Post-Op Alcohol Abuse PSA

[DianaCox]

I've seen or heard about some posts recently on various message boards in which post-ops are discussing what is clearly alcohol abuse, seemingly without owning it for what it is, and - to my surprise - without other people calling it out for what it is.

It is well known that post-op bariatric patients are at heightened risk for alcohol abuse, for a wide variety of reasons, including trading one addiction for another; underlying psych issues and medications potentiating the effects of alcohol; increased absorption of alcohol; reducing the stress of coping with changes in their life induced by weight loss; and the just plain life-shit that affects everyone getting out of hand.

Anyway, this is just a reminder that if you see someone posting on the internet in the bariatric groups who is clearly or even possibly abusing alcohol, you should call it out, either publicly or at least privately. If they are posting about it, and nobody calls them out, that may well be the same as endorsing that what they are doing is OK. Remember - we wouldn't ignore it if they were not taking their vitamins, so why would you ignore it if they are abusing alcohol? That is just the same as being a rainbow and unicorn enabler over specific bariatric issues.

Here are some of the signs: http://www.helpguide.org/articles/addiction/alcoholism-and-alcohol-abuse.htm

Common signs and symptoms of alcohol abuse include:

• Repeatedly neglecting your responsibilities at home, work, or school because of your drinking. For example, performing poorly at work, flunking classes, neglecting your kids, or skipping out on commitments because you’re hung over.
• Using alcohol in situations where it’s physically dangerous, such as drinking and driving, operating machinery while intoxicated, or mixing alcohol with prescription medication against doctor’s orders.
• Experiencing repeated legal problems on account of your drinking. For example, getting arrested for driving under the influence or for drunk and disorderly conduct.
• Continuing to drink even though your alcohol use is causing problems in your relationships. Getting drunk with your buddies, for example, even though you know your wife will be very upset, or fighting with your family because they dislike how you act when you drink.
• Drinking as a way to relax or de-stress. Many drinking problems start when people use alcohol to self-soothe and relieve stress. Getting drunk after every stressful day, for example, or reaching for a bottle every time you have an argument with your spouse or boss.

Just because someone is being open about their drinking, doesn't mean they are actually accepting the fact that they are abusing alcohol - it means they are DARING you to call them out, by acting like what they are doing is OK, or making excuses for why they are drinking. BUT IT IS NOT OK, AND THERE IS NO EXCUSE FOR ABUSE.

 

[Jo777]

By someone who is very openly (on the boards, with family, friends..) working to fix an unhealthy relationship with alcohol myself, I never thought I'd be in the situation I'm in. I thought I was smarter than to fall into that particular issue. Those last two of that list apply, thankfully not the others.. BUT if I let things progress, a few years down the road? Scary thought, not to mention health issues.

I DID start out by misusing alcohol for stress relief, and never-ending stress created an opening for an escalation in drinking that I was unprepared for frankly, but walked into anyway. I was aware of it, but not willing to do anything about it at the time. I should have nipped it in the bud early on, but didn't. It just went south from there, as it did not help my moods, and only magnified the mood I was currently in.. start drinking to "fix" a bad mood, does not end pretty. It's taken me a bit to learn that, but I have.

My opinion, I wouldn't necessarily advocate for a public "call-out".. a couple well-placed words of concern for a pattern (if there is one) happening that isn't healthy, followed by a pm with more detail- yes, but public shaming/call out/intervention of a potential problem/developing problem I don't think is helpful. ESPECIALLY if you suspect they are actively under the influence at the time.. I am not an expert in addictions, and I have no idea what makes someone get back to a balanced place, so who knows.. I just know my own experience and how I work (or don't.)

I also don't see public posting of drinking behaviors as a "dare" to call them out, for some, it's a way to work through the admission to themselves that things may not be quite right in their world. You don't wake up one morning and suddenly have clarity that "oh, I DO have an abusive relationship with alcohol!" It takes some time to note, come to accept as true, then figure out how you wish/need to address it. I'd be willing to wager that IF the person does have a truly unhealthy relationship with alcohol, they already KNOW they do.. but knowing it, getting the intention in place to work on it, then actively working on it are three different stages. You can't force a person to fix something they are unwilling to fix yet, but you can encourage, and you can help prevent harm as much as possible.. try to keep them safe, as well as others around them, physically and emotionally (meaning, sometimes you need to distance yourself physically if they are drinking/refuse to participate yourself if you believe it encourages the problem to continue.)

Putting out warnings to everyone, regardless of surgery type, about the traps of alcohol- YES most definitely.. even the ones that think never me, might get sideswiped at some point.

 

[DianaCox]

Thank you for your view on things - as I often do, I hit the highlights of what I was thinking without the nuance, which is what I was hoping it would provoke others to provide and fuel further discussion. And I'm sorry you have had to deal with these issues personally.

I'm aware of course that this statement would be controversial in particular: "you should call it out, either publicly or at least privately" - and I said it because when someone publicly posts about their abusive drinking, there are MANY people potentially in and around the conversation: (1) the alcohol abuser; (2) non-abusing readers (presumably IRL friends, family and relative strangers); (3) future readers of the thread; and (4) IRL friends and family who are NOT reading the posts. To be honest, the abuser is unlikely to benefit immediately from someone calling them out publicly - that's true. When I wrote the post, I was thinking of publicly calling it out as having two possible benefits - ensuring that the abuser did not take from the lack of calling it out as tacit approval or lack of concern, but more that others reading the post (or coming to the thread later) didn't think it was OK - that is actually the larger audience for posting concern and disapproval than the abuser him/herself, as they are unlikely to benefit immediately anyway.

I don't have personal experience with addiction - but I have personal experience in DEALING with someone with addictions. Ignoring it (as the potential observer and commenter), hoping the person will realize it and fix it themselves, is never helpful - it NEVER happens. It harms the abuser and the person withholding/trying to ignore it. But I actually think it's worse on the least empowered observers who see it and don't see the person who is in a position to call it out DOING anything about it (and here, I'm thinking of my kids, who saw their father using and me being oblivious - perhaps deliberately - for a while) - they don't understand why the abuse is being tolerated. Does that make it OK, or even normal? I think it desensitizes them to identifying abuse in the future.

And, even if eventually gets addressed, what is to be made of the group ignoring the pink elephant in the room, ESPECIALLY when it is occurring in a place where people come for support, in particular in bariatric support groups? It seems to belie the mission of those groups, which is (at least in some instances) to PROVIDE SUPPORT - and letting someone yammer unopposed about their self-destructive drinking without calling it what it is feels very wrong to me.

I guess what I'm saying (with my somewhat cynical background) is that my concern is more about the group than the abuser, and that while saying something will not necessarily help the abuser (immediately), it MAY help other members of the group who are put into a state of confusion and anxiety about seeing someone self-destructing, without someone (in particular, one of the more experienced vets) saying SOMETHING about it not being OK.

 

[Jo777]

True addiction, yes unlikely, but not impossible that the person will fix it themselves unprompted.. I have witnessed that happen with a friend.. Many more however do need a shove, to get "popped" or whatnot.. honestly doubtful that anything on a message board will get them into the place of getting help, that usually needs to come from a lot closer (friends, family, work, law.)

I guess I have a bit of a rose-colored view that most having issues, know they are.. and want to eventually fix the issue, whether it's abstinence or just putting things back into normal sane balance. That probably comes from being in a place where I abused something that I formerly had a pleasant relationship with, vs. someone who has went much further down that path. Getting a person to pull up short before a psychological dependence becomes a full fledged physical dependence is the best outcome, and if that gets the attention of someone else that's walking the same road- great, win-win. So, my roundabout brings me back to: yes, get their attention that you are seeing a problem start up.. as early as possible, as kindly as possible.

Taking my fluffy bunnies and rainbows and going on my way now..

 

[DianaCox]

Since my post was prompted by a particular poster, I'm trying to not be too specific, but someone to whom at least four of the above criteria apply, and who I hear is freely and seemingly without concern about what people might say mentioning doing things that should not be done while under the influence, while drinking. That seems to show a lack of perspective or realization of the depth of the problem, and I am surprised that nobody has said anything (and I could be wrong, of course - I'm not there). And the latter is what prompted my comment, more than any interest in an intervention for ANY particular person.