I get a rush when I see a woman lift a glass of red wine, part her lips, tilt her glass and head at just the right angle, and let the liquid pour into her mouth. Not because I like to watch, but because, vicariously, I’m drinking it myself.

I find these experiences tedious. The predictable swell of emotion, the anguish of longing and not having, then weepy stability regained, similar to the shaky relief after a bout of stomach flu. Since I now understand the instinctual automaticity created by the neurobiology of addiction, I note these episodes without judging myself or others. Still, I try to put myself through this as rarely as possible. When people say, “Come on over! Just don’t drink!”, I think, “Right. Be around air, but not breathe, except in little gasps? No, thanks.”

This Medscape article has been updated, but the line I read several years ago is still the same: “Patients who have been sober for 5 years are likely to remain sober, but they are still at risk for relapse.” I thought if I could just hold out for 5 years, I’d be done with this.

I’ve been asked, “How do you abstain?” Since the primary symptom of addiction is an inability to abstain, I don’t. I can’t directly command myself to abstain. Instead, I help myself not drink. I do hundreds of things every day, choosing from among the myriad ways research suggests help people not drink or use.

When people congratulate me for five years of abstinence from alcohol, I’m not appropriately or humbly grateful. Since addiction is a medical condition, not a moral one, abstinence is not a moral achievement. While some people recover from addiction on their own, a whole lot don’t because being without is so very difficult. And knowing ethyl alcohol is a neurotoxin doesn’t help.  Reasons don’t change minds. I help myself the best I can, but I’ve mainly just been lucky with this illness.

I have wondered if, given a choice between opioid use disorder and alcohol use disorder, I should choose opioid use disorder. Although opioid addiction is much more rare than alcoholism – 2 million vs. 16 million – at least there’s medicine for it.

I get in trouble with people in recovery when I say I think my life would be better if I could drink wine again. I feel as much desire to have a bottle of wine tonight as I did five years ago. Personally, everything wine did for me would be done again. Socially, oh my gosh. My town, Blacksburg, Virginia, and its environs, were rated the drunkest locale in the state of Virginia by USA Today. Now, where I am to go, or with whom am I to be, in a town where beer and wine are served at the movies, even church? We have recovery support groups, but talking about not drinking often elicits the automaticity thing in me. Let’s have a drink while we’re talking about not drinking, shall we?

Alcoholism has stripped me of my life with others.  I get that a sense of social connection and possession of social capital – even the existence of love – are considered essential to human thriving, as well as to recovery from addiction. But they’ve been hard to come by in my town. Stigma certainly hasn’t been a pal, either. Inability to be around alcohol in a drinking town puts defeating constraints on prescriptions for happiness that I, or others, might derive.

I hear the “you-shoulds” starting. You should be happier, Anne. You should think differently, Anne. You should want more for yourself, Anne. You should do something about this, Anne. And for heaven’s sake, you should write an uplifting recovery story at 5 years sober, Anne!

It’s un-American to not try to manufacture good times, to not set things up to make better things happen, to not toil now for future reward.

My peak experiences were chemically created in a brain not built to be overwhelmed by chemicals. Nothing in life since – no sunrise, no kitten licking my nose, no lover’s touch, no work achievement – has done for me what wine did. Why would it?

How I have found a modicum of contentment is decidedly un-American. I don’t wish things were different. I practice extreme, intense, relentless, radical acceptance of reality. I laugh at the appalling absurdity of giving work-loving Anne something that work won’t fix.

Then I become available to take delight in what’s available.

The first person I ever saw do this was my father. He usually takes his coffee black but once, when I was a little girl  standing by his chair at the dinner table,  he poured cream into his coffee.

“Look at that swirl,” he said. He pointed for me to look. I peered into his mug. I can still see the star of white cream, black coffee, and caramel.

A few moments like that each day, day after day, make a sweet, little life. Not a grand, famous, or accomplished one.

When my thoughts turn to tragedies in the past or worries about the future, I become aware of this, and I just shift.

I have a friend who nearly daily cooks an astonishingly exotic meal for himself in a studio apartment’s tiny kitchen, plates it, and sends me a photo. The colors and textures are gorgeous, the imagined scents heavenly. I chortle over what he has wrought today.

A friend fosters cats who need special care before they can be adopted. She blocks off the entry way and hall to her house to make them a safe haven and invites friends over to help socialize them. We sit on pillows on the floor, and pat the cats. She describes every nuance of each cat’s morphology, gastroenterology, and kinesiology as if uttering lyric poems.

My former owner of my house and I share joint custody of her garden, and she and our gardener coach me on the wonders in our yard. Who knew breathing in the scent of lavender could bring such a sense of tenderness?

I have adopted two of my friend’s foster kittens. I have named them Ken and Ted for the boy dolls my sister and I had as little girls. My elder cat and I rub chins when we meet, but she would bolt when she smelled wine on my breath. She hasn’t run from that odor in five years, my middle cat has never needed to, and maybe these kittens never will, either. I can’t say one way or the other. Protecting them is neither an incentive nor a disincentive. Addiction persists despite the fear of negative consequences or the promise of positive ones.

Substance use disorders occur on a spectrum, and so does recovery from them. Some people claim gratitude for having developed addiction because of new gains. I do not. I had a quarter century as a respected teacher, and a lovely new marriage, when alcoholism delivered its sucker punch when I was 50. Alcoholism cost me everything I valued. I am okay with this good-enough, workaround life. But, gee.

To my friends, family members, and to anyone who thinks they might even have the hint of a problem with alcohol, maybe wine like I did, perhaps my tale can serve as a cautionary one. Limit yourself while you can. Once you can’t? You do not want this.

Ah, wine, my lost love. I miss you so.

Shift.

Looky! The markings on Ken’s and Ted’s fur swirl like cream newly poured into black coffee.

When I was a teenager, an older teenager in the neighborhood gave me a copy of Abbie Hoffman’s Steal This Book. Decades later, I continue to feel both affronted and enchanted by the dialectic of opposites both being true: a book that uses the convention of sentences to foment revolution is for sale, but directs readers to steal it.

I have been abstinent from alcohol for four years and eight months. That’s just over 1700 five o’clocks that have passed without me participating in happy hour.

Here is my status report:

• My subjective experience is that I felt better while I was drinking.
• The chemically-induced euphoria and sedation of alcohol are heightened states I have been unable to experience again naturally and organically.
• I would prefer not to abstain from alcohol but to drink it as desired or needed.
• I miss belonging to a majority culture, i.e. Americans who drink.
• I miss being able to pay attention to my surroundings and the people in it without having my brain’s sensitivity to environmental cues overpower my attention and draw it the alcohol that is nearly ever-present in my town.
• I have done everything I can think of, and has been suggested to me, to be able to say that my life is better without alcohol, but it is not.

That a beverage has achieved such importance in my life is appalling to me. Especially a beverage containing ethanol, a known neurotoxin, for which there may be no safe level of consumption.

On the ten-year anniversary of Kurt Cobain’s death by suicide, psychologist Alan Marlatt wrote, “Do not attempt to take away a person’s main means of trying to cope with pain and suffering until you have another effective coping strategy in place.”

That’s the down side of things. And that’s why we’re seeing suicides among pain patients cut off from pain medications. Ruggedly individualistic Americans don’t want to believe it, but there truly are unbearable things from which one cannot rescue oneself.

The upside matters, too. Humans feel feelings, think thoughts, and have experiences that result in fluctuating inner states. Ups and downs are normal. If a person experiences a substance as a remarkably efficient and effective lift from a down state, and repeatedly practices that method because it works better than others, the over-learning of addiction can occur. If that person is cut off from the substance, the person can become suspended in a down state with no hope of escape. Feeling unremitting, helpless despair is an unbearable, inhuman, inhumane state.

I appreciate the estimated 4-46% of people who recover from addiction spontaneously, the people who attribute their abstinence to 12-step recovery, and the small number of people who recover through rehab. In my personal experience, and in my work with others with substance use disorders – this is my opinion, not a report on the data – I see a subset of people with substance use disorders for whom life is not perceived as qualitatively better without the substance. I am a member of that subset.

What I learned from writing a memoir is that it’s no wonder I developed alcoholism and it just won’t give.

Resisting that reality, attempting to reverse that reality with beliefs – my own and others’ – wishing that reality weren’t true, pretending that reality didn’t exist, purveying the fake news that I am “fine” – these mythologies increased my suffering.

People have told me that if they had my level of on-going distress, they couldn’t stand it. I’m certainly not a fan of it.

What of my distress is due to residual brain impairments from having developed addiction to alcohol, a.k.a. feeling compelled to persist with drinking despite harmful consequences (falling down stairs, and imperiling myself and others while driving under the influence), fallout from what happened before I developed alcoholism, the u-curve in happiness at midlife, unexpectedly different life circumstances, brain challenges with developing addiction at 50 rather than at 20, the possibility that long-term anhedonia in some people with substance use disorders is also a brain thing? I don’t know.

While I appreciate dialectical behavior therapy’s concept of radical acceptance, I think, at least for the subset of people with substance use disorders for whom life is not experienced as better without the substance, the level of acceptance required to do without, to make do, to settle for less, to tolerate downness, requires an extreme, Steal This Book, post-apocalyptic, revolutionary type of acceptance.

The kind of acceptance that lives with the possibility that things will never get better. 

That substance use disorders are disorders of the organ of the brain and, therefore, medical conditions for which medical care, including medications, is first-line treatment, is not widely known, understood, accepted – even allowed – by society at large, the health care industry, the addiction treatment industry, lawmakers, people with substance use disorders, or their partners, families or communities.

That not results in malpractice. From a volunteer survivor who advises people attending support groups, to a lawmaker whose bill creates wait lists for life-saving medications, to a treatment provider who admonishes a person for being unready for change, to a researcher who attempts, one more time, to prove that addiction is a personal problem – anyone who attributes addiction to the person, not to the person’s brain, in my opinion, is engaging in life-endangering malpractice.

In my personal experience, people’s beliefs about addiction, and about people who have addiction, and their refusal to look at the evidence, just won’t give.

At the end of the film, A Beautiful Mind, the main character, who suffers from paranoid schizophrenia, sees the entities who have plagued him, but does not engage with them.

In her DBT Training Manual, Marsha Linehan writes, “People may not have caused all their own problems, but they have to solve them anyway.”

I have had to steal the reality of my inner experience away from those who would deny it or fault me for it.

For me, moving from radical acceptance to revolutionary acceptance means:

• My life is more than half over.
• I need to protect myself from harm from those with good intentions or claims of expertise but who lack knowledge and understanding.
• More disinformation about addiction exists than information and I need to practice ruthless discernment about what I let into my life.
• I am the one who must seek and discover what the research says is effective, implement it for myself, and see if it’s effective for me.
• I need to forgive myself for entrusting my recovery to others.
• I need to forgive myself for developing alcoholism in the first place.
• Some things just won’t give.
• No matter what I say or what I do, someone, somewhere will disapprove or disagree.
• Even as diminished as my life has become from alcoholism, even as problematic as my inner experience has become, I love it all, I want to have it all, and I want to keep it all, for as long as I can.

I’m stealing my recovery from addiction to alcohol back from those who would want to direct it. I am not a fan of stealing. But this is my life, my one life. It is precious to me.

From what I’ve learned about community trauma, I know that grief and aftershock may emerge involuntarily. I know that people with substance use disorders can experience bereavement differently from others. Since strong emotions make me ripe for relapse, I am planning for April 16 very carefully.

Things I am not doing: fussing at myself for not being able to get over it; avoiding and minimizing my reality by saying, “I don’t do anniversaries”; stuffing my inner wail into a stages-of-grief spreadsheet that poor Elisabeth never intended to be hafta-dos; giving in to my tendency to withdraw and quake alone; bending to the complex terror welded to my bereavement that blocks me from asking for help; going to Kroger for any purchase whatsoever because I will only see (usually only see) the wine aisle.

What I am doing: I invited friends for breakfast and they are coming, even though it’s Easter Sunday. I asked my 83 year-old dad to go with me to our local, afternoon SMART Recovery meeting and he is going, even though he doesn’t have addiction issues. I am exercising today and Saturday. I am eating simple foods moderately – no chips, no cakes, no cookies. I will take naps.

I have started to feel the first licking flames of what, for me, is horror rather than grief. I am turning towards it, not away. I acknowledge it. “Ah, horror. There you are.”

If Sunday is an ordeal – or the days before or after – I am preparing myself to endure it the best I can. If it’s not, that’s fine. If I don’t attend the candlelight vigil at 7:30 PM, I will light a candle in my mind. In the past, I have feared immolation. I have no idea what the fires of feeling and memory will do to me this time or how long the burns will take to heal. But I make it through these things. Over and over again.

Photo: John H. Rains, IV

Imagine standing at your kitchen counter, pouring crisp, pale, chilled sauvignon blanc into a glass measuring cup to the one cup mark, then pouring that amount into a wine glass. You have resolved to limit your drinking to federal guidelines: 3 drinks tonight, no more than a total of 7 drinks this week. You’re healthy, at home, and not driving, so you’ve allowed yourself a generous 8 ounces, 3 ounces beyond the 5-ounce measure of a standard glass of wine.

Note your awareness of the need to drink this amount and no more. Sense your willingness to make responsible choices and to be accountable for them by tangible measures.

Bring the wine glass to your lips, take a sip, hold the coolness in your mouth, then swallow. Tilt your head back in near ecstasy at the first hint of alcohol’s initial euphoric effect. Chop vegetables for stir fry, continuing to sip.

Let’s say each sip measures about a tablespoon. In 16 sips, about 1 sip every 2 minutes, that cupful of wine is done in a half hour. You’ve only just finished the food prep. You measure and pour another cupful of wine, cook various combinations of foods with various spices and sauces, and find this second glass gone. You arrange your meal on a plate, measure and pour the third glass of wine, fill a glass with water, and place all three at your seat for dinner.

Alcohol’s initial euphoric effect has passed and you feel its warm, sedative glow. You may or may not be aware of the uncertainty it has brought to your decision-making. You’re not sure how long you’ve been eating, but the third glass of wine is gone and you still have part of your meal left. You dutifully switch to water and pair sips of it with the rest of your meal, sensing with disappointment water’s dulling effect on flavor.

Clear the table and view the kitchen. Pots, dishes, utensils, peels and spills everywhere. And on the counter is the rest of the bottle of wine by its glass measuring cup – intentionally glass instead of metal in case pouring the wine first into metal might interfere with its taste.

Pick up your wine glass, walk over to the counter, and place it by the measuring cup. Look at the wine left in the wine bottle, the measuring cup, and the empty wine glass.

Know with the entirety of your mind, heart and body that you are not going to pour wine into the measuring cup and that you are not going to pour that measure into the wine glass. Feel the power of who you are and what you can do rise within you. Remember your credentials and successes, envision the faces of everyone you love and who loves – even admires – you. Revel in the power of your intelligence, knowledge and experience to guide and lead you, and in your willpower to make choices in your best interests. Feel your heart swell with compassion for yourself and all beings everywhere. Lift your shoulders and shift your weight to feel the strength and health of your body.

Pour the rest of the wine directly into the wine glass.

Feel the horror of knowing you are no longer who you were.

Bring the wine glass to your lips.

Image: iStock

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