Tuesday, September 25, 2018

The Ins and Outs of Moderation

My Nan, just like everyone else’s nan, always used to say “everything in moderation”. And with most things, I think it’s a fairly good rule of thumb. I genuinely believe that life is too short to agonise over whether you should eat a piece of delicious chocolate cake - if you want the cake, you know you will enjoy it, and you have a healthy relationship with cake, then eat the damn cake…in moderation. Because any Roald Dahl fan will know that the joy you get from one piece rapidly diminishes when you’ve eaten the entire bloody thing. 


Just a tiny piece...oh, go on, a little bigger...a little bigger...what, afraid you're gonna run out, cut me a real slice!
Moderation is a pretty big topic in the world of addiction, and I reckon it’s the number one thing people think or ask about when the idea of stopping drinking or taking drugs comes up - “can I use in moderation?” Abstinence seems like the only option available, especially if you look at treatment and recovery programmes, but it scares us, and the idea of quitting forever is often off-putting. So we make bargains with ourselves, like only having a drink on the weekend, or at a wedding, or only smoking at parties. 

I recently listened to a great podcast, an episode of This Naked Mind, that really highlighted some of the issues with moderation. It seems that there’s a few things about the way drugs and alcohol affect the brain, and the way the brain itself works, that make moderation much harder than we think it will be. The first is that moderation requires us to make decisions all the time. We have to decide how many drinks we’re going to allow ourselves, whether this social event or that is the one we’re going to ‘treat’ ourselves at, when to start, when to stop. Making decisions, whether they are big or small, uses up energy, and eventually you get to a point where you just can’t make any more. This is called decision fatigue, and it’s exhausting. And when you’re exhausted, you’re ability to make good, rational and healthy decisions is impaired.

Secondly, using addictive substances like alcohol and nicotine (to mention just the legal ones) causes you to build up a tolerance. This means that after a while, those two drinks an evening, or one cigarette a day that you promised yourself you would stick to are not going to have any affect at all, and you will need more to get your kicks. 

Finally, (and this is the one I find most worrying) continued use of addictive substances ends up numbing the pleasure centres of your brain. This happens because this area of the brain has been continually artificially stimulated to produce high levels of dopamine by alcohol, cannabis, or whatever it is you’re using. In response to this artificial stimulation, the brain produces a chemical called dynorphin,  which counteracts the affects of dopamine and reduces the feelings of pleasure you get from those substances. This has two affects. The first is that, because dopamine causes feelings of craving, you still want to do things that you now no longer enjoy. This is not a good place to be. And secondly, because dynorphin can’t tell the difference between using drugs and anything else, your enjoyment of everything goes down. It literally sucks the joy out of your life.


How amazing is life when you can get pleasure from the little things...like undoing all the hard work of raking in a few beautiful moments.

When I realised that I needed a break from drinking, and later from smoking, the first (and best) decision that I made was being honest with myself. I looked long and hard at my habits, and asked myself, “am I someone who can have one drink and stop? Am I someone who can have weed in the house and not smoke it?” The answer to both those questions was a resounding no. It doesn’t matter that I might want to be that person, I just know I’m not. I knew that trying to moderate, to just have a drink at weekends or only smoke after 4.20pm, would take more willpower than not drinking or smoking at all. So abstinence was the more daunting but easier way to go. There is a clarity that comes from making a decision once - you might ask the question a hundred times a day, but you always know what the answer will be, and that takes away a huge amount of anxiety.

There are some consequences to abstinence being the be-all-and-end-all of recovery. People who need help choose not to get it because the idea of abstinence puts them off, so those who could be making big changes in their lives aren’t doing anything at all. Recovery becomes all about the substance, by giving the impression that all your problems will be solved if you stop using completely. In reality, your problems are only just beginning because now the thing you used to mask them is gone. It’s true that you can’t fix a problem you don’t know is there, so uncovering your issues is half the battle, but only half. A firm belief that abstinence is the only way to recovery also dismisses a lot of achievements that people make - if you were a heavy daily drinker and now you only drink at weekends, that’s a huge difference and a great achievement. Should we negate that just because you haven’t quit completely? I don’t think so. Motivation is important, and we all know that we respond better to the carrot, not the stick. 

If you’re struggling with addiction, and the idea of moderation has occurred to you (which it almost certainly has), I have a few suggestions:

Start by being honest. Do you think you can moderate, bearing in mind the problems with moderation the substances you’re trying to moderate will cause? Can I fit the word moderate into that sentence one more time? 

Try, see what happens and keep being honest. Any changes you make in the direction of moderation will be positive. But be observant and notice if what you want to be true and what is actually happening are no longer the same.

If you’ve tried moderation and it’s not working, don’t beat yourself up. As I’ve hopefully given you a glimpse of, the brain is some complicated shit, and the way drugs work on it isn’t helping. The important thing to realise is that it’s not because you can’t stop, that you don’t have will power or that you are a hopeless addict. Humans are capable of truly amazing things, but not when the cards are as stacked against them as they are in the struggle with addiction. Give yourself a break.

Finally, give yourself a break, this time from moderation. If it’s not working you need to try something else, and maybe that something is abstinence. You never know until you try, and who knows, maybe the thing you were most scared of turns out to be the thing that sets you free. 

-Ems-

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