Life and Death.
I found out Robin Williams was sober when I found out he killed himself. Another incandescent talent. Another squalid death. Another public face on this disease I have, ironworked in choking little spirals around the columns of my own self.
I am Robin Williams. I have gifts and talents. I have a life to share and a work to do here in this place. I love people, and people love me. I am stupid and silly and passionate and cowardly and angry and I have so much inside sometimes I burst at the hope of telling it all.
I am an alcoholic. I nearly died a drunk. I wasted a decade. I shuddered at the light and recoiled into the dark so that none of you could see my shame. I drank until I couldn’t drink anymore, and I didn’t care if I lived or I died. I drank in the dark, because the light let me see myself.
And like Robin Williams must have, I finally found myself at that place where I was defeated. And like Robin Williams must have, I turned into the light of surrender and found that millions of us have ascended from the graves we dig for ourselves in the darkness. And like Robin Williams did for so long, I no longer drink, and I work my program, and I share my story so that you can come get what I have.
After twenty years, Robin Williams drank again. He tried again to recapture his sobriety. And in the end, he decided death was preferable to the cell he found himself in. I know Robin Williams. I’ve known too many suicides. We die. By the thousands and in dark, lonely places, all over the world, we die.
I am Robin Williams. I am powerless over this disease. I understand that coffin’s luster. I don’t know that I could return from relapse and desolation back into this green, gold landscape that I have been set on by powers beyond me, communities stronger than me, love more powerful than me. I can’t know that I will never drink again. I can’t know that suicide won’t ever be the best option I have left.
Today I am sober. Today I am alive. Today, I am fucking angry at another fine man laid in earth or burnt in a box because of this same wretched affliction that I have written on my soul. Today, it wasn’t me.
I am in great middle of my life. While I live, while I’m sober, while I breathe clear air, I stand humbled by the men and women around me who cannot attain or cannot keep what I have. And I don’t know where I will stand at the end of my life. Among those sober? Among the silent dead, lost? I cannot know.
I am Robin Williams. But I don’t have to die like he did. Today, I am a sober member of Alcoholics Anonymous. Today, I walk among the living, rather than hanging among the dead.
Paid Interns Only.
I don’t accept unpaid interns. MECMC is a teaching hospital, and it is affiliated with VFU, a major university with a prominent medical college. Just down the way there is UHR, another fine school with a well-respected school of medicine, and school of nursing. Vast swarms of undergrads at both institutions are, like just about everywhere, “pre-med” majors. As a quality and safety researcher, there is no shortage of engineering students who would love to work for me without remuneration, who intend to move on in healthcare, or medicine, or simply get real-world experience on their resumés.
I like working with students. I’ve mentored more than a dozen through internships, school projects, and my own research projects. I like teaching how to do systems engineering at the professional level. I like teaching engineers how to communicate with physicians. I’m a fan of the student engineer in the healthcare setting, and I’ve even published about it.
I don’t take on unpaid interns. In order to work with me, a student must receive either money or scholastic credit worth a commensurate amount to the work they put in. I try to pay at least $15/hour for undergraduate labor. I can usually not arrange benefits, because I haven’t had enough money for actual hiring, just stipends. But if I can’t pay enough to make the internship a legitimate source of income for the work done, a real value, I don’t accept the student. And authorship on a paper is not a fiduciary instrument. That alone is not sufficient value. Value must be quantifiable, and real rather than imputed.
The reason is that I believe that unpaid internships reinforce class structures that exist to the detriment of science, productivity, education, and society. Students from lower socioeconomic backgrounds often do not have the option of doing unpaid work: they must earn a living while studying. This often means accepting whatever paid work they can find, which is usually not something that will further their career and help them make professional connections. Conversely, students who can afford to work without pay, for experience alone, generally already have significant privileges (or scholarships).
I do not, however, means-test my interns. When I have funds to provide student interns with stipends, I hire according to the resumés I receive. I try to do the best I can at finding the best students without regard to their personal status. Like all humans, I have biases and preconceptions, but I work hard to limit them. And I have mentored students from just about every race and gender and socioeconomic category there is among undergraduates at private R1 universities in the USA.
I believe in trying to set a flat field to compete on. I know I’m not perfect at it, and I’m not sure a perfect solution exists. But I think it starts with the basic justice of reasonable pay for reasonable work, and not selecting against fine students who simply can’t afford to work for free.
The World’s Best Coffee.
I grew up in Seattle. As a child of the grim Pacific winter, I was bottle-fed coffee from birth. And there is good coffee in Seattle. Little trailers with espresso machines in grocery store parking lots are your best bet for the truly great stuff. Usually operated at a languid pace by someone who desperately wishes they’d been at Woodstock (the real one, in the sixties) and could not possibly be happier that recreational marijuana is now a thing in Washington State. They see it as a matter of civil justice. And they make ruthlessly magnificent coffee and charge you like robber baron.
Thus, I grew up something of a coffee snob. Though, if I’m honest, I grew up as an everything snob, and coffee falls into the set of ‘everything’ as an element. I prefer, all things considered, brewed coffee over espresso. Milk, no sugar. No flavors. Simple, classic. Medium-dark roast. Shade-grown* is a sucker’s cup. Trying to fool you with expensive placebos.
Even in the appalling years of my alcoholism, when I drank vast quantities of liquor and did little else of value, I still drank coffee and appreciated it. And it wasn’t until I entered sobriety that I discovered the best coffee in the world. The very best.
The world’s best coffee can be found all across America. In church basements and community centers. In museum rec-rooms and VA hospital activity areas. It’s usually a store-brand, freeze-dried. But it might be instant. The person making it is probably doing so as a commitment they keep to remind themselves that real happiness comes from serving others. Or because they’ve been told to keep making the coffee until they discover that, and then they might be pissy and resentful about it.
There’s a folding table in the room, probably. And metal chairs. And survivors. And we tell each other our stories. And we share our struggles. And we reclaim our lives from that grim winter.
And some of us fall. And some of us die. I’ve known too many suicides. Too many who slip away and then months later, “Did you hear how they found her?”
But so many of us rise. From ash and bankruptcy and the cold silence of withering misery, we rise to daylight and sunlight and color shining from the apple-cheek of all this impossible beauty around us. This path we walk, out from war-torn desolation and into the serene places of soft green silence. We rise to living. We rise to fellowship.
I am a sober member of Alcoholics Anonymous. And if you are where I’ve been, then I can show you how to get where I am. Come have coffee with me. It’s awful. And it’s the best in the world.
_____________________________
*As I understand it (poorly) the concept of “shade grown” was originally about biodiversity in orchards, to ensure that vast areas had more than just coffee trees, for more robust ecosystems. If that’s true, then I obviously have nothing against such efforts. But let’s all be grown-ups and admit it has nothing whatsoever to do with the flavor.
The Second Half.
You know, it really is something to be 40 years old and literally be in the best shape of my life. You hear that a lot, and for the most part I’ve always assumed it’s bullshit from someone selling powdered youth on television. And usually, I think, it is. But in my case, I spent such a very long time poisoning, abusing, and neglecting my body that it frankly wouldn’t have taken a lot to get me into the best shape of my life.
And of course, I’m using “life” to mean “adulthood”. I was a wiry, fit child. That ended at puberty. From age 14 to age 37 I was overweight, often flirting with obese. And I was in poorer shape than many people of my same height and weight, by a long shot, because of my drinking and smoking and sedentism. Starting in my 37th year, I began to walk and run and work out, having quit smoking about 18 months prior. I was sober about three years.
A lot of alcoholics run marathons. Recovering ones, I mean. I will not likely ever run a marathon, though it has gone from “ruled-out” to “distant possibility”. But I am about to run my second half-marathon. In about seven weeks, I’ll suit up again to go 13.1 miles, on September 21st in Philadelphia, where they’re holding the “Rock and Roll Half Marathon”. I’ll be running with my partner again. And I am hoping to improve on my time from the Pittsburgh half, where I ran 2:38. But if I’m slower, I’m slower. My only real goal is to finish.
I’m excited. I have an obsessive personality. It’s not a disorder – thankfully, that’s one mental illness I don’t suffer from – but it does lead me to collect things. I collect experiences, objects, travels. I collect things I’ve read, things I’ve done, academic degrees, professional milestones. But my most precious collections are things I’ve accomplished.
Now, I am trying to accomplish something that I never tried to before. I’m trying to accomplish health. I’ve been working slowly on it for about six and a half years now. From pounding angrily on Death’s door, demanding to be let in, I have stepped back. Surrendered to my nature, and relinquished the substances of my addictions. Rooted myself from torpor and begun to move with more intention across the landscape of the second half of my life.
I am out of the sludgy wallow I inhabited for so many years. I have learned much of living. Mostly, I’ve learned how much more I have to learn. But I need not lucubrate on life. I run in bright light.
Label Makers.
I am an alcoholic. I claim that label, because it’s true. I am an alcoholic in recovery. I use “recovering”, “recovered”, and “in recovery” interchangeably. Some people in AA argue about the use of particular terms. In particular, some people object to “recovered” because it sounds too final, and we live a day at a time. We all know that we can return to drinking. But the book Alcoholics Anonymous uses the term recovered, and it’s our own founding document. If it’s good enough there, it’s good enough for me. I also like to use the term “in remission”. It focuses on the disease-state of alcoholism in a way that I feel “recovery” often fails to.
But the above is an essentially complete list of labels that I choose for myself. In some ways, that’s a result of my privileges. I don’t need to assert and defend an identity that’s not broadly accepted. I don’t suffer discrimination or marginalization or violence because of the randomness of my birth. That alone makes me incredibly fortunate.
In other ways, I don’t adopt labels because they so often seem loaded with other baggage that I may or may not endorse; indeed may not even be aware of. Years ago, I considered myself a Christian. But even when I felt deeply connected to that religion and that community, I rejected a lot of the social implications of that label. Nevertheless, I was lumped in with a stereotype, and observed that I was perceived a specific way by others (both within and without the Christian community) that often had little to do with the truth of who I was or how I felt.
A few years ago, I attended a skeptic/atheist conference with a friend. I do not call myself either one of those, but I find that there’s much to admire (and much to criticize) about that community. And I am sympathetic to the use of evidence in decision-making. And I took the opportunity to hang out with one of my best friends for a few days. The opening speaker, David Silverman of American Atheists, gave a half-hour long speech in which he tried to push the label “Atheist” on the crowd. His entire focus was on getting people to adopt that specific label. Over and over he said things like, “If you consider yourself an agnostic because you don’t know if there’s a God, you’re an atheist!”
Nothing makes me less likely to accept a label than someone telling me I need to do so. And not because I’m simply contrarian. I’m not very contrarian. I don’t, generally, enjoy disagreeing with people. I do a reasonable amount of it, but I don’t like it. Not anymore.
I don’t accept labels because so often they come with agendas that I don’t understand, or don’t agree with, or am not willing to fight for or about. Because any label I accept walls me off from engaging meaningfully with people who take on an opposing label. Because I’m not interested in being a statistic in someone’s algorithm for promoting their political agenda. Not even when I agree with that agenda. I am completely opposed to the teaching of creationism, intelligent design, or other religious concepts in the public schools as an alternative explanation to scientific facts and theories. Nevertheless, I do not accept the labels of distinction that the people who oppose such things promulgate. I am not a “skeptic”. I am not an “atheist”. Even if I believe many, most, or all of the same things that people who call themselves those things believe.
The same is true of just about any other label that people like to put on people who believe in particular political causes. I have opinions about almost any political agenda a person can name. But I don’t accept the identity-labels that go along with these positions. Because I would have to accept many, and some would conflict with others. Because taking on a label about taxation policy means capitulating to being perceived to have other unrelated opinions about agricultural policy or the health care policy or circumcision or military interventions. Labels rarely come alone. And many are deemed incompatible with each other.
Not adopting labels has consequences too. People assume that if I do not call myself the appellation of their movement, that that necessarily means that I oppose it. That’s not true. I support, and even fight for, many causes that I don’t identify with. But I have made the decision that I’d rather be mistaken for a bystander than a warrior.
I am an alcoholic. I wear that label. And it is the only one. Because as an alcoholic in recovery, I am dedicated to being available to people of any political position. Of any identity. Of any circumstance. When someone seeks recovery, I do not want them to pass by asking me for help because I wear some other label they find objectionable.
Now from Then.
Today I start my fifth decade of life. I don’t think I have anything remarkable to say about it. I am now a middle-aged man living in a large city on the East Coast of the United States. I have a partner who lives in another nearby city, whom I love deeply and loves me. I have a career and a house with a mortgage. These are all unremarkable things. In these respects, I am similar to millions of people all across this country and this world. These are all good things. They represent an achievement that I am proud of. My achievements do not need to be extraordinary to be worthwhile, to be valuable to me.
As a boy, I always felt apart. I was never popular. I rarely had many friends. There were plenty of good reasons for that. I was odd, and I was smart, and I was insecure. This manifested in me learning to find ways to prove to others that I was better than they were. So I developed a powerful need to know more, to be right. I pursued this self-defeating arrogance for many years, even when it was obvious that it was preventing me from developing socially in ways that would allow me to be happier.
I never knew how to relate to people until I found alcohol. Or alcohol allowed me to find people I related to. But I didn’t remain a gentlemanly drinker for long. And soon enough I was entrenched in fatality-statistic drinking. I smoked. I sat. And I drank. And I was miserable. For more than a decade, I smoked, and I sat, and I drank.
My fourth decade included a brief marriage. I don’t feel much need to write about her anymore. We were right for each other in many carefully-chosen ways, because we were each seeking someone to make us miserable. And we each succeeded at that. And there were innocents caught up in it, and I lament that. I cannot change it.
But in trying stupidly to save a marriage failed from the outset, something wonderful happened. I learned that I was the cause of my problems. I had to be shown that, but when I saw it, I could not unsee it. My drinking, my recalcitrance, my arrogance, my righteousness. I was the cause of my own misery. I had chosen my misery carefully and elaborately, and I could suddenly see whole bankruptcy of it. And if I wanted my life to change, I had to change.
I went to an inpatient rehab. I went to Alcoholics Anonymous. I stopped fighting. I stopped trying to assert control over the things I have no control over, and first among those things is alcohol. When I stopped trying to control and manage my alcoholism, I found that I could relinquish my need for alcohol. There was a slow, terrifying but enlightening process of unclenching.
I remember thinking then: “When I turn forty, I will be sober for six and a half years.” It was unfathomable. And it is not how I would recommend anyone think when they are new to sobriety. When I looked at now from then, I couldn’t imagine what it would be like. I could barely imagine going a month, a season, without drinking. Years had little meaning.
But years pile up just the same. Now, six and a half years later I am still sober. I am no longer married. In fact, I’ve been divorced now longer than I was married. I don’t know much about what my ex-wife is doing. But I genuinely wish her well. There are still things I resent about my marriage, but they are mostly about myself. I set myself up to fail, and I failed as designed. And that’s ok, in the long run. Because I lave learned to learn from failure, instead of repeating my self-defeating behaviors.
In the years since I got sober, I’ve done a lot. Eighteen months after I quit drinking, I quit smoking. Which means I’m approaching five years without a cigarette. Eighteen months after I quit smoking, I started exercising. Professionally, I got my first real job at six months of sobriety. After a year and a half, I was promoted to a Principal Investigator position. After three years of that, I moved on to my current post, which involved leaving the city I’d spent my entire adult life in. I have now held this position for about fifteen months, and it seems to be going very well.
I met my partner. With whom I share far more than I understood was possible before. It is wonderful and liberating to be a part of a relationship in which both people are invested in success and support and intimacy and companionship. I finally have the relationship I dreamed of. Because I finally became a man capable of participating in it. Capable of waiting for the right relationship.
Today, as I start my fifth decade, I am a grown man making his way in the world. My life today is very close to what I imagined long ago. A home. A partner. A career. I used to imagine children, but I’m grateful that that never happened. I’m not as rich or as fit or as handsome as I’d like to be. But who is, really?
I feel like it took me a long time to learn things that other people learn early on. How to look inward for the source of my disquiet. How to take responsibility for my career and my home and my relationships and my happiness. How to recognize my limitations, and not struggle fruitlessly at things I cannot attain. How to recognize the difference between a limit and a challenge, and find ways to meet challenges that once seemed impossible. How to appreciate the passage of time.
I have learned how to live. I owe that to Alcoholics Anonymous, and to surviving a great many mistakes. I don’t know what the next decade brings. I don’t need to know. Because I know what I am. And where I stand in a world full of unknowable things. And that makes me grateful for all this wonderful mystery. All this incredible life.
How We Feel. What We Do.
Lately, I am feeling slow and stupid and lazy and ill at ease. Discontent. Fraudulent. Useless. I’m feeling angry and irrelevant. Uncreative. Dull. I am supposed to have ideas and be interesting. I am supposed to be engaging and dynamic and focused. I am not any of those things right now. Sludge and bituminous, sessile stupefaction. I don’t have the things in me I feel like I should have to be productive and mobile. I am wasting but bloated.
That’s how I feel. I’ve felt this way for a while. A month at least. When I feel this way, and it isn’t uncommon, I have a tendency to wallow. It’s an appallingly childish, dramatic inclination. I want simultaneously to shrivel into total oblivion and to have everyone come look at how horrible I am. A masochistic narcissism.
It is a state that we alcoholics often refer to as, “being in my own head.” I’m in a peculiar and absorbing headspace. It does me no good to linger here. So what can I do?
Well, I used to feel this way all the time. What I did was drink. Drinking doesn’t cure this space. In fact, it worsens it catastrophically. But it also obliterates the keenness of it. The glass-blade sharpness of intolerable disquiet. Alcohol does a magnificent job of sanding down that edge for an hour or a day. At least, until it doesn’t anymore. That’s the problem with disease progression of course. First I needed more to get the same effect. Then, no amount could ever produce what I needed from it.
What can I do instead? Being sober has allowed me to understand time in a new way. I can let go of the immediate need for anesthesia by recognizing that pain and discomfort are temporary. I will not feel this way forever. Hell, I didn’t feel this way yesterday. I might well not tomorrow. It used to be that even during the hours that I wasn’t drunk, I still wasn’t sober. I didn’t know how to recognize that things pass. I may not need to treat every insult with a blackout drunk.
I can work my program specifically on the issues that I am struggling with. In AA, we often call this “doing a 4th step” or “doing a 10th step”. We look at the thing that’s troubling us, and we ask questions. “What does this affect in me?” “Who is involved?” “What is my part in it?” All by themselves, these questions can lead me out of the dark. When I understand the source and impact of a period of melancholy, and can identify my own part in it, I can often just let it go from there.
I’ve always been told that courage doesn’t mean not being afraid. Courage means doing what needs to be done despite my fear. I think that’s true of my melancholy and my laziness and my general discomfort. It’s not so important how I feel. It’s important what I do. I am lazy: I will run. I am angry: I will meditate. I am bitter: I will do things for others. I will take actions I know to be effective in changing my feelings, rather than actions designed to mask, obliterate, or conceal them.
And crucially, I will not be alone. I have many, many loving friends and a devoted family. Those are wonderful things, but they cannot replace the simple understanding and support that I get from talking with another sober alcoholic. One who understands what it means to walk through the feelings rather than away from them. Who understands how my mental state is related intrinsically to my alcoholism, my disease. Who understands that relieving my condition is not the same as removing it.
I never want to be a non-alcoholic. I’m so grateful to be what I am. Where I am. In all this tumult, I have found a deliberate way to live. And I will not relinquish it.
Tiny Little Crises.
Jesus I’m tired of myself. I’m tired of wanting to be right. Tired of wanting people to agree with me. Tired of arguing and striving. I’m doing it completely wrong. All of it.
When I first got sober, there was an enormous relief that I felt in so many things. Relief that I didn’t have to be right for the whole world anymore. Relief that I didn’t have to care if other people were right or wrong. Relief that I didn’t have to lie and struggle and remember who I’d told which lie to. Relief that I could simply be clear and calm and restive in my mind and heart.
I’m wrenching myself into knots again. Struggling with people. People who know more than I do. It’s so easy for me to feel like I have some secret knowledge that other people don’t have. I don’t. I’m the same puffed-up know-it-all I was when I was twelve. And just like when I was twelve, I don’t actually know very much.
I’m turning forty in a minute. My life is around half over. I have a wonderful partner and a good career and I’m tying myself into knots worrying about things I have no influence on, and no real knowledge about. I’m still acting like a child, indignant and insistent and spoiled and unaware.
I know a few things. I know how to help someone who wants to recover from alcoholism recover from alcoholism. The way I know isn’t the only way. But it’s a way that worked for me and many others. I need to stop worrying about anything else, when it comes to recovery. I can help who I can help. And I don’t have much to say about anything else.
Of course, my lack of knowledge hasn’t stopped me from spouting off and being stupid. I hope I do less of it now than I used to, but I still do far too much.
A lot of people I care about are going through trials that are greatly burdensome. I can’t help any of them with it.
I am utterly and completely powerless over other people. Over my relationship with alcohol. Over the tribulations of my loved ones. I can choose only to engage or disengage. Fight and lose, or surrender and be free. There is no victory in struggling for me. I do not have access to the kind of life where battles are fought and won.
I am tired. I am tired of manufacturing these tiny little crises. I need to let go.
A Three Month Failure.
Over at Complex Roots, I’m closing up shop after deciding I don’t have what it takes to make that place in my vision.
Medicine Will Never Cure Alcoholism.
A couple of online conversations have me thinking. I’m about to put forth a fairly long “No True Scotsman” description of alcoholism. I am friends with a bunch of neuroscientists. Many of them study addictions. I am not going to pretend that I understand the first thing about neuroscience. I don’t even understand basic cell biology at the high school level, much less the cutting edge of brain science. My best attempt at a precis of their basic argument about the ability of science and medicine to cure alcoholism goes like this: “As we come to understand how substances affect and make changes to the brain, and understand the way that addicts’ brains behave differently from normal people’s brains, we will be able to make targeted interventions which will relieve symptoms and causes of addiction. These interventions may take a variety of forms, including therapy, pharmaceuticals, surgery, or something that hasn’t been developed yet. But understanding the brain will lead us to relieving and preventing the suffering from addictions.”
I want to stress again that this is my understanding of their argument, and could be flawed. It’s not a quote from any person, but a brief synthesis of many discussions in a variety of venues. One area which has been specifically described to me by a couple of my neuroscientist friends who study addiction is the area of relapse. Several neuroscientists have told me that they believe that “a pill to prevent relapse” is a reasonable possibility. Maybe not soon, but eventually. Essentially, they seem to believe that we could, with appropriate understanding, devise a pharmaceutical intervention which relieves addicts of all cravings, and thus prevent them from returning to use.
I am happy that people are making these efforts. I suspect that they will, in the long run, be useful for some people who struggle with addiction. And as I have repeated over and over here, I believe in the value of medicine for treatment of addictions, especially in the acute phase of detoxification and withdrawal. When I quit alcohol I was at extreme risk for seizure and death. I quit cold turkey, going from a bottle (or more) of 80 proof liquor a day to nothing in the period of 24 hours. I took Depakote, and Atavan. I didn’t have any seizures.
I stopped taking Atavan within 3 days of abstinence. I stopped taking Depakote a few months after that. I have taken and anti-depressant from time to time, but other than that, I take no medicines other than aspirin. But I would, if I needed to and was under the supervision of a physician. There are medicines, like Chantix, which purport to help quell cravings. It did not work for me when I took it for nicotine withdrawal. Apparently, it has worked for others for a variety of substances.
But the idea of a pill that prevents chronic relapse is ludicrous to me. But first, the issue of definitions.
Now. Not all problem drinkers are alcoholics. Not all alcoholics are the same, and what works for one may not work for another. Scientists and physicians tend to use particular and specific definitions for “abuse” and “dependency” which are, frankly, irrelevant to those of us in the trenches with “real” alcoholism. When I talk about alcoholism here, I am talking about a state far, far advanced compared with what meets the scientific thresholds for “abuse” or “dependence”. Those definitions are so broad as to envelop huge numbers of drinkers who have no need for AA, or who are able to moderate or quit without outside assistance of any kind.
When I speak of alcoholism, I eschew the denotative definitions. In some ways, even having those definitions at all is counterproductive. We alcoholics, we can use any deviation from a medical definition we find to justify that we don’t have a problem. And any definition that does not allow us to wiggle out from under it will be too broad to be meaningful. The very existence of an attempt at a rigorous definition causes harm to alcoholics like me. And yet, without one, scientists and physicians cannot treat or study the disease.
Now, as I said before, medicines in the acute phases of withdrawal are perfectly appropriate. I had some awful cravings, and having those relieved would have been lovely. But a pill that could be taken long-term to prevent relapse in a chronic sense is absurd because it wouldn’t be treating anything. No one I’ve met or heard of with sobriety of a duration longer than a year says they continue to have cravings. No one I’ve met or heard of who has relapsed after long sobriety has said they did so because of cravings. Cravings exist in acute withdrawal, and then cease to exist. I haven’t had one since day 12.
People who relapse after long sobriety do so because, almost uniformly, they have stopped doing the things they need to do to maintain their sobriety. None of which have anything to do with alcohol, really. And if there were a pill that somehow – magic by today’s standards – prevented a person from taking another drink, they would still have to take that pill. We don’t relapse because we suddenly want alcohol. We relapse because we stop engaging with treatment. So any pill to prevent chronic relapse is almost by definition useless: it is treating something that doesn’t exist; and people who will assiduously take it don’t need it, because they already remain engaged with their sobriety.
The problem with addiction science is the same as its strength: it is focused on addiction. As such, medicine has done a wonderful job of treating the medical issues associated with cessation of substance abuse. Alcoholics used to die with alarming frequency while in acute withdrawal. Now, not so much. Thanks to science and medicine.
However, what addiction science and medicine cannot seem to accept is that treating my alcohol abuse and dependency was easily, far and away, by leaps and bounds, the least important part of my recovery. Alcohol is not my problem. I’m just addicted to it. That’s not really that big a deal. The big deal is that I am a person who likes to treat my discomfort with obliteration. Treating that required some enormous efforts, none of which were medical, or required medical intervention. And without which any attempt at treating my addiction to alcohol would have been futile, because I would not honestly engage with any treatment for my addiction to alcohol.
Barring some kind of childhood injection which fundamentally alters human responses to alcohol and/or misery, there will never be a cure for alcoholism based on science and medicine. Nor do we need one. Science and medicine have already done their heavy lifting, in my opinion. They have dramatically softened the course from active alcoholism to abstinence. But they continue to have nothing to say about sobriety. Alcoholics of the type that I am, which is a lot of us, cannot be maintained in sobriety – that is, long-term, fruitful and happy abstinence – by science and medicine.
Those of us who do not want sobriety cannot be compelled to it. We can be compelled to abstinence, but those I know who have been down that road tell me it is worse that active alcoholism. There will be no triumph for the scientist who compels abstinence on unhappy alcoholics. That life is no better than drinking. And that path may actually cause great harm. Placing our sobriety in the hands of a physician gives us permission to fail: we can rationalize the failure to be someone else’s doing. Sobriety is emphatically not about will power. But we alcoholics often like to believe it is, so that we can blame our failures on frailty, or the failure of medicine to support our will. We will recruit anything at all to justify returning to alcohol.
And those of us who want and are willing to be sober have no need for science and medicine after the first initial detoxification. There is already a path to sobriety for us, and there is no way to make it easier by treating our addictions. Our addictions are not the problem. Our addictions are our perverse solutions to the disquiet in our selves. Treating that disquiet, daily and for the rest of our lives, is how we become sober, and happy, and free. It requires no medicine. No will power. Only willingness, and another alcoholic to talk to.
Infactorium 