Expert: Joseph Lee O. - 5/30/2008

Question
QUESTION: How can I know if my husband's drinking is "reasonable" or crossing over into alcoholism?  Am I making his few drinks a night into more of a problem than it actually is?  Is it possible to be a "borderline" alcoholic?  

Here are certain elements of my husband's life: he's got a good, steady job which he enjoys (and is not affected by his drinking), he is well respected in our community, he has two great kids with whom he is a loving father, and as a married couple, we are the best of friends and get along very well.  His family is fantastic.  He comes from a solid, loving, stable background.  By all accounts he is a “great guy.”

Enter the drinking:  he drinks almost daily (almost exclusively beer) maybe about 2-4 a day—enough so that from across the room I can tell he’s been drinking, but it may not be totally obvious to someone who doesn’t know him as well. When he drinks, he sometimes experiences insomnia and panic attacks.  He gets depressed in the winter and has sought counseling for this. Under pressure from me to quit drinking, he has tried, but admits to being unable to *not* drink.  (He has found the Moderation Management approach and internet support group helpful—especially when he abstained from drinking for 4 months.)   He had on OWI arrest about seven to eight years ago.  

Enter the angry wife:  I do not like it when he drinks.  Even though he isn’t a “mean drunk” or loosing his job or anything like that, I don’t like how the drinking affects him (muddled, unfocused, “stupid”) and the effects on our marriage and family.  I become withdrawn, angry, and cold-shoulder him for days.  He now lies to me at the drop of a hat about drinking (even though I can tell immediately he’s been drinking).  I *hate* the lying.  I find myself threatening to leave just to illustrate how serious I feel about all this (tough love?)  (And now I have just read here how counterproductive that is.  Clearly.)  

But taking a few steps back:   If I try and pull back and get my emotions out of the way, 2-3 drinks a night isn’t wholly unreasonable.  What if I stopped making such a big deal about it?  What if I gave him space and stopped the anger… I still think he would drink, and he would still probably not be able to stop drinking, however, so many things are good here. Is it me who is rocking the boat?  I am not trying to rationalize or be an enabler, I am just wondering if what we are dealing with here is real alcoholism or “a drinker” with an angry wife?  


ANSWER: Greetings to you, Dawn.

I might be the only one who ever does this, but I sometimes like to distinguish between “alcoholic” and “an alcoholic” ... and I believe doing that might help a bit while trying to answer your question:

>> Subject: Is husband "a drinker" or an alcoholic?

As I understand it, alcoholism is a two-fold condition, and your husband does not (yet?) seem to be showing evidence of a certain abnormal body chemistry or so-called “physical allergy” that almost always makes controlled drinking virtually impossible.  Therefore, and while he still might be a “borderline” (your term) alcoholic or a potential alcoholic, I would not be inclined to presently say he is obviously and truly “an alcoholic”.

However, and as to his possibly being “alcoholic”, it does sound to me like he is in a sense such as found in an old Webster’s dictionary:

Alcoholic, a. Pertaining to alcohol, or partaking of its qualities. (Webster)

In other words: It seems he actually can live with his drinking since he apparently does not lose all control over how much he drinks once he gets started, yet it seems he presently cannot live without the effect he gets from having at least a few.  So then, he might yet be quite a way from having any real desire to stop.

You have asked:

>> How can I know if my husband's drinking is "reasonable" or crossing over into alcoholism?

In words simpler than my own, here is something from page 44 in “Alcoholics Anonymous”, the book:

“In the preceding chapters you have learned something of alcoholism.  We hope we have made clear the distinction between the alcoholic and the nonalcoholic.  If, when you honestly want to, you find you cannot quit entirely [or ‘cannot live without it’], or if when drinking, you have little control over the amount you take [and therefore ‘cannot live with it’], you are probably alcoholic.”

>> Am I making his few drinks a night into more of a problem than it actually is?

In my own personal opinion: No.  You did not marry him to spend you life with an intoxicated man.

>> Is it possible to be a "borderline" alcoholic?

Again: Yes.

>> Here are certain elements of my husband's life ...
>> By all accounts he is a “great guy.”

Yes, and that helps to prove alcoholism is not a matter of morals or character.  As another example:

“Fred is partner in a well known accounting firm.  His income is good, he has a fine home, is happily married and the father of promising children of college age.  He has so attractive a personality that he makes friends with everyone.  If there ever was a successful business man, it is Fred.  To all appearance he is a stable, well balanced individual.  Yet, he is alcoholic.” (“A.A.”, the book, page 39)

>> When he drinks, he sometimes experiences insomnia and panic attacks.

Alcohol can be both stimulant and depressant, but his panic attacks while drinking surprise me a bit.  I used to have a panic problem, but the attacks only ever came while I was sober.

>> He gets depressed in the winter and has sought counseling for this.

In my own experience, that is not related to drinking.

>> ... he has tried, but admits to being unable to *not* drink.

If he now or ever has an actual desire to stop, you might try to quietly suggest “Alcoholics Anonymous”, the book.

>> I do not like it when he drinks ...
>> I don’t like how the drinking affects him ...
>> I become withdrawn, angry, and cold-shoulder him for days.
>> He now lies to me at the drop of a hat about drinking ...
>> I *hate* the lying.

It is time to begin seeing him as a sick man, and to stop asking questions when you can reasonably expect only lies in response.

>> If I try and pull back and get my emotions out of the way, 2-3 drinks a night isn’t wholly unreasonable.
>> What if I stopped making such a big deal about it?

You would likely be lying to yourself about being willing to spend the remainder of his or your days with an intoxicated man.  However, I am sure it would be helpful all around if you were to read at least the chapter “To Wives”, in “A.A.”, the book.

>> What if I gave him space and stopped the anger…
>> I still think he would drink, and he would still probably not be able to stop drinking, however, so many things are good here.

Sure, but they might not remain that way ...

>> Is it me who is rocking the boat?

Yes, but sometimes the boat needs to be rocked ... but possibly in a different way.

>> I am just wondering if what we are dealing with here is real alcoholism or “a drinker” with an angry wife?

A drinker with an angry wife can often be a convincing indication of (at least oncoming) alcoholism.

Please read the book and stay in touch.
http://www.aa.org/bigbookonline/en_tableofcnt.cfm
I will help you in any way I can.

Joseph Lee O.
Email: leejosepho@hotmail.com
Forum: http://xsorbit28.com/users5/restored/ (new)


---------- FOLLOW-UP ----------

QUESTION: Thank you for your thoughtful response.

Some follow up clarifications/questions:

Regarding the comment that he's an "all around great guy"--I do realize that addiction to alcohol is not a character issue.  I wanted to illustrate that, to me, the problem has fuzzy edges and seems "borderline."  If he turned mean or angry when he drank, or had another DUI arrest, or was passing out and pissing in his sleep, or drinking a 12 pack a day--these things would make it crystal clear to me there was a serious problem--no fuzzy edges.  I have read some incredible descriptions on the internet in other places from other wives about their husbands' drinking that left me thinking--"you know, I don't have it so bad..."  It would be easy to know what to do if it were very obvious.  It's harder to know what to do--which approach to encourage him to take--when it's not.

What would be evidence or symptoms of abnormal body chemistry or allergy to alcohol?  

To clarify, the panic attacks my husband experiences usually come in mornings after a night in which he has drunk, (not while drinking) and a time or two during the day.  To me, *something* abnormal is going on here related to drinking.  He does not have them if he can go for a stretch without drinking.

What about the sugars in alcohol?  I have read that maltose, the sugars in beer, are extremely glycemically active--more so than pure glucose in the same amount.  Have you heard of this?  I often talk to my husband about the nutritional elements of being addicted to beer as perhaps even a carbohydrate addiction.  

Physically, he's not a big guy, 5'9" and 145 lbs. When he's been drinking, he really "off gasses" an alcoholic smell. I don't know a precise physiological explanation about this, but to me it seems like the amount he drinks is too much for the regular detox pathways and his lungs must assist?  Or maybe it just means he drank too damn much?  

Any thoughts?  

We are able to talk frankly about all of this. (It isn't always anger.) He tells me it's a disease and that I can't understand what it's like.  He is correct.  However, I am an alternative-health minded person (with my husband being along for the ride.)  If one of us had cancer or diabetes (depending on the severity of course) western doctors, drugs, and surgery would be the last place we'd start.  We'd enlist other alternative therapies and health care providers only using invasive therapies as a last resort.  So, thinking of alcoholism as a disease, with an alternative approach, my husband has many tools: he has access to nutritional counseling, a therapist, he once had a meditation practice that he would like to begin again, he could join me in a yoga practice, he is active in his church, he engages in semi-regular exercise.  I have told him he needs to aggressively apply all these things at once, hitting the disease from several angles at the same time.  This hasn't happened yet.  And now he is talking about seeking medications.  (keep in mind that we both have the belief that usual western medicine doesn't "cure" but is only palliative.)  Perhaps this is as it must be if the thinking goes "once an alcoholic, always an alcoholic?"  Then there is no cure, only management.  

Thank you for reading this and for your unique perspective.

Answer
Greetings again, Dawn, and I thank you for your continued candor.  That really helps here.

You have written:

>> ... to me, the problem has fuzzy edges and seems "borderline" ...
>> What would be evidence or symptoms of abnormal body chemistry or allergy to alcohol?

Uncontrollable drinking, and here is what makes that happen beyond any matter of personal character or mental control:

Alcohol is a poison in the human system, yet the body can usually metabolize it quickly enough to keep from being killed by it as long as the intake is not too rapid or excessive.  The pancreas provides the enzymes, and the liver cleanses the bloodstream by chipping away at the alcohol until it has ultimately been reduced to carbon dioxide (passed out through the lungs), water (released as perspiration or urine), and sugar that is either burned for energy or stored in fatty tissue.  I have heard (but could be wrong) that a normal and healthy system can usually handle about an ounce of ethyl alcohol (one drink) per hour for a total of around four ounces over twenty-four hours maybe once or twice per week without assuredly suffering significant damage.

In certain people with slower-functioning systems, however – real alcoholics seem to be born with such systems – an insufficient quantity and quality of enzymes results in alcohol (as acetaldehyde) remaining in the bloodstream for too long and finding its way to the brain in a quantity sufficient to interact with the brain’s dopamine and produce an alkaloid known as tetrahydroisoquinoline (THIQ of THQ) ... and that highly-addictive substance (also found in the brains of heroin addicts) can trigger an actual and immediate “physical phenomenon of craving” (A.A. jargon first borrowed from Dr. William D. Silkworth) for more ethyl alcohol.  Hence, and for the real alcoholic: One drink is too many and “a thousand” could never be enough.

You have written:

>> The panic attacks my husband experiences usually come in mornings after a night in which he has drunk, (not while drinking) and a time or two during the day.  To me, *something* abnormal is going on here related to drinking.  He does not have them if he can go for a stretch without drinking.

Ah.  I suspect his panic attacks are related to his fighting a desperate desire to have “just a few” for the effect he needs in order to feel emotionally okay inside, and while simultaneously fearing the uncontrollable drinking he possibly already knows would prove him to be a “full-blown” alcoholic on his way to the grave.

You have asked:

>> What about the sugars in alcohol?  I have read ...
>> Have you heard of this?

No, I have not.  I have low blood sugar, but I do not know much even about that.

>> When he's been drinking, he really "off gasses" an alcoholic smell. I don't know a precise physiological explanation about this, but to me it seems like the amount he drinks is too much for the regular detox pathways and his lungs must assist?  Or maybe it just means he drank too damn much?

On both counts: Yes.  I had the same deal when drinking: Almost any amount at all is “too much” for a slow-functioning system.

>> We are able to talk frankly about all of this.

That is good, and here is a thought for you:

“If you have a number three husband, you may be in luck.  Being certain he wants to stop, you can go to him with this volume as joyfully as though you had struck oil.  He may not share your enthusiasm, but he is practically sure to read the book and he may go for the program at once.  If he does not, you will probably not have long to wait.  Again, you should not crowd him.  Let him decide for himself.  Cheerfully see him through more sprees.  Talk about his condition or this book only when he raises the issue.  In some cases it may be better to let someone outside the family present the book.  They can urge action without arousing hostility.  If your husband is otherwise a normal individual, your chances are good at this stage.” (From the chapter “To Wives” in “Alcoholics Anonymous”, the book, page 113)

>> He tells me it's a disease ...

Not literally.  Rather, it is a simple condition such as being allergic to strawberries, yet coupled with an insane obsession to go eat some anyway.

>> ... and that I can't understand what it's like.

Here is what all of that is about:

“Most of us have been unwilling to admit we were real alcoholics.  No person likes to think he is bodily and mentally different from his fellows ...” (page 30)
“Highly competent psychiatrists who have dealt with us have found it sometimes impossible to persuade an alcoholic to discuss his situation without reserve.  Strangely enough, wives, parents and intimate friends usually find us even more unapproachable than do the psychiatrist and the doctor.
“But the ex-problem drinker who has found this solution, who is properly armed with [certain medical] facts about himself (such as above), can generally win the entire confidence of another alcoholic in a few hours [via ‘mutual vulnerability, openly shared’ (Ernest Kurtz)].  Until such an understanding is reached, little or nothing can be accomplished.
“That the man who is making the approach has had the same difficulty, that he obviously knows what he is talking about, that his whole deportment shouts at the new prospect that he is a man with a real answer, that he has no attitude of Holier Than Thou, nothing whatever except the sincere desire to be helpful; that there are no fees to pay, no axes to grind, no people to please, no lectures to be endured - these are the conditions we have found most effective.  After such an approach many take up their beds and walk again.” (pages 18-19)

>> I am an alternative-health minded person ...

That is good, for today’s doctors, therapists, counselors, treatment centers and even today’s AA – psychobabble – can do virtually nothing for real alcoholic.

>> My husband has many tools ... nutritional counseling, a therapist ... meditation ... yoga ... church ... exercise.
>> I have told him he needs to aggressively apply all these things ...

... and in so doing, the two of you will come to know their futility with absolute certainly in relation to chronic alcoholism.

>> ... now he is talking about seeking medications.

Other than the same kind of sure knowledge being gained, none of those will do any real good either.

>> (keep in mind that we both have the belief that usual western medicine doesn't "cure" but is only palliative.)

Yes, and that is the reason ... and here are the reasons for that:

"At first some of us tried to avoid the issue, hoping against hope we were not true alcoholics.  But after a while we had to face the fact that we must find a spiritual basis of life - or else.  Perhaps it is going to be that way with you.  But cheer up, something like half of us thought we were atheists or agnostics.  Our experience shows that you need not be disconcerted.
"If a mere code of morals or a better philosophy of life were sufficient to overcome alcoholism, many of us would have recovered long ago.  But we found that such codes and philosophies did not save us, no matter how much we tried.  We could wish to be moral, we could wish to be philosophically comforted, in fact, we could will these things with all our might, but the needed power wasn't there.  Our human resources, as marshalled by the will, were not sufficient; they failed utterly." (pages 44-45)
“If your [employee] accepts your offer, it should be pointed out that physical treatment is but a small part of the picture.  Though you are providing him with the best possible medical attention, he should understand that he must undergo a change of heart.  To get over drinking will require a [spiritual] transformation of thought and attitude [via abandonment of self to The Creator of all].” (page 143)

>> ... if the thinking goes "once an alcoholic, always an alcoholic?"  Then there is no cure, only management.

“Once an alcoholic, always an alcoholic” is a statement related only to the fact there is no cure for the physical, one-drink-takes-another element of alcoholism (and that is why MM never ultimately works for the true alcoholic).  The mental obsession is an entirely different matter – it can be removed:

“And we have ceased fighting anything or anyone - even alcohol.  For by this time [around Step Ten] sanity will have returned.  We will seldom be interested in liquor.  If tempted, we recoil from it as from a hot flame.  We react sanely and normally, and we will find that this has happened automatically.  We will see that our new attitude toward liquor has been given us without any thought or effort on our part.  It just comes!  That is the miracle of it.  We are not fighting it, neither are we avoiding temptation.  We feel as though we had been placed in a position of neutrality - safe and protected.  We have not even sworn off.  Instead, the problem has been removed.  It does not exist for us.  We are neither cocky nor are we afraid.  That is our experience.  That is how we react so long as we keep in fit spiritual condition.” (pages 84-85)

Hence, and as referenced at the opening of my first letter:

I am still and will always be “an alcoholic”, yet I am no longer “alcoholic”:

“Seemingly he could not drink even if he would.  G-d had restored his sanity.” (page 57)

Peace to you, Dawn, and please know you are always welcomed to write ... and of course, so is your husband!

Joseph Lee O.