Addiction, alcoholism - "I can quit anytime I want to"

There was a fellow in his 60s. He lay dying in a hospital bed. He maintained vehemently that he was no alcoholic - that he could have quit anytime he wanted.

He had gone through three families. But, he saw no reason to think that his drinking had interfered with his family relationships.

He had lost numerous jobs. He had started a business, and experienced some success. But that, too - gone. But - no, boozing was not an issue.

And, even in his hospital bed, he continued to deny that drinking was a problem - as he lay dying of cirrhosis. OK, drinking wasn't a problem for you. Staying sober was.

STEP ONE: Admitted we were powerless over alcohol, that our lives had become unmanageable.

I'm Rick, and I'm alcoholic. I've heard the stories, and met some of the people. I have more familiarity with addiction than I ever wanted to have. I've lost friends. One of my alcoholic friends that is no longer with us died of AIDS. What - AIDS? The virus isn't transmitted by a bottle or glass? It is, however, transmitted by unprotected sex, and alcohol lowers inhibitions like few other things.

I'm limiting myself to alcohol in this post because it's the form of addiction with which I'm most familiar. It's been my battle. But the addictive process is the same, whatever the chosen addiction is - heroin, meth, tobacco.

The starting point is genetics. There remains little doubt that there is a genetic component in addiction. This shows in any number of types of studies, including separated twin studies. However, we really have not identified the gene, or the type of deficiency of that gene. Some studies seem to have gotten close. The genetic tie is strong enough that doctors have said "No genetics - no addiction."

If I were talking to someone who was considering that they may have an issue, I wouldn't bring this up. If the person with whom I was speaking could not think of any relative that showed the signs, I have provided a rationalization for their thinking that they do not really have a problem. But, they may think they have no family issues when, in fact, their family is shot through. This is a subject that, even within family, is often just not talked about. Just. Not. Talked. About. Seems odd - alcoholism is a condition, just like cancer is a condition, just as diabetes is a condition. But, if Uncle Bob dies of cancer, hiss family will discuss all the gruesome details of the treatment, and will freely discuss the cause: "You know, all those years he smoked like a potbelly stove." (Never mind that smoking is an addiction, too.) But, if Uncle Charlie dies of cirrhosis:"Well, you know he was really sick."

Genetics is the one factor no one can change, and if the alcoholism of family members is off-limits, then anyone in the family is defenseless.

If there is a genetic predisposition (and, remember, genetics is not destiny), then frequently item number two is some sort of mental illness. Counselors and treatment facilities often refer to "dual diagnosis" - the discussion of what issues confront the patient besides alcoholism. My issue is depression. I know well the feeling of being sucked into a black hole from which I see no escape. A lot of alcoholics don't even like the taste of the stuff, but we think that, at first, the booze served a useful purpose. It was anesthetic.

Depression is not the only condition that can lead to seeking some sort of chemical relief. We have a lot of bipolars among us, and quite a few social anxiety disorders. PTSD is not an area of my expertise, but I would not be surprised to find out there's a link between somebody's being a combat veteran and that person's being an addict.

I don't want these posts to get too long, so I'll resume the topic in subsequent posts. But there are two points that I would stress if I were making public presentations about this (and I have):

• If you are a youngster, the only drink that you can be sure that you can control is your first one. After that, who knows? Some alcoholics develop their addiction over years. Others are gone with the first drink. You don't know which one you are.

• If you already have this issue, DO NOT SURRENDER. Alcoholics have a huge suicide rate. So do their families. But - THERE IS HELP, AND THERE IS HOPE. But you have to accept it.

And make as your mantra: One Day At a Time.

STEP TWO: Came to believe that a power greater than ourselves could restore us to sanity.