wpainterw

Sometimes when folks run into trouble with alcohol they spend a lot of time thinking and debating about what might be the "cause" of alcoholism. They read a lot of books. At least I know I did.
The more I think about this the more I'm inclined to believe that debating the "cause" is a time waster. If there is an answer it's likely to be highly complex, require further research and be impeded by "either or" or "black and white" thinking.
A much more important question, arguably the only question for a person suffering from a drinking problem, is "What do I do about it?" "What can doctors do about it?"
Taking the latter first, namely what can doctors do, here's a preliminary list: (1) help with the detox, which can be dangerous, (2) exercise caution in prescribing medications (avoid, if possible addictive substances, closely supervise refills, conduct urine tests to ascertain whether patient continues to drink), (3) diagnose and treat other illnesses, both physical (e.g. liver) and mental (e.g., depression, bipolar), (4) prescribe exercise and appropriate diet, (5) strongly encourage and assist patient in seeking help from AA or some alternative group support program, (6) advise patient to be skeptical and exercise extreme caution about the possibility of "moderate" drinking, (7) keep posted on continuing developments and research in alcohol studies.
As to the patient, (1) quit drinking and consult the doctor as well as an addiction counselor if appropriate or if required (2) investigate and, if possible, participate in a group program offering companionship and support, such as AA or some alternative, (3) investigate and participate in internet sites offering group support for alcoholism or other addictions, (4) eliminate and dispose or all alcoholic beverages or drugs, other than prescribed, in the home, (5) avoid, if at all possible, all companions who drink or places where drinks are served, at least during the early stages of recovery, (6) avoid isolation (e.g. get out and enjoy things, non alcohol associative activities, people, places) so as to divert the mind and make time pass more quickly.

Wpainterw

Eddiebuckle

I find it interesting how well Bill W et al nailed the disease of alcoholism in the big book. The scientific tools available today to better understand the process and state of addiction would be incomprehensible to someone living in the era of the great depression, yet all that information really hasn't improved on the solution they derived emprically. I suppose it's comforting to know that my "allergy" is an observable fact of neurophysiology, but that doesn't change my situation any more than having a watch changes the fact that I am late for an appointment.

In my heart of hearts I still want there to be a pill that I can take that would allow me to drink again, but I now know that is the kind of thinking that enabled me to cower within my addiction and allow it to continue. My life sober is at times far more challenging than while I was drinking, but this more authentic life is absolutely worth the effort.

wpainterw

P.S.: Please permit me to add to the "patient" checklist something which should not have come as an afterthought, namely: (7) disclose all the facts candidly to the doctor, and specifically the problems with and the extent of drinking.
I learned this from bitter experience. I had been sober for seven years. I had to give a talk in a large city and was suffering from bad throat symptoms. My doctor, to whom I had not disclosed my drinking history, prescribed powerful antihistamines and other medications, some of which I believe were in an alcohol based liquid solution. I managed to give the talk and, congratulating myself with my success, decided to have "just one or two" cocktails at the reception which followed. This began one of many relapses.
Significantly, in the years prior to that, several doctors of considerable professional standing who had teated me for alcoholism had made little or no effort along the lines of items (2) (exercise caution in prescribing addictive substances, conduct urine tests) and (5) (recommend and assist in participation in AA or other support groups) of the checklist.

W.

wpainterw

Thanks Eddiebuckle: Bill W et al. discovered the greatest of all insights, namely that recovery from alcoholism is best done through group support, that "you'd best not to try to do it alone." Developments in medicine since that time have also been helpful but from my own experience I believe that the medical schools should make every effort to train the doctors to provide more active guidance and encouragement to patients in entering AA or other support programs, as well as being appropriately restrictive in prescribing, and mandating periodic urine tests. It is not enough that a patient merely says he or she is abstaining.

W.