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Chronic vs. Acute

I first heard it on a Dr. Drew podcast and it whizzed over my head. I read it elsewhere weeks later and took note. Then yesterday while walking my dogs I was listening to this podcast (Sober Conversations with Dr. Harry Bell: Guest Joe Schrank) and there it was again:

If alcoholism and addiction are chronic conditions, why do we treat them as acute illnesses?

Alcohol addiction grows over time and the brain changes remain permanently (i.e. a chronic condition), so why is it only considered worth treating once it reaches crisis (i.e.  acute illness)? Why watch the problem escalate to dangerous levels but then only treat it with episodic care? Do we do this for any other health issues?

How many of us ignored our growing drinking problem for years because it “wasn’t that bad” in our own opinion? How many had some idea in mind of what behaviour or consequence would be “bad enough” to require change? Isn’t this the opposite of how we have been taught to care for ourselves?

We check our moles for change and our breasts for lumps, rushing in for assessment at the first sign of trouble. No doctor ever says, “Yep, that looks bad buuuuut let’s wait until your life is threatened before we treat it.” The idea is preposterous, but that is how we think about getting help for addiction: wait until it is the worst that a person can tolerate before getting help.  And by the way, the help available is 30-90 days of treatment generally, and though the care may be excellent, shouldn’t the medical system then follow patients for a lifetime if they have a life-long condition susceptible to relapse? My sister had cancer and she received routine scans for 20 years after her treatment.

I’ve always felt a bit apologetic about getting sober pre-crisis. I used to feel pressure to explain that even thought my situation wasn’t “that bad”, the process was clearly well underway and needed curtailing.  I’ve since discovered that most people in recovery don’t need to hear this justification – they understand that all of us follow a similar trajectory and our differences are really just “yets”. By that I mean we can take all the things we didn’t do (I didn’t lose my license, I didn’t publicly humiliate myself, I didn’t blackout) and tack the word “yet” onto those statements, because if we kept drinking they likely would have happened to us.

I hadn’t lost my license, yet

I hadn’t publicly humiliated myself, yet.

I wasn’t blacking out, yet.

The “yet” is a reminder that I stopped before those problems arose, but they were certainly as possible for me as for anyone if I continued to drink.

Like myself, many readers  of this blog have stopped drinking before their condition reached an acute stage. This can leave us wondering if we over-reacted, over-compensated, over-corrected. It can mean that those around us are not as supportive or understanding because they were not personally impacted by our behaviours…yet.

It is simply wrong to think that help is only necessary for the worst cases. I suspect that recovery care providers would LOVE the opportunity to work with people earlier in their addiction, but so many of us have been conditioned to think that we are not worthy of help unless we have had a horrendous “rock-bottom” experience.

Even though this whole blog is about how I self-managed my recovery, I hope one day it is easier for everyone to talk about this and ask for help. Shame and stigma kept me hidden and sick for far too long. I was lucky it didn’t kill me, and I am glad it didn’t kill you either.

Perhaps the real obstacle is public perception. Funding, legislation, and treatment protocol all respond to societal demands and until Joe Average starts to understand the “Chronic vs Acute” issue, there is no outcry against the system, no support for proposed changes, no money for tv campaigns with catchy jingles.

Maybe there are a lot of us in recovery who need to understand it better ourselves before we can hope anyone else will.

***

Note: shout out Bubble Hour co-host Catherine for introducing me to the concept of “yet”. We all learn together. 

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About UnPickled

I am learning to walk without the crutch of alcohol. As I begin I am 1 day sober. Gulp. I drank in private and hope to quit just as privately. The purpose of this blog is to help make me accountable - just by following you will give me enormous support and encouragement.

Posted on January 30, 2015, in Getting Sober and tagged , , , , . Bookmark the permalink. 47 Comments.

  1. Back on day one. Worried this will never end.

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    • Don’t be too hard on yourself – it does take some time. Many people need to take several runs at it before they fully make it over the wall, and it can be very disheartening to feel like you are continually failing but remember that your sober days are adding up and with persistence you can get there. Be patient with your mistakes, but not permissive with yourself. Love and hugs – you are worth every ounce of effort it takes!

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      • Yes, keep trying. I’ve had several attempts, and I feel a little stronger each time. Don’t give up. Annie x

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      • It was day one and I failed, hope to start over tomorrow, any replies or help is appreciated, although I live US. This is the best site I have found. should I taper as I drink every day? Thanks for any help you can offer.

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  2. Hmm…I could say I’m not that bad. But I’ve done some bad stuff. And I’m happier sober. The Bubble Hour has helped explain a lot of things, and that’s made a big difference in my willingness. But WHY AM I SO TIRED???? And when will I stop feeling hungry???? I thought I would easily drop weight when I quit drinking and instead I feel like a marshmallow. I have 3 kids – I don’t have time to sleep all the time. I functioned pretty well drunk, and now I accomplish very little while asleep. (That’s kind of a joke…kind of).

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  3. Thank you thank you for this post…I returned to drinking a few times after stopping for weeks at a time, in part because I bought into the idea that I “wasn’t that bad” and that I needed more bad stuff to convince me that I could never drink safely or non-obessively. Now, I’m living alcohol free because I want to be free of that obsession that we all share as addicts regardless of how far “down” we are on some spectrum of alcohol-induced bottoms…I definitely did stuff I wasn’t proud of…but I still have my home, my job, my children and my health and I want to keep it that way and I want so much more from life than to live in a high-functioning wine addicted hell. I hope that voices like yours reach people who think they “aren’t that bad YET”.

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  4. Thank you for your posts, its very inspiring knowing that you have already achieved what i have set out to do. I also have started a blog my url is http://mrplonkaa.blogspot.co.uk please come visit sometime 🙂

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  5. I needed to read this post. I keep avoiding the ‘yets’, but I know they are there. I am falling back into old ways and not finding the strength to climb out. Annie x

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    • This is my day one. Trying to deal with my first “yet”. Neuropathy. I don’t think I can do this alone. Going to spill my guts to my doctor Monday and I’m scared.

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      • Hello Dear! I saw this and hope you found your strength to ask for help. This is the countless time I’ve been on day 2, and I know my recovery will involve long term support. I do not have the strength to do it alone, and this time I’ve gotten really honest with everyone that I know can support me. Praying for you as we do this battle in unison.

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        • Katdawg, I chickened out at the doctor. On day one again. I was honest with my husband but he thinks I’m over-reacting. I was honest with a good friend yesterday. I have no idea how she feels about me now. Just trying to get through work, read some blogs. I have a phone number now for help, but haven’t used it yet. I’m praying for you too. I know I’m not alone but it sure feels like it today.

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  6. I am 18 months sober now and happier than ever.
    It is unbelievable that this happened..magic 😎🙏
    I fear, and it is my experience with others, that in order to get on that right track, a terrifying rock bottom has to happen…..

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    • Hi Wouter, congrats on 18 months!!! So awesome! I hear every day from others like myself who found the willingness to change without hitting a rock bottom. For some, willingness doesn’t come until a catastrophic bottom, but I promise it’s not essential. Willingness is what we need.

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  7. This is perfect. Love this post and love you too! 🙂

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  8. Certainly it is better to treat early, before a crisis. The problem is that alcoholism/addiction is different than other diseases, in that the victim often does not want treatment. You will not find cancer patients or diabetics refusing treatment. But the addict often does. Unfortunately, it sometimes takes a crisis to convince them that they need to change. If you can get them to accept treatment earlier, fantastic, go for it. Or if you can get your minor child into treatment before they can legally refuse (i.e. before age 18), do it. We did with my son, multiple times.

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  9. Thank you as always for your great blogs

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  10. thank you. Always so so good to read someone elses experience that mirrors your own. Reinforces this new concept that I am not an isolated freak!! I am 5 weeks sober and self managing with the help of blogs like yours. A little scared to use the “F” word (forever) just yet, but feeling oh so positive about the future!

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  11. I am almost 8 months sober…I’ve done it on my own. I’m also a young business person who has done well. Out of all the things I’ve done in life I am the most proud of quitting the booze. Nothings gives me a greater feeling of accomplishment to know I go to bed sober, and wake up sober, to go out for dinner have a virgin drink than water. To have lost weight without really trying, when I struggled so hard to lose a few pounds before.
    Noone knew how much I drank before, but I knew and that’s what mattered.
    I was close to the *yets* but thankfully I was stong enough to say no more I’m done with it. For every weak moment I just would remember how far I’ve come and how great I feel the next morning when I wake up.
    I believe the power of positive thinking can help you climb mountains when all you thought you had the strength before was little hills.
    Always pat yourself on the back…each hour/each day takes strength, something to be proud of!

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  12. My drug of choice was marijuana, but I’ve kind of kept this quiet, since many people don’t think it’s possible to be addicted to it the way alcohol is addictive. But for me, it absolutely was. It’s strange that one the one hand, many people think pot is relatively benign, and yet I feel more stigma against drug addiction than alcoholism. That, and the concern that people will think I’m silly to have had to give up a “mild” drug – like I was weak, or whatever. Eventually I’ll post about it in my blog, I guess. I stopped drinking, too, because I worried that I might turn to it as a substitute crutch. It’s hard enough to reach a point where you recognize you have a problem and quit, without feeling like you have to justify your decision to finally protect and take care of yourself. I have a friend who considers herself a “binge drinker” – she doesn’t drink every day, but when she does, she really overdoes it, just wrecks herself. But since it’s not everyday, she doesn’t have a “problem.” Even though she can’t seem to stop doing this.

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    • Funny thing Peppergrass, I really, really tried to smoke pot. Just couldn’t do it. I’d cough and cough until I pee’d my pants. Started drinking wine. After enough of it I’d cough and do the same thing! Oh well, they’re both behind me. P.S. I must say, the brownies were delish!

      Liked by 1 person

  13. I am so glad I found your blog when googling to see if it was legal to sell my wine collection! Yes, a love for the taste has turned into a problem during a rapid succession of life events in 2011. And this is my day one I guess. I’m determined not to finish my open bottle. It’s almost 6pm too… Dinner is being made… And I’m sitting here wondering how far I am on the “yet” road.

    The thing is, my husband doesn’t take it that seriously. Plus he’s the one who bought me the collection, the full size wine fridge… And he doesn’t drink! I hate the indifferent attitude. But just what you say here – I can see the road. I can see my yet. Thank goodness I am sober enough to see my destiny if I stay on this road. I love that I don’t have to deal with watching my husband drink but the indifference to my problem is driving me mad. And I don’t have any friends for support. At least I have a gym, and the aspiration to make it my new addiction (in part to lose the 40lbs I’ve gained since 2011 from the best friend I’m dumping today).

    Thank you for this blog. I started one so at least I can write and hold myself accountable. Thank you.

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  14. I love this post, it all is so interesting. I’ve learned so much in the last 6 months since being introduced to the sober blogging and support world, and since I’ve been actively trying to stop drinking for good. I imagine that sometimes it’s harder for the person who doesn’t hit a low bottom to quit and have it stick. Like me, for instance, I’ve had to learn and learn again but as a whole I feel I’m headed to a better and fully sober life. For me, my rock bottom was a private and shameful hell- living in my own head and knowing that I had a problem but also knowing I was living it privately, nobody knew and I could hide it very well. So, I’m “digging up” now out of my hole and seeing so much light:) Thank you:)

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  15. Did the Universe tell you that I needed this today???This post was perfect and describes me exactly!!! I stopped drinking before really anything horrible happened because of the conflict in my head. My friends, my family, my own husband tell me that I’m overreacting. In fact, sometimes, I feel like I am a faker…like I’m pretending. My sober pen pal said two things to me that I often remember: 1. I need more sober time under my belt, and 2. Whenever you are true to your heart, you can NEVER be a phony.

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  16. I love the “yet”, when I first ‘attempted’ sobriety I was constantly comparing my self everyone else in the rooms. Oh I’m not that bad or thank god im not like her or.him…… Well, needless to say I didn’t last very long in recovery with that frame of mind. …. Being a sober woman, in a society where addiction is not accepted by many, is not always easy…. How is my disease any different than others?. Just because its not visible? Thank you for discussing this issue! I feel passionate about this!!
    Katie

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  17. Hey there. The available research says that most people quit drinking/using on their own. And they do so because they’ve decided it’s just not worth it anymore. So for most people, alcohol/drug abuse is a self-limiting condition. You’re right, though, that what needs to be brought into the open is that “quitting is OK” – it’s not a sign that you’re weak, damaged, or otherwise unfit.

    For example, when people say, “I don’t eat wheat,” we used to think it was weird but now we hardly bat an eye. And people who quit drinking because they’ve decided it’s not good for them should be seen the same way, not treated as someone who can’t control themselves around alcohol (because if they couldn’t control themselves around alcohol, they wouldn’t have been able to quit in the first place.)

    https://parkinglotpushups.wordpress.com/

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  18. I didn’t get to my “rock bottom”. But I sure was on the way down before I stopped drinking. Once you stop drinking, you stop digging and can find a way out of the black hole. But you’re pretty much on your own. I found your site to be a ladder that I used in my early sobriety to help me get a step up. I’m now proud to say that I’m 135 days alcohol free. Thank you for reaching down and giving me a hand up.
    But more to the point of your blog. The health care system in the U.S. doesn’t care about chronic/acute alcohol abuse/dependence until and unless a person needs hospitalization and/or emergency medical treatment. In which case they’re held until they sober up and are then sent on their way with an Rx that basically says ” Don’t come back until you get liver failure “. Just the same as they don’t treat smokers until they get emphysema and/or lung cancer. The tobacco industry = big money. I’m sure the alcohol producers gererate as much if not more revenue. The folks who pass the laws don’t want to bite the hand that feeds them. To them we’re just a bunch of drunk bums who probably smoke. Unless we have the income to send ourselves to The Betty Ford Clinic time and again we’re on our own. (Sorry this got long but I tried to get treatment years ago and my medical insurance wouldn’t cover it.)

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  19. I do think that this is a public health issue, much like smoking was. There needs to be more education on the dangers of legal alcohol and drugs. AND, Madison Ave. needs to wake up to the fact that people die. (Although sex sells. And alcohol is still percieved as sexy. So is pot.) Insurance companies are just starting to get on board with preventitive incentives to encourage healthy lifestyles. The truth is that most primary care Drs. just don’t have time to really educate their patients and some are suffering themselves. Advocacy and grass roots movements do change public perceptsion. (Hello womens movement circa 1970). We have a long way to go.

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  20. I have been pondering this a great deal recently Jean. I nursed alcoholics so for me it was always a disease but in our experience we stopped before our drinking got out of hand and with some behaviour management changes we are now effectively in remission. What other illnesses could this same approach apply to? Diabetes maybe as you can be a diet controlled diabetic so that is behaviour change that supports non progression. I know some reject the disease model and their arguments are pretty convincing so I am now questioning my own beliefs around this. That doesn’t mean I’m going to go out and do more alcohol research! At 3 days away from 500 days my life is immeasurably better so whether it is a disease or not is now a mute point for me personally! You are right though that we need to understand and form a consensus opinion within the recovery community to strengthen the message 🙂

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  21. yet= you’re eligible too

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  22. Bad is more than what is socially bad , bad is the middle of the night bad , it’s your spirit talking to you , that’s what you need to listen to ,

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    • This has been happening to me for awhile now and I think you have hit the nail on the head is it your spirit talking to you ???? There is defiantly a voice in my head on these particular nights I never thought of it as my spirit

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  23. Wow — I was just talking about this last night in my SMART meeting. The conversation turned to stigma one can feel in recovery and “normies” not understanding (but through no fault of their own). I said that I feel the pull towards advocacy to share my story so that others understand that rock bottom is not a gutter. It’s something totally made up! This needs so much more attention than it gets!

    I wish I had understood all of this a long time before I walked away from the wine. Like so many others, I thought I wasn’t that bad, I had a job, my car, a house, family, everything, just this one teeny tiny problem of not having an off switch when it came to booze. I felt so damn alone though! I thought I was broken and couldn’t be fixed. Thank goodness I started reaching out through some boards online and found a community of extraordinary people in exactly the same boat! After the boards came the blogs and dang! the # of women out here is overwhelming! Something tells me the revolution towards the public better understanding recovery is underway. I can’t wait to help it. Your posts and the Bubble Hour do so much to help not only us in recovery, but to give us strength to move through the stigma! Thank you for what you do!

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    • Great job! Can I ask what boards you reached out to in the beginning. I need support, I can’t do this alone, believe me I have tried!

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      • Glad you reached out. I went to bright eye at http://www.brighteyecounselling.co.uk/alcoholic-forum/ which i liked a lot. I even splurged for skype session with Tobin. If you’re thinking about counseling its a very easy way to test the waters. I also tried the boards at women for sobriety and i think i looked into online meetings at smartrecovery.org. i will say though things got easier for me when I started going to meetings. I chose to go with smart and its been good to me. AA wasnt quite my cup of tea. Feel free to ask more questions. I learned so much from others and im happy to share.

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  24. Good post… thanks 🙂

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  25. OMG – I love this and it is just what I needed to read today. I’m on day 21 Alcohol Free and yesterday and today have been doubting my decision, because I have never done anything “that bad” (now I need to add the yet). Just Like Stop Wineing Start Living says, I too have felt awkward at AA, like a “poser” because I’m not ‘that bad’.

    winecoloredmemories.blogspot.com

    Liked by 1 person

  26. Yet is a powerful thing.
    My favourite saying is “our bottom is where we stop digging”. You can always go deeper, but why?

    Anne

    Liked by 2 people

    • That’s a pretty awesome saying. It reminds me of this episode of The Simpsons where the townspeople are all out digging for treasure, and they’ve dug themselves into a giant hole that they can’t figure out how to escape from. Homer has the bright idea that “We’ll dig our way out!” and then everyone starts digging again. Police Chief Wiggum takes control and says, “No, no, dig UP, stupid!”

      Wonder how many folks justify their digging by believing that they’re digging up.

      Liked by 1 person

  27. Wow, I relate to this so much. I too feel awkward or guilty in AA because I wasn’t “that bad yet”. Somehow I feel like I need to justify my alcoholism to prove… what? It’s ridiculous thinking! Thanks for sharing!!

    Like

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