Showing posts with label withdrawal. Show all posts
Showing posts with label withdrawal. Show all posts

Sunday, December 2, 2018

Breaking Free

It's been over 100 days now since I had my last cigarette.  I've saved approximately $1,000 during that time.  A bit less than that because I'm still vaping as a nicotine replacement therapy to aid in this process.  With the vaping you can buy the juice in a variety of strengths.  I began at 24 mg.  I've managed to reduce that to 12 mgs.  It's going well.

Probably the most significant development during this time of breaking free is that I'm developing a self image and identity that I am not a smoker.  I am moving from a compulsion to always having tobacco at hand to a revulsion at the thought of ever purchasing again.  I am confident in saying that I've purchased my last tobacco. 

This is major.  It's the mindset that I've achieved with respect to alcohol.  That's the reason for my optimism regarding smoking.  Not one more.  Done.  Finished.

There remains the issue of vaping.  The advantage of using vaping as a stop smoking aid is that it has proven to be a good substitute.  I had reached a roadblock in that I just couldn't get through a work day and the breaks without having a smoke.  Vaping got me beyond that.  The encouraging thing is that I've been able to reduce the nicotine content of the vaping without issue.  You can actually get the vapor juice with nicotine levels of 36, 24, 18, 12, 6, and 0.  My strategy has been to settle in at one level until I'm very satisfied, and then to reduce to the next level.  In the end, it will get to the point at which I'm not getting any nicotine, and then it will be just a matter of finally saying "hey, I don't need this pacifier anymore.  Then I'll be done.

This whole issue of chemical addiction is an interesting one to experience.  One observation that has come to me is that it is the body's ability to adapt to the presence of chemicals in the system that makes breaking free so difficult.  The point being that once the body adapts to a certain chemical, be it alcohol, or nicotine, or other drugs, there is a negative reaction that comes from cessation.  Withdrawal.  For those of you who have never been addicted, just understand this.  The problem is the withdrawal.  It's not that a smoker can just put down the tobacco and feel as good as a non-smoker.  During withdrawal one feels terrible, quite frankly.  That's why we continue. 

I'm told that smoking is one of the most difficult addictions to break.  I believe that.  It's been a greater struggle than drinking, by far.  In my case all that was required to stop drinking was a recognition that it had truly become a problem.  Well that and the recognition that one more day drinking might have been the end of my life. . .  With drinking, once I recognized that I'd hit rock bottom I recognized that this was not something I could wait until 'tomorrow' to address.  It had to happen now.  Smoking is different.  Unless one is diagnosed with lung cancer, for example, one always believes that one doesn't have to stop today, you can always do it tomorrow.  And even if one has a diagnosis of lung cancer or other such smoking related diseases there is a sense that the damage has already been done.  I can have another cigarette.  I'll quit tomorrow.

I grew up in the context of the religious pietism of my scandinavian family.  Though some of that pietism was subsiding by that time, there still was a sense that smoking, drinking, gambling, (and dancing!) etc., were sinful.  To this day, there is an anti-pietist tendency in the church that scoffs at the old notion of the sinfulness of these things.

I'm either becoming a pietist in my old age, or at least recognizing that those old timers understood something significant.  After having fought the battle of addiction I'm more convinced than ever of the sinfulness of these addictions.  There is a point at which one crosses the line.  One can drink alcohol in a healthy manner and I'm not suggesting such consumption is a sin.  But for some of us, addiction happens.  Why, I'm not sure we know.  But it happens.  Same with other drugs like nicotine.  I've also been addicted to Ativan. 

The thing about addiction is that you can talk all you want about loving the Lord your God with all your heart, soul, mind, and strength, but it is another god that controls one's behaviors.  One's entire life is structured around the addictive behavior.  Provisions are made to insure that one never faces withdrawal.  No sacrifice is too great.  Family, jobs, and even one's own life are all sacrificed at the altar of the addiction.  If that's not a definition of a god, I don't know what is.

Part of what I'm saying is that I recognize now the importance of a deep repentance in the process of breaking free.  This is not just about coughing less.  This is about 'having no other gods before me'. 

Thursday, September 6, 2018

Breaking addictions

I wrote recently how wonderful it was to be able to sleep through the night again.  That development came as I was using the patch in my effort to quit smoking. 

Now I'm weaning myself from the patch, have moved through step 2 and started step 3 yesterday.  Step 1 provides 21 mg of nicotine a day, 2 provides 14, and 3 provides 7.  Next week it'll be 0.

And so I'm up, this morning at 1:30 am.  It's no doubt that my addiction is responsible, at least in part, for my inability to sleep through the night.  It's a powerful force.  Bear in mind that I'm on a couple of medications that would knock out a normal person.  I should be sleeping.  But I'm not.

To understand addiction, and why it's so hard to quit, just understand this:  that withdrawal has such negative consequences that the addicted person will choose to resume their use, just to avoid the withdrawal.  That's why people continue drinking.  Or using.  Or smoking.  Or eating to excess.  Etc.

What I discovered when I went through chemical dependency treatment is that one just needs to buckle down, bear the pain, and wait patiently for it to subside.  Easier said than done.

What I'm most concerned about is losing hope.  "It's just not worth the effort, and I don't like who I am in withdrawal, and there will be a better time to do this down the road."  These are the statements that have kept me smoking for all these years. 

The point is, often in life when one is trying to make positive changes, it gets worse before it gets better.  Accepting that is necessary for success.

Sunday, June 24, 2018

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."

Saturday, November 25, 2017

Then, now, and always an alcoholic

I wasn't always an alcoholic, but I always shall be.  Not everyone will be an alcoholic, but anyone can be. These statements I believe to be true.

It's been over five years now, since I had my last drink.  Time to remember, reflect, and share.

Some people I know were out of control with their drinking from day one.  Not me.  It was probably harder for me to admit I was an alcoholic because I had thirty years or so of normal drinking patterns that seemed like evidence to the contrary.  For most of my adult life I drank an occasional beer, mostly during the summer months, during football season, and with certain meals such as pizza.  There were some occasions where I drank heavily, such as at the pastor's conference.  But most the time I drank no more than a beer or two.  And only occasionally.

Then life happened.

First I was prescribed Ativan for depression, insomnia, and anxiety.  It is a drug that works on the same receptors in the brain as alcohol, with effects so similar that it is also used to manage alcohol withdrawal symptoms in treatment.  I was told point blank at the time that I had to quit drinking.  My psychiatrist put it this way:  "I can't effectively treat your depression if you continue taking a depressant (alcohol).  No problem.  I just didn't drink.

What the doctor didn't tell me is that long-term usage of Ativan can produce "tolerance, dependence, addiction, benzodiazepine withdrawal syndrome, cognitive impairments, etc., which is why it is generally not recommended for use treatment beyond two to four weeks."  However, it is often prescribed for long term use.

After a number of years, a change of employment, a new home, I felt great and decided to cease treatment for depression.  My doctor, Brad, recommended I reduce the dose of Ativan prior to ceasing completely, and also warned that some people develop a drinking problem after going off of Ativan.  I was unphased because I had never had a drinking problem, and was quite confident I never would have.

Prior to ceasing medication I had begun to drink moderately, as in 6 to 7 fluid ounces of Scotch per week.  A couple of Scotch doubles, usually on the night a friend came over for dessert.  In spite of my doctor's warning, that drinking became a nightly affair immediately upon quitting Ativan.  My financial records of purchases confirm that I was now drinking 6 to 7 fluid ounces a day, not a week.

This is what I believe happens in the development of alcoholism.

First of all, a normal person has an adverse reaction to alcohol as a toxin in their body.  That's why it's called 'intoxication'.  Some people such as my wife so dislike this feeling that they will not drink enough to even begin to feel the effect.  Many people like the feeling of early intoxication.  That' why they drink.

When a consistent pattern of drinking develops, the body adapts to the presence of alcohol in the system, called 'habituation', and no longer has as strong a reaction against the alcohol as before.  The drinker who once got a buzz with the first drink now must drink more to feel the same effect.  Which if you are drinking for the effect means you will drink more.

The next stage is that as one drinks more and more to achieve the effect of intoxication the body adapts to the presence of alcohol to the extent that it now has an adverse reaction to the lack of alcohol in the system, that is withdrawal symptoms, not to the presence of alcohol in the system.  During a particularly stressful time in my life I stated to a friend that "It takes two drinks for me to feel sober."  I thought it was a joke but it was actually true.  I had to drink to feel normal.  At that point I had become an alcoholic, beyond a doubt.

Though an alcoholic probably doesn't realize this.  Toward the end, I was concerned that my congregation might smell alcohol on my breath Sunday morning, so I quit drinking Saturday night.  I got the shakes Sunday mornings as a result, though I didn't understand it to have anything to do with my drinking.  I couldn't pour the wine from the pouring chalice.  I didn't know what was happening but blamed it on stress, or something.  Only after treatment did I recognize I was going through detoxification.

If an alcoholic could simply manage by maintaining a base level of alcohol in their system at all times they would.  Anything to avoid withdrawal.  But the problem is with the habituating properties of alcohol.  It takes more and more to achieve the same effect.  But there is only so much of this toxin that the body can tolerate-- before it simply shuts down.  That shut down comes first as 'passing out'.  And then, the body's systems get so depressed they shut down entirely--that's called dying, by the way.

My rock bottom came in part because a doctor had prescribed Ativan again for me.  Circumstances at work sent my into a rage one afternoon, and after consuming a fifth of Scotch that afternoon and evening, I still felt I needed something and so I took Ativan.  The combination of the two almost killed me.

Why does an alcoholic allow this to happen?  One of the reasons is that to the alcoholic it appears that they are in control.  I used alcohol to 'control' my moods, or so I thought.  This is one of the reasons people with mood disorders such as Bipolar Disorder often become addicted.  Alcohol gives them some control.  One drink, two drinks, three drinks, four, I knew what I was drinking for.  "I'm in control" means "I don't need help".  Do you have a drinking problem?  No, I have no problem drinking.

I avoided some of the pitfalls of drinking.  I sat out on my deck, drinking myself to sleep at night, but rarely drank out on the town, and did not drive drunk (well, not very often).  My heaviest consumption was when I was alone.  Most of the time I convinced myself that I was only having a couple of drinks, a nightcap, and that was not a problem.  At the end those couple of drinks averaged 9 to 10 fluid ounces a day of Scotch.  Bigger glasses, less ice, kept the 'drink' total at two.  The truth is that 9 to 10 fluid ounces is consider at the minimum, 7 drinks, some would consider it 10.  That sounds like heavy drinking.  And it was an average.

Now I'm free.  I've gone through detoxification, dealt with many of the issues that contributed to the drinking, and no longer experience cravings.  The smell of Scotch is repulsive to me, now.  I can be around people drinking wine or beer, just not Scotch.

I share my story hoping that it will not be your story.  Even a lifetime of drinking normally is no guarantee against developing alcoholism.  Some people are more prone than others, but it is possible, I am convinced, for anyone to become alcoholic.  No one is immune.  Especially vulnerable are those with other issues like bipolar disorder, depression, or other mental illnesses.  Genetics can also play a role.

I don't have a problem with  normal people drinking normally.  Some people drink for the taste, not the effect.  Some people drink occasionally, not consistently.  Some people will enjoy their last drink like they enjoyed their first.  But not all.  Remember that.