Many substance abuse workers today question whether all problem drinkers fit the classic Alcoholics Anonymous model of someone who suffers from a disease which makes it impossible to control their consumption. There are, for example, people who go on long self-destructive benders once or twice a year (or less) but can drink reasonably in between. Others rarely drink to the point of drunkenness but their attachment to a couple of glasses of wine each night is so habitual they could easily be regarded as alcohol dependent.
How easy it is for someone with an alcohol problem to drink socially depends on the role alcohol has in their life, the pattern of their drinking and the length of their alcohol “career”. The longer someone has been a heavy drinker, the harder it will be to maintain lower social’ levels, especially if their social circle includes other heavy drinkers. Small amounts are also more likely to cause problems for someone whose drinking reached the stage of physical dependency with withdrawal symptoms like the shakes or DT’s.
One person I spoke to who was sure he needed to stay completely abstinent described being drawn to alcohol “like candy”. If he saw it, he wanted it – even after years of sobriety. He was attracted by the alcohol itself. For many people, however, the move is not so much towards alcohol as away from something else.
We’ve all heard the phrase “drinking to forget”. Clinicians use the term self-medication’ to describe using alcohol or other drugs to dampen symptoms of depression, anxiety, post-traumatic stress disorder, social phobia or other difficulties. In this model, alcohol is not seen as the main problem but as an unhelpful coping mechanism. It suggests that if the underlying problem is treated successfully and/or the person finds better ways of managing negative feelings, he or she should be able to drink socially.
More recently, I heard an ex-binge drinker describe herself as being unable to recognize how much was enough, so she would drink until everything was finished or she could drink no more. This is similar to some of the theories around today that overeaters have problems knowing when they’re full. Unlike the AA alcoholic, she didn’t spend a great deal of time thinking about or seeking alcohol when it wasn’t around and had many drink-free days. When she became aware of her problem and worked on it she was able to return to a healthier drinking pattern.
But the ability to drink socially is by no means the same as drinking socially forever more. People can remain fully abstinent OR social drinkers for lengthy periods of time and then lapse. A lapse is a single return to old behaviours as opposed to relapse, where the recovery program is abandoned. Many workers in the addictions field believe that change is like a spiral staircase; picking oneself up after a lapse and learning from it is part of the process.
There’s no clear way to predict whether someone can return to safe drinking levels and for how long, but it’s never a good idea to test one’s resolve just for the sake of it. The urge to test one’s resolve can indicate that a person is impatient to have alcohol back in their life so it’s probably too soon to try.