How To Have a Sober 2014

2014 Resolutions: When alcohol isn’t working for you anymore

When a person recognizes there’s a problem with his or her drinking, New Year’s often brings resolutions to quit or cut back. Quitting or cutting back can be as life-changing as pledges to work out more in 2014 or promises to get a new job for the new year. Here are five things to know about alcohol use disorders, quitting and staying sober, whether it is for life, or an experiment for Dry January.

I suggest you scroll down the box and read them all.


1. Alcohol abuse and alcoholism are not the same thing. I’ve got the detail on the differences in both my books as well as at www.alcohologist.com… and the differences are aplenty. Cutting back on alcohol consumption may be a practical outcome for an alcohol abuser. If a person has the disease of alcoholism, total abstinence is the only way to put the disease into remission.2. Nine out of ten people who quit drinking fail to stay sober the first time they quit. More than half drink again within six months. Set your expectations accordingly. Lapse or relapse or slips are as likely with alcoholism than with any other disease. They are not the end of recovery. It just means you have another chance to quit. One man, who might be the most famous alcoholic ever, lapsed four times in 22 months. He quit a fifth time though. That’s Bill Wilson, one of the founders of Alcoholics Anonymous (AA).3. AA is not the only game in town. There is rehab if you have the resources or insurance, either inpatient or intensive outpatient. There is counseling, either one-to-one or as part of a group… there are also several other self-help groups, such as Self-Management and Recovery Training (SMART), Secular Organizations for Sobriety (SOS) and Women for Sobriety (WFS). None of the latter enjoys the widespread availability of the 12-step program of AA however. Those who have success in sobriety acknowledge one common thing: No one gets sober and stays that way without help, whether through counseling or self-help groups or both.4. A chronic, heavy drinker should never attempt to stop drinking on his or her own. Alcohol withdrawal is the only other drug aside from benzodiazepines (think Valium) in which the withdrawal can be fatal. Heroin withdrawal is not fatal. Cocaine withdrawal is not fatal. Alcohol withdrawal can be. Alcohol changes the body tissues. Once the tissues become dependent upon alcohol, it is possible that taking the alcohol away will cause cardiac arrest, stroke or seizures. Supervised detox means medical assistance is nearby and nearly all supervised detox involves medication to ease the physical discomfort of withdrawal, which increases the probability for success.

5. Changing a habit takes three to four weeks, which is one reason many inpatient rehabs have a 28-day program. But that isn’t nearly the end. More severe alcoholics are barely medically stable after just a month. It takes effort – some days more than others – for the first year of sobriety, and an acknowledgement that alcoholism is not curable so the change will mean making adjustments for the rest of one’s life. Alcoholics and non-alcoholics alike return to alcohol for the same reasons of stress, grief, guilt or shame. Getting sober and staying sober only begins with a desire to stop drinking and getting some help in the first part of abstinence. The rest of recovery is learning to live without alcohol for those stressors.

The long-term benefits outweigh the short-term discomfort…

Stopping may seem like a labor today, but there are long-term considerations for the alcohol consumed, even for so-called moderate drinkers.

Alcohol itself is toxic. It’s broken down in the body in the following sequence:
Alcohol>Acetaldehyde>Acetic Acid (vinegar)>Water+CO2
The first metabolite, acetaldehyde, is 30 times more toxic than alcohol and is responsible for damage to tissues.

The relationship between chemicals and your DNA is part of a field called epigenetics and epigenetics is now showing that the alcohol you consume and its acetaldehyde byproduct leave a biological imprint on your DNA, one that can surface in diseases later (Wall Street Journal, February 28, 2012). If the drinking doesn’t kill you immediately, it can kill you years down the road.

The weight of scientific evidence demonstrates a link between alcohol and a greater risk of mortality for diseases of the immunological, nervous,,cardiovascular, and respiratory and digestive systems. This was most recently confirmed by researcher Domenico Palli, a scientist at the Cancer Research and Prevention Institute of Florence in 2012, and new links with diseases and alcohol are being reported nearly weekly. Absence of evidence is not evidence of absence. If you don’t have the following conditions now, there are provable connections to getting them years after abstinence… the longer a person waits to quit, the higher the risk.

Just some facts why you really should think twice before pouring again.

Liver damage/disease
The alcohol user is eight times more likely to get cirrhosis, which is irreversible,incurable and fatal. Not all alcoholics will get it. One in 10 develops cirrhosis. However,it is not the only liver disease cause by alcohol/acetaldehyde.A fatty liver occurs when alcohol consumption disrupts how the body chooses its fuel. Cell mitochondria—our body power plants—normally use fat to produce energy. As aacetaldehyde breaks down in the body it releases hydrogen, which mitochondria use before fat as fuel. The unused fat then accumulates around the liver. Even in someone who doesn’t look fat in their extremities or midsection, fat deposits choke the liver.

Alcohol itself raids the body of vitamin B (Thiamin) which is essential for a healthy heart. B-deficiency enlarges the heart and creates distended neck veins, narrow pulse pressure, elevated diastolic blood pressure (the second number in your BP) and peripheral edema. Acetaldehyde also physically weakens muscle, the heart being your body’s most important one. Think of how the tongue muscle is weakened from drinking (slurring) and leg muscles are weakened (wobbliness) and the same thing is happening to the heart muscle. However, with the heart, the weakening causes damage that accumulates.

Acetaldehyde also increases cholesterol, especially triglycerides. High cholesterol is a leading indicator of heart trouble on the horizon and the number one condition treated with prescription drugs in the U.S.

Brain damage/mental disease
Cadaever brains have provided conclusive evidence of a brain atrophying (shrinking) after alcohol misuse. However, Dr Ernest Noble of University of California—Irvine says, “Brain damage caused by alcohol, in relatively small quantities can affect the ability of brain cells to make proteins and RNA . . . essential for metabolism and organization of all cells as well as their ability to duplicate themselves.” A former social drinker, he quit drinking at all upon conclusion of his study.

A 2012 study similarly indicates that moderate drinking reduces the production of new brain cells by 40 percent. The November 8, 2012 journal, Neuroscience, reports the level of alcohol intake was not even enough to impair the motor skills of the rats in the study, however, the decrease in the brain’s ability to create new cells could have profound effects on learning and memory later.The area of the brain that produces the neuron cells is the hippocampus, which is associated with learning and memory. Affecting this part of the brain might not be something immediately noticeable, but over time, weekly drinking could have so dramatically reduced the neurons that learning or remembering things becomes more difficult. The study indicates that people don’t have to be alcoholic to do damage to brain structures and that social drinking may be more harmful to people than is currently perceived by the general public.

The impact on mental health and the many fingers of the mind are varied. On one hand there are those who endure years of heavy drinking with the mind’s fingers remaining as nimble as a pianist’s. Others emerge not so deft. It is believed alcohol increases the chances for Alzheimer’s and earlier onset of dementia. Stanford University research in 2010 also proved that alcohol abuse and alcoholism cause deficits in working memory and visio-spatial abilities (think: coordination) even after abstinence.

Sociologist William Anixter pointed out in 1990 before the Anxiety Disorders Association’s Washington, DC, conference that 80 percent of Alcoholics suffer from depression. The unanswered question more than two decades later is how much of that was there organically and how much was caused by the alcohol/acetaldehyde. A 2007 study does make the connection between alcoholic liver disease and the mind. The frontal cortex—responsible for reasoning and memory—is more impaired in patients when they have cirrhosis.

Alcoholic hepatitis is a third type of liver injury connected to alcohol misuse.It is a condition similar to the other hepatitis diseases, but is not the same as A, B or C hepatitis.

Liver problems are not the realm of only the hard drinker, they can be stimulated by amounts of alcohol between five to nine drinks in 24 hours. There are very few symptoms of liver injury until it becomes chronic because the liver has no pain nerves to tell you when it is hurt. If the liver had nerve endings, you’d never make it to the second drink.

Pancreatic damage
The pancreas is a long, flattened, pear-shaped organ located behind the stomach. It makes digestive enzymes and hormones including insulin. Alcohol users are 1.6 times more likely to develop pancreatic cancer, the most fatal of cancers. (Dr. Mirjam Heinen, Maastricht University, Netherlands, May 2009).

Men should be especially conscious of alcohol/acetaldehyde when it comes to the pancreas. University of Pittsburgh School of Medicine researchers isolated a gene variant in men that puts those who drink heavily at risk for pancreatitis.

Muscle disease
Acetaldehyde fragments muscle fibers, weakening them and allowing them to tear easily. Muscle atrophy or destruction can occur fairly easily. The weakness and atrophy have been known to medicine for 200 years as myopathy, but myopathy has come to be known as a common side effect of acetaldehyde and alcohol.

Nerve disease/neuropathy
Alcoholic neuropathy is identical to the neuropathy experienced as a side effect of diabetes. Neuropathy causes a tingling of burning sensation, or a loss of sensation all together. In Alcoholics, as with diabetics, it is an affliction of the limbs and especially the legs. Commonly there is a reduced sensitivity in the feet. You’re not able to feel pain. When this happens, foot injuries, like blisters, can become infected so severely because you cannot feel pain that amputation is necessary. But the fatal problem with the neuropathy is the increase in the risk of stroke it carries, covered in part four of this series.

Stomach disease
Gastritis—sharp stomach pains—and gastric ulcers are very common results of regular alcohol use and can last for years after abstinence. Alcohol slows the emptying of the stomach, which allows more acid to build up in the stomach and therefore more time for it to permanently damage the stomach lining. Cancer of the stomach is called gastric cancer. Gastric adenocarcinoma is the most common type of stomach cancer. It arises from those cells in the stomach lining.

Chronic gastritis also is a predisposing factor in developing stomach cancer (“Alcohol and stomach cancer in northern Italy,” in the Nutrition ResearchNewsletter, September 1994) The newsletter concluded, “heavy intake of total alcohol (at least eight drinks/day) or wine (six to eight or at least eight drinks/day) was associated with a small but significant increase in stomach cancer risk.”

A more recent study put the cancer risk in much more exact and troubling terms. Researchers evaluated information from the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

More than 400 cases of stomach cancer were diagnosed among study participants. Heavy alcohol consumption increased the risk of stomach cancer in men. Men who consumed an average of more than four drinks per day were 65 percent more likely to develop stomach cancer than men who were very light drinkers. The link between alcohol and stomach cancer appeared to be stronger for beer than for wine or spirits.

Breast cancer
One out of eight women will have an encounter with breast cancer. Alcohol use is the ONLY dietary factor increasing the likelihood of getting breast cancer.

Breast cancer risks increase 10 percent for every 10 grams of alcohol consumed daily. That’s about one drink.) Women who consumed even “modest” alcohol (equivalent to 3-6 glasses of wine per week) were linked with a 15 percent increase of developing the disease. Researchers also found that the increased risk of breast cancer for those who drank at least 30 grams of alcohol per day on average (at least two drinks daily) was 51 percent higher compared to women who never drank alcohol.

In addition, when the researchers looked at alcohol consumption levels between the ages 18 to 40 and after the age of 40, they discovered that both were strongly linked with an increased risk of breast cancer. The connection with alcohol consumption still remained even after controlling, reducing or quitting alcohol consumption after the age of 40.

Other cancers
Dr. Palli’s 2012 research identified “significantly” higher risks for cancers of the pharynx, oral cavity and larynx and higher rates for cancers of the esophagus and rectum. “Alcohol’s role as a dietary carcinogen emerged quite clearly,” said Palli. An older study put the numbers at an estimated 75 percent of esophageal cancers in the U.S. are attributable to chronic, excessive alcohol consumption and nearly 50 percent of cancers of the mouth, pharynx, and larynx are associated with heavy drinking.

According to Annual Review of Pharmacology and Toxicology, alcohol misuse results in abnormalities in the way the body processes nutrients and may subsequently promote certain types of cancer later in life. Alcoholism also has been associated with suppression of the immune system. Immune suppression makes you more susceptible to various infectious diseases and, theoretically, to cancer.

Heart disease
Heart disease is a leading cause of death in the U.S. and carries a definite link to alcohol misuse despite French studies showing low amounts of red wine benefiting the circulatory system. Acetaldehyde – a byproduct of the metabolism of alcohol – causes hypertension, a.k.a. high blood pressure. In a 2007 Medical University of South Carolina study, 120 alcohol users charted lower blood pressure only 12 weeks after abstaining.

I know as well as anyone the challenges quitting can present, but I can honestly say… IT’S WORTH IT. Happy New Year, and here’s to a serene ’14.

Thanks Scott, for giving us a something to think about. For those who don’t know why Scott is the person to listen to, read his book Every Silver Lining has a Cloud about the topic at hand.