Type of Alcohol AbuseOur culture often reinforces a particular caricature when people are asked to imagine an alcoholic: that of the chronic drinker, bottle kept on the bedside table—someone that is never sober. The reality is that this stereotype only describes one of many kinds of alcoholism, typically called “steady” or “chronic” alcoholism. There are many other forms of alcohol abuse, such as the “binge drinking” alcoholic, who can be sober for weeks or months at a time but eventually needs to seek extreme intoxication as an escape valve from the mounting stress. (The National Institute of Health defines a “binge-drinking session” as five or more drinks in under two hours, and a “bender” as two or more days of sustained drinking.) Another is the “functional alcoholic,” who successfully maintains performance in their job and responsibilities—thereby avoiding the signature “your life is falling apart” signs of alcoholism—but quickly disappears back into drinking as soon as the workday is over or they are alone. It is crucial that “steady” or “chronic” alcoholics not attempt to sober up outside of rehab—it can be fatal without supervision. Binge drinkers, functional drinkers, and episodic drinkers may be able to experience the alcohol leaving their body without severe medical consequences worse than a hangover; that may, in fact, be what happens each morning after they are done drinking. But the steady alcoholic who has had at least some level of alcohol in their system for days, weeks, or months on end is in severe medical danger if they suddenly cease drinking unsupervised. The abrupt removal of alcohol from a body that has adjusted to make room for its presence over time can cause hallucinations, confusion, fever, seizures, and death.
Strength of Social Support CircleSobering up is hard; I was a functional alcoholic for a decade of my life and to this day I still consider it the toughest thing I ever did. It can be downright impossible without the support of people who care about you. I was lucky: when I stopped drinking, I made a firm pledge of determination to my roommate at the time, who had always disapproved of my unhealthy relationship with binge drinking on weekends. He kindly helped me remove alcohol from the house and offered me a shoulder to lean on when the temptations got strong; his support made a difference on a few key moments in my journey to sobriety. But what if I had gone just a little longer in my alcoholic phase before deciding to get clean—what if I had pushed his patience too far during a bender and he had moved out? Who knows if I would have succeeded if I’d had to do the part where I get clean, and stay clean, alone? Alcoholics may lie and hurt those around them, which can often drive away their social support circles. By the time an alcoholic decides they will clean up, they may have already alienated their partner, children, parents, or friends. Or, they might still have plenty of friends in their life, but those people may not be able to offer support or they may encourage their drinking. Rehab can provide the human connection and empathy that someone who is embarking on the hardest journey of their life needs, in the form of therapists, counselors, and community.
Real ConsequencesAnother surefire sign you might need to consider alcohol rehab is that your drinking problem has begun to intersect with forms of authority and result in consequences. You should consider attending alcohol rehab if you have experienced the following:
- A warning from your doctor that your drinking needs to be severely curbed lest your health suffer. (Bloodwork can often help make this case more clearly. Any patient can misrepresent the number of drinks they have per week—I know I did—but liver signals in my bloodwork such as my AST and ALT levels, which indicated a liver that was half dead, couldn’t lie.)
- A run-in with the law resulting from alcohol, ranging from a Driving While Intoxicated arrest or a criminal mischief, vandalism, assault, or other destructive act while drunk
- A boss or coworker explaining that your job is in jeopardy due to your behavior, or a job loss due to drinking.
Epstein EE, Kahler CW, McCrady BS, Lewis KD, Lewis S. “An empirical classification of drinking patterns among alcoholics: binge, episodic, sporadic, and steady.” National Center for Biotechnology Information. NIH. 1995 Jan-Feb. Accessed Sept. 25, 2016. http://www.ncbi.nlm.nih.gov/pubmed/7785480
“NIAAA Newsletter, Winter 2004 edition”. pgs 3-4. National Institute on Alcohol Abuse and Alcoholism. National Institute of Health. Winter 2004. Accessed Sept. 25, 2016. http://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.pdf