Can an Alcoholic Ever Drink Again? 

You’ve celebrated New Year’s Eve with sparkling water. You don’t have wine on the kitchen counter or vodka in your freezer. In fact, you haven’t had a drink in months or maybe even years.

At one point, it might have seemed impossible, but you did it — you’ve left booze behind. But then a thought crops up in your mind: “I’ve been doing so well, what if I have just one?” Is it really true that “once an alcoholic always an alcoholic?” Does one drink break “sobriety”? In other words, the question on your mind is: can an alcoholic ever drink again?

All About AUD

First, let’s make sure we know what we’re dealing with. What is an “alcoholic” anyway? While the term is somewhat outdated, the concept hasn’t changed over the decades: it refers to a person who has become dependent on alcohol and is struggling with alcohol use disorder (AUD).

While AUD might take longer to develop in some people than in others, and will look a bit different in every case, there are certain hallmark features that are well-known to medical professionals and scientists who study it. For a deeper look, check out “Alcoholism: Genetic Disease or Lifestyle Choice? Debunking Myths” and “Understanding Alcohol Dependence: Health Issues, Causes, and How To Overcome.” But for now, here’s the gist.

• AUD stems from alcohol’s effects on the brain. Alcohol artificially boosts dopamine, the reward neurotransmitter, and GABA, an inhibitory neurotransmitter (while lowering glutamate, its excitatory counterpart).
• Over time, misuse turns into dependence. Drawn by the pull of the neurochemical “reward” we get from booze — as well as the sense of relaxation from the release of GABA — we might find ourselves using alcohol more and more. Eventually, the brain gets used to the “new normal” and dependence sets in. We need alcohol to feel “okay” and get withdrawal symptoms if we suddenly stop drinking.
• Once AUD sets in, it tends to get worse over time. We find ourselves drinking more than we planned to on a regular basis and continue even though it’s harming our health and relationships.

All in all, AUD is, unfortunately, very common. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), as many as 29.5 million people ages 12 and older had AUD in the past year. That’s over 10% of people in this age group! 

And while many philosophies about treatment exist, collective experience has consistently shown that once we’ve developed AUD, drinking again is a bad idea. Time and time again people have fallen back into the same trap and ended up where they were before — or worse. 

Let’s take a closer look at why that is. Then, we can see if maybe we can look at the question from a new perspective and, instead of asking ourselves if we can drink again, we can ask ourselves this: do we really want to?

Can an Alcoholic Ever Drink Again?

Everybody is different, but in general it’s not a good idea to drink again after recovering from AUD. If you’re worried about how your body will react if you drink again, then you probably shouldn’t. There are several points to consider as to reasons why it might be dangerous, as well as alternative ways to look at the question altogether. Let’s dive deeper.

1. History Can (and Often Does) Repeat Itself

The bottom line is, alcohol is addictive — and the fact is, it hasn’t gotten any less addictive since the last time we got hooked on it. As NIAAA explains, the brain drives us to repeat behaviors that make us feel good and avoid ones that make us uncomfortable or distressed. As a result, drinking becomes a way to do both: “These dual, powerful reinforcing effects help explain why some people drink and why some people use alcohol to excess.” However, as we continue to drink, tolerance develops, and alcohol’s ability to “produce pleasure and relieve discomfort” decreases.

Moreover, once we’ve been drinking heavily for a long time, we’re likely to experience withdrawal symptoms when we stop. These may be a mere nuisance, or they may put us in serious danger. We might feel nauseous, shaky, dysphoric, irritable, and tired. However, on the more severe side, we might experience seizures or delirium tremens (DTs). For an in-depth look, check out “Alcohol Withdrawal: A Timeline of What To Expect.”

As we can see, alcohol dependence is a powerful neurochemical trap that has gotten us before and can get us again. It doesn’t matter if our decision to drink is made “rationally” — while we might be rational, our substance of choice isn’t. In Alcohol Lied to Me … Again, author Craig Beck explains this point by bringing up the famous myth about the scorpion and the frog. The scorpion needs to get across the stream and asks the frog for his services, promising he won’t bite him along the way — after all, doing so would kill them both. And yet, once the passenger is en route, he does exactly that. The frog’s last question — “Why?” — gets an unflinching response: “Because it’s in my nature.” 

Beck goes on to say that in a similar way, it doesn’t matter how prepared and reassured we might be when we set out to drink (again). After all, “Would you advise the frog to carry fewer scorpions across the river, perhaps limiting the activity to the weekends only?”

2. Neurochemical Changes: The Brain Keeps Score

There are chemical changes in the brain of someone with AUD. Some of us are at greater risk than others for a number of reasons, including genetics and environment. For example, a study in Biological Psychiatry argues that “exaggerated reward center stimulation” puts some of us at greater risk than others — a predisposition that doesn’t disappear after a few months or years.

Moreover, a recent study in Science Advances took a deep dive into so-called “memory traces” left by alcohol misuse in the brain years after abstinence. PhD student Esther Visser and her colleagues from the team led by Michel van den Oever looked at long-term alcohol-related patterns in the brains of mice. They focused on a small group of neurons in the prefrontal cortex that fired up in response to alcohol-related cues in the environment (i.e. signals that there was booze nearby) and were associated with alcohol-seeking behavior. When these neurons were artificially deactivated, the mice — having become dependent on alcohol and then forced to “put down the bottle” — lost interest in booze. The response was highly specific and didn’t apply to other rewards: for example, the mice didn’t lose their sweet tooth and were still happy to get an occasional treat. 

The researchers concluded that the group of neurons represented alcohol-specific cues that functioned as a “lasting memory trace.” And while eventually this knowledge could be applied to relapse prevention, right now “turning off” specific neurons in the human brain is a tad more difficult than doing so in lab mice. What does that mean for us? It means they just might fire up after we have that “one drink” after months or even years of going alcohol-free. Is it really worth the risk?

3. Alcohol Wasn’t Healthy for Us — and It Still Isn’t

It’s no secret that alcohol was wreaking havoc on our body before, and guess what — it still does. For a detailed look, check out “How Does Alcohol Affect Your Health?” For now, here’s a brief overview:

• It harms our liver. We all know about this one, but it’s worth repeating. The liver is on the front line of alcohol metabolism, and over time alcohol takes a toll. Liver damage is silent and progressive, so after giving this vital organ a much-needed break, do we really want to strain it again?
• It strains our heart. Alcohol is also hard on our heart. It lowers our blood pressure initially through vasodilation, but this effect is followed by a rebound spike in the hours following. In addition, it raises our heart rate and can lead to serious heart damage over time if we misuse it.
• It’s bad for our brain. In addition to causing temporary changes in brain chemistry, alcohol can have permanent effects on the brain if we misuse it. Nobody wants to end up with alcohol-related brain damage, memory problems, or other neurological disorders attributed to booze!
• It messes with our sleep. While alcohol might make us drowsy, the sleep we get is unlikely to be restful. The fact is, booze robs us of the most restorative REM phases of sleep, leaving us groggy the next morning even if we clocked in the full eight hours or more.
• It makes us gain weight. Alcohol is full of empty calories — in fact, it’s second only to fats as far as caloric density is concerned. Besides, it does a number on our metabolism. For one thing, the body prioritizes breaking it down above everything else, leaving other foods we eat on the metabolic back burner. The result? They’re more likely to get stored as fat.

As we can see, even taken at face value — without the specter of dependency looming in the background — alcohol is a dubious substance to put in our body. And if we fall into the pattern of drinking more and more, we’re really putting our health on the line — again.

4. Deeper Look Into the Reasons: Do They Hold Up?

However, there’s an equally important question to ask ourselves as we consider whether or not to drink again. Why do we drink in the first place, and how does it actually make us feel? Is it possible that alcohol “promises” more than it actually delivers?

Here’s how Annie Grace puts it in This Naked Mind:

“Alcohol erases a bit of you every time you drink it. It can even erase entire nights when you are on a binge. Alcohol does not relieve stress; it erases your senses and your ability to think. Alcohol ultimately erases your self.”

In other words, alcohol doesn’t really add anything to our lives — it mostly takes things away. Being drunk creates the illusion of relaxation, but is it really true relaxation or something closer to a numbing, anesthetic effect? Sure, it might “take our stress away” for a few hours — along with our ability to think, connect with others in an authentic way, remember what we did and the conversations we had, or be able to walk in a straight line. Is that really the kind of “relaxation” we want?

And if we think that alcohol makes us have fun and enjoy ourselves, the same illusion begins to reveal itself. Sure, everything seems “funnier” under the influence (until it doesn’t). But is that true joy or simply a lowering of standards as to what we think is entertaining? In the end, do we really want to be laughing at laundry detergent commercials (or those “funny” jokes that don’t seem as funny the next day, if we happen to remember them)?

A Different Set of Questions

In the end, instead of asking, “Can alcoholics ever drink again?” perhaps you can switch your focus to asking a different set of questions:

• How did alcohol actually make you feel when you drank in the past, and did it deliver on the “promises” of providing fun, boosting creativity, or strengthening relationships? 
• Is it possible that other activities are actually more rewarding?
• What would life be like without alcohol (or with less alcohol)?
• What if having to stop was a “blessing rather than a curse”? 

As you ponder these new questions, you can switch modes, shifting from a mindset of “lack” to that of “gain.” After all, there’s so much to explore beyond booze. (For a deep dive, check out “Alternatives To Drinking Alcohol: Exploring Life Beyond Booze.”)

We Are the Luckiest

As Laura McKowen writes in We Are the Luckiest: The Surprising Magic of a Sober Life: 

“We have to pick a side. If we ever want out of purgatory, we have to decide if we are going back to a life of denial and secrecy and hiding and gripping onto the thing we do not know how to live without, or if we are going to take a stab at doing a thing we have never done before.”

All in all, we can think of our previous struggles with alcohol as an important step that got us to make lasting changes in favor of greater health and well-being. In that sense, we have an advantage: by coming face-to-face with the problem, we are given a chance to reach our full potential in ways we never thought possible.