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Medical Immunity (to addiction)...

  1. Sep 3, 2016 #1
    I am a 72 year Caucasian male who quit drinking at 50 after having been an alcoholic for 36 years. Many is the time that I have awakened the next day with an empty liter bottle of VO or Cutty Sark close at hand. I suppose that if I had not been 90 lbs overweight, it would have killed me. When I quit, naturally I thought that I would need the services of a treatment center. I had my family doctor check me into a dry out place in Waco. To make a long story short, my psychiatrist at the facility released me on the fourth day. I never thought about a drink, I never wanted a drink, and I had no withdrawal. It's the same to this day. I asked my doctor how this was possible, and he said that he did not know. There must be a certain percentage of the population that cannot become addicted to alcohol, and I must be one of them. What say you?
     
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  3. Sep 3, 2016 #2

    Fervent Freyja

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    I say, that you have contradicted yourself...
     
  4. Sep 3, 2016 #3

    jim hardy

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    Sounds plausible.

    Addiction can be psychological or physical or both.
    Not everybody metabolizes alcohol the same.
    If you had no physical craving my guess is you have the "lucky" gene for alcohol metabolism so don't get a very high acetaldehyde peak.
    Did you have blackouts ?


    Here's an excerpt from a decent article
    http://pubs.niaaa.nih.gov/publications/arh294/245-255.htm
    .

    old jim
     
    Last edited: Sep 3, 2016
  5. Sep 3, 2016 #4

    Student100

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    This is normal, there are always segments of the population that don't become addictied to a substance after regular use.

    Some substances are more addictive.

    The majority who smoke become addictied, but there are those who can remain longterm casual smokers who experience no withdraw or cravings during periods of abstinence.

    I'm not one of them. : (

    The majority who drink alcohol don't become addicted, but some do.


    Simply because you don't have a physiological addiction doesn't mean you aren't addicted. In your case it sounds like the alcohol dependence was a result of environmental/psychological factors.
     
    Last edited: Sep 3, 2016
  6. Sep 3, 2016 #5

    Fervent Freyja

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    Still, all people addicted to alcohol should take precaution during withdrawal! We should assume that it's dangerous for all people, even if there is a small minority that don't have the same withdrawal risks and somehow aren't physiologically addicted (whatever that means). Until a person can be tested and proven to safety recover without healthcare assistance, then they should take it seriously! And don't you know, how many people have made the claim to be so unaffected by alcohol that they can still safely drive and function normally while drinking? It wouldn't surprise me to read that they also believe they aren't subject to withdrawal symptoms or even addiction.

    From: http://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf
     
  7. Sep 3, 2016 #6

    Ygggdrasil

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    There is evidence that genetics can influence individuals' susceptibility to addictive behavior: http://learn.genetics.utah.edu/content/addiction/genes/

    However, the are considerable environmental factors as well (e.g. ones upbringing, access to treatment, social pressures, etc.).
     
  8. Sep 3, 2016 #7

    jim hardy

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  9. Sep 3, 2016 #8

    Student100

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    It means what it sounds like, most peoples bodies don't develop a dependence on alcohol and they experience no withdraw symptoms.

    Of course, any long time drinker who experiences symptoms of withdraw should go to the ER for monitoring. The seriousness of withdraw is overblown though, very few require in-patient monitoring. That said, only a doctor can make that determination.


    I don't see the correlation between thinking you can function on alcohol and thinking you won't have withdraw symptoms. Even mild symptoms are readily apparent.
     
  10. Sep 4, 2016 #9

    Fervent Freyja

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    Because, people tend to believe that they have superpowers when intoxicated.

    I'm already aware that some are more susceptible to alcoholism, this was linked back when I was in high school- I don't drink much myself primarily on account of that. I'm talking about after-the-fact, when someone is already physiologically addicted for a long period of time.

    Old men are supposed to be nice, not grumpy or drama-seeking. You are probably decreasing your life span by being so argumentative. Grumpy Old Men Don't Live Long: Study
     
  11. Sep 4, 2016 #10

    Student100

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    But you need to not be drinking to experience withdraw.

    It doesn't matter if those predisposed to become alcoholics drink a little or a lot, they will become addicted. If you're an alcoholic, there is no such thing as drinking in moderation.

    Not being argumentative, unless you consider a friendly discussion argumentative.
     
  12. Sep 4, 2016 #11

    davenn

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    I agree totally

    FF really needs to lighten up with her attitude
     
  13. Sep 4, 2016 #12

    jim hardy

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    ??
    I thought you pretty girls liked us that way.

    grumpieroldmen.png
     
  14. Sep 6, 2016 #13
    I think that most addictions are related to a persons vulnerability at particular periods in their lives, even with drugs like heroin, the use of which was endemic in US soldiers in Vietnam, on return to the USA the rate of addiction quickly fell back to the normal background rate. There has been some work with rats (referred to as Rat Park) that also demonstrated the importance of the environment rather than the nature of the rat or the drug. If you were willing to forget long periods, waking up with a bottle, it suggests it must have served a function for you at the time and when it no longer served that function you stopped. Whether someone is addicted or not, or even the drug used is not a great predictor of the physical harm that might be done with continued use at high dose. The most significant harm caused by alcohol is to the liver, which luckily has an amazing capacity to repair itself, the big problem in acute with-drawl is it can increase the chances of an epilepic type fit, so short term monitoring is usually a good idea. The belief that an alcoholic is alcoholic for life is part of the philosophy of groups like the AA and becomes part of a self fulfilling prophecy which is probably unhelpful, there are increasing numbers of therapists that aim to teach people to control their drinking.
     
  15. Sep 6, 2016 #14

    jim hardy

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    It's the unpredictability that marks an alcoholic. Alcoholics lose control , they might do fine for some time but will experience that oblivion where they do not remember the end of an evening or a week.

    Anyone able to control it is not an alcoholic they're just a heavy drinker.

    escapism.

    Loss of control, declining emotional condition

    An alcoholic might get that "click" and drink to oblivion after just a couple beers on some nights and on other nights not at all.
    'Blackouts' are something not everybody experiences .
    http://www.aa.org/assets/en_US/en_bigbook_chapt3.pdf
    AApage32.jpg

    Success of 12 step treatment baffles the scientific community.
    http://www.scientificamerican.com/article/does-alcoholics-anonymous-work/

    If you don't like how your life is going you need to change your behavior.
    It's that simple.

    A therapist who hasn't experienced "that click" is in no position to give advice.

    old jim
     
    Last edited: Sep 6, 2016
  16. Sep 6, 2016 #15
    There is an interesting discussion about this based on the data from National Epidemiologic Survey on Alcohol and Related Conditions which shows that the majority of people do improve, especially if they avoid treatment. If you think about it there is something very strange about the belief that people have to hit rock bottom, effectively loosing everything in life they value before they can be helped, when we know how important social support systems are. Then they have to acknowledge that they have no control over their own behaviour and never will have, before expecting them to control their own behaviour. The outcomes generally for AA/12 step style approaches is not significantly different from the spontaneous recovery levels. This has acted as an impetus to develop alternative approaches, particularly in CBT with more realistic goals.



    http://www.thecleanslate.org/self-c...ce-recovery-rates-with-and-without-treatment/
     
  17. Sep 7, 2016 #16

    jim hardy

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    What's strange about that ? It is a factual observation of behavior from the 1930's .
    Human nature hasn't changed but general public awareness has. It's 70 years later now and we talk about problems, it's almost a status symbol to have a therapist . Look in any bookstore at how big is the Self Help section. Yes, people are self-treating.

    From the study that author links:
    http://www.thecleanslate.org/wp-content/uploads/2012/07/Recovery-Rates-In-General-Population.pdf
    That level of awareness indicates those people were well on the way to recovery when they entered the study.

    Here's the telling line from that report

    I don't know anything about Steven Slate's experience with St Jude Retreats , for whom he apparently works
    http://www.thecleanslate.org/about-2/
    but they seem to be an upscale treatment center
    https://www.thefix.com/content/saint-jude-retreats-non-12-step-rehab00222
    selling the same thing that AA promotes, namely behavior modification.
    Bless his heart, if it worked for him he should spread the word.

    Many people are put off by the mild religious allusions in 12 step programs and need an alternative .
    .
    That's what the 12 steps are for.



    Which outcomes ? 12 step programs promote abstinence and for that outcome the numbers speak, see red rectangles : AAstudy2.jpg
    Better than 2::1 everywhere.


    old jim
     
    Last edited by a moderator: May 8, 2017
  18. Sep 7, 2016 #17
    I think all studies have to use fixed criteria as to what constitutes an alcohol problem and the DSM IV or 5 criteria are the most widely used, you can't really just make up your own.
    again, you cant just choose an outcome to suit your beliefs, if your treating alcohol dependence it makes sense that this should be reflected in the primary outcomes.
    The fact is that AA is the only thing offered to most people, it allows providers to pretend they are doing something while spending very little.
    This is a evidence review that goes into some detail about the methods used and looks at specific interventions. The reality once again, is that none are brilliant. I have no real problem with AA and recognise its place but I also believe that some of their teachings are inconsistent with current theories about behaviour change.
     
  19. Sep 7, 2016 #18

    jim hardy

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    What put me off about the article was Slate's crowing about what he offers up as debunking of AA. I'd say he's still in denial or perhaps still grinding an axe..

    I also believe anybody who can control their drinking does not have the "unlucky " metabolism
    That genetic predisposition toward unlucky metabolism is ethnic. For old Mediterranean societies that have had wine around for all of recorded history it's in 5-10% of the population, North Eurpoean 20%-ish; American Indians 80% ish . (Source- that "Under the Influence" book i linked above. )

    If i combine "Still Dependent" and "Partial Remission" together the difference virtually disappears.

    What that table tells me is people with "unlucky metabolism" for whom abstinence is necessary tend to get steered into treatment,
    hence
    the greater numbers of "low risk" and "asymptomatic" drinkers in the untreated group , people who are able to control it after they deal with their demons,
    and the greater numbers of "abstainers" in the treated group .

    Maybe somebody will do some DNA screening and publish.

    Meantime i'll remain circumspect of anybody selling $30,000 treatment programs be they 12-step or CBT based..

    Slate's article does support Gooddoctordoc's premise in post 1 , though.
     
    Last edited: Sep 7, 2016
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