Sunday, November 30, 2008

What happened on Wednesday - part two, Community Addictions Unit assessment

Have no doubt, the services that deal with addicts of various stripe are stretched and could probably hoover up a whole pot of further funding.

What this means for the patient, service user or (shudder) customer of these services is simply that there's a fair amount of waiting around to be done.

After my counselling on Wednesday I went home waisted (as I do far too readily and far too often) a couple of hours on the Guardian's Comment is Free website and then headed back out for my first appointment with a doctor at the Community Addictions Unit.

And there I sat. The appointment was at high noon and the letter confirming it had told me to expect it to take around an hour. I left in the end at 2.45.

Not that I minded. I avoid going out of the house, partly through anxiety and fear and partly because I know if I do I will sooner rather than later end up in the pub. Sitting in a dingy NHS corridor is at least harmless. It also humbles and shames me: I see others struggling with far harder problems than I have and who are in a plainly evident far worse state in terms of physical or mental health. I sometimes feel a fraud: you should be able to pull yourself together I tell myself as I watch people collect their methadone scrips and read the posters about open wounds and the safest way to inject and clean works using water from a toilet.

The doctor was Asian and quietly spoken and patient. He ran through a long list of questions - asking about my history of drinking (I started pretty early in my teens, developed into a heavy binger and from there to pretty constant and addicted drinking from my late 20s onwards, it's been a problem for 20 years now), use of other drugs, family relationships, mental and physical health, my suicide attempts, where I am now and what I hope to get from the process.

It was all rather cathartic, it's nice to be able to speak openly and honestly to a sympathetic ear. He told me the options: basically in patient or outpatient detox using diazepam. I told him I'd prefer an outpatient detox because that's what I've experienced before and I'm nervous about being admitted to hospital.

In reality, I know this is unlikely to get the thumbs up. There is a risk of fitting during detox and with my girlfriend at work I'll be on my own during the day. I must admit I dread hospitalisation - there surely aren't many people who look forward to spending time in hospital - and the attendant group therapy: I find it very hard to open up to a therapist in one-on-one situations, competing for air in a group is something I'll find incredibly hard. But, perhaps that's something that has to be got through and will induce the sort of cathartic breakdown into real tears that will help cleanse me.

I raised the idea with the doctor that I was a self-medicator; that I find my thoughts very hard to control, and that drink really is the best way I've found to do this. He nodded, but it's early days in the process and the first aim is to get me off the booze, that's the only aim really, the rest may well be down to me. He certainly accepted the fact that I'm currently depressed and said he would write to my GPs to ask them to raise the dose of my antidepressants. "It could be prolonging your problems with alcohol," he said.

I wasn't able to provide a urine sample but had two sets of blood tests down - all I heard was renal and liver function. Despite everything, I think I'm probably in relatively good physical health and I hope there's nothing serious hidden under my irritable skin.

My blood pressure was taken and is apparently good, my pulse was 74 I think, which is a bit high but there's a certain amount of stress in having needles stuck in your arms and I should imagine that would account for that.

I left feeling lighter still. Something's moving at least. It'll be slow I know, the doctor told me to expect another appointment in three weeks and asked me to think more about the treatment options and also to think about reasons why I've relapsed three times before after detox.

(If you are reading this thinking, "You feckless waster of NHS resources that could go to people that are really ill and who chooses the path of addiction," I have every sympathy with your view. All I can say is the hatred and opprobrium of others merely confirms my own opinion of myself (although I doubt anyone could hate me as much as I hate myself), and that I really don't want to be like this anymore and I will try as hard as I can. I want desperately to be a useful person.)

I left at 2.45, knowing I was going to go straight to the C. As I've said, I've avoided the place of late, it's been getting me down, it's the only pub I use where I have people to speak to but they too have their problems and that tends to be what we talk about. As it happened I bumped into my best mate from the all-day-drinking gang, he'd just left the C and was on his way to one of the social/working men's/sporting clubs in the area.

I didn't want to go. The last time I went there was bad. My girlfriend was working away as she often does. While she's here I do much better, I desperately want not to upset her so my drinking stays relatively stable. With her gone the brakes come off. I'd gone out to watch football that time and ended up spending 12 hours on the pop, I'm sure I got mouthy and obnoxious in the club and couldn't remember much after arriving and certainly couldn't recall getting home. That was Jack Daniels. I rarely drink spirits, almost never in fact, I drink pints far too quickly - I drink everything far too quickly and even when I've been dry I've chugged through pint after pint of soft drinks when I go out, it's all to do with nerves I think - so spirits vanish even faster.

As it happened I did fine. Four pints, relatively slowly, after downing the first two.

Again, it was a sobering experience. Most of the pubs I use are filled with habitual drinkers and the club was no different, I see faces not so much damaged as completely wrecked by alcohol. People on the margins and with troubles, often unemployed and with money troubles who spend all day drinking and desperately staring at the horse racing on the screens waiting for a much-needed winner.

A man came in with a terrible facial wound - his left eye was hugely swollen with an open wound beneath it. He said he'd had a plate put in.

"I haven't had a pint since Monday," he said, "so don't look at me I've got the ******* shakes."

The barman offered him a straw.

The place stank of weed after a while. No-one inside was smoking, but it was drifting in strong and unmistakable from somewhere.

I'm angry with myself for trying to score some weed through my mate - which was easily arranged. I've been without for maybe two weeks and I should have accepted that that's a good thing. But, when I'm in my cups I do crave it. I was weak and stupid.

Onwards and upwards nevertheless.

Saturday, November 29, 2008

What happened on Wednesday - part one: cast from counselling and the addiction assesement

I went to counselling on Wednesday morning. A 9.15 start, which is a sharply double edged sword. It's good that I'm not able to wallow in the misery pit that my bed becomes every morning. But, anyone who drinks heavily is never going to be much of a 'morning person' and walking round feeling like you've been smashed in the face by a lorry is not going to make the counselling process easier.

I'd worked myself into a terrible state in preparation of this session. My homework after the last session was to prepare myself for a whopping great dollop of self-revelation. The theory was illuminated in the copy of the worthlessness schema - the counsellor, by listening to the supposedly unbearable secrets of the worthless schema patient, and by still caring for them can show them that what they had done is bearable and they are not beyond the pale.

Sadly, the counsellor seemed to have forgotten that this was the plan and we began as usual with a "How are you?" and my predictable account of stable but heavy drinking and continued stumbling through a numb half-life.

Then she dropped the bombshell, wanting to "Put it on the table," that we should take a break from counselling. This has happened before - I've been prescribed a cognitive behaviour therapy (CBT) book and asked to work through a chapter for discussion at the following session, only for the sessions to drift back to the same old same old.

The title says cast from counselling and that's unfair and far too melodramatic. I could quite easily have said that I wanted to carry on, as I could previously have guided the sessions more strongly. But, expressing my self and leading the way in conversation are very much part of my problems.

I certainly don't feel any resentment towards my counsellor. We haven't really clicked and I've never felt truly comfortable. She almost certainly has too many cases and why should I expect to receive months and months of publicly-funded counselling when little progress is being made and someone else, with much worse problems, could be benefiting. She told me that new users were facing a month long waiting list to even get an initial assessment appointment.

"You're stable and we need to wait for the medical intervention of detox," she said, promising to fit me in ASAP, should I need help urgently; should my drinking increase, or my assessment of my mood pick up on a real down.

Should neither of those scenarios come to pass the plan is for me to come back in for counselling around six weeks before the detox to start work on preparing for abstinence.

I've also been prescribed a book. This is a neat little scheme whereby you are genuinely given a prescription to hand in at your local library. My book is Mind Over Mood, which seems to be the CBT book.

I sensed she was starting to get a little nervous at the end of the session. I was asked to fill in one of those self-assessment forms anyone who's been treated for depression will almost certainly be familiar with; a list of questions about mood (have you felt despairing) with multiple choice options - never, sometimes, often, everyday.

The fact that I remain ticking the often or worse option for all the negative questions made her a little nervous I think - including the, have you thought of hurting yourself.

Sad to recount, I do think about suicide every day. My suicide. It's always there as an option and I'm so used to thinking of it it's a constant background noise. However, it's nothing more than a fantasy - I look at pills but I never have any real intention of taking an overdose and the fact that it's overdose I always think of (rather than the more certainly successful options - and I'm sorry to say that I have visited some of the notorious suicide websites to research this in the past, although not recently) means a 'cry for help' is as far as I am ever likely to go in that direction. I'm simply far too much of a physical coward to take such things likely, I'm also scared of death, I'm very far from a happy camper, but I do still have things to live for. I also have no faith - I've often wished that I had, and, although I'd probably call myself an agnostic at best I do 'pray' - and don't believe I will be swept to heaven when I pass on.

I think I felt slightly lighter, released in a way, and determined to do more for myself. I've ordered the library book and will contact the depression charity offering self-help and volunteer work.


The Drinker.

What happened on Tuesday.

Tuesday seemed a slightly brighter day to me.

The reason was not very substantial and very much of this internet age - I 'spoke' to people. Rather I interacted with them remotely.

Part of the rut into which I've sunk is to log onto the Guardian website each day. Specifically, the Comment is Free section - a robust discussion forum if ever there was one. Seeing an article on cannabis - something I know plenty about - I joined the discussion and got some nice responses.

Although the Guardian is quite the home of the liberal left, a Labour Party house journal even, Comment is Free draws a much broader spectrum of views - in fact the comments tend towards the right in my view. Perhaps it's because the Guardian has that reputation and those on the right see the chance to beard the so-called Guardianistas in their den. Maybe it's simply because the site is the best established, nicest looking and easiest to use (the simple expedient of putting new comments at the bottom rather than the top of threads makes a great deal of difference; that's the way we read innit).

I should stop going there to be honest. I just read the comments generally, not being brave enough to enter the fray myself very often. And, believe you me, a fray it is. The words 'I think', or 'in my opinion' rarely feature in comments, everyone's so fricking certain, it's seldom 'I disagree', it's 'you're an idiot'.

The level of polarisation it reveals in our society I find rather distressing. But, I've never coped well with conflict, I hate it.

A further reason for cheer popped into my email inbox. On my walkabouts I'd seen the offices of an organisation called Journeys, recovery from depression, and in one of my days of real despair I dropped them a line. Partly bemoaning my own unhappiness and also mentioning that I'd been a journalist and was keen to find voluntary work as part of my recovery - feeling useful would be, I believe, a great boost.

Some weeks had passed since I sent the mail, but the reply made my day. They offer a self-help approach, including stuff like diet and exercise, which makes sound sense to me. They also asked me in to discuss volunteering. I haven't replied yet - falling into my slough of despond again - but I shall today and hopefully it will go somewhere.

Just reading up on the coverage of their launch is sobering - not literally in my case.

In Wales, the adult suicide rate is nearly double that of England, while amongst Wales’ young people the suicide rate is five times higher than England’s.

Stereotypes are rarely helpful, but perhaps there is some truth in the idea of the melancholy Celt. It seems more likely that the frightening figures reflect a country that has lost its economic heart.

Silence is rubbish

I've not done too well with my stated aim of writing something every day.

The simple reason for this is laziness, a complete lack of motivation and the almost total fear that can transfix me.

However, part of recovering from alcoholism or any addiction you must learn to fail and, when you fail, to get back on the horse. When I'm in my cups I'm full of great ideas and schemes, the novels, plays and films I'm going to write, the music I'll record and so on. These dreams vanish though, they are as substantial as snow, and in the morning the routine begins again - this half life in permanent twilight.

So today, I'll try and catch up on my week.

Tuesday, November 25, 2008


I failed to write this again yesterday. Oh well. I'm doing it today, trying to keep the old blog lively and interesting.

Is anyone reading? I have no idea.

Saturday, November 22, 2008

Taffy was a Welshman, Taffy was a drunk?

Our culture has chosen alcohol as it's main drug. It's not always an entirely happy relationship though.

I wasn't particularly of the opinion that Wales has a worse problem than anywhere else in the UK, as South Wales Police Chief Barbara Wilding has suggested. I can say for sure that Cardiff seems to have a very healthy drinking culture, if healthy is the right word, but, would imagine that it's no better or worse than most big British cities.

I've heard that Newport is the most violent place in Britain, but have no reason to believe that's anything other than an opinion. The violence, I was told, was caused by large numbers of people from satellite towns arriving in the city on Friday and Saturday nights with the intention of getting plastered. The same certainly happens in Cardiff.

When I went to university among the first friends I made were a couple of lads from Cwmbran, who called Newport 'Stab City' and were the first people I'd met in my sheltered rural life who carried knives when they went out.

Now, I may be a drunk, but I'm no sociologist, so all this is so much anecdotal waffle. But at least Barbara Wilding has got people talking - launching a campaign with churches to cut binge drinking - and you'd have to be blind (blind drunk perhaps) not to see that choosing alcohol, with its estimated £20 billion annual law enforcement and health cost to the economy, as our chief drug is not without cost.

Self-medicating, for what?

I emailed someone about this blog.

They were extraordinarily kind and encouraging, which is nice.

From their own experience they suggested the description of my 'skittering mind' might indicate I had a problem with ADD, or attention deficit disorder.

It's a possibility I think. Many alcoholics and other addicts are said to be self-medicating - using a drug which alleviates the symptoms of an undiagnosed or untreated (usually mental) health problem.

It's tempting isn't it? It's not my fault, I'm ill, is one of the attractions. I'm tempted by the idea myself - and, partly, if I'm honest for the reason I've just mentioned. But, I do see some merit in this is my own case - the first time I ever got drunk it seemed a perfect fit for my mind, nothing had ever made me feel so clear, so happy, so at ease.

I do have a problem concentrating on one thing at a time, my mind flies all over the place and I'm happiest multi-tasking - while doing this I'm listening to the radio, and occasionally checking the comments at a newspaper site.

It's certainly something I'll try and mention at my Community Addiction Unit appointment on Wednesday.

Bright eyed, bushy tailed, online help.

In my misery I signed up on Thursday to the forums at an online alcohol counselling service called Brighteyes. I left a message in their SOS section, but with no instant reply, I haven't returned until now.

It seems a lively community and genuinely supportive. Nothing that can do any harm and with any luck it will do some good.

Checking back, I've received some lovely supportive messages, and I'm determined to log in more regularly. (But, then I'm determined to do a lot of things which I never follow through on).

I'd think about giving it a try if you're on the computer and need someone to talk to - it can be very lonely to be an alcoholic. Some of the stories are harrowing, some inspirational.

A bad day.

Yesterday was not such a good day. No day is at the moment, that's the way it is. But, I'm trying to change my whole life and it's bound to be difficult.

I woke very early, astoundingly early for me. Even so, the streets at 6.30 were starting to fill with traffic as I drove my girlfriend to the station for a day working away.

I promised to make my way through the list of things to do as I dropped her off. In reality, I slunk back to bed, and stayed there till 1pm.

Trying to start my drinking later in the day has been successful so far and yesterday's absence of my partner was dangerous. My worst excesses are committed when she goes away to work, as she does quite often, and as she wasn't due home till 8pm I had plenty of freedom.

To my surprise I didn't cave in as badly as I have in the past. I made it to the library, bought some food for my evening meal and arrived in the pub at the dot of 4.30. I stayed there longer than I usually do and had four rather than three pints, but my total intake for the day was still seven.

I cried in the pub. The catalyst was an article in The Times about a British diplomat who helped Jews escape from the Nazis - that was the catalyst, I suspect the real reason was personal self-pity.

Oh well. I made it through. Only one meal though, which is disappointing; no exercise, which is also disappointing.

Still, I'm still alive, nothing disastrous happened and today is another day - a cold, grey and drizzly one - but it dawned nonetheless.

Thursday, November 20, 2008

Dehydration and walking therapy.

Exercise is supposed to be a great help with depression. Yesterday's walk into town exhausted me, but it felt good to get out into the sunshine - many days I simply feel too dispirited and self conscious to leave the house.

Today, I'm off again. Towards the leafy parks of Roath I think.

Because of the drink I'm pretty badly dehydrated, so I'm also trying to get some water down me each day - as well as start to approach three meals a day, rather than my habitual one in the evening. Some dioaralyte too might help and hopefully have something of an effect on my dry skin.

Onwards and upwards.

Slightly brighter.

A couple of achievements of note yesterday. I say achievements, and to me they are, but anyone reading this is likely to regard them as the sherryiest of trifles.

In an effort to get some routine into my life and improve my self-esteem my girlfriend has been writing me lists of things to do each day. (She really is a wonderfull support and without her love and care I'd be in a much worse state than I am.)

Chief among these is getting up. Easy right? Sadly not. I wake with a hangover, it goes without saying, and have found the mornings the hardest time of the day - I lie in bed hating myself, brooding obsessively on past unhappinesses or my lack of a future.

The last two days - and today - have been better. Yesterday I got up and left the house as my girlfriend went to work. I walked into town.

Once there I found myself overwhelmed and exhausted by the hustle and bustle. But, I managed to make it to the health food shop to buy a stack of vitamins and supplements.

My mother bought me a copy of Optimum Nutrition for the Mind by Patrick Holford. I can see plenty of common sense merit in his theories, although I gather that his ideas (and he claims some marvellous results for the use of nutrition in the treatment of mental illness including addiction) are very far from universally accepted. In fact he's considered a dangerous charlatan by some.

Still, eating better and taking some vitamin pills is harmless, and it makes me feel as if I'm trying to do something - the placebo effect is at least an effect. I've been prescribed vitamins by my GP too because alcohol inhibits their absorption.

So, I have hemp oil, vitamin C, some ground pumpkin and flax seeds and magnesium, calcium and zinc tablets.

Should I be cured immediately, I will of course let you know.

Wednesday, November 19, 2008

Drinking diary.

Anyone who has attended alcohol treatment services will be familiar with the concept of the drink diary.

You write where and when you were when you drank and what you thought, in the hope that you can get to the bottom of some of your emotional reasons for drinking and trying to change them.

Thus, yesterday.

4pm, at the The O, a pint of Stella. Physically relieving, but also distressingly predictable. I've been trying to start my drinking later and later in the day in a bid to cut down. To an extent, I've succeeded in this - I used to hit the pub at about lunch time. Now it's usually 4.30pm. Yesterday, I started earlier. My girlfriend had rung to say she was coming home from work early and would I like to meet her for dinner out - this threatened the treasured routine that guarantees me my current seven a day, so I went to the pub half an hour early.

Yesterday I drank, three pints Stella, one pint Asahi, one watermelon collins, two cans Stella.

We went to a Japanese restaurant. We both like the food and it feels healthy too - mmm, seaweed! Then to a bar. Then home.

Failed at the first attempt.

One of the reasons I wanted to start this blog was to start to introduce some routine into my life - intending to post at least something every day.

I failed on the second day.


Oh well, onwards and upwards.

Monday, November 17, 2008

Appointment confirmed.

A letter has just arrived confirming my appointment with the Community Addictions Unit (CAU) next Wednesday. That's something I suppose - things are moving, I've done the right things in a way, I've admitted my problems and asked for help.

Counsellor has warned me that I am likely to face a waiting list of up to six months and told me that funds are so tight that only alcohol and heroin addicts are getting treatment at the moment, everyone else is being left to their own devices.

The truth is, although I know I am addicted to alcohol and want to stop, I also dread sobriety. There's a reason why I've fallen into drunkenness; I enjoyed it, it was perfect for me. I've told several professionals that I think there is an element of self-medication to my addiction - that it's the only way I can deal with my skittering mind and what I believe is a hugely over-developed inner dialogue which I have difficulty controlling and which tends towards the negative and apocalyptic. That's my schema I guess and what I'm trying to change.

No-one has ever really acknowledged my view or offered any thoughts on it. I'll try again when I go to my assessment.

Finding it hard. Hurting others.

I'm finding things very hard at the moment and I would say I'm as close to despair as I've been for a long while. I'm exhausted, dispirited and depressed.

I'm too tired to do anything and too nervous to leave the house. Eating seems pointless and I've no appetite anyway, everything seems pointless in fact.

My girlfriend collapsed a little under the strain of it all last week and had to take Thursday and Friday off work. She said she was spending so much time and energy worrying about me that she had neglected herself and now she too was exhausted and depressed.

I drank my usual yesterday, which is currently three pints and four cans of Stella Artois. I wake up and wish I hadn't and start the dry retching that begins every day. My stomach is in a mess, I feel permanent mild nausea and have diarrhoea. My skin is revolting. It started when I was prescribed an antidepressant called Mirtazapine, my hands swelled up with a ferocious angry red rash that spread quickly across my body. It's a shame because the pills had been great: I did notice, if not a lifting of my mood, then a slight lessening of the lows. Along with skin eruptions, one of the side affects listed was drowsiness, that was a marvellous under statement, they knocked me out and while taking them I managed to go five days without a drink. Mitazapine was ditched, the skin problems remained. I now take Trazadone.

Frank Sinatra said: "I feel sorry for people who don't drink. When they wake up in the morning, that's as good as they're going to feel all day."

Sadly, I know when I will feel better today, it will be on my second pint, and it won't exactly be feeling good, it will be feeling vaguely human. At least that's better than I feel now.

I keep telling my counsellor that one of the reasons I drink is boredom and loneliness - I'm unemployed at the moment and I've only lived in Cardiff for a year, I don't really know anyone.

I generally use two pubs: The C and The O. I have a small group of friends at The C, but I've decided to stop going there. My pals are all like me - if not alcoholics, certainly heavy and habitual drinkers. The C is also a pretty depressing place on occasions. Very much a drinkers' pub, most of the clientele are alcoholics, unemployed or elderly.

There's also a good smattering of people from local sheltered housing for drug addicts and people with mental health problems. One of these poor people, a young woman, attempted suicide in the pub toilets not so long ago after a minor altercation with another customer.

The O is cheerier, although I don't say much more than hello to anyone in there. It just doesn't have the same aura of impending doom as The C and I can come close to contentment sitting in there reading the paper or a book.

Sunday, November 16, 2008

I'm worthless. Which is good news

"That was a good session, very open and honest," my counsellor said as we walked towards reception to make the next appointment.

That was on Wednesday. It was a good session, I had been open and honest and cried (or rather welled-up; if I let go enough to actually cry properly I completely fall apart) three times as I made my confessions or inadequacy, self-loathing and the deep-seated belief I have that I am an evil person.

This, apparently, is my schema. Counsellor promised to post me a chapter from a book that described this belief system that rules my thinking.

I'd asked if we could take a route towards Cognitive Behaviour Therapy (CBT), because I believed it would be more positive and active than what I had experienced before - simply talking about my past and events that may have contributed towards my drinking and depression.

The schema description arrived on Friday: Defectiveness/Shame is my name.

"Patients with this schema believe that they are defective, flawed, inferior, bad, worthless or unlovable. Consequently, they often experience chronic feelings of shame about who they are."
That fits the bill nicely.
The next session is designed to be a confession, a revealing of what I feel is bad, worthless and unlovable about myself. It's going to be tough I think but I have to hope that in revealing I will find some escape.

Where I am and where I want to be. Welcome to Drunk in Cardiff.

DON'T worry, it's not my life story, just a first post to say a little about the point and purpose of this blog.

I am 37 years old and I have a drink problem. I've had one for a long time.

I was first treated for it in the late 1990s. I'd gone to my GP complaining of depression and anxiety and also a stomach complaint. He took some blood tests and discovered I showed symptoms of heavy drinking.

I successfully completed an outpatient detox, but three months of sobriety later, I relapsed. Soon my drinking was out of control again and my relationship and job went down the pan.

I managed to get some sort of a life back together, with a good job and a lovely girlfriend. I continued to drink, but as I was living at home with my parents, it was controlled.

I moved out and my drinking increased massively. In 2006 I again went for treatment.

I again completed a successful outpatient detox. Six months later, I relapsed and my life collapsed - I lost my job.

I put myself straight back into the hands of the local drugs and alcohol service and detoxed again. I think I lasted about three months again.

I'd been seeing a counsellor as part of my treatment and getting help with the depression that is a toxic chicken dancing around the stinking egg of my drinking.

The counselling was going well - I'd tried before but never really engaged with it or made any progress.

I decided I was better. Or at least well enough in my thinking to start to drink socially and sensibly (as I have done occasionally in my life). I went to a function at my girlfriend's work and had a couple of glasses of wine.

At the moment I drink at least six pints a day.

I need to stop.

I can't stop.

I'm on the waiting list for another detox - it will mean going into hospital this time. I'm also seeing a counsellor through the local drugs and alcohol team. I take antidepressants called Trazodone.

I think I can do it.

I know I must do it.

I'm writing this partly as therapy for myself - counsellors have encouraged it. Partly in the hope that others who have addiction problems will find it useful and that it may help them find the help they need. Partly, because I was a professional journalist for six happy years - I love to write, and I've had articles on my treatment published in the national press. So, I hope this is good professional practice and may even help me find work.