Humility: An Essential Feature of Recovery

Humility is considered an essential trait for a person recovering from alcoholism or other addiction to have. It seems to be true that if you think you're humble, you're probably not. What is humility anyway? In early recovery I thought, wrongly, that humility was equivalent to the way I felt about myself, namely, that I wasn't worth much, that I was a bad person because of what my addiction had caused me to do, and that I was basically an unlovable person. I came to understand that all of that negativity had to do with the disease of addiction, and, indeed, did not reflect humility but a lot of self-centered fear and self-loathing that was the result of seeking power in the wrong places. Lack of power is the basic dilemma of the alcoholic or addict. Recognizing the need for, and finding, a source of spiritual strength leads the recovering individual to the beginning of a sense of humility. I suggest, humbly, I hope, that humility for the recovering person is gratefully recognizing, most of the time, that his/her recovery and the strength to live life with emotional balance come from reliance upon the help of a spiritual source, Higher Power, God, or whatever term one might use. As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 07/30/2013.

Personality and Behavior Styles Developed by Age 5 May Predict Teen Alcohol Use

Because there is a genetic component in risk for development of alcoholism, individuals with a family history (blood relatives) of alcoholism as well as those in alcoholism recovery themselves are naturally concerned about the risks of development of alcohol (or other drug) problems in their own children. In a recent study (Dick, D., et al. (2013). Adolescent alcohol use is predicted by childhood temperament factors before age 5, with mediation through personality and peers. Alcoholism:Clinical and Experimental Research. doi:10.1111/acer.12206), researchers identified personality and temperament factors that were apparent in children before the age of five that were correlated with their later use of alcohol by the age of 15. This study is is also relevant due to the fact that commencing alcohol use at a young age is shown by research to be strongly associated with development of alcohol use disorders at an older age.

Using data from over 12,000 children, ages 6 months through age 5, the researchers found:

1) "...temperament characteristics found in very early childhood are significantly associated with alcohol use more than 15 years later. ***Children who are rated as consistently sociable through age 5 and children who are rated as having consistent emotional and conduct difficulties through age 5 both show elevated rates of alcohol problems at age 15."

2) Children who were sociable had problems because of their being outgoing and sensation seeking. Those with emotional and conduct difficulties had problems because they were less concientious and emotionally stressed.

So, what is to be learned here? Basically this study merely adds some data to the effect that temperament and behavior causing problems even before the age of five can be significant in terms of future, potentially problematic behaviors such as early alcohol use.

What is a parent to do? A consistent, truthful, age appropriate message to children about their family histories of alcoholism and the risks they run should they drink can be helpful. Ensuring that children are involved in healthy positive activities (for ex., sports, clubs), have a positive, respectful relationship with parents and peers, are successful in school, and learn to be assertive and that it's OK to be themselves, have been shown to be useful in preventing destructive behaviors including early alcohol (and other drug) use. As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 07/24/2013.

Quitting Smoking: Which Is Better, Abruptly Stop, or Taper?

A study in the prestigious Journal of the American Medical Association (JAMA. 2013;310(1):91-92. doi:10.1001/jama.2013.6473) found that whether a smoker stops "cold turkey", or attempts to quit by cutting down on the number of cigarettes, with the goal of abstinence, does not significantly affect the quit rate. Outcomes in terms of staying stopped from smoking using either abrupt cessation or a taper are poor. In a review of ten randomized controlled studies from 1978 to 2010, involving 1528 men and 2108 women, in four countries (U.S. Spain, Austria, Switzerland), with the outcome, using either abrupt or gradual smoking cessation, being staying abstinent for at least six months, here are the quit success rates:

-Gradual quit success rate for at least 6 months = 14.1%
-Abrupt cessation quit success rate for at least 6 months = 15%

Other research suggests that, while use of medication (e.g., Chantix, bupropion) to quit smoking may be associated with slightly better quit success outcomes, long term abstinence rates are still poor. Use of nicotine substitutes (what I call "nicotine maintenance") certainly do help lessen lung damage and other medical problems (if the individual stops smoking) but often the individual finds it difficult to stop the nicotine replacement. Although this post may seem discouraging for those wishing to quit smoking, remember that if a method for stopping smoking works for you, it is 100% successful, and that statistics are just numbers; the individual can achieve long term abstinence. I myself have 33 years abstinence from smoking, using tools learned in my recovery from alcohol and sedative addiction. As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 07/23/2013.

Men and Women May Use AA Supports Differently

Research looking at "whether women engage and benefit from AA as much as men have found that women become as, or more, involved, as their male counterparts, and also benefit as much or more than men", but may have differing ways in which they get help from AA. In  a recent study (Kelly, JF, et al. (2013). Does Alcoholics Anonymous work differently for men and women? A moderated multiple-mediation analysis in a large clinical sample." Drug and Alcohol Dependence, Volume 130, Issues 1–3, 1 June 2013, Pages 186–193), researchers found in a study of over 1700 men and women attending AA meetings the following:

1) The Fellowship or social, non-drinking relationships were significant in men's recovery. "AA may help men more by facilitating reductions in high risk drinkers in favor of new sober friends while simultaneously boosting ability to cope with what may be more commonly encountered “male-specific” high risk situations (e.g., when attending or watching sporting events at friends’ homes...). While these mechanisms also appear to be some of the ways in which women benefit from AA, for women these risky social contexts may be less frequently encountered, and, consequently, women do not benefit as much in this way.  ...the majority of the effect of AA on reducing drinking intensity for men was by facilitating recovery-supportive social-changes and may reflect the greater need for men to find new ways of coping with common social risks.

2) The social aspects (or Fellowship) of AA were less important for recovering women. For women the ability to handle feelings of depression, anxiety, loneliness was more important than learning to deal with high risk social situations without drinking.

The researchers concluded: "Viewed more broadly, these findings suggest there may be gender-related differences in relapse precipitants with women generally more susceptible to negative affect and men more susceptible to cue-induced social precursors." In other words, women in recovery need to learn to deal with negative feelings without drinking, more so than men. The latter, according to this study, seem to need more social support to handle situations that may invite relapse, such as a football or baseball game, or eating crabs. As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 07/22/2013.

Cutting Back on Cigarettes Does Not Reduce Death Risks from Smoking

Just a brief research note for those of you who still smoke cigarettes. A recent study in the American Journal of Epidemiology (Am. J. Epidemiol. (2013). doi: 10.1093/aje/kwt038) indicates that just cutting down on the number of cigarettes smoked does not reduce the mortality risks from smoking. The authors of the study, conducted in Scotland, stated that: "In this long-term prospective study of both working and general population cohorts, we were unable to detect a significant overall long-term survival benefit among smokers who reported reducing their daily consumption of cigarettes..." This study confirms findings of most other studies that reducing the number of cigarettes smoked does not reduce mortality associated with smoking, but found that such a reduction can be helpful in pursing eventual abstinence from smoking. Thus the study concluded: "Existing research does not provide useful guidance for the level of reduction of cigarette consumption required to confer meaningful health benefits. On the other hand, continued smoking, even at low levels, clearly carries substantially increased health risks. Reducing the frequency of smoking should thus primarily be recommended as a short-term step toward cessation."

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com. 07/18/2013.

Are There Any Sleep Medications That Do Not Endanger Recovery?

My answer is, "Probably Not", but with explanation. Generally speaking, individuals in recovery from drug or alcohol addiction tend to develop dependence-like problems with use of any substance or behavior that results in feeling good, from candy (for ex., chocolate turtles, my favorite), to ice cream, to gambling (a few wins seems to ignite interest), to sex, to video games, to golf, to you name it. Sleep problems, however, are common and potentially serious problems in early recovery and beyond. I can say categorically that recovering individuals should not use any of the following central nervous system depressants as sleep aids: benzodiazepines (for ex., Xanax, Ativan); the newer medications like Ambien, Lunesta, Sonata; older medications such as the barbiturates (for ex., Nembutal and Seconal) and what we used to call "nerve pills", meprobamate (Miltown, Equanil). These substances have been called freeze dried alcohol or alcohol in pill form and have the same (usually greater) effects as alcohol and clearly endanger the recovery of the alcoholic or addict, whether the drug is prescribed by a physician, or not. The central nervous system of the alcoholic or addict does not react to why the drug is taken but just whether it IS taken. But, you say, what about some medications that I have heard are not addictive, such as, diphenhydramine (found in Benadryl and Tylenol PM, and other over-the counter (OTC) drugs), Trazadone, and Ramelteon? My research of these drugs reveals that Trazadone, an antidepressant, and Ramelteon, a melatonin triggering drug (melatonin is a naturally occurring chemical in our brains that regulates the sleep cycle) are not considered addictive, are not regulated as controlled substances, and may be safe from an addiction potential standpoint to treat insomnia in the recovering alcoholic or addict. Diphenhydramine is also not regulated as a controlled substance, seems to have low addiction potential, but has a long-acting sedative effect that could cause problems with drowsiness and confusion the next day, especially in the elderly.

I just have a few comments and cautions. First of all, before taking any medication, even OTC medications (melatonin is available OTC at low cost), please check with your doctor and be sure to tell him/her about all the medications you take. Second, I suggest that before taking any sleep medication you make every effort to find non-chemical ways to sleep. Click herer for a website has great tips on learning to sleep: National Sleep Foundation. Third, be aware that addiction is sneaky and that, if you decide to use a sleep aid, be sure that you are not, by doing so, opening the door in your mind to use of other drugs (for example, some consider marijuana a good sleep aid). This is a controversial topic that I have raised before. As always, I invite comments. Jan Edward Williams, www.alcoholdrugsos.com. 07/15/2013. 

Reaction to Sweets May Be An Indicator of A Risk for Alcoholism

A recent study, summarized in ScienceDaily for July 10, 2013, and to be published in the December 2013 issue of the Journal Alcoholism: Clinical & Experimental Research, suggests that pathways in the brain that respond to ingestion of sweets may be the same as those activated by ingestion of alcohol. The study found that individuals with binge drinking patterns (drank more than just a few) have an intense brain response to sweets. One of the authors of the study explained the background important to understanding the implications of the current study:

"It has long-been known that animals bred to prefer alcohol also drink considerably greater quantities of sweetened water than do animals without this selective breeding for alcohol preference. More recently, it has become clear that animals bred to prefer the artificial sweetener, saccharin, also drink more alcohol. Although the data in humans are somewhat more variable, some studies do show that alcoholics, or even non-alcoholics with a family history of alcoholism, have a preference for unusually sweet tastes. Thus, while the precise reasons remain unclear, there does seem to be significant evidence suggesting some link between the rewarding properties of both sweet tastes and alcohol. This is the first study to examine the extent to which regions of the brain's reward system, as they respond to an intensely sweet taste, are related to human drinking patterns.”

The researchers summarized: "In a more practical sense, the findings are compelling evidence that the brain response to an intensely sweet taste may be used in future research to test for differences in the reward circuits of those at risk for alcoholism.”

As always, comments are invited. Jan Edward Williams, www.alcoholdrugsos.com, 06/10/2013.