Sunday, July 24, 2011

Addiction is a DISEASE, dammit.

In today's Boston Sunday Globe there are two full length obituaries. 

Above the fold is the tragic tale of soul/pop singer Amy Winehouse's death from drug and alcohol addiction at 27 years old.  I am profoundly impacted by her death, although it isn't much of a surprise.  Her struggle with addiction has been plastered across headlines for years now. I remember a couple of years ago a British tabloid was running a contest - a morbid countdown of sorts - asking readers to bet on how much longer she would live. 

Her obituary spells out in sad clarity the ravages of drugs and alcohol; her life cut short, her talent squandered to the disease of addiction.

Below the fold is another obituary, George Brewster, who died after a fifteen year battle with cancer.  He was 70 years old.  Despite a life full of challenges, his children describe a man of unbridled optimism, someone whose spirit shone through adversity.  His daughter describes how even near the end he would talk about embracing the "glorious day", how he would walk every day; even as cancer treatments weakened his physical condition, his spirit soared.  He was 27 years sober at the time of his death, and the obituary describes how he was active in AA, a pillar of the recovery community, always ready to lend a hand to help a fellow alcoholic in need.

The juxtaposition of these two lives leaves me trembling with gratitude and fear.  Gratitude that I am sober, that I didn't lose my own battle with the disease of addiction, that I am able to embrace life, with all its ups and downs - as a sober woman of grace and honor.  Fear because I know so many people who are struggling to get sober, who haven't surrendered to the fact that alcoholism is a disease, one that cannot be cured.  You can't think your way out of addiction any more than you can think your way out of cancer.

Fear because addiction kills.  Just last week a member of my home AA group died from an alcoholic seizure.  My heart aches for the people I know who are struggling to get sober, because death - as horrible as it is - isn't the worst thing alcoholism does to you.  First it destroys your life, your spirit, your family.

Now that I have been in recovery for almost four years, I fully understand the power of the disease of addiction.  It is a disease that tells you you don't have a disease, that if you just tried harder, had more will power, you could beat it.  It drives you into isolation, full of shame and fear, and slowly erodes your spirit, your will.  It wants you silent, alone and afraid.

I am humbled and honored to be able to help women who are struggling to get sober. It helps my own recovery to reach out, share what I have learned, be an empathetic voice at the other end of a phone line, or over coffee.  I know I can't get anyone sober. I realize that in order to get sober a person has to surrender, to accept that they are powerless over alcohol, that they need help.  All I can do is encourage them to get honest, to be a safe harbor in their sea of bewildered hurt. 

But I'm scared.  I'm scared for everyone who is in the clenches of alcoholism. I know first hand how hard it is to wrench yourself from the jaws of addiction.   The statistics aren't good.  I hate talking about statistics, hate how despairing they are; I prefer to focus on the hope.  But the bleak reality is that alcoholism eventually kills the majority of the people afflicted by this horrible disease.

And it is a disease.  I am aware that this is a controversial topic, and I listen with an open mind to to those who argue that it isn't.  But I'm done being polite about it, because I know it is a disease.  It is a disease of the mind, body and spirit.  No addict wants to destroy their life. When bewildered loved ones ask addicts "WHY?  Why are you doing this to yourself?"  I know the answer is this:  because they have a disease.  An alcoholic who drinks can no more control how their body reacts to alcohol than a diabetic can control their body's insulin. 

People who argue against the disease concept - and many of them are in recovery themselves - don't like the loophole it creates, fearing the alcoholic will keep drinking, saying "I can't help it.  I have a disease." 

My response to this is simple:  my disease isn't my fault, but my recovery is my responsibility.  My responsibility is to stay away from that first drink, the one that will activate my disease. To stay away from that first drink I choose a program of recovery; I surround myself with other alcoholics in recovery, I talk about how I'm feeling. I ask for help.  A lot.

I didn't choose to be someone who can't have one or two drinks safely.  I would never, ever have done the things I did, taken myself and my family down such a dark road, if I had been able to stop drinking on my own.  I don't know that I will ever be able to find adequate words to describe what alcohol did to my brain.  It possessed me.  Even when I wasn't drinking, it nagged at my consciousness, pulling me back in over and over.  I don't know how to describe to someone who isn't an alcoholic what it feels like to wake up in the morning thinking, "Oh NO. I did it again."  

I have a disease.  A disease that springs to life if I have one drink.  It may not destroy me right away, but eventually, it will. I have no control over my own life when I'm drinking, because alcohol calls all the shots. 

The only way out of the disease of addiction is to surrender to it.  To accept in your heart that you can't have even one drink without triggering the craving, the obsession.  

Surrendering is hard.  It takes more guts to surrender than it does to fight, because surrendering involves vulnerability, and we're hard-wired to avoid feeling vulnerable.

The stigma of addiction keeps people unsurrendered.  People simply don't understand what alcohol does to an alcoholic, how it eventually takes over every aspect of our thinking.  It is hard to ask for help, because the response is all too often, "well, why don't you just stop, then?"

Choking out the words, "I can't stop," feels like defeat of the worst kind. It feels like you are the weakest, most morally corrupt person on the planet.   Ironically, choking out those words is the bravest thing anyone can do.   Eventually, alcohol degrades a person's life to the point where drinking feels like the only good thing left. And then the script changes, goes from "I can't stop" to "I won't stop".  

THAT is the disease of addiction.

To break the cycle, to get out of the spiral, you have to surrender.  You have to look yourself dead in the eye, and admit that you have tried everything you can to stop, and nothing is working.  That you aren't in control when it comes to drinking.  Peel your hands off the wheel, and go get help.  Fall back into the arms of people who understand, who can carry you until you feel like carrying yourself.

When I die, I want to be that sober person who faced the ups and downs of life with gratitude in my heart and a hopeful spring in my step.  I want to grow and learn through adversity, not skirt around it, shrinking from the hard truths in a bottle.

I didn't choose to be an alcoholic.  But I can choose surrender, I can choose recovery.

I feel sometimes like I end every post about addiction and recovery this way, but I will keep saying it over and over:  if you are struggling with alcoholism, open your mouth to save your life.  Tell your truths. And please, please surrender.   You will never be able to have one drink in safety.  If that thought sends terror into your heart, go find the people who understand, who have walked the path before you, who can show you that a life full of light and hope is waiting for you. 

Because here is the bleak truth:  it will kill you. But first it will destroy your spirit, your happiness, your ability to love.   It will.


  1. I LOVE LOVE LOVE reading your blog :) Thank you for your courage!

  2. Beautifully said, my friend. Thank you.

  3. It makes me sad that the person who struggled for so long with cancer and had such a wonderful outlook on life was put below the crease, for fewer people to read about. But that's how life is...he wasn't famous.

    Beautifully written. Thanks for saying the last paragraph over and over. It reaches out to someone each and every time.

  4. Great post, Eliie. Thanks for speaking the truth we so need to hear, again!

  5. I missed reading your writing. I pulled from this piece and quoted it on my facebook page. My 26 yr old son is refusing to surrender. So hard to watch and so hard to feel helpless in helping your child. Thank you for your words. You ALWAYS give me hope.

  6. this is powerful, absolutely necessary. thank-you.

  7. The thing that gets to me, loving and knowing people with addictions is that if I knew someone who had diabetes or cancer and they were just toodling through life not getting help and pretending they were fine, I would probably want to say to them "why are you doing this!?" Not "why do you have cancer" but why are you not doing something to treat the cancer, or why are you exacerbating your diabetes. And if someone with diabetes or cancer died because they actively chose not to treat it, I'd wonder what in the heck was wrong with them. And if they were someone I loved I would be horribly pissed off at them.

    And then I'd remember that I can't control other people's actions, and I'd surrender too. But I'd remain baffled, sad, and pissed for a while while I was surrendering.

  8. I love this post. I just reminded someone yesterday that alcoholism IS A DISEASE. He had relapsed and was completely whirling.
    I'm so glad you wrote this. I'm going to forward it to some of my non-alcoholic friends.
    Hugs to you, Ellie.

  9. Thank you. This is poingent honest and beautiful.

  10. I read this and thought of you...

  11. The other thing that makes me struggle with the disease concept is that someone with cancer who chooses not to treat it isn't putting their children at risk, or me as a fellow driver, or running into people and killing or maiming them. I suppose the cells that are addicted are disease-like but the chosen behaviors are not a disease. They are behaviors. And that is a huge difference between an addict and someone with cancer or diabetes.
    I don't know what difference it makes, but like I said, I'm trying to wrap my head around this.

  12. This sums it all up. "You can't think your way out of addiction any more than you can think your way out of cancer."

    Amen my friend, amen!

  13. Anonymous, just a few comments from someone that is both a recovering alcoholic and a diabetic. Different diseases bring out different behavior. As for diabetes if I don't take care of it, my blood sugar gets too high or two low, when high I am cranky and nasty to be around. If I drive a car when my blood sugar is too low my judgement and responses are slow and I may well cause an accident.

    I have also had cancer, and as a result my hormones are not normal, and that causes behavioral changes. Believe me, I never realized how much effect hormones have on our thinking until now.

    So while addiction leads to one set of actions, other diseases, particularly the mental ones, cause other sets of actions, perhaps not as drastic, but none the less still there.


    Mike L

  14. Anonymous 7:24am -

    You raise a really good point. I think I will have to address this in more detail in a post, because this topic is in dire need of more discussion.

    In a nutshell, though, the behaviors exhibited by an active addict or alcoholic are symptoms of the disease. The physiological reaction that takes place when an alcoholic drinks drives them to think and behave in ways they NEVER would if they weren't drinking. It's like an allergic reaction - alcohol triggers a craving response that in turn leads to the behavioral one.

    Your comment is also why I am so determined to chisel away at the stigma of addiction. There is an arc, in my opionion, to slipping into addiction, and the addict's thinking goes something like this:

    1) Drinking and not aware of a problem/no bad consequences.

    2) Drinking and slightly aware of a problem/some bad consequences/starts questioning drinking patterns.

    3) Awareness that drinking is a problem - bad consequences of drinking happening more frequently - but denial that they are an alcoholic - try to control it on their own.

    3) Awareness that they are an alcoholic but can't (or won't) get sober due to fear of the stigma of addiction or physically addicted and stopping seems impossible.

    The reason I am so determined to chisel away at the stigma of alcoholism/addiction is that if more people were able to talk openly about their problem without fear of being judged, perhaps more people could get sober when they are at steps 2 and 3 in the above (albeit hastily created) list. Most often the fear of being open about a drinking problem means that most alcoholics have to experience dire consequences (also known as rock bottom) before they are forced into sobriety.

    I have a lot more to say on the subject, but I know from personal experience that the denial an alcoholic experiences is part of the symptoms of the disease - it changes our thinking - it isn't just the physical reaction to alcohol or drugs.

    Having said all this, the underlying point is that recovery IS a choice, if the cycle of addiction is broken and the addict/alcoholic can get help. But MOST of the time, help is needed to get sober, and that help can't come if the person isn't honest and open about their problem. Getting to that first step - the truth - is the toughest part.


  15. Sorry about the typo in my above response - obviously that last point on the list should be #4.


  16. yes, it's a disease

  17. Amazing post. I see myself in so much of that. Thank you!

  18. Great post. Miss hearing from you more often. I know that you're going through a lot and hope you're doing ok.

  19. What a great post. I just received my copy of Beyond the Influence - the authors emphatically agree IT IS A DISEASE.

  20. What a stunning piece of writing on such a sensitive subject. I have treasured reading your blog since I found it a few weeks ago. Thank you for your honesty, you are inspiring.

  21. There are various ways to take control of the addiction. You need to be aware of the habit.

  22. This is just as timely as ever, isn't it?

  23. Why do we spend so much time arguing about whether it is a disease or not. At the end of the day, we know the addict has very little to no control, is compulsive and is on a downward spiral headed toward destruction. What I struggle with is the idea that they must be abandoned; that they must be allowed to hit rock bottom so that they might save themselves. Sometimes rock bottom is death. I left my ex-boyfriend of a year and a half because I saw that he was destroying my life and the stress of it all was affecting my health. Afterwards, he wants to be friends. I am staying away because I still love him and can't trust myself not to get sucked back into his vortex (I know alcoholics can be very manipulative). But I have nightmares, I am terrified that something terrible will happen to him; and I struggle with trying to figure out if there is something, anything at all, that can be said to him that might be the right thing to steer him in the right direction. As I write this, I see that I am powerless over him; that this is beyond my control. But then I think "but maybe, just maybe, there is something I can say, some link that I can send to him, anything . . . that might help save the beautiful person I know is underneath all the crap and quickly being lost . . ."

    1. Anonymous: I don't know anything about your beliefs, but the best thing you can do is pray for him.