"Cause it makes me feel like I'm a man
When I put a spike into my vein
And I'll tell ya, things aren't quite the same"
And later in the song he says
"Heroin, be the death of me
Heroin, it's my wife and it's my life"
In this love song to heroin Reed tells us what it is about the drug that he loves so much—it transforms how he sees things and makes him feel like a man. But clearly love is not blind, he recognizes the negatives "..be the death of me," but it is worth the risk "..it's my wife, it's my life."
That is the complexity of addiction. Mostly, alcoholics are not completely blind to the problems, but the gains are so valuable. In my own life of addiction I could identify very much with Lou Reed, alcohol and drugs did transform my life, they made me feel alive and in control.
Without them I felt weak and insignificant. The longer I was drinking as an alcoholic the worse this feeling of worthlessness became and the more dependent I became on alcohol or drugs to make me feel alive.
I could see that there were problems, of course I could. However, I minimized them and I always thought that I will sort them out—tomorrow. But please, just let me have this one last good feeling first!
So, why do alcoholics not stop drinking? It is not because they love the taste of alcohol, although they may do. It is not to be sociable, although many will say it is.
It is because alcohol fills the hole where self-worth, confidence (or whatever) should be. It does it quickly and it does it perfectly and, for a short time, there are no problems and everything is right in the world even though everyone, but the alcoholic, can see that these feelings are false and won't last.
So, am I saying that alcoholics never change? Absolutely not. A great many of them have a moment of clarity when there is a real desire to change. The moment is individual to the person and can be something dramatic or profound or they can seem small and trivial.
For me the moment was being told I had 6 months to live if I continued, for someone else it was the look of disappointment on his little son's face, for another it was when he lost control of the car while drunk.
The point is that these moments changed the balance between the benefits and losses of drinking, so that drinking was no longer as attractive. Later, when the alcoholic gets into recovery they can see that what alcohol gave them was counterfeit and fleeting. It is in recovery that they can build real self-esteem as they are no longer reliant on alcohol.