Chino

In my AD's case, she's still on our insurance.

Rates of alcoholism in foreign countries have always been of interest to me. About 10 years ago I called the National Council on Alcoholism and Drug Dependence and asked about it. Their answer at that time was that foreign countries don't track alcoholism like we do. They were of the opinion that it was actually higher than in our country.

AbsentFriend

Insurance: Medicaid? If the incidence of mental illness among alcoholics is as high as I think it is, most may qualify for disability. Not sure though - functional impairment may have to be proven.

Thanks, Chino. Nice initiative, actually calling around! Too bad other countries don't track it - I'd be curious if it were true that the rate of alcoholism was higher elsewhere, and if it had anything to do with the purely genetic component: exposing more people to alcohol than would otherwise choose for themselves to pick up the first drink. I'm sure there are plenty of Americans who have simply never chosen to drink, (or were too afraid to), and thus never discovered (lucky for them) that they had all the markings of an alcoholic or addicted brain.

I drink, and have gotten drunk, but was never the partier and never did anything harder. However, I think very much like an alcoholic/addict, being that I'm an ACoA. My boyfriend says, "You might be the only addict who's never done drugs. That's probably what saved you." I go to NA meetings with my boyfriend, and after every one, all I can think is, "There but for the Grace of God go I."

nandm

Quote:

Originally Posted by AbsentFriend

Insurance: Medicaid? If the incidence of mental illness among alcoholics is as high as I think it is, most may qualify for disability. Not sure though - functional impairment may have to be proven.

Disability is extremely hard to get. You have to have not worked for a year because of the disability to even be considered, then you have to go through the lengthy and intense application forms, then wait, and wait, and wait (for most it is a minimum of 3 months), and most people are denied the first time they apply, so figure out what was written wrong the first time, then fill out the paperwork again, then wait, then wait, and the struggle goes on. To many people with a mental illness it is enough struggle just to get up and put one foot in front of the other each day let alone go through that process. And then there is the concern of if someone hasn't worked for a year then can they even afford their meds right now and if they can't then they probably are not able to fill out the disability paperwork. The red tape of our social security and disability system is amazingly complicated and confusing for someone who is doing well mentally forget it for someone struggling.

It is actually a shame that our country does not take better care of it's mental health population. Instead many wind up homeless, living off the grace of others, in nursing homes, etc...

SpringRose

Yikes! nandm and I agree on something. One of us must be wrong!

Peter

We live in a very "pill oriented" society. From the moment we are born to the day we die we are given drugs and bombarded with information that there is a drug "for what ails ya". From hair loss to impotence. From flattulence to restless feet syndrome to toenail fungus. You name it there is probably a wonder drug out there , all with some potentially lethal side effects. We seem to have this conditioned belief that whatever happens the medical community will come up with a drug to fix us. It is no wonder that we persist in the belief that we will soon have a drug too for one of mankinds oldest scourages alcoholism and addiction, but I am willing to bet good money that we will see no such invention in my lifetime or in fact for a very very long time. Why, simply because of what I and many other people in AA already know to be true that the real nature of addiction resides in our minds and requires a spiritual approach. Treating the physical manifestations of addiction with drugs is just a short term solution to the problem. The symptoms rather than the affliction.


Quote Jeff70204

Jeff I hope I am not misunderstanding you. but if this is your belief then i am sure you must realize that AA may never work for you.

AA is a programme of complete abstainance and only a profound change in your thoughts and ideas about drinking will have any long term effect.

Chino

I spent a few minutes debating back and forth with myself over my response to that. Not to argue with you but to attempt to look at all angles.

I agree with you to an extent. If my AD had been inoculated against her DOC, she still would have possessed certain behaviors that are detrimental to her well being and might have led to other addictions. But that begs the questions, do those behaviors reside in her mind and do they require a spiritual approach?

Yes, they do reside in her mind and the mind is the brain. If the brain is malfunctioning does it require a spiritual approach or a scientific approach? Knowing her circumstances, it requires both. Spirituality as a coping mechanism and ongoing treatment towards that, and medical science for her physiological issues.

AbsentFriend

But is the brain "malfunctioning" first, or has the substance caused the malfunction that remains?

While I do know that being drawn to a substance in the first place is the result of other issues (mental illness, dysfunctional family, etc.), my instinct is to say that while certain minds (brains) are structurally receptive to addiction, but any physical/measurable "malfunction" is a direct result of the substance itself.

Much the same way that certain people are predisposed genetically to be depressed, but if life circumstances never trigger that predisposition, that person never becomes depressed. Depression itself, if it is triggered, then leads to measurable malfunctioning - sleeping, eating, etc.

nandm

I do wonder where you get this information from as to my knowledge the cause of alcoholism has never been completely proven. Many people who have rough childhoods, mental illness, etc.... do not wind up using substances to escape. Many people who have never had those things occur in their life wind up abusing drugs or alcohol. To say that people with substance abuse problems were drawn into it because of mental illness or rough childhoods is a statement that I do not believe any research will back up as substance abuse occurs in all types of people with all types of backgrounds.

Chino

That made me smile. My first thought was chicken or egg? Either way, it has to be treated. Or plucked

AbsentFriend

Well, exactly - that's my point. Almost NO mental illness has a proven cause - the only DSM disorders whose origins are somewhat known are the developmental disorders, (MR, autism, etc.) and schizophrenia. And even then, it cannot be proven that one thing always causes each, or that one thing can prevent each. Only that they have certain genetic features in common.

The only non-organic disorder with a specific trigger listed in the diagnostic criteria is PTSD. Again, not everyone exposed to the kind of trauma listed even develop the disorder.

In the same way, not everyone exposed to a substance gets addicted - just as you said. I am an example of someone with a "rough childhood" who chose to stay away from any substance (until I was legal) for that very reason - I saw what alcohol turned my parents into. I do drink now, but I am very aware of the potential for problems, and I work very hard on paying attention to when I feel like "using" alcohol to tame anxiety, for example, rather than just for enjoyment. If I notice that tendency, I do something else instead. (I still escaped when I was young - just into books and school activities instead.)

In every case, there are protective factors and risk factors - it is the critical mass of these things present in a given individual that determines whether they will develop the disorder, and even then, no two individuals with the same disorder are completely alike.

My younger brothers are both intelligent, but still - they both drank in high school (yet another risk factor), and one of them recently had to stop drinking altogether because he saw unhealthy behaviors in himself that he just couldn't control once he picked up his first drink. This clearly illustrates a difference in genetics - I simply lucked out that one drink doesn't have that effect on me. Still, if my brother did not have a good life now, he would probably return to drinking and get much, much worse. But since he has the current protective factors of having escaped the house we grew up in, being intelligent, having a strong work ethic, and being extremely honest about his issues, his desire for one drink doesn't get the best of him.

And that is what 12-step programs do - they provide people who happened to lose the addictive-genetics lottery with other protective factors: spirituality, community, support, validation, normalization, options for better choices.

We already HAVE pills for depression, but the incidence of depression is NOT going down. If there were a Depression 12-step group, I believe that would make all the difference in the world.

Post-Script: While it is true that addicts are you have also said elsewhere that I do believe that the phrase "character defects" is interchangeable with "other issues," and can constitute learned behaviors, perceptions, and attitudes as a result of mental illness, growing up in a dysfunctional family, etc.

nandm

Quote:

Originally Posted by AbsentFriend

But is the brain "malfunctioning" first, or has the substance caused the malfunction that remains?

While I do know that being drawn to a substance in the first place is the result of other issues (mental illness, dysfunctional family, etc.), my instinct is to say that while certain minds (brains) are structurally receptive to addiction, but any physical/measurable "malfunction" is a direct result of the substance itself.

Much the same way that certain people are predisposed genetically to be depressed, but if life circumstances never trigger that predisposition, that person never becomes depressed. Depression itself, if it is triggered, then leads to measurable malfunctioning - sleeping, eating, etc.

While I appreciate the explanation from your last post, I do not see where it actually addressed the statement from your OP, in red above. That is the statement I was addressing. I do not disagree with you on the points you addressed in your last post.

What I do not agree with is "being drawn to a substance abuse in the first place is the result of other issues (mental illness, dysfunctional family, etc)." IMHO this over simplifies and generalizes the problem. Not all people who are drawn to substance abuse have mental health issues or come from dysfunctional families. IMHO to generalize them and lump them into this category is incorrect. I know of people who do not fit into the neat little category that your statement would have them fit into yet they have substance abuse problems. It is no different than if I were to generalize that all Pit Bull dogs are agressive because I have seen and heard of agressive Pit Bulls. Yes, many have been trained and/or bred to have this behavior but it does not mean all of the dogs have it. Just as all substance abusers did not start using because of poor child hoods or mental illness.

It would be nice if substance abuse were as simple as your statement makes it sound. If that were the case then the problem would be much easier to solve.

29a

one definition of the word miracle- An exception to the laws of nature escaping scientific verification since it cannot be repeated at will but is dependent upon the necessity of grace. ...

The twelve steps have proven miraculous in my life. I would not expect someone who has not worked them to understand them. I cannot claim to understand why they work either. To believe everything can be understood by the human brain is arrogant.

I respect everyones opinions, however, I feel sharing negatively about a recovery option that has saved hundreds of thousands, if not millions of lives on a recovery site is incredibly irresponsible. Some one who might be saved via AA might take your opinion as fact, and take it all the way to the grave.

Emimily

taking a pill doesn't stop someone from being an *******. i was an ******* when i drank - that's why i got sober. if there's an anti-******* pill on the market, i can think of a good amount of folks that oughta take it...

Jeff070204

I think you understand me just fine, Peter. I do not know, and may never know, whether "AA worked for me". The most reasonable statement I can make now regarding my experience is that I was spared by a power or powers greater than myself.

If you'll review my posts, I think I've explained clearly enough how and why I came to attend AA meetings, and continue to do so. And to be fair, I cannot say with any real honesty that the reasons for the emphasis on total abstinence -- why alcoholics can't moderate -- were never communicated to me. It may simply have been a case of my not wanting to hear those reasons. Most likely, it was a combination of my not wanting to hear them AND their not being communicated to me clearly, or emphasized enough.

When I came to AA and to treatment centers, I heard a great deal about spirituality, the waiting list to get into Mather, rigs, having a sponsor being a requirement, "the first 164 pages", "rippin' & runnin'", thirty- sixty- or ninety-days, T-houses, God, the County, CPS, potlucks, Bill W., and birthdays.

Somewhere in there, I'm sure, the reasons why I, as an alcoholic, needed to stop drinking entirely were addressed to some degree. I'm reasonably sure they were couched in terms like "powerless", "insanity", and "obsession". The message didn't get through to me.

As I continued to drink after my first stay in a treatment center, I began to sense vaguely -- but not really understand -- the gravity of what I was facing. As I say often in meetings nowadays, what it took 17 years to do to myself the first time, the second time took four months. I got a taste of what drinking myself to death might be like.

I reached a point where the threat posed to me by the alcohol itself outweighed the threats posed to me by poverty or unemployment or debt or loneliness or "anxiety". I wanted to stop drinking because, as I stated in my original post, I had had it with the whole business -- enough was simply enough.

Again, I asked for help, because obviously at that point I couldn't simply stop -- if for no other reason than the withdrawal symptoms would likely kill me. I was hospitalized for a day or two, and that was the end of the "medical treatment" of my "disease". Still shaking and shaken, wobbly, unable to stand up or sit down without assistance, I went right back to an AA facility.

The difference of course, this time, was that I had decided to stop drinking, and wanted to stay stopped. I accepted AA into my life as an inescapable consequence of what I had become in our culture. And I hoped that one day "the Program" would begin to work with me or even for me, as opposed to against me. I am eminently grateful that this has indeed come to pass.

AbsentFriend

I think we are missing what each other is saying. I'm sorry if it seems like I am trying to simplify the problem - addiction is anything BUT simple. It involves a complex interaction of behaviors and thought processes.

To put my original thoughts a different way, it is precisely BECAUSE the illness is so complex that it CANNOT be mere coincidence that it appears around the world and among diverse people. The internal complexity itself is so similar across people, that there must be SOMETHING they all have in common. It can't just appear out of thin air.

I believe it can be understood from the perspective of Convergent Evolution in the cultural realm. Two people may come from completely different backgrounds, and be geographically separate, but if their environments require things of them that are similar, they will adapt by similar mechanisms and develop similar traits - for example, escape into substances as a coping mechanism.

Based on this theory, one can be from a happy family, or from a dysfunctional family, and be equally likely to develop an addiction in either case. So we have to look deeper. These situations are different on the surface, but what do they have in common on the structural level?

Growing up in a happy family, being cared for and protected, might be comforting at the time but may prevent the child from dealing with real problems on his/her own, and lead to fear of confronting many aspects of the real world. On the flip side, a child learns fear very early on, learns to protect him/herself the best way a child knows how, and comes to believe that if he/she is not in control at all times, reality will hurt them deeply. Again, reality is to be feared.

So, the common thread is Fear. And if one is afraid of things that other people appear to handle with ease, then along with fear comes shame of being afraid, and self-hatred. Not to mention anger that life is harder than expected. All of these can occur in different environments for different reasons, but the coping mechanism is the same.

nandm

Thanks for the explanation. I understand your point a lot better now. It does make more sense. I do think there is more to it than the theory would lead one to believe. I believe there is also a genetic component to it. Just as their is a difference in the brain chemistry of a person with a mental illness I believe that medical science will find that there is also a difference in the brain chemistry of alcoholics and addicts. Just my personal opinion though based on the fact that both of my grandfathers were alcoholics; on my mothers side out of herself and her 3 siblings, 2 are alcoholics; on my fathers side out of himself and 8 other siblings, he and one of his brothers are not alcoholics, the other 6 are and several have died from the disease; as far as cousins the rates are greater than 50% being alcoholic; out of myself and four siblings, 3 of the 5 are alcoholic and one of the remaining two is anorexic. Of my 3 children, one is only 12 so I can not predict her future but two have fought with substance abuse, one of which no longer uses or drinks anything the other still plays the lets see if I wind up addicted to alcohol game. Personally, what I see is a variety of different people raised in different environments with a genetic link that has predisposed them to substance abuse. Just my opinion. I am still waiting to see what the final verdict is from the medical science community.

bugsworth

Jeff, I can identify with you regarding finally just wanting to stay stopped. I had more than my share of beat downs from the bottle. I too went to aa thinking that, like you, it was an inescapable consequence of what I had become. I too am grateful that I no longer believe that. Enough is enough now extends to many areas of my life. Best of luck!

Jeff070204

Another thing that I wanted to mention was that science has pinpointed the part of the brain where the "phenomenon of craving" described in the AA Book's Doctor's Opinion lives. It is called the nucleus accumbens, located behind the bridge of your nose. This is the part of the brain which is different in an addict than in a non-addict.

I learned this tidbit of information not in any meeting or anything AA-related, but in an interview I happened to see with Dr. Drew Pinsky on some show on CNN, I believe.

Learning this little bit of information was of great significance to me -- it validated the AA tenets of the nature of an alcoholic as "bodily and mentally different from his fellows", which I previously felt I had to accept merely on faith.

It would appear that even though he didn't have the modern physiological technology to back up his assertions, Dr. Silkworth (the "Doctor" of the Doctor's Opinion) essentially had the nature of the disease dead to rights.

nandm

Jeff,
Thank you for the info. I googled it and found more info that backs up what you said. Here is a link to more info for anyone who is interested:
nucleus accumbens - Research the news about nucleus accumbens - from HighBeam Research

It just backs up my thoughts on addiction/alcoholisms not being just an environmental issue.

nandm

This is an interesting article that goes into more depth about addiction and genetics.

Here is a quote from the article

Quote:

These data have
led to the hypothesis that DRD2 deficiency or downregulation
may predispose subjects to drug use as a means
of compensating for the decrease in activation of reward
circuits activated by these receptors (Blum et al., 1996;
Volkow et al., 1996, 2002)

Link to article:
http://www.bnl.gov/thanoslab/Thanos%...ER%20Paper.pdf