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Can drinking cause a stroke?
October 4th, 2011 / Living Sober / James W. West M.D. F.A.C.S.
Question : My mother had a stroke three years ago. With intensive rehabilitation she is now able to function pretty well. She is 60 now, but up until the time of the stroke she drank almost every day. At the most she would have four or five drinks, but regularly. I never saw her drunk. These drinks would always be separated in the most “civil and socially acceptable manner.” Many of her country club friends are still following this routine. In the past year she has been gradually getting back into the kind of social life she enjoyed before. She has also started to...

Why do I keep relapsing?
September 20th, 2011 / Living Sober / James W. West M.D. F.A.C.S.
Question : I have been going to A.A. for a number of years now, but every couple of months I slip. I put together a year of continuous sobriety three years ago and felt so good about myself. I have a sponsor and I go to meetings. Am I going to be one of those people about whom they say “He could never make it”? Answer : It would be a pity if that were true. Take heart – many others have gone through this same relapse history and have made it. I suggest that you read the beginning of Chapter 5 in the Big Book of A.A., which starts by saying that “Rarely have we seen a person...

How Does Alcohol Affect Athletic Endurance?
May 3rd, 2011 / Living Sober / James W. West M.D. F.A.C.S.
Question: I am 46 years old and have been competitive in local and even some national women’s amateur athletic tournaments. I am also a recovering alcoholic with seven years of sobriety behind me. I have noticed in the past year that my endurance has decreased and I seem to get short of breath more quickly than my contemporaries with whom I’ve been competing all these years. I have checked with my doctor a number of times and she says that there doesn’t seem to be anything wrong. I have not told the doctor about my previous heavy drinking because I have been sober so long. Do you...

How does one become an effective sponsor?
April 1st, 2011 / Living Sober / James W. West M.D. F.A.C.S.
Question: Are there any directions about how to be an effective Alcoholics Anonymous sponsor? A sponsor is an alcoholic who has made progress in the recovery program and shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety through AA. A sponsor usually shares her or his own story and how the program has led to sobriety. Sponsorship includes bringing the newcomer to a variety of AA meetings and introducing him or her to other members in the group. The Big Book of Alcoholics Anonymous is a central part of the...

What happens if I hold secrets?
March 29th, 2011 / Living Sober / James W. West M.D. F.A.C.S.
Question: Is it a mandatory Alcoholics Anonymous rule that when a person has a “slip”, he or she must declare it to the AA group in order to stay sober? I told my sponsor. Why isn’t that enough? Answer: Alcoholics cannot bear heavy secrets for long without falling under the weight. Only sharing it with others offers relief. Every little detail of the episode does not need to be told. The bare facts are enough, including a new sobriety date. There are feelings of guilt and failure, coupled with the humiliation of “having to tell” that are part of the event. To suppress...

How can I stay absolutely honest?
March 25th, 2011 / Living Sober / James W. West M.D. F.A.C.S.
Question: I have been sober for eight months, and am realizing I cannot really live the Alcoholics Anonymous program and keep my job, which involves an illegal activity. The Big Book is very clear about being absolutely honest in everything, which I cannot do and survive in my business. What should I do? Answer: Getting and staying sober is more than just quitting drinking. After a short time on the program, the alcoholic’s conscience emerges after being partially buried for those drinking years. I do not know what your business is, but laws are passed to protect the people....

Is there an AA success rate?
October 19th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: What is the success rate of Alcoholics Anonymous? I have never seen it published. Answer: Every few years Alcoholics Anonymous does a survey of its members. In 1992, a random survey of 6,500 A.A. members in both the United States and Canada revealed that 35 percent were sober for more than five years; 34 percent were sober from between one and five years; and 31 percent were sober for less than one year. The average time sobriety of members is more than five years. According to A.A. World Services, the survey is designed to provide information to the professional...

Can AA Ask you to Leave?
September 20th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: Can a person by expelled from AA if he keeps having slips? Answer: No. This is one of the identifiable indications for getting professional help, ideally in an inpatient or intensive outpatient program. Whether the slip is a short-term, low consequence relapse or a major alcoholic catastrophe, success is always possible and probable if the person in question is persistent in his or her wish for sobriety and continues to attend A.A.

Is Exercise Important in Recovery?
September 20th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: I am a 51-year old recovering alcoholic woman who has never exercised in a formal way. I would like to start an exercise program now to get in better shape. Answer: Starting a regular exercise program can be one of the most valuable tools you can include in your recovery program. Regular exercise is an excellent way to manage stress and anxiety as well as increase your feelings of well-being. It is important to develop a program that is rewarding and satisfying. If it is not fun, you won’t do it.

What Can I Learn in AA?
September 20th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: I have been through a treatment center for alcoholism. I was told by my counselor that I should attend AA. I went a couple of times, but I knew more about alcoholism than most of the people there, even though a lot of them have been sober a long time. What more can I learn? Answer: How to stay sober for a long time. A piece of knowledge you may have missed is that you must go to any length to achieve permanent sobriety and going to AA meetings is one of the most essential lengths.

What are Financial Rewards of Treatment?
September 20th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: Can you give any concrete data on the economic savings that result from successful treatment of alcoholism? Answer: there are so many economic advantages. Here are just a few: 50 percent decline in medical services; 60 percent decline in psychiatric services; 30 percent reduction in ER admissions; 50 percent reduction in psychiatric ER admissions; 75 percent in detoxification services. Also, according to the “Cal-Data” Study (by the State of California in August 1994), every dollar spent for treatment returns $7 in savings primarily due to reductions in...

What is the Difference Between Dry and Sober?
September 20th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: I quit drinking and that is that!! Although most of the time I feel like having a drink, I don’t. My girlfriend, who is in Alcoholics Anonymous, keeps asking me to join; she says there is a difference between being “just dry” and being sober. Sounds hair-splitting to me, but either way I don’t drink with the crowd and I stay dry. Answer : Tell her to lay off (nicely) but watch her grow emotionally and become more serene and balanced as time goes on. You may see a kind of happiness that radiates from these not only dry but sober people in A.A. Being “dry”...

Why Didn’t Treatment and AA Work?
September 20th, 2010 / Doctors Office / James W. West M.D. F.A.C.S.
Question: My son died two years ago while drinking and driving his speedboat alone. He had been through two treatment programs and went to AA for a while. Answer: I offer my deepest condolences to you. He tried and had he persisted, which he hopefully would have, he probably would have made it. People who don’t quit trying for permanent sobriety, in spite of many relapses, almost invariably make it. Drowning is the number four cause of accidental death in the United States and is related to alcohol use about half or more of the time. I hope you have had the...

How does Diazepam relate to Addiction?
August 27th, 2010 / Doctors Office / James W. West M.D. F.A.C.S.
Question: I have been dry four years and I do not belong to any sobriety organization. I have used my own willpower to stop drinking. Two and one half months ago, I had some business reversals and I had great difficulty sleeping. My doctor prescribed a mild nerve pill which helps me to sleep all right, but I have the same feeling I had after a drink or two. The name of the pill is diazepam. Answer: My guess is the reason you have written is that you feel you are on dangerous ground. Let me reinforce your concerns: You are at risk of either becoming hooked on these...

Are there people who don’t make it in AA?
June 24th, 2010 / Doctors Office / James W. West M.D. F.A.C.S.
Question: I have been going to A.A. for a number of years now but every couple of months I slip. Am I going to be one of those people about whom they say “He could never make it”? Answer: It would be a pity if that were true. Take heart---many others have gone through this same relapse history and have made it. I suggest that you read the beginning of Chapter 5 in the Big Book of A.A., which starts by saying that “Rarely have we seen a person fail who has thoroughly followed our path.” The emphasis throughout this first paragraph is rigorous honesty.

Is there a connection between alcoholism and eating disorders?
June 24th, 2010 / Doctors Office / James W. West M.D. F.A.C.S.
Question: I have been in recovery with AA for three and a half years. I am also anorexic. Is there a connection between alcoholism, anorexia and bulimia? Answer: There is evidence of a relationship between eating disorders and alcohol abuse in women. A study (Goldbloom, British Journal of Addiction 87, 1992) of two populations of adult women, those presenting for alcoholism treatment and those referred to a specialized eating disorder program, showed that 30 percent of the women in alcoholism treatment met the diagnostic criteria for an eating disorder and 26.9...

How long does withdrawal last?
June 24th, 2010 / Doctors Office / James W. West M.D. F.A.C.S.
Question: How long does alcohol withdrawal last? I ended my last binge twenty-seven days ago and I am still shaky and I can’t sleep. I’ve been going to AA daily. When do I start feeling better? Answer: Soon; hang in there! It really does get better. Because you were a heavy drinker you are still experiencing a condition known as protracted withdrawal syndrome. This state of affairs is characterized by restlessness, irritability, impatience and a general sense of disquiet. The length of time for this condition is proportional to the length of time you have been drinking...

Do alcoholics recover without AA?
June 24th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: Do alcoholics recover without having to go to AA [Alcoholics Anonymous?] Answer: Persons with alcohol problems have stopped drinking without the AA program and have done so for centuries. Professionals and others who know the disease see simply not drinking and recovery from alcoholism as two different things. There are those whose drinking problem ends with going on the wagon. These persons are dry, but for the most part are unchanged in their thinking and attitude. The lack of change distinguishes them from those who are dry and also in recovery. Since...

Is AA for life?
June 24th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: Is it necessary to go to AA meetings for life? How long does treatment for alcoholism take? Answer: Yes. Treatment takes as long as a person has alcoholism , which is a lifetime. As with diabetes, heart disease, rheumatoid arthritis and other similar chronic illnesses, the treatment is ongoing. The goal of treatment in all these conditions, including alcoholism, is to establish a steady state of optimal health and functioning. This means that the destructive symptoms of the disease are arrested. However, in some diseases like alcoholism,...

Do people need AA when they move?
June 24th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: I have been going to AA [Alcoholics Anonymous] meetings for about two years and I have heard it all. I am moving to a new city and I am inclined not to start these meetings again when I relocate. What is your experience with people who follow this plan? Answer: I have probably detoxified a number of them without knowing this was the plan that resulted in their relapse. Remember, it is the nature of the illness that one is more vulnerable in times of change, so I would strongly advise that you get to meetings immediately upon your arrival in your...

Should I follow advice to not go to AA?
June 24th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: I am in the ninth year of my sobriety, and for the last three years I have attended AA [Alcoholics Anonymous] perhaps once a year at most. During the first seven years, I had a wonderful analysis and in the final year my therapist’s goal was to wean me away from AA. He is familiar with and supportive of the program but claims that my progress, growth and insight were so strong that AA and its “peer counseling” were restrictive to my growth. I am not better than anyone else and I am grateful to AA for starting me on the road to recovery. I have no desire to...

How long do I have to go to AA?
June 24th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: How long does a person who has gone through a treatment center have to keep going to AA? I feel that I have learned enough in the treatment center to get along without drinking. How about it? Answer: It works this way. You have a chronic disease (alcoholism) characterized by relapse. Experience with people who are recovering has taught us that unless a person constantly renews his commitment to sobriety, his resolve to abstain may totally erode. There are complex reasons for this. Recovery starts with the penetration of denial which every...

Does AA work?
June 24th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: I have been hanging around AA for years and it hasn’t worked. I know all about the steps and all that stuff. I even went to AA meetings while I was in prison. I’ve had the D.T.s a couple of times. Doctors don’t know anything about alcoholism—they just tell me I’m going to die if I don’t quit—anyway there are more old drunks than old doctors, ha ha. I’ve had a couple of drinks just to write this but I’m just about to give up. Answer: Please don’t! In the rest of your letter you mention that you are 62 years old and have lost...

Is religion involved in AA?
June 24th, 2010 / Living Sober / James W. West M.D. F.A.C.S.
Question: I go to AA meetings every week or so, but I am turned off by the religious tone of the discussions. I relate to the drinking stories of the other members and they seem to have helped me stay sober so far. However, I do not understand what the God part has to do with it. Answer: A quote from that great psychiatrist Carl Jung, who was also a close friend of Bill Wilson, the founder of A.A., expresses the answer to this good question better than I can: “Among all my patients in the second half of life---that is to say over 35---there has not been one...

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