Where to Draw the Line on Mind-Altering Substances?

By Sarah Jones 05/07/13

Mouthwash and Sudafed, non-alcoholic beer and caffeine. What's cool for recovering addicts and alcoholics to eat, drink and take—and what's not?

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Last week I made my first batch of chia-seed pudding, a mixture of chia seeds and almond milk with the consistency of tapioca. Unsurprisingly, it tasted like dirt. So I added some vanilla extract—and gobbled down the rest in record time. Then I looked at the ingredients and realized the extract was 45% alcohol. No wonder it had been so delicious.

In many AA meetings you hear the phrase, “Please don’t share today if you’ve taken any self-prescribed mood or mind-altering substances.” But what does that mean, and where do we draw the line? After all, what’s self-prescribed in England—certain strengths of Tylenol with codeine—is prescription-only in the US and Canada.

And do they really mean any mood-changing, mind-altering substance? When I count down the minutes until my next cup of coffee, does that jeopardize my sobriety? What about gargling with Listerine, or cooking with wine? People are bound to disagree on some of the finer points, but all of us in sobriety have to find real-life solutions. So I talked to some sober friends about what everyday substances they are uneasy about, as well as some medical professionals about when we should we be worried.

Have you ever had Bananas Foster? There’s enough alcohol in it to disinfect a small village.

FOOD & DRINK
Many foods contain trace amount of alcohol that can be triggering. Some ex-drunks will eat foods with alcohol, assuming that the alcohol has been “cooked off,” or evaporated in the preparation process. However, a US Department of Agriculture study shows that all cooking processes are different, and some foods must be cooked for nearly three hours to eliminate all traces of alcohol.

Sauces White wine and beer are common ingredients in pasta sauces and marinades—the latter because alcohol can help tenderize meat. Menus may not list all of their ingredients, so when at a restaurant, ask your server to be sure.

Can they get you twisted? Probably not by themselves, although tasting beer or wine could cause unwanted cravings.

Vanilla extract Household vanilla extract is 41% alcohol (!), however alcohol-free versions are available.

Can it get you twisted? Maybe, if you drank the whole bottle by itself. Otherwise, use sparingly or buy the booze-free extract.

Desserts Tiramisu, which contains rum-soaked ladyfingers, is refrigerated but not cooked—meaning it contains totally un-cooked-off alcohol, and should be avoided. Flambeed desserts—the technique used in desserts like Bananas Foster and Crepes Suzette—have the same story: because the alcohol is cooked for such a short amount of time, 75% of it remains.

Can it get you twisted? Have you ever had Bananas Foster? There’s enough alcohol in it to disinfect a small village.

Kombucha Fans of this Chinese tea made of live bacteria and yeast (yuck) claim it stimulates the digestive and immune systems, and even can prevent cancer. But, because the drink contains fermented yeast—same as beer—it has about 0.5% alcohol. Some kombuchas which are aged longer, contain 1-1.5% alcohol.

Can it get you twisted? Maybe not to the point of intoxication, but it definitely tastes like alcohol.

Non-alcoholic beer and wine Under federal law, beer that contains less than 0.5% alcohol can be called non-alcoholic beer, so most NA beers have 0.4% alcohol. It’s made the same way as normal beer (typically 4–6%, but most of the alcohol is distilled off). Same deal for NA wine.

So is NA beer intoxicating? According to this website, a 200lb male would need five beers over an hour to become too drunk to drive—but he’d need 50 bottles of NA beer in the same time frame to reach the same level of intoxication.

That said, a recent study by researchers at Indiana University found that just the taste of beer can trigger cravings. "We believe this is the first experiment in humans to show that the taste of an alcoholic drink alone, without any intoxicating effect, can elicit this dopamine activity in the brain's reward centers," said David A. Kareken, PhD, professor of neurology at the IU School of Medicine. And dopamine has been linked to cravings and relapse triggers for ages.

Can it get you twisted? If you have the wherewithal to drink 50 in an hour, then yeah. But more importantly, just tasting beer and wine can make you want more—so probably best to stay away.

 

OVER-THE-COUNTER MEDICINE
It’s common knowledge in AA that all pills prescribed by a doctor should be taken as directed to avoid an unintentional relapse—but what about over-the-counter medicine, like Sudafed, Benadryl and ZzzQuil? Danielle of Brooklyn says, “DayQuil gives me a weird shaky feeling. I hate that feeling, but it's something other than what I normally feel, so I can still obsess and find justifications for it. Even Ibuprofen sometimes. I just like taking pills!"

ZzzQuil This new drug, produced by the makers of NyQuil (which contains 10% alcohol) and meant exclusively to help you sleep, contains the antihistamine diphenhydramine, alcohol and high-fructose corn syrup. If it doesn’t gross you out to drink sugar right before bedtime, know that mixing alcohol and diphenhydramine can put you in an extremely sedated state.

Can it get you twisted? ZzzQuil definitely will alter your mood and mind—and, because of the alcohol, it may trigger relapse or cravings.

Sudafed The active ingredient in this cold medicine—as well as any allergy medication/decongestant combo, typically signified by a “D,” as in Zyrtec-D, Claritin-D, and so on—is pseudoephedrine, which is classified as an amphetamine. It also happens to be a starting point for making meth, which is why you have to ask the pharmacist to give you Sudafed or similar meds from behind the counter, even though it doesn’t require a prescription to buy.

Can it get you twisted? Yes, for sure. If your drug of choice is an upper, then be especially careful!

Codeine/cough syrup A cough suppressant found in Tylenol 3 and Robitussin, codeine is derived from the opium poppy. It’s available without a prescription in some countries, and in the US it’s a controlled substance but is still available in lower doses in some pharmacies. Combined with a Jolly Rancher and flavored soda, the combo is known as sizzurp and almost killed Lil Wayne in March.

Can it get you twisted? Yes, definitely. Stay away from it! Plus, it’s gross. Why would you want to drink cough syrup? “People who suffer from opioid addiction should not use codeine as a cough suppressant because they are at a very significant risk of relapse,” says Dr. Petros Levounis, chair of the Department of Psychiatry at New Jersey Medical School. Woman-in-recovery Claire agrees: “Even if the cough syrup is a kid-friendly, alcohol- or codeine-free one, I want to grab the bottle and chug it like Lil Wayne fresh outta jail."

CAFFEINE/NICOTINE

Coffee When ingested in excess, this stimulant can cause anxiety and insomnia. But it’s also so, so amazing. Many recovering alcoholics depend upon it as their lifeblood. Says Seth, “I literally never wanted a cup of coffee until I started drinking alcoholically. When I got hangovers, coffee was my poorman's speedball.” Dr. Peter R. Martin, director of Vanderbilt University’s Addiction Center, conducted a 2008 study which found that 88.5% of recovering alcoholics drink coffee regularly, compared to 57% of the general population.

But he says it’s not the caffeine alone that should be considered. “Coffee is much more complex than caffeine. We don’t think it’s the caffeine necessarily that helps people stay sober. Chlorogenic acids, a large number of biologically active compounds in coffee, can act on the opioid receptors in much the same way as Naltrexone,” a drug prescribed to manage alcohol consumption and marketed under the names Revia, Depade, Relistor and Vivitrol. “We wonder, based on our findings, whether coffee could actually reduce the rate of relapse for alcoholics in recovery,” says Martin. Hooray! Drink up!

The problem with many herbal supplements is that they work so well because they contain a buttload of alcohol.

Can it get you twisted? Yes, but not in a bad way! All jokes aside, if you’re obsessing about coffee in the way that you would drugs or alcohol, it’s probably bad for business. According to Dr. Levounis, “Coffee is a mind-altering drug, but, pharmacologically speaking, it’s certainly in a different class and will not trigger you to go back to drinking. The same is true of nicotine.”

Energy drinks This $10-billion-a-year industry includes 5-hour Energy, Rockstar, Red Bull, and Monster. Depending on the drink, these are packed with stuff like B vitamins, amino acids (such as taurine), tons of sugar—and three times the caffeine as soda. They have been linked to addiction and seizures due to the crash that comes after downing a few in quick succession.


Can they get you twisted? Probably not if you drink one every once in a while—but they can be dangerous in large quantities, and some countries don’t even allow them to be sold to minors. For a disturbing documentary about energy-drink addiction, check this out.

Cigarettes Nicotine is totally addictive and cigarettes can cause strokes, heart attacks, several types of cancer, and other diseases. But, says former smoker Sean, “Cigarettes helped me initially get sober because I had something else to turn to and do” other than drink.


Can they get you twisted? Maybe. Sean says, “I radically separated my alcohol and nicotine addictions. When I quit, I used the spiritual tools I learned in AA, but I didn’t feel like my nicotine addiction was compromising my sobriety.”

 

HERBAL SUPPLEMENTS

There are many herbal supplements that can alter your mood and mind like kava, maca, passionflower, valerian root and Rescue Remedy. The problem with many of these is that they work so well because they contain a buttload of alcohol. Alcohol-free versions are available, but, according to Dr. Levounis, “The research is quite scanty, but some caution should be observed.”


Can they get you twisted? Probably. Kelly says, “I am the kind of recovering drunk that is okay with having beer in the fridge and whiskey in the freezer, but cannot deal with the following: vanilla extract, Rescue Remedy, mouthwash, NyQuil or Tylenol PM. There is too much wiggle room for justifying overuse in those for me.”

 

HOUSEHOLD ITEMS

Things containing alcohol like facial toner and hand sanitizer can be triggers for recovering alcoholics, as can items that can be abused, like canned air, which is used to clean keyboards or electronic devices. (Remember Allison the Huffer from Intervention?) Jess says, “I used to huff [canned air] when I was first starting to use drugs and I became obsessed with it. It was so cheap. I’d just huff it throughout the day. When I see it now, this little voice says, ‘It’s not a drink...’ I don’t worry about it today, but it just proves how insidious this disease is.”

Meanwhile, Carl notes that he “had isopropyl alcohol for disinfecting and I started getting the crazies. I just dumped it out without thinking twice about it. I used to think people who wouldn't use alcoholic mouthwash were draconian but I totally get it now. My disease would want me to go out on fucking rubbing alcohol.”


Can they get you twisted? You’d need to drink a lot of mouthwash to get a buzz, but it could make you have a craving. According to Dr. Martin: “Alcoholics should consult their doctors, but in general, they need to be very careful with altering the way they feel with medications and external agents that change the way the brain functions because it might increase the possibility that they relapse.” 

Sarah Jones is a pseudonym.

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