Sober realization

Dear Buzzed,

In Recovery

Dear In Recovery,

Congratulations on maintaining your recovery from alcohol addiction for all this time. We can understand that you would worry about damage you might have done to your brain and other parts of your body. Many people in recovery from different addictions have the same concerns. In your case, we don't think you have much to worry about. We've looked at the research literature and talked to physicians who treat people in recovery. If you survive serious alcohol dependence and stay in recovery, the data shows that your health will be fairly good.

Alcohol is one of the most well-researched recreational drugs, and we know a lot about the acute effects of this drug. Most people know that it has toxic effects on almost every major organ system at high levels, and in low doses (about one to seven drinks per week) it probably promotes cardiovascular health. However, most people are not aware that the safe limit for women is just one drink per day and for men it is two drinks per day. Beyond that, alcohol promotes liver disease, heart disease, hypertension and cancer. At higher levels (about three drinks per day), there's a chance of injuring the brain and, as psychologists say, producing cognitive deficits.

But what about those who are already in recovery? The research literature about this is rather thin. But we think there's good news for you. Given that you are in apparent good health after a number of years, whatever damage may have been done has either been repaired by your body or your body has managed to do well in spite of it.

You may have heard that high and long-lasting alcohol use produces brain shrinkage. That's true: You can see this by using modern brain imaging procedures. However, studies that follow people who are in recovery show the brain returning to a normal appearance after a year or so. Likewise, if the liver is not too damaged, its function is successfully maintained. In fact, people seem to do quite well if they just stop drinking, so long as the alcohol abuse has not caused a major health event such as a stroke, malignancy or heart attack. Obviously, those sorts of consequences can have long-lasting effects that may leave one impaired for life.

So, what do you do now? Our advice is to first recognize that you should never drink again. While your body has recovered, your brain still has powerful cues stored in it that may lead you back down the path to abuse. Beyond that, all you can do is live a healthy life. If you did suffer long-term damage, all you can do is live in such as way as to maintain the function that you do have. There's no magic bullet for that. It's just the same old boring advice: don't smoke, choose a diet low in animal fat and high in fruit and vegetables, and get enough exercise. You are a very lucky person to have been able to stop drinking. Now go and enjoy the life you have given yourself.

Buzzed appears every Wednesday in Salon Health. Do you have a question? E-mail us at buzzed@salon.com.