Borderline Alcoholics

While some alcoholics are at the full-blown or chronic stage, most are in earlier phases. This article is for those still on the road, the ‘borderline alcoholics’ about to cross the boundary into the dark realm of addiction and heartbreak…

You find them everywhere, from pulsating clubs where young people get sloshed for an evening of fun, to old age homes, informal settlements, and city flats and parks. They consume alcohol to blunt poverty, loneliness and hopelessness. You find them on manly hunting and fishing expeditions drinking beer, brandy and coke, in corporate golf clubs drinking whisky, in exclusive country clubs drinking gin and tonic, behind the walls of exclusive golf estates, and in the brown bag of the tramp hiding his or her fix.

Trying to address the issue of alcoholism and alcohol abuse in one article won’t do justice to the topic or to the many people who struggle with this addiction. I will therefore focus on the biggest percentage of alcohol consumers – those in the ‘progression’ or ‘crucial’ phase. They are what I call ‘borderline alcoholics’. Hopefully this article may discourage such people from crossing the boundary to the next stage. I have no problem with the moderate and social consumption of alcohol and have great appreciation for the fruit of the vine in all its forms and variety. But in my view alcoholism is a progressive addiction and one should assess one’s progress on this rocky road. What I mean by a ‘progressive addiction’ is that it develops enticingly and subtly over time. Certain variables like age, weight, gender, and how often and how much one consumes must be borne in mind.

The progression of this addictive disease can be seen in the following diagram.

Borderline Alcoholics

According to this model the disease has five major phases. The symptoms in each phase are not exact, but should give an indication of whether you have a problem.

The phases are as follows:

Progression phase: relief drinking, urgent need to drink, feelings of guilt, need to drink more, find socially acceptable excuses to use alcohol, regular use of alcohol, occasional binge drinking, occasional intake of ‘one too many’, etc.

Crucial phase: increasing dependence on alcohol, using and finding excuses to drink, failure to keep promises, loss of will power, increased binge drinking, more tolerant of alcohol and therefore increased intake, memory loss, etc.

Chronic phase: less tolerant of alcohol, i.e. gets sloshed easily, neglects diet, periods of being drunk, thinking and relationships deteriorate, obsessive drinking, admits defeat, etc.

Rehabilitation phase: honest desire for help, admits to being an alcoholic, takes an inventory, asks for help, improves diet, relies on support groups, new hope, etc.

Recovery phase: desire to escape disappears, develops new interests, inspires confidence in family and employers, operates within support groups, etc.

Alcoholism is a progressive disease with four main features:

1. Craving – a strong need to drink.

2. Loss of control – not being able to stop drinking once you have begun: ‘the bottle has got to be empty’.

3. Physical dependence – withdrawal symptoms such as nausea, sweating, shakiness, or even anxiety attacks on ceasing to drink.

4. Tolerance – the need to drink more in order to repeat the same ‘high’, or feeling of relaxation or inebriation.

With borderline alcoholism it is possible to have a problem with alcohol but not display all the classic characteristics of alcoholism. Remember alcoholism is a progressive disease – if it doesn’t get you now it might get you in a couple of years. The excessive and intermittent abuse of alcohol might cause health, career, social, relationship or even legal (drunken-driving) problems, but as a borderline alcoholic you might not be totally dependent on alcohol and might not have lost total control over your alcohol consumption. Not yet, anyway.

The main defence mechanism on the rocky road to full-blown alcoholism is denial. It is not my responsibility to convince you. Rather be honest when you do the checklist below and act accordingly.

If you have two or three symptoms you should be concerned. If you have five or more symptoms you should seek help.

SIGNS AND SYMPTOMS OF ALCOHOLISM

  • Do you drink alone or in secret? This includes two or three glasses of wine or spirits on your own every night or most nights of the week.
  • Do you find it difficult to limit the amount of alcohol you drink? For example you only stop when there is nothing left to drink, or you have to go and buy some more.
  • Do you binge drink, the purpose being to get sloshed? This comes in various disguises, e.g. emptying the bottle, ending up tipsy or drunk, drinking many ‘shooters’ in a short time-span, etc.
  • Do you forget conversations/events or parts of conversations or events?
  • Do you make a ritual of having drinks before, with or after dinner and become annoyed when this ritual is disturbed or questioned?
  • Have you started to drink earlier in the day?
  • Do you feel a need or compulsion to drink? This is sometimes innocently disguised as often visiting friends where alcohol is abused, or creating events like eating out in order to drink.
  • Do you keep alcohol in unlikely places at work, home or in the car (stash it in case of emergency)?
  • Do you ‘down’ drinks, play drinking games to get intoxicated, down shooters, order doubles, or drink to relax quickly, to feel normal or to socialise?
  • Do you have legal, relationship, financial or career problems due to alcohol abuse?
  • Have you built up tolerance to alcohol so that you need more in order to feel tipsy, relaxed or inebriated? Many people boast that they can take or hold their drink. Be wary of this – be very wary.
  • Do you feel irritable or anxious if alcohol is not available during your normal drinking times?
  • Do you get annoyed when other people comment on or criticise your drinking habits?
  • Do you secretly harbour the thought that you need to cut back on your alcohol consumption?
  • Do you secretly feel guilty about your alcohol consumption or your behaviour when intoxicated?
  • Have you been cautioned by a health specialist about the effect of alcohol on your health, sexuality or relationships?
  • Do you have impaired control – the inability to limit your drinking on any given occasion?
  • Have you ever embarrassed someone else or yourself when drinking?
  • Do you drink every day?
  • When you have one or two drinks, do you find it difficult to stop and walk away?
  • Have you woken up with a hangover a number of times in the last month?
  • Have you ever decided to stop drinking for a week or so, but it only lasted for a couple of days? Have you had a drink in the morning during the past year?
  • Do you ever tell yourself you can stop drinking any time you want, even though you keep getting drunk?

Borderline Alcoholics

WHY DO WE ABUSE ALCOHOL?

Physical dependence (alcohol addiction or dependence) occurs gradually as drinking alcohol alters the balance of some of the chemicals in the brain, such as GABA which inhibits impulsiveness, and glutamate which excites the nervous system. Alcohol also raises dopamine levels in the brain, which is associated with the pleasurable aspects of drinking alcohol. Dopamine is an essential neurotransmitter in the intense rush we experience when we climax. Psychologists call it the ‘dopamine reward system’ and humans as well as animals will go to great lengths in order to get a dopamine rush, e.g. the consumption of alcohol, cocaine, nicotine, chocolate (yes, chocolate) and even the experience of pain (sadism) or danger (bungee jumping, etc.) all push the dopamine button and provide a dopamine rush. Excessive long-term drinking can deplete or increase the levels of some of these mood-altering neurotransmitters, altering chemicals, causing your body to crave alcohol to bring back the good feelings or avoid negative feelings.

The reason for this is that the body and mind constantly pursue homeostasis or balance as a steady state of being, and in order to cope with the perpetually high levels of dopamine the human body found a creative solution. The brain begins to reduce the number of dopamine-binding or receptor cells. Unable to latch onto these receiver cells the unattached dopamine is powerless to give you that pleasure rush. That is one explanation for why nicotine, alcohol and cocaine addicts needs more and more of the stuff to experience that bittersweet rush again. Eventually the protective down-regulation of dopamine receptors leaves the brain in a state of burnout. Fortunately there is a normal and acceptable alternative available. Having great and rewarding sex with your lover is an excellent way of receiving a healthy rush of dopamine pleasure without the associated risks.

Remember, alcohol is a very seductive but extremely dangerous lover. It will chew up your essence and spit out only the husk. In short alcoholism is:

  • Chronic: it can last a lifetime without help and treatment.
  • Progressive: it will not get better by itself or go away. It gets progressively worse.
  • Incurable: a patient in recovery can never go back to ‘normal’ drinking.

The reasons why we abuse alcohol are as varied and unique as the people who abuse alcohol. Some of the reasons are: to dull or blunt emotional pain or bad memories, despair, poverty, hopelessness, loneliness, to anaesthetise oneself to life and its demands, to dull failures or the past, genetics, to relax, to feel less anxious, to have a good time, depression, low self esteem, social and cultural demands, boredom, bad habits, lack of coping skills, spiritual despair and purposelessness, because we are children of alcoholics, etc.

WOMEN AND ALCOHOL

Women should be wary of alcohol because it affects them badly for the following reasons:

  • They weigh on average less than men, therefore the same dose of alcohol leads to a greater concentration in women’s bodies.
  • Women have more fatty tissue than men (sorry girls), and body fat has less water with which to dilute the alcohol.
  • Women have less of the enzyme that breaks down alcohol, so more alcohol hits their bloodstream.
  • Women who are premenstrual with high oestrogen levels will get intoxicated faster.

WHAT TO DO?

There is professional help and treatment available. Make use of it. Most people with an alcohol abuse or dependency problem enter treatment reluctantly because they often deny that they have a problem or minimise the severity of the problem. Various treatments are available and depending on circumstances, the patient, and the severity of the addiction, the following choices are options:

  1. an evaluation
  2. brief intervention
  3. surgical procedure ( Disulfiram implantation)
  4. an outpatient programme or counselling
  5. residential inpatient stay

With a residential treatment programme you can expect:

  1. detoxification and withdrawal
  2. medical assessment and treatment
  3. psychological or psychiatric assessment emphasis on acceptance and abstinence, drug treatments
  4. continuing support

SUPPLEMENTATION IF YOU ARE A DRINKER

Keep in mind that alcohol is filling, so it displaces more nourishing food in your diet and causes thiamine (vitamin B1) deficiency in particular and a deficiency of other nutrients as well. Make sure that you supplement your diet with optimal quantities of the following:

  • Vitamin C improves metabolism of the toxic by-products of alcohol and is a powerful anti-oxidant, and might be helpful in cases of hepatitis.
  • Vitamin B-complex. Regardless of its other benefits, B-complex also helps with blood sugar problems which are a by-product of drinking alcohol; it also relieves the symptoms of delirium tremens.
  • Chromium is deficient in 90% of all healthy people, and is almost certainly lacking in the drinking person’s diet. It improves your body’s sensitivity to insulin.
  • The amino acid L-Glutamine has been shown to improve brain function in alcoholics, resulting in improved sleep, decreased anxiety, etc.
  • Lecithin provides choline, which your body can make into the neurotransmitter acetylcholine, that produces a feeling of wellbeing. Additionally lecithin is lipotrophic, which means it can help fats move around the body.

Controlled vegetable and juice fasting has many benefits, one of which is to cleanse the liver and assist it to regenerate. Eat more fibre and complex carbohydrates, and cut out fatty junk foods.

Alcoholics Anonymous (AA) has run very successful programmes since 1935 with their 12-step approach and acknowledgement of the spiritual needs of alcohol abusers and alcoholics. Find a treatment centre near you.

Editor's note: A crucial correlation exists between the craving for alcohol and other forms of addiction and a deficiency in NAD, a lack of cellular energy. NAD stands for Nicotinamide Adenine Nucleotide, a coenzyme found in all living cells. NAD is available in supplement for (pills and oral spray) as well as in drip form.

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