evening came, I pushed the vows I’d made to the back of my mind. Sound familiar? For you it may be a different drink, a different cycle. Perhaps your drinking is not quite as bad, or maybe it’s worse. The bottom line is that when we discover we are unable to control our alcohol, we blame ourselves. It’s easy to do. Society blames us; our families blame us; our friends look at us with pity, wondering why we can’t get our lives under control. We live in a state of constant self-loathing. What if it’s not your fault?
It is difficult to be drinking more than you would like. You start to hate yourself, feeling weak and out of control. If you hadn’t hid your problem so well more people would judge you, wondering why you can’t simply “get it together,” “be responsible,” and “take control.” After all, they drink but don’t seem to have a problem.
If you are like most problem drinkers, you interpret your inability to control your drinking as weak willpower or a personality flaw. If only you had more willpower, you could drink less or abstain. If only you could quit for some unknown length of time, your desire for alcohol would diminish. You would finally be like all the people you know who seem to be in control of their alcohol, who seem to be able to take it or leave it. But wait. Are you weak-willed in other areas of your life or is alcohol a strange exception? I am distinctly not weak-willed, as people who know me can attest. Isn’t it strange that I seem to lack willpower in this area?
Does it make any sense that alcoholics—those who need to control their drinking most—are the same people unable to do so? Why can’t they simply exercise their free will and stop? Is there something, apparently undiagnosable, that makes certain people less able to control their alcohol consumption than others?
Am I an Alcoholic?
So what is an alcoholic? And how do I know if I am one? The majority of adults drink. According to the National Institute on Alcohol Abuse and Alcoholism, a whopping 87% of adult Americans drink.23 What differentiates the casual drinker, the moderate drinker, the heavy drinker, the problem drinker, and the full-blown alcoholic?
According to Paying the Tab by Philip J. Cook, if you drink a single glass of wine each night you’re in the top 30% of all drinkers. If it’s two glasses, you’re in the top 20%.24 That means that 80% of adults drink less than you. But many people who imbibe a glass or two of wine with dinner do not fit the stereotypical description of an alcoholic. Alcoholism isn’t strictly defined by how much or how often you drink. There is an invisible and ill-defined line that categorizes the “true alcoholic.” Since the line is arbitrary, and alcoholism does not have a standard definition, how are you supposed to know if you actually have a problem?
A quick Google search reveals dozens of test questions intended to answer the question, “Am I an alcoholic?” They all carry a disclaimer saying they cannot provide a diagnosis for alcoholism. They say that is a decision I have to make.
How is it that the majority of Americans drink, yet for a self-diagnosed select few, a fun, social pastime turns into a dark, destructive secret? And why then do we deny the problem and put off asking for help as long as possible, until the problem becomes truly unmanageable?
It’s quite easy for us to self-diagnose as “non-alcoholics” when we start to think we have a problem. Most people believe that alcoholics are somehow different from other people, different from “us.” Many assume that alcoholism results from some type of defect. We’re not sure if the defect is physical, mental, or emotional, but we’re sure that “they” (alcoholics) are not like “us” (regular drinkers).
Jason Vale explains that most doctors belong to the “state the obvious” brigade. They pronounce something like: “You are drinking a lot, and it is starting to affect your health. My recommendation is that you moderate or stop drinking.”25 Then the doctor goes on to say that only you can decide if you are an alcoholic. Really? I might have a fatal illness, but no one can diagnose me? As a drinker, the suspicion that I have a serious problem will likely cause me to drink more. And why not? We believe alcohol relieves stress, and the journey to overcome denial, put away my pride, and determine if I am an alcoholic is terribly stressful.
If there is a specific physical or mental attribute responsible for alcoholism, why can’t we test for it and segment the population into alcoholics and regular drinkers? That would enable us to prevent the afflicted individuals from falling victim to drink. If there is something inherently different about alcoholics, surely we could find some indication of it before they harm themselves, their family, and society as a whole.
With good reason, we applaud the strides scientists have made in medicine. Amputees with prosthetic limbs can now control the prosthetics’ movements with their thoughts, which are translated to the limb by electrical signals from the brain.26 Dr. Sergio Canavero, an Italy-based neuroscientist, is preparing to transplant a human head.27 Recent advances in medicine blow our minds. If there is a specific physical or mental defect responsible for alcoholism, I find it hard to believe that we can’t, in this day and age, diagnose and prevent it.
Am I saying every person responds the same way to alcohol, no matter their genetic or physical disposition? Not at all. Like the way one glass of wine affects two people differently, long-term exposure to alcohol has different effects on each of us. I am not debating this. Nor am I saying there is no evidence for a gene that increases a proclivity for alcohol addiction. We have discovered many loose relationships between genes and alcohol use but none definitive enough to declare responsible.
The genetics lab at the University of Utah, a department that studies the role of genes in addiction, says that someone’s genetic makeup will never doom them to becoming an addict.28 Polk confirms that, despite any genetic connections, someone cannot become an alcoholic without repeatedly drinking alcohol.29
It seems strange to use the term “alcoholic.” We don’t have cigarette-o-holics but rather people who have smoked and therefore become addicted to cigarettes. Similarly, you don’t hear about people who are cocaine addicts suffering from cocainism.30 If you consider yourself a regular drinker, you probably take issue with this sentiment. Why? Because if we agree that no specific, diagnosable physical defect separates alcoholics from the population of “responsible” drinkers, everyone who drinks is susceptible and perhaps on the path to alcohol dependence. I assert that over time, with the right level of exposure, anyone can develop a physical dependence on alcohol. And since we are all built differently, no one can determine at what point an individual will develop dependence. This message isn’t popular; it flies in the face of our thriving alcohol industry, our societal dependence on the drug, and the attitudes of “regular” and “responsible” drinkers who pride themselves on maintaining control.
The Blame Game 2.0: A.A. and the Alcohol Allergy Theory
I used to accept the notion that alcoholics were different than regular drinkers. Why not? The alcoholics I knew said they had a disorder or defect, so who was I to argue? Since that time I have done a tremendous amount of research. It took me some time to find out where the belief started and why it was accepted. I discovered at once how genetics play into the diagnosis. Neuroscientist Thad Polk says, “There is no single addiction gene; dozens of genes have been identified that affect addiction susceptibility, and most of them only have a small effect by themselves.”31 We have not yet found a way to diagnose or prevent addiction based on genetics.32 Understanding why alcoholics themselves believe they are different from the normal population proves more difficult.
We accept this theory for a handful of simple reasons. Regular drinkers like it because it allows them to believe they are in control— safe to continue drinking without any worry that they will cross the arbitrary line into alcoholism. Alcoholics like the theory because once you “come out” as an alcoholic, your friends make an effort to help you abstain, rather than pressuring you to drink. They mix you mocktails and support your journey to fight the disease. It is easier to abstain when no one offers you alcohol. Also, physical difference means you receive less blame. We don’t blame people who get cancer; disease allows for forgiveness. Finally, it is easier to maintain sobriety if you believe one slip will bring a fatal disease out of remission.
A.A.