We hear the phrase “everything in moderation” throughout our entire lives. When you were six years old and wanted one more cookie, your mom reminded you, “Everything in moderation.” When you were sixteen and got your first job you realized that “everything in moderation” pertained to time off. In reality, this phrase pertains to quite a lot. Eat desserts in moderation, exercise in moderation – it’s all about balance, really. In early sobriety, it’s easy to convince ourselves that the same is true of our drinking or drug use. When you hear “once an alcoholic, always an alcoholic,” you might scoff to yourself. Isn’t the whole point of rehab to help you learn how to drink successfully, after all? Hardly. The point of inpatient rehab is to help you regain the balance you lost during your active addiction. Think about how balanced your life was when you were drinking or using. Did you used to moderate your use, or did you use excessively? Did you balance your time between friends, family, work, hobbies and the occasional happy hour? Or did you shotgun eight beers, black out, and skip work the next day because you were too hungover to make it… three to four times a week? Regardless of your own personal story, your inability to practice moderation is what led you to rehab in the first place. And when it comes to chemical substance abuse, moderation can’t simply be learned.
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Why Can’t I Moderate?
Drug addiction and alcoholism are chronic, relapsing diseases of the brain. It is crucial to understand that addiction has absolutely nothing to do with weak moral character. Many people believe that if an addict really wanted to stop, they would just stop. If you’ve had firsthand experience with addiction you understand that it’s far, far from that easy. The brain disease model of addiction takes environmental factors and genetic predisposition into account. There are a number of factors that contribute to the development of a chemical dependency. People don’t just wake up one day and think to themselves, “You know what? I’m going to drive to the liquor store and pound a bottle of vodka before noon.” Addiction happens over time – though in some cases, it does happen rather quickly.
The Disease Model of Addiction
The make-up of the brain contributes to addictive disorders in two major ways. First of all, there are certain genetic traits that can be passed down through generations, making an individual more susceptible to substance abuse. This means that if your parents have struggled with substance abuse you’re far more likely to develop a problem of your own. Secondly, regular drug use or excessive drinking will actually change the neurological pathways in the brain. The reward centers will be thrown completely out of whack, which will lead to increased tolerance and long-term problems.
Tolerance means that a greater quantity of the substance will be required in order for the same effects (the same high, the same drunk) to be produced. Say you started out getting drunk off of two beers in high school. You drank two beers a night for several months, then moved into four beers. After several years you were drinking a six-pack and a fifth of whiskey every night. This is how tolerance works. The long-term problems relate to lasting brain damage. Your brain and central nervous system become reliant on your drug of choice to make you “feel good” – or at least to feel normal. When the drug is taken away the brain doesn’t know what to do, so it taps into the already extremely low levels of dopamine and serotonin left in your brain, leading to either further depletion. This, in turn, leads to depression. There aren’t any more chemicals in your brain that can tell the rest of the body you’re happy – of course, it’s important to remember that these supplies will be replenished over time. Usually with the help of a medication that normalizes your brain chemistry until it can successfully normalize itself.
One is Too Many
Once you understand that addiction is a disease that you can’t control with strong will, admitting that you have a problem will be less difficult. Many of the greatest minds on the planet have struggled with addictive disorders – there is no shame in seeking the help you need to overcome your physical and mental dependency. So… you enter into rehab, learn even more about the disease model of addiction, go through months of intensive therapy, and then – eventually – you transfer into a sober living house. Here you begin to slowly transition back into day-to-day life. You get a job, you begin to pay your own bills, you make a whole new circle of friends. You learn what self-care actually is, and you begin doing things that push you farther towards self-betterment and away from self-destruction. And then one day, you’re out at a restaurant with your friends and you see the bartender making a margarita. For whatever reason, it looks especially appealing. You realize you haven’t been to a meeting in two days and immediately brush that off as irrelevant (spoiler alert: it probably isn’t irrelevant).
You start to think, “Why can’t I just have one? I’m stable in my recovery now… I’ve been doing so much work on myself. Why wouldn’t I be able to have one drink? I know I can stop after one, it won’t be a problem.” First of all, as soon as you have a thought like this, reach out to a sober support! As recovering addicts and alcoholics, we’re wonderful at convincing ourselves of things that aren’t true. We’re actually experts at lying to ourselves so convincingly that we end up doing serious self-damage. So as soon as an unproductive (and potentially super harmful) thought pops into your head, get it out as soon as you can. Secondly, it’s important to understand that this a common thought for those in early recovery. Questioning things from time-to-time is perfectly normal and it doesn’t mean that you’re doing anything wrong. It’s how you handle the hesitations that arise that matters.
Remember all of the tools you learned regarding relapse prevention and utilize those!
The truth of the matter is, no alcoholic can ever safely take one drink. One of the main symptoms of alcoholism is as soon as an alcoholic begins drinking, he or she cannot control his or her intake. Stopping use after a certain point is impossible, and for most alcoholics, this point is the very first sip. Because of the chemical changes within the brain which lead to intense cravings when the drug is introduced, it is never safe for a diagnosed alcoholic or addict to take chemical substances in any amount. The idea of “never again” can be extremely overwhelming, despite the fact that it’s a reality. This is why the slogan “one day at a time” exists. Rather than think about never again, remind yourself that all you have to do is stay sober for today. Just for today.