Axel and alcohol: a story of life and death
When I meet Axel in a cafe for this interview, I have to admit that he really doesn’t match the image one might typically conjure of an alcoholic man, that is, a guy who is violent, constantly drunk with a bad pint in his hand, face puffy and red, his beer belly sticking out from under his half-buttoned shirt... No, quite the opposite. Blond, slim, well-dressed and discrete, Axel vapes peacefully as he waits for me. His history with alcohol makes even more sense, given how little he fits the stereotypes.
Born and raised in Paris, Axel went abroad to study international commerce. After doing some work experience in Asia, he ended up settling down there for 5 years, working in administration and then tourism. Upon his return to Paris, he got a job at a famous travel agency. So far, all seemed to be going well. But Axel explains to me that alcohol addiction is a long and gradual process, characterised by inertia. Indeed, alcohol, unlike other drugs such as cocaine (and he would know this), isn’t highly addictive, at least not to start with. It creeps up and settles in over the years. Such that, for a relatively long time, it may not affect the individual’s socio-professional functioning: the loss of control isn’t yet manifest.
Axel is 14 when he starts consuming alcohol, and it’s at the same age, in an amusing and convivial family setting, that he gets drunk for the first time. After that, he will start to search for and test his limits in a totally festive and relaxed setting, especially abroad: he tells me of controlled drinking, explaining that he was aware of (some of) the effects (positives: disinhibition, self-confidence, relaxation) but not the risks.
Before being a problem, [alcohol] is a solution
Alcohol as a plaster
When he returns to Paris, Axel finds himself in a toxic and unhealthy professional environment: his subordinate is harassing him to make him crack. On the other hand, he’s receiving treatment from a psychiatrist - poor treatment: the psychiatrist gains huge influence over Axel, is very directive, imposing himself as a father-like figure, all the while giving him very bad professional advice... An explosive cocktail (excuse the pun), whilst at the same time Axel is taking medication and consuming another substance: between the catastrophic medical treatment and pressure at work, Axel has been sucked into cocaine use. A close friend introduces him to it: in the early 2000s, this particular drug is booming in Paris, and Axel convinces himself that he needs it to get through at work; it’s not in a festive context whatsoever. At that point, he tells me, he is perfectly aware of the risk of addiction and health problems linked to drug use, but he just wants to feel better. He tells me that for cocaine, 5% of users become addicts within the first year of using, and 20% over 10 years, with the consequences we all know.
Alcohol to get through
It’s professional pressure, his depression and addiction that push Axel to quitting and upping to move to the countryside. He manages to wean himself off the cocaine of his own accord, but it’s his alcohol consumption that goes through the roof as a consequence. In the countryside, there aren’t many doctors specialised in addiction, so Axel is treated by a GP, to whom he talks of his depression and anxiety -- but not his alcohol addiction.
Once he’s moved to the country and is living in a little farm that he inherited, he makes a deal with a builder, himself very much dependent on alcohol: the idea is that they renovate the aforementioned farm together. It takes 4 years, with mixed results. Axel goes downhill because he tries to get his builder friend out of his own addiction, to open his eyes to his situation; with hindsight, he explains, it was a very bad strategy: you can’t force someone out of alcohol addiction against their will. And the builder remains in complete denial.
Little by little, alcohol becomes a plaster - one that Axel needs. He tells me that there isn't a turning point as such, it’s hard to pinpoint a precise moment when he fell into addiction... It’s all a question of time, it’s a process. Axel explains that many of his peers are hypersensitive people, with a certain fragility, vulnerability at their core that finds a form of protection in drink, however illusory it may be.
Alcohol is an amazing plaster
Unfortunately, by this point, alcohol is no longer for fun, and denial has dug in its claws. The substance will slowly take over his life, stealing his freedom and eventually his dignity. Axel plunges inexorably into the illness to the point of becoming socially isolated: for fear of judgement from others who have seen us lose control, we avoid them. For fear of judgement from those who see us drink beyond reason, we hide away to drink. But the denial is there. His family is worried, he knows it, and he goes through an initial period of treatment. Not for himself, but for his family, for fear that they pick him up on it. But Axel quickly realises: you can’t get out of substance abuse for others, you have to do it for yourself. One month later, Axel relapses, straight away. But he has also gained a lot from that first period: he now knows that addiction is an illness that can be cured, that he suffers from anxiety and depression. These are his weaknesses. The denial has vanished.
Alcohol and treatment, for oneself
Axel is gradually able to open his eyes to his own situation. He tells me that between the moment he realises his loved ones are not blind and his first stint in treatment, at least 2 months go by.
That first course of treatment was in a reputed establishment, only 7km from his home: a blessing, given that he no longer has his driving license. An aunt of his supports him through it, and the treatment (of a duration of 1 month minimum, 3 maximum) is followed by a post-treatment phase (that can last much longer). The morning information sessions, fairly technical in nature, are given by a doctor, and the afternoons are dedicated to activities -- it’s about giving residents a structure that they have been lacking for a long time. They participate in housework for example. It’s a public establishment, with the program partially subsidised by the Social Security (the French national healthcare system), and an extra refund that Axel gets through his personal health insurance policy. He laments the near-total absence of individual therapy: it’s usually sessions with around twenty people. We now know that individualised treatment with a therapist post-treatment is often necessary. Axel goes in with the hope -- rather, wishful thinking -- that he will be able to start drinking again afterwards, this time, normally.
But as soon as his treatment is over, he relapses and leaves for Asia. His state worsens. When he returns, he breaks down. He has hit “rock bottom” and asks for help from his loved ones who take charge. His return to France is incredibly difficult.
Even when you’ve reached the bottom, there is still a way down
A family friend gets him an appointment with an addiction specialist working at hospital Bichat (Paris). A month later, he is hospitalised at Bichat and then monitored, individually this time, by the same addiction-specialised therapist. He is still treated by her today, although Axel has been sober for 4 years.
Becoming aware of the denial is huge, painful and freeing
From alcohol to peer support work
Axel tells me he will never be fully recovered. For nearly a year now he has been able to call himself an “ex-drinker”. But to others, he prefers to put it differently. He is not out of the woods, in that he has to constantly be careful; I understand, given how prevalent alcohol is in France.
Axel allows himself to vape. After all, he’s coming out of 18 years of multi-substance abuse and wishes, over 40 as he is, to take care of his body. The e-cigarette could be the next step, but he isn’t aiming to stop completely; he just wants to learn to limit his use as much as possible. He doesn’t feel as though his nicotine consumption stems from the same emotional compulsion as his alcohol and drug use. He prefers to savour his two victories: to have successfully freed himself from alcohol and cocaine. I can’t help but admire and feel happy for him.
He, who loved to do lots of sport has been able to get back to it: he has started tennis again, discovered pilates, goes skiing and is passionate about hiking.
I am happy to have found my freedom and dignity again
Nonetheless he doesn’t rest on his laurels: he has been taking a course to become a peer support worker so he is able to integrate a therapeutic team to help others. A peer support worker in addiction is someone who is recovered, has experience and is trained to participate voluntarily in the recovery process of another patient, in conjunction with their treatment team.
I don’t drink anymore, I enjoy it too much
- To evaluate one’s own consumption : you can refer to the DSM-V criteria, the psychiatrists' bible.
- What are the SOS signals a person might be sending to their loved ones, indicating a desire to open up about their drinking at last: drinking during a Skype session, for example, or drinking openly before midday... Loved ones aren’t necessarily best placed to help someone suffering from addiction, however.
- How to speak to a loved one who may have an issue with drinking:
- Get the person to speak for themselves, don’t confront them
- The discussion must be based around concern for the person's wellbeing
- Go to a specialised center for addiction prevention and support (CSAPA in France) or a rehabilitation information center for drug / alcohol users (CAARUD in France) where you can can get redirected or given advice
- How to get through in a social situation involving alcohol:
- If you are too tempted, it is important to allow yourself the freedom of saying no to the event (even last minute) or leaving
- If you want to avoid nosy questions that an open and frank discussion might solicit, don’t hesitate to tell a little white lie as Axel does nowadays, “I can’t drink, I’m on antibiotics”
- I would add a top tip from Kyan Khojandi's show Une bonne soirée : say, “I’m fine, I already feel good”, in a slightly tipsy manner!
To go further
- Several tests here, here and here to self-evaluate your own alcohol, cannabis, gambling use and more
- An interesting article on the causes of addiction
- A more detailed explanation here and here of what a peer support worker is
- An article on how e-health can help in addiction matters
- A study arguing that alcohol is the most harmful drug of all
- An article on the link between trauma and addiction
- A TedX on the causes of addiction
- The infamous Sobriety Notebooks (in French) of an ordinary drinker
- The DrugAbuse website (USA) that gives lots of information on addiction