Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
The moment I knew I had a problem was when I had my first drink before breakfast to get rid of a hangover from the night before.
A swig of something strong and the horrendous hangover lifted for a few hours. The fog would lift and there would be a distant glimpse of that warm alcohol enveloping feeling.
And when the cloud lifts why not keep going?
I used to do this ‘hair of the dog’ routine quite frequently over recent years in complete denial that I had a problem. It actually wasn’t during one of these episodes that I realised I had a problem but I’ll tell you about what happened there in a minute.
I have worked as a pharmacist for quite a few years now. I still work in community pharmacy owned by one of the multiples in the suburbs of a city.
The stress that drove me to drink came from my job. The absolutely soul-destroying pressurised loneliness of being a community pharmacist was clearly too much for me to cope with. I can see that now.
The heavy responsibility that comes with being a pharmacist has pushed me to drink over the years. Trying to please everyone and falling on my face in the process. A grand game of denial. That feeling when you think you might have made an error or not cared for someone as best as you could.
The torment of working in the pharmacy at times comes from the fact you can never give everyone the same level of care. You just don’t have time. And then there are the factors that are outside your control like near misses and dispensing errors. Dispensing errors are inevitable and I find this in combination with the ‘blame’ culture in pharmacy is very hard to deal with.
Community pharmacy is like a battleground at the moment. I’m not saying that the pharmacy that I work in is any worse than most but the clients are challenging. Combine these difficult patients/customers with huge pressure from my corporate employer and you have a perfect stress storm.
There is no doubt that working in this chaos has led to my alcoholism.
For people who don’t currently work in community pharmacy, they need to know how difficult it is for pharmacists there. Pressure, staff, targets, diminishing budgets and in our company the constant next big idea to have to ‘buy-in’ to and ‘lead’. The thing that I struggle with most is the lack of freedom to be a pharmacist and truly care for patients. I’m tethered to the dispensing bench for eight hours a day so there is no chance to deliver good care to my patients.
So in my spare time, I drink to find brief relief and I feel really guilty about this. Alcohol has a serious impact which crept up on me over many years of coping. The impact on me and my family has been significant over recent years.
Alcohol almost messed up everything. I hate it but for addicts like me, alcohol forces a shallow heartless love of it.
I have never had a drink at work and I have never, therefore, put patients at risk. That said, recently I craved a drink whilst at work and that is when I knew things had to change. That scared me because I desperately need my job to support my family. I’ve got kids at University to support for example.
I have read in self-help books that you need to hit rock bottom. Well, I think this moment of craving a drink at work may have been my lame ‘rock bottom’.
I’m undecided as to whether my issue with alcohol stems from my genetics or from my environment. Were there aspects of my childhood that led me to the rock bottom point I hit a few months ago? It is a bit of torment that there might be something there that has influenced my behaviour in adulthood but if there is I can’t remember. There certainly is nothing obvious.
So one day a few months ago I stopped drinking. Just like that. I have done this before but on every occasion, I have relapsed into the usual pattern of drinking within a week.
I have been sober for 98 days as I write this article.
Christmas was really hard. I have never been to a work Christmas night out and not had a drink. This could be my last because I found it to be miserable. Colleagues understand you are the heart and soul of the party so when I said no thanks to a drink I think it raised eyebrows.
“Go on just have the one. We’ll share a taxi home.”
“Oh. [concerned look] Is everything ok?”
Many people become someone completely different when they drink alcohol. I was this person but had never seen it in stark reality until I went to that Christmas night out. It turns out my colleagues are not very nice at all when they are drinking. Who knew?
Looking back a huge part of my problem was the fact that my whole social life has for years revolved around alcohol and until recently I couldn’t stop. I feel very fortunate that I seem to have been able to do so successfully. Many people are not so lucky.
I’m an introvert but I have only discovered this since I stopped drinking. Working in community pharmacy demands that you are an extrovert and I find this exhausting. Maybe I’ll do a different job someday where I don’t need to be ‘on form’ all day when I’m feeling crap inside.
You see alcohol masks who you really are. You become a disinhibited version of yourself and the trouble with this is that you never get a chance to learn how to socialise without it. This was bleakly obvious at our recent Christmas night out.
I am beginning to find now that you can have fun, be silly and even dance without alcohol. For years the thought of doing these things in the absence of the influence of alcohol horrified me. And looking around I think it might horrify many of my colleagues too.
The thing that I didn’t notice for years was how much stress and pressure being a pharmacist causes. Coming to terms with this will be the key to staying off alcohol.
Looking back I think I have always been an alcoholic. I used to steal alcohol from my parents’ drinks cupboard. I remember drinking spirits secretly as far back as my teenage years. I would drink some and on occasion top the bottle up with water. I have subconsciously taken this behaviour into my adult life.
I have no idea if my parents noticed this behaviour. They never said and I have not asked.
You don’t suddenly wake up being an alcoholic. Rather I feel it is a slow drift towards oblivion punctuated by hundreds of denial related false peaks.
And actually, you can exist as a functional alcoholic for years and never reach rock bottom. I hate that alcohol does this to people.
Over the years I have exhibited behaviour that could be seen as out with the norm in relation to alcohol. The trouble is, much like a frog being boiled, you never notice that it is happening until it is too late.
I would drink to excess the majority of the time. For someone with a weakness for alcohol, it is really difficult to show restraint and not go on a binge. Once that first hit of dopamine kicks in there was usually no turning back for me.
Now that I am sober I hate going shopping for food. Supermarkets are such cruel places for people trying to curb their drinking. You get your shopping done and then you are hit with the alcohol aisle on the way to the checkout. I wish there was at least some sort of deterrent to this feast of alcohol. Maybe just put up a barrier or place the alcohol in a separate area of the shop.
I used to locate alcohol when I visited other peoples’ houses. Having a drinking problem is not easy. It takes skill and planning. You need to be ahead of the situation and plot your next few drinks to ensure you maintain the glow. In a completely irrational way, I used to do this when I visited other peoples’ houses.
I would often have chasers. Non-drinkers would never drink quick enough for me. The problem is they don’t need to get the alcohol into their system as quickly as you because they will probably have a lower tolerance. As I continued to drink over time I found that I would have to drink much more than my peers to find that fuzzy feeling.
I would hide alcohol around my home. The first time my partner found an empty bottle was about five years ago. The first few times this would happen my partner didn’t really think much of it but the problem was as my drinking escalated, I would forget where I put the bottles. The pattern continued and the link was made. My partner was the first person to identify that I had a problem although I didn’t believe it at that time.
I used to make sneaky trips to the shops to buy alcohol. I would find a multitude of excuses to go. It is this deceptive and secretive behaviour that is most destructive in relationships.
All of these behaviours took time and effort to plan. Skill and precision to execute whilst never getting caught out or questioned.
The only thing that matters to me now is staying sober. I will avoid the drink pushers and might even stop socialising for a while. I also might consider leaving pharmacy. I can’t go on like this. Maybe things will change with time but right now being sober whilst still working in pharmacy is taking a lot of energy.
Being addicted to alcohol for me is like drifting down a river. It is easier to effortlessly drift downstream. This is the equivalent to having a drink. It is difficult to swim so that you no longer drift downstream and harder still to swim back upstream. I know that putting myself in high-risk situations, like parties full of drink pushers, will turn the gently flowing river into crashing rapids flowing faster and faster. Working in pharmacy may soon be too much to bear.
This simplistic analogy is now how I live my life.
So far I am sober.
So far I am surviving.
I want to finish by saying thank you to Johnathan for accepting this article for publication. I remember reading the articles on bullying and thought how sad yet true they were. There are few people in pharmacy that speak the truth, and most importantly let other people speak their truth as he does.
The author of this article wishes to remain anonymous. Johnathan has re-written some parts of the original submission to further disguise identity. If you, your colleagues or your family have been affected by any of the issues in this dilemma you may wish to contact Alcoholics Anonymous by clicking here. It’s ok to ask for help.
Pharmacy in Practice is a UK pharmacy publication with its roots in Scotland.