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March 2017 When you announce you have a sore throat or an ear infection or diabetes or cancer, you typically receive sympathy and support. If you announce that you’re mentally ill, suffer from addiction, are morbidly obese, or have HIV, people sometimes blame you for your illness—or at least give you very little sympathy. These social stigmas make it harder for us to seek treatment. Shame often prevents us from admitting we have a problem. Sometimes we fear people’s reactions; other times we do not want to embarrass our family—sometimes both. This is why MCHC Health Centers has a program called, “We Ask Everyone.” At least once a year, our health professionals ask you about all those embarrassing issues: addiction, sexual dysfunction, mental health, and more. Our screening tools alert us to potential risks, and allow us to open conversations about difficult topics. One common challenge patients face is alcohol addiction. Like many of the illnesses listed above, alcohol use disorder (often referred to as alcoholism) affects people from all walks of life. It does not discriminate but is more common in people with a genetic predisposition and in those who have experienced adverse childhood events such as abuse. Drinking alcohol is different from using other drugs because it is legal and socially acceptable up to a point. This can make it difficult to know exactly where the line is between healthy and unhealthy. When we assess patient drinking in a clinical setting, we do so in an effort to help you—the patient—become healthier, not to judge or condemn. Broadly speaking, men can have two drinks a night and women can have one and still be considered healthy. (Men and women metabolize alcohol differently because of differing fat and enzyme levels.) More than a drink or two a night and you begin to damage your brain and your liver, among other things. Why do we drink when we know it’s not healthy? Typically, people are trying to escape physical or emotional pain. Alcohol is a depressant that makes people feel numb. It relaxes us and makes us feel less inhibited; but taken too far, it impairs judgment and slows brain functions that control reaction time and physical coordination. People with alcohol use disorder are just like the rest of us: they sometimes struggle to recognize they have a problem. They tell themselves they can stop drinking anytime—they just choose not to. But when drinking alcohol gets in the way of a productive life or damages important relationships, it’s time to take a closer look. It’s often hard to see our own faults, which is why we depend on those we love to help us. If you have a friend or family member struggling with alcohol use, you don’t have to manage the problem alone. According to the local Al-Anon website, “The Al-Anon Family Groups are a fellowship of relatives and friends of alcoholics who share their experience, strength, and hope, in order to solve their common problems. We believe alcoholism is a family illness, and that changed attitudes can aid recovery. Al-Anon is not allied with any sect, denomination, political entity, organization, or institution; does not engage in any controversy, neither endorses nor opposes any cause. There are no dues for membership. Al-Anon is self-supporting through its own voluntary contributions. Al-Anon has but one purpose: to help families of alcoholics. We do this by practicing the Twelve Steps, by welcoming and giving comfort to families of alcoholics, and by giving understanding and encouragement to the alcoholic.” (www.ncwsa.org) Alcohol use disorder is a treatable disease, not a choice and not a weakness. When you realize this, you can begin to let go of the shame and guilt and begin the work that we call recovery. You don’t have to do this alone. If you or someone you love needs help, reach out. Help is here.