Alcohol is a drug. That’s a fact that often gets lost amidst the raucous cheer of a corner pub, or the friendly bustle of a classy cocktail party. It’s not “like” a drug, or “kinda” a drug. It is a drug, plain and simple. Recognizing it is as such—calling a spade a spade, as it were—is an essential step on the road to sobriety.
Very few people think of alcohol in the same way they think of, say, heroin. Or crack. Or even marijuana, for that matter. Much of this has to do with the law: alcohol, unlike heroin or crack or marijuana, is legal in the United States. More broadly, its legality means that alcohol is free of the stigma which is often attached to “bad” drugs. Drinking is a socially acceptable pastime; shooting up heroin is not. For the alcoholic, though, things like laws and stigmas do very little to change the fact of addiction itself.
And what of that addiction? How does alcohol function within the human organism, and why does it pose such an irresistible temptation for so many Americans? On a biochemical level, alcohol elevates activity in the body’s natural opioid system. In plain-speak, this means it works in a strikingly similar fashion to a drug like heroin. Forget what’s legal or illegal, forget what’s stigmatized or not stigmatized: what matters for the alcoholic—and for the alcoholic’s friends and family—is the nature of the process by which the drug operates. Recovery is impossible without knowledge, without the truth. Recovery is impossible without understanding.
Natural opioids, when released into the bloodstream, trigger a state of positive affect—pleasure—within the individual. Drinking feels good. Anyone who’s ever cracked a cold beer on a hot day knows that much. The problem, though, is that drinking feels too good for alcoholics. In addicted individuals, the pleasure derived from alcohol consumption becomes a compelling—a compulsive—need, either because of natural chemical imbalances or preexisting psychological problems—or, more often, from a combination of both. In any event, the alcoholic is quite literally overwhelmed by his or her desire to drink. Such is the nature of addiction, whether to an “acceptable” drug like alcohol or a “bad” drug like heroin: addicts use because they have to.
Unfortunately, the psychoactive properties of alcohol are strongly conducive to repetitive—addictive—behavior. As with all drugs, the pleasurable effects of alcohol are impermanent. Heaters fade, buzzes wear off the happy haze of those first few drinks ultimately resolves itself to clarity. What’s worse, after the drunk comes the hangover. For alcoholics, the post-use low is particularly painful; their acute sensitivity to the pleasure of drinking is mirrored by an equally acute sensitivity to the pain of its aftermath. Put simply: hangovers hurt more for alcoholics. And that hurt, in turn, gives alcoholics stronger incentive to start drinking again. All told, it makes for what can often amount to a devastatingly vicious cycle.
The point, then, is that the abuse of alcohol—or heroin or crack or any other drug—is not a choice. Nobody “chooses” to be an addict; addicts don’t “prefer” addiction to sobriety. Like all drug abusers, alcoholics are the way the way they are for reasons that lie largely outside the scope of their control. Recognition of that fact—of the extent to which addiction confounds anything we might deign to call individual willpower—is vital for anyone whose life is affected by alcoholism: for addicts themselves, and for the people who love them.
First, for addicts: As noted above, recovery is impossible without understanding. Many alcoholics naively believe that they are “in control” of their alcohol consumption. They believe that they drink when and because they want to, that they could drink less, or even stop drinking, if they chose to do so. This is an exceedingly dangerous state of mind. Again, alcoholism is not, is any conventional sense of the word, a “choice.” The addict who believes he or she can stop drinking without external intervention—that he or she doesn’t need help, or doesn’t even have a problem—is the addict who is doomed to stay addicted. Addiction stems from the compulsive relationship between the individual and his or her drug of choice. Ignorance to the compulsiveness—the uncontrollability—of that relationship only serves to perpetuate the problem.
Such ignorance is no less destructive for those individuals who live with and around alcoholics. Alcoholism, at its core, is a social disease: it affects both the alcoholic and his or her friends and family; it ruins lives on a grand scale, devastates the well-being of everyone it touches. Understanding the nature of the beast is essential to the act of confronting it. If someone you love has an alcohol problem, it is not his or her “fault.” To hate an alcoholic for being addicted to alcohol is like hating a dog for barking: it’s not right, or fair or sensible or even constructive, no matter how much damage the addiction has caused in your own life. More pressingly, if an alcoholic you love tells you that he or she doesn’t have a problem, or doesn’t need help, he or she is wrong. Dead wrong. Remember, alcohol is a drug. Alcoholism is not a choice. Alcohol abusers, like all addicts, need help in order to recover. And if they’re ever going to get that help, someone who loves them—someone like you—has to recognize what’s true and what isn’t. Anything less just isn’t good enough.
(Source: Biological Psychology: An Integrative Approach, by Frederick Toates)