Be tender with yourself when you look at this. If you have a problem with alcohol, you probably have had all sorts of people who have been far from tender with you. No doubt you have been criticized, shamed, fought with, talked to, cajoled, bargained with or argued with. In fact, if someone around you criticizes your drinking, it is one of the most reliable indicators that you have a problem with alcohol. People who do not have a problem with alcohol do not evoke pain, frustration or concern about drinking in the people around them.

Take a quiet look at your alcohol use. You don't have to admit you have a problem, you don't have to surrender anything. Your own commitment and experience will guide you in this process. Honesty about your relationship to alcohol is hard because the very nature of the disease of alcoholism is denial. Do this review in the privacy of your own home or office and give yourself absolute discretion over whether you share your findings with anyone at this time. If privacy supports your honesty, embrace it. If sharing serves you better, find a trusted friend to help you ask these questions. The very best alternative is a friend in recovery.

What is very surprising is that people who do not have a problem with drinking don't feel bad about it. They don't feel guilty. We talk a lot about the "denial" of alcoholism. I believe denial is the response that emerges when the person is made to feel defensive about their behaviors. When there is no reason to be defensive, people are remarkably on target about what is going on for them. Take away the shame or the judgment and you can assess your problems pretty clearly.

"Oh, come on," you say. "Everyone does that!" Everyone doesn't do this.

People who don't have a problem with alcohol are not inclined to want more when they feel bad. Having a problem with alcohol or alcoholism is defined as "continued use of alcohol despite adverse consequences." When a non-problem drinker has an adverse consequence from drinking, she stops. She will make the connection between feeling bad and alcohol. A problem drinker doesn't see this connection.

Not making the connection is not about being stubborn or stupid or even about willful "denial." Not making the connection between drinking and feeling bad is about chemical changes in the brain that alter the parts of the brain that form judgment by making a connection between cause and effect. The parts of the brain that are responsible for saying, "Hey, this made me feel bad, I don't think I want more," don't work properly.

Not making the connection creates a vicious cycle. In the problem drinker's mind, the alcohol actually makes her feel better, so she drinks more. Her opinion is confirmed when the alcohol triggers a beta endorphin release of euphoric feelings. This reaction is why everyone drinks - the effect is nice. The sugar-sensitive person feels especially good because alcohol causes a even greater beta endorphin response in her brain. She feels far better than other people do when they drink. But the next morning, she is hung over, a feeling that comes from withdrawal. All the beta endorphin receptors that were stimulated, or primed, by yesterday's alcohol use are screaming for more.

That morning-after feeling of wanting to do anything to feel better is so easily taken care of by having a drink. So she does. Relief comes. Blessed, sweet relief. And with her "adverse consequences" switch turned off, the problem drinker's natural response is to feel that having a quick one is a reasonable and logical way to take care of bad feelings.

So CAGE stands for:
C - CRITICIZED
A - ANNOYED
G - GUILTY
E - EYE-OPENER
Now, let's go back to each question individually.

Have you ever felt you should cut down on your drinking?
Not a hard one. People usually know the answer to this right away. Yes or no. No cheating, or fudging. If cutting down is even a passing thought, answer this one "Yes."

Have people ever annoyed you by criticizing your drinking?
Okay, be honest now. Ever? Think about those times when you have held your tongue, or wanted to smack someone for making a comment about your drinking. Think of the fights you have had with your spouse about it. Answer honestly.

Have you ever felt bad or guilty about your drinking?
This question is pretty straight forward.

Have you ever had a drink first thing in the morning (an "eye-opener") to steady your nerves or to get rid of a hangover?

A score of ONE is a warning sign.

Remember the meaning of CAGE. Let yourself think about this for a while. One of two things will happen. You might begin working very hard to say, "Naw, I don't really feel guilty about my drinking." This is an example of denial creeping in and wrapping its deadly little body around your neck. Just pay attention. Consider whether you are getting farther away from relationship to your body and your own inner wisdom.

The other thing that might happen is you may be jostled into realizing that you do have a problem with alcohol. If you decide that you would like to stop drinking, there are a number of factors to take into consideration before you do. First, you will need to estimate how severe a withdrawal you will have based on the frequency and volume of your drinking. You will need to honestly and accurately figure out how much alcohol you consume in a week. You can do this by recording your alcohol consumption right in your food journal. Do this for a week and then take an honest look at the frequency and amount of your drinking. Calculate the number of drinks you have in a day or a week. A drink is 4 oz. of wine, one beer or 1 oz. of hard liquor. So if you have three 6 oz. glasses of wine (18 oz.), this would be the equivalent of 4.5 drinks.

After you know where you now stand, you can start to plan your detox process. Just as in your detox from sugars, you will want to determine your style for making change. You can either taper down and then stop or you can stop all at once. Most people find it much easier to go for sobriety all at once. You don't have to be making decisions about how much, when, where, with whom all of the time. You can focus on one decision only - the decision not to drink.

It will be important for you to have some sort of support as you make the change. Do not stop drinking without telling anyone what you are doing. Work with us on the recovery list. And find someone locally who has been through alcohol detox. Talk to that person. Alcoholics Anonymous (AA) can be a wonderful support because everyone in AA has been through this process. The only requirement for going to AA is a desire to stop drinking. You don't have to be an alcoholic. You don't have to sign up, you don't have to agree with the program, you don't have to do it any particular way. You don't even have to talk in the meeting. You can sit quietly in the back and slip out quickly any time you want.

AA can give you a lifeline to others who know about recovery. They can provide you with a road map and concrete suggestions about how to handle what you are feeling. If you go to a meeting and don't like it, don't assume that you won't like a different meeting. Some meetings are boring, some are abusive and most are profoundly supportive and life-giving.

If you are not comfortable in meetings, find at least one person to support you in your alcohol detox. Do not expect your spouse or partner, your daughter or your son to be your primary support. They are too closely involved. Find at least one person who has been there. Talk about what you are doing. Tell your story. Get books about recovery. Go to a treatment professional.

If you plan to stop drinking all at once, you must have medical supervision for your detox if any of the following are true for you:

1. If you have a history of blood pressure that is higher than 140/90.
2. If you have used more than a six pack of beer daily, more than six 4 oz. glasses of wine or more than eight ounces (half a pint) of liquor per day for over a year.
3. If you have had prior withdrawal symptoms, such as depression or agitation.
4. If you have ever had seizures for any reason, and in particular if you have had alcohol DT's.
5. If you are using any other (either illegal or prescription) drugs in combination with the alcohol. This particularly includes benzodiazipines such as Valium, Librium or Xanex.

Withdrawal from significant or long standing alcohol use can be a serious process. Keep yourself safe as you make this change. You are taking a very important and brave step. Withdrawal symptoms can include depression, insomnia, sweating, tremulousness, agitation, irritability, and brain "fog." In fact, go to the sidebar which lists the withdrawal symptoms for nicotine. You may experience may of these same things since alcohol and nicotine do share some neurochemical pathways.

Withdrawal usually starts 4-6 hours after the time you usually have your alcohol. If you drink every day at 6:00 PM, you will begin to experience discomfort that evening. If you have been a heavy drinker, your doctor may prescribe short term medication which will minimize the possibility of having seizures during detox.

Making the food changes in preparation for going off of alcohol will greatly enhance the likelihood that you can achieve and maintain long term sobriety.

When you actually start your detox, increase your vitamins and increase your fruit intake the first week you stop drinking. If you feel edgy during the day, have an additional 1/2 teaspoon of the B-complex liquid. (Don't have it in the evening, though, it will keep you up.) We encourage our clients to have 2-3 bananas a day for that first week. You can add one to your power shake and then use them as a snack later in the day. Make sure you have a baked potato before you go to bed. It will help your serotonin function and will support the normalization of your sleep patterns.

The clients in my clinic cannot believe what a difference it makes to have done the food plan first. They have fewer withdrawal symptoms, very little craving and feel better than they have in years. This food plan can support the power of your commitment.


Kathleen DesMaisons, Ph.D., Addictive Nutrition
www.radiantrecovery.com


May be reprinted and distributed with acknowledgement of authorship