It seems crazy, booze is making him ill, everyone can see that, her friends don't want to be around her, and she can't see that. Why can't they see what everyone else sees so clearly? Why do they seem incapable of recognizing that that there is a problem at all and that it is destroying them? With all these signs of a problem, why do alcoholics not stop drinking?
To anyone who lives with, works with, is friendly with or is associated with an alcoholic it is baffling, infuriating, frustrating, incomprehensible. And unfortunately, unless you have experienced addiction of some sort, it may stay that way. I have been addicted, to alcohol, assorted drugs and tobacco, and at times even I find myself unable to fathom the behaviour of some alcoholics.
Many years ago I worked in an alcohol and drug unit in Scotland. The people who came through the doors were usually severely dependent on alcohol and/or drugs and were admitted for a two to three week detox period. Nevertheless despite how bad they were, there is one particular patient that stands out for me, let's call him George.
Alcohol in large quantities on a regular basis is a poison that can have life threatening effects on the drinker' body. One of the more acutely life threatening conditions is oesophageal varices (this is where the veins in the throat swell up like varicose veins). This condition occurs because the liver is affected by alcohol and can no longer cope, so the blood supply gets backed up and swells the blood vessels like balloons.
The problem is that the veins can burst and the alcoholic can bleed to death very quickly. Drinking any alcohol in this condition can be fatal.
George had a bad case of these oesophageal varices and I had to sit all night with him until he could be admitted to hospital in the morning. His liver was so badly affected that he was bright, almost dayglow, yellow. I don't know how he felt that night, but I was terrified.
The emergency equipment was all laid out and I knew exactly what I had to do, but that didn't reduce my terror one bit. It may seem callous, but I just prayed that morning would come soon and I could hand him over, alive, to someone else's responsibility. Morning eventually did come and I did hand him over, alive. An ambulance arrived to take him to a general hospital where he would have medical attention.
George is dead now, he only lasted a short time, which was no great surprise to anyone. However, it was the manner of his death that was most memorable. One evening after being in hospital for a couple of days, he dressed himself and walked out of the hospital and straight into a pub that was directly across the road. He never made it back to the hospital.
So, what would drive a man to an apparently suicidal act like that? He was not a stupid man, we had chatted at some length the night that I had sat with him and he told me about the successful business he had built. You might suggest that he had a death wish, but there were no signs of depression.
The bottom line was that he did not believe that it could happen to him, despite doctors, nurses, therapists, counselors and his family telling him what could happen.
About 25 years ago, I was a research fellow in the psychology department at Glasgow University. The main thrust of most people's research in addiction at that time was "How do people change?"
This was seen as a great way to improve treatment for alcoholism and drug addiction, and it has led to some interesting and better treatment approaches. I had a different question however.
The question that I was most interested in was "Why do people not change?" The short answer that I found to the question is, that they get so many good things from alcohol or drugs that they don't have a rational view of the bad effects.
So, am I just saying that they drink because they like it? No, it is so much more complex than that. One of my favourite musicians died recently—Lou Reed. Reed was a wild man in his early days and, like many musicians of his generation, a heroin addict.
While he was with the Velvet Underground, he wrote one of the truly great drug songs, it is called simply Heroin. I often played this song to my students when we were discussing the nature of addiction as I think that it eloquently describes his relationship with heroin. Keep reading...
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