Addiction and Recovery

By Bob Gaydos

Thanksgiving ushered in the triple-threat season, so-called by many people in recovery because of the heavy emphasis on celebration … and drinking. It’s a time for extra caution and heightened awareness of the easy access and, sometimes, emphasis on alcohol in order to protect one’s recovery.

    But it’s also a time when people not in recovery often find out, often from friends or family, that their drinking is not normal. It’s problematic. Possibly dangerous. 

   With New Year’s revelry upon us, it may be a good time for anyone wondering about his or her drinking behavior to take a self-assessment.

There are a few tests available and I’ve offered a couple previously in this column, but in the interests of time I’m presenting the shortest one here. It’s the AUDIT, offered by The World Health Organization and is the most widely used alcohol use assessment tool in the world. AUDIT stands for alcohol use disorders identification test. As always, be honest for the best result.

The AUDIT questionnaire:

Please circle the answer that is correct for you

1. How often do you have a drink containing alcohol?

• Never
• Monthly or less
• 2-4 times a month
• 2-3 times a week
• 4 or more times a week

2. How many standard drinks containing alcohol do you have on a typical day when drinking?

• 1or2
• 3or4
• 5or6
• 7to9
• 10 or more

3. How often do you have six or more drinks on one occasion?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

4. During the past year, how often have you found that you were not able to stop drinking once you had started?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

5. During the past year, how often have you failed to do what was normally expected of you because of drinking?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

6. During the past year, how often have you needed a drink in the morning to get yourself going after a heavy drinking session?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

7. During the past year, how often have you had a feeling of guilt or remorse after drinking?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

8. During the past year, have you been unable to remember what happened the night before because you had been drinking?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

9. Have you or someone else been injured as a result of your drinking?

• No
• Yes, but not in the past year
• Yes, during the past year

10. Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested you cut down?

• No
• Yes, but not in the past year
• Yes, during the past year

Scoring the audit

Scores for each question range from 0 to 4, with the first response for each question (eg never) scoring 0, the second (eg less than monthly) scoring 1, the third (eg monthly) scoring 2, the fourth (eg weekly) scoring 3, and the last response (eg. daily or almost daily) scoring 4. For questions 9 and 10, which only have three responses, the scoring is 0, 2 and 4.

Scoring the AUDIT

The range of possible scores is from 0 to 40, with 0 indicating an abstainer who has never had any problems from alcohol. A score of 1 to 7 suggests low-risk consumptions, according to World Health Organization (WHO) guidelines. Scores from 8 to 14 suggest hazardous or harmful alcohol consumption and a score of 15 or more indicates the likelihood of alcohol dependence (moderate-severe alcohol use disorder).

If your score concerns you, there is help available. Talk with your primary care doctor. Call an Alcoholics Anonymous hotline in your area. Call a mental health crisis hotline if one is available.

Excessive alcohol use is now classified as a mental disorder by health officials, somewhat in response to the stigma attached to the word “alcoholic.”  However, most recovering members of Alcoholics Anonymous have no problem with identifying as such. In any case, it is not a moral failing. It can be treated. First, it has to be acknowledged.

Again, be honest. And have a safe and sober new year.

rjgaydos@gmail.com

Addiction and Recovery

(Reprinted in honor of AA’s founding, June 10, 1935.)

By Bob Gaydos

By Bob Gaydos

This column is updated from three years ago because it’s election time again and, well, denial is the first, big obstacle. Until and unless they can admit they were/are powerless over Donald Trump, Republicans have no hope of recovering. They will be forever known as Trumpaholics, people addicted to avoiding reality and destined for a life that is, by any reasonable measure, unmanageable. I cite the last eight years as evidence.

  But, as they say, there is a solution, one that has changed lives for the better for millions of people worldwide — a 12-Step program. It has worked miracles for alcoholics; it can work for Trumpaholics.

       I’ve written on addiction and recovery for more than 15 years. One of the recurring stories I’ve heard over that time is that the 12 Steps of Alcoholics Anonymous are not just a proven way to stop drinking, but also an excellent formula for living a good life. Getting rid of the booze — or in this case, the Donald — is only the beginning. Republicans can reap these rewards, individually or as a party … but only if they really want to change.

        So, with a deep bow to Bill Wilson, Dr. Bob and A.A. and adapted in all humility, here are the 12 Steps of Recovery for Republicans:

1. We admitted we were powerless over Trump, that our party had become unmanageable.  This state of affairs is usually evident to non-addicts of the individual’s acquaintance well before that aha! moment arrives, if it does. Members of A.A. say this is the only step they have to get perfect, for obvious reasons. If a Republican can’t admit — still — that Trump dominates his or her every political thought or action, there’s no sense going on to Step 2. Denial. However, if Republicans can look at the past eight years of saying yes to virtually everything Trump did or said and acknowledge the trouble that this blind obedience, this dependence, has caused in Republicans’ lives (broken relationships, lost jobs and opportunities, ruined reputations, trouble with the law) as well as the pain it inflicted on the lives of many others, there is hope.
2. Came to believe that a power greater than Trump or Mitch McConnell could restore us to sanity. (No one said this was easy.) No, this does not mean everyone becoming Evangelical Christians. Quite the opposite. That would simply be swapping blind faith in Trump for blind faith in other con men and women. Give me your money and you will be saved. For a party that professes a belief in strong family values and makes a public display of respecting religious (well, Christian) teachings, this should not be a problem. Theoretically. However, I think it could be challenging to many Republicans who have become used to giving lip service to their professed religious beliefs. Skeptical alcoholics are sometimes advised to pick a higher power of their own choosing or at least to believe that someone whose sobriety they admire has such a belief. Instead of putting their hands on some charlatan’s shoulders and bowing their heads, supposedly in prayer, Republicans should look within the ranks (or without) for a source of strength, hope and faith and emulate that person. It should be someone with a sincere, demonstrated, spiritual footing. Hint: it’s not Ted Cruz. Not a Koch brother or Rupert Murdoch either. Keep looking. Someone more like Lincoln, remember? It may take a little time. That’s OK.
3. Made a decision to turn our will, our money and our platform over to the care of whatever power we came up with in Step 2.  A key step. Last time out, Republicans did this almost accidentally with Trump. That was blind, misplaced faith in the flashy guy. No willpower, true, but no sense of shared responsibility to the greater good. This time, they need to decide to follow the lead of someone with sound moral principles and then lead their political lives accordingly. That is, decide to do the rest of the steps.
4. Made a searching and fearless moral inventory of ourselves. This step could be a problem for a lot of Republicans because it requires honesty. But if they want to change, they need a list of the things they want to change. For example, lying that the presidential election was stolen while knowing there was never any proof of this would be something to put high on the list. Lying is bad, even in politics. Hypocrisy is just a fancy word for lying. Also, stealing and harming others so as to benefit yourself. Breaking the law, too. Insurrection. All Trump’s pardons did not remove the guilt, they merely freed the guilty.
5. Shared with that higher power from step two, with ourselves and another human being the exact nature of our wrongs. In other words, look in the mirror and say, “I have been a self-serving, lying, backstabbing, selfish, hypocritical, cowardly son-of-a-bitch for the past four years,“ and then release a statement to that affect — in detail — on social media. Get Liz Cheney to pose in the picture with you. Piece of cake.
6. Were entirely ready to have my higher power (with the help of a new party leader of sound moral standing) remove these defects of character. Basically, Republicans must resign themselves to the fact that they have been a group of self-serving, lying, cowardly, etc. since they chose Trump as their leader. This is the truth, the real news. When and if they accept it, they can move on to Step 7.
7. Humbly asked him or her to remove our shortcomings. Harder than it sounds. First of all, shortcomings seldom ever really go away. They find new hiding places. Republicans will have to become aware of them and try to avoid them. Stop lying about the deficit, That’s a lifetime of work and will require humility. Good luck finding someone to explain that concept to Republicans. Again, not Ted Cruz, who confuses humiliation with humility.
8. Made a list of all persons we had harmed and became willing to make amends to them all. Really. You don’t get to totally screw up a country and just walk away like nothing happened. Not if you want to change.
9. Made direct amends to such people wherever possible except when to do so would injure them or others. That last part lets Republicans stay out of jail and not hurt their own family by admitting how they routinely cheated minority voters with sketchy redistricting plans and harsh voter registration laws.
10. Continued to take personal inventory and when wrong promptly admitted it. This is the new way of living part of it. “I’m sorry; I was wrong.” Try not to abuse this step. Match your words with action.
11. Sought through regular meetings and work sessions, at which an honest exchange of ideas is encouraged and welcomed, to maintain contact with our new party leader, seeking only to learn what the new Republican Party stands for and the power and courage to carry that out. Prayer and meditation wouldn’t hurt either.
12. Having had a major reprieve and possibly a spiritual awakening as the result of these steps, we tried to carry the new Republican Party message to Trumpaholics and others and to practice its new principles in all our affairs. One day at a time.

   That’s it. The formula for recovery for the Republican Party. But there is one thing more. With alcoholics, the drinking is just a symptom of the disease. When the drinking stops, the disease (much of the behavior) doesn’t go away. That’s why recovery is a daily practice. To avoid relapse.

 The real question for Republicans is what made them Trumpaholics in the first place.

rjgaydos@gmail.com

Bob Gaydos is writer-in-residence at zestoforange.com.

Addiction and Recovery
By Bob Gaydos

    For those looking for a New Year’s resolution that can actually be challenging to keep and potentially beneficial if done the right way, I offer some thoughts I shared last year when I first heard about Dry January and some new ones.

    You hang around with an experienced group of people for any amount of time, with any luck, you learn a few things. 

     I’ve been writing a column on addiction and recovery for more than 15 years. In that time, I have been fortunate to have many conversations with members of Alcoholics Anonymous who have decades of sobriety. They have freely shared some of their experience and wisdom with me.

      One bit of AA wisdom goes like this: “People who don’t have a drinking problem don’t have to control their drinking.”

       Hmmm. So why are social media and news feeds filled daily with stories on “Dry January”? Why the sudden interest in non-alcoholic beer and no-booze cocktails? What’s the big rush all of a sudden for, reportedly, thousands of people to decide to see if they can not partake of alcohol for the month of January? Last year, one poll said 41 percent of respondents planned to partake of Dry January. I couldn’t find a report on how well they did, but clearly, not drinking alcohol for one month at least is suddenly chic. 

  For what it’s worth, alcoholics, or rather, those who insist they are not alcoholics, have been taking the post-holiday challenge forever in valiant efforts to prove to themselves and (mainly) others that they can control their drinking. Often, they’ve failed. Rehab February. Others have attempted to give up drinking for Lent, for the same reason and often with the same results.

     But this is different. This is people, many apparently younger people, supposedly deciding that it might be in their best interest to abstain from or at least reduce their alcohol intake, at least for the month.

     Given recent reports on an upsurge in alcohol consumption (particularly by women) during the pandemic, an increase in alcohol-related deaths and a myth-busting report which concludes that “no amount of alcohol” is ever good for your health, going dry or easing up on alcohol for a month sounds like a reasonable idea for anyone.

      But there are risks involved and if you’re intrigued by the idea of stopping or controlling your drinking there ought to be rules. For starters, what is your purpose? Is it, as previously mentioned, to prove you don’t have a drinking problem? If so, you need to tell other people what you’re doing so there is accountability and, crucially, protection, in case a serious alcohol problem does exist. 

  Going through withdrawal symptoms from avoiding alcohol on one’s own can be painful and dangerous. Be aware of the symptoms and get professional help if they begin. Your effort may have failed, but it might have saved your life.

     If, on the other hand, the purpose is truly to see if life can be just as interesting and fun without alcohol always being involved, again, don’t do it alone. Get some friends involved. Plan alcohol-free activities. Try some of those fancy new alcohol-free “mocktails” the Dry January movement has spawned. If you’re really serious, maybe focus more on exercise. Try to get more sleep. See if you start to feel better physically and emotionally.

     Drawing again on some AA wisdom, the key to succeeding, whatever your goal, is to be honest and realistic. Whether you’re trying to not drink for a specific month or just cut back, if you find yourself drinking or thinking you’d really like to be drinking in spite of your stated goal, by all means start over again. But be aware of any recurring pattern. There may be a problem.

      On a positive note, if Dry January results in a more responsible general approach to alcohol consumption (as brewers and distillers are obliged to promote), it has to be good for society’s overall health. Excessive alcohol consumption contributes to a multitude of societal and health problems as well as highway and other accidents.

    Fad or not, the movement would also go along with the effort by health agencies and providers to remove the stigma and shame often attached to alcoholism by getting rid of the word “alcoholic,” which still conjures up negative images for many people. Today, people are diagnosed with alcohol abuse disorder, mild, moderate or severe. (Sober members of AA still call themselves alcoholics with no shame attached.)

   According to the National Institute on Alcohol Abuse and Alcoholism, alcohol use disorder “is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.”  That’s the “drinking and trouble” connection members of AA often talk about.

      On the basic issue of stopping drinking and trying to keep things simple, AA’s Third Tradition states that “the only requirement for membership is a desire to stop drinking.”

     Adding that touch of reality necessary to recovery, an AA friend asked, “Who would have a desire to stop drinking other than someone who drank too much and got in trouble over it?”

     With sincere hope for the success and good intentions of anyone participating in this year’s Dry January, that’s a question to keep in mind for anyone planning on a just plain February.

rjgaydos@gmail.com

Bob Gaydos is writer-in-residence at zestoforange.com.

Addiction and Recovery

By Bob Gaydos

Thanksgiving ushered in the triple-threat season, so-called by many people in recovery because of the heavy emphasis on celebration … and drinking. It’s a time for extra caution and heightened awareness of the easy access and, sometimes, emphasis on alcohol in order to protect one’s recovery.

    But it’s also a time when people not in recovery often find out, often from friends or family, that their drinking is not normal. It’s problematic. Possibly dangerous. 

   With Christmas and New Year’s revelry still to come, it may be a good time for anyone wondering about his or her drinking behavior to take a self-assessment.

There are a few tests available and I’ve offered a couple previously in this column, but in the interests of time I’m presenting the shortest one here. It’s the AUDIT, offered by The World Health Organization and is the most widely used alcohol use assessment tool in the world. AUDIT stands for alcohol use disorders identification test. As always, be honest for the best result.

The AUDIT questionnaire:

Please circle the answer that is correct for you

1. How often do you have a drink containing alcohol?

• Never
• Monthly or less
• 2-4 times a month
• 2-3 times a week
• 4 or more times a week

2. How many standard drinks containing alcohol do you have on a typical day when drinking?

• 1or2
• 3or4
• 5or6
• 7to9
• 10 or more

3. How often do you have six or more drinks on one occasion?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

4. During the past year, how often have you found that you were not able to stop drinking once you had started?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

5. During the past year, how often have you failed to do what was normally expected of you because of drinking?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

6. During the past year, how often have you needed a drink in the morning to get yourself going after a heavy drinking session?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

7. During the past year, how often have you had a feeling of guilt or remorse after drinking?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

8. During the past year, have you been unable to remember what happened the night before because you had been drinking?

• Never
• Less than monthly
• Monthly
• Weekly
• Daily or almost daily

9. Have you or someone else been injured as a result of your drinking?

• No
• Yes, but not in the past year
• Yes, during the past year

10. Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested you cut down?

• No
• Yes, but not in the past year
• Yes, during the past year

Scoring the audit

Scores for each question range from 0 to 4, with the first response for each question (eg never) scoring 0, the second (eg less than monthly) scoring 1, the third (eg monthly) scoring 2, the fourth (eg weekly) scoring 3, and the last response (eg. daily or almost daily) scoring 4. For questions 9 and 10, which only have three responses, the scoring is 0, 2 and 4.

Scoring the AUDIT

The range of possible scores is from 0 to 40, with 0 indicating an abstainer who has never had any problems from alcohol. A score of 1 to 7 suggests low-risk consumptions, according to World Health Organization (WHO) guidelines. Scores from 8 to 14 suggest hazardous or harmful alcohol consumption and a score of 15 or more indicates the likelihood of alcohol dependence (moderate-severe alcohol use disorder).

If your score concerns you, there is help available. Talk with your primary care doctor. Call an Alcoholics Anonymous hotline in your area. Call a mental health crisis hotline if one is available.

Excessive alcohol use is now classified as a mental disorder by health officials, somewhat in response to the stigma attached to the word “alcoholic.”  However, most recovering members of Alcoholics Anonymous have no problem with identifying as such. In any case, it is not a moral failing. It can be treated. First, it has to be acknowledged.

Again, be honest. And have a safe and sober holiday season.

rjgaydos@gmail.com

Addiction and Recovery

By Bob Gaydos

The absence of in person meetings lead to relapses, a study suggests.

   “Don’t drink … and go to meetings.”

    “Meeting-makers make it.”

    Those two bits of advice — “suggestions” as they are officially considered — have been welcoming newcomers to Alcoholics Anonymous ever since the group was born 86 years ago. 

     The message is simple: Alcoholics, especially those new to recovery, are more likely to get and stay sober if they keep regular contact with other alcoholics in recovery. The “all in the same boat” philosophy. “We” get sober, especially if some of us know how to do it and can guide others. Fellowship. Coffee. Hugs and handshakes. Easy does it.

      Then came COVID. No more hugs. No more handshakes. No more coffee. No face-to-face support and fellowship. And for some, no recovery. Or worse.

       According to a recent report published in the Journal of the American Medical Association, alcohol-related deaths increased by 25 percent in the United States in the first year of Covid. Researchers from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) looked at mortality data to compare the number of alcohol-related deaths among persons aged 16 and older in 2019 and 2020. Deaths were considered to be alcohol-related if alcohol was listed as an underlying or contributing cause.

          The report found that the number of alcohol-related deaths, including from liver disease and accidents, jumped to 99,017 in 2020, up from 78,927 the previous year. That 25 percent increase is compared to an average increase of 3.6 percent annually for the previous 20 years. Perhaps not surprisingly, in response to the pandemic, many Americans drank more. They binged more. And more of them died because of it.

           The researchers cited the stress of living with all the changes and restrictions of Covid, including isolation, as a major factor in the increase in drinking and deaths. Of course, isolation and feeling stressed are major reasons many alcoholics drink. Recovery is largely about dealing with stress and other people without drinking.

         In addition to the Covid-related stress in general, it became more difficult to seek help at rehabs. Hospitals with recovery programs were swamped with Covid patients. The researchers say many people got discouraged and just put off looking for help.

            And for those meeting-makers, there were no more meetings. At least not in person. The researchers also said they assumed many people in recovery relapsed because they couldn’t access any in-person support, including from 12-step groups like AA.

           To be sure, Zoom meetings proliferated online and many AA members found themselves staring at their smart phones or iPads, communicating with alcoholics across the nation and, indeed, across the world. The messages were the same, just not in person. Make your own coffee. Hug your cat. It was new and, for many, a welcome lifeline.

         But for many others, this wasn’t enough. Having been resourceful about managing to get a drink, a lot of alcoholics in recovery did manage to figure out how to have meetings in person, safely.

         In New York’s Mid-Hudson region, some began meeting in their cars in parking lots. Once the weather warmed up, groups with venues that offered private space began meeting outside. Bring your own chairs and coffee. Meetings sprang up in parks throughout Orange, Ulster and Sullivan counties. If there was a park pavilion with a large crowd of people sitting quietly and sipping coffee, there was a good chance it was an AA meeting. The restrictions or requirements changed with Covid. Masks, sanitizer, and social distancing were common place.  It wasn’t the same, most agreed, but it was far better than not meeting at all.

      COVID is not yet gone. It seems to keep reinventing itself. Local AA groups continue to adapt as well, most now meeting indoors, with or without masking and distancing rules. For many, the coffee pots are back. Zoom meetings continue.

      But the importance of in-person contact is not lost on many members.

       “The meetings are where I get my medicine,” says F.G., a longtime member from Orange County. “I need to see the faces,” he says.

        More personally, G.E., an Ulster County resident, says he was within months of 25 years of sobriety when he stopped going to meetings and eventually relapsed. Then Covid arrived. Back a couple of months now, he says, “I must treasure my sobriety. I have to respect it. I thought I could do it without the personal contact. I couldn’t. Now, I really enjoy the fellowship.”

       At least one study suggests there’s a compelling reason to continue to do so.

rjgaydos@gmail.com

 Reprinted in honor of Alcoholics Anonymous’ 87th birthday, June 10, 2021.