Addiction and Recovery

By Bob Gaydos

Pete Hegseth … working in a blackout?

Did Pete Hegseth recently order the cutoff of some military aid to Ukraine while he was in an alcohol-induced blackout? I posited the possibility at the tail end of a recent column about all the screwups in the Trump administration. The comment was made partially in jest, but the more I thought about it, the more serious it became a possible reality.

Did the secretary of defense of the United States of America make a life-threatening military decision while he was in an alcoholic blackout? Does anyone else wonder about that? If so, I haven’t heard or read about it. Given Hedgseth’s much-publicized reputation as a heavy drinker/alcoholic/drunk, it seems to be an important question. At least to me.

If you remember the July 7 press conference, Trump was asked who ordered the cessation of delivery of certain types of weapons, mostly missiles, to Ukraine. His answer was, “I don’t know. Why don’t you tell me?“

To me, a shocking response from the commander-in-chief. Later, cameras caught Trump, leaning over to Hegseth and whispering, “Do you know?“

A poker-faced Hegseth answered, “No.”

But really, how could he possibly not know? It’s his job to know. It’s his job to make recommendations of this kind of action to the president. Yet it happened and neither man knows why.

So. I suggest one man hardly ever knows why decisions like this are made and the other man was possibly in an alcoholic blackout. I’ll set aside the obvious social and political implications of this for now and talk a little bit about blackouts.

There are two enduring views about alcohol-induced blackouts:

1. They don’t exist. They’re just an excuse for inappropriate behavior.
2. They exist, but they’re just a harmless, often humorous, occasional price to pay for a night of fun.

Both views are wrong — dangerously so — for the same reason: Denying the existence of blackouts or minimizing their significance could lead to serious consequences (health, legal, personal, professional) for the persons experiencing them and others. If you’ve experienced blackouts or know someone who has and are not concerned about them, you should be.

To start with, blackouts are not the same as passing out. That’s a common misconception. People who drink too much and pass out stay put. They wake up in the same place they passed out and remember, maybe with a hangover, how they got there.

People in blackouts can wind up in different states, strange beds, wrong apartments or behind bars when they come to and not know how they got there.

“How did I get home last night?” is a common question for blackout veterans. “Where’d I leave my car?” is another.

Many recovering alcoholics who recall their drinking history in Alcoholics Anonymous meetings point to blackouts as one of the “healthy fears’’ that help them stay sober. After all, it can be frightening to find out about some reckless behavior that happened apparently in a blackout and to wonder what else may have happened without your being aware of it.

Some volunteered local examples:

— Jordan, a mid-50s man from Orange County, who has been sober more than ten years, says he once spent a four-day business trip in Texas in a blackout. Airport-to-airport. He did come out of it briefly, he says, to call his boss on Day 2 to tell him he wasn’t feeling well.

— Whitey (all names used are fictitious), who drives for a living, says he regularly drove routes between New York and Virginia in blackouts.

— John, retired in Sullivan County and sober more than three decades, says he’s positive he was fired from an excellent job because of remarks he made to his boss’s wife while in a blackout. “Why did you say those things?” No memory of it.

— Sunshine, a nurse sober half her life, recalls with a mix of horror and shame coming out of a blackout “as a guy was trying to have sex with me.” She says she fought him off. But she didn’t immediately stop drinking.

That’s often the case — not stopping drinking despite risky or embarrassing consequences. As an isolated incident, a blackout may not signify anything except drinking too much, too fast. Something you might want to avoid because of potential embarrassment or worse. As a pattern, it could be a sign of a more serious problem.

While it’s not just alcoholics who experience blackouts, the connection between blackouts and alcoholism or alcoholic use disorder is real and knowing some facts about the symptom could help dispel some of the myths and avoid more serious problems.

For a long time — most likely from whenever humans first discovered the mood-altering effects of wine until modern science started doing research on the brain and behavior — blackouts were regarded as just one of the possible side effects of drinking alcohol. A little fuzzy memory. No big deal. Just drink less.

When researchers began studying blackouts, however, they soon discovered that persons experiencing them didn’t have just a little amnesia. Rather, they had no recollection of certain events and, try as they might, even when told the details many times over, they had no memory of them. Their subjects didn’t forget, researchers concluded; they never formed a memory in the first place.

The prevailing accepted science, as cited by the National Institute on Alcoholism and Alcohol Abuse and other similar agencies, is that persons experiencing a blackout can function and appear to be “normal” to others because their brain is operating on stored, long-term, procedural memory, but the short-term memory of what they are experiencing never gets to the hippocampus, the part of the brain that processes long-term memory.

Alcohol — especially a lot of it in a short period of time — short-circuits the process. According to the NIAAA, “As the amount of alcohol consumed increases, so does the magnitude of the memory impairments. Large amounts of alcohol, particularly if consumed rapidly, can produce partial or complete blackouts.”

More about blackouts:

— It’s not what you drink, it’s how much alcohol gets into your bloodstream and how fast it gets there. This means it’s possible for anyone to black out if he or she drinks enough alcohol quickly enough.

— People who have a low tolerance for alcohol are not necessarily more likely to black out. On the other hand, those with a high tolerance for alcohol are often able to drink heavily and carry on conversations, drive, etc. while in blackouts.

— Women may be more susceptible since they tend to be smaller than men, meaning each drink has a greater effect on the body’s blood alcohol content.

— Drinking on an empty stomach can make blackouts more likely, again because of a more acute impact on the blood alcohol concentration.

— People sometimes have glimpses of memory of an event, but not total recall. These partial lapses are called “brownouts.”

— Blackouts are the product of consumption of an amount of alcohol that affects motor coordination, balance, impulse control and decision-making. This is bad enough when someone is not in a blackout, never mind being unable to recall any risky, self-sabotaging behavior that may have caused serious harm to others.

— Some researchers suggest that people in blackouts, operating on procedural memory and little more, have little impulse control and are more likely to do things they would not otherwise. (See examples above.) This presents embarrassing, sometimes dangerous situations for the person in a blackout, family, friends and even strangers.

— Blackouts are often the unrecognized explanation for someone’s uncharacteristic actions. “Why did you (say/do) that last night?”

— Because of a shortage of evidence-based science on the subject, there is considerable difference of opinion on the use of blackouts as a defense in criminal trials.

So, what to do if you have blackouts? Take them seriously. Maybe talk to a professional health provider who knows about them. While blackouts are not solely the result of years of heavy, alcoholic drinking, they can be a sign of an existing or potential alcohol problem. Even one or two — perhaps the product of binge drinking in college — should be enough to cause concern since not being aware of what one has done is not considered acceptable to most people.

For example, possibly cutting off significant weapons shipments to a country in the middle of a war without checking with your commander-in-chief.

Again, just asking.

Addiction and Recovery

The Big Book

By Bob Gaydos

On June 10, 1935, Bob Smith, a doctor in Akron, Ohio, had a beer to steady his hand for surgery he was about to perform. It was the last drink of alcohol Smith, who had tried and failed to stop drinking many times, ever had. It became the founding date of a movement that in 90 years has grown to some 2 million members around the world: Alcoholics Anonymous.

Smith was the famous Dr. Bob, the first person Bill Wilson “talked” into sobriety by repeatedly telling the doctor how he, himself a hopeless drunk, had managed to stay sober. Wilson had failed with other potential converts, but realized at some point that, while the others were still drinking, he was managing to stay sober by telling other alcoholics his story. Smith eventually followed the same path and the story-telling has continued ever since.

Eventually, the two men put their stories and other stories of recovery into a book, along with the steps they took to get and stay sober.

It is one of the best-selling and most influential books of all time, with more than 30 million copies having been sold and millions of lives changed by what is contained on its pages. Yet it is not exaggeration to suggest that many of its readers don’t know the actual name of the book.

It is known, proudly and even reverentially, by most who have read it as the Big Book. Officially, the book’s title is “Alcoholics Anonymous,’’ the same as the 12-Step program for treating alcoholism (and other addictions) described within its covers. A dozen years ago, the Library of Congress included it on a list of “Books That Shaped America.”

There are 88 books on the list, ranging from Thomas Paine’s “Common Sense,” to Edgar Rice Burroughs’ “Tarzan the Ape Man,” with the common factor among all being that “they shaped Americans’ views of their world and the world’s views of America.”

While it may not be for everyone, the Big Book has certainly shaped people’s views and lives. Since it was first published in 1939, it has been the textbook, if you will, of how to get and stay sober for millions around the world. AA has spawned numerous other 12-step programs to deal with addictive behavior. And, while basing its recovery program on established spiritual, psychological and medical precepts, Alcoholics Anonymous has also widened the dialogue within all three areas and influenced the way practitioners in those fields deal with addiction.

One could say the Big Book is a classic example of what it preaches. Much of the recovery program contained is taken from the Oxford Group, a Christian fellowship that emphasized self-examination, making amends and working with others. (Wilson and Smith both were members of the Oxford Group for significant periods.) But the Oxford Group’s heavy religious emphasis did not sit well with many of the other drunks who were early member of AA. As a result, most references to “God” were eliminated or changed to a “Higher Power of your understanding.”

Editing also changed the preachy “you” to the inclusive “we” in describing how alcoholics got sober. Thus, this is what we are and this what we did. If you follow these suggestions, “Rarely have we seen a person fail who has thoroughly followed our path.”

What do current members of AA think about the Big Book? A sampling of recent comments:

• “When I first read it, I had to say, ‘(Expletive!) I’m an alcoholic. How did they know?’”
• “I used to walk around with the Big Book (in early sobriety) like a protective shield.”
• “It helped me understand I have an allergy.”
• “In many ways it’s like the bible for alcoholics. It provides direction and order.”
• “Think about the impact. One person reads it and passes it on to others for more than 30 million.”
• “When they get (the Big Book) people are usually in such pain, they will read it.”
• “It gave me a guide for living, far beyond just not drinking.”
• “Simple rules for broken people.”

When it came time to publish the book, Wilson and the others chose The Cornwall Press, a now-defunct printing operation in Cornwall, N.Y.  Because they were going to charge $3.50 for the relatively short book, they wanted it to look impressive, so they used thick paper and the widest possible margins. Hence, the “Big Book” nickname. Subsequent printings were smaller in size, but the name stuck.

The first press run was for 4,800 copies, with the promise from the printers that more would be printed when the first copies were sold. But even those original copies were in limbo as the printer refused to release any books until they were paid for. Although printed in the winter of 1939, only a few copies were paid for at the time. The significant release came in early 1940 — 85 years ago. Today, with inflation, “Alcoholics Anonymous” sells for around $12, but many AA groups simply give copies to new members, continuing to spread its message from one drunk to another.

rjgaydos@gmail.com

By Bob Gaydos

The First Family … in need of an intervention?

Democrats are talking about impeachment. Robert Mueller is looking at indictments. I’m fine with both, but honestly, more than anything else, I think America needs an intervention. Our addict-in-chief is out of control.

In addition to writing a blog for the past 10 years, I have been writing a monthly column called Addiction and Recovery. The goal always is to provide information on issues that are widely misunderstood. Like non-drinkers behaving like full-blown alcoholics.

Like Drumpf.

The Dotard-in-chief has talked sparingly about his respect for the power of alcohol, noting that his brother, Fred, died of alcoholism and at least implying that this may be the impetus for the Donald’s tea-totaling ways. But professionals in the field of addiction and alcoholics in recovery will tell you that alcohol is but one symptom of the disease. Take away the alcohol but change nothing else and you have what’s known as a “dry drunk.” That’s someone who has all the “isms” and can be so miserable to be around that people often wish he or she were drinking again.

They’ll also tell you it’s a family disease. It can cross generations, skipping here, striking there and can manifest in many ways. To repeat, alcohol need not be present for alcoholism to exist. It generally just makes it easier to spot.

What got me thinking about Drumpf and alcoholism was the obvious state of withdrawal he went into following the defeat of so many Republicans in the mid-term elections, culminating in the Democrats reclaiming the House of Representatives. It was bad enough to drive a man to drink. He was obviously depressed and reportedly irritable and angry at everyone in the White House. He even blamed Republican losers for not soliciting his support. He claimed Democrats voted more than once by changing clothes outside polling places. He fired his attorney general. He sat in his hotel room in Paris, watching TV and refusing to attend ceremonies at a cemetery to honor Americans who died fighting in World War I. Because it was raining. He was pouty with all the assembled world leaders, save for his buddy, Vladimir Putin, who managed to bring out a smile in him.

Why Putin?

Well, for one thing, the Russian president may be the only head of state who hasn’t let it be known, directly or otherwise, how little regard he has for Trump, as a person or a president. I think it’s fair to assume that Putin buffs Trump’s huge, fragile ego every time they meet. Especially in private. That’s because Putin is smart and Trump is a sucker for applause, adulation, approval.

It’s his alcohol.

The other factor in his more-erratic-than-usual behavior of the past week or so was the absence of political campaign rallies in his life. Leading up to the elections, they were an almost daily ritual. Get on a plane; fly here or there; make up scary stories of caravans of immigrants threatening America; rile up the base; hear them cheer. Look at all those MAGA hats! This is great! Bartender, hit me again. …

Whaddya mean it’s closing time? I’m the president and you’re not. I want another campaign stop. They love me. Let’s do Arizona again. Tell them I’ll give them a tax cut.

It’s tough to go back to work after that, especially when you hate your job and know you don’t know how to do it but have to act as if you do. Alcoholics tend to have large egos and low-self esteem. This is often disguised by an outsized personality or an ability to persuade people.

Sound familiar?

Dr. James West, founding medical director of the Betty Ford Clinic, who was described by the clinic’s director as “an addiction physician before there was even that term,” also wrote a column on addiction that appeared in the Desert Sun, a daily paper in Palm Springs, Calif. in the 1990s. One column addressed the question of an “alcoholic personality” in someone who doesn’t drink.

“Generally,” he wrote, “alcoholics seem to have the same kinds of personalities as everybody else, except more so.”

Among traits, he said, “The first is a low frustration tolerance. Alcoholics seem to experience more distress when enduring long-term dysphoria or when tiresome things do not work out quickly. Alcoholics are more impulsive than most. Secondly, alcoholics are more sensitive.”

“Alcoholics have a ‘low rejection threshold.’”

Don’t we know it.

Dr. West, who was a recovering alcoholic himself, died in 2012 at age 98. He also wrote: “Another trait found in excess in alcoholics is a low sense of one’s own worth. Then there is isolation. Alcoholics are loners. It is with most difficulty they are able to share innermost thoughts and concerns with anyone.

“Although they may be articulate, charming and very persuasive, they operate behind an armor or shell that keeps the world out. They are afraid of intimacy.”

This brings me back to Trump and the subject of an intervention. Much as I think it’s needed, I don’t see it happening. It’s usually the family and close friends who initiate such a drastic step. Melania seems to have accepted her role as wifely enabler, probably with a sweet pre-nup. The two older sons are chips off the same old block and probably fear daddy’s wrath. Ivanka, the apple of his eye, obviously does not see herself suffering from his addiction. Should that ever happen, the dynamic could change dramatically.

Which is to say, intervention for America from this First Family addiction could come from an interested third party, say in the form of a Robert Mueller indictment of Ivanka, or one or both sons. A moment of stark clarity for the Trumps. No cheering crowds. No MAGA hats. Lots of lawyers and legal fees.

“Daddy, turn off the TV. We need to talk …”

rjgaydos@gmail.com