Moderation management....

[timer lady]

My husband is a problem drinker with a diagnosis of bipolar. He approached his psychiatrist on moderation management as an approach for his drinking issues versus the 12 step AA program. (psychiatrist changed the diagnosis from alcoholic to problem drinker after the BiPolar (BP) diagnosis at his last hospitalization.)

Ultimately, he hates the lack of accountability or personal responsibility in the AA program...the line that he is "powerless" over his choices. He accepts responsibility to choices he's made & is working to change it.

Now that husband is on his medications (& sober) I see an entirely different person; the man I married & it's good to see him again. I seriously have no problem if he has a drink or two.....with a few caveats.

1. Medications
2. Mania/grandiose decisions.
3. Definition of moderation/if husband steps over that line.

I've made no comment on this one way or another. I hold husband accountable for his decisions....let him know that if alcohol ever ever came before our marriage or family again I didn't see any other resolution than separation/divorce. Our family, as a whole (including himself) deserved better. We cannot afford, emotionally, physically or financially, the stress of chronic drinking.

Has anyone seen any other course of treatment for MI/CD issues? husband is very stable & is motivated to stay the same. He resents the AA guidelines.

Personally, I don't care about the diagnosis or treatment plan. Will it work for husband? Has anyone seen a change for the positive utilizing the moderation management plan?

 

[DammitJanet]

I dont know if I would be the one to answer this as I am not a huge drinker. I drink maybe every couple of years socially and have to plan those times around my medications.

The biggest problem I can see with being bipolar and having alcoholic drinks is the medications. Most of them will interact with alcohol. When I know that I will be going out and having a drink with a friend I go off my medications for a day or two prior and dont take them that evening. For instance, I knew we were going to Jamies 21st birthday party and I was going to be drinking so I went off my medications. I had a great time but it isnt something I do often. I havent had a drink since so I am probably not the one to answer this question.

 

[Suz]

Linda, the program name struck a bell when I read your post. I recalled an article in PEOPLE magazine about it. I didn't find that article but a derivative of it from another source. It is not good:

http://seattlepi.nwsource.com/local/mod11.shtml

I don't know anything about alcoholism, I only know how alcohol has affected my family. Rob's birthmom admits to "drinking excessively during pregnancy," no doubt contributing to some of Rob's problems. And Rob has had his fair share of alcohol-related problems. Even more devastating was that my father was killed by a drunk driver 3 months after he retired from the Marine Corps and was starting a new life. He was barely 51 at the time. I was only 20.

For obvious reasons I cannot be impartial on this subject and, with his chemistry and track record, I must urge your husband to please reconsider any thought of trying alcohol in any amount.

Suz

 

[tiredmommy]

Unfortunately, I simply must agree with Suz on this. My mother is more than capable of drinking in moderation. The problems come when she is in a manic phase and feels grandiose because her definition of "moderate" changes. She's really not capable of being objective about alcohol at those times.

 

[hearts and roses]

Did you go to the Moderation Management website?

http://www.moderation.org/

Perhaps your questions can be answered there.

I looked into that program for my H and while he was interested, he feels that moderation is not something he is capable of at this time...and as much as I'd love to differ from that opinion, I have to agree with him.

Best of luck to you h. Mine is 'white knuckling' it since December 1st 2006 and he's supposed to be seeing a counselor but he skipped his last appointment.

 

[kris]

<span style="color: #663366">interesting that you should post this now.

the part of the AA pledge about not having power over their disease has been running through my head for some reason this past week or so. the question that keeps running through my mind is if they don't have the power then who in the bloody he*l*l does?

my husband has a long & bitter hx as an alcoholic. i've never been able to develop much faith in AA. i could go on & on as to why but it will only offend people so i won't.

i never would have believed that husband would achieve a place of moderation, but it seems for the most part he has. he has made friends with-a group her in the complex. he spends every spare moment with-them when not directly involved with-family stuff or work. while they all drink he doesn't come home banging into the walls & reeking after spending time with-these folks. yes, it happens, but more & more infrequently. whatever influence they have over him the rest of us are appreciative of it.

i can't address the issues of your husband's medications or the mania/depression that comes from the BiPolar (BP). as the wife of an severe drunk i can tell you i happily accept the moderation my husband seems to have found. it's all about what you can live with.

kris </span>

 

[donna723]

I may not be the right one to comment on this either, as my “drinking” is limited to maybe a toast at a wedding … the last time I had anything to drink was a “girls night out” with co-workers about five years ago. But I did have an alcoholic father and spent twenty years married to an alcoholic who abused not only alcohol but prescription drugs as well.

Who knows when anyone crosses that line from “social drinker” to “alcoholic”, but by any definition of the word “alcoholic”, my ex- was and IS one! My ex- did and still does live in total denial that he has a problem with alcohol. The term “problem” is putting it mildly! I couldn’t tell you how many times I have heard from him that he DOES NOT have a problem, he could quit anytime he wants to, he just doesn’t want to, he chooses to drink ... blah, blah, blah. That your husband recognizes the fact that he has a problem and takes the responsibility for his own choices and actions is very commendable. I think that the biggest, most important part of making a change for the better.

The way I see it, alcoholism IS a disease. An alcoholic no more asked for alcoholism than a diabetic asked for diabetes! But both are life-long diseases that CAN be managed by closely regulating ones choices. Nobody said it was easy, but the consequences certainly make the effort worthwhile. A diabetic can’t pig out on Twinkies all day and then blame the disease when he gets sick! That’s where the choices come in.

Maybe these “moderate” people are looking at the prospect of “occasional drinking” like the people who have quit smoking but still carry a pack of cigarettes around with them. They can’t handle the idea of “never again”, but knowing that they could if they wanted to makes it a little easier. I KNOW that if he ever quit drinking (which he won’t) my ex- could no more handle an “occasional” drink than I could ever smoke an “occasional” cigarette if I had quit. Just one and I’d be right back in to it, and so would he!

You said that, “I hold husband accountable for his decisions … let him know that if alcohol ever, ever came before our marriage or family again, I didn’t see any other resolution than separation/divorce”. Did he believe you when you said that? He needs to ask himself if that “occasional drink” he would like to have is so important to him that he would risk losing his marriage and family over it if it turned out that he couldn’t handle it!

 

[timer lady]

Oh yeah, Donna, husband took me very seriously. And we've been in marriage counseling; husband has been attending aftercare meetings & such - he also belongs to rational recovery.

And he isn't in denial over his drinking problem. He isn't currently drinking. He just brought this up to me very recently & I wondered if anyone knew of this program & if they have found it to be effective. The little I've read is that a percentage of these members prefer abstinence versus drinking. Another percentage bomb out, while others have some level of success.

I'm on the fence here - there is still no alcohol in the house. husband & I have a marriage therapist appointment this coming week & we will be addressing it.

I just don't care to go on another roller coaster ride in that area. husband knows where I stand if he chooses destructive behaviors over his health, our marriage & our children. He knows that I've drawn my line & respects it. Has told me so in counseling.

Again, just wondered if anyone had been through a program of this type & the outcome.

 

[hearthope]

I would say that the difference in a social drinker and an alcoholic is that the social drinker can say "No thanks, I have had enough" and the alcoholic can't do that.

I would question a program that teaches moderation to a person that can't control the drinking.

You said they changed his diagnosis from alcoholic once he was diagnosis'ed bipolar.

He can not consume alcohol with his medications, so he would have to choose from treating his bi-polar or treating his habit of alcohol.

I hope you find the answers you are searching for.

But to me it seems like he just doesn't want to admit he doesn't have control and to work the steps he would have to.
Do you think he is searching for an easier way out?
Having his cake and eating it too?

I am just throwing out thoughts, I don't know him. only you know the real man. I am just looking back on my dealings with drinkers.

 

[DazedandConfused]

I know that there are alternative programs to AA, but not many (though I did hear of one years ago on Donahue) that subscribe to the philosophy that one who is/was an “alcoholic” that can learn to drink in moderation. I do remember it being scoffed at by “experts” and the audience.

I went through a six-week addiction program 20 years ago that used the AA twelve steps. Like your husband, I struggled, and in the end, simply could not accept that I was “powerless”. How can one be powerless, yet make choices not to cave into the addiction? That, to me, is power. Plus, for me, my whole life I felt powerless over my own destiny, and now I had professionals telling me, no, make that demanding, that I accept being powerless over something that had haunted me my entire life. Frankly, it only made me sink deeper into depression. It is simply not true. I do, and did, have power in that area of my life. Being an agnostic with atheistic leanings, the higher power thing didn't sit well with me, either.

I do not accept that any addiction is a disease. To me it's a way of coping with what life throws at an individual.I know that directly contradicts the AMA and, to be honest, I think they are mistaken. There are no set medical criteria that one must meet to be diagnosed with alcoholism. The truth is that, for the most part, patients diagnose themselves. And the diagnoses are BEHAVIOR based. There is no blood test done, nor is there any type of brain scan, etc, What I was told: “If you think you are, you probably are”.

People in AA will tell you that if you refuse to accept your powerlessness you are doomed to failure. People will also claim that AA is the only program proven to work. However, there is no evidence to this claim because of anonymity, which makes any accurate study impossible. And, the limited studies that have been done, only point to AA’s poor record of success. People would be unwilling to pay for such a program with such a record.

Having written all that. I do not criticize anyone who has been able to abstain from addictive behavior, whether it be drinking, gambling, food, or drugs through meetings and the 12 steps. If it works for you, I’m honestly happy you have found success with it. My own brother, who was King difficult child, has found “recovery” with a 12-step program. I’m thrilled for him, his wife, and children. I hope he stays clean and sober. However, AA is not the only path to sobriety.

As far as the moderate drinking, that’s a tricky one. I am not an alcoholic. My body tells me when enough is enough (Though, I wish it did the same thing when it comes to cookies!). I come from a family of heavy drinkers. My Dad could drink a case of beer and still pass a sobriety test! He could never drink in moderation. Lord knows he tried over the years, but he always went back to the heavy drinking which ultimately ruined his health. Do I think he had a disease? No.

I think your husband needs to be very careful with the whole moderation concept since he is so newly sober. Especially, if he’s taking medication. I’m not saying it can’t be done, but especially to one that is just now dealing with life alcohol free, it think abstaining completely would be wise.

 

[timer lady]

I appreciate your thoughts & concerns over this topic. I'm not convinced it's the way for husband to handle things....medications for his BiPolar (BP) are a priority in my mind.

Dazed, this is exactly how husband feels....if you're powerless, how can you say no to the problem.

I can't say if husband is trying to rationalize things or "make it easier" on himself. I let husband know that my concern (besides the medications) would be HIS definition of moderation.

Ultimately, this would be husband's choice. And the consequence would once again be his to own. husband knows my stance on alcohol over family & himself.

As I said, we have a marriage therapist appointment tomorrow. I am understandably nervous of this type of talk. husband knows my concerns & those will be addressed again in therapy tomorrow.

Since we have started marriage counseling things in our relationship have improved 100 fold. We are communicating once again - speaking with-o the anger - with love to one another. I don't want to lose that again.

husband also knows my line in the sand.

 

[dreamer]

I am not sure cuz it has been many many years since I was in a 12 step program, BUT.I think "higher power" is not necessarily a "God"- but rather can be just about anything...including your own conscience. Or it can be the unity of the group around you.
ANd I think the powerlesssness thing is not that you are a powerless person, but rather that you have been weak in handling whatever the problem is that brought you into a 12 step program, and you admit to being powerless, so to speak, so that you can accept that you need help, guidance, support- to fight your demon. You give up the mindset that you are all so great and wonderful, as if you have some problem that causes you to join a 12 step program, it is a stepping stone to admitting you do not always use the best judgement.
Most people who join 12 step programs do so of their own accord, and if they are joining a support system, they most likely are going to buy into it, they are more likely to be admitting they have a problem and they are more willing to be amenable to being helped.
Do they work for everyone? No, all of us here know there is no one size fits all for anything. Heck, my first husband was diabetic and the insulin he required to live killed him cuz he developed an allergy to it. (that was back in the late 70s, early 80s)
SOme kids do great with Magic 1,2,3. SOme it makes worse. Weight watchers works wonderfully for some, for others it is useless.

Is addiction an illness or disorder? Science has found differences in bodies of some people with various addictions. Gosh not that long ago, lots of things we now call illnesses were not considered illnesses or disorders. Schizophrenics and bipolars were considered possessed by demons.

As for addictions, there are different kinds of addiction, as well. AN addiction where your body craves the substance can very likely be considered an injury or illness or disorder just the same way a cold, or flu is an illness, becuz the offensive substance can alter the body, and it can be considered an injury becuz it can traumatize the body. And if your body has adjusted and adapted to a need for a substance, your body will demand the substance in order to work. Until you are detoxed physically, you can be quite ill without the substance. (and for some substances you can die without the offending substance)

As for the psychological addiction, well, I suppose that is a psycholigical issue.......thinking you need the offensive substance, craving it even after the physical addiction is broken. Scientists have discovered dfferences in peoples bodies that make that craving harder to deal with in some people.
Similar, I believe, to food issues? The amount of food and fluid we really neeed to survive is QUITE different than what we normally intake.
Do you shower daily? How do you feel if you do not shower? How about if you were to go a week without a shower? I do not know about you but I think after 3 days I would be nuts. (no, truth is I am nuts after 12 hours, I am a bathing addict) BUT we do not NEED to shower. AN addict does not NEED their addicting substance. and we do not NEED to bathe or shower at all, ever. We FEEL like we might die if we don't, but we will not REALLY die.

SOmething else to consider is.........what IS the problem the "addict" is having related to ....the drinking? Is it the money they spend for their alcohol? Is it depriving family of things the family REQUIRES? Food for the children? Money to pay the rent?
Is it absenteeism at work and hangovers? Job and financial insecurity?
Is it a problem due to their own health? An chronic underlying illness where the intake of alcohol is a serious health problem, like to their liver?
Is ir becuz they do get drunk, are drunk and do awful things when drunk? Things they do not do when not ddrunk? (LOL, remember some people do awful things even when not drunk, in some it is not the drinking that makes them do those awful things)
Are they simply careless and out of control, and fall etc when drunk, or do they get mean and violent when drunk? abusive?

Which of the associated problems are a problem in the drinking persons mind and which are problems in the drinking persons loved ones minds?
If there is no financial problem related to the drinking and the person can afford the drinking, and they have no health problem, and they do not get too careless or abusive is it a problem? To who? and why?
SOme people can drink one beer and become violent. SOme families cannot afford even one beer.
Some people can drink a case of beer, can afford it and do not seem any different. Are they both alcoholics? Problem drinkers? Social drinkers?

Very rarely will there be any success with handling an addiction unless the addicted person WANTS help. IF they want help, and are ready to stop- then I suppose there are many different programs that MIGHT help.
12 steps, IIRC just happen to be the most widespread, most readily available, most well known, most accessible.......Is there scientific evidence they help? I have no idea. But for me personally it is the only help I have seen where so many have utilized it, and I have seen countless success stories. I know there are people in our area who can choose from 2-3 AA 12 step meetings ANY time of day or nite 7 days a week. And I know some people who spend a HUGE amount of time attending AA meetings, so much time, I have wondered gosh, is this any better than drinking?

Am I gonna knock people trying to do something to help themself? Nope. I'm not.

 

[donna723]

It really is a lot to think about. I know that it is supposed to run in families, and that there is such a thing as an "addictive personality". It's hard to tell if it is a true physical thing or environment - what you grow up seeing. My dads' family had a lot of heavy drinkers, but that's what people did back then! All my dads' brothers drank quite a bit, his sisters more moderately, but my dad the most. And it was just accepted that when you grew up, you drank! Both of my brothers drank, and the younger one, caught up in the Viet Nam era, also did drugs when he was in the military, but so did everybody else in his situation! The younger one realized that, with him, it was all or nothing and hasn't done either drugs or alcohol since back in the 70's! The older one still drinks, and he drinks way too much at times, even though he now has serious medical problems. He would never call himself an alcoholic, but he is one. So who really knows if it's genetic, or just what they grew up seeing and accepted as "normal" male behavior in our family.

And I, coming from the same family, have never had the slightest desire to drink! In the rare social occasions when alcohol is served, I force down a little to be polite and then ditch the rest. BUT, I am probaby just as thoroughly "addicted" to my coffee and cigarettes as they were to alcohol. So maybe there is such a thing as an "addictive personality".

My ex- came from a family where both parents could qualify as alcoholics, his father with a very severe problem and his mother less so. Alcohol truly rules his life - it comes before anything else - his family, his health, everything. And he is not a "funny" drunk! The more he drinks, the meaner and more abusive and irresponsible he becomes. And he has been in total denial most of his life about the affects his alcoholism has had on his life. He can rationalize away anything, and truly believes that alcohol doesn't have the same affect on him that it does on other people. If other people drink and drive, they are a hazard and should be locked away forever - he, on the other hand is, "different" and he can handle it! He really believes this! He also mixes the alcohol with prescription drugs, pain killers, etc. And if he ever did cut down on his drinking, he would just substitute more drugs to make up the difference. Two of his three brothers have already died at a very young age from problems connected with or aggravated by their alcoholism. The third brother drank when he was very young, but then quit completely and has never drank or done drugs again. He is the only one who has had a successful, happy life. But even with them, is it what they grew up seeing? Self-medicating for some undiagnosed mental disorder? Or are they genetically predisposed towards substance abuse? Is it just "wired" into them? Needless to say, I have always been very worried about my children!

 

[skeeter]

I've only know one alcoholic really well, my uncle (my mom's sister's husband).
My uncle could NOT drink at all, or it would automatically turn into a week long binge. There were certain times (holidays and funerals) that we could pretty much guarentee he wouldn't be around, or if he was, he'd be extremely drunk.
He wasn't a "nice" drunk, or a violent one, he was a silent, sulking drunk.
He wrecked every single car they ever owned, but for some bizarre reason, never once did he get a DUI.
He did go to AA, he tried medication.
But he was just so dang bull-headed, that the only way he could stay sober was to stay completely away from it. He was also stubborn in other areas of life - he became a diabetic, but still ate whatever he wanted, he had high cholestrol, but hated chicken or fish, and only ate red meat. He had quaduple bipass, and emphasema, but continued to smoke (he had an electric scooter the last few years of his life, he would go outside the retirement home, unhook his oxygen and smoke - I kept waiting to read about him blowing himself up!).
He was also an extremely intelligent man, who never really amounted to anything. He would gamble away any money he did have. My cousin got out of the house the second she could. My aunt worked all her life, and eventually (and I swear purposely) got senile so she didn't have to deal with him anymore.

If your husband can do this, then more power to him. I just know in my uncle's case, ANY alcohol, including swallowing a bit of mouthwash or taking some Niquil would be enough to throw him.