A big part of the pleasure of writing is the feeling of communion. Communion is an important drug, social need, spiritual experience, component of a sane life. I get some of my biggest kicks from writing when I succeed in having an audience feeling as if we are sharing the human condition. That we are not alone. Someone gets us, understands us, is going through the same thing.
Alcoholism is rather impossible to explain to non-alcoholics. The videos below are the best I’ve ever seen in giving a sense of why people drink, and how that slowly turns into alcoholism, and how difficult that is to get out of.
A lot of people who stop drinking are helped by lying to themselves. And if you are going to lie to yourself it’s much easier if you do it by lying, VERY LOUDLY to others. People say that you can be just as happy and sociable without it. That you don’t need it. All you have to do is to learn new habits. Alcohol is just a “crutch”, that serves no real purpose.
That’s fucking bullshit. Alcohol is great! For some of us, especially those with high social anxiety, it is transformative and a godsend. It quite obviously has an effect. We’ve had experiences with it we’d not have had without it. Fantastic stuff.
If alcohol wasn’t great, there would be no alcoholics!
I’m a bit lucky, I suppose, in that after long abstinence I don’t get cravings much. I have my triggers – old haunts that I frequently drank at, including the beach, can bring on a strong desire. But I don’t have to take things one day at a time as a constant battle against a looming bottle.
Regardless of how much you drink, I think you’ll find these videos either informative or reassuring in how you not alone.
Some of you might also consider the videos as cautionary. I doubt any alcoholic thought it could ever happen to him.
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I take low dose naltrexone before sleep, for immune regulation reasons. It’s also recommended to combat addiction.
The Ted talk below talks about a woman who used naltrexone in a different way to successfully treat her addiction.
Naltrexone is easy enough to get.
Random Xpat Rantings 
When I was in my early twenties I used to drink a lot of soda. I know an alcohol addiction is far stronger than that of course, but I understand to a degree. It feels like you get a break. Like it’s now time to relax and you are excused for not studying or working. I have heard from a family member who is a dentist that when she tells people that they will get cavities, lots of them, their eyes just glaze over. They don’t want to know, so it just disappears instantly from their minds. I guess most people are just wired this way. I belong to the minority that is able to listen to advice even when it is uncomfortable, so I stopped and started drinking lots of tea instead. Not as satisfying, but I realized that what I wanted most of all was something to do.
The one argument that stuck with me was long-term damage to skin and teeth. If you want to tell a woman to stop smoking or consuming a lot of sugar, the permanent skin damage seems to be the most efficient, and it works on me as well. You only get one life. And movies where an older man looked back at life with regret, and realized he could never change what had been done in his only life, have made an impression on me.
If there is such a thing as an “addictive personality” I think I have it, as I like to pick something to do over and over again as a break from ordinary life, but I fight it by finding other and better things to do instead. The replacements are never as satisfying – people who say they are, aren’t truthful – but that’s the price you have to pay. And it works. I get by.
Another advice is to be outdoors a lot. That is the best environment for fighting addictive cravings.
You want to dig in and zone out, and the world feels grey if you don’t get to do so, but you learn eventually that it feels less grey in time. You get by, and that’s enough.
On Sept 29 18 I wrote this in a comment:
Then I waited two weeks, and allowed myself 250ml of vodka over an evening. The plan was that I had to wait another two weeks.
The plan didn’t work. I drank again for the next two days.
It’s amazing that this is so, to me. I’m watching many youtube videos now, trying to learn more about how the brains choice mechanisms can get routinely hijacked by alcohol cravings.
Did you know 40 percent of heavy drinkers actually die by drinking themselves to death? And 35 percent do what I do, which is fall on and off the wagon. Only 20% actually stop drinking. That’s just incredible – people seem to have either no free will or a very different kind of free will when it comes to alcohol cravings.
I don’t put myself into any shame, nor give excuses. I’m doing mostly fine right now, and am doing reasonably well staying fine, and working towards doing better with drink, even if that means never drinking. It’s fascinating, if somewhat scary, to be so first hand close to this problem. Forty percent of people with it drink themselves to death. Yikes.
If you don’t have this problem, of course you could not possibly imagine what it’s like to be in the shoes of someone who does. I’m in those shoes and even I don’t understand it.
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My biggest motivation to control drinking at this point is different than it has been. At various times in my past I’ve had big motivations because of:
* failing health
* acting poorly towards others
* making dangerous and reckless decisions that endanger myself
* just a feeling of dependency that alienated me from the “normals”. I needed booze and no one else did and couldn’t understand my constant holding of a bottle, or why I drank so fast.
If I let things go too far, I’ll still have any of those problems, but I don’t get into benders for that long lately. But I’ve read that each time you go through detox and withdrawls, you get brain changes, and it makes it so that you get alcohol dependent much faster in the future and get worse withdrawls the next time. That’s actually where the majority of the brain damage happens – not being drunk, but during withdrawls.
So now I notice brain chemical changes even just after a few days of drinking. I may have had those symptoms in the past and just not been able to pin down the cause, but more likely the withdrawl symptoms are also stronger now.
After a few days of drinking, working up to a 750ml bottle in a day (more if I get really off the rails), and then stopping, I might miss V a lot for a few days.
Now of course life events can trigger that – I did hear her voice lately and it cut through me like an electric shock – a blast from the past that was so familiar it was as if it was 10 seconds ago that we met, insead of nearly 1 full year.
But I’ve seen this pattern – during withdrawls the types of thoughts and emotions I’m prone to are different. I’m a little more quaky and vulnerable inside. Sometimes I get the literal shakes. If my hands are shaking then for medical reasons I will take a drink – it’s completely unsafe not to – you don’t want to ride or tough out the shakes – that’s medically irresponsible.
There are ideas here and there in the youtube vids on alcoholism that seem applicable to my situation. I prefer the first person vids by alcoholics, even as much as I appreciate technical vids by credentialed researchers. One idea people like is to create a life that you don’t need to escape from.
I consider being addicted to love and sex a powerful type of drug, and I’m often under the influence of it. I’ll try to write about that more. I don’t write about that much as I can’t recall ever getting a single positive and empathetic comment or feedback for any such ideas. People seem to think of love as completely abhorent.
But for me it’s a type of being high, and drunk, that is sustainable. It does take a full lifestyle, not just a perfect unicorn girl, to be able to use love as a type of sustainable drug. Maybe I’ll just go against the inevitable tide of negativity and write more about that in the future.
Another idea I’ve come across this morning is how to deal with the seeming choicelessness and inevitability of drinking. Most alkys don’t stop after the first drink. You might say that they can or could or would or should, but regardless of what stories they’ve told themelves about what they want to and plan to do, they don’t stop after the first, or second, or third drink. That’s just what happens, and the concept of free will becomes very abstract and academic. What happened last time happens again. And it’s not just me, it’s all of us with this long standing chemical dependency that has caused lasting brain changes.
The way I like to put it, somewhat poetically, is that it’s the booze that drinks the booze. Brain circuits get activated that push aside all the thoughts that would stop you from drinking. The booze creates new narratives, and when you drink you may experience what is a litteral multiple personality. An alter ego. You likely even have several drunken alter egos. Some of them you’ll be quite fond of, and proud to associate and identify with. Some of them might shame your sober self, yet seem perfectly righteous to your drunken alter ego.
So the idea was to focus on what free will you still have before you touch that first drink. One tactic was to just delay for 15 minutes, without telling yourself that you won’t drink in 15 minutes. One was to just notice the thought, remain uncomfortable, realize that you are not going to die, realize that yes, you truly would feel MUCH better if you did drink, but just simply live with lower expectations, and feel a bit uncomfortable for a while.
I’m at a scary high risk right now for struggling with alcohol dependency again, because I toy with trying to drink in moderation.
I know that there is no safe amount of alcohol for me to drink. If I do successfully drink moderately, let’s say for a week – once or twice drinking an amount that didn’t hurt my body or lead to stupid actions, it’s just the on ramp to the highway. It’s never just the side road that I was looking for.
But on days that I decide to drink, I can’t see it. I know I can’t see it, because the last time I drank, I tried to see it. I tried to remind myself of all the reasons that I’ve quit in the past. On days when I’m not yet alcoholic, and feel perfectly fine, I can’t see any reason why not to drink. It seems crazy and impossible, but my brain won’t allow me to see it – even if I ask it politely to let me see it.
So what I’m doing lately is watching youtubes on alcoholism. It’s all so very familiar. So first person. Every alcoholic will tell you, unless you’ve experienced it, you can’t possibly imagine what it’s like. It’s like sex. Until you actually have great mutually passionate sex, you can’t possibly know what it’s like. And then even after, you can’t know – your memory can’t hold that information – memory doesn’t work like that. It can hold some concepts, smells, and imagery, but not such intense sensations and feelings.
I often get the urge to share the youtube vids that I watch, but I watch so many very interesting and informative ones, that I don’t bother. Maybe I’ll make a post and copy and paste them into it, so over the years there will be hundreds of them that I find interesting. Oh, wait, that’s called a youtube channel. Hmm. Maybe I’ll do it here anyway.
For now I’ll just copy some about alcohol, here.
Severe and long lasting (some most likely permanent) brain changes happen to long term heavy drinkers.
I have all risk factors, started at age 11, and therefore at age 11 had a 50% chance to get alcohol abuse disorder. I now score 11 out of 11 symptoms on the AUD score in the DSMV 5 manual, where a score of 6 or more is their most severe rating.
I also stopped drinking for 4 or 5 years in a row within the last 8 years, and since then never drank consistently for more than a handful of months at a time, and for the most part would just peek my head in the rabbit hole instead of explore it. I’ve also stopped for one or more years at a time several times before. But other than that I was a regular drinker since age 11 and pro drinker since age 16. So I can expect that my brain is no longer suitable for moderate drinking, and until there is new technology that can undo those changes, will remain so forever.
If you have kids, please educate them to wait until 21 to start drinking. Knowing my family risk factors, if this video was available to me back then, I might have actually listened.
What the above video explains is that people who have progressed in their AUD brain changes have the exact parts of their brain that would make them want to drink, feel horrible during withdrawl, and be willing to not seek out new drinks to feel better, all damaged. Plus we grow strong habit area of the brain neurons are very succeptible to the cues we associate with drinking. For instance for me it’s dangerous to even go to the beach, just because I’ve drank there so many times before.
The dopamine receptive areas of the brain responsible for day to day happiness and pleasure take more than 1 month to just begin to start to grow back. I’m remembering it takes over a year – maybe over two – to really steadily feel good and not crave a boost from a bottle on occassion.
For me lately the day after what for me is moderate drinking – 500 ml, or 20 shots, is a day of withdrawls where I really don’t feel good. It’s not a physical hangover, so much. It”s the mental feeling bad.
So there’s my motivation. I’ll keep watching these videos. They will help me remember why I truly don’t want to feel very great for a day or two or three, using booze. Because I really do feel fucking great when I drink. Always have – until it gets very regular – then I’m just first working to get back to feeling normal, and eventually the good feelings diminish.
I remember a bummer of a night, maybe 20 years ago, out on the town. I kept drinking more and more trying to get disinhibited so I could more easily approach girls. It never happened. The booze simply stopped working that way.
Great drug. It’s the brain that adapts to it that is the problem. And some of us have genetic and epigenetic predispositions to fast and severe adaptation to alcohol, plus severe overal brain changes. Plus of course genetic reasons to drink in the first place, as self medication, that at first works very, very well.
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A lucid explanation of the shocking similarities between various types of addictions, including internet addiction, sex addiction, love addiction, heroin, alcohol, gambling, etc, and the neurological underpinnings of how addiction functions. I love this reductionism from mind to wiring. It’s strangely satisfying.
I’m looking into reversing the damage to gaba and dopamine systems with some pharmaceuticals. The gaba system can be fixed with flumazenil https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014019/ . Dopamine receptors can be regrown using anti-psychotics, however those also cause dementia, however the neurotoxic effect of anti-psychotics can be reduced or eliminated with some anti-oxidants such as vitamin e and ALA.
This video needs to be fast forwarded past the long intro and slow build up, but again really shows the strong correlations between damaged brains and the ability to make choices, and what choices we make. Brain damage is not exactly reversable, but types of repair, or restructuring in a positive way are possible.
Here is a screenshot from the above video. Interesting how many of my personal activities have been addictions, including sex, relationship, and work. Even cults, you could say, as I was heavily involved in Buddhist groups. Media and food are there. I gave up video games ages ago, thankfully.
More about damaged brains and correlations to crime, anxiety, mental problems, choices, etc. He doesn’t explain his rehabilitation program, which I find sketchy, because it’s a portion of his income source. Brain rehabilitation is a thing, but when it’s an income source, the sellers of the treatment have an incentive to obfuscate what is their treatment (because they don’t want you to know the info for free) and exactly how efficatious it is.
Alcohol abuse causes major problems in the dopamine system. Coincidentally, one treatment for chronic stomach inflamation, that I have very badly at times (sometimes near life threatening), is to use drugs that target the dopamine system. One antipsychotic, and an antidpressent that removes dopamine from the brain. The effect of these are to regrow the d2 dopamine receptors.
Nortriptyline (30 mg/day) CAS Number 72-69-5 or 894-71-3
Fluphenazine (1.5 mg/day) CAS Number 69-23-8
Ketamine also resets some other damaged receptors (including opioid, and others that I forget which), but is also highly addictive, and causes serious damage to the bladder, and possibly heart, if abused. Addictive drugs to treat addiction are of course dangerous for people who have the parts of their brain that make choices about rewards damaged. None the less, judicious use of ketamine, along with flumazenil to reset the gaba receptors, an antipsychotic to stop dopamine receptors from receiving as much signal and Nortriptyline to sequester dopamine from the brain, would all work together to rebalance the broken reward and stress systems.
Bupropion is another antidepressent that helps with chronic inflamation. I’ll research more into it’s use for alcohol addiction recovery – I would guess there are rehabilitation effects.
Dopamine is involved in motivation – even long term motivation for rewards that come from school or work. I have been unable to get myself to do any money producing work for over a year. There are some PTSD type of reasons for this, regarding betrayals, thefts, and persecutions related to how my last company dissolved, but brain chemistry is a big fucking deal. There can be feedback loops of pathology, and chemical fixes are often not only helpful, or even more helpful than lifestyle fixes, they can be absolutely required in order to just begin to make the lifestyle changes.
I take ritalin regularly as a stimulant, initially to combat the brain fog and sleepiness caused by my stomach and inflamation problems. It increases dopamine.
Apparently melatonin reduces dopamine at night, and dopamine and the circadian rhythm is connected and can be disrupted by dopamine altering meds. So I’m researching if low dose anti-dopamine meds (which are all antipsychotics, also called neuroleptics) can be used at night time, so that dopamine receptors can regrow during sleep. The side effects look scary, and I’m not finding enough research for the field of addiction treatment, but I’ve heard that there is some. Searching searching.
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One ex addict Dr. and expert on addiction mentioned in an above youtube talk that the pathology of addiction is one of learning that involves several brain pathways, especially the dopamine reward system. The learning makes us think differently about what is intention and choice, and ultimately free will. From a biological view, we associate the dopamine surges with environmental cues, and what that looks like to an addict is that if you go to the same places where you used to get your dopamine rush, you’ll have intense cravings to recreate that rush. The mental self talk will get quite weird – it will only support ideas that agree with getting the dopamine hit – you won’t be able to remember the reasons why not, and you will be able to remember the reasons why to. At least, on the whole – you’re mental talk might fight a bit, but your actions will happen, and the mental talk might bother to back rationalize.
One type of environmental cue is simply stress. The last time I drank, it was after hearing Vs voice, which saddened me quite a bit. So I drank, and I felt a great deal better. I felt quite good. The self medication worked perfectly. The problem came the next day when my brain chemicals were way out of wack because of alcohol withdrawls (which alcoholics feel very differently than others) and I felt even worse than before drinking, specifically about V.
After I blogged about her, I felt much better, and it’s as if a weight has lifted. I got more clarity the last time I blogged, and was able to let go much more. Blogging can really be quite therapeutic.
I figure I’m an addict in recovery – I’m a sober alcoholic who is prone to and often relapses. So I’m learning as much as I can about the underlying brain and neurochemical processes, and the ways to recover as much healthy brain function as possible, so that I can be as happy, productive, and socially positive as possible.
I’ll certainly be ordering the gaba resetting medicine, and more melatonin. I don’t think we have properly targetted anti-dopamine drugs yet – and may never have them. Those might need to be injected into specific parts of the brain to have the proper effect. Dopamine does many different jobs, in many places of the body. You can’t just lower or increase it everywhere with a drug that runs everywhere in the body – that fucks up the system. You can wind up with parkinsons, or various other problems. It’s all extremely interconnected and complicated.
It might still work and be helpful to have a d2 antagonist used at low dose at night, along with antioxidants, however I’ll need to see good research. I don’t want to be a guinea pig with so much at stake.
For now I’m focusing on rather extreme lifestyle choices to repair the dopamine and other systems. I have long experience with chi-kung and mindfullness meditation, and am putting extra effort in that direction. Plus I fast every second day, plus I stopped the ritalin. I’m trying to associate negative moods and hunger with positive long term gain. Sometimes a routine I need to do, such as flushing my nose with salt water, will be painful, and I’m trying to associate pain with pleasure. It used to be like that for me, decades ago – going to the dentist was crazy pleasurable, because intense pain and pleasure were indistinguishable, because my sex life back then was so incredibly intense that the pleasure became indistinguishable from pain.
With dopamine and dopamine receptors, the idea is that if you diminish your pleasure, and especially diminish the pleasure spikes, that you’ll grow dopamine receptors. It’s a bit more comlicated then that, because lack of stimulation and isolation can also lead to depression.
I often notice that with chi-kung, it seems as if I’m directly and conciously altering my bodies neurochemical feedback loops. It’s difficult to describe, but using synesthesia emotional and body states get mapped onto non-existant but real enough energy fields or kinesthesthetic representations of internal states. It’s very sophisticated biofeedback, without any instrumentation.
So my idea is that a quiet contemplative day filled with mindfulness and chi-kung should help get dopamine levels and receptors working more and more towards constant well being. Not big spikes up and down. That’s my goal, and I’m going to be very mindful of that goal the next time I want to get high and feel great.
I’ve had that constant contentment many times before in my life, and even often do quite recently.
But alcohol really fucks that up right fast. Throws me off my diet and excercise plans and meditation schedules too.
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First day off ritalin, went out grocery shopping with the little girl, and the beer and wine and liquor kept grabbing my attention. I found myself standing in front of the wine a few times, wondering what the hell I was doing there.
I was really grateful for the youtube videos about the biological underpinnings of addiction. It was a great emotional and intellectual comfort to get some context for my behaviors and thoughts.
I don’t think it’s a coincidence that I’m stopping ritalin is coinciding with the same crankyness that I get after I stop drinking. Last time I had a serious regular drinking problem and stopped, I was seriously cranky and had heavy cravings for at least two weeks, and it took a month for my mood to improve.
So I googled it and ya, it takes about a month for mood to recover, and can take several more for cravings to stop:
Also in an above video it mentions that the hedonic set point gets fucked up if you keep using drugs that make you swing very high. I recently was taking ritalin together with alcohol, which would give a huge dopamine surge, and I tell you I felt incredibly good every time I did that. Like WOW! Apparenlty it’s quite dangerous to feel that good as an upswing, because the dopamine receptors and system responds by downregulating pleasure in general, so day to day you feel less good. Not good enough. Then it becomes a vicous circle of chasing the dragon – using drugs just to get normal, needing more and more, and getting ill and behaving poorly.
Fuck. If I could spend the rest of my life slightly buzzed and and high on ritalin I would. But I can’t – it simply stops working. Every pleasure drug stops working after a while, according to addicts. Although perhaps for some people low doses work for many years. For others the dopamine system adjusts faster. For instance for some people the recomended dose of tianeptine will be noticable long term, others, like me, adjust within about 6 months and then later can’t seem to notice anything but a massive dose of it.
I vary between 1/2 and up to 2 pills of ritalin, usually staying between 1/2 and 1 pill. When I regularly need more than 1, I’ll stop use for a bit. Why do I want to give up ritalin?
Well, when I was living at the monastery in my early twenties, I even gave up caffeine. Yet I was able to train to be hyper aware yet at the same time calm. That was a great combo. If I’m on stims, sometimes I’ll also want valium. Which of course increases dopamine and is also addictive, and messes with the gaba system, so that you are more anxious than usual when you don’t use valium.
So the brain can naturally be stimmed and alert without drugs – it just takes dedicated training. And the balance is more sustainable and overall works better together – better and more sustainable happiness in other words.
At the monastery I did learn to grow addicted to the meditative state, and would have to always meditate to keep and maintain it. A few months ago I meditated daily every morning, and it made a big difference – things got more colorful and intensely vivid, the same way they do with the ritalin alcohol combo. It’s like going to the gym, or tending a garden. If you want the rewards, you need to maintain the habit. And the habit takes more effort than popping pills and drinking.
But the habit repairs, instead of destroys, your reward system.
I’ve been using as many stimulants as I can get my hands on. Daily ritalin, theobromine from chocolate, and caffeine. Sometimes modafinil.
I’m stopping them all. Looking in the mirror I have a look of pain on my face, and I have this song running through my head:
It’s going to take a while to adapt.
This lovely young woman isn’t just an attention whore; I appreciate her helpful sharing of her personal story:
Some promising news is that you can inject viral genetic vectors into parts of the brain to increase d2 dopamine receptors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030518/ . That’s got to be the future of mood altering medicine – the drugs are too globally acting, and there are problems with the brain re-adjusting to them. We’ll be wanting to directly alter brain receptor densities and make other location specific changes. It should be possible to reset the hedonic set point higher with such mechanical means, as well as to improve concentration, motivation, etc.
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I took a trip to visit a place where I have a many year habit of drinking, even though I know it’s a huge trigger for me. What the research shows is that such places cause several brain chemical changes. One is that the brain not only increases cravings at that spot, but it also expects alcohol, and so adjust brain chemistry as if alcohol is about to (or has already) entered the system. Alcohol calms stress, so what happens is that trigger locations or events increase stress. The craving actually compounds the craving – because the craving at the trigger place tells the brain alcohol is on the way, and it adjust to a brain chemical state that, without alcohol, is experience as stressful, which makes you really really need a drink.
And every time I saw any trigger – signs for booze for sale, it drew my attention like a great young body and face, and each time I had to say no, the stress increased. I could see my will trying to make itself snap.
If I were near those old haunts I’d have to meditate there regularly, to try to reclaim those spaces. For now I’m just using my new location to avoid triggers.
Anyway, I got progressively stressed, just being there, and got a bit cranky. The research compiled by Dr. Kevin McCauley really helped me to understand why and how this happens, and the context gives me better strategies for control. It seems much more workable, knowing what’s going on.
The following doesn’t promise any immediate cure, but at least you may gain the knowledge that there is an underlying biological reason for binge drinking – it’s not a character failing:
https://www.medicalnewstoday.com/articles/323432.php?utm_source=newsletter&utm_medium=email&utm_country=MY&utm_hcp=no&utm_campaign=MNT%20Weekly%20%28non-HCP%20non-US%29%20-%20OLD%20STYLE%202018-10-24&utm_term=MNT%20Weekly%20News%20%28non-HCP%20non-US%29
That’s an interesting piece of the puzzle. Dr. Kevin McCauley also talks about some other pathways that include dopamine and gaba, in a few different parts of the brain, that I think gives a nice wide picture that can correspond to day to day events, for instance cravings and stress at a place a person used to drink. He’s a great speaker, and has done some very valuable consolidating of research. He hopes that the justice system can one day catch up to the science, and I think has done a hell of a job so far to help get us moving in that direction.
Of course it makes us look a bit like robots, but I can live with that.