push ups.

Oh yeah and I have all the major risk factors: alcoholism on both sides of the family, early exposure to second-hand drug and alcohol abuse, trauma history, and early drinking.

So like, yeah, I see myself in this picture. I'm just having trouble accepting it. For years I have been doing everything right -- sugar free, gluten free diet, exercise, meditation, psychotherapy, etc. Why now?

Has anyone else here had this kind of experience? Or does anyone known anything or have insight into how this works biochemically? I mean, I know I just need to learn to accept this and work the recovery program so as to reduce my risk of actually using again. But it would help to understand it better. If possible.

Thanks for listening.
--YA
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Old 02-07-2016, 08:30 PM
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Welcome. This is a great place.

What is going on in your life right now?

I have recently read Peter Michelson's work on the website "Why We Suffer" and found it extremely helpful.

You might want to check it out for another perspective.

Whatever you do --- Don't drink. You have such an impressive life style, don't blow it over something so stupid as drinking.
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Old 02-07-2016, 09:01 PM
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You might like to look into the physiological aspects of addiction, in particular how amino acids restore and support healthy brain function. (Healthy brains don't crave things.)

Stay healthy, be well, and don't fall back into the trap!
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Old 02-07-2016, 09:04 PM
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A bit long, but I think it is just what you are looking for. https://www.youtube.com/watch?v=b2emgrRoT2c
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Old 02-08-2016, 04:02 PM
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Originally Posted by awuh1 View Post
A bit long, but I think it is just what you are looking for.
Yeah, this presentation is _perfect_ . His presentation is clear and systematic. Very helpful. Many thanks!

And thanks to the others who responded as well. I appreciate the encouragement to abstain. With my addict's brain, it's something I need to keep hearing repeatedly.

--YA
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Old 02-08-2016, 04:09 PM
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Welcome to the family. I've got over six years sober and still get cravings to drink sometimes. But I ignore them, or talk back to them, and get thru them sober.

Cravings are just feelings and don't have to become actions.
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Old 02-09-2016, 12:31 AM
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When I first came here I was told by D that relapse is part of addiction its not a part of my recovery that calmed me so much I can't tell you but more than that what it really means to me is I never have to face a relapse I can stay strong in sobriety by working it kinda like fuel for a car it won't run if there's no fuel & if there's no car there's no going anywhere (action)
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Old 02-09-2016, 06:07 AM
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This is a strange one YogaAba. The big book gives an example of somone who stopped on their own power, and drank again upon retiring, nut they were a lot older than 15 when they stopped. It sounds like you stopped in time, before you completely lost control, and that is a wonderful thing. I stopped, having lost the power of choice, when I was 22 and I can appreciate what a huge plus it is to have most of your life free of alcohol, and be able to experience life as it was meant to be.

I have been an active member of AA for 36 years tomorrow. I have got to know a lot of old timers, say 25 years plus, in that time and while I am aware that some old timers pick up, I don't know any that have reported fighting cravings to drink. It's never happened to me or anyone I know.

Those with some time up who relapse, I'm remembering a few in the 3-10 year, all reported drinking for some trivial reason or, on quite a few occasions, just picking up a drink without any thought. Those that make it back often can point to things happening like not working with others, withdrawing from AA, or getting into old bad habits again as the type of things that indicated a relapse was on the way. It didn't happen out of nowhere, there was a regression in thought processes sort of thing.

What you describe sounds much more (to me) like when I gave up cigarettes. Monumental cravings for quite a long time. But I have never experienced that with alcohol in sobriety.
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Old 02-10-2016, 06:57 AM
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Originally Posted by Gottalife View Post
This is a strange one YogaAba. The big book gives an example of somone who stopped on their own power, and drank again upon retiring, nut they were a lot older than 15 when they stopped. It sounds like you stopped in time, before you completely lost control . . . What you describe sounds much more (to me) like when I gave up cigarettes. Monumental cravings for quite a long time. But I have never experienced that with alcohol in sobriety.
I quit smoking when I was in my early twenties. I continued to have cravings, diminishing in power, for the following ten years. And then I never had them again. For me, alcohol seems to be quite different.

That video by Dr. McCauley (posted above by awuh1) is instructive. The physical addiction is always there. As long as one keeps "spiritually fit", stress levels will remain manageable. It is when stress levels rise too high that the brain can't handle it and the craving kicks in.

With respect to age, what the brain science folks have revealed is that actually one is at much higher risk of developing addiction to a substance in the teen years because that's when the neural patterns are forming. That indeed is when many people become addicted (just take a look at the poll in this very forum and you'll see a huge numeric bulge in that age group of when people started drinking.)

--YA
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Old 02-10-2016, 08:10 AM
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I think the key is, if you're getting cravings, they're being caused by something, and figuring out what's going on is the way to stop them. I don't believe in the "disease doing pushups" theory, there's no basis for it, but it is true that people who relapse after long sobriety often fall deep down the hole quickly. Some reasons why (there are many more links if you google around) are linked below. So if you're really contemplating drinking again, it might be a good time to dig into what's going on and increase your support.

http://alcoholrehab.com/addiction-re...s-in-recovery/
http://alcoholrehab.com/addiction-re...er-many-years/
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Old 02-10-2016, 08:28 AM
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Originally Posted by JeffreyAK View Post
I think the key is, if you're getting cravings, they're being caused by something, and figuring out what's going on is the way to stop them. I don't believe in the "disease doing pushups" theory, there's no basis for it, but it is true that people who relapse after long sobriety often fall deep down the hole quickly. Some reasons why (there are many more links if you google around) are linked below. So if you're really contemplating drinking again, it might be a good time to dig into what's going on and increase your support.
Thanks so much for these links for the good point. I did do a lot of soul googling for material on this topic, but I missed these.

Again, in light of the brain science, an alternative explanation to the "disease doing pushups" theory is simply that the strength of the cravings is proportional to the level of the stress that triggers them.

And you are 100% right: I am dealing with some stressors in my life right now that are pretty huge, combined with being over worked and stressed out by my job. It's kind of a bad mix. I am getting support for these things. It's just going to take TIME, and drinking would certainly make it harder to make progress on the issues.

To say that I am "contemplating drinking" doesn't quite describe it. It's more like my body wants to drink so badly that it's almost going to take me someplace I don't want to go all on its own. This again is consistent with the mid-brain survival urge thing.

To Gottalife's point: I really do feel my experience is not typical of folks in AA. I don't doubt that I have an honest to goodness addiction. But he's right that it somehow did not get as out of control as it is for folks by the time they get to AA. So I feel like I have a physical addiction but am not an "alcoholic" in the AA sense of the word.

It makes me wonder whether AA is the right place for me.

Thanks again.
--YA
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Old 02-10-2016, 02:02 PM
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hI Yogaabba

It may not be common but it's certainly not unprecedented to 'become' an alcoholic in your 50s or 60's...sadly it's also not unprecedented for some to return, or feel a pull to return, to drinking after a period, even if that period that may be decades long.

I've seen examples of both things here on SR.

If your facing some huge stressors right now, that might be enough for the obsession to return?

The one thing I think we can all agree is common ground is that this addiction can be relentless.

There's a lot of support here though and I hope to see you around the place
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Old 02-10-2016, 06:22 PM
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Originally Posted by Dee74 View Post
It may not be common but it's certainly not unprecedented to 'become' an alcoholic in your 50s or 60's...sadly it's also not unprecedented for some to return, or feel a pull to return, to drinking after a period, even if that period that may be decades long. . . . If your facing some huge stressors right now, that might be enough for the obsession to return? . . . .
Yes, they are clearly enough for the obsession to return. I am beginning to think of the obsession as an unhappiness index. When I am not consciously aware of being discontented, this is what happens. I need to figure out how to work my way back towards equanimity.

The one thing I think we can all agree is common ground is that this addiction can be relentless.
There's a lot of support here though and I hope to see you around the place
Relentless, mysterious, and baffling. I'm trying to let go and just accept this thing as it is.

One thing I have also found, both in forums such as this one and in AA meetings, is that other recovering addicts are kind and generous with each other. Folks also don't hesitate to bust on someone when they need a push in the right direction. That can be supportive too.

Thank you for the welcome and the support.
--YA
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Old 02-11-2016, 12:12 AM
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Restless and discontent appear above, the only word missing is irritable and you would have the AA descriptions of things that preceed a relapse. I thought Dee also made a good point about alcoholism in later life, as did you about the effects on the adolescent brain. The book reckons that most of them could have stopped earlier without to many problems (as you did) , but that they lacked the will at the time. Things then were not too bad.

The actual cause of relapse is a little harder to define, again in AA terms. The key seems to be our reaction to life. Whatever life throws up, stressful, boring, tragic, mundane seem to be external circumstances that can cause relapse. But is it the circumstance, or our reaction to the circumstance. People drink because of a major tragedy, or because they had an argument over nothing with someone, for example. Those two circumstances are so vastly different we might even call the first understandable and the second stupid.

That's why I believe it is not the event, but our reaction to it, and the AA approach is to bring about a profound change in our reaction to life through a thing called a spiritual awakening brought on by working the steps.

An alcoholics usual reaction to an event might be fight, flight, resentment, drink. That reaction can be changed to forgiveness, contrition, love, positive action, courage, amends. The change is not conscious, the new characteristics simply become part of our nature. We react differently.

I believe it is not what is going on in our external world that causes us to drink. Think about how impossible that would be, to eliminate all triggers and get life so perfect that we wouldn't have to drink. It would never happen. But if we can find a way to react differently, then whatever life throws our way, we will be able to handle.
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Old 02-11-2016, 05:27 AM
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Originally Posted by Gottalife View Post
Restless and discontent appear above, the only word missing is irritable and you would have the AA descriptions of things that preceed a relapse.
Yes, I am also extremely irritable. I don't remember ever feeling this irritable in my life. I completely identify with "restless, irritable, and discontented."

The actual cause of relapse is a little harder to define, again in AA terms. The key seems to be our reaction to life. . . . That's why I believe it is not the event, but our reaction to it, and the AA approach is to bring about a profound change in our reaction to life through a thing called a spiritual awakening brought on by working the steps.
Yes, I can see this too. I believe that major stressors and a boatload of mounting resentments (you should see the list I've been making in anticipation of the fourth step) pushed me into this state of restless of irritable and discontented, but in this state I can see that the most minor and ridiculous things are sending me in the direction of liquor. And so, too, in a deeper sense, I could have a different reaction to the big things as well.

An alcoholics usual reaction to an event might be fight, flight, resentment, drink. That reaction can be changed to forgiveness, contrition, love, positive action, courage, amends. The change is not conscious, the new characteristics simply become part of our nature. We react differently.
Thank you for this beautiful description. It has given me a much deeper appreciation for what can be attained by working the twelve steps and for what I can aspire to.

Thanks again.
--YA
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