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Am I at risk for other kinds of addictions if I have been addicted to alcohol?

Alcohol shares many properties in common with other drugs of abuse. Chemically it acts on dopamine, the final common pathway of all drugs of abuse and the instrumental chemical in the brain's reward system. Alcohol also acts on opiate receptors, which are the target of opium and its variants, namely heroin. There is a theory based on the discovery of a chemical found in the brains of alcoholics known as tetrahydroisoquinolone (THIQ). The theory is that THIQi which is a breakdown product of heroin and is also highly addictive, is uniquely produced in alcoholics. THIQ_leads to both intoxication and withdrawal, similar to other sedative hypnotics and opiates. Physiologically, alcohol addiction and heroin addiction share a similar chemical in common leading to euphoria, tolerance, dependency, and craving. Environmentally, alcohol and heroin share many of the ritualized behaviors that become linked to the pleasure of using other substances. Although many people have a drug of choice, the likelihood of developing an addiction to another substance when one is addicted to alcohol is certainly higher than when a person is not addicted at all. If an individual is in recovery, all of the doctors must know so that they can choose medications with the least addictive potential and so that they can monitor the effects of the medications and therefore reduce the potential for addiction.

Tetrahydroisoquinolone (THIQ) a chemical compound that can be formed by combining acetaldehyde (the toxic breakdown product of alcohol) and dopamine (the neurotransmitter). It is thought to be specific for alcoholics and has opioid-like activities causing euphoria, thereby explaining their increased propensity toward addiction when compared to the normal population.

What are some of the triggers to relapse?

The triggers to relapse are numerous but can be boiled down to extremes in emotion. Feeling sad or angry or let down or disappointed may lead to frustration and a careless attitude toward one's current success. "Who cares?" is a sentiment that can echo in the bottle. Euphoric feelings from achievement or success can lead to complacency and a desire to "celebrate." An alcoholic's excuses to drink are endless. As one alcoholic said to another, "Don't give me any of that BS about why you drink! You drink because you're thirsty!"

Euphoric a happy and elated mood.

Although triggers are the final common pathway toward drinking again, specific triggers differ for each individual. Identifying the triggers is critical because you can then put into place a crisis plan to deal with them. The plan should include steps to be taken and who to turn to for support in order to avoid slipping, as well as a plan for an evaluation and the possibility of re-entry into treatment if a slip leads to the old patterns of drinking. Both your family and primary care physician should know the plan. If you are attending outpatient treatment, the staff should know the crisis plan. Relapse can rapidly progress to the point of even greater problems than before sobriety was attained. The chances for adverse effects are too great to take the chance of drinking again. The adverse effects include social, psychological, and physical problems, which often occur the second time to an even greater degree of severity.

Susan's comment:

I have had many conversations with Ben about what makes him relapse. His answer is twofold: He "picks up," as they say in AA circles, as a result of what is referred to as frustration and carelessness. He expresses his sentiment as, "What the — ?" He then explains the sad reality that after he starts, he must continue, so that he won't get sick. Only a severe case of addiction can cause someone to drink so that they stay well.

 
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