Free The End of My Addiction by Olivier Ameisen M.D.

strove to limit the health impact of my binges when I couldn’t. The key time of the day for me was late afternoon. That was when my craving for alcohol began to build. Some days I fought the craving successfully, although the struggle left me feeling awful.
    Craving can be an elusive concept, because it has physical, emotional, and mental symptoms that come in waves over the course of hours and days, but for me it was a brutal fact of life. At its worst, research has shown, craving for an addictive substance models the hunger for food that starving people feel, releasing the same hormones and activating the same brain areas. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has stated that craving for alcohol can be even stronger than hunger or thirst, and that once alcoholism takes hold, the brain perceives alcohol as indispensable to survival.
    Thoughts about an addictive substance or behavior can insinuate themselves into an addicted person’s consciousness in even the calmest moments and quickly preoccupy the whole mind with anxiety about obtaining it. This is a harrowing experience mentally and emotionally as well as physically, because it is charged with shame and self-loathing for even experiencing the craving.
    Craving could propel me into a near-trance state, in which I set out to buy liquor as if someone else were controlling my body and directing my steps. When craving defeated me, I could only hope, pray, and strive to do a better job of resisting it the next day.
    I’ve already mentioned the AA acronym HALT, or Hungry, Angry, Lonely, Tired, the four situations that most foster and exacerbate craving. Eating food does attenuate craving. But at that time I didn’t know how to cook for myself, and ordering in food or going out for it did not offer the quicker and much fuller relief of alcohol.
    I went to many AA meetings, and twice achieved the AA goal of “90 in 90,” ninety meetings in ninety days. Often I went to two, three, or even four AA meetings a day. My sponsor constantly urged me to attend more meetings and said, “There is a chair with your name on it.”
    Unfortunately AA meetings could trigger powerful cravings for me because of the constant mention of alcohol. Other people in AA said they also had this problem. At the 79th Street Workshop, the last meeting of the day was at ten p.m. Sometimes as I sat there listening to the word alcohol being repeated over and over again, I knew that craving had won, and I slipped out to buy a bottle before the liquor stores closed at eleven.
    Partly out of denial that I would need to drink more and partly as a safety precaution, I always bought only one bottle and never stockpiled bottles at home. It was all too easy to binge to the point of a lethal blood alcohol level. My other great fears were a fatal gastrointestinal bleed or passing out and suffocating on my own vomit, both also not uncommon occurrences for alcoholics.
    When I woke up in the middle of a binge, I checked my eyes in the mirror to make sure they weren’t yellow from elevated bilirubin, a sign of serious liver stress. As I did so, I often vowed not to drink that day, and I sometimes succeeded in ending the binge or at least interrupting it for a day or two. Other times I told myself, “You’re not strong enough to fight the cravings today. Go with the flow and try not to drink too much.” I thought of this as not swimming against the tide, waiting until I could summon more strength for the struggle to stay sober.
    The daily question in a binge was how much I would have to drink until I could fall asleep and give my mind and body some rest from anxiety and cravings. If I hadn’t had enough, I woke up after only a brief sleep, still thirsty for alcohol.
    During the winter, I might wake up in the middle of a binge and see that it was five o’clock and dark outside. Then I wondered, “Is it five a.m. or five p.m.?” Five p.m. meant D-Day, victory, and 5 a.m. meant despair. I