In a college class on addiction I learned about the “gas/brake” metaphor for how our bodies respond to substances (think stimulant- puts on the gas / depressant – puts on the brake). Our bodies want to maintain homeostasis. If a substance causes one response (gas), then our body will cause the opposite response to bring things back into balance (brake). This validated my experience of poor sleep after drinking alcohol – even with extra water/electrolytes, my heart races all night and I feel anxious. When I would tell people about my experience I was often met with this response – “but alcohol is a depressant, it puts you to sleep!” Aha! Now here was the gas/brake theory. If alcohol had my body slamming on the brakes (depressant), then perhaps I was experiencing my body bringing things back into balance by pumping the gas. This made sense to me.

I was reminded of this when I recently read Never Enough by Judith Grisel. You can hear her interview on NPR here. Grisel explains, “the opponent-process theory posits that any stimulus that alters brain functioning to affect the way we feel will elicit a response by the brain that is exactly opposite to the effect of the stimulus”. This is some food for thought. Often people may turn to a substance to cope with a certain feeling (anxiety for example)...yet they may eventually experience an increase in the initial feeling they were trying to alleviate.

Chapter by chapter, Never Enough evaluates a specific substance and its unique impact on the brain. It helps us to understand that substance use and recovery is incredibly individualized. I am especially fond of this book because Grisel, a neuroscientist, is also in recovery herself. She imparts the knowledge of a neuroscientist with the empathy of someone who has experienced the effects of many of the substances she writes about. There is no condemnation, only curiosity and exploration about substance use and its impact on our brains.

Grisel makes the point of how entrenched alcohol use is in our everyday; whether we are mourning, stressed, or celebrating. When I turned 31 last month, my initial thought was to celebrate with drinks with friends. It was such an immediate thought: birthday = gathering = drinks. But I reflected and thought, wait, is that really how I have to celebrate? Instead, I started the day with a breakfast gathering with friends. This isn’t to condemn the idea of going out for drinks, only to examine the fact that it can be such a given in our culture.

To be honest, I haven’t paused to think about my friends and their own experiences with alcohol use. How often do we just assume that everyone else wants to drink? Per the NIMH, in 2014, 20.2 million adults in the US had a substance use disorder. On top of that include those who haven’t been formally identified as having a disorder, those who perhaps experience negative health or behavioral consequences from drinking, and those who just don’t want to drink. That’s a lot of people and yet - unless someone says they’re in recovery - we often just assume that they’ll want to meet up with us at a brewery or wine bar. Can we get more creative with our options?

I’m not the only one giving a second thought to my social use of alcohol. The sale of non-alcoholic specialty drinks and gathering spaces focused on sober environments is projected to be a growing industry. Which may help since, as Grisel points out, that if one isn’t drinking their options are often relegated to plain (boring) water. Guests and friends poke and tease or are sometimes downright confused if you decline the offer of a drink when in the past you would typically accept. This is complicated even more when in certain business environments drinking alcohol is the norm. Even making the choice to not drink for just one night can feel isolating and so against the grain. Not drinking can change the experience of traditions, daily routines, social and family circles. Basically wherever alcohol is ever involved, that environment or relationship is going to look different.

No matter a person's intake of alcohol, if they are looking to reassess their use it is always a good idea to first start with a primary care provider to talk about questions and concerns.  This is a great way to practice getting comfortable talking about this subject with a person who is a neutral party.

After that, there are several ways you can find new ideas, community and professional support. Here below is a whole spectrum. I realize in the same post I am providing resources on the spectrum from those looking to reduce their drinking or reframe their views on alcohol use, all the way to those with substance use disorder looking for inpatient treatment. While I do not want to minimize anyone’s experience with alcohol or equate experiences that are very different, I want to do my best to capture the wide spectrum of use and acknowledge the varying support needs of those who may read this. This is also meant to be a place to start, a topic like this certainly deserves much more time and attention than what one blog post can provide.

Employees can explore the topic more with these books in the Work/Life Library.

Sober curious : the blissful sleep, greater focus, limitless presence, and deep connection awaiting us all on the other side of alcohol / Ruby Warrington.

A happier hour / Rebecca Weller.

Never enough : the neuroscience and experience of addiction / Judith Grisel.

Understanding the high-functioning alcoholic : professional views and personal insights / Sarah Allen Benton.

Unhealthy helping : a psychological guide to overcoming codependence, enabling and other dysfunctional giving / Shawn Meghan Burn, PhD.

Addict in the house : a no-nonsense family guide through addiction & recovery / Robin Barnett, EDD, LCSW.

Prodependence : moving beyond codependency / Robert Weiss, PhD, MSW.

The recovery book : answers to all your questions about addiction and alcoholism and finding health and happiness in sobriety / Al J. Mooney, M.D. ; with Catherine Dold and Howard Eisenberg.

Outside of AA meetings, here are other opportunities for support.

SMART Recovery (There is a meeting the Cary, NC area.)

19 Sober Communities Beyond Traditional AA

Oak City Recovery Run Club

NCY12SR - Yoga of 12 Step Recovery

Therapy can also provide support.

I want to be clear that a person doesn't need to have a substance use disorder in order to seek a therapist’s support for alcohol related issues. As mentioned above, family and friend dynamics can greatly change if most socializing is done around drinking. A therapist can be of support if you are going through transitions in life and reassessing your goals and environments.

If more intensive support and therapy is needed there are Intensive Outpatient Programs (IOP) and Partial Hospitalization Programs (PHP). (The term Partial Hospitalization can be a little misleading as it does not necessarily take place in an actual hospital). IOPs and PHPs are not inpatient, so a person remains at home or stays in supportive housing and then attends for a certain number of hours and days for a few weeks. Some programs are structured so that a person can continue to work and then attend therapy and programs outside of working hours. The next steps are detox and inpatient rehab programs.

Work/Life helps to connect SAS employees and their family members to these kinds of resources. You can also use the SAMHSA Behavioral Health Treatment Services Locator to find resources.