Maybe you don’t consider yourself an “alcoholic,” but you’d still like to reduce your drinking. That’s where Heather Serody, founder of the blog Thrive in Midlife, found herself not too long ago. A mother of two, she would use wine to cope with stress, to the point where she’d drink more than she wanted. But that changed when she discovered naltrexone, a medication that lowers alcohol cravings by reducing the pleasure received from drinking.
I recently interviewed Heather via email and webcam. We discussed how over-drinking affected her life and how naltrexone worked like “kryptonite” for her alcohol habit. Check out our webcam conversation below, followed by our email interview.
Katie Lain, Ria Health: In your blog, you address the notion of “over-drinking,” which you describe simply as “a place where you find yourself drinking more than you want to.” This isn’t a full-blown alcohol addiction, but alcohol is still impacting your well-being. A lot of people find themselves in the same place: not feeling in control of their relationship to alcohol. Can you describe what th dialogue was like inside you when you began to question your own over-drinking?
“It Is an Emotionally Exhausting Place to Be In”
Heather: The dialogue goes like this: I’m not drinking tonight. Then, often around dinnertime, the thought would pop into my mind: I want a glass of wine. Then I tell myself, “No, I’m not drinking tonight.”
In the beginning, this might happen once or twice. I’d be able to distract myself or go for a run and that was it. But over the course of 10 years this cognitive dissonance—wanting two opposing things at the same time—grew. Thinking this way feels like an exercise in insanity. Eventually over the years this dialogue might repeat over and over up to 20 times. It is an emotionally exhausting place to be in.
Inevitably, I started giving in more and more often to drinking when I didn’t want to.
Ria Health: You have two sons, and you realized you were using wine to cope with the “trying to do it all” mentality. What are your thoughts on the “mommy wine culture”? And what do you think about alcohol being marketed to moms as a way to cope with the stresses of mom-hood and life?
“Women Often Still Expect Themselves to Be Able to Do It All”
Heather: I was watching the movie Book Club last night and noticed the plethora of scenes in which the main characters are drinking wine. The premise of the movie is about not giving up on a woman’s right to a fulfilling sexual life as she gets older. The wine consumption in the movie is symbolic of releasing societal and familial inhibitions enough to go for the the life these women deeply want.
Women often still expect themselves to be able to do it all, do it well, and they put incredible pressure on themselves to do it perfectly. This is what I call a pressure cooker, and often there needs to be a relief valve. That relief can just as easily be yoga or wine.
Over-drinking is often a symptom of how other pressures in our lives are imbalanced and need addressing. I don’t have a problem with wine being marketed to mommies any more than I have a problem with yoga being marketed as a way to relax. However, if we find ourselves over-drinking, then it is up to us as individuals to address imbalances and take full responsibility for where we are with all of our actions.
Ria Health: When you realized you were using wine to cope, you stopped drinking during the week for 10 years. You talk about how you beat yourself up anytime you would “slip up” and drink on a weekday. Over time, that mentality chipped away at your own self regard. Can you speak more about this experience?
“I Quietly Worried That I Was Becoming Addicted”
Heather: I spent more than 10 years asking myself to not drink during the week. Although most of the time I was successful, I always felt like I was failing on the mornings when I would wake up and see the empty glass of wine in the sink, even if I’d had just one glass the night before. I would always ask myself why was it so hard to just leave it? Does this mean I have a problem? I knew that I was an incredibly disciplined person, and it didn’t make sense. I quietly worried that I was becoming addicted, and as a result I became a hyper-vigilant disciplinarian and consistently ended up disappointing myself. Over time, this self-judgment and disappointment began to chip away at my positive self-regard. I had always believed that I could do anything I set my mind to, and eventually my relationship to alcohol took that away from me.
Over-drinking is often a symptom of how other pressures in our lives are imbalanced and need addressing.
I also see now that between the time I was 35-45, when extremely stressful events happened I’d lean more on drinking for relief. Whether I was lost in grief, was having relationship problems, coping with crushing worry over a family member’s cancer diagnosis, or going through an incredibly stressful moving process—those were all instances where I would find myself drinking more than I wanted to. And then I’d have to mightily struggle to dial back my drinking to an acceptable place. I needed insight and some tools to help me, but all there was was AA, and I knew I wasn’t an alcoholic. I was something in between, but I didn’t know what.
Ria Health: When you decided you wanted to change your relationship with alcohol, you were having a glass or two of wine a day. This isn’t a ton of alcohol, but you still realized it was holding you back in life. In society, we have this rock bottom mentality of alcohol where you’re either a full-blown alcoholic, or someone who doesn’t have an alcohol problem. And I think your story highlights perfectly how that’s not always the case. Alcohol can still be controlling us, even if it hasn’t destroyed us yet. Can you speak about this a bit more?
“Alcoholism Is a Progressive Disease”
Heather: Yes, I agree 100 percent! I just decided that for me, there was no way I was going to be someone who had to hit “rock bottom” before I got control. I threw myself into learning about why we become addicted to alcohol so that I could interrupt this addictive process downstream. The first thing I learned is that alcoholism is a progressive disease. This meant that unless I did something radically different and/or got some kind of help, that I was destined to become fully addicted to alcohol.
I knew I’d have to short-circuit the pleasure/reward mechanism that alcohol creates in the brain. I read several books about alcohol, and stopped drinking for more than six months two different times. I took a course. I experimented with myself and tried scheduling my drinking ahead of time. I learned that it is absolutely not my fault, or a character flaw, or anything to be ashamed of when you find yourself drinking more than you want to. Mother Nature hardwired us to become attached to pleasure.
I just decided that for me, there was no way I was going to be someone who had to hit “rock bottom” before I got control [over my drinking].
Ria Health: So tell me about how you learned about naltrexone. I understand you had been doing research to better understand how addiction and habitual reinforcement work on the brain, is that right?
“I Felt Alarmed at How Quickly That Happened”
Heather: About eight months into being about 80 percent successful in reducing my drinking, I had a very stressful personal event happen in my life that was emotionally devastating. Suffice it to say that it derailed my resolve to stick with drink-planning. Within a few weeks, I found myself right back to over-drinking about the same as before, maybe more. I felt alarmed at how quickly that happened, and I knew that once again I was out of balance. This time I just didn’t have the reserves I needed to push through alone. I needed help.
I remember that morning, I did more research and was certain that I was still not an alcoholic. I didn’t want to stop drinking for the rest of my life, but I needed something else to help me get back on track. Thankfully, I found exactly what I needed in a TED talk by Claudia Christian that explained how low-dose naltrexone is used to help extinguish the desire to drink over time while still allowing you to drink alcohol. I was fascinated and intrigued and I made an appointment to see my doctor that day. I surrendered to my inability to control my drinking on my own in that moment. I was at peace with that hard reality. I decided that I would tell my doctor about my over-drinking and ask for the naltrexone prescription. That was in October of 2017 and it’s the best thing I’ve ever done for my mental and physical health.
Ria Health: I love the way you describe the pleasure/reinforcement that is designed in humans to keep us alive and away from pain. Can you speak a little about this analogy and how it relates to alcohol?
“It’s Almost Like Mother Nature Knew How Stupid Humans Can Be”
Heather: The key to overcoming over-drinking is to understand how all pleasurable actions are reinforced in the brain. The brain’s purpose is to keep us alive. All human descendants through countless generations have managed to stay alive by avoiding pain and pursuing pleasures like food and sex. It’s almost like Mother Nature knew how stupid humans can be, so she downloaded a mechanism whereby we couldn’t help but remember and be drawn back to the habits that give us pleasure. It’s why we have taste buds on our tongues, so we eat. It’s why we have orgasms, so we procreate.
Every time we do something pleasurable we are rewarded with a surge of the feel-good neurotransmitters serotonin and dopamine. When that happens, the memory pathway that led to this action is strengthened. We remember more vividly exactly what we have to do to make this pleasurable thing happen again.
I [told] my doctor about my overdrinking and ask[ed] for the naltrexone prescription….It’s the best thing I’ve ever done for my mental and physical health.
It’s how the Alaskan brown bear remembers to come back to the exact fishing spot year after year after he has an epic salmon fishing day. It’s why my kids forget almost everything, except they seem to remember very clearly where I hid the Oreos. Reward (pleasure) reinforces that behavior.
“As Long As It’s Pleasurable, That Habit Gets Rewarded”
Like sex, food, and Oreos, every time we drink alcohol (it is, after all, a pure source of fuel) we are rewarded with a surge of serotonin and dopamine. We feel good after we drink it, and that habit is further strengthened in our memory and our sensory recall.
This is what’s happening in the brain when we think of drinking around the same time every day. It’s the familiar look of the late day sun or the sight and smell of cooking dinner or hearing Lester Holt’s voice on the Nightly News that recalls the memory, “Let’s have a glass of wine, it’ll be great!” If we answer that primal pleasure memory by pouring a glass of wine, boom! We’ve strengthened that habit even further.
As long as it’s pleasurable, that habit gets rewarded. The brain’s only job is to avoid pain and pursue pleasure. In order to overcome over-drinking, you have to find a way to extinguish this pleasure/reinforcement mechanism as it relates to drinking.
Ria Health: I know you tried other strategies, like abstinence and drink-planning, to cut back on drinking. How did those compare to naltrexone?
“I Wanted to Not Want to Drink Pretty Quickly”
Heather: I’ve tried cutting down and also abstinence. For me, those felt like white-knuckling my way through the day. Both required heaps of discipline, resolve, and focus. Practicing cutting down and abstinence for me felt like training for a marathon that I didn’t want to run. Did I do it? Yes. Did it work? About 80 percent of the time.
Once I was on naltrexone, I sort of felt the pressure to hurry up and feel it working. I wanted to not want to drink pretty quickly. But in reality it took 12+ weeks of drinking every day on low-dose naltrexone before I found myself pouring a glass of wine and then not drinking it.
Ria Health: I love how you said that “it’s almost like taking naltrexone removes the kryptonite effect of alcohol on my body and brain.” Can you please describe what it’s like for you to drink on naltrexone?
“Taking Naltrexone Removes the Fuzzy and Buzzy Effect”
Heather: As for how I feel drinking on naltrexone…it’s hard to describe because its effect is subtle. It’s little things. Like, before taking naltrexone, halfway through a glass of wine I’d definitely laugh more and have a slight feeling of relaxation and relief. On naltrexone, I just feel like myself, unaltered, having a glass of wine. It’s almost like taking naltrexone removes the fuzzy and buzzy effect of alcohol on my body and brain.
I still do drink and I still enjoy drinking. However, I feel fully in control of how much I want to drink.
Ria Health: You talk about how you realized that your habit of drinking wine gave you permission to relax and enjoy yourself. You noticed a pattern of overdoing many things in life, getting to a place where you needed a relief. Can you speak more about this realization and what it meant to you?
Heather: What’s interesting is that over the course of those first 12 weeks taking naltrexone, I really thought hard about why I was continuing to drink if I wasn’t feeling the euphoric effects.
I had to conclude that drinking wine gave me permission to take on a “relaxed and enjoying myself” frame of mind. What a shame, because I am always in charge of giving myself permission to relax and enjoy myself, and I certainly don’t need wine to access that.
The lesson that remains for me now, and the insight gained in my experiment to overcome my over-drinking, is that I just don’t often give myself permission to rest and relax enough.
“I Would Make a Solemn Promise to Myself”
I think I, like so many other women, tend to overwork, overdo, and drive myself too hard. That leads to a mindset of needing relief from life.
I resolved that if I was really going to leave over-drinking behind me, I would make a solemn promise to myself to rest, take more breaks, and slow down. This way I won’t keep finding myself on the uncomfortable side of addictive behaviors in order to find peace, rest, and equilibrium in my life.
Ria Health: How have you changed since you started taking naltrexone?
Heather: Since taking naltrexone, I am mentally free from a consistent craving for alcohol, although I still do drink and I still enjoy drinking. However, I feel fully in control of how much I want to drink and don’t find myself wanting to drink more. It’s still surprising to me that I’ll pour a glass of wine and it sometimes sits there unfinished.
I am still in the process of extinguishing my desire for alcohol in my brain. Being honest, I now know that I was much more addicted than I thought I was, and for me, the process is taking a lot longer than it does more many people on naltrexone. But that’s okay, I don’t judge myself for any of that.
“I No Longer Worry About Becoming an Alcoholic”
Knowing I have my naltrexone with me everywhere I go is my insurance policy against alcoholism. I no longer worry about becoming an alcoholic. I no longer get down on myself like I used to, and I feel like my old capable self in that I can overcome any obstacle in my life. In this regard my struggle with over-drinking has been a great gift.
Knowing I have my naltrexone with me everywhere I go is my insurance policy against alcoholism. I no longer worry about becoming an alcoholic.
Ria Health: What might you say to other women and mothers out there (and men too) if they’re struggling with over-drinking?
Heather: I wrote a three-part series on overdrinking to share what I learned with others the information that I really needed when I was looking for my own solution to over-drinking. The freedom I now have from over-drinking is indescribable. I feel like my old self, one who is in control again. I grew up with alcoholism in my family. As a result, I have worried about that affecting me for my entire life. So I really can’t adequately describe how relieved I feel to finally be free of this lifelong anxiety. I want others to know that they can have this freedom, too.
Please give yourself lots of time and the grace to stumble along the road in an imperfect way. Change is always messy and difficult. It can help to remind yourself as you embark on this journey that nothing really worth having comes effortlessly. As long as you have a desire to overcome overdrinking, I have every faith that you can and will.
Are you concerned you’re drinking too much, and want help drinking less? At Ria Health, we use FDA-approved medication and 24/7 support to help you achieve your goals—all from the comfort of your own home. On average, our members reduce their drinking by 50 percent within the first 30 days. Learn more about how our program works here, and get started here.