Addiction

Simply put, the ultimate sign one is addicted is when one is using to avoid withdrawal.

But before I review again, a disclaimer regarding alcoholics.  One size doesn't fit all.  Drinking patterns vary.  Some are binge drinkers who did not drink daily but when they did drink it was to extremes.  They may remain sober during the work week, but keep quite swashbuckling drunk over the weekend.  This was not my experience.

Other drinkers, more like myself, maintained a consistent daily pattern of drinking to achieve the desired effect, but remained largely "in control".  Personally, I believe this is a more troubling pattern of drinking in that it is easier to deny you have a problem.  "Out of control" is one thing non-alcoholics believe about alcoholics.  For this second type of drinker, it is a misnomer.  When I was drinking I was very intentional about making sure that I got the 'prescribed dosage' to achieve the necessary effect.  Now it is true, on some occasions I would drink more.  Weekends when my wife was gone were an opportunity to drink to excess, for sure.  A fifth of whiskey during an afternoon/evening of drinking was not unusual on such occasions.  But on a daily basis I simply maintained a sufficient level of intoxication to get by.

Habituation is the issue here.  One's body adapts to a certain level of alcohol in the system.  When alcohol is not present at the level the body has become accustomed to one experiences withdrawal.  The unpleasantness of withdrawal is such that there is an incredible compulsion to maintain at least the necessary amount of intoxication.  So, for example, I used to joke that I needed two Scotch doubles to feel sober.  The truth behind that was that I needed a minimum of about five or six ounces of Scotch daily to avoid the symptoms of withdrawal.  That amount of alcohol was only sufficient to make me feel 'normal'.  I did not achieve the 'buzz' at that level.  In fact, as my drinking progressed I never achieved a buzz at all.  I was so habituated to alcohol that I would drink myself into a stupor without ever having experienced the buzz, or the high, of intoxication.  Drinking had ceased to be fun.  It was about avoiding the pain of withdrawal.

And others just don't understand.

In my case, addiction began with Ativan, which I had been prescribed for sleep.  Ativan works on the same receptors in the brain as alcohol, and so "cross addiction" is a risk.  When I ceased taking Ativan I replaced it with alcohol.  Prior to that time my alcohol consumption had been very moderate.  For decades, very moderate and sometimes months without a drink.  Then, immediately upon quitting the Ativan, I was drinking on average, 6 to 7 ounces a day, which remained my preferred dose until the last year, when it went up to about 10 ounces a day.  In my mind, the 6 to 7 ounces only constituted a 'couple of drinks' and so I didn't have a problem.

But without those drinks, I experienced withdrawal symptoms.  Among other things, I would shake uncontrollably.  I would not drink on Saturday nights, so as not to smell of alcohol at worship Sunday morning, but instead would shake to the point I could not serve communion.  Withdrawal.

In order for an alcoholic to want to stop, you have to get to the point where you realize what is happening and are willing to endure the pain of withdrawal in order to be free from it.  It will get worse before it gets better.  When I checked into treatment I was offended that they started medicating me against all sorts of potential withdrawal symptoms, including seizures, as I had never experienced that in my mind.  The truth was I'd never allowed myself to go through withdrawal.  When I did, I experienced partial complex seizures for months following.  I do not know if these were directly related to withdrawal or not.  But after a while, they went away.  I remain suspicious.

I continue to fight addiction as I struggle with smoking.  During my chemical dependency treatment I had quit for awhile using the patch.  Last night I bought the patch again and am going to give it a try.  One thing that is very similar between alcohol and smoking is that there comes a time when you are smoking just to avoid withdrawal, even if it gives you no other pleasure.  I've been putting off quiting since my treatment for alcoholism in part because my doctors emphasized that my number one priority needed to be staying sober.  Drinking could kill me in a night.  Smoking was more of a long term health hazard.  Stay on top of the one, and the day will come to address the other.

I'm planning for retirement.  Two things:  I want to be alive for retirement, and I'd rather not have to account for the $250 a month of additional income to support this habit.  Freedom from it would be nice as well.

Anxiousness is one of the primary symptoms of withdrawal, coupled with an extreme irritability.  But there are other issues beyond just the physical withdrawal.  What do you do, for pete's sake?  What do you do?  I've spent a life time structured around having a smoke.  Now what do I do?  I'm an introvert and introverts need space, a time to regroup and recharge before re-engaging with others.  Smoking was my excuse to step back from social interaction and recharge.  What will I do?

Can I think and write without my pauses to reflect over coffee and a smoke?

Can I tolerate the feeling of nakedness that comes with a pocket empty of a pack and a lighter?

One of the struggles is  determining whether to go 'cold turkey' or to do a more measured decrease and withdrawal over time.  The patch is intended to maintain the nicotine level as one deals first with the behavioral issues of smoking, and then, over a period of months a gradual reduction of the level of nicotine until total cessation maybe three to four months down the line.  I have had others suggest that this is like cutting a puppy's tail off a little bit at a time.  It just prolongs the withdrawal.

Whatever works.

"Opa, (cough, cough)."  To one extent, Jasper's mimicking of me is cute.  To another extent, his identifying me with a cough is not.  I never wanted to be a role model of smoking for my children, but that was not enough to convince me to stop.  I don't want to model smoking for Jasper either, but the truth is that alone won't be sufficient.

I'd like to live long enough to enjoy being a grandfather, and enjoy retirement.  $3,000 a year would be a nice budget for entertainment, a boat, or golfing, or travel.  Or it could just go up in smoke.

One of the hardest things to deal with, other than the long term health effects of addiction, is the cost.  My smoking cost me, in today's currency, $2,500 to $3,000 a year over a life-time.  Add to that the cost of my drinking and we're talking real money.  Deposit $250 a month at 3% interest over 43 years and you have over a quarter million dollars.  We could use that money now.  We don't have it.  Actually, I might not have saved it anyway, but still. And I tell myself that when I started, a pack of cigarettes did not cost over $5.  Actually, when I started, 50 cents would buy a pack from a vending machine.  But however you cut it,  a lifetime of smoking represents a lot of dough.

Social pressures to quit smoking have not been helpful to me as I'm a rebel at heart.  From the first day of our marriage, Karla's made it clear that she doesn't like my smoking.  Actually, it wasn't until I quit drinking that she became 'tolerant' of my smoking.  When I'd try to quit, I'd get angry at her for her insistence that it be good for me to do so.  For a period of years I hid my smoking from her.  Dishonesty is a element of addiction.

My father also tried to get me to stop.  Didn't work.  It just compromised our relationship for years.

If others could quit for you, if their will power were enough to achieve success, every smoker would quit.  But they don't feel the pain.

In the dark of the night, as I lay back down, hopeful to get some more sleep, I am conscious of the sound of my breathing.  I hear the air in my bronchial tubes.  It's just short of a wheezing.  Sometimes a cough clears the airway and the sound stops.  Other times it doesn't.  At this point in time the effects of my smoking are complicated by the effects of my inhaling far too much sawdust as well.  I sometimes tell myself that it is the hearing aids that I wear that makes the sound of my breathing so pronounced.  Of course, I know better.  Clear airways would help.

Finally, identity is an issue.  As a drinker, I prided myself on being a "Scotch drinker".  Over a life time one builds up and identity as a "smoker".  One needs to adopt a new self image and identity.  That is easier said than done.

And so the battle begins.  Can someone like myself, who has battled addiction throughout my adult life, be free?  Can I do so without complicating other areas of my life, such as my mental health and tendency toward depression?

And so I offer a prayer.  And I remember the Psalm for this Sunday:  "Then in their trouble they cried to the LORD, and you delivered them from their distress."