Bubovski

With almost four years with SR I have gained some valuable insights.
One of these is that the the first drink, as some AAs seem to think, may not lead to immediate disaster, but that same first drink can set up a very dangerous mind set and eventual doom.
So in the long run AA is right
The big Book seems to teach that some people can drink sensibly and maintain that pattern. Is this really so? An illness (allergy or mental) can come on any time, so why take the risk?
My drinking for the last 20 years, post the really bad years, was reasonable by some conventional standards but far from ideal and constantly a worry re really going over board again.
It just isn't worth flirting with that' moderation mantra'. Booze has zilch going for it and everything against it!
Thanks SR! and especially those super dedicated people here who are fighting alcoholism with a passion.

Gottalife

Well, they reckon that of booze was discovered today it would be banned.

MIRecovery

I think the people who can aren't alcoholics. My father-in-law drank heavily and from the sounds of it even alcoholicly for many years. As he got into his 70s his drinking decreased dramatically and towards the end of his life he would drink now and then but but infrequently at most. He didn't decrease his drinking because he had to he just did.

I never thought he was alcoholic because he controlled it, it didn't contil him

ThomPom

This is a very broad subject and for sure different profiles of alcoholics exist.

Jellinek has detailed different types of alcoholics and different stages of alcohol abusage / addiction, but I don't think this detailed enough to cover all types of alcoholics. It is very easy to google and it might help one to get a first self assessment.

@MI-recovery, maybe your father in law never needed to use alcohol as a buffer for handling life or his own emotions?

advbike

I drank heavily in my twenties, like many.. but then when I was married and began to gain a career in my early 30's, I was able to moderate fairly successfully for another decade. At the peak of my career (age 45) I was in a Fortune 50 company and had 600 employees reporting up to me and a lot of stress. I was back to drinking a 6 pack every night (including two on the way home) until I quit the job, and that career, lol. Not a brilliant move, but it turned out okay.

Before it reached that point, I had tried outpatient rehab and AA, but couldn't stay sober. I was divorced, and dating and simply enjoyed my microbrews and wine too much, even if I had to struggle to moderate it. Once I hit age 50 however, I began to realize it was taking too much effort.. and I was worried about my health.. so I was able to slowly reduce the quantity I drank until it was down to an average of 60 drinks per month. I stayed at that level for a couple more years then finally quit for good when I was 58.

In retrospect, I wish I had quit sooner but I just couldn't. I had anxiety and relationship issues and it was a form of self medication. Because I was able to control it, my ego told me I wasn't alcoholic, so I resisted treatment and meetings. The net result of all that was that I wasn't able to really work on my recovery and understand my relationship problems until the past couple of years. You can't really do any of that until the addiction has been dealt with. So it goes.. we all have our own path to follow and mine has been interesting if nothing else. I have no real regrets. Life is good.

JamesfrmEngland

I don't really believe in "types" of alcoholics.

Gottalife

I might not believe in tax, but there it is.

I listened to a talk partly about how the dsmv views alcohol problems. They use the term alcohol use disorder and have stopped using the term alcoholic. I got the impression that this was, in part, because the badge "alcoholic" created confusion when applied too broadly.

The terms chronic or severe alcohol used disorder covers what AA refers to as the real alcoholic, but that is only a relatively small proportion of the total. AA has an effective treatment program for these types of which I am one.

They told me this is a disorder with a very long tail. There are many variations along the spectrum towards the severe cases and there are effective treatments for pretty much all sufferers who have not yet reached the stage where they have lost the power of choice. Further, most aud sufferers will not reach that stage at all.

NYCDoglvr

Good point. The American Medical Assn. classifies alcoholism as a mental illness. Like BiPolar disorder.

Centered3

Mike, I'm confused. So most people in AA who call themselves alcoholics aren't "chronic" alcoholics? What other type is there? Which type are you?

Please can you shed some light on this?

I was always afraid in the beginning to call myself "alcoholic" because my bottom seemed to be higher than others in my home group, but this might make more sense to me with some clarification. Thanks in advance.

I once heard a circuit speaker explain the difference between a chronic alcoholic and a periodic alcoholic and I am definitely more of a periodic alcoholic, but I don't recall seeing that in the big book.

Gottalife

Hi C3,
It seems there are many types of problem drinkers just as AA described in the big book. Anyone who consumes excessive amounts of alcohol can have a diagnosis of alcohol use disorder. That could be the wayward student, the grieving person, the shocked person, you get the picture. But they grow out of it usually.

Most people with aud could simply decide to stop. At the more serious end of the scale however the option to do that doesn't appear to exist. The symptoms of loss of control and choice were there almost from my first drink. At the beginning they did not manifest in problems, but by the time I was 16, I was diagnosed chronic alcoholic.. no control, no choice. I drank for six more years getting steadily worse until I was unable to continue, yet unable to stop. That is when I got help.

The distinguishing thing with my alcoholism, the reason AA has worked so well for me, is that lack of control or choice. It was there at the end, but it was there all along, even when I was able to function reasonably well. Other friends appeared to have control problems, but they regained control, and they were able to make free choices around alcohol even though for a time they appeared to drink like me.

Control and choice are the criteria, or the progression, though the book does suggest we might have once had the ability to stop on our own power, but then goes on to say that few of us would have seen the need. Control and choice.

Gottalife

Sorry C3, I missed your first question. Small screen.

What I was meaning is that the proportion of all aud sufferers that are at the severe end of the scale are the ones AA refers to as the real alcoholic, and who I think of as the hopeless or chronic alcoholic. It is a small proportion of problem drinkers. These are the folks AA is designed to help. I was not referring to the proportion of AA members, but of aud sufferers.

I was a hopeless chronic alcoholic, and a binge drinker to boot. Control and choice. The chronic part I think means the conditions has existed over a long period of time, and manifests in the same way. Binges may get closer and longer over time.

I am sure there are a good number of non alcoholics claiming AA membership these days, though I can't think why they would want to do that.

advbike

Well I am probably more on the "problem drinker" end of the scale, having been able to mostly moderate my drinking, stop when I had to, and not having suffered blackouts or severe consequences.. My problem stems more from my "thinking", than my "drinking", which was simply my way of self-medicating emotional problems. Yet I have found a lot of value in AA - both from the fellowship, as well as the 12 step program of recovery, which allows one to become more emotionally healthy.

KAD

It was ambiguity about where I fell on the spectrum in some of my earlier visits to AA that was enough to convince me my problem was manageable and maybe I didn't belong there. I even had an old timer I'd never met, and who knew nothing of my drinking past, suggest that I wasn't "bad off enough to need AA." So I left. Six months later I returned in a neck brace, having totaled my car in a blackout and broken my neck. Bad off enough now? Point being, the lines between what constitutes a "real" alcoholic vs a problem drinker is a moving target as far as I can tell. And what alcoholism looks like from one alcoholic to the next is not always clear. The only requirement for membership is a desire to stop drinking, not how we label ourselves.

Delilah1

I learned through many failed attempts that moderation doesn't work for me. I never had a big rock bottom event, just way too many days of not being completely present in my life,

That old cliche if I got sick and tired of being sick and tired really is true.

Bubovski

I don't think "periodic alcoholic" appears in the Big Book.
That was more my genre. Irrespective of type it only takes one really bad episode to go right off the rails, kill yourself or someone else for that matter...........

Bubovski

I think that AA can help people who see their drinking a problem as well as the more serious extreme cases. Perhaps a bit of ambiguity gets in the way.

Gottalife

Strictly speaking this is not true. Out poster version of the third tradition is often misinterpreted in this way. When we look at what was behind this tradition at had to do with making sure no alcoholic was ever excluded. In the early days some groups struggled over whether they should allow alcoholics with other problems or who were different in some way to the mainstream as it was then.

Women, gays, people of different religions, people of no religion, people with serious mental illness. The third tradition was designed to include all who suffer from alcoholism, regardless of any other problems they may have had. The third tradition full form, states any two or more alcoholics may call themselves and AA group provided that, as a group, they have no other affiliation.

In the pamphlet Problems other than alcoholism, the matter is further clarified by the statement that we cannot offer AA membership to non alcoholics.

One of the main reasons behind all of this has to do with the level of treatment necessary for the hopeless alcoholic to recover. AA writes about half measures getting us no where, being fearless and thorough from the very start etc. this was the path I had to take if I wanted to survive.

On the other hand the problem drinker does not need to do this work, because they would have been ok regardless. This is where correct labelling has quite serious implications. When someone claiming AA membership tells me they didn't have to take the steps and therefore I wouldn't need to, not only is that not true, it is quite dangerous to me.

Common problem, common solution. Control and choice. If I have the power of choice, then choice would have been an adequate solution. My problem in common is loss of choice, so I need the solution that works for that.

KAD

Maybe, maybe not. Problem drinkers frequently become alcoholics.

I don't want to make this any more complicated than it need be because it might drive away someone who is already confused enough, but correct labeling as determined by whom? Oneself, an AA member, a doctor, a psychiatrist? I agree it can have serious implications. It can also have serious implications if there is a misdiagnosis. As I mentioned in an earlier post, an old timer suggested to me that I might not be bad off enough to need AA. Obviously, he was very wrong. Serious implications indeed.

If you choose to believe him/her. It is also quite dangerous to others if one attempts to determine for them whether or not AA is suitable based upon a somewhat subjective determination of alcoholism. It is frequently said that only the individual can decide whether or not one is alcoholic. I've read that here at SR many times. How do you really know which is which, and how do you determine the value of the program in any case? It is mostly an individual decision as far as I can tell.

But, again, this kind of conversation starts to look too much like splitting hairs. The net result of that is nobody really "wins" anything, and people seeking help just get frustrated and move along. Plus, it's late and I'm tired and not sure I'm making sense anymore. So...I'm done.

Gottalife

It is pretty simple really. We sit down together on a 12 step call. The recovered alcoholic follows some general direction form the book, sharing his experience with the illness, to see if the prospect identifies. They get talking. They take a look at the big book key definitions of alcoholism, loss of control, and choice, doctors opinion etc, and see if the prospect identifies. A few simple yes / no answers to the question " is this your experience" helps the newcomer determine if this is something they identify with.

Meanwhile the 12 stepper is forming a view as to whether the person is a real alcoholic. You'll find this direction on page 92 I think. If the two relate and are happy they are on the right track the 12 stepper will explain the program, meetings etc, and it goes from there. If the person does not identify and does not appear to be alcoholic, the 12 stepper may still help them find the kind of help they need for whatever their problem is.

That's how I was introduced to AA. That's what AA is, a spiritual program of action for the real alcoholic, and it does not claim anything else. The clear distinction between the problem drinker and the real alcoholic is that the problem drinker can stop or moderate.

The A
alcoholic does not have to be at the "end of the road" to qualify. The literature refers to helping people who were scarecly more than potential alcoholics, by bringing the bottom up to hit them. That really involves detecting the loss of control and choice, which begins to happen long before skid row appears.

A medical expert recently stated that the only effective solution for the extreme aud sufferers ( real alcoholics including those in earlier stages of the disease) is some kind of conversion experience, which AA does via the 12 steps. Other folks with milder forms of aud do not need this, and because they don't need it, they often dangerously assume nobody else needs it. They have a different message to the AA message because they have different experience.

KAD

I understand what you're saying here, but is this really any more (or less) prevalent than people who do self-identify as "real" alcoholics also spreading a somewhat distorted, custom-fit message? I've been active in AA for about 2 years now and I've heard variations (and sometimes contradictions) even among very long-term members, most of whom are sponsors. The ones who may fit your description above, in my experience, tend to stay fairly quiet and avoid attracting attention. Or, if they determine they don't need the program at all, they simply stop coming. If the answer is to always refer back to the message in the BB, that should be the case regardless of the messenger, right?

I read pg 92 in the Big Book. It still sounds like the determination of whether or not someone seeking help is really an alcoholic is largely based upon opinion, and ultimately that of the "prospect." It admonishes the 12-stepper to "be careful not to brand him as an alcoholic. Let him draw his own conclusion." This suggests that it is still up to the individual to make the final decision. There is mention of having the additional diagnosis of a doctor, but as has been pointed out here, many doctors now lump it all together as alcohol use disorder. There are different variations and manifestations of that, would you agree?

For example, for the first 2/3 of my drinking "career" I was only psychologically dependent on alcohol. I could quit with no withdrawal symptoms whatsoever, and I often did. But I kept going until I did develop physical dependence, and quitting created increasingly intolerable withdrawal symptoms. It's a progressive illness. That is not to say the program of AA wouldn't have been as helpful, or useful, to me during first ~20 years as it was in the final 10. It just means I wasn't ready for it yet. I spouted off a lot about what does and doesn't work, but I was mostly trying to convince myself.