A reader asked a very common but important question today:
Question: do you think an addict can ever drink normally? Because if it is truly a choice, not a disease, someone who was addicted to any substance should be able to drink “normally” again. The choice-proponents never touch this subject.
Answer: First, I must clarify that my answer is not a recommendation to drink or use substances (I’ve made it a policy to never tell anyone to quit, moderate, or continue as is, I can only recommend that people do that which they objectively judge to be in their best self-interest), but yes it is possible.
Most reliable data on “alcoholics”* show that the majority return to moderate levels of drinking, for example see this data from the NIAAA.
Although I don’t have a boatload of statistics to back it up, anecdotally, I personally know many former “addict level” heroin and cocaine users who are now moderate alcohol and/or marijuana users. Usually, the path I’ve seen these people take is to be fully abstinent of all intoxicants for a few years before learning a new substance use style.
This next point is nit-picky, but important. In the purest choice view, you were never “addicted” (i.e. powerless or out-of-control) – you were always in full control and choosing each and every instance of substance use. You choose it because you believe it is the best available option which will bring you the most happiness (in the St Jude Program, we call a form of this view The Freedom Model Philosophy).
When people successfully change their habits, they tend to move towards activities and lifestyles where happiness is based on delayed gratification rather than instant gratification, they experience the greater rewards which come along with that, and thus they grow to fully believe that excessive substance use is no longer their best option for happiness. For example, think of those who quit upon becoming parents, or those who quit and otherwise re-invigorate their lives with new careers, relationships, and living situations. They believed these new things would bring them more happiness than their former lifestyle, and importantly, they believed these things were viable options for them – that they could be great parents, or get a new career, or achieve a goal of their choosing – whereas before, they may have wanted these things and believed they’d bring more happiness than substance use but simultaneously believed that these options were not possible for them (commonly either out of perceived lack of ability, or perceived lack of opportunity). I bring up these life changes only as examples, but none of them are necessary – whenever one realizes in any way that they have better options for happiness of some kind, and moves towards those options, they are moving away from “addiction”, they are choosing to change their behavior.
Even within AA and the recovery culture at large, the above principle is in play – people begin to believe that the “recovery lifestyle” is their best option for happiness, and this belief allows them to move away from substance use (unless of course they also strongly believe all the self-defeating recovery stuff about triggers and “relapse is a part of recovery” etc). But still, this is what’s going on when people make long term behavior change in any context (other than being deprived of substances by force within a jail).
It is precisely when people no longer view a substance induced high as their best available option for happiness that they will then find it effortless to use substances moderately (unless they hold on to an all-or-nothing powerlessness/loss of control belief). If you find you need to manage your substance usage, constantly telling yourself ‘no’, setting and being vigilant about sticking to arbitrary limits, and this all feels like a struggle – then this probably means you still think the high is the best thing going, which means you’ll gravitate towards doing it more and more. The tough part about this situation is that the internal debates about substance usage that one goes through only feed the fire of desire as it consumes your thinking. The solution is to stop using substances for long enough to expand your range of life options and explore them until you find a lifestyle which is more rewarding – this displaces the drug at the top of your metaphorical happiness list.
I should also note that I’m not saying anyone needs to do anything new or different with their life in order to change a substance use habit – you don’t. All you need to do is choose, but I guarantee that the successful lasting choice to change will be born of the belief that some other course of behavior will bring more happiness than the previous behavior. For some people, they may simply realize that even with no major life changes, they would get more happiness out of their life if they stopped using so many substances – and still, some other people may end up believing that some simple changes in the way they think about things may provide a better level of happiness. Each person has to forge their own path, but there is a simple principle of human behavior underlying it all: people move in the direction of what they believe will bring them the most happiness.
The Mainstream Opinion, or Pickle Theory
Of course, my opinion is an unpopular one, considered wrong and dangerous by those who follow the conventional disease paradigm of addiction. The way that addiction counselors often answer the question of whether it’s possible to become a moderate user after a period of “addiction” is by stating “a pickle can never go back to being a cucumber.”
If you believe the disease theory, this makes sense. In the disease theory, addiction is the result of permanent changes to the brain, and behavior is driven purely by chemical and physical processes of the brain. So in a sense, in this theory, the brain has been “pickled” as it were, and can never go back to a state where moderate use is possible.
The problem is, this disease theory has never been proven. Loss of control has never been proven. Powerlessness has never been proven. But on the flipside, experiments have shown that heavy drinkers, even when unknowingly slipped alcohol in a beverage designed to disguise and hide its flavor, do not drink “uncontrollably” (see Marlatt). Moreover, as I’ve stated already (and indeed, Ad Nauseum throughout this site), most “alcoholics” resume a pattern of moderate drinking at some point (see Dawson). And perhaps most damningly, the very studies which generated the now famous brain scans of “the addicted brain” done by NIDA director Nora Volkow show that after a period of abstinence, brain function moves back towards “normal.” ** The brain of a user begins to look like the brain of a non-user when the user decides to stop using – imagine that! Sure, permanent brain damage is possible in the case of strokes and other injuries brought on by substance use, but in general, the neural correlates of addiction are simply following behavior and choice, and likewise follow new behavior and choice – the brain is not permanently “pickled”, rather it is plastic – looking more like a pickle when someone is actively choosing to use, and looking more like a cucumber when they choose to stop.
In short, the evidence we have points to the conclusion that moderation is possible and indeed probable.
I hope this answers your question,
Steven Slate
* My incessant use of quotes around various versions of the word “addict” are meant to reflect my disdain for it as an inaccurate and harmful term.
** The true rub of Volkow’s work is that there are no actual medical treatments for meth addiction (the subjects of her brain scans I mentioned were meth users). There isn’t (or at least there wasn’t at the time of the study, but there may be some new treatment now that I haven’t heard of yet) any sort of pill, surgery, or “treatment” other than sitting and talking with someone about addiction. To paraphrase Jeffrey Schaler, ‘talking with someone about your problems can be helpful, but it’s not medicine’ – and I would add that if it helped, it probably wasn’t a disease that was responsible for your behavior, it was obviously just you – your mind, your thoughts, your free choices.
ONLY MY EXPERIENCE. I AM A PICKLE. I CANNOT BE A CUIKE AGAIN. of course i binge drank off and on for 40 years. I KNOW it did something to my metabolism, and I’m afraid to think about my brain. (in all fairness, i have KILLED more than a few brain cells, but seem to have REWIRED that over the last few years). I can’t tolerate alcohol any more – it ‘s not relaxing or fun and I always have to be on guard for a BLACKOUT. You can think whatever you want, but this is my body and my opinion. I can have a great life without booze. It is totally unnecessary for my survival and happiness and besides, it is metabolized similar to straight up sugar, which I avoid as much as possible. I think everyone has to do what is best for them. When it does not work anymore, it becomes the law of diminishing returns. peace, zig
Right, everyone has to decide for themselves if it’s really something they stand to gain more benefit than pain from after a prolonged period of abstinence.
If drinking and drug use caused a person so much pain, why return to any form of substance consumption if there are truly a wide array of non-synthetic avenues for experiencing happiness open to the ex-user? Isn’t this just admitting that one’s life is not fully complete without alcohol or drugs?
However, I do agree that the self-deprecating language does more harm than good, and that there is a lot of psychologically unhealthy mantras that pervade AA recovery culture. Why insist upon calling yourself an “addict” for the rest of your life, or envision yourself as a wrinkly, salty, pickle? No thanks, I’m just a human being that has discovered new ways of having fun and enjoying life with the people I love and care about.
At age 20, I was court-ordered into rehab and sober living for speeding with an open container of beer. Yeah, I used to get drunk and have wild parties. My worst problem was freebasing (6 months or so). I In rehab, they convincved me I was an alcoholic. I went to 12 step meetings for about a year afterward, maybe 2 years. Then I stopped going, didn’t believe the negative labels.
I graduated with an engineering degree, got married, had children, a masters degree, a very good life. All along, I drank moderately. In 30 years, I have never been drunk or done any illegal drugs except the 2 or 3 times I did a couple lines with a relative who was visiting. I just didn’t want to go back to a drug life. I was happy with my family. My values had changed. Still, I felt guilty about drinking almost every night. It was just 1-3 drinks, but I remembered a time I didn’t need any.
Then, forward to a move out of state, and I remembered reading a Wall Street Journal article on internet pharmacies. I started an addiction to norco that took me to doctor shopping when the pharmacies were shut down in 2007. I believed this was not as bad as the illegal drugs. I had zero drinks the last 7 years of my addiction. I never used benzos. Nothing else. Just the norcos. I was successful in my job. Nobody in my family knew about this. So yes, I was functional. Yes, I would have passed that NIDAA test as someone who left behind the alcohol and cocaine habit. I have been clean for some time, no rehab this time, did it myself with some 12 step meetings which I no longer attend.
So the test is really flawed. They don’t ask these former addicts if they are now addicted to shopping, or a mild pill habit, or work, etc.
I can tell you this. I have never been so happy in my life. My long-term marriage rocks! I love my new job. I love my kids. I don’t want to be f*d up anymore, I still don’t like alcohol, and if I take any pills after surgery I doubt I would even like them!
Addiction is all about distorted thinking, a false belief that a substance can be my friend.
If I could change one thing about 12 step, it would be to eliminate the readings at the beginning of the meeting. I think the sharing and hugs, the ideas and inspiration are very useful. And I don’t believe I am powerless either. My step 1 is “I came to believe I could live a life without sustances, and this life could be bettter”. Then step 2 is “Don’t pick up no matter what”, because my life is better today without substances and I want to keep it that way. I hate being tipsy, so there is no point to drinking. Step 3 is, “Take the next indicated step”. And that is all I need.
Kelly – thanks for sharing. your story rocks. we are on the same page – as my best buddy puts it (sober since 1985) I WANT TO BE COGNIZANT OF MYSELF AND MY SURROUNDINGS. That’s about it for me. I still have a few good years left, in spite of SMART RECOVERY meetings scaring me almost to death. They are definitely AA without the spirituality (i can handle that – just not powerlessness – me? powerless? ) Conquering MY beast and taming it lately involved letting out a LOT of pent up anger. Who was it that said “I’d rather be hated for who i am than loved for who i am not”. I may be an old fart now (63) but I still have another 30 years to kick butt. lol. I just try to stay away from screwed up people in RECOVERY groups (another addiction or useless pastime). Good luck Kelly.. I am glad you are finally happy.
I was really scared for a while into staying in the meetings by old timers who kept saying, “meeting makers make it”, and they had horror stories of those who stopped going. They forgot to mention all those who come to meetings loaded and who relapse while going to meetings. Then I started noticing my life was better than theirs. How many women are romancing their husband after 20+ years? And it just keeps getting better with him!!
I also think that going to meetings and discussing our own addiction is living in the past. My family has already forgot all about my addiction, even though I ruined our finances and it has only been about 2 years ago that I quit. They don’t want to hear it!
I like what this site is doing, and I wish I could do it too: show the newcomer it’s possible to live without drugs, and show people a positive way forward. I don’t have a venue currently to “give back what was so freely given to me”, and I’m not willing to sit through the 12 step readings anymore. I still toy with the idea of going back for my next token, just to show them I didn’t “relapse” after I stopped going to their meetings, but maybe there is no point?
There are a couple meetings I sometimes visit. One is a freethinker AA. It is atheists, mostly 20 – 30 years sobriety. I love free thinkers.
Maybe we can reach people here. I do know a lot about “addiction” I.e. Overmedication for me, on a personal level but I also was pharmacy tech and psych nurse so I know the medical side of years of self abuse o. An intellectual or scientific level. I too would like to Pay It Forward but “recovery” meetings scare me because of the really desperate and creepy people there.
Any ideas?
I thought of speaking at recovery places or going on the news, but my the media usually prefers the most desperate cases, ie the gorgeous housewife who became an oxycontin addict and lost everything. I’m the gorgeous housewife who didn’t lose all that much. Not a sexy story.
When I go to meetings, I introduce myself by name only and say what I think. I go to meetings where people are ok with that, but that has little influence on a large scale. People like Steve, and also the guy who wrote The Forgotten Five Steps are making a larger scale difference.
What can we do?
I used to drink heavily. My marriage was falling apart and my husband worked away and drinking was the only source of “happiness” I had in my life. Now that I have been divorced for several years, I only drink occasionally and in moderation. Many people, even myself, thought I was an alcoholic. I’m very grateful that I didn’t get help, I would have been labeled powerless and would probably be a hopeless drunk now. Working with addicts as a law enforcement officer, I see the disease theory played to the fullest and used as an excuse. There is no disease that causes women to abandon their kids and solicit themselves on the streets. Crack and meth addiction, in my opinion, is more of a possession than an addiction.
I just wanted to thank you for this article. I come from an addicted past as well. I started using drugs at the age of 16, got into a lot of trouble, and I finally hit my bottom at the age of 20. I was court ordered to rehab, successfully completed treatment, and went on to stay sober with the help of AA for 5 years. However, there came a point in my life where I felt that I no longer needed the rooms of AA. I couldn’t explain the phenomenon, I just knew I felt happy and normal again, without needing to participate any longer. I stopped going to the rooms of AA, and very slowly and cautiously (hoping my past would decieve me), began to think I could have a drink again. In the rooms of AA, this is what’s known as the “obsession” getting to me. However, I wasn’t obsessing, it had been 5 years without a drink, without even THINKING about a drink, and all of a sudden, I just “felt like having one”. I made the decision, went out one night, and attempted to have a glass of wine with dinner. To my extreme surprise, I took one sip, and was disgusted at the taste. I knew right then I did not want to drink again. And that was over a year ago, I have a husband, am in college starting a new career, have a beautiful family at home, and find that whatever addictions plagued me long ago as a teen, had disappeared. I could never explain it, and have been looking for some help to understand what went wrong back then, or what went right just recently. Thank you so much for writing this, it may not explain what exactly happened to me…..but at least it gives me some insight into what MIGHT have happened. Again, thank you so much.
I had some wine with my husband this weekend, after almost a year and a half of abstinence. I only had a few sips, and I liked it. Then I went back to my hot tea and chocolate to finish the evening. My history is youth addiction, followed by 15 years of moderate drinking, followed by a decade of vicodin addiction. Even that, I didn’t like to use anything that left me out of it, or out of control. So that part is good. My only worry was if I drank, would I go back to having 1-3 drinks every night, like I did for those15 years of moderation? I didn’t like that, but I was stuck there so long. I have learned a lot about choices and values. I have learned to love life and sobriety. I have finally released the fear based thinking of the 12 step groups in making the decision to share that glass of wine with my husband. So an occasional glass of wine with my husband empowers me. I’m not different after all! I truly put my addiction behind me. I have been so happy since I made that move.
“I’m not different after all! I truly put my addiction behind me. I have been so happy since I made that move.”
It is so empowering for me to read that. Thank You.
Hi I’m John. I used amphetamines for 16 years and was mashed. I did a 12 step rehab 8 1/2 years ago and have not used or touched a drop of alcohol in that time. I’m well moved on in my life. I’d love to have a couple of pints but worried something may happen like releasing the desire to use again. I don’t know what to do. Any ideas??
I really appreciated your article. I had a very bad crack habit for several years. But even in the depths of my own addiction, I functioned in ways most people think it is impossible to do, and still use crack. I got married, bought a house, kept up with friends and family, kept up with hygiene, beauty and fashion, and held onto high paying jobs. Unfortunately I married another addict, and our marriage did disintegrate to a nightmare of nightly using and trying to live normal lives at the same time. Thank God we didn’t have children. On Nov. 8, 1997 I finally had enough. I walked out of my house and marriage and into AA and NA. I got clean and was vigilant NA member for 3 years. But I was always troubled. I still didn’t feel like I belonged. I never BELIEVED people were powerless over drugs and drink or their addictions. How can someone be powerless and still put tge drink down, or put the pipe down, or put the needle away? We CHOOSE to stop doing anything we no longer want to do. Nobody says it’s easy or pleasant to stop, but we are exercising our power to stay stopped. On very rare occasions I choose to have a drink. It’s something I can do and in 19 years it has never caused me to use drugs again. Maybe that’s not true for other people. But I know more than one former coke and heroin addict who can truly take or leave alcohol. So most choose to abstain, because they want to be completely free of mood altering substances. But this is still a choice… not an inescapable life rule. My dilemma is there is no recovery program where I can freely fellowship and celebrate MY truth and my drug free clean time without also pretending I can’t drink safely. So, for the past 16 years I have had no program to call home. I just don’t use drugs. My life is absolutely better than in active addiction. But it would be nice to fellowship with others like myself.