Alcoholism posts in the Guardian

Alcoholism posts in the Guardian.

The guardian is a great paper and website from the UK that tends to write more balanced articles that are detailed compared to many other news organisations. A couple of recent pieces caught my eye so I thought I would add them here.

The Guardian

The next AA? Welcome to Moderation Management, where abstinence from alcohol isn’t the answer:

The moderation management organisation does not get as much exposure as it should do, but has survived controversy, such as the Audrey Kishline car crash and slowly continued to build. It offers a great alternative to the 12 steps AA type approach, as many people cannot or do not wish to be abstinent. Not everyone with a drink problem is a full blown alcoholic and some support can often help them change their ways. The piece talks with Marc Kern who has written some great pieces on the subject.

Here is a section from the piece – you can read the whole thing here

Upstairs from one of my favorite Oakland dive bars, 10 people of varying ages and backgrounds are sitting in a circle, talking about their drinking problem.

“I make plans for my non-drinking days so that I’m not thinking about it so much – I work out, I schedule late work meetings, so it’s not even a temptation,” a tall, thin older woman says. Later, she explains that there was a time not long ago when the idea of getting through any day without five or six drinks seemed impossible to her.

“Go out later, hold off on that first drink, set up a game for yourself like ‘I can only buy one drink and then I have to get any others I want bought for me’,” adds a young man in stubble and a newsboy cap. “Hold off on your second drink, too,” adds the older man sitting next to him. “I used to order my next drink halfway through my first, so I’d be halfway through my second before the effects of the first one would kick in and then forget about it.”

This is Moderation Management (MM), a program whose rising popularity and success rate is posing the first real challenge in decades to the traditional, black and white approach to addiction.

The program typically starts with 30 days off booze altogether – “doing a 30” in MM parlance – followed by a slow reintroduction of alcohol, and eventually a plan to limit your intake: no more than 14 drinks a week for men, nine a week for women, and no drinking more than three or four days a week for either. There’s increasing talk of applying MM to marijuana use as well, although that’s not officially condoned by the nonprofit of the same name, which administers the program.

“People do come in lately who want help moderating marijuana and because it’s still illegal in California, we shy away from it,” explains Marc Kern, the organization’s director. “That doesn’t mean they can’t come to meetings and listen and stuff like that. But in states that have legalized it, I can see a time where there’s a different MM – Marijuana Moderation.”

While there is a framework to MM, based on Kern’s book Responsible Drinking, it’s also a program that prides itself on flexibility and enabling people to find their own paths forward. Three out of the 10 people at the meeting I attended said they weren’t ready to do a 30 yet, but were planning shorter breaks. One man celebrated the fact that he’d taken one day off from smoking weed and drinking. He does both in moderation daily, and his concern was more about the frequency and the fact that he can never seem to take a day off than the amount of any particular substance consumed.

Another woman nearly started to cry when talking about issues with her son, her marriage, and her stressful job. She said the only thing getting her through was the bottle of wine she drinks every night. She’d had a few occasions recently where she blacked out from drinking, then spent days in bed depressed. The group gave her ideas for ways she could take a few days away from all of it – the stress, the husband and the drinking – and suggested more therapy to deal with the psychological triggers of her drinking and depression.

A young man in the group explained that he had bipolar disorder, that he was feeling great on his new medication, but that there might be a problem when it comes to alcohol. “I’m not someone who drinks when they’re depressed, I drink when I’m up,” he said. “If I’m feeling good, I want to be out being social, and that means drinking.” The group offered some tips and tricks for sticking to the four-drink-a-night maximum, and for finding ways to be social without drinking. When the older man sitting next to him talked about his daily marijuana use and how it keeps him from being too irritable about anything, the bipolar man raised an eyebrow and gently suggested that using marijuana as a mood stabilizer was different, and more problematic, than just smoking pot because you like it and think it’s fun.

There was no therapist in the room, and the moderator, a two-year MM “veteran”, gently steered people away from delving too deeply into issues that might be better addressed in therapy.

The Guardian logo

Homeless and an alcoholic, Steve’s story shames modern Britain

This is another piece worth reading and shows some of the problems that people face getting help in the UK, And I met a few people like this when I was a member of AA. . There is not enough help out there for people who are on the streets with mental health and substance use problems. Most of society turns their back on them. I have copied a section of the piece below.

I met Steve five years ago when he began sleeping on the porch of the church I used to attend; he was in his mid-40s and had recently been released from prison. He had never lived independently, and was clearly a man with complex needs. Many of us at the church grew to know and like Steve. He showed great care for others, and displayed an endearing wit: he’d describe the fruit he’d picked and stored in the crevices of the porch as his “ornaments”.

Steve could be aggressive when drunk, but was typically benign and the most committed churchgoer in the parish. We treated him not as a client or patient or problem, but as a person, and he respected that. So when he mustered the courage to seek assistance in turning his life around, we did all we could.

Our resulting experiences were akin to being punched repeatedly in the soul. Here’s a brief summary. He needed help for his chest pains, so we contacted a GP surgery. “No, we can’t help,” they said. “He needs to register with us.” What information do you need? “His address.” He doesn’t have one. “Then we can’t see him.” It took a formal complaint to the practice manager to get this vulnerable, sick man an appointment.

The benefits system was similarly ill-equipped to deal with Steve. He had no chance of navigating the labyrinthine bureaucracy and alphabet soup of initialisms. Attempts to get the money to which he was entitled were stalled by the need for official documents, of which he had none. After weeks of struggle, the benefits were approved – but were accessible only by using a card, a device with which Steve was unfamiliar. So he’d need help just to get the money. No one official offered support with budgeting, either, so he had no idea how to manage it.

Then there was the nausea-inducing carousel of mental health care. He didn’t tick enough boxes for any formal diagnosis; well-intentioned efforts were made to admit him to hospital, but he wasn’t ill enough. Because of his alcoholism, no hostel would take him; but without the stability and shelter afforded by a hostel, he had little chance of recovery. Mental health services wouldn’t help until he’d recovered from the alcoholism; but the alcoholism was bound up with his mental health issues. There was institutionalised buck-passing – and without our group from the church trying to help him, he’d have been entirely alone.

And then, 18 months ago, the very church in which he’d placed his trust evicted him. Some members of the church have continued their efforts but this has been made harder by the difficulty in knowing where he was. And now? He’s behind bars.



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