Can alcoholics achieve “controlled drinking”?
“One drink from a drunk,” the AA saying goes. The adage is not meant to be taken literally, for alcoholics can and often exercise amazing control over their drinking. Control is, in fact, an integral part of the disease of alcoholism, and repeated attempts to control drinking are a common symptom of alcoholism. When alcoholics wait until 5 PM to start drinking, they practice control. That’s control when they quit drinking for a day, a week, or a month.
In the early or middle stage of the disease, alcoholics try where, when, how and how often they drink. What they lose as the disease progresses is the ability to control their drinking consistently.
In alcoholics, trying to control their drinking requires intense mental and physical effort (compared to nonalcoholics). As the disease progresses, the effort involved in control increases. While a social drinker might quit for a month and then have a couple of beers once or twice a week, an alcoholic might quit drinking for a month and immediately start guzzling five or six drinks every night. Over the years, the number increases and the days of drinking “two or three” dwindle. Loss of control in alcoholics has a wild unpredictability about it.
Fully aware of the shame and stigma attached to the label “alcoholic” and terrified of losing control, alcoholics devise many different experiments to prove that they can drink like “normal” people. In Alcoholics Anonymous (the “Big Book”), Bill Wilson lists some ways how alcoholics conduct research on themselves. The list is over fifty years old, but some things never change:
Here are some of the methods we tried. Drinking beer only, limiting he number of drinks, never drinking alone, never drinking in the morning, drinking only at home, never having it in the house, never drinking during business hours, drinking only at parties, switching from scotch to brandy, drinking only natural wines, agreeing to resign if ever drunk on the job, taking a trip, not taking a trip, swearing off forever (with and without a solemn oath), taking more physical exercise, reading inspirational books, going to health farms and sanitariums, accepting voluntary commitment to asylums – we could increase the list ad infinitum.
Every alcoholic – and there are no exceptions – has tried at one point or another to drink “normally.” As every alcoholism expert knows, one of the telltale symptoms of alcoholism is the attempt to exert “sensible self-control” by cutting down or quitting. To make the leap from the uncontested fact that alcoholics can and do successfully control or curtail their drinking to the notion that alcoholics can be successfully taught to return to social drinking in the community is more than wishful thinking – it is a dangerous, unsupported theory that if put into practice can destroy people’s lives.
Can alcoholics manage “controlled drinking”?
Yet, despite such cautions, controlled-drinking programs still exist even as the scientific evidence supports the total need for total abstinence.
Teaching people how to control their drinking is not inherently a bad idea. Alcohol is a drug, and anyone who drinks is susceptible to this drug’s toxic and potentially fatal effects. Teaching elementary, middle school, and high-school students about the dangerous effects of the drug alcohol and the health risks associated with excessive drinking or binge drinking is essential. However, any talk about “control” must acknowledge the differences between nonalcoholics, who are not physically addicted, and alcoholics whose behaviour is governed by a neurological addiction to alcohol.
Researchers have been trying to prove that alcoholics can drink in control for over four decades. The end result can be summed up in two words: They can’t.
Given the facts about brain addiction, this should come as no surprise. Alcoholism is not a psychological habit, a sign of collapsed willpower or emotional weakness, or a learned response to psychological, emotional, or physical trauma. Alcoholism is a genetically transmitted neurological disease.
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