For this week’s All About my Diagnosis, I’m talking about one of my diagnoses, Alcohol Use Disorder!
What is Alcohol Use Disorder?
Alcohol Use Disorder (AUD), also commonly called alcohol addiction or alcoholism, is a mental health condition that about 16 million Americans live with. People with AUD have symptoms like:
- Feeling out of control of their drinking, often drinking more than intended, more often than intended, or for longer than intended
- Experiencing cravings and withdrawal symptoms when not drinking, and experiencing increased tolerance for alcohol over time
- Wanting to cut down or stop drinking, or experiencing a lot of negative consequences because of drinking, but feeling unable to stop
AUD is a very lethal mental health conditions. People with it who continue to drink can:
- Develop liver disease and other health complications
- Have serious injuries from falling, driving while intoxicated, or behaving recklessly
- Have deadly withdrawal effects called Delirium Tremens (“the DTs”)
Fortunately, AUD is treatable and people like me recover from it every day. I was diagnosed with AUD in 2014, during my second detox, and I haven’t had a drink since.
What it’s like day to day
Most days, I forget that I have AUD. I don’t keep alcohol in my house and I’m not really friends with anyone who drinks heavily, so I’m just not around it very much. Sometimes I have mild cravings for alcohol, or fantasize a little bit about drinking. Usually that happens when I’m having trouble falling asleep or I’m having a rough day. Most of the time, these feelings pass within a few minutes and I can forget about it again.
Sometimes, though, I have really intense cravings and fantasies about drinking that won’t go away. When that happens, I usually do the following:
- Put my wallet and keys out of reach, which gives me time to reconsider my actions between the decision to go to the liquor store and actually leaving to do so
- Read a recovery-oriented book
- Write a list of reasons why I stopped drinking
- Distract myself by talking to a friend, knitting, playing video games, or something else
I don’t like the smell of alcohol, so that’s something that comes up periodically for me. It simultaneously gives me cravings and reminds me of a time in my life when alcohol ruled my world and everything was crappy. I don’t like that feeling at all. Usually, if someone is drinking near me, I’ll just ask them to move their drink a little further away so I don’t smell it.
One of the main things I have in place to avoid relapse is taking Naltrexone every day. Naltrexone is an opiate antagonist, which means that it prevents opioids (both ingested and produced by the body, like endorphins) from binding to receptors in my brain. This basically means that I can’t get high from opiates and I can’t get an endorphin rush from doing things like drinking, binging and purging, or self-harming.
While I haven’t actually had a drink since I started taking Naltrexone, I feel safe knowing that it’s in my system. If I have a lapse, it will be a whole lot less rewarding that it would be if I wasn’t taking it. A lot of people who take Naltrexone find that they can actually start to drink moderately like people who don’t have AUD because it interrupts that heightened reward pathway that we have. I’m not personally interested in trying moderate drinking, but it’s just nice to know that, if I do have a lapse, it will be a lot easier to prevent it from becoming a full blown relapse.
The hardest thing about living with AUD
It isn’t actually avoiding drinking that’s the hardest thing! Taking Naltrexone is one of the hardest things, because it’s not like it can interrupt endorphins for only negative things. It does it for everything that produces endorphins. So that means I don’t get an endorphin rush when I do exercise, which makes me uninterested in it. It makes me uninterested in food during the day, so my eating pattern is a little messed up. It makes sex challenging. Immediate gratification doesn’t really exist for me, I have to focus on long-term gratification. But those are sacrifices that I’m willing to make to protect myself from relapse.
Misconceptions about AUD
- The idea that there is only one way to recover – total abstinence and going to AA. While I have chosen complete abstinence from alcohol, not everyone does, and that doesn’t mean they haven’t recovered. I listed the symptoms of AUD above. If someone learns to drink moderately and stops having those symptoms, they are in recovery. Some people use Naltrexone to help them learn to drink moderately and some people do Moderation Management without it. Some people use Antabuse to help ensure their abstinence, some people don’t use any medications. Some people like AA, but SMART Recovery, LifeRing, and Rational Recovery are all good options too. Some people don’t like joining a group at all. No matter what their method, recovery is recovery.
- The idea that someone under 25 is too young to have it. I’m encountering this less as I get older, but I got it a lot several years ago. Some people have this idea that alcohol addiction is something that happens slowly and I was just too young for it to have developed yet. I was just binge drinking like a college student. But that’s not true. I knew I had a problem with alcohol within weeks of my 21st As soon as I had regular access to alcohol, I drank it all the time. I had the shakes in the morning within months, and I went into detox before I turned 22. It doesn’t start slowly for everyone.
- The idea that you have to hit “rock bottom” in order to recover. I think a lot of people, myself included, are perfectly capable of realizing that they have a problem and choosing to get treated for it long before they destroy their entire lives. The idea that I’m not going to stay in recovery just because I didn’t wreck everything is a little insulting and disempowering in my book.
What having AUD means to me
Having AUD has given me an interesting perspective on life. I can’t choose to rely on a drink to help me unwind at the end of the day. I’ve had to find other ways to do that, like knitting, which keeps me very present and mindful. I don’t feel like I have an escape from the world like other people do, forcing me to stay aware of all the things I don’t like and want to change. I think having AUD has helped me become more stubborn-in-a-good-way. If I don’t like something, I feel motivated to change it because I don’t have a way to forget about it. This has helped me get back into school, find fulfilling work, and leave an abusive relationship.