Dispelling the myths about overcoming alcoholism.
Recent statistics indicate alcoholism directly affects the lives of one out of every five Americans—and many of the alcoholic or the hurt are in our churches. So understanding alcoholism and its treatment is important. To further that understanding, we have adapted the following article from the just-published book Dying for a Drink, coauthored by Anderson Spickard, Jr., and free-lance writer Barbara Thompson. Dr. Spickard is director of general internal medicine and professor of medicine at Vanderbilt University Medical Center, and a frequent speaker on the subject of alcoholism.
When painful circumstances or an organized intervention compel an alcoholic to seek treatment for his addiction, he and his family members are confronted with important questions. Where does an alcoholic go to learn how to quit drinking? What kind of help does he need?
For many Christians, the answer seems obvious. They are skeptical of efforts to “treat” addiction and convinced that alcoholics find deliverance from alcohol only through repentance and personal conversion. As I travel among church groups, I frequently hear people say, “If only he were right with the Lord; then he wouldn’t need alcohol or drugs.” The implication is that addiction is strictly a spiritual problem, and that alcoholics and drug addicts who give themselves to God and faithfully attend church services and Bible studies will be cured of their problem.
I identify deeply with this point of view because it was once my own, and I know it often springs from a deep concern and compassion for addicted people. At the same time, I have learned from painful experience that the search for a “Christian” solution to the problem of addiction usually does more harm than good, and in a sad number of cases it prevents alcoholics from getting the help they need.
When I first began practicing medicine, I avoided alcoholic patients altogether. Hundreds of unpleasant encounters had taught me that addiction was a hopeless problem, and I preferred not to waste my time with “drunks.” Alcoholics I couldn’t avoid, those with acute physical symptoms, such as cirrhosis or bleeding ulcers, I rushed through the standard hospital treatment. They were detoxified with the use of drugs, treated for the most serious of their physical problems, and then discharged back into an alcohol-saturated world to await their next physical crisis.
My only “success” during this period was getting rid of an alcoholic patient who had irritated me for years. Henry was an old fraternity friend, and the more he drank, the more he presumed on our friendship. He constantly pressured me to give him pills for hangovers or to admit him to the hospital for imaginary illnesses. His phone calls came at any hour of the day, and he talked continuously of “unlucky breaks” and lost job opportunities. Finally I had had enough. When Henry called one afternoon threatening to jump off Nashville’s New Memorial Bridge unless I renewed his Valium prescription, I told him to go ahead. He was a pain in the neck, I added, and if he let me know the time of his departure, I would invite our mutual friends. I hung up on Henry without a trace of bad conscience. There were a lot of sick people in the world who wanted help: my time was too valuable to waste on patients, or even friends, who were trying to destroy themselves.
In the early 1970s I went through a revolution in my spiritual life that profoundly affected my attitude toward alcoholics. Like most Southerners from the upper-middle class, I had grown up in an achievement-oriented world of private schools, dance classes, and church services. Except for the months following the death of my father, who was struck by lightning when I was 18, I maintained a distant but cordial relationship with God. I called on him when I was in a tight spot, and otherwise I relied on my own abilities and professional accomplishments.
Over a period of several years, this optimistic self-reliance began to crumble. My responsibilities as a faculty member of Vanderbilt Medical School were increasing, my private practice was expanding rapidly, I saw a steady stream of patients whose illnesses did not respond to conventional medicines. These patients, many of whom had consulted numerous specialists, came to Vanderbilt Medical Center in a last effort to find effective treatment or an accurate diagnosis. Their needs were enormous, and far beyond the range of any doctor.
The stark realities of human desperation began to illuminate my own spiritual inadequacy. I needed something to give my patients, but I also needed something for myself. I began to pray for a deeper, more intimate relationship with God; over a period of several months, these prayers were answered. With help from a perceptive patient and lay renewal ministry within my church, I entered into a new and profoundly personal relationship with God. I surrendered my “M.D.-eity” ego to Jesus, and experienced the joy of having his Spirit fill my life.
After this profound conversion experience I was eager to help my alcoholic patients by leading them into a personal relationship with God. I felt a strong sense of identification with these people, whose lives were out of control, and I knew that if the Lord could rescue me from the bondage of pride and arrogance, he could also rescue others from the bondage of alcohol.
In order to help my addicted patients surrender their lives to God, I spent a great deal of time sharing my testimony with them and writing out prescriptions for selected passages from the Living Bible. I even handed out copies of Perry Como’s recording of “He’s Got the Whole World in His Hands.”
During this time I saw a string of patients (including three medical doctors) who were bright, gifted, and alcoholic. Despite my good intentions and genuine concern for these patients’ spiritual lives, I never cured, or even controlled, a single drinking problem. It was as if my simplistic remedies reduced alcoholism to a spectator sport. With a diagnosis in one hand and a Bible in the other, I could only stand and watch while my patients exhausted the last energies of their talented lives in pursuit of “just one more drink.”
The Impotence Of Will Power
One of these patients was a close friend. Jerry was the toughest, most strong-willed man I ever met, and our friendship went back many years. I knew that Jerry was a heavy drinker, but by the time his embarrassed family brought him to my office, I had trouble believing the results of my own examination. Jerry’s liver was barely functioning, his pancreas was acutely inflamed, and his blood pressure was dangerously high. Jerry spent a week in the detoxification ward, and then, in the presence of his wife and children, I warned him that he was going to die in a matter of months if he did not stop drinking. Jerry was visibly shaken by my diagnosis, and vowed never to take another drink. His family promised to do everything in their power to support his decision, and when they left my office I was convinced that Jerry was on the road to a new life.
Jerry’s strong will to live, his determination to stop drinking, and the constant love and attention of his family combined to accomplish nothing. And despite my prayers, my Living Bible prescriptions, my threats and my pleadings, Jerry never could stop drinking. For over a year I watched in unbelieving sorrow as this remarkable man involuntarily drank himself to death. It was one of the most anguishing experiences of my medical career. Never again would I dismiss alcoholism as a disease of weak-willed persons.
In the midst of this perplexed helplessness, I attended a week-long workshop at an alcoholism rehabilitation unit in Minnesota. My initial skepticism—what was left to learn that I hadn’t already encountered in medical school?—slowly turned to amazement as I watched skilled counselors lead dozens of alcoholics into honest confrontation with their addiction. Many of these counselors were themselves “recovering” alcoholics who had been sober for 10, 20, or even 30 years. The key to their sobriety was a 12-step program that had been in existence since before World War II; now, in every major city and in most small towns, there were successful, well-run treatment centers or self-help groups for alcoholics.
It is difficult to communicate the astonishment and regret with which I digested this information. I was a professor of medicine at a major medical university teaching students the most up-to-date medical science, and reluctantly treating numerous alcoholics. All of these patients, as far as I could tell, were drinking themselves to death, and neither I nor my medical colleagues knew of any reliable or medically sound alternative to benign neglect. As a follower of Jesus Christ and a firm believer in the power of the Holy Spirit, I had tried to fill this vacuum by leading my alcoholic patients to conversion; but even the few who recognized their spiritual need were unable to give up drinking.
Now, after 20 years of medical practice, I was learning that alcoholism responded to a specific program of treatment, and that over a million men, women, and teenagers all over the world were recovering from addiction. I felt it was as if I had spent years unsuccessfully treating diabetic patients with prayer and psychotherapy only to discover that thousands of diabetics were doing quite well by controlling their sugar intake and using insulin. It was a rude awakening.
Before Choosing Treatment
Today, hundreds of alcoholic patients later, I am more convinced than ever that alcoholism is a treatable disorder. My professional involvement with alcoholics and their families has become one of the most hopeful and inspiring aspects of my medical practice, and while setbacks are unavoidable, the joy of participating in an alcoholic’s recovery far outweighs any disappointments I encounter.
Before alcoholics and their families choose among the available treatment options, there are several important points about the treatment process that need clarification. These include the following:
1. No alcoholic should be left alone during the period of physical withdrawal. Alcohol is a depressant drug, and its habitual use results in physical dependence. This dependence is a consequence of the perpetual depression of the central nervous system’s normal activity, and adjustments it makes to adapt to the constant presence of alcohol. When alcohol is suddenly withdrawn, the central nervous system “rebounds” into hyperactivity. The alcoholic experiences withdrawal symptoms ranging in severity from irritability and nervousness to seizures and delerium tremens (DTs). The most common withdrawal symptom is tremulousness, or “the shakes,” which includes an increase in blood pressure, profuse sweating, rapid heartbeat, and sleeplessness. Withdrawal symptoms normally last for two or three days, but they can persist for two or three weeks.
While some alcoholics have little or no difficulty during withdrawal, the majority of addicted drinkers have physical problems of one kind or another. The severity of their symptoms is usually related to how long the alcoholic has been drinking, and how much. Occasionally even short-term drinkers have serious or life-threatening complications. The death rate for unassisted alcohol withdrawal is higher than the rate for heroin withdrawal, and no alcoholic should be alone during this time. Hospitalization is required for most long-term alcoholics, and for any drinker who shows signs of delerium tremens. The DTs include some of the most acute mental and physical suffering known to man: the alcoholic’s escalating confusion, anxiety, and terrifying hallucinations result in a racing pulse, fever, high blood pressure, uncontrollable shaking, profuse sweating, and a high rate of respiratory and infection problems. Fifteen to 20 percent of alcoholics who have DTs die. There is no excuse for withholding medically supervised sedation from any alcoholic who is heading for trouble.
Members of Alcoholics Anonymous are often available to sit up with an alcoholic during withdrawal, and help can be obtained by calling a local AA chapter. Whether withdrawal takes place in a treatment center, a hospital, or, on a rare occasion, at home, the alcoholic needs constant reassurance and loving support to help reduce his anxiety and fear. A special effort should be made to explain to him the nature of his symptoms, and the purpose of any necessary medical procedures.
2. There is no known cure for alcohol addiction. Alcoholism, like diabetes, is a progressive chronic disorder that can be controlled or arrested, but is seldom cured. While a small percentage of alcoholics are thought to return to social drinking after developing an addiction, the vast majority of alcoholics will for the remainder of their lives only control their craving for alcohol by not drinking.
The incurability of alcohol addiction is a stumbling block for some Christians. “I move in Full Gospel circles, and I believe in healing because I’ve seen God heal,” says an alcoholic friend. “But whenever I tell my friends I’m a recovering alcoholic, they say that’s a ‘bad confession.’ They try to convince me that I’m not recovering, I’m healed. Sometimes I’m tempted to believe them and have a little glass of wine—after all, other Christians drink socially, why can’t I? Then I remember. I am an alcoholic. God has healed me from my burning compulsion for alcohol, but all my life I’m going to be just one drink away from a drunk. These friends mean well, but without knowing it they are one of the biggest threats to my sobriety.”
3. Instant healings are rare, and seldom complete. There is no question but that some people are miraculously and instantly delivered from their physical craving for alcohol. We wish this kind of experience happened frequently, but the truth is that instant healing from addiction is no more common than instant healing from cancer, heart disease, or diabetes. God can heal any of our diseases immediately, but such healings are his business; and as a doctor, I have learned that no one can predict if and when they will occur.
The very real possibility of direct divine intervention does not prevent a doctor from administering God’s grace to sick people through medicine and other forms of therapy. Nor does it excuse the patient from the responsibility of participating in his own health care. The diabetic waiting for healing is responsible to control his diet and, if necessary, use insulin. The alcoholic, his family members and friends, have a responsibility to use the tools and principles that are delivering thousands of alcoholics all over the world from the bondage of addiction. To encourage an alcoholic to search for an instant healing while a program of recovery is available is a dangerous form of “enabling,” and it frequently prevents alcoholics from getting the effective help they need.
In my experience, it is often the case that “instant healings” do well for a couple of weeks or months, and then the wheels start coming off. Even if the alcoholic’s physical craving never returns, both he and his family must contend with serious emotional, spiritual, and relational problems related to his addiction. None of these problems will disappear overnight, and we do the alcoholic and his family a grave disservice if we mislead them with a superficial understanding of the gospel. Without adequate information, they will be unprepared to assess their weaknesses realistically, and they will be caught off guard by persisting problems. At this point, even alcoholics who have been miraculously delivered from their physical craving often get discouraged and turn to a bottle for consolation.
