Wet Brain


Wet brain is a form of brain damage. Wet brain is also called Wernicke Korsakoff syndrome, Korsakoff’s psychosis, Wernicke’s encephalopathy, and beri beri. The symptoms of wet brain may sometimes improve with therapy but it is often permanent and irreversible. Wet brain is caused by a deficiency of thiamine which is also known as vitamin B1. Chronic, heavy alcohol consumption can lead to a thiamine deficiency which can then lead to wet brain. This is because alcohol interferes with the absorption of thiamine. Wet brain can also occur in people who have never consumed alcohol. A diet of nothing but polished rice can cause wet brain because of the lack of thiamine in the diet. Wet brain can also be brought on by periods of vomiting which last for several days such as might result from severe morning sickness or bulimia. Wet brain is not caused by alcohol killing brain cells. A study by Jensen and Pakkenberg suggests that chronic heavy drinking does not result in the loss of gray matter–the thinking part of the brain–although it can result in the loss of white matter. The exact nature of the impact of chronic heavy drinking on cognitive abilities in well nourished individuals remains something of a matter of dispute. Symptoms of wet brain: Staggering, irregular gait, and other muscular incoordination Confabulation – remembering events that never happened Inability to form new memories Loss of memory–this can be severe Visual and auditory hallucinations Vision changes – including double vision, eyelid drooping, and abnormal eye movements


Treatment for wet brain:

Abstinence from alcohol, thiamine, and time can help lead to some improvements of Korsakoff’s psychosis. Total recovery is extremely unlikely.


(Alcohol is toxic to the brain.
It kills brain cells resulting in brain damage.
In the end stage of alcoholism, alcoholic dementia is relatively common.
While in a minority of cases, Wet Brain Syndrome can develop)

10 things no one tells you before you go to an AA meeting

Alcoholics Anonymous survivor John Sutherland explains why you should never interrupt someone or agree to buy a car while attending one of the fellowship’s meetings

1. The coffee is execrable

It’s like drinking paint-stripper. After years of alcoholism, you finally understand what ‘rotgut’ is.

But, for newcomers, what else are you to do with your shaking hands now that they won’t let you smoke? You gulp and gag and hope that it helps.

Occasionally, very occasionally, it’s a different story. The most upmarket AA meeting I’ve attended was in Gstaad, Switzerland. The place where, as the joke goes, they won’t even let Swiss born Roger Federer join the tennis club. At AA-Gstaad it was espresso coffee and Lindt chocolates to help the millionaires on their path to ‘recovering’. A rare experience.

I was so bowled over I almost couldn’t listen to the ‘shares’.

2. Sharing is not conversation

One of the first things newcomers have to learn is that ‘cross-talk’ – meaning dialogue, talking ‘to’ others in the group, during a meeting – is a no-no.

You share, spill your guts. The others listen, carefully reflecting on your spilt entrails, like Roman soothsayers. They do not respond (other than with a formal ‘thank you, John, for a wonderful share’, or whatever). No one offers ‘advice’ or ‘counselling’.

There’s a good reason. Dialogue leads to argument and argument, before you know it, leads to quarrels. Fights even.

‘Serenity’ is the desired atmosphere.

3. Chips with everything

AA is crazy about chips – or ‘sobriety coins’. You get a version of these small, key-ring medallions after 90 days, six months, and every calendrical milestone thereafter.

For newcomers they’re coloured leather (or its imitation). For old-timers (two years and plus), bronze. Mine? I’ve had it thirty years and my thumb has worn the inscribed serenity prayer off its surface. It’s flown away, I like to think, to help others embarking on a life without what they thought they couldn’t live without.


4. AA is not, oddly, all that focused on alcohol

Only the first of the 12 steps (the admission that you can’t control the stuff, or yourself when you’re drinking) touches on it. AA is about reconstructing your life. How you do it is ultimately up to you.

Don’t try to work anyone else’s programme, is the guiding motto. Just work your own.

5. No two groups are the same

Because AA is self-organising at the grass roots level, groups define themselves differently. Some go for big ‘speaker’ events. Others are ‘participation meetings’, where everyone has a chance to share. Some recommend ‘sponsoring’, others don’t.

There are men only meetings, women only meetings, and meetings for any variety of LGBT. Not exclusive (all are welcome), just self-selecting.

I’ve been to meetings at universities where the IQ is stratospheric. Others where there’s a guy just out of prison sitting on one side of you and someone who really ought to be there on the other.

Some meetings are fun, others glum. You find the slipper that fits your foot.

6. It works!

Or so meetings like to chant at the end of the session, after reciting the Serenity Prayer. But, of course, because of the anonymity rule, and no follow-up in the outside world, no one’s really that sure.

AA’s headquarters quotes figures as high as 75pc. Unlikely. But it’s a refrain in the fellowship that AA works better than aversive medicine (the dreaded antabuse, Ebola in tablet form), white coats (cognitive intelligence therapy), or sermons from self-appointed experts who’ve never themselves been there but know all about it (which, alas, includes most of the medical profession. Instruction about alcoholism at medical schools is abysmal).

7. Never buy a car from someone in your group

Likewise, never date anyone in your group. It always leads to tears.

What goes on in the meetings is a separate planet. Keep it that way. AA is not the Masons where, outside of gatherings, you keep in touch with code words or secret handshakes and conspiratorial ‘assistance’.

The AA World and the Real World should never meet.

8. Keep it simple

Supposedly the last words of AA’s founder, Bill Wilson. AA lives by the distilled wisdom contained in the proverb, motto, and slogan – not ‘theory’.

Top of the proverbial list is ‘One Day at a Time’. It’s a simple rule – but with a complex purpose. It shortens the horizon. Newcomers shudder at the prospect of never (ever, ever) being able to drink again.

‘Perhaps the Day after Tomorrow’ another proverb promises. But ‘tomorrow’ never comes. It’s always ‘today’.

Even more importantly, if I, after 31 years, 2 months, and 4 days, fall off the wagon, what have I lost? ‘Just a day’. It makes it easier to clamber back on again, and go for that 90 day chip.

9. Respect the first tradition: anonymity

Which, of course, is what I’m flagrantly not doing here. But the rules have relaxed since the patriarchs, Bill W. and Dr Bob, founded AA in Akron, Ohio, in the 1930s, when even to have stopped drinking was shameful – evidence of past ‘moral weakness’.

Nowadays, while sitting on appointment committees, I’ve seen personal statements in which the job seeker says they’ve been through AA (to counteract any mention of their drinking days in confidential letters of reference). No big deal.

10. The Serenity Prayer

Few have heard it before they first attend an AA meeting, but once it’s in your life it never leaves.

God, grant me the serenity to accept the things I cannot change,
The courage to change the things I can,
And the wisdom to know the difference.

Could wisdom be any simpler?








Where Science Meets the Steps

by David Sack, M.D.

Few approaches to addiction generate as much controversy as 12-step recovery. On one side are the ardent supporters of the program, some of whom credit it with saving their lives. On the other side are the critics and those who found that the program didn’t resonate with them or even hindered their recovery. Both have valid points, and both, in the end, are seeking answers to a problem that defies easy solutions.

It is understandable that 12-Step recovery would generate such strong opposing views. The program touches on fundamental questions everyone has to answer for themselves. Still, it works for many where other approaches fail – and that, to me, is enough to warrant further investigation.

Although it is by no means a perfect program, many of the objections to 12-Step recovery are based on widespread misconceptions. Let’s clear up a few of the most common misunderstandings:

#1 You have to be religions  or believe in God to make the program work.

The 12 Steps contain numerous references to God or a higher power, and some meetings conclude with a prayer. Although the Steps were initially conceived from a Christian point of view, the core principles have been beneficial for millions of people who do not believe in God. Like other texts and programs, the 12 Steps are a series of words and concepts that are open to interpretation.

Some people have difficulty maintaining abstinence by willpower alone and need to look outside themselves to a “higher power” to change their behavior. A higher power can be a religious deity or entity, but it can also be the power of a group working toward a common goal, nature or some other outside force. If you feel uncomfortable with the spirituality  of a particular group, keep searching until you find a closer match.

#2 Powerlessness frees the addict from accepting responsibility.

While the initial choice to use drugs or alcohol is within the individual’s control, once physical or psychological dependence sets in, they have lost control. Despite repeated attempts to quit, they continue using even in the face of job loss, financial and legal troubles, and other negative consequences. Powerlessness occurs because prolonged drug abuse changes the structure and function of the brain, and it takes time in sobriety to repair the damage.

Powerlessness does not mean that the addict is inherently flawed, exempt from thinking for themselves or incapable of recovery, or that they can rely on their higher power to fix everything without taking steps to improve their own lives. That would contradict the entire premise of the 12-Step program. Instead, it is a statement about the nature of the disease, designed to remove the blame and shame that often prevent addicts from getting help, and to show addicts one way of reclaiming power over their lives.

#3 Addicts substitute their addiction with a dependence on 12-Step meetings.

As a chronic, relapsing disease, long-term care is vital for sustained addiction recovery. If meetings provide some recovering addicts with the support and fellowship they need, they are encouraged to keep going as long as they wish. In the early stages, people may benefit from frequent attendance, which often diminishes over time as they develop other support systems and become more firmly grounded in their recovery.

Addicted or not, everyone needs support. If recovering addicts find that support in 12-Step meetings, they should continue to go. This type of ongoing participation in a program that improves members’ lives is very different from a destructive drug or alcohol dependency.

#4 The 12-Step program is a cult.

Twelve-Step programs have overarching principles and traditions that may seem unusual to people unfamiliar with addiction and recovery. It is a close-knit group of people who share similar struggles, but this does not make it a cult. People are free to participate or not, and to take what works for them and leave the rest. There is hope that participants will embrace the wisdom of some of the 12-Step principles but they are also encouraged to think critically and to find their own way.

#5 There are too many rules.

Twelve-Step recovery is full of guiding principles and suggestions, but there are actually very few rules. Working the Steps is a choice participants make, of their own volition, every day. You can come and go as you choose, adapt the program to suit your needs, and if you relapse, the group will welcome you back with open hearts.

The 12-Step principles are not random or haphazard. Rather, they address specific deficits in learning, memory , empathy  and other areas impacted by drug abuse. Sharing stories, along with routinely scheduled meetings and oft-repeated mantras, for example, help addicts remember the next right thing to do even when their thinking is still clouded by drugs.

#6 Twelve-Step recovery is for old men, losers and people who are too weak to do it on their own.

This misconception is based on inaccurate and outdated information. Addiction is a chronic, progressive illness, not an issue of willpower, and it affects all types of people. The opposite of weak, it takes tremendous strength and courage to reach out for help. Some people may be able to recover on their own, but most cannot – and there is no shame in that. People with other chronic diseases do not expect to heal themselves, nor should addicts. Even teens benefit from 12 step programs.

Addicts often feel they are different, better or less damaged than the people they meet at 12-Step meetings. In a group as diverse as is typically found in a 12-Step meeting, it would be surprising to instantly connect with, or even agree with, the perspectives of every member. You may look different on the surface but inside, the people in 12-Step recovery are fighting to stay clean just like you. Even if their stories are different, the underlying messages, struggles and goals are similar. If you feel out of place in a specific meeting, look inward to see if you are unfairly judging people before you get to know them. If you get to know the people a bit better and still feel uncomfortable, consider trying a few other meetings.

#7 Twelve-Step programs don’t work.

There has always been a divide between two schools of thought on addiction: the scientific community and the recovery community. At least in part because of this divide, there is a lack of scientific evidence documenting how and why the 12-Step program works (though anecdotal evidence is abundant). Science has long dismissed 12-Step recovery, leaving a dearth of data where 75 years of history should provide much more, and 12-Step recovery has long rejected the need for and validity of scientific inquiry. But the necessary conclusion is not that 12-Step recovery doesn’t work; rather, the research, to date, has been inadequate.

It’s unfortunate that 12-Step recovery is widely misunderstood and under-researched. Even less fortunate is the fact that these misconceptions drive people away from the process before they can evaluate whether the program might make a difference in their recovery. Like any single approach to addiction, 12-Step recovery isn’t for everyone. But for those who give it a fair try, the potential payoff is great. Recovery is not just about stopping one isolated behavior (drug use) but learning a new way of life – and this is the real value of 12-Step recovery.

David Sack, M.D., is board certified in psychiatry, addiction psychiatry, and addiction medicine. As CEO of Elements Behavioral Health he oversees addiction treatment programs at Promises Treatment Centers in Malibu and West Los Angeles, The Ranch outside Nashville, The Recovery Place rehab in Florida, Texas drug rehab The Right Step and Spirit Lodge, and San Cristobal rehab for men in New Mexico. You can follow Dr. Sack on Twitter @drdavidsack.

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What Would The World Be Like If Obituaries Started Saying, ‘Lost Their Battle With Addiction’?

By Abby Rosmarin


I’m going to hate that this is my opening paragraph and I’ll tell you why in a minute. But, for the sake of starting this, let’s just get it over with: another person from my hometown recently died from a drug overdose.

There was no big overlap in our lives. He graduated from our high school four years before I did. I didn’t know his family and he was not part of the same groups as me. But it didn’t really matter. My heart hurt for his family. My heart hurt for his friends and my heart hurt for his life cut short. My heart hurt in a way that would make people accuse me of being unnecessarily sensitive. I was holding back tears for someone I had never met. I was mourning a face I was seeing for the first time in an obituary.

But there was something that caught my eye. For the first time in my life – for the first obituary in an absurdly long list of obituaries that I’ve read – I read that he had died, “after a well-fought battle with addiction.”

He died after a well-fought battle with addiction. A battle with addiction. I’ve lost count of the number of obituaries I’ve read where the person had died from something addiction-related. This was the first time I had ever seen that kind of phrasing.

What if this approach to describing an addiction-related death were the rule, not the exception? What would happen if we dropped the euphemisms – or if we stopped omitting the cause of death entirely, afraid that people wouldn’t show sympathy if they knew the truth?

What if we labeled these overdose deaths what they actually are: a lost battle with addiction?

I know I’ve gone on spiels like this before. After Robin Williams’s passing, I said that we needed to start seeing suicide as a lost battle with depression. And, while I’ll be the first to admit that the phrase “lost their battle” is problematic (making it sound like the onus was on the patient to “beat” it, or that they would’ve been guaranteed a win if they had just fought harder), to phrase that kind of death as a lost battle is lightyears better than what we have right now.

What would happen if we stopped acting like addicts got what they deserve? What would happen if we finally let go out some seriously outdated views on things like addiction and finally looked at them the way they are supposed to be looked at?

We still have such specific attitudes and value judgments about addiction. We scroll past the parts about genetic predispositions (which accounts for over half of all addictions cases) and past the parts about neurological rewiring. We deliberately turn our backs on the reality of the situation. Instead, we look at the full spectrum of diseases and label people the victim in one, but a perpetrator in the other.

Some are even hesitant to call addiction a disease in the first place.

It reminds me of a Mitch Hedburg joke: Alcoholism is a disease, but it’s the only disease you can get yelled at for. While every disease will have it’s own varying shades and layers to it – and while every patient will react to their individual illness in different ways – the fact remains that the tone shifts when you find out someone is struggling with addiction. Dammit Otto, you’re an alcoholic. Dammit Otto, you have lupus.

Ironically, Mitch Hedburg would lose his own battle in 2005.

So let’s get back to my opening paragraph. What feeling does, “He died of an overdose” usually elicit? Maybe we’re sad. Maybe we’re angry. Maybe we think he had it coming. Either way, we get a very set image in our head: he took too many drugs, his body couldn’t handle it, and he died because of it. We gloss over a history of addiction and focus on one specific action, as if he carelessly went bungee jumping without checking the cord and hit the ground instead.

Dammit Otto, you did this to yourself.

We tiptoe around the subject. We use euphemisms. We omit and lie with the truth. She died in her sleep – meaning she was unconscious on her bed when she died. And all this does is cement a lot of old and outdated attitudes. It keeps the taboo and the stigma preserved, making it just that much harder to solve a very real problem.

Some argue that, had we recognized addiction as a disease from the very beginning, we’d be upwards of 40 years ahead in research and treatment. Think about that. Think about the medical world in 1975. Think of how antiquated and outdated almost every method is. Imagine being able to look on how we treat addiction today as if it were how we did things back in 1975. Where would be today? How many obituaries would we be reading for men and women who ultimately lost their battles with addiction?

Sometimes I feel like a broken record. I’ve already wrote, downright begged, for us to actively change how we go about addiction. And I hate that this time, much like the last time, it was all inspired by yet another death. Another obituary, another part of a frightening trend. But think about it: where would we be if we replaced all of the euphemisms and omissions? Where would we be if we started seeing overdose deaths as a lost battle?

Maybe it wouldn’t do much. Maybe it would be a pointless change in the ever-evolving world of semantics. Or maybe it would be just enough to rethink how we go about addiction. Maybe for a brief second, a flickering moment as we read “he lost his battle,” instead of “he ODed.” Maybe it would be just long enough that we understand that it’s an illness. That, like many illnesses, you can be born with a predisposition for it. That, like many illnesses, it can chemically change you. That, like every illnesses out there, it’s not something you can overcome by telling yourself to get over it, ignoring whatever few resources we have out there.

More people die every day from overdoses than they do from car crashes and I’m exhausted from the sheer number of obituaries for people in my hometown, for people that I once knew, for people that those I love once knew. Words are a powerful force. Maybe it’s time to see what one little change can do.m

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Daily Reflection

cover daily reflections
January 22
A few hours later I took my leave of Dr. Bob. . . . The wonderful, old, broad smile was on his face as he said almost jokingly, “Remember, Bill, let’s not louse this thing up. Let’s keep it simple!” I turned away, unable to say a word. That was the last time I ever saw him.
After years of sobriety I occasionally ask myself: “Can it be this simple?” Then, at meetings, I see former cynics and skeptics who have walked the A.A. path out of hell by packaging their lives, without alcohol, into twenty-four hour segments, during which they practice a few principles to the best of their individual abilities. And then I know again that, while it isn’t always easy, if I keep it simple, it works.
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Brain on Alcohol


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