On Alcohol Addiction for the Patient With Cancer

In 1997, I went to substance abuse treatment three times, plus I made good on a reservation to the psyche ward. Each time, the mental anguish during withdrawal felt soul-suckingly horrific. The panic was indescribable. I was drenched in sweat and self-pity. “How did I let it get this far?” I asked — not of the alcoholism, but of the journey to treatment.

Decades ago, I was also taken to the hospital after I fell off a bar stool. Too much tequila. In the ER, they took my blood alcohol level twice. I had a .592 — the highest on record at the time. (Maybe still is.) I remember thinking, “I’ve been more drunk than this.” That said a lot since I often blacked out. If I was conscious at .592, what was my BAC during the blackouts? After they gave me charcoal to help purge the tequila, I refused to stay. I left and went to a bar. (I knew another alcoholic who survived after a .70 BAC reading at a hospital. Regardless, it is not a contest.)

I have many examples of running from help to feed my addiction.

My guess is that many alcoholics and addicts with a cancer diagnosis hope to use openly or secretly during treatment. The foreboding detox pains and mental panic may even prevent an addict from accepting cancer treatment at all. 

Unfortunately, substance abuse behavioral change is largely absent from the oncological treatment environment. There is plenty of data that indicates an increased risk of various types of cancer from excessive drinking. However, as of this writing, there is little research done on how to treat an alcoholic who is newly diagnosed with cancer, in treatment for cancer or as a survivor of cancer.

I may have had leukemia when I relapsed on alcohol in 2019. I quickly went into the vomit-y stage. I don’t remember feeling that ill when I was on my last legs the first time around — over 20 years ago. After the relapse, I went to rehab and shortly after found out my leukemia was back. (Perhaps I ought to be grateful for my leukemia? It might have made me so sick so fast that an intervention was welcome.)

Approximately 15,000 people with a history of cancer participated in the National Institutes of Health’s All of Us Research Program. Researchers reported that 12,000 people in this group reported that they drink alcohol, and nearly 40% reported engaging in hazardous drinking, repeated excessive alcohol use. Amoing those who may have been actively undergoing treatment for cancer, about 75% drank alcohol, many heavily, according to a report from the National Cancer Institute. The study found that contrary to physician expectations, alcohol use was not reduced by patients being actively treated for cancer.

Alcohol consumption and risky drinking behaviors among cancer survivors are associated with various adverse long-term outcomes, including higher risk of recurrence, secondary primary tumors and increased mortality, according to findings published in JAMA Network Open.

If I had been using, I would have wanted compassion, and the comfort of knowing that a smart detox plan would be integrated with my cancer treatment, along with counseling and an after-cancer-care plan. I would want to know about the social workers, chaplains, yoga, mediation, acupuncture, and other mind and body wellness programs that are offered at the center. Thank God I was sober when I got diagnosed! If I was hiding my addiction, I would have later thanked those that shared their suspicions with the medical team thereby possibly saving my life in more ways than one.

I wish to share that getting sober is worth it. If you have cancer, it is especially worth it. Sobriety is not a nerdy pursuit. It is paradoxically both invigorating and calming. It is far from boring. Welcome to next-level coolness.

My biggest fear was that getting sober would make me insane. (Yes, I see the irony.) It took a lot of therapy and some medication for me to jump from irrationality to clarity. Being clear-headed led to progress which led to self-esteem. I learned to truly love myself.

For patients with cancer with a substance abuse disorder, I hope that you accept help. Your cancer center may or may not have a chemical dependency program or partnership. But this is when you need to be your own advocate. Let the medical team support you through a safe detox. The physical suffering will pass. Breathe, draw, write, sleep and engage in therapy. Pharmacology can help with anxiety or depression. Professional and social support will help you in your sober journey through good times and bad.

It’s not always that simple. But it’s also that simple.

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