Tuesday, June 30, 2009

So, am I ill or just an idiot?

That's a big ol' question up there in the title isn't it. If you have an opinion, please drop it in a comment.

I'm thinking thus, because there's not much to report from today. Another pretty routine (and thus successful and also unsuccessful one of sobriety).

Again, I went to the pub and saw my mates and that's where the question came up. But it's one that plays on the mind of anyone who's had a drink problem I should imagine, and it's also a BIG and IMPORTANT question because knowing the answer is vital to how drink problems (I'm avoiding the word alcoholism for the moment) is treated.

One of my pals has experience as a drugs counsellor and started off on a fairly strong and long-gestated attack on AA. Lots of people don't like AA because they see it as cult like and religious. I haven't yet been to a meeting, but I do plan to go and will reserve judgement till then - I also understand that each meeting is very individual. We were visited on the ward by members of AA who hold a meeting in the hospital and their main thrust was to play down anything to do with religion and Jesus. I know the organisation uses the term Higher Power rather than God and asks people to define that in their own way.

Anyhow, my purpose is not ill-informed pontificating on an organisation about which I yet know very little. But, it is the law that any alcohol blogger must ask the, is alcoholism an illness question at some point, and now is my turn, just from what I know of myself.

It matters enormously of course. It matters because it affects spending large amounts of public money and it matters to me enormously because if I accept the disease model that means I'm probably going to have to accept that I can never drink again; something I find hard to contemplate despite all I've been through because of drink. Put the question into Google and you'll see a huge amount written on the subject - much of what I've read is axe-grinding rubbish designed to sell books, or treatments or traduce other books and treatments.

There doesn't yet appear to be any concrete evidence either way, although from what I've read the idea of a genetic predisposition to alcohol abuse seems to have some support.

So, this is what I reckon. And, I really don't know where I'm going with this, it's just a ramble on what I think. By the way if you're a medical researcher and want to look at my brain I'd be only too pleased to help, I've always wanted electrodes on my brain.

One reason I think they're might be some merit in the predisposition concept is my own first experience of getting drunk. Charles Bukowski may have put it better: "With this, life was great, a man was perfect, nothing could touch him," but I absolutely recognise that thought. It was like a light going on and seeing the world in proper focus for the fist time, it fit, it was the real me this drunk person and straight away I knew I wanted to be like this as much as possible. I was 13. Now, it may be that everyone feels like that the first time they are intoxicated, but they simply learn to ration their pleasure. I also know there is some history of alcohol abuse in my family.

I find that very hard so powerful is that pull. I also recognise that I have a tendency to over-indulge with almost anything pleasurable and along the way I've had abusive relationships with almost every pleasure I've ever encountered from sweeties to porn to speed, acid, weed and coffee to sucking my thumb as a child.

On the other side in going through a therapeutic day programme that has really amounted to very simple, common sense guide to coping with life. And I can see in my love a drink a running away from that - from life, or anything unpleasant there within, from conflict of any kind to responsibility, getting up in morning and living to a budget. I've seen the so-called 'addictive personality' dismissed, it is in fact a narcissistic personality and when I'm not indulging in extreme self-hate there's a lot of that in me, a lot of self-regard, (just look at this blog, it's all me, me me) and the fact that the rest of the world does not bow down at my feet in supplication might indeed be a trigger for drinking. It's tough to take that is but I'm very glad that I've had my learning-to-live-classes and I'm really trying very hard to put what I learned into practice. Don't get me wrong; if you met me you would find me shy and self-effacing, much of my personality is hidden inside and only came out when the shutters were drunk into their open position, that's the only time I would have anything even approaching confidence - I need to try and find a healthy balance here somehow.

Self-medication. Another theory that I think has some merit. Narcissism taken, I was always very nervous and drink dealt with my anxiety and indeed my sadness, (narcissistic?) constant self-examination and self-admonishment. Of course, we all know that it's not a very good medication in the long run, but boy does it work at the moment of administration - instant confidence.

This, you see, could be dangerous temptation talking too. If I can learn to deal with life better, through counselling or what have you and if I get my depression and anxiety under control, through medication or what have you, then I can join those lovely lucky people like Mrs CD who have a glass of wine with their meal or a drink with friends on the way home from work without starting off on a three day bender. Wouldn't that be nice? But can I do that? I never have done, but then I've never grown up and accepted what life is all about in this society either.

This isn't getting to anywhere very conclusive at all. (I warned you). I can see merits in both sides of the argument, but not in the vituperative and self-serving nature of many of the arguees. Perhaps describing alcoholism as a disease does take responsibility away from the drinker but I also think it helps them - yes, it's easier on yourself to believe you ended up in a hideous mess as a result of some predetermined nasty gene over which you have no control, but it also might help you stop once you come to believe that you have an illness which means if you drink you will die. People with serious peanut allergies don't tend to try the odd Snickers bar for the thrill of it.

So, I don't know. I really don't and I'm tired now and in need of 300mg of Trazadone and some sleep - I'm sure I'll come back to it, we all do. But, if you've got a thought then I'd love to hear it, but, I think we'll both have to accept that whatever you say it will be a theory nothing more than that on the current state of evidence, so don't go getting all definitive on us.

Monday, June 29, 2009

Phew what a scorcher... Hiding in the pub... A trigger spotted...

Zoinks it's been hot today. Hot and heavy. It's still shining down now at 9.17pm and it's fair whacked me out has all this sun.

I spent a couple of hours in the pub today. I've been popping in occasionally but without intoxication on the menu I don't have the temptation to waste hours there.

I went down to the Community Addictions Unit to take my Antabuse at around 10am and from there walked into town to look at the new central library. It's a nice building - very open and airy despite, or in fact because, of the concrete functional look. But, and excuse me for being old fashioned, it's not exactly rammed with books. This is the way with libraries now, they're more and more becoming computer sheds. Fair enough I suppose and free internet access is now a massive resource for learning, being an active citizen, having a social life and just straight up living, but for a central library in an important city I was sorry to see the shelves so sparse and so sparely populated.

I went to the pub to hide to be honest. We get on OK with our neighbours. Brilliantly on one side. But the other side make me nervous. They've got three little kids and a growing tribe of visitors, they're boisterous and noisy, which is fine, but they've also taken to chucking stuff over the wall. I went to have my last cigarette last night - all ready for bed - and saw a ball in the garden which I knew came from next door so I popped it back and went back to my fag. Then a shower of small coins comes over, which I ignore. Then a second one, which causes me to shout, "Oi, what are you doing!" Feet scurry away and Mrs CD arrives to see what's happening. While she's there another shower comes over. We're about 30p richer by now. I get enormously paranoid about this, distressed even, and have to be calmed down: "They're only doing it to get a reaction," she says. "They're only little and they're playing, they're not targetting us they're trying to piss off whoever's money it is." OK, and I do remain relatively calm. Nonetheless, the neighbours put me on edge a bit; the police were round while I was in hospital and I'm 99% sure the men of the house are involved in something criminal, I've seen enough to know that. To be honest I don't really care as long as I can have a quiet life at the moment and not get involved (which is pretty pathetic really), I still say hello to them and they're friendly enough, in fact when the kids do come to the door to ask for the ball they're really lovely and polite.

But it puts me on edge when they're home all day - screaming and fighting away and being shouted into submission. That's partly why I got so down being in the house and the pub felt such a good place to be. Today, it's fine. I take a book and sit in the garden and C soon turns up and we chat away while I chug through my blackcurrant and sodas and buy him an SA. But my inability to deal with even the slightest conflict - the fear that any disagreement will escalate out of control and into violence and humiliation (I think it's the humiliation that bothers me in some silly way) is paranoia that I need to deal with. Stuffed to the gills with Antabuse, seven anaesthetising pints of cider and the courage they bring is not an option and I didn't get as upset as I would have done in the past. But it's put me off going into the garden, which is a shame. Mrs CD was going to bring a friend home for dinner and I was glad she didn't because I know she would have wanted to eat outside, which I know would have been an agony of worry for me.

So, that's a trigger. Avoid is probably the best plan but I know I'm going to have to find courage at some point - I'm not really comfortable with children to be honest and my conflict avoidance is something I've inherited from my dad. I can't keep running forever.

One thing that I know will make me more comfortable in my skin (apart from my skin completely clearing up of course) is feeling physically stronger. I've toyed with the idea of learning some sort of martial art in a desultory sort of way - the discipline would be good. But, the first step is some sort of exercise. One for the morrow that because I'm pretty shattered now and once I've taken my pills will be off to sleep.

They're are kids outside now, just early teens, mates play fighting: why do my legs turn to jelly at the sound without a gut full of alcohol? I was never really bullied properly at school or anything; but I always felt under threat from it. Mrs CD is wise in such matters, but I'm learning sober that I have a huge amount to unlearn - a lifetime worth of it and sometimes it feels too much.

This seems a very negative post when in fact it's been a pretty good day.

If you spent it, thank you for your time.

If I make it to the support group tomorrow I'll try and bring it up, which'll take courage of a sort again.

Sunday, June 28, 2009

21 pills a day - rattle 'em.

Ah yes, 21 pills each day. So many in fact that I've had to invest in one of those trays I had previously thought the product of choice of the mentally enfeebled - which, of course, to some extent is me to a t! Oh, yes.

So, on Thursday I took my lovely big bag from the pharmacy and dumped it all in to the four slots for each day. It would make a cracking percussion instrument, great for samba if anyone's setting up a Latin troupe in Cardiff shout me man.

Sadly, it doesn't go beep at the appointed hour. Writing this reminded me to go and check where I stood today and I missed two so I've just had a big swallow.

This is what I take every day and why. Four Thiamine, remember that from the cereal packaging of your youth? Well, I do. Apparently it's destroyed by alcohol so if you want to soak your kiddies' Cocopops in gin you'll at least be doing a not half bad thing. Strong vitamin B, two four times a day, for similar reasons. Six Acamprosate or Campral tablets; these are supposed to reduce cravings but the medical technicalities of it (and everything else to be honest) are beyond me, stick it in Google and you'll be deluged with discussion on its use and even the ethics of using it. One Antabuse or Disulfiram tablet: this is the big one, the deterrent, the chemical cosh and one which the professionals drink to. The idea in short is; you drink, you're seriously ill.

I was a bit chary about Antabuse at first. I've used it in a previous suicide attempt plan and knowing how low my mood can go I was wary of having access to a guaranteed self harmer like that. Also, in hospital, it turned out that every damn cream, lotion and unguent I used to treat my eczema contained alcohol. I was offered another drug called Naltrexone which works by making alcohol impotent, you can't get drunk it, therefore drinking it is pointless.

However, in the end, and I think to my relief too (a subconscious part of me didn't want something 100% effective I think), alternatives were found for my eczema treatments (although since leaving hospital - where my skin became as a lovely nectarine in its smoothosity and loveliness; it was like listening to Al Green singing masses by William Byrd to look at my skin - it's flared badly again) and I am now an antabuser.

It's not part of my 21 tablets a day in reality because I've decided to have my intake supervised. This shouldn't really be necessary but I relished the chance for another appointment, another reason to leave the house and get into some sort of routine of obligation and timetabling. So, each Monday, Wednesday and Friday I trot off down to the Community Addiction Unit. There I am breathalysed to ensure I'm not about to poison myself and take two pills or three on Fridays.

Of course, me being me, I mislaid my tablets on Friday so didn't go and wasn't able to take them until today when they turned up, not in the traditional last place I looked but rather the first place I'd looked but just not seen them. D'oh!

If you spent it thank you for your time.

The Daily Happy - look at the swerve on that...

Well, it makes me happy. I can actually remember watching it on telly and my jaw dropping to the floor - you have to wait for the footage shot from behind the thunder-thighed Brazilian left back to see the incredible swerve.

Saturday, June 27, 2009

Some of what happened in the hospital - welcome to the NHS detox...

I had intended to keep notes or a diary while I was in hospital for 16 days - hoping to make it the basis of a saleable article. I managed a day. There was plenty going on inside unruly Mr Brain and it soon became apparent that I was going to feel disloyal to my fellow patients in so doing - I'll still try and write something but it's obviously going to have to be heavily disguised; there's enough material for a damn good TV drama but I feel guilty about the very concept of using others and their troubles as 'material'. Hey ho.

Here's the short of it though and I hope it will be reassuring to those who are preparing for an inpatient detox, because I found the experience rewarding and strengthening. Partly, the enhancement to my confidence came from dealing with my fear of people: an NHS detox ward is a mixed bag and there are moods and tantrums and people who've been in prison and unpredictable behaviour and conflict, all things which set my fear antenna twitching like Herbert Lom in the Pink Panther series.

This was my fourth detox but my first one inside and my first one in Wales. My previous community detoxes have been fairly free and easy affairs - a substance misuse worker pops round and doles out your diminishing daily dose of sedatives, Lithium where I've been.

Inside every thing is more clinical and more serious. A full physical examination to start with, which to my delight led to an immediate referral to the dermatology department and a regular and adequate supply of treatments for my eczema. I've been asking my GP for such a referral for months only to be told, "It's not bad enough." In my semi-full time intoxicated state and with my confidence at rock bottom until pint four I was loath to disrobe to show the full extent of my problem and speaking up for my views was beyond me - I suffered in sullen silence.

Then there's a contract to sign. Extensive and admonishing. Don't form relationships with other patients; you are advised not to exchange phone numbers; inappropriate behaviour will lead to expulsion; you must not enter other patients' rooms; you must stay on the ward for three full days before you are allowed out; if you go out you must tell staff where you are going and when you will be back and you must be back then (one patient failed this clause and the police were informed; more in concern for his safety than anything else I like to think).

My bags were logged and searched and toiletries and medication removed to the staff office to be doled out when applied for. It didn't help my nerves that I was earnestly told to keep my mobile phone and cash on me at all times for fear of thievery.

The withdrawal medication here was Valium (diazepam to its mother) and it was available only on completion of a questionnaire of symptoms; score enough you get a swig of strawberry swoozy juice. Antabuse tablets are dissolved too to stop patients stashing tablets under their tongues. The upshot is instead of a five day swoon I'm off the stuff in two. Another patient advised licking of hands to simulate the sweats that get one point and other symptoms are are easy enough to lay claim to - headache, sensitivity to light and noise, anxiousness.

There are also six super vitamin jabs, administered with varying degrees of sensitivity to the buttocks during the first three days.

The days are routine and easy. Breakfast at 8am; medication at 9am; lunch at noon followed by more meds (we all soon fall into the jargon); dinner at 5pm followed by, guess what, more tablets; sandwiches come at around 8pm and the final doses at 10pm. Telly off and in your rooms by midnight during the week and 1am on Friday and Saturday.

There's a TV ban during the day to encourage patients to go to the Therapeutic Day Programme (TDP) which is the main purpose of the stay in the eyes of our hosts. But there's a pool table, a small library of books, visitors from 2-5pm and 6-8pm and a permanently filled smoking room. This little privilege has it's own rules, designed to render it as unattractive as possible - windows open at all times, air con on at all times, no chairs (a patient told me these had to be removed after two patients recently used one to bar the door while they fought inside, but the rule was in place when I attended the TDP as an outpatients), no cups. The kitchen is open to us and there's always something to eat - bread, salads and leftovers in the fridge and endless, endless cups of tea and coffee made all the easier with the super hot water tank that means you don't even have to boil a kettle.

The rooms are small but comfortable: a sink, a wardrobe, a three drawer desk unit, a reclining medical bed.

It's a closed and consequently gossipy world. Some patients (close to a majority I think) were returnees and know each other from previous stays or from the small South Waleian world and villagey Cardiff. There's bitching and moaning about the staff and the treatment - principally about the non-administration of more diazepam or codeine painkillers. We all get on pretty well though, people with only one thing in common really, addiction, but there's only the odd contretemps.

Once you're well enough, the TDP beckons. I've attended before as an outpatient but didn't take much from it, this time it's a far more beneficial programme - I know the others so don't fear them or want to make a particular impression and although I was still among the quietest in the group I chipped in when I could.

During my stay, we lose three patients before their official discharges. The first is the most upsetting. A patient who has a history with the ward and is often unhappy with his treatment - complaining of being messed around in unspecified ways - walks off one morning. There's gossip about them while they're away with rumours of violence when drunk. Hours later they return unnoticed by the staff and drunk as hell. I meet them in the smoking room, unprepared, and am given an overly enthusiastic handshake and bearhug. I'm not sure why, but a no-grassing rule seems to have a hold and he's not simply reported to the staff. I retreat to my room, shaken by the invasion of a loud drunk man and hear him laughing and shouting up and down the corridors. I'm later told their behaviour got worse, bordering on the threatening and cracking cans of Stella in front of the rest of the patients in the TV room. Finally the staff spot the incursion and I'm told they leave quietly enough.

The second leaves just a day early. They fall asleep in the TV room after dinner, snoring loudly and simply cannot be woken by staff, who grown concerned and the suggestion is made that they may be 'over medicated', knowing what I know this is far from unlikely. The staff search the patient's room and find nothing; though I'm told later by another patient that this is because they aren't looking in the right place. Outraged, the patient orders a taxi home, a doctor arrives to formalise the discharge and they're away, happy enough I think.

The final patient to leave is another involuntary discharge and it happens while I am an outpatient on the TDP after leaving the ward. They were on the programme with me and I'd known them inside. Not an alcoholic (most of us are, I only encounter three drug users; two methadone and one amphetamine) but a meth addict. I'd got on very well with them but God they loved to speak, and I know they'd got a few people's backs up in a minor sort of way. One day I come in for the programme and am told something kicked off the night before - a row over noise or talking or something that comes close enough to a fight for the methadone addict - who I'd seen going through terrible physical withdrawals and maintaining a really positive attitude to their new drug-free life - to be asked to leave in the morning.

I've written about the TDP before. I can't remember the full programme but I learned a hell of a lot more this time. They call it a relapse prevention programme and it's really a short sharp self help course - anger management, conflict resolution, spotting psychological traps and dangerous situations, relaxation techniques' a support group including former patients. Art therapy too, which accounts for my lovely collection of tiles with marks on them and a not-too-bad Easter Island head sort of thing.

I also get a referral to the gym and get a real boost out of my short iron pump. I'm told I can meet a physiotherapist on the outside but am yet to hear anything. If nothing comes through soon I'll use the GP referral scheme - that's the plan at least.

I could go on for hours but that's a potted version.

If you spent it, thank you for your time.

Friday, June 26, 2009

Anything to say...?

I don't seem to have a huge amount to say, which is why I haven't been saying it. I ought, of course, to have plenty to say - I've just been through an inpatient detox and changed my life in an enormous way. Therein lies the problem. I do feel bereft and resentful of the world; a foolish and, hopefully, passing feeling.

I've been here before, after detox an enormous sense of achievement and euphoria - I'm gonna write symphonies, climb every mountain ford every stream and reroute the water to permaculture guerrilla plantings of organic vegetables free for all to pick and pluck. Palestinians, Israelis, Christian Evangelists, gay street theatre groups, give me a call, I've got this so-simple idea you're going to love... then, the oh, is this it?

It's quite natural I suppose. I'm in mourning. I haven't read, Drinking, A Love Story, but the title certainly rings true. Something that recently took up around eight to ten hours a day has gone. Us problem drinkers, alcoholics, addicts whatever you want to call us might have come to a bad place with our chosen drug, but, if the rest are anything like me, we sure loved it too. I miss my main interest (and, drinking can be a full-time job my friends), and also my main medication for depression and anxiety - so now I'm sober and I'm depressed and anxious.

My euphoria came in hospital. Despite being scared arseless at the prospect of going in and then sometimes during the process I came to feel very comfortable in there and made some decent friendships I would say - although meeting in such a hothouse environment and sharing such an intense experience people, it's a little hard to say how they will, or even should - official advice on entering the ward is explicitly not to form relationships and even exchanging phone numbers is frowned upon - develop.

While in the hospital, with its Kafkaesque corridors, I was also in a cotton wool bubble. Four meals a day served up; sent to appointments; summoned to take medication; a day course to attend and even told when to go to bed - midnight in the week, 1am at weekends.

So, I'm struggling a bit now. I drank, at least in some measure, to deal with an over-sensitivity to my surroundings that bordered on occasion on paranoid, crippling fear. I've been out of any kind of lifestyle that requires a regime or a routine for at least two years now. My routine was this (and there was a comfort even in this) wake around 9am, watch Mrs CD leave for work, throw up, sit listening to the radio waiting for a 'decent' time to go to the pub but must be before the shakes set in, then from noon, or 1pm, or 2pm, drink in the pub and read the paper and chat to friends till 6pm-ish - go home via corner shop for cans and cook then drink till sleep - repeat. It wasn't sustainable or rewarding or healthy but it sure made life very easy to deal with.

Now, this all comes across as appallingly self-indulgent and ungrateful even. So I would like to make it clear I am hugely grateful for this chance; the stories of others I met in the ward made it very clear to me that I have been extraordinarily lucky - there were tragedies, lifestyles, health, legal, housing, etc. etc. problems and surroundings I quite simply could not countenance surviving.

So, I'm pleased to be clean and hoping for better things but, as ever, I'm just trying to be honest and I know that in many ways the hard work starts now.

If you spent it, thank you for your time.

The Drinker.

Tuesday, June 16, 2009

The first sober Daily Happy!

I'm sure a lot of people will think that this is a bit syrupy, but it makes me smile like Cristiano Ronaldo's accountant...

Cardiff Drunk went to rehab...

He said, yes! Yes! Yes!

This is my 16th day sober and my first out of hospial... News from the detox ward and beyond will soon follow.

You'se all me best mates you is...


On a typically tedious type-setting note - Drunk in Cardiff (the blog currently known as Sober in Cardiff) uses Trebuchet because I think it's a medieval siege weapon; why is a font named after a medieval siege weapon? Answers on a comment please. . .