How will I know?
Are you or a loved one suffering from what could be alcoholism or drug addiction? How can we distinguish between actual illness and someone going through a “rough patch.” The first step of the 12 steps provides some significant qualifiers. The two greatest indicators are “powerlessness” and “unmanageability.” For simplicity, this article will refer to alcoholism and drug addiction as the same cause in fundamentals there is no difference.
According to the book “Alcoholics Anonymous,” powerlessness has two separate components: Physical allergy and Mental Obsession. One must have both to qualify as more than a problem drinker or user.
“We believe and so suggested a few years ago that the action of alcohol on these chronic alcoholics is the manifestation of an allergy: that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker.” (Doctors Opinion, pg xxviii).
An allergy is loosely defined as an abnormal reaction. The abnormal reaction to alcohol in a real alcoholic is called the craving. A craving can be described as an insatiable unfulfillable desire for more. When an alcoholic takes, one drink, all bets are off. The way the Chinese proverb explains this is, ” A man takes a drink, the drink takes a drink, then the drink takes the man.” This accounts for an explanation explaining their behavior on things from the inability to keep their word to commitments all the way to stealing from loved ones. These harms caused have been given a medical explanation beyond moral defectiveness, although morality is a concern, it is not the cause. Basically, an alcoholic can never control the amount ingested regardless of willpower, desire, or fear of consequences. They more often than not drink more than they intended to of for oblivion.
The mental obsession is a the more confusing aspect. Many get small bouts of nondrinking stints. They have decided the consequences are too much and quit. This may even require detox. The mental obsession is often referred to as the “insanity.” The book states it this way, “Men and women drink because they like the effect produced by alcohol. The sensation is so elusive that, while they admit it is injurious they cannot after a time differentiate the true from the false.” Even though an alcoholic may be fully aware that drinking is harming them, after a period of abstinence the second aspect of powerless presents itself as a mental blank spot that always convinces them through some form of self-deceit to start again. This comes in numerous forms, from “I’ll just have a few.”, “I’ll do this other brand or substance.”, or “who cares?” The insanity is not the drama that ensues from the drinking, its that despite the past consequences they will start again.
Here is a well-known information pamphlet with 20 questions that should be helpful in fleshing out what the symptoms of powerlessness are.
An even more straightforward way to qualify would be only two questions. “If when you honestly want to, you find you cannot quit entirely (stay stopped via choice) or when drinking you have little control over the amount you take (control). You are probably an alcoholic.” (big book, pg 44)
Another aspect of qualifying the disease is the unmanageability caused by drinking and using. The step working guide of Narcotics Anonymous has a section on this in that can provide some useful insight. Unmanageability can be divided into to parts: inner and outer.
Outer unmanageability can be easily seen It exhibits itself in life consequences. Here are some:
- Strained relationships
- Inability to complete goals
- Poor self-care
- Medical consequences
These are internal consequences. They may be harder to spot. Many alcoholics may not even appear to suffer outer consequences. Some function and have very successful lives. Some people are alcoholics that maintain successful careers, provide for their family, and lead productive lives. We call these functioning alcoholics. From the outside looking in the community would not suspect a problem. But the family does. The inner unmanageability can rarely be kept from the inner circle. Here are some symptoms:
- Withdrawn/Anti Social
- Feeling of uselessness