Is Alcoholism a Disease?

Day 97! A gloriously sunny, sober Saturday. Children still slumbering and the husband out hunter gathering (buying coffee and newspapers) on the streets of Chelsea.

Spoiler alert: this post is somewhat controversial. Please do not feel obliged to agree with me, in fact all debate warmly encouraged!

It was announced in the press yesterday that Charles Kennedy (see my post: When the wine witch wins. Part 2) was, indeed, killed by his alcoholism. He had a 'massive haemorrhage'.

This news caused yet more discussion about alcoholism in the press, which you might think is a very good thing. Here's a typical quote from the Guardian:

“I also hope that politicians of all parties develop a better understanding of alcoholism, take it more seriously and devise policies to treat it as a disease on a par with the other major diseases."

And, yes, it would be good for "all parties develop a better understanding of alcoholism", and to "take it more seriously," BUT all the language used is designed to distance the commentator, and the vast proportion of the population, from the problem.

What they are, in effect, saying is "pity those poor souls that have this terrible disease they can do nothing about. Thank goodness the vase majority of us don't have it! Let's raise a glass to that!"

They think they know what the 'disease of alcoholism' looks like. It's the homeless wino in the gutter. It's the girl collapsed, in a pool of her own vomit, outside the nightclub with her knickers on show.

It's not them with their 'civilised' half bottle of wine with a colleague or client over lunch, gin and tonic when they get home, and another bottle shared with the wife at dinner. Oh no.

I don't believe that alcoholism is a disease or an illness. I'm with Jason Vale and Alan Carr, who believe that 'alcoholism' is a drug addiction like any other.

Some people are more prone to becoming addicted more quickly. The Horizon documentary on the BBC recently showed how some racial groups (e.g. Irish, American Indians) are, because of the slow speed with which they metabolise alcohol, more likely to develop alcoholism than others (e.g. Japanese, Chinese).

And 'nurture' plays a part as well as 'nature'. If you're raised to believe that drinking daily, copious, amounts of alcohol is the norm, you are more likely to do so yourself.

Certain professions encourage 'alcoholism' for the same reason: advertising and media, journalism and investment banking for example.

Plus, anyone dealing with any form of 'emotional damage' is far more likely to become hooked on the blurry oblivion provided by alcohol (and other drugs) in order to fill the 'hole in the soul'.

But, the truth is, that just like heroin, nicotine, cocaine and any other addictive drug, anyone who drinks enough alcohol over a long enough period of time will eventually become hooked.

Sooner or later your brain chemistry is permanently altered such that it becomes reliant on your drug of choice (in this case alcohol) for dopamine. Eventually your cucumber becomes a pickle (see Moderation. Is it possible? Part 2 for more on this one)

Going back to the quote from yesterday's papers, if it had read like this: “I also hope that politicians of all parties develop a better understanding of alcohol, take it more seriously and devise policies to treat it as an addictive drug on a par with the other addictive drugs"  then that would be helpful. That would be a game changer.

Why? Because talking about it that way makes it clear that no-one is immune. It would encourage people to question their own drinking habits before they become too entrenched. More and more people would jump off the elevator before it gets to rock bottom.

As a society we insist on treating alcohol differently from other drugs because a huge proportion of the population are using it. The same used to be true of nicotine. At one point even doctors promoted smoking as, not just harmless, but healthy! How extraordinary that seems now.

I understand that talking about alcoholism as 'a disease' or 'an illness' ensures that people struggling with it are pitied rather than scorned, which is something. But even when we manage to 'recover' they feel sorry for us, trapped in a world without alcohol for ever.

Do we want pity? If alcoholism was seen for what it is - as a chronic addiction that anyone can be sucked into - then those of us who manage to break the chains would be envied and lauded. We wouldn't be hiding behind anonymity in church halls, or pseudonyms on the internet.

We have to stop blaming 'the disease' and start blaming the drug.

Only then can we give people proper help before they get to rock bottom, like Charles Kennedy. Only then can we properly counsel our children. Only then can we stop, not just the effects of alcoholism that people know about - like fights in city centres late at night and cirrhosis of the liver, but the effects they don't see: the gradual leeching of talent, ambition and energy of vast hidden swathes of the population.

Wake up, and smell the coffee (on a glorious hangover free, sunny day like today) people.

Feel free to disagree vehemently in the comments section below!

Love SM

Related post: Is Alcoholism a Disease? Part 2

Role Models

DAY 60!!!

I heard yesterday that a new movie of Absolutely Fabulous is being released. I was overcome by a huge wave of nostalgia for the wonderful Patsy (Joanna Lumley) and Edina (Jennifer Saunders).

In the early 1990s, when I was in my twenties, Absolutely Fabulous (or AbFab as we called it), was my favourite comedy sitcom - along with Friends, obviously. Not only did I adore Patsy and Edina - I actually wanted to be them.

And with my great fondness for nicotine and alcohol, plus my high paying advertising job, love of Harvey Nichols and convertible sports car, I was a pretty good approximation. For me, they were not an ironic comedy duo, they were role models.

So when I heard the news yesterday I looked them up on YouTube for a trip down memory lane (isn't the interweb just marvellous?).

Now please, please check out this compilation of 'Edina and Patsy's Finest Moments'. The amount they drink, in just this seven minutes, is horrifying. But at the time I honestly thought that drinking every day, and with abandon, was cool, rebellious, kooky and cocking a snoop at the establishment and the uninspired.  Just like Patsy and Edina.

These two were obviously extreme examples, but they weren't my only role models. My parents drank every evening. Gin and tonics before dinner. Wine with dinner. And, for my Dad, a brandy or whisky afterwards. They were never drunk, but often drinking.

All my friends drank, at least they did whenever we met up, and I assumed they did at home too. I never felt any concern, stigma or shame about daily drinking, or drinking at home alone.

The 1990s were, if you remember, the era of the 'ladette'. The cool girls who refused to be demure and cute, but worked hard and played hard with the men. Zoe Ball, Denise van Outen, Tara Palmer Tomkinson and the like, were pictured out drinking hard every evening (or so it seemed).

One of my main reasons for quitting now is so my three children don't grow up thinking that drinking every day is normal. Their example will be a mother who doesn't drink at all, and a father who drinks from time to time in moderation (goddamn him!).

Then, hopefully, even if they've inherited my 'caution to the wind' genes, they will at least question their habits well before I ever did. With luck, and good role models, they will keep their cucumbers unpickled (see Moderation. Is it Possible Part 2 if you don't get the cucumber reference - it's important!) and be happy, moderate drinkers throughout their lives.

I could hate Patsy and Edina for leading me astray, but I only have myself to blame and, the truth is, I still have a huge fondness for them in all their flawed fabulousness. The problem is that their new film, I'm sure, will portray them as unchanged - still chuffing and chugging away twenty five years later.

Yet we all know that, if that were really the case, they'd either be in rehab or dead. But where's the comedy in that?

An absolutely fabulous day to all of you.

SM x

Moderation. Is it possible? Part 2

Day 55. Since I wrote Moderation. Is it possible? I found a fabulous insight into the topic in Caroline Knapp's 'Drinking, a love story,' so I thought is was a subject worth revisiting.

Knapp explores the neurological and physiological reasons behind alcohol addiction. Don't panic, I'm going to explain this in easy terms so that I can unserstand it properly, as well as you!

She explains that when the brain is 'excessively and repeatedly' exposed to alcohol (that'll be me then!) its natural systems of craving and reward are screwed up.

When we drink, our brain's reward system is artificially activated, and it produces dopamine. Dopamine is the brain's 'feel good' chemical. Over time, the brain susses out that it's producing far too much of the stuff, so it compensates by kicking into reverse gear and actively decreases our base levels of dopamine.

That's why, over time, drinkers feel more and more depressed, and start to believe that only alcohol will make us feel better. We're not actually wrong. Drinking enables us to produce dopamine again. What we fail to understand, however, is that it was drinking that caused the problem in the first place.

Effectively, we reach a tipping point where alcohol stops being the solution and starts being the problem.

The good news is that as soon as we stop drinking our brain gets back into balance, and starts producing the happy hormone again all on its own. In fact, in the beginning it can overcompensate. A bit like a rubber band pinging back into position, it initially overshoots. This is why ex drinkers experience the 'pink cloud' stage, followed by a series of ups and downs as our brains struggle to find equilibrium again.

The bad news is that by now our brains have been hard wired to believe that alcohol equals pleasure. Years of our dopamine levels being controlled by alcohol have, in effect, created the 'wine witch' in our heads. And the only way to shut up the wine witch is to not drink.

Knapp uses the best analogy I've heard to explain why alcohol addicts can't drink 'normally' again - that of cucumbers and pickles. She says that you can stop a cucumber turning into a pickle, but once it is a pickle it can never be a cucumber again.

If you're reading this thinking 'am I a cucumber still, or am I already a pickle?' have a look at 'Am I an alcoholic? Part 2' and try Bill Wilson's moderation test. If you find it impossible, over a decent length of time, to stick to drinking just one small drink a day then it is probable that your brain chemistry has already gone haywire. You have, in effect, pickled it.

I know this all sounds a bit depressing but, on the upside, it shows that you are NOT weak willed or pathetic. You are dealing with powerful physiological forces that 'normal drinkers' don't have to face. It is not your fault - it's the fault of the drug.

Plus, there are physiological reasons why you're feeling miserable (if you are) and you will get better. In fact, once we sort out our bain chemistry we should be able to feel as good as we ever did after a large glass of vino all the time!

Have a great weekend, all you fabulous pickles,

SM x

Related Posts: Moderation. Is it possible? What's so great about moderation anyway?