Alcoholism: leading cause of preventable death

alcohol abuse

Alcoholism is a treatable disease

Did you know that alcoholism is now the leading cause of preventable death in the U.S.? This is from The Addiction Advisor:

Alcohol abuse is killing Americans at record rates not seen in the last 35 years, according to new research conducted by the Centers for Disease Control and Prevention (CDC).

The research shows that alcohol abuse deaths are now up 37% since 2002, making alcoholism now the leading cause of preventable death in the United States. According to the CDC report, more than 30,700 people in the US died from alcohol-related causes in 2014, including alcohol poisoning and cirrhosis of the liver.

I work in the field and yet I find it as hard to believe as anyone else. After decades of treatment, education and prevention efforts, the problem is getting worse. There just aren’t enough quality providers and not enough advocates who understand alcoholism and treatment of alcoholism. Most people I meet don’t even know how to talk  about alcoholism with the same understanding as say, diabetes or asthma.

The article goes on:

The CDC reports that these numbers do not include deaths caused by drunk driving accidents or homicides/suicides committed while intoxicated. Taking these numbers into perspective, alcohol abuse has now killed more people than the overdoses of prescription painkillers and heroin combined.

We hear in the news concern about heroin addiction, and rightly so, but I haven’t heard the above statistics reported with the same concern about alcohol abuse and alcoholism. The denial surrounding alcoholism is not as bad as it was when I started working in the field in the early 80s, but the denial’s still prevalent. There’s still too little emphasis placed on alcoholism as a major medical problem — doctors and nurses are not trained properly to deal with alcoholism. Even in 2016, alcoholism is still considered a moral weakness by far too many.

It’s mindboggling when you really let it sink in that alcoholism is the number one cause of preventable death in the U.S. This means that alcoholism is treatable. Not only can proper treatment prevent premature deaths, it can increase the quality of life for millions of people and their families who now suffer from alcoholism. Although a lot of alcoholics have received treatment and have recovered through the years since alcoholism was first recognized as a chronic brain disease, we’ve still got a very long way to go.

Alcohol is a depressant

tolerance

A brain trick

Alcohol is classified as a depressant drug, but there’s more to it. Alcohol produces a stimulant effect in small amounts for most normal drinkers. Alcoholics, however, develop tolerance and are able to drink much more than the normal drinker, thus extending the stimulant effect. Regarding the multiple roles played the drug alcohol, this is from a Forbes article:

We hear many different things about how alcohol affects the brain and body, most notably that it is a depressant.  That’s only part of the story. Alcohol is a depressant, but it’s also an indirect stimulant, and plays a few other roles that might surprise you.

Alcohol directly affects brain chemistry by altering levels of neurotransmitters — the chemical messengers that transmit the signals throughout the body that control thought processes, behavior and emotion.  Alcohol affects both “excitatory” neurotransmitters and “inhibitory” neurotransmitters.

The more a person drinks the more the brain is tricked — first, the brain reacts to the increase in dopamine, a brain chemical that produces good feelings, then, at the same time, the more a person drinks the more the alternate, depressant effect takes over causing all the negative effects of alcohol, slurred speech, loss of balance, impaired judgment, loss of inhibitions, and a shut down of the central nervous system if enough alcohol is consumed.

Most people learn how to balance the competing effects of alcohol, therefore avoiding most of the negative effects of alcohol. The alcoholic, though, gradually increases tolerance, extending the feel-good, dopamine effect of alcohol, then gradually becomes psychologically and physically dependent on alcohol. The mean  trick with alcohol is that it eventually damages the liver and the alcoholic can’t extend the feel good period because the live is not breaking down alcohol properly. The alcoholic quickly reaches the negative effects but continues trying to capture the magic, then drinks just to feel “normal” for awhile, because going without alcohol is too painful. The physical withdrawals from alcohol get progressively worse for the alcoholic, thus the dilemma. Also from the Forbes article:

Over time, with more drinking, the dopamine effect diminishes until it’s almost nonexistent. But at this stage, a drinker is often “hooked” on the feeling of dopamine release in the reward center, even though they’re no longer getting it.  Once a compulsive need to go back again and again for that release is established, addiction takes hold.  The length of time it takes for this to happen is case-specific; some people have a genetic propensity for alcoholism and for them it will take very little time, while for others it may take several weeks or months.

It’s needless to say that that alcoholism is confusing and frustrating for a person who never intended to experience this terrible existence. Treatment is necessary as alcoholism progresses, and the sooner alcoholism is recognized and treated, the better for all concerned.

 

The Economics of Alcoholism

alcohol costs to society

Awhile back I wrote a post on the economics of addiction. This new post is focused on the economics of alcoholism and alcohol abuse. First we’ll define an economic term – externalities. Here is an excerpt from an article that discusses externalities related to alcohol consumption and consequences:

 Alcohol use has received a considerable amount of attention in the economic literature because of what economists call “externalities”.  Externalities emerge when two events occur: 1) my behavior impacts your well-being and 2) the price I pay to consume a good is not equal to the price born by society for my consumption of that good.  An externality can be either negative or positive.  If it is negative, as is often the case with excessive alcohol use, the price I pay is less than the costs to society of my consumption.  I consume more of a good than I would have consumed had I paid the full price, and other members of society are negatively impacted.

When a drunk driver runs into another vehicle, major damage is usually caused far beyond whatever it costs the drunk driver. The costs of alcoholism and alcohol abuse to society is in the hundreds of billions of dollars, thus government often attempts to intervene to recoup the costs, such as raising the taxes on alcohol.

In the above article the author makes the point that these government interventions haven’t reduced heavy drinking, and it’s the heavy drinkers who most often create the societal costs related to alcohol consumption. It doesn’t seem fair to punish moderate, social drinkers for the actions of drinkers who are addicted to or who misuse alcohol.

The author suggests that treatment for alcoholics and those who misuse alcohol is the best solution. Knowing what I know about the regenerative power of recovery, I have to agree. Not only will treatment reduce the negative externalities to society, it will increase the positive externalities — what a person in recovery contributes to society far exceeds the cost of treatment.

If a special focus is applied to addiction treatment, treatment outcomes will improve, thus more recovery, thus greater benefits to society. Many of those alcoholics who cost society billions of dollars annually will begin adding to society. This makes too much sense, I guess. Just kidding, but it’s easy to become jaded and skeptical when you know there are better solutions, yet the solutions are ignored or half-heartedly applied. We’re living in complicated times, and innovative solutions are needed to deal with our myriad social problems. Alcoholism is treatable, but it requires a great deal of effort — it also depends on smart and dedicated men and women getting into the field to contribute their talents.

The Damaged Alcoholic Mind

psycholical effects of alcoholismScience is learning more and more about the biological damage to the brain caused by alcoholism, and there are more and more medical treatments to help ameliorate the damage. The biological damage is the easiest to understand. The alcoholic mind is harder to understand. What’s difficult to deal with is the lingering psychological damage caused by alcoholism and past behaviors under the influence. This post is about alcoholism, but most of it pertains to addiction to other drugs such as opiates, cocaine, benzos, etc.

Once an alcoholic has been abstinent from alcohol for a period of time, the psychological damage is easier to assess. During active alcoholism and early withdrawal, alcoholics are often misdiagnosed psychologically. Alcoholism causes strange, irrational behavior (rational to the alcoholic, but irrational to others), and most alcoholics are anxious or depressed due to the consequences of alcoholism. The depression is also due to the fact that alcohol itself is a depressant.

The recovering alcoholic can experience intense, painful and persistent feelings of shame, fear, anger, depression, and any other feeling known to man. If these persistent emotions and states of mind are not dealt with, sobriety becomes an unbearable experience. If the painful, confusing, disorienting emotions and the uncomfortable states of mind are not dealt with, the recovering alcoholic is at risk for relapse. Most often, group therapy, counseling, support groups and behavior changes are enough for the painful emotions to subside, but if the depression or anxiety continues, a doctor who understands addiction should make appropriate recommendations — there might be a dual problem of alcoholism and depression or alcoholism and anxiety or alcoholism and some other mental health problem.

In treatment we help clients deal with their emotions and states of mind as they relate to alcoholism. Once the alcoholic (the drug addict of any sort) accepts their condition and understands that changes are necessary, the combination of talking therapy and a plan of action enables the person in recovery to perceive his/her reality as it is, and to begin changing that reality. If a person is going to change they must first acknowledge the starting point.

Often, the starting place is not pleasant, to say the least. The person in recovery doesn’t like admitting that they’ve hurt and alienated loved ones, wasted their savings, lost another job, have a DUI on their record, but reality is reality and nothing much can change if the person denies reality or blames other people, places or things. There’s a misunderstanding among much of the public regarding the disease concept of alcoholism — many people think that calling alcoholism a disease, which it is regardless of what the public thinks, is a cop-out and that it lets the alcoholic off the hook for responsibility. I hear non-alcoholics say all the time that no one poured the alcohol down the alcoholics throat. This is a simplistic way to perceive the problem.

What we do in treatment is educate our clients about the chronic brain disease of addiction, then the clients are responsible to do something about the problem and to answer for past behaviors. No one is getting off any hooks — in fact, it’s quite a rigorous and emotionally exhausting process dealing with past actions and the present consequences from years of irrational behavior and impaired judgement.

When the alcoholic understands the condition of alcoholism, then they can do something about the condition. If the alcoholic is simply condemned, berated and shamed, the problem only gets worse – if the person doesn’t understand that alcohol, and how alcohol affects their brain, is the main problem, they might try to do the right thing but continue to lose control of the alcohol and create more problems for themselves and others. The alcoholic who doesn’t understand his/her condition might stop drinking for awhile, start feeling better, straighten out problems, then think that they can drink responsibly again because they’ve become responsible and clear-headed. In fact, when family and friends tell someone in treatment that the disease concept is a cop-out and that the person only has to tighten up and control their drinking, they’re setting the person up to drink more and to continue the progression of alcoholism.

Recovering from alcoholism is difficult, but it’s worth the effort. Recovery requires abstinence, first of all. A recovering alcoholic has to understand their condition regardless of whether others understand or not. The reason Alcoholics Anonymous is so effective for long term treatment of alcoholism is that other recovering alcoholics understand what alcoholism and recovery are about. The average person, although they might have good intentions, doesn’t fully understand. The family member or friend can help, though, just by understanding they don’t understand.

Alcoholics drink every day

alcoholism treatment

Facts about alcoholism

Another myth about alcoholism is the idea that to be an alcoholic you have to drink every day. There are different types of alcoholics and different stages of alcoholism.

Not every alcoholic drinks every day, although most alcoholics in the late stages of alcoholism drink daily as long as they can physically withstand the consequences. Some alcoholics, though, are periodic drinkers. A periodic drinker who is also an alcoholic will go on what’s been termed “benders”. The periodic might drink to excess for 4 or 5 days then suffer the hangover and withdrawals to stay sober for 2 weeks or a month, then go on another bender for another 4 or 5 days.

The problem is what alcohol does when the drinking begins. Alcoholism also has stages. No one goes straight to late stage alcoholism when they first start drinking, so there might be years in which the alcoholic can control his/her drinking to a certain point, then lose control at another point. Some have called this controlled and uncontrolled drinking. If a person has to exert energy to “control” drinking, this could be a symptom of alcoholism. Normal drinkers don’t have to exert energy to control their drinking — they can take it or leave it.

An alcoholic’s drinking increases in frequency as the alcoholism progresses and it becomes harder and harder to control. Many alcoholics deny they have a problem because they can stop for periods of time. In order to diagnose alcoholism it takes a number of signs and symptoms, so the ability to control the drinking in the early and middle stages doesn’t mean the person is not an alcoholic. Below from alcoholreham.com is a list of stereotypes regarding alcoholics and how stereotypes are not always valid:

The usual stereotype of an alcoholic includes a list of characteristics including:

* Someone who doesn’t have much money.
* Drinks cheap alcohol – often from a paper bag.
* Is unable to hold down a job and may even be unemployable.
* They are usually estranged from their family.
* Physically or verbally aggressive.
* Someone who drinks every day.
* Someone who drinks alcohol as soon as they wake up.
* They frequently suffer from blackouts where they can’t remember what has happened.
* They have made a mess of their life.
* They will probably be wearing cheap clothes and have poor personal hygiene habits.
* They enjoy drinking alone.

While there are certainly alcoholics who do fit in with at least some of the characteristics of the stereotypical alcoholic the majority do not. In reality an alcoholic can:

* Have plenty of money and nice possessions.
* Only ever drinks expensive beers or wines.
* Is highly successful in their career and their work colleagues respect them.
* Are loved by their family and friends.
* Never become aggressive when alcohol. They may even be able to completely hide the fact that they have been drinking.
* They are able to stop drinking for days at a time.
* Never drink in the mornings.
* Never experience blackouts – or at least don’t remember experiencing them.
* Are highly respected in their community and thought by many to be a successful person.
* Wear expensive clothes and are always well groomed.
* Rarely drink alone.

Understanding Alcoholism

destroying the myths of alcoholism

About Alcoholism

If I could recommend only one book to gain a comprehensive understanding of alcoholism, I would recommend Under the Influence. There are so many myths associated with alcoholism it’s truly amazing, and I’ll bet that the average person who reads this book will be astounded at how much they learn. This book will likely astound even healthcare professionals who think they understand alcoholism.

Even in Alcoholics Anonymous there are still old-timers who tell new-comers to eat something with sugar in it to kill the craving for alcohol. Not a good idea, and the book will tell you why. One reason  there’s so much misunderstanding regarding the myths and realities of alcoholism is our definitions. Most people call all problems related to alcohol either alcoholism or alcohol abuse, yet the two are different in fundamental ways.

A “problem” drinker might not be an alcoholic. Alcohol is selectively addicting. About 10% of the people who drink become alcoholics, and that’s based on physiological factors that aren’t present in 90% of drinkers. The “problem” drinker might simply misuse alcohol when things are going wrong. The alcoholic drinks when things are bad, good or indifferent. The alcoholic drinks because he/she gradually becomes physically, mentally and emotionally dependent on alcohol.

You’ll never understand the alcoholic until you understand alcoholism itself. The reality of alcoholism doesn’t excuse the alcoholic of all actions under the influence, but it does explain a lot, and when the alcoholic is treated and understands alcoholism then the person is responsible to do something about the condition. Understanding alcoholism is not about excuse making, it’s about learning how to treat or deal with alcoholism — it’s about what works and what’s counterproductive or deadly harmful.

Society can continue to look down on alcoholics as moral weaklings, failures or irresponsible jerks, but this will only compound the problem. More importantly, though, is what the alcoholic understands about his/her drinking. Regardless of what society thinks of alcoholism, the alcoholic must know the truth if recovery is to ever happen.

 

If you have an alcohol problem…

seeking treatment

Do you have an alcohol problem?

Here is a simple test to determine if you have an alcohol problem, or if someone you know might have a problem.

Alcohol use disorder (AUD) is a medical condition that doctors diagnose when a patient’s drinking causes distress or harm. The condition can range from mild to severe and is diagnosed when a patient answers “yes” to two or more of the following questions.

In the past year, have you:

  • Had times when you ended up drinking more, or longer than you intended?
  • More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  • Spent a lot of time drinking? Or being sick or getting over the aftereffects?
  • Experienced craving — a strong need, or urge, to drink?
  • Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
  • Continued to drink even though it was causing trouble with your family or friends?
  • Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
  • More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
  • Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
  • Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
  • Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if an alcohol use disorder is present. For an online assessment of your drinking pattern, go to RethinkingDrinking.niaaa.nih.gov.

There’s nothing to lose by talking with an addiction professional to see if you have an alcohol problem, but everything can be lost if the problem is ignored. Millions of people need treatment for addiction, but few seek treatment. In the next post I’ll discuss some of the reasons why so few seek treatment.

Alcohol, other drugs and society

drug addiction

A drug is a drug

In reference to alcohol, other drugs and society, one of the biggest barriers in recovery from addiction is societal attitudes and beliefs concerning the use of alcohol or other drugs. Alcohol is the nation’s socially acceptable drug, yet most people have no idea that, first, alcohol is a drug. When most people think about drugs, they think about pot, cocaine, prescription drugs, heroin, etc., but not alcohol. Alcohol is a drug — it’s just a socially accepted drug. We could have accepted some other drug as our drug of choice to legally sell, but alcohol was the drug chosen. The stigma associated with the use of other, illegal drugs prevents a lot of people from getting help, but a social/legal construct doesn’t have anything to do with how a drug interacts with the brain and body — drug addiction is a health concern first and foremost. It helps to understand the facts about all drugs, especially alcohol. Legal concerns should be secondary. Value judgments made about the use of other drugs are suspect in light of facts about alcohol and the damage it’s done to society.

Advertising dresses up this drug, alcohol, in respectable clothing, so that it’s an escape to the beach, a social lubricant, a romance enhancer, a sports-watching aid, and all that, but alcohol is still a mood-altering drug to which 10% of the people who drink alcohol become addicted. Even health professionals who know alcohol is a depressant drug talk about alcohol as if it’s separate from other drugs — they will say “alcohol or drugs” rather than “alcohol and other drugs”. Ideas about “good” alcohol and “bad” drugs are ingrained in society, so much so that it’s difficult to have an objective discussion. A drug is a drug, and alcohol does more damage to society than all other drugs put together. Making a decision to drink alcohol when one comes of age shouldn’t be an easy, automatic decision. There’s a lot to be said for living a drug free life. At least a person needs to know the facts before making such a big decision.

Many people are irritated with talk about alcohol and the damage it does — they’re likely protecting one of the few pleasures they have left. Most people drink responsibly and have no problem with alcohol, but that doesn’t mean we shouldn’t know the facts about alcohol and to put its use as compared to other drugs in perspective. This is from NCADD.

To get a better understanding of how devastating alcoholism is in our country, here are a few figures from the Centers for Disease Control and Prevention (CDC):

  • 88,000 deaths are annually attributed to excessive alcohol use
  • Alcoholism is the 3rd leading lifestyle-related cause of death in the nation
  • Excessive alcohol use is responsible for 2.5 million years of potential life lost (YPLL) annually, or an average of about 30 years of potential life lost for each death
  • Up to 40% of all hospital beds in the United States (except for those being used by maternity and intensive care patients) are being used to treat health conditions that are related to alcohol consumption

Over time, excessive alcohol use, both in the form of heavy drinking or binge drinking, can lead to numerous health problems, chronic diseases, neurological impairments and social problems, including but not limited to:

  • Dementia, stroke and neuropathy
  • Cardiovascular problems, including myocardial infarction, cardiomyopathy, atrial fibrillation and hypertension
  • Psychiatric problems, including depression, anxiety, and suicide
  • Social problems, including unemployment, lost productivity, family problems, violence including child maltreatment, fights and homicide
  • Unintentional injuries, such as motor-vehicle traffic crashes, falls, drowning, burns and firearm injuries.
  • Increased risk for many kinds of cancers, including liver, mouth, throat, larynx (voice box) and esophagus
  • Liver diseases, including fatty liver, alcoholic hepatitis, cirrhosis
  • Gastrointestinal problems, including pancreatitis and gastritis
  • Alcohol abuse or dependence – alcoholism.

Alcoholism has little to do with what kind of alcohol one drinks, how long one has been drinking, or even exactly how much alcohol one consumes.  But it has a great deal to do with a person’s uncontrollable need for alcohol.  Most alcoholics can’t just “use a little willpower” to stop drinking.  The alcoholic is frequently in the grip of a powerful craving for alcohol, a need that can feel as strong as the need for food or water.  While some people are able to recover without help, the majority of alcoholics need outside assistance to recover from their disease.  Yet, with support and treatment, many are able to stop drinking and reclaim their lives.

These are just facts, and the social drinker need not worry — however, given the severity of alcoholism, everyone should know the true nature of the drug alcohol.

Abstinence or Moderation?

alcoholism

Alcoholism or Abuse?

The ongoing debate over whether alcoholics can moderate their drinking or if abstinence is the only solution is not a new debate. Alcoholism treatment arose decades ago as a reaction to alcoholics failing to moderate their drinking. Psychologists and counselors have worked with alcoholics for a long time trying to teach alcoholics to moderate their with disastrous results. Abstinence or moderation? It’s a false choice for alcoholics.

I won’t post any research findings, because I don’t want to give the impression I support the research, but you can find research on Google that suggests some alcoholics can moderate their drinking. The results of the polls are questionable, because they usually rely on self reporting which is unreliable. The alcoholics who are surveyed have been told they can drink moderately, and the alcoholics likely want badly to drink moderately, so their responses are surely tainted by denial and minimization. Denial and minimization are common among alcoholics. To put it nicely, alcoholics aren’t always 100% truthful.

Also, a lot of these studies start from a false premise, that treatment professionals and AA tell all drinkers, alcoholics or temporary alcohol abusers, that abstinence is the only answer. This is not true. If there are not enough signs and symptoms to suspect alcoholism, most treatment professionals will counsel the alcohol abuser on better ways to deal with stress, or whatever triggered the temporary abuse. I don’t know of anyone in AA or the addiction treatment field who tells everyone who drinks who has any problem at all associated with alcohol that they need to stop drinking forever. So the premise of some of these studies is false.

Telling someone, with no history of alcoholic symptoms, who abuses alcohol for a period of time after a painful divorce that they can deal with the divorce and most likely drink moderately in the future is not dangerous. A healthcare professional telling an alcoholic they can drink moderately is malpractice. There’s a mountain of evidence regarding alcoholics attempting to drink moderately who’ve failed and died early deaths. There might a relative handful of reported cases in which an alcoholic drinks “moderately”, but how reliable is this information? How long are the alcoholics followed? Are the responses to the surveys corroborated by family, employer and friends? Is the “alcoholic” someone who simply abused alcohol for a short period of time?

Go the alcoholic ward at a local VA and spend a couple of days, then tell me if you would suggest to any of these alcoholics in late stage alcoholism that they try to drink moderately. When professionals manipulate research to prove one of their pet theories, they have to realize that what they put out there erroneously as scientific research can do a lot of harm if it’s not based on solid evidence and facts.

The Alcoholic’s Delusion

problem drinker vs alcoholic

The Alcoholic’s Delusion

In the book Alcoholics Anonymous there’s a passage from the chapter More About Alcoholism about the alcoholic’s delusion:

Most of us have been unwilling to admit we were real alcoholics. No person likes to think he is bodily and mentally different from his fellows. Therefore, it is not surprising that our drinking careers have been characterized by countless vain attempts to prove we could drink like other people. The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing. Many pursue it into the gates of insanity or death.

We learned that we had to fully concede to our innermost selves that we were alcoholics. This is the first step in recovery. The delusion that we are like other people, or presently may be, has to be smashed.

There are healthcare experts who say some types of alcoholics can drink again, but it has to be determined if the studies on which this claim is based used problem drinkers in their studies or alcoholics. Plus, we have to look at so many factors in a study like this, it’s almost impossible to determine facts. Self-reporting is suspect, so if you go by whether the person studied is not drinking like he once drank and is not having the problems he once had, you also have to look at what happened to the person during the period of abstinence. If there was a period of abstinence in which the person studied improved his life, then when he started drinking again his life might not have fallen apart again in a short period of time. It takes awhile sometimes to tear down what’s been built. The person could be using all his will power to hold it together, and wants so badly to prove he can drink he ignores how miserable this effort has become and that it’s likely a matter of time before he loses all control again. Social drinkers don’t have to exercise all their will power to “control” their drinking — the social drinker can take or leave alcohol — alcohol is not that important to the social drinker. It’s just very difficult to get real information in situations like this when the study is not controlled and there’s no way to know what’s really going on with the person studied.

Having dealt with alcoholics for 18 years, I see people stay sober for years, then drink, then have serious problems as a result of the return to drinking alcohol. No one has yet come up to me and told me about their successful return to drinking, if the person was, indeed, an alcoholic. Many have tried, but I see them returning to treatment befuddled as to why they thought they could drink again after what happened before. Drinkers who have no history of alcohol problems, then start drinking heavy after a divorce because they don’t know how to deal with the painful emotions, will likely adjust their drinking later on after the pain subsides, but these drinkers aren’t alcoholics, never had the signs of symptoms of alcoholism, so, yes, they can most likely drink successfully later on — but let’s not mix temporary problem drinkers with alcoholics — it’s dangerous to fuel the alcoholic’s delusion.