Why Do Alcoholics Stay Alcoholics?

Addressing the frequently asked questions dealing with addiction.

Question:

Why do alcoholics say that they are still alcoholics after 15 or 20 years of continuous sobriety?

Answer:

Alcoholics take very seriously reports of experience.

They have heard and believe that when an alcoholic starts to drink after many years of continuous abstinence the pattern of drinking reverts very rapidly to the same compulsive, loss-of-control drinking that existed before becoming sober.

There is a neurobiological reason for this.  Special nerve pathways in the brain were highly and permanently sensitized to alcohol by earlier heavy drinking.  Even the smallest amount of alcohol after many sober years will inevitably set into motion an irreversible cascade of mental and physical events.

The first is euphoric recall, that vivid expectation of “how good a few drinks” can be. The second is obsession, or being unable to think about anything else but drinking. The third is compulsion, an overpowering, irresistible urge to “go ahead and drink.” The fourth is physical craving a need, beyond desire, to drink alcohol.  All of these events take place in the brain.

Many persons who had long-term sobriety and relapse are elderly.  Because experience has shown it is so hard to reestablish abstinence in the late relapse, many quietly drink themselves to death.

Although a person in recovery may have gotten used to being a “non-drinker” for years, there lays beneath the surface of his or her consciousness what neuro-scientists now call Chronic Relapsing Brain Disease.

We do know that those who respect the power of the disease continue to go to AA meetings for as long as they have the disease.  The disease is lifelong, but so is sobriety for those who remember that reality.

"Sober Days" ran in the Palm Springs daily newspaper, the Desert Sun, for several years in the 1990s-2000s. The popular Q&A column was written by Dr. James West, the Betty Ford Center’s first medical director. He remained with the Betty Ford Center until 2007, when he retired at age 93.

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