One blog too many

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Disulfiram - the miracle drug?

So, for a long time now, I've been very interested in trying a drug called Disulfiram, more commonly known by its trade name "Antabuse" (I always remember it because it sounds like "anti-booze"). It's purely a deterrent drug, which is not a common concept in medical science. Basically, it makes your body react very badly to alcohol.

So how it works, is you take a pill every day, and if you're lucky, it has no effect on you at all (there are some side effects, but ideally it should do nothing). BUT when it is in your system, alcohol becomes a vicious poison. If you drink half a glass of wine, then 10 minutes later you essentially get a REALLY bad hangover - migraine-type headache, itchiness/rash, hot flushes, nausea, and some other effects (Your Mileage May Vary as far as I've read, people react differently). It CAN kill you, if you drink a large amount of alcohol quickly or have a bad reaction, but it's usually not that dangerous, just really horrible.

So in a way it's a placebo-like drug, in that you're not taking it for the effect it has, but for the potential effects it will have. The idea is that the fear of the effects will keep an addict away from the bottle.

I started taking it about 6 weeks ago, and personally, I swear by it in the short term. The best way I can explain the effect it's had on me personally is to describe the process by which I used to get drunk. This might sound odd, so bear with me, but I hope it will make sense.

So Stage 1 is normal, sober life. Simple.

Stage 2 is when the ide of drinking appears in my mind

Stage 3 is where I consider whether or not to drink

Stage 4 is when I buy the bottle (hopefully I don't reach this stage!)

The reason I separate the stages like this is to explain what a deterrent drug like antabuse does, at least to me. So, if you consider those stages, WILLPOWER kicks in at stage 3. I consider whether or not to get drunk - obviously objectively I shouldn't, but I want to. Sometimes the willpower wins out and I resist the urge. Sometimes (most times) it doesn't, an I end up with the bottle.

I thought that antabuse would help at this stage. It would be extra ammunition on the "don't drink" side of the debate, and combined with my willpower, it will help me resist. But I was surprised to find this wasn't the case. Stage 2 might happen at 8 in the morning, or if I'm busy or distracted it might not occur until later, but it almost always happens, and then leads naturally in to stage 3. Antabuse kicks in BEFORE stage 3. As soon as the possibility of drinking enters my mind, I just think "well, I can't. Simple as that."

We've all had the idea of buying a supercar in our daydreams. But as soon as the possibility of buying a supercar occurs in your mind, you immediately accept that you can't afford it. So you never reach Stage 3, where you consider whether or not to do it, because it's just not possible. Antabuse does the same thing to alcohol.

On the surface, this is a good thing - no more willpower needed, hooray! However, it's also dangerous. I will almost certainly at some point come off the antabuse, as it's not a great drug to take super long term, and it's inconvenient (I can't buy a Tiramisu from the supermarket in case the 0.02% alcohol causes a reaction, and forget about fine dining). So what happens when I come off the antabuse? My willpower has had no exercise. I haven't considered whether to drink for weeks or months. And when I come off the magic pill, suddenly Stage 3 is back on the menu - will I simply be as weak as I was before? Or even weaker?

My intention with the drug was to "get some dry time under my belt" before properly tackling the problem. It's very difficult to engage with any of the support available when you're hungover as hell, or fighting week-old withdrawal symptoms and feeling like shit, knowing that you could SO EASILY cure your bad feeling with a quick walk to the shop. You have to appreciate, dear reader, that when an addict quits, it's in the hope of making life better, but they are then forced to accept that life is actually going to get a lot worse first, and that is really difficult. Antabuse is my short term crutch - right now I'm 7 weeks dry. I'm through the painful bit, through the shakes and the sweats and all that, and it's been easy, because willpower hasn't been involved.

We'll see how things turn out...

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Opiate Withdrawal

I'm not sure how to blog as such, so I thought I'd break this down in to posts of a few paragraphs - otherwise, if I get going, I'll write 40,000 words of directionless drivel, and nobody will gain anything from it!

So, I got myself hooked on codeine after being given LOADS of it by the NHS without much review or concern. I even told my doctor that I was hooked, but I still needed them, and he still kept them flowing for over a year. Looking back, I think I probably needed them legitimately for no more than a month. Anyway. So an over-the-counter co-codamol dose is 16mg of codeine. The typical prescription dose for acute pain is 30-60mg. By the time I came off, I was on 600mg, TWICE a day.

The doctors had been quite blasé about the codeine being "habit forming" but I never thought it would be hard to come off them. So, being the headstrong all-or-nothing kind of guy, I decided to just ditch them and sweat it out.

There is a great scene in the movie Trainspotting which shows the dark side of getting clean, and what I went through was barely less harrowing than that. First the physical - for days I was cold regardless of the temperature, and I got to experience being too hot but feeling like I'm too cold. I was continually sweating - the sheet that I had on me often literally felt like it had been soaked in a bathtub, I must have lost litres of water through my sweating. I also had almost continual diarrhoea, visiting the toilet at least once an hour, so my anus felt like it had been sandpapered off. And vomiting - if I put ANYTHING other than water in to my stomach, it would come back up fairly quickly, and even eating nothing I would throw up bile and stomach acid, or just dry heave with nothing coming up. This meant that I didn't consume any calories at all for several days.

Sleep was almost non existent, and when it did come it was never for long. I would crawl up the stairs at around 10 each night (literally) not even able to brush my teeth or get undressed, and get in to bed, only to lie with my eyes closed but still awake until I saw it start to get light. I'd sleep for 10 minutes here and there, and occasionally get an hour, but it was fitful and unpleasant. God, I wanted to sleep so badly, but my brain was having none of it.

Then the mental - EVERY thought becomes stressful. If your phone beeps, a shudder of panic goes through you and you don't want to check it in case its something bad. If the TV show or movie you're half watching takes an unexpected turn, it feels like the world is closing in around you. I got around this one by only watching things I had seen before. And if you allow yourself to dwell on one particular topic, even a good one, for more than a few minutes, it manages to become stressful too, and you have to stop thinking about it and try to think of something else.

Hallucinations are never like the ones you see on TV, but I did find myself seeing patterns in the wall, in a very real way, such that I had to consciously remind myself they weren't real. No babies crawling on the ceiling or giant rats coming out of the walls or that crazy shit, just some minor things that aren't really there.

When you have a memory problem, it's usually that you don't remember what happened - I certainly had that, I would forget my topic halfway through a sentence. But I also had it the other way around - I remembered things that didn't really happen. I remembered whole conversations and actions which had never actually taken place, which then confuses you, and becomes stressful again. I've been told that that is something Alzheimer's patients struggle with, leaving them feeling afraid an isolated, and I can only sympathise - in my case at least I knew it was temporary.

The emotional element to withdrawal surprised me. I'm a very emotional person generally, so I was expecting to be a crying shivering wreck, but in my particular case, emotion just left altogether. I didn't feel happy or sad, I couldn't empathise with anyone and I didn't even self-pity, I was just an emotional brick, unable to feel anything. It felt like my brain was too busy keeping me alive to have any feelings about anything, just stress and anxiety which, once you know are just the withdrawal and not real, are manageable. Horrific, but manageable.

After a few days, things start to get better fast. I found myself literally able to note how much better I felt than a couple of hours ago. Some symptoms remain for days or weeks, but they become quite manageable by then. Once my body recovered, I was actually noticeably thinner than I had been just a week earlier, and once my guts stabilised I found myself binge eating for days - 4 or 5 decent sized meals, and snacks and junk on top!

So there you go, that's my experience. Seriously guys, stay away from opiates. You don't need them at all unless you're in really serious pain, and you don't need them for long even if you are, so don't just take anything the doctor offers you. They hand them out far too easily, and mostly have little education and sometimes little knowledge about addicts and addiction. Self medicating is usually a bad idea, but a little bit of self-UNmedicating might do more good than harm. At least talk seriously to your doctor about it.

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My first "free detox!"

Its the start of 2017. I was very unhappily but VERY gainfully employed as a sort of sales rep, I got very drunk every night, and had done for many years. It wasn't ideal, but it was manageable - my wife liked a drink too, and my body could apparently handle it, so I was on probably 500-600ml (Americans, that's 17 ounces, apparently) of Jack Daniels mixed with coke per day. I didn't take anything else at this point, just booze. I wanted to quit, but I couldn't because the length and severity of my habit meant that quitting cold turkey would have been very dangerous. To detox safely would likely have meant going to rehab to get the anti-withdrawal drugs which was complicated and unpleasant, and life was basically working OK, so meh, just carry on as you are for now.

Then I fell down the stairs. Most people fall down the stairs and sprain their ankle or bruise their shoulder, but I like to do things properly, so when I fell down the stairs I split my head open. Fortunately my wife was home, and she called an ambulance, and I woke up 2 days later in a hospital bed being told I nearly died.

For the next week or two, I was VERY doped up on painkillers - codeine, morphine, God knows what else they were giving me. BUT, unbeknown to me at the time, for medical reasons they also had no choice but to detox me off alcohol too! So I often refer to this as my "free detox" - you can't walk in to a free NHS hospital and ask to be detoxed, but if you go in with a fractured skull, they have to treat that, so they have to detox you so you don't seize in the meantime. After a week or two, when I was a bit less doped and thinking clearly, I realised that I had basically not had a drink or a cigarette for weeks, so I'd basically managed to quit both with no effort on my part!

Then, they wanted to discharge me for the bed, but they couldn't send me home with some of the drugs I was on. My mum is a retired theatre nurse, so we had a chat with the doctors and they said they'd discharge me as long as I stayed with my mum and was supervised. So they sent me home with a few bottles of oramorph (which is liquid morphine that you drink, powerful stuff!) and, crucially, 200x30mg codeine pills. I was told that the oramorph was highly addictive, and that they'd only give me a couple of bottles to remain with my mum, and then call to review in a few days; all very cautious. But they never said a word about the codeine, except "take these as you need them, if you run out just call and we'll give you another prescription."

More to come on that later, but this is the story of how I found myself in a position where I WANTED to quit drinking, and a solution landed in my lap. I was sober for the next year, and quite happy to be. Of course it didn't last, more to come on that later too, but at the time I felt blessed.

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Introduction to my life as an addict

6 months have passed since my last post. A LOT has happened, and most of it bad. In case you haven't read previous posts, this is a blog about addiction and my experience of that, but so far I've been mostly general and said little of my personal experience. I could of course write a whole book about what led to this point, so to avoid that, I'll start 6 months ago. So I'm living at home in my nice house, with an incredible wife, who is 6 months pregnant with our first kid. I'm an alcoholic, currently manifested as a struggling on-and-off drinker.

My son was born in September. He stayed in hospital for a few days because there were some mild concerns, the particular hospital were strict about their visiting hours, and on some days they wouldn't let me in at all because of Covid, so I saw very little of him for a few days. Of course, I was home alone every night, so I was drinking like a fish most days.

When there's no reason to NOT drink, then I drink. Which means if I'm ever home alone, I'm getting hammered. If I can, I'll keep it from my wife and others, but I don't see it as essential - they hate me drinking, but at least when I'm home alone it doesn't directly affect them.

In the past, I've been hooked on opiates - never the REALLY hard stuff, mostly codeine (which I often refer to as "diet heroin"). Now I'm not physically hooked any more, but I still indulge now and again, taking great care not to get to the point where withdrawal kicks in, but it's sometimes walking a tightrope. Combining alcohol and opiates is not advisable (if you do it with heroin, it's quite easy to die), but I've done it plenty and never knowingly come to any harm.

So thats me. I don't know how to blog, but I like writing and it's good for me to get some of this shit out of my head, and it's not like I'm ramming it down your throat - you're the idiot who chose to waste the last 90 seconds reading this! Seriously though, do read on, I have some interesting experiences and insights to share

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Struggles with Alcoholics Anonymous

I've been to AA meetings. I've even been to rehab where they guide you through the 12 steps. I really struggle to make it work for me, and I'll try to explain why.

Step 1 - We admitted we were powerless over alcohol - that our lives had become unmanageable.

OK, this one, I can do. I have struggled in the past to fully accept that I am "powerless" and questioned the definition of the word. After all, I haven't had a drink for a couple of days now, so I'm not totally powerless, surely? More recently, I have realised that it doesn't work like that. "Powerless" doesn't mean that I absolutely have to drink all the time; it's more about the second part - has my life become unmanageable as a result of alcohol? Absolutely. I don't work, I barely accomplish anything at home, and when I do have a good couple of days, I turn back to the bottle and ruin everything. My wife doesn't like being around me, I often don't feed myself or look after myself very well.

Step 2 - Came to believe that a Power greater than ourselves could restore us to sanity.

THIS is where I hit a major stumbling block. I am not a spiritual man, in the slightest; in fact, I'm a card-carrying atheist. Some people say that everything happens for a reason, and I say yes, that reason is called physics. What is this "Power" that is greater than me, which can return me to sanity? The problem I have exists entirely within my own mind, and therefore I struggle to accept that the solution can come from outside my own mind.

Sure, I go to AA meetings, and I share my experiences and feelings with others. And sometimes I do feel like it helps. But it helps because it helps ME. It helps in the same way as other kinds of talking therapy, or even psych medication - the changes taking place are within my own mind, not outside of it. And the only person effecting those changes to my mind is me, even if I'm doing it with help from others. But is there a "Power" at work here?

There is a chapter in the AA book ("The Big Book") written for agnostics. I hoped it would be helpful, but it basically just tries to convince the reader to accept spirituality into their life. I really wish I could do that, I really do. I've always thought that faith in a supreme being who is watching over us must be terribly comforting, but to me it's only as comforting as believing in unicorns.

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Day 2 - urges and opportunities

Day 2 of sobriety.

The difficulty of staying sober is difficult to express. It's not an urge, or a craving, like a smoker needing a cigarette, or a heroin addict desperate for another hit. I feel fine, I'm not sick, I'm not in withdrawal and I'm not clawing at the walls. There's just this dull sense that it is possible to feel better than I feel now, which carries with it a desire to seek that out.

As my alcohol problem and associated desire to drink are well known to my family, they generally try to keep me from acquiring it. That means if I want to go to the shops, someone will insist on coming with me. Lately I've taken additional steps, such as surrendering my bank/credit cards so I have no access to money. Fortunately my addiction has never sunk so low as to steal, so having no access to money is a strong barrier to obtaining it. But addicts have a knack for finding a way.

Some days I feel strong, I feel like my desire to be sober is greater than my desire to drink, so I can make it through the day without too much trouble. But some days, I refer to as my "opportunity days" - these are the days when, usually as soon as I wake up, I tell myself that if I get the opportunity to drink today, I'll do it. I don't choose these days, they just happen. On these days, I will go to certain lengths to create my own opportunity, but not extreme lengths. A common one is to convince whoever I'm with that I'm strong today, or that I don't have any money, and that I want to go for a walk to clear my head. Whereas in reality, I have a £20 note they don't know about, and I'm heading to the shop.

The battle that goes on inside my head on these days is difficult to describe to a non-addict. My conscious, rational mind wants to fail to find the opportunity and stay dry. But the addict in me is hammering my rational mind with justifications and excuses. No matter what the situation, there are always perfectly good reasons to drink. Perhaps its because I've had a few dry days, and therefore I've proven its "not a problem" and one day won't hurt. Perhaps its out of spite - maybe my wife has kept me under lock and key for a few days, and even though it was at my request, I'm now feeling bitter about being controlled - why shouldn't I be allowed to drink? It's my body, my mind, my money. Perhaps its because I'm going to stay at my mum's tomorrow, so I won't be able to drink for a week, so I deserve one last night. There are dozens of other cases.

If that opportunity presents itself, my conscious and rational mind has one last ditch attempt at saving me from temptation. I tell myself I don't need it, and it's a really bad idea, and I need to resist. "But," my addict says, calmly, "why don't you just buy it now, quick, while you've got the chance, and then you've got all the time you need to think it through. You don't have to commit to drinking or not drinking right now, just buy it, then you can relax, and talk yourself out of it later." Of course, that never, ever works. Once I have it, it's going to get drunk. And so am I.

If the opportunity doesn't present itself, I will usually try a few last ditch attempts to force it. I have in the past deliberately started cooking a meal knowing that I'm missing an ingredient, so that I can get halfway through cooking and then shout "oh shit, we haven't got any pasta, I'll just nip and grab some quick!" I've pretended to forget my Covid mask, so when we get to the shop I can say "you go grab the stuff, I'll wait out here," knowing there's an off-license next to the co-op, and I can be in and out before anyone knows.

In the cold and sober light of day, I'm not proud of these deceptions. But in the moment, I think I kind of am. It makes me feel clever, like I've outwitted my captors, like I've performed a magic trick. Later on, they find me drunk and say "how the hell did you get hold of that?!" and I think "Ha! Fooled you!" It's a strange mix of pride and shame. I'm not a dishonest person, except where alcohol is involved, but once it is, I become a master of deception. As a result, I have worn away every last shred of trust that my wife and family have in me. When I'm genuinely sober, and someone accuses me of drinking, it's heartbreaking, because as much as I want to convince them, I know I can't expect them to believe a word I say, because if I HAD been drinking, I would swear blind that I haven't. And when that does happen, it gives my inner addict another piece of ammunition - "well, if they think you've been drinking anyway......"

When 11pm rolls around and I haven't yet found that opportunity, I actually breathe a sigh of relief. There is no more urge by then, no more desire, and I'm pleased that I've managed another day. But sometimes, even as I'm getting in to bed, I can't help but start work on how to create that opportunity tomorrow.

"They" (AA, counsellors, therapists etc) say that you can't quit for someone else. You have to quit for yourself. I understand that, because if you're trying to quit for someone else, that's not telling you not to drink, it's just telling you not to get caught. But doing it for yourself is incredibly difficult, when the addict living in your brain is so clever, so devious, and so utterly convincing.

They also say it gets easier with time. Well, it doesn't feel easy on day 2. Here's hoping that opportunity doesn't arrive today, and that it gets easier on day 3.

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A day in the life of a still-drinking alcoholic

At the moment, I am sober. I'm on day 1 of being sober. I have, in recent weeks, frequently reached day 2 and day 3, but rarely beyond that. Let's explore why.

Firstly, I have long since accepted that I am an alcoholic. I am not, presently, physically dependent on alcohol - that means I can safely quit drinking without getting the unpleasant withdrawal symptoms associated with the physically-dependent alcoholic. I know this because I have been physically dependent in the past, and that is a MUCH more difficult position to escape from. Basically, you need prescription drugs such as librium and these are very difficult to obtain without going in to a private and very expensive rehab centre.

So if I'm not physically dependent on alcohol, why don't I just quit? It's a very good question, and one I wish I could answer myself. Today, I have no desire to drink. If I had a bottle of whiskey with me now (I don't, but for the sake of argument), I would happily ignore it. But, crucially, I wouldn't want to pour it down the sink. Why? Because as much as I want to quit drinking, the demon in my brain will want to hold on to it, in case I want to drink tomorrow, which I probably will. I justify it to myself and to others in various ways - I want to hold on to it to prove I can resist, as a show of my strength. Or I want to hold on to it to give it to someone else, because pouring it away is wasteful. But deep inside my mind, the reason is because I want to have the opportunity open to me.

Then, tomorrow, I will wake up, knowing I have a bottle (probably hidden somewhere, so that nobody else knows about it), and I'll tell myself that I did well yesterday for not drinking it. I feel proud of myself for not drinking it, and I want to continue to feel that pride, so I'm not going to drink it today. I'm doing well! I'm recovering, and I'm doing it with willpower! Yay me! Well, that deserves a treat, right? I mean nobody can expect me to go to complete abstinence right away. I did well yesterday, so if I just have a quick drink this morning, not enough to get drunk, just to get that nice warm feeling in my stomach, then where's the harm...? I'm not going to get drunk, so nobody else will know I've had a drink and nobody will judge me. They'll be proud of me. And they should be! I'm doing well!

I FIRMLY believe in everything I've just said to myself at that time. So I have that first swig, which will be my only drink that day, then go for a cigarette (which feels SO GOOD right after a swig of whiskey), and prepare to go about my day. But I need to let myself wake up a bit first, so I'll get some toast, stick the telly on for an hour, then I'll be ready to start my day. It's probably about 9am at this point - that's fine, I don't need to start my day already, I can take an hour to ease in to my day, then at 10 I'll start being productive. I want to mow the lawn today, and I've got some DIY to do, so I've got plenty of stuff to do to keep me occupied. And if I'm going to be sat on the sofa for an hour, another quick swig won't hurt - it'll help me relax, and that will wear off in an hour, so I'll be ready to start my day as planned!

10am rolls around. Right, time to start my day. Ugh, I'm a tiny bit hungover now because of having a drink before breakfast. A quick hair of the dog will sort that, then I'll mow the lawn. Another swig. I go out to the shed to get the lawnmower out, and then realise - oh shit, I'm actually a bit drunk! I didn't expect that, I've only had three swigs of whiskey! Right, I'll mow the lawn, then at least I've accomplished something with my day. 45 minutes later, the lawn is done. Great! I've been productive, I've done a thing! Time for a break. A cup of coffee, and a cigarette. Ooh, but you know what goes so well with a cigarette... Gulp gulp gulp.

I then notice that my 70cl bottle of whiskey is nearly half empty, and I'm actually quite drunk. Shit! My wife is going to notice! Then she'll get upset! I don't want my wife to be upset, because I'm a good husband and I want to keep my wife happy! Right, I know what I'll do. I'll go tell my wife that I didn't sleep much last night, then I'll come and have a nap for an hour, that will sober me up, and everything will be OK. But I don't feel tired - well, if I have a couple more generous swigs, that will help me sleep, and the problem will be solved and everyone will be happy. Gulp gulp gulp.

Cut to an hour or so later. I wake up, still quite drunk but now hungover at the same time. Ugh, I feel rough as anything. A quick swig to take the edge off...

Of course, this isn't a standard repeating pattern. The circumstances, excuses and justifications vary from day to day. But there are a few things which are consistent. Firstly, if I have a first drink, at any point in the day, I will end up drinking until I can barely stand up. Secondly, I will emphatically deny that I've been drinking, sometimes going to extreme lengths to "prove" my sobriety, even when I'm slurring my speech beyond recognition or falling all over the place. That lying only ends when I get definitely caught, by someone finding my bottle, or using a breathalyser on me (I bought one during one of my "committed" periods). Although I have in the past hidden the breathalyser, tried to fake it, or claimed that it is broken and giving a false positive. The lengths I will go to to demonstrate my sobriety are often downright evil - even if I feel like I've succeeded (and sometimes I do), I will then push the point, trying to guilt trip anyone who doubted me for not trusting me, and not helping with my "recovery". The day after, I really hate myself for these lies and deception, but I still don't want to come clean.

So there you have it. A typical "drinking day" in my life. I've had dozens of days like this in recent months, and yet every time I take that first drink, I am utterly convinced that it won't end badly this time.

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Defining "Alcholism"

My name is Chris, and I'm an alcoholic.

I've been an alcoholic for about 20 years, with various dry spells (one of which was nearly a year), and various spells of "reasonable" drinking (which basically means getting hammered every Friday night). But during those times, I didn't understand what addiction was, or what alcoholism was. This post is about my understanding of "alcoholism."

Apparently, the word "alcoholic" has fallen out of favour, with people now preferring to talk about "alcohol use disorder" instead. It's basically the same thing, but the reason for the change is that alcoholism falls under many different definitions. The one we all know and love is the classic drunk - he wakes up every morning and pours his first drink, spending his life drunk and never considering the idea of giving up. That is what I call the "all day every day" drinker, and it actually accounts for few sufferers of alcoholism.

Next we have the "functioning alcoholic" - these are quite popular in fiction. Jimmy McNulty in The Wire springs to mind. He often carries a bottle of whiskey with him, but he goes about his life. He still holds down a job and keeps a sort of life together, and doesn't get drunk all day. Rather, he drinks to get through the day. I worked as a barman in my youth, and I knew a few of these alcoholics. One, who I'll call Tom, would usually be waiting by the door when we opened at 11am, when he'd come in, sit at the bar and drink three or four TRIPLE brandies, then go to work. I think he was a gardener. He'd be back in the early afternoon for a few more, then back in the early evening, when he'd stay until closing, only ever drinking neat brandy. Tom was very rarely noticeably drunk, he was just keeping himself "topped up" - anyone who met him who didn't see him drink would probably see a man who has his life together. He was quite a happy chap on the outside, and seemed like he had accepted his lot in life. I only knew his as a barfly, so I don't know what his life was really like.

Then, we have those "heavy drinkers" - these are people we don't usually consider to be alcoholics. They get up in the morning, go to work, they cook their dinner and keep the house clean, they wash their car at the weekend, and take the kids out to the park. But every night, they drink a couple of bottles of wine in front of the TV, or they go to the local and sink 8 pints. Many of these people (of which I was one for many years) don't consider themselves alcoholics, and don't consider themselves to have a problem. After all, they can afford it, they're fairly fit and healthy, they hold down a good job and support their families. They may not even be physically dependent on alcohol. Whether these people are alcoholics or not depends on your definition of the word, but they definitely have a certain requirement for alcohol to be in their lives. Many people go through their entire lives in this fashion, and for many of them, it doesn't cause their lives any problems.

Finally, we have the "binge/bender" drinkers. I've combined these two in to one, but essentially these are people who don't drink every day or all day, and may go for many days, weeks or months without alcohol. Few people consider these individuals to be alcoholics, but what separates them from "normal folk" is that they only ever drink to get drunk. The idea of a glass of wine and an early night is pointless to these people - if you're going to drink, why not do it right? So they might not drink often, but when they do drink, they get absolutely wasted. A binge drinker will only drink on certain days, maybe only on a Friday night, or only when he sees certain friends. A bender drinker is the one who temporarily becomes an all day every day drinker, or a functioning alcoholic, for a few days, or a week, or even months, but then sobers up and stays dry until the next bender.

None of these people HAVE to stop drinking. Some of them, like Tom, are quite happy with their lot in life, and in my experience, most students and many pub regulars are binge drinkers and still have happy and functional lives.

One definition I have heard, is that a heavy drinker drinks more than they should, but an alcoholic drinks when they shouldn't. This is not correct, in my opinion. For most of my alcoholic life, I only ever drank when they day was done. I worked had, and I was good at my job and I never drank during the day, or drove a car after drinking. But once I'd finished work, and eaten dinner, and everything was taken care of, out would come the Jack Daniels and coke. Does that make me a functioning alcoholic? Does it make me a binge drinker? Or was I an all day every day drinker, who simply had the willpower to not start until it was reasonable to do so? God only knows. And that's why alcoholism is so difficult to define.