Why Can’t I Have Just One Drink?

One question puzzles nearly every problem drinker, and often their family and close friends, too: Why can’t an alcoholic have just one drink? Indeed, the desire to be able to drink normally, which is usually defined by an ability to control consumption and, subsequently, avoid negative consequences, can become an obsession for alcoholics in recovery. Some even enter rehab with the false hope that getting the right information and perhaps a well-deserved rest will help them moderate their drinking. Although not all people who abuse alcohol are alcoholics, a large percentage do become addicts. To understand this dilemma — and to learn why abstinence offers the best chance for recovery — read on.

Alcohol Abuse vs. Alcohol Addiction: Who Gets Hooked and Why

Not all people who use alcohol abuse it. Some heavy drinkers can binge with seeming impunity, perhaps partying hard over the weekend, then showing up none the worse for wear at work on Monday. Others get trapped. Addiction may develop over months or years, depending on factors such as genetic vulnerability, gender and cultural pressures, among other variables. What tips the scales for the latter group, according to Harvard Medical School[1], is brain chemistry.

Among individuals who develop dependence, the brain’s reward system shows abnormalities. For instance, MRI scans show that addicts have more intense responses to stress, and also react to stress at levels other people barely register. Additionally, they succumb to addictive habits more quickly, especially if they suffer from comorbid conditions such as depression, anxiety or schizophrenia, among other mental-health issues.

The biochemical basis for this cycle is found in a cluster of nerve cells called the nucleus accumbens, a region that lies just beneath the cerebral hemispheres. When a person satisfies a need or fulfills a desire – say by taking a drink to relieve stress or feel more socially confident – dopamine floods the nucleus accumbens. As it generates a sense of pleasure and relaxation, dopamine is simultaneously etching a reward pathway in the brain. In essence, it grows an appetite for the high. Each time the person does something to activate this reward system, the brain records the experience, making connections that encourage the likelihood of repeating the behavior.

Understanding this physiological response sheds light on cravings — arguably the bane of every recovering alcoholic. For instance, a person who quells crippling anxiety by pouring a glass of merlot, may initially choose to take a drink in order to cope. As dependence develops, something as simple as the clink of stemware or the sight of a wine bottle can trigger a craving. With repeat exposure to the alcoholic high, the brain learns that drinking is the fastest way to feel better. At this point, anything associated with drinking can serve as a stimulus—a bar stool, a swizzle stick or even simply the sound of ice hitting glass.

One Drink: Too Much and Never Enough

Sometimes most easily explained as an allergy, this conceptualization of addiction as a brain disease clearly shows why abstinence is the only surefire route to recovery for certain addicts. Once the craving cycle gets kick started, one drink rarely quenches the desire. Furthermore, one drink usually leads to many, many more. A true alcoholic may not always drink to inebriation, however. Unpredictability, however, is the telltale trait of dependence. One night she may be able to stop at a glass or two, but the next time she drinks could just as easily lead to a blackout, a condition of memory loss caused by high alcohol levels, describe Mayo Clinic[2] doctors.

Deep down, most people who become alcoholics know they have a problem. One way to discern the truth is to reflect on your schedule. Consider how you’ve spent time over the past six months, paying attention to what people and pursuits have taken a backseat to your drinking habit. Questions compiled by John’s Hopkins University physicians can also illuminate the truth. Drawn from trends revealed through scientific studies, they include the following:

  • Has your work performance declined due to drinking?
  • Does drinking make your home life unhappy?
  • Does drinking help you socialize?
  • Is your reputation suffering due to drinking?
  • Do you feel guilty after a binge?
  • Are financial difficulties one result of your drinking habit?
  • Have you lowered your standards of character and integrity, particularly by associating with people who normalize your drinking habits?
  • When drinking, are you more prone to being careless of your family’s welfare?
  • Have professional ambitions diminished as your drinking has increased?
  • Do you drink or use drugs to escape from worries or troubles?
  • Do you drink or use drugs alone?

Answers to these questions can provide information for an armchair diagnosis of alcoholism. In order to receive an official diagnosis, however, at minimum of three criteria from the following list must be met including:

  • Tolerance
  • Withdrawal symptoms
  • Drinking to relieve withdrawal symptoms such as shakes and sweats
  • Drinking more than you intend to, or for longer periods of time
  • Unsuccessful attempts to cut down or control use
  • Increased time maintaining a supply of alcohol, drinking and recovering from hangovers
  • Losing interest in former hobbies, relationships and ambitions

Another characteristic of alcohol dependence is continuing to drink despite negative consequences. For instance, a person who continues to use despite signs of liver damage, or an individual who serves time in jail for DUIs yet keeps drinking has most likely succumbed to chemical dependency. At this stage, seeking professional help from a qualified rehab facility is advised.

Getting Help for Alcohol Addiction

If you or someone you love abuses alcohol, we can help. Admissions coordinators are available at our toll-free, 24-hour helpline to guide you to wellness. Don’t go it alone when help is just one phone call away. You never have to go back to a life of addiction. Please call today.


 

[1] How addiction hijacks the brain – Harvard Health. (n.d.). Retrieved from http://www.health.harvard.edu/newsletter_article/how-addiction-hijacks-the-brain

[2] Alcohol use disorder Symptoms – Mayo Clinic. (n.d.). Retrieved from http://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/basics/symptoms/con-20020866

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