WHO, WHAT, WHY?
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Kerry Katona says she is an alcoholic, but can control her addiction enough that she can drink. How does this square with the abstinence mantra of many recovery programmes?
Kerry Katona: Is it all or nothing for an alcoholic?
When pop singer turned reality TV stalwart Kerry Katona went public with her alcoholism at the weekend, she made a rather surprising admission. "Yes, I still have a drink when I want to, like any other 28-year-old woman."
Yet the popular image of someone who says "I am an alcoholic" is that they will also have sworn off booze. Those at Alcoholics Anonymous aim for abstinence one day at a time.
"The basic adage is that the first drink causes the problem," says Michael, whose own road to recovery with the AA started 10 years ago. "It's the first drink that opens the field for a second drink and then a third."
For those with severe dependence, abstinence is only option
Others can change their drinking habits - but this isn't easy, and they may opt for abstinence
But there are treatment programmes, including on the NHS, where abstinence is not the only goal. "To say if you are alcoholic you must never drink again is over-simplified - alcohol dependence is on a continuum," says Nick Heather, emeritus professor of alcohol at Northumbria University.
But this does not mean those heavily dependent on alcohol - who suffer severe withdrawal symptoms such as the DTs, and drink to ward off these effects - can aim to be moderate drinkers in the future.
Will one lead to another and another?
"The evidence clearly shows that those with severe alcohol dependency are far more likely to achieve recovery with abstinence," warns Professor Heather, a clinical psychologist.
There's no concrete definition of what an alcoholic is, rather experts talk of a sliding scale of alcohol dependency.
But for those at the lower end of the scale - an estimated eight million in England alone - it's possible to return to drinking in a responsible manner.
"But it's not easy. It means giving up hard-drinking friends, giving up going to the pub, taking up hobbies they might have put aside long ago."
A major study by the US's National Institute on Alcohol Abuse and Alcoholism in 2002 found that of the adults surveyed with alcohol dependency, 35.9% were fully recovered - with roughly equal proportions of abstainers (18.2%) and those who drank moderately (17.7%).
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For Michael, a mental obsession with alcohol is part of his condition. "Just one drink sets off the compulsion. If I had a drink, I'd want the next one. I was always one for sessions, I could never see the point of stopping at just one or two."
Even when he began to attend AA meetings, having lost his family, his job and his home, it took a long time to accept that "just one" would do no harm.
"Every addict likes to think they're special - 'I'm slightly different and I'll be OK'. Even with the wreckage around me, I thought that."
For Michael, abstinence has turned out to be the answer. But the perception that this is the only cure deters many from seeking help, says Professor Heather.
Below are a selection of your comments.
The idea of battling alcoholism was summed up best in The West Wing by Leo McGarry. "I don't want one drink, I want ten drinks, and I don't understand how others can settle for just one." Severe alcoholics don't want to have a drink - they want to be drunk. The only way to escape that is to never touch alcohol again.
Kate Jones, Lancaster, UK
I'm being treated for alcohol abuse at the moment. I'm not addicted - yet - but for several years I've been drinking up to 100 units a week. My alcohol counsellor and I are aiming to reduce my drinking to safe levels. For me, the problem is not about staying away from pubs, but learning not to drink alone, a tough call when you live on your own and suffer from depression. I find my drinking much easier to manage in company, when I am less likely to drink to blot out my pain. I'm slowly training myself not to buy alcohol to drink at home unless I really, really feel I have "earned" a drink. The NHS has excellent alcohol programmes and I wouldn't have managed without their support. My intake is now down to about 30 units a week so I'm seeing real progress. AA is not for me - the Christian ethos underpinning it is not appropriate if your background is in another faith or you are an atheist.
You don't have to be an alcoholic to know that the first drink is the easiest to refuse. Designated drivers take note...
Caroline Brown, Rochester, UK
When I was in the Navy, I discovered I had a drink problem - whether I would have been described as an alcoholic is a moot point, but it was definitely a problem. I managed to crack it without seeking external treatment, but it was extraordinarily difficult. When discussing this with a doctor a few years later, he said he thought I probably had a "non-addictive" personality, otherwise I wouldn't have been able to do it on my own. I still enjoy a drink, but I'm now aware of how much I am drinking, and I know when to call a halt to ensure that I have a good time, without going overboard. As regards abstinence or not, I think it is down to the individual, and how they can cope with their own personality and cravings.
Anne Boyce, Halifax, England
So Kerry is a wet alcoholic not a dry one. From my experience, a wet alcoholic is someone that has a problem and still drinks, a dry alcoholic is someone that has a problem but abstains because they have to. If Kerry can live with being an alcoholic who still drinks, then let her get on with it. Is her life in chaos? If it is, then she should abstain for the rest of her life. So she must go to a wet meeting also, if she attends AA, that is? There are many types of AA meetings as well, wet and dry, open and closed, it can be quite confusing when you first get involved, the key is, if your life and the lives of others are being destroyed by alcoholism, then abstinence is the only answer for all those concerned.
Brett Sentance, Derby
If the alcoholic or problem drinker could see the carnage of his association with alcohol then one begs the question, why return to the insanity or belief that ,this time it will be different. The obvious answer is this, the alcoholic cannot see it. Thus, after a period of abstinence, usually a lot shorter than planned, the alcoholic returns to the drink believing it was the drink that was the original problem. It never occurs to them that they are the problem and believe alcohol is the solution.
Scott Brooks, Toronto, Canada