Friday, 7 August 2009
Controlling Alcohol Cravings
The choice? Is there a choice? -- to accept the craving for alcohol or controlling alcohol cravings. Photo by i_yudai (new window).
There are some methods for controlling alcohol cravings. If they can be controlled, in theory, the alcoholic is no longer an alcoholic but a recovering alcoholic and eventually, at least potentially, will no longer be an alcoholic. I believe that every time the alcoholic beats a craving for alcohol he or she is retraining the brain to stop demanding it. It is the conscious controlling the subconscious. The retraining is a long process, of course. This is because the initial training (the slow process of becoming an alcoholic before "crossing the wire") was also slow and to unlearn that takes a similar amount of time.
I list some thoughts below on controlling alcoholic cravings. Ultimately, however, all these methods depend on the will and commitment of the alcoholic to exercise them at the right time.
Awareness and discipline
This confirms what we all know, which is that in the end, it is down to the alcoholic to decide to stop and use strength of character to see it through. There are all kinds of alcoholics and some can use a bundle of methods to assist them to stop and control the dreaded booze. On the basis that it is ultimately about will and that alcoholics may suffer from a lack of will, is it possible to increase ones will to the point where it can master the desire to consume alcohol? This is quite a nice thought. Note: people will disagree with this. Some people think that alcoholics are programmed to be addicts or have a heavy predisposition to alcoholism or addiction, which cannot be mastered. Alcoholics are probably predisposed to alcoholism but despite that a person is still able, at least potentially, to exercise control over their addiction.
For example, Jane my alcoholic partner says that she is too weak to change. She has openly admitted this and it looks like a correct assessment to me. It is not just about strength of character through (before someone criticises me!); there are a number of factors involved. However, is there a method that builds strength of character to master alcoholism? This guru thinks there is:
I am not a mystical type! And I am not saying this guru is necessarily good but he has a good thought on this, I think. I am a realist and scientific in thought. But this guru does have a nice idea. He is suggesting that the addict can become more aware of the situation and can build commitment with the will to stop and as a result control the addiction. I get this. Jane almost automatically drifts into an alcoholic binge. She doesn't check or put brakes on that moment when the craving takes hold and she starts drinking. A greater awareness of that moment can help. And when the alcoholic is aware of the moment when he or she can comply with or reject the craving the will to reject it must take over, which requires commitment and desire.
I am a believer in the idea that if the alcoholic can see the opposite to a reward from drinking, then a certain degree of control can begin to take place over the alcoholism. For example, I like a drink myself after working hard and I get a slight craving to have a drink but I consciously know the downside, the unpleasantness of the after effects of drinking and steer clear of drinking too much.
I believe that alcoholics do not register the downside; are not, if you like in tune with the effects of consuming large amounts of alcohol (or lack awareness as mentioned above) and therefore carry on well beyond the point when they should stop. So one way of controlling alcoholic cravings is to be aware of the decision at the beginning of a drinking session that this will lead to problems unless control is exercised. That takes a lot of will initially but after a while becomes automatic.
Perhaps one way to assist in awareness is to use cards. Write down the effects and downside and produce them when the craving starts. This may help remind the alcoholic.
One method of controlling alcohol cravings is to use antabuse. This is a drug that takes away the promise of a reward that the brain is telling the alcoholic he or she will get if she drinks. It blocks the liver from breaking down alcohol and if you drink you experience flushed skin, shortness of breath, nausea and vomiting, I am told. The result of drinking with antabuse in you is discomfort not pleasure and so the trigger to drink is nullified. The only problem with antabuse is that you really have to have someone to give it to you and ultimately the alcoholic has got to agree to take it. It comes in the form of a white pill and contains the chemical disulfiram.
Jane has used antabuse and I have given it to her. This is the standard procedure. It is taken once a day. She doesn't take it now. This tells you that the person in charge of taking it is the alcoholic. I would give her the antabuse every day but when the time came for Jane to have a binge she would take the pill in her mouth and store it in the side of her mouth then spit it out after I had gone. I knew she did this because it was pretty obvious. Then I would mash the pill up and put it into glass of water in suspension but when push came to shove she refused to take it. So much for antabuse. Also I am not sure that it is actually a drug rather than a mind game drug as when I was working a client of mine who had an alcoholic husband told me that she put the pill in the beer and vodka and it still didn't work. I am not sure about antabuse.
AA suggest distractions for controlling alcohol cravings. When cravings start, the idea is to distract the brain from the craving by using it to do something else. If one does exercise for example that can help. Or simply finding pleasure somewhere else like sucking a sweet. Sounds simple but it can help. I guess going for a run might do it but a distraction requires a positive action by the alcoholic instead of drinking so a degree of will power is demanded.
Some people say relaxation can be a way of controlling alcohol cravings. I am not sure about this. My experience with Jane is that one of her most susceptible moments is when she is bored or in effect very relaxed. Boredom can be a trigger. The mind wanders to the bad things when unoccupied. The mind should and I believe must be kept active and focused to avoid these thoughts. That is why a distraction like exercise can defeat the craving until it passes.
The drug companies and alcoholics are all searching for the wonder drug that stops alcoholism. It would be a near miracle is such a drug existed. Baclofen a muscle relaxant has been found to short-circuit the craving for alcohol. This was the case for the person who "discovered" it as a possible means of controlling alcohol cravings. His name is Dr. Amelsen and he was an alcoholic suffering from anxiety. The drug helped him immensely. He took very large doses and he was fearful that at high doses the body would slow down to a stop but he acclimatised to it and at 270 mg a day it worked. The story was told in Feb 2009 but I have heard nothing since. I feel that this is a drug that may help some people but it is not a wonder drug.
The search for a "cure" will go on but I fear will never be found. It will always be a retraining process. To unlearn what was learnt, I feel.
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