Tag Archives: alcoholism

Sobriety, dual diagnosis, and personal OTC self-help

First, I want to make clear that this is just about my personal experiences, since Lifering is about personalized, individualized, self-empowerment, or self-help.

That said, let’s jump into what’s on my mind.

A fair percentage of people who eventually have addictive problems to drugs or alcohol are “dual diagnosis.” That is, they have some mental health issue connected with their addiction. Often it’s depression. Often it’s anxiety. Sometimes it’s bipolar disorder, occasionally schizophrenia.

For people that have “simple” depression or anxiety, and have been to a doctor before, for lower-level depression or anxiety, it’s tempting to self-medicate with over-the-counter items. For example, it’s a “commonplace” that Benadryl can help mild anxiety. Many people use St. John’s wort for mild depression. Beyond that, over-the-counter versions of lithium compounds, somewhat similar to, but not the same as, the prescription versions, are available. And more.

But, even over-the-counter medications aren’t risk free.

For example, prescription lithium has a narrow range of dosages. The non-prescription versions are presumably similar.

With St. John’s wort, there are studies indicating it can help with some cases of mild-moderate depression. There’s no “magic secret” as to why, though. The active ingredient is an MAO inhibitor, just like the first class of anti-depressant medications. Given that prescription MAO inhibitors come with certain warnings, like not combining them with aged cheeses, something similar might apply to St. John’s worth.

And, there’s the placebo effect. A lot of people swear by GABA, a natural neurotransmitter, to help with anxiety. However, GABA does not cross what’s known as the blood-brain barrier, therefore people are presumably just talking about a placebo effect.

Also, just as a prescription anti-depressant that works for one person might not work well for another, the same is true of these OTC self-helps.

A Lifering friend mentioned his doctor suggested he take a new OTC medication, which is GABA chemically linked to niacin, the B vitamin. He said it helped totally kill alcohol cravings, as well as some anxiety.

I decided to order it myself; it’s readily available online.

Well, my “sample size date” is only 10 days so far, but, I may discontinue it after another week.

While it’s not quite making me MORE anxious, I have had trouble falling asleep since then. I’ve had a couple of issues in my mind, but, this may be a contributing factor.

For me, the one time I went to a doctor with even more serious anxiety, it was anti-depressants that helped.

There’s nothing wrong with a prescription from a doctor, and there’s nothing magical about over-the-counter items. It never hurts to get professional advice.

Yet another “false dichotomy” story

Just a couple of weeks after the New York Times, in a column by a person pushing a book, presents a false dichotomy between Alcoholics Anonymous and science-based moderation as the only alternatives on the table, Slate does the same thing. And, it’s story author is a Slate staffer who doesn’t even have the excuse of publishing a book. You can comment on the page or Tweet Brian Palmer here.

The story’s good otherwise; Palmer knows the history of AA’s semi-official opposition to medical assistance for addiction, counseling and more. But, there’s not a single word in there about secular sobriety organizations. Only by people like us contacting people like Palmer to get the full story out there, can we get the full story out there.

And, whether Palmer’s analysis of AA is close to correct or not is not the primary point of this blog post. (That said, I do think he is broadly correct.)

AA vs moderation — false dilemma rears its head again

NY Times image

And unfortunately, it rears its ugly head in a New York Times op-ed, and even worse, it’s one of those New York Times op-eds written by an author who’s got a new book to plug.

Gabrielle Glaser thinks that she is saving many a woman with some degree of a drinking problem from the moralizing of AA. She gets right that, as well as noting that AA is male-focused, unscientific, and still largely rooted in the days of its founding.

She also gets right this:

Women increasingly need help, as their drinking has escalated. Women are being stopped more for drunken driving than they were two decades ago. They’re also the biggest consumers of wine, buying the larger share of the 856 million gallons sold in the United States in 2012. These women are drinking partly because alcohol is a socially respectable way to slog through the smartphone-tethered universe of managing demanding careers, aging parents, kids’ activities and relationships at once. And while it’s not healthy to pour yourself a third or fourth glass every night, it doesn’t mean you’re powerless to do anything about it.

But, she then says the alternative to this:

(T)he A.A. program offers a single path to recovery: abstinence, surrendering one’s ego and accepting one’s “powerlessness” over alcohol.

Can, and should, (often) be moderated drinking.

I put the “often” in parentheses because she does, at her website, albeit on a hyperlink whose linkage is broken, or was for me, abstinence-only alternatives to AA. Besides us, and the others, I was simply flabbergasted that, because her column was about drinking problems particular to women, she wouldn’t even mention Women for Sobriety in the column.

She then goes on to specifically tout Moderation Management, without noting, besides just founder Audrey Kishline, its own problematic history, lack of verifiable information, etc. This is a sad case of wanting to have one’s cake and eat it, too.

Next is this:

This approach isn’t for severely dependent drinkers, for whom abstinence might be best.

“Might”? Try “is.” Period.

Unfortunately, she got curt with me when I pointed out some of the above issues in an email. I have made multiple comments on the Times op-ed, my original ones being about the book itself, then responding to a couple of diehard AAers trotting out the classical “no true Scotsman” stance in saying Glaser wasn’t critiquing true AA, etc.

Her book is getting a number of unfavorable ratings on Amazon from people who are NOT diehard AAers, for a variety of reasons, so a few people are looking at the devils in the details.

A New Year’s thought – quit now, while you’re younger

If you’re a new visitor to Lifering, and either you or a friend has made a New Year’s resolution to quit drinking, I have one good reason to stand by that resolution.

Likewise, if you or a friend is considering that resolution, but not yet sure about it, I have one good reason to follow through.

It does get worse as you get older.

Scientific evidence is starting to come in that hangovers get worse as people get older.

So, why wait? Save yourself some pain, or encourage a friend to do the same.