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My husband has had a drinking problem probably since we first started dating, although I didn't know it then. That was 27 years ago. My question is whether he will ever stop drinking? He knows he has a problem, we talk about it all the time, but he just can't seem to ever stop completely. He may go for a few months, but he relapses. Thanks.

Without knowing your husband, I can't really say whether he will ever stop completely for the long term. That he is able to put together several months does suggest that he has the ability to stop, which is great. In reading your letter, my first question is what kind of support he obtains, if any, when he stops drinking? Given his long history of drinking, I would think that some outside support would be very important and might help him to achieve longer term abstinence. For example, has he ever attended AA or other self-help meetings or ever obtained counseling? So many people find this kind of support to be extremely helpful. Through this kind of treatment, perhaps he can learn what leads him back to drinking and what he needs to do differently to avoid this pattern. In addition, there are some medications available for the treatment of alcohol problems, which can also be of benefit in conjunction with the support of self-help and professional supports.
So in answer to your question, I do not know whether your husband will ever be able to achieve long term abstinence, but I would strongly encourage him to get involved in some kind of treatment, which could greatly increase his chances of achieving this. I will also say that one never knows when a person will achieve long term abstinence. Regardless of the length of a person's problem with alcohol, you never know when a person "gets it" and I have seen people with long drinking histories finally "get it" and achieve long term sobriety.

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My son was recently talking with me about some of his friends taking cough medicine. My son said that he never would, but I wondering if you know about what this is about and if you have ever heard of kids doing this. Thank you.

     There have been many reports of youth taking DXM or dextromethorphan. DXM is a cough-suppressing ingredient found in a variety of over-the counter cold and cough medications. Youth often drink the entire bottle as in excessive amounts, DXM causes a variety of psychogenic and physical effects. These can include confusion, dizziness, double or blurred vision, slurred speech, impaired physical coordination, abdominal pain, nausea and vomiting, rapid heartbeat, drowsiness, numbness of fingers and toes, and disorientation.   DXM can also cause visual hallucinations and “out of body” experiences. DXM is a dissociative hallucinogenic drug and can cause effects similar to ketamine and phencyclidine or PCP, two very dangerous drugs that are often abused.
Taken in large quantities, DXM can be very dangerous, as well as taking it along with alcohol. I am glad that your son states he would never take this drug.
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I just have one question about marijuana. Is it addicting and do people go through a withdrawal when they stop smoking? Thanks.

     Actually, this is actually two questions: is marijuana addicting and do people experience a withdrawal when they stop smoking it. I say this is two questions because a drug can be addicting, despite it not causing a withdrawal syndrome when a person stops using the drug. Cocaine, for example, is highly addicting, but stopping cocaine does not lead to a withdrawal syndrome.
     To answer your question about whether marijuana is addicting, I must first define chemical addiction, which is the compulsive use the chemical, seeking to use more and more of it, and being unable to stop. Often with addiction, there is the preoccupation with using the drug and more and more is spent on getting and using the drug. In this regard, marijuana can be addicting as many people report compulsive use and an inability to stop using it.
     On whether stopping marijuana can lead to a withdrawal syndrome, research has demonstrated that it can, although there is a variability between people and not everyone does. If withdrawal symptoms occur, they typically begin within 24 to 48 hours after stopping, they peak between 4-6 days, and can last for 1-3 weeks. Symptoms can include irritability, anger, depression, drug craving, sleep difficulties, and decreased appetite. In general, compared to other drugs that cause withdrawal, such as alcohol and other opiates, the symptoms are mild. However, some report that these symptoms hamper their ability to stop using it. So in answer to your questions, marijuana can be addicting and for some people, abstinence from marijuana can cause withdrawal symptoms.

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Dear Dr. Levy:
I know that heavy drinking can affect someone’s memory. My question is whether you know of any research that has looked at whether drinking can lead to Alzheimer’s? Thanks.

I am aware of a study that studied almost 1000 people 60 years of age and older who were diagnosed with possible or probable Alzheimer’s disease. Of these people, 7% had a history of heavy drinking, which was defined as two or more drinks/day. While there are genetic components that increase the risk of developing Alzheimer’s disease, it was found that overall, heavier drinkers developed Alzheimer’s disease almost 5 years earlier than those who were not heavy drinkers. It was also found that those who smoked one or more packs of cigarettes each day developed Alzheimer’s disease an average of 2.3 years sooner than those who were not heavy smokers. I think this research shows that for Alzheimer’s disease, while genetic loading may be relevant, many other variables play a role, which is true for many illnesses. And it this research suggests that drinking is one of those variables.

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I'm reaching out to ask your advice as I am a desperate mother who wants to help her son and nothing seems to be working. My son is 26 years old and is an alcoholic. He's a well-educated college graduate and has a wonderful job at a prestigious firm. His superiors always commend his work and encourage him to go further. What they don't know is that he drinks himself to unconsciousness some work nights and every weekend. He rarely leaves his room on a weekend since he's too drunk to get up. We have sent him to counselors and to a rehab program. He has 2 DUIs and has attended countless AA meetings. He says there is no sense in trying to change because he can't do it. The disease always wins.

My husband and I have been to Al-Anon meetings and we went to a therapist to help us understand the disease and its ramifications on us. Our therapist recommended we throw him out. We have been unable to do this. At times we're so angry at him and we want to throw him out. But, mostly, we view him as a very sick person who needs help. We know that part of the disease is the denial and we're desperately trying to get him to want the help. When he's not drinking, he's a wonderful young man, filled with promise. My husband and I are heartbroken and would do anything we can to help him. Do you have any advice or recommendations? I appreciate your time. Thank you.

    Like many parents who have a child who struggles with addiction, this is obviously a very painful situation for you. In fact, I know that at times the pain feels unbearable. The first thing I need to say is that you cannot get him better. He needs to do the work, and as much as you want to see him have a different life and to make him better, it is truly up to him. I also want to say that if you cannot throw him out of the home, you should accept that and not get down on yourself because you cannot do that. The more important issue for you is not whether you throw him out or let him live with you, but for you to emotionally detach from him so that his drinking no longer brings you so down, as difficult as that is to do. Whether you continue to live with him or not, the key is for you and your husband to not allow his drinking to affect you as much as it is. To do this, I would continue to encourage Al-Anon, as well as therapy for you and your husband. I would also continue to compassionately let him know who worried you are about it, how much you care, and how much you wish he would again seek treatment and help.
     You are right that he is a sick person who needs help, and it seems that he has had a number of treatment experiences with limited success. What concerns me the most about what you wrote is that he feels that there is no use to try because he believes that he can’t ever achieve abstinence. I see many people who struggle with alcohol and at times, they give up on themselves and no longer believe change is possible. That is a terrible place to be because not believing that change is possible can become a self-fulfilling prophesy. It doesn’t sound like he is in denial; rather he has given up on himself.   Again, when you talk with him, I would not buy into that and I would give him the message that you do not believe that he can’t stop drinking.
     As a suggestion, I would talk with him and suggest that he again seek help. Let him know that because he has not succeeded in the past does not mean that he cannot succeed now. If is willing to try again, in addition to therapy or AA meetings, I would suggest that he try some medication. There are now several medications to help people who struggle with alcohol, which include Vivitrol, Antabuse, Camprol, and Revia. Some people who struggle with alcohol respond to this medication in conjunction with therapy and I would definitely have your son get evaluated for some medication. If you want more information about these medications or any of my suggestions, please contact me again. I wish you the best, as well as your husband and son.

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It seems like most everyone who has a drug problem relapses that I sometimes don’t even know whether drug addicts should even try to stop using. I know this sounds negative but so many members of my family have drug problems and it gets so frustrating to see what is happening in their lives – constant relapses, drug use, arrests, etc. I don’t know if I have a question but I guess I do wonder if anyone ever makes it.

   I hear your frustration and how difficult it is to see your family members who struggle with addiction. But let me say that absolutely beyond a shadow of a doubt, many many individuals who suffer from alcohol and drug addiction make it! They stop using drugs and alcohol and turn their lives around! While relapses do occur, many people turn their lives around and put their drug use behind them
     Drug addiction is no different from other chronic illnesses. For example, many people who suffer from diabetes, hypertension, and asthma relapse and require ongoing care to avoid a recurrence of problems. In fact, without care, they will relapse. The same is true with addiction: while treatment helps people, many people need ongoing care to continue to remain abstinent and to avoid a relapse. In fact, research has shown that the rates of relapse among addiction, asthma, hypertension, and diabetes are all pretty much the same. Regarding your family, it seems like they need ongoing care which may help them to avoid a relapse. If they get some kind of treatment and stop using, but then they no longer continue to receive treatment and eventually relapse, this is a sign that they need ongoing care to sustain the gains they have made.
     I certainly can sense your pain as well as your perspective based upon what you have seen. It seems that you have seen many loved ones return to using drugs after having stopped, which I know is very painful and frustrating to see. But in answer to your question, there is no doubt that many people who struggle with drug addiction make it and achieve long term abstinence.

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I have friend who I know has gotten very involved in cocaine and drinking. I want to say something to him, but I am not sure if I should. Any advice would be appreciated. Thank you.

I absolutely think that you should say something to your friend about what you see. I know that this can be difficult to do, but I think that is so important to do. So often, a caring person saying something can help to set the wheels in motion for a person to begin a change process.
I think the key is how it is stated. And also, you need to talk with your friend when he is not high or intoxicated. Provided your friend is not high, I would in a very caring and compassionate way let him know that you want to talk with him about something and would it be ok to do that. When done in that way, he will more than likely say “yes” and then you can let him know what you have noticed. Let him know that you are bringing this to his attention because you care so much about him and that you are worried about him. If there are any specific incidents that particularly concern you, share these with him. Doing this cannot hurt and may help him make the decision to do something about his drug and alcohol use. I wish you the best.

Michael Levy, Ph.D.
Director of Clinical Treatment Services
CAB Health & Recovery Services, Inc.
(978) 739-7691
e-mail: michael_levy@cabhealth.org

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