Wednesday, August 28, 2013

Booze or the band: Ultimatum to Bon Jovi guitarist points out flaw of coerced treatment

From my Aug. 28 news article...

Guitarist Richie Sambora was booted from the band Bon Jovi for ongoing alcohol problems following a hit-rehab-or-hit-the-road ultimatum, according to reports of a secret intervention on   The website's Aug. 27 exclusive claims Sambora refused and was kicked off the current tour by bandmates.

The apparent failure of the intervention points to the difficulty involved in forcing compliance to an alcohol-free lifestyle.  Faced with losing his position in one of the most successful touring acts and even with reported doctor warnings that Sambora faces possible severe — and life threatening — liver damage, the decision remains the alcoholic's whether he is “ready” to change.  Sambora has been in alcohol rehab facilities for treatment in 2007 and 2011.  The 2011 stint came just days after being discharged from probation for a 2008 drinking and driving arrest.

Treatment professionals remain divided on intervention-style tactics.  Proponents say that while “you can lead a horse to water but can't make him drink, you can make him thirsty,” meaning the intervention can successfully plant the seed that rehab is a good idea.  Opponents argue that no person with the disease of alcoholism will comply with a program until he or she is so “sick and tired of being sick and tired” that they decide on their own to accept help . . . and it is difficult to convince anyone actively drinking that the alcohol is unmanageable.  At issue is the difference between compliance and surrender.

Many alcoholics find themselves at the same crossroad, whether it is through contact with the legal system or a personal crisis such as deteriorating marriage or a vexing professional situation such as Sambora's. 

Psychiatrist Harry Tiebout, prominent in the middle of the last century, often wrote of compliance vs. surrender. Surrender is an acceptance, intellectually and emotionally. “Only when you surrender to the fact that you cannot control alcohol once you become alcoholic,” says Tiebout, “Can you move toward recovery.”  Compliance can get a person closer to long-term recovery, only surrender can keep them there.

The disease is noted for its high rate of relapse.  Louise Bailey Burgess, author of Alcohol and Your Health, says, “Unfortunately, despite desperate determination, the depressing fact remains that not more than 50 percent of those who decide to quit, manage to attain sobriety for the rest of their lives.” Neuroscientist George Koob of the Scripps Research Institute, in Moyers on Addiction: Close to Home, puts the number even higher, with 80 percent of those who have detoxed relapsing within a year.

Detoxing entirely from alcohol takes several months beyond a 28-day treatment program due to tissue changes in the body caused by the chemical.  Even a year later, an alcoholic can feel, “If I keep drinking I’ll die” simultaneously to feeling, “If I don’t have one right now I’ll die” because the body's tissues have been programmed to prefer the alcohol molecule.

As noted in the 2010 book, What the Early Worm Gets, rehab starts when you leave rehab.  A rehab facility is only the start of a really long road that has a speed limit and cannot be sped up to 28 days. If an alcoholic doesn't want to be on the road to begin with, it is unlikely he or she will stay on it. “A person enters therapy insisting he wants to change. Nobody wants to change really. When coerced medically or by family or the courts, what you really want is to remain the same and have therapy make you or your interveners feel better.”

The problem a lot of alcoholics face early in sobriety or while actively drinking is the illusion that they are leaves who don’t think they’re part of a tree. “I’m unique.” Surrender acknowledges that nobody with the disease is so unique and others have surrendered and lived to tell about it.  Every alcoholic stops drinking eventually, some just aren't alive when that day hits.