I had just completed a workshop on relapse prevention. As I was leaving the conference room, a thin and frail-looking man from the audience approached me. “Mr. Gorski,” he said, “My name is Malcolm. I am recovering from chemical dependence and have been sober for nearly eleven years. I’ve had AIDS now for over two years and I’m beginning to get sicker and I know I will eventually die. A big part of me wants to start drinking to deal with it and, to be quite frank, considering my condition, I can’t think of any good reasons to stay sober. What should I do?”
Alcohol and Drugs Won’t Help!
It is tempting for terminally ill patients to believe the mistaken notion that alcohol and drug use will somehow make their disease easier to cope with. It does not. I ask patients to think back to the times when they were using alcohol and drugs and to remember the quality of their lives.
No matter how painful or debilitating your terminal illness may be, alcohol and drugs will only make it worse. The mental anguish and pain you may be experiencing will increase and your ability to cope with your disease will progressively disappear. At best, alcohol and drugs will provide brief moments of temporary anesthesia, followed by periods of shame, guilt, and dysfunction. As the chemical dependency progresses, and it always progresses, the resultant loss of control will prevent you from responsibly treating your illness, destroy any hope of having quality moments of life, and escalate your movement toward a painful death.
For people who are addicted, alcohol and drugs are never a solution to any of life’s problems, including terminal illnesses. The temptation to believe that alcohol and drugs are a solution is part of the delusional system that accompanies chemical addiction.
The Choices In Facing A Terminal Illness
When facing a terminal illness, we only have three choices:
• We can deny it by pretending everything is fine.
• We can fight it by learning all that we can about our disease, fortifying our sobriety, steeping ourselves in courage and hope, and doing everything we know how to do to increase the duration and quality of our survival time.
• Or we can accept it. We can face the inevitability of our death and surrender to it. By surrendering we can reinvest our energy in finding a sense of dignity and meaning in the experience of our illness and death. We can finish our business here on earth and turn to strengthen ourselves spiritually to face the transition from this life to the next.
Which is the best or correct way? There is none. We each will have to choose which of these alternatives we will embrace at each stage of our movement toward death. At times, it is best to deny our illness and live as if we will live forever. At other times, it is best to steep ourselves for the battle and fight for our lives with everything we have. Yet still at other times, it is best to surrender to the inevitable and face our death for what it is, the final transition of our physical lives.
The bottom line is this — if we choose to use alcohol and drugs to cope with our illness, none of these alternatives will be available to us. Our addiction will rob us of all of our choices, make our pain worse, and rip us away from ourselves, our God, and those who love us. Alcohol and drugs can never be a solution to anything for people in recovery from addiction.
Reasons To Stay Sober
When Malcolm asked me the question, “Why should I stay sober?” my response was very direct, “Because you owe it to yourself and those around you. Because you are in recovery and you are able to face anything sober and this includes your own eventual death.”
For a moment I became philosophical. “We can all create precious moments in time,” I said, as I leaned forward and looked him in the eyes. “We can, at times, transcend our fear and carve out moments of joy and wonder.” I looked away for a moment as I realized how often I had failed to follow my own advice. Then I continued: “We can choose to laugh when we feel like crying. We can live fully, even in the face of death. This is just true for all of us.”
My mind flashed words of Ernest Hemmingway: ‘All true stories end in death.’ In other words, we are all dying in every moment that we are alive. We are all living in every moment we are dying. We can choose to embrace life and revel in it, or we can choose to embrace death and quake in horror, fear and despair. Many people have told me the most painful thing they faced when confronted with their own impending death was how many moments in their lives they had wasted.
Then my rational brain took charge and I began explaining to Malcolm that there are seven good reasons to stay sober even if you have a terminal illness.
1. There Is Always Hope: Only God decides when we die. In recovery, we learn that we are not God. Although we will all eventually die, the timing of our death is never certain. Many people with HIV will never develop AIDS. Of those who have AIDS, some will have spontaneous remissions and others will live a long and meaningful life before eventually dying. On top of that, there is always the hope of a major medical breakthrough in treatment. Perhaps a cure will be found! Even if such a breakthrough never comes, people are happier and healthier when they live with hope than when they live in despair.
2. Staying Sober Increases The Length And Quality Of Survival Time: Staying sober, eating right, exercising moderately and managing stress (all of the components of a good recovery program for chemical dependence) will increase the length and quality of survival time.
3. Staying Sober Allows Us Connection With A Higher Power: It is only in sobriety that we can experience a deep connection with our Higher Power and contemplate with hope what lies beyond the limits of our physical existence. This is the only true source of comfort when facing our own death.
4. Alcohol and Drug Use Escalates Disease Progression: Alcohol and drug use inhibits the immune system and accelerates the development of AIDS. Alcohol and drug use will also interfere with the effectiveness of many of the new medications and other treatments that slow down the progression of AIDS.
5. Staying Sober Gives Us The Possibility Of Death With Dignity: By staying sober, we can approach our death with dignity and self-respect. We can reflect upon the meaning of our lives, the loves we’ve shared, the experiences we have had and the things we have accomplished and contributed. We can bring closure to our lives and our relationships. We can search for and find a deeper meaning to our lives and to our death.
6. Relapse Adds Pain and Problems to an Already Bad Situation: When a chemically dependent person returns to alcohol and drug use, there is a big price to pay. Physically, the booze and drugs rip our bodies apart and make us more vulnerable to the progression of other illnesses and less responsive to treatment. Psychologically, our self-esteem suffers and we develop shame, guilt and anguish. This emotional response accelerates our plunge into depression and eventual despair. Socially, we become isolated and unable to give or receive love. We inadvertently hurt the people we love most and cut ourselves off from one of the few sources of true comfort, the loving embrace of other human beings. Spiritually, we become bankrupt and disconnected from the God of our understanding. We lose conscious contact with our source of courage, strength, and hope.
7. It Is Better To Die Sober than To Die Drunk: I strongly believe that it is better to die sober than it is to die drunk. Using alcohol and drugs is never a solution for anything. Alcohol and drugs cut us off from our inner source of courage, strength, and hope. Addiction destroys our self-esteem and self-respect. And, on top of that, it will make whatever other disease we have worse. In the long run, it will create more pain and misery.
Terence T. Gorski is the Founder and President of The CENAPS Corporation. He is an internationally recognized expert on substance abuse, mental health, violence, and crime. He is best known for his contributions to relapse prevention, managing chemically dependent offenders and developing community-based teams for managing the problems of alcohol, drugs, violence, and crime. He is a prolific author and has published numerous books and articles.