Why is Alcoholism Different than a Smoking Addiction?
They say that a drug is a drug, right? Alcohol is a drug, marijuana is a drug, and nicotine is a drug.
Substituting one drug for another is bad news, and will just lead you back to your drug of choice eventually.
This is conventional wisdom. They even go so far as to say that people who are addicted to nicotine use it to self medicate in much the same way as people who are hooked on other drugs, including alcohol.
But are they really the same thing?
Can you really lump nicotine in with alcohol and other drugs? Is it possible to substitute one for the other?
I don’t think so.
What I noticed in recovery: A clear separation between nicotine versus other addictive drugs
When I was in early recovery from alcoholism I started to seriously think about this issue. I was still a nicotine addict myself and I was still smoking cigarettes when I got sober and quit using other drugs.
First of all I noticed that many of my peers in recovery were also smokers. Then there were a few people in recovery who had eventually quit smoking and were totally free of all addictions. But a lot of people in recovery also continued to keep smoking cigarettes.
So obviously there was a separation here.
What I found is that there is a clear distinction between nicotine and other drugs. That distinction is based on the idea of relapse.
If you take an alcoholic who also uses other addictive drugs (such as marijuana, cocaine, and nicotine) then here is what will happen. That person can get clean and sober and they may or may not stop using nicotine. The nicotine use seems to have no influence on their overall sobriety when it comes to the other drugs. If they happen to use one of the other drugs (such as marijuana for example) then this will “reactivate” their addiction and they will be off to the races again. The same would be true if they took a drink. Or if they used some cocaine.
But this is NOT true if they smoke a cigarette. If they use nicotine, it does not reactivate their “core addiction,” if you will. All it does it to hook them on nicotine again.
So there is a clear separation here. You have two different addictions: One is the addiction to alcohol and other mood altering drugs (painkillers, cocaine, marijuana, etc.). The other addiction is to nicotine. And they appear to be completely separate. They are similar, no doubt, and there are many areas of overlap. But in the end if you relapse in one of these addictions it does not cause instant relapse in the other area. Somehow nicotine is separate from alcohol and other drugs in that way.
Strange. And, as we will see in a moment, this is important.
Alcoholism and nicotine addiction tend to go hand in hand
The percentage of alcoholics who are also hooked on cigarettes is much, much higher than the non-alcoholic population. This is based on the fact that it is much easier to get addicted to cigarettes if you are drunk and your inhibitions are lowered. It is also based on the fact that other drinkers will tend to be smokers, so there will be a lot of peer pressure for the alcoholic to become a smoker as well.
The way that alcohol works on the brain to produce that “feel good feeling” is much the same as the way that nicotine works on the brain. So once the alcoholic is hooked on cigarettes the two addictions compliment each other very well. The percentage of alcoholics who are also smokers is very, very high.
This is not a good combination when it comes to mortality, by the way. Alcoholism and nicotine addiction, taken separately, both reduce your expected lifespan. Taken together over long periods of time the combination is particularly devastating.
Implications for relapse prevention: How to build insurance into your recovery
Why is this relevant? Who cares that nicotine addiction seems to stand apart from alcohol addiction, even though they tend to go hand in hand?
What difference does it make?
In my opinion it makes a huge difference, and it is an opportunity for any smoker in recovery to buy themselves some insurance against relapse.
Here is how it worked for me in early recovery. I think every smoker should take advantage of this concept.
If you are addicted to nicotine when you first get sober you are going to hear some advice from people. Many of them will give you the idea that you are doing well in quitting drinking, and that you should “give yourself a break” because getting sober is very difficult. Therefore they will sort of give you a free pass on the cigarettes, and they will pat you on the back and tell you to keep smoking if that is what you need to do. Because really, that is harmless compared to the devastation that full blown alcoholism can bring, right? That is the logic they are using and that is how they help you to justify your cigarette addiction.
But therein lies an opportunity. If you are sober and you also quit smoking, then you have an extra layer of insurance against relapse. Why? Because if you ever become stressed out to the point of relapse, you will not take a drink at first. Instead, you will turn to your “lessor addiction,” which is cigarettes. So you will relapse on nicotine first. And because the addiction is separate from your alcoholism, this will not trigger a full blown alcohol relapse. You will simply go back to smoking, and if you want to be nicotine free then you will have to deal with quitting smoking all over again. But this is far less damaging than taking a drink or a mood altering drug.
This is how a smoker can build a layer of insurance into their recovery. They must quit smoking cigarettes. That’s all there is to it. Now if they relapse they have two options instead of just one: They could relapse on nicotine, or they could relapse on alcohol and other drugs. But the two options are totally and completely separate.
It is an interesting idea and no one ever really talks about it. I used the concept in my own recovery to help motivate me to quit smoking cigarettes.
Similarities between addictions and the holistic approach to recovery
Of course there are some similarities with alcoholism and nicotine addiction as well. In both cases you are self medicating. But I think the main difference is that nicotine is not mood-altering in the same way that alcohol or other addictive drugs are. Nicotine does not medicate you as severely, it does not drastically alter your mood in the way that alcohol can.
For example, if you are having a really bad day and some horrible things have occurred in your emotional life, you can either smoke a cigarette or you could drink a lot of alcohol. If you drink enough alcohol eventually you will completely medicate that emotional problem away. You may have to black out in order to do it but you can just keep drinking until the problem is gone from your mind. With cigarettes and nicotine you cannot really do this. You smoke a cigarette or you chain smoke a whole pack of them but your emotional problem has not really been dulled at all. It is still right there in the forefront of your mind. With alcohol it is possible to temporarily erase that emotional pain. Alcohol can alter your mood in a profound way, nicotine cannot.
When you are living the sober life you want to move towards greater health. There are a number of reasons for this. We could call this the holistic approach to recovery.
There is some data out there concerning alcoholism recovery and quitting smoking. There is much controversy over the idea because all of the rehab centers in the US used to let their clients smoke cigarettes. Now they generally have cracked down on this idea as much of the world has gone smoke free, and they are justifying the decision with data to back it up. In other words, you have two groups of people making different arguments.
One group says that the alcoholics and drug addicts have a hard enough time getting sober and going through detox, so we should let them smoke their cigarettes in rehab. Otherwise if they cannot smoke in treatment then they might use that as an excuse not to go at all.
The other group says “no, wait a minute, let’s look at the data here. When we force people to give up the cigarettes upon entering rehab, we get better success rates when it comes to sobriety. So why not force them to make the healthier choice anyway if it helps treatment outcomes?”
In the end it is not going to matter as far as the debate, because the non-smoking group has already prevailed. Rehabs everywhere have basically gone smoke free, and nobody really gets to smoke while they are in detox any more. But this is easily justified based on the fact that it seems to improve success rates.
The data seems counter intuitive, because we imagine that it would be harder to stop drinking if you have the added stress of nicotine withdrawal. But facts are facts, so you should take advantage of the idea and try to quit smoking as soon as possible anyway (if you happen to be a smoker).
The implications for quitting cigarettes in alcoholism recovery are huge. It is a really big deal to quit smoking in recovery. In fact it is the single biggest change that you can make in your life that will have the greatest positive impact.
In early recovery we need to eliminate negatives. When we get sober we have to fix our lives from the ground up. All of the negative stuff that is left over from our addiction has to be dealt with on some level. If you just stop drinking and fail to change anything else then eventually your recovery will crumble.
The holistic approach to recovery is the most powerful path you can take in recovery. This is because it draws strength and power from every possible angle (spirituality, physical health, emotional balance, nutrition, etc.). Quitting smoking is a big part of any holistic approach. If you are still smoking cigarettes in recovery then you have a huge opportunity. Not only will quitting enhance your chances of success in sobriety, it will also seriously enhance your overall enjoyment of life.
In about two weeks I will have 8 years off of cigarettes. I smoked about a pack and a half a day before I quit. Had I continued to smoke over the last 8 years, I would have consumed over 87 thousand cigarettes, costing me just under thirty thousand dollars. I am not making those numbers up, that is the real math! Perhaps even more shocking is that I would have spent almost a full year of my time engaged in the physical act of smoking. That is a whole lot of time huddled outside in the cold when I could be interacting with friends and family instead. Not to mention any of the ill health effects down the road!
How the daily practice can help you overcome any addiction
If you want to overcome alcohol or drug addiction then you need to change your daily practice.
In active addiction we had a daily routine. We had certain patterns that dictated how we lived.
In recovery, we have to change those patterns. We have to do something different. We have to find a new way to live our lives.
Everything that we do can be plotted on a continuum of action. Some of it is positive and some of it is negative.
When you use the holistic approach to recovery, you start to consider every single action that you take every day. Is this helping my recovery, or is it hurting my recovery? This is how you have to evaluate your actions on a day to day basis.
If you do this continuously and you are also experimenting and taking suggestions from other people, you can build yourself a new life in recovery through the concept of the daily practice.
We become what we do every day.
It is as simple as that. You take actions each and every day, and these actions lead you somewhere.
If you don’t know where you want to end up then any actions will do. But if you want to sculpt a better life for yourself then you need to start making deliberate choices.
The holistic approach to recovery is about your overall health. I had a close friend in recovery who died quite young because he did not make some of these deliberate choices. He was sober but he continued to struggle with some of these “holistic health issues.” He continued to smoke cigarettes in recovery. He was not one to exercise. He was overweight. But he clung to the fact that at least he was sober, at least he was not drinking or using drugs any more. He was very spiritual though and he used this as a platform to justify all of his non-action.
He should have embraced the holistic approach. He should have considered the idea that there is more to your health than simply:
1) Don’t drink.
2) Find God.
If you go to traditional recovery channels then you may find that the above list is a very good summary of what they teach you.
You are instructed to not drink and to find God. This will heal your life and change your whole world. This is the foundation of most recovery programs.
Now some will take it a step further, and in AA they often say it like this:
1) Don’t drink.
2) Clean house.
3) Find God.
Now this is a little closer to what we want, because now there is an action step in the middle. “Clean house” means that we need to do some work on ourselves. But in AA they frame all of this work in terms of spiritual growth and relationships. A good start, but not quite as good as a full blown holistic approach to recovery either.
In order to really be a holistic approach we would need to expand the “clean house” thing to include:
1) Doing internal work on our own character defects, working to overcome guilt, shame, fear, anger, etc.
2) Doing external work in our lives to change our life situation. Eliminating toxic relationships, leaving a stressful job, working on physical health, quitting bad habits, etc.
Traditional recovery tends to focus on the first one (the internal work) while ignoring the second one (the external life situation). In my experience you need to do both of these things in order to recover.
If you follow a holistic approach then you will naturally build up strength in your recovery based on personal growth.
Relapse prevention is not a list of cheap tactics, though this is how it is often presented to the newcomer. Instead, relapse prevention should be a strategy that you use on a day to day basis.
The holistic approach to alcoholism recovery is a strategic approach. If you happen to be a smoker then part of that strategy will address your nicotine addiction at some point. You would not just continue to smoke forever in your recovery without eventually addressing the problem. This is because the holistic approach forces you to question your health on many different levels, asking “is this helping me in my recovery, or is it hurting me?”
My advice to any alcoholic or drug addict is to focus on sobriety first. Don’t feel like you have to give up the cigarettes right away, even if there is a treatment center telling you that this will “statistically increase your odds of staying sober.” If the fear of giving up cigarettes is preventing you from going to rehab, then give yourself a break and just continue to smoke cigarettes for now. Go to rehab and wear a nicotine patch. Get out of rehab and go back to cigarettes. You can always quit later.
This is how it worked for me. I continued to smoke for the first 4 years of my sobriety. I had to get to that next level of health (or personal growth if you will) in my own time. Apparently I could not do it when I got clean and sober, I had to hang on to that crutch for 4 years.
In the long run I think every recovering alcoholic and drug addict should consider the idea of holistic health. This will help to change your daily practice, the actions that you take each day in order to remain clean and sober. Remember that you become what you do every day. Thus you can change your daily actions and in the long run this will change who you become. If you want to become someone who is healthy and happy and content then you need to form a daily practice that will lead you to that outcome.
Are you a smoker in recovery from alcoholism? Have you since quit smoking cigarettes as well? Or do you continue to struggle with nicotine addiction? Let us know in the discussion forums. It only takes a second to register!