Anyone who has gotten sober after drinking and drugging for an extended length of time is probably familiar with what it feels like to be “mocused.” Mocus is a word used by old timers in AA that describes the state that exists where you haven’t ingested booze or drugs for a while, but you’re still afflicted with a kind of brain fog that impairs decision making, memory and sleep and also puts you on an emotional roller coaster that makes the most horrifying ride at Six Flags seem like a foot massage by comparison. The condition can last from months to years, and it isn’t just 12-step folklore either. Research scientists have determined that it is a real phenomenon that occurs in nearly all cases of addiction recovery, and even have a cute acronym for the condition: PAWS (Post-Acute Withdrawal Syndrome).
One of the best descriptions of how it manifests itself comes from my friend Patrick. “I went into a sandwich shop when I was six months sober, and I just stared at the menu on the wall for a full 10 minutes,” he says. “I couldn’t think straight enough to make up my mind about whether I wanted tuna or roast beef, so I just left—and I was starving.”
The good news is that this condition eventually passes if you stay clean and sober. But a new study indicates that you clear up a whole lot faster if you don’t smoke, especially if you’ve never smoked at all. In the snappily titled report “Effects Of Cigarette Smoking History on Neurocognitive Recovery Over 8 Months of Abstinence in Alcohol-Dependent Individuals,” researchers found that smokers scored far more poorly on basic cognitive tests than non-smokers.
The researchers examined a pool of 133 (89 percent male) alcohol-dependent individuals who previously averaged 370 drinks per month, but were currently abstaining from alcohol. The group was composed of 30 who had never smoked, 28 former smokers and 75 active smokers. Each was given a battery of tests (auditory-verbal, visuospatial learning and memory, processing speed and working memory) after being sober at intervals of one week, four weeks, and eight months. The results are pretty eye opening.
After eight months off the booze, active smokers showed poorer recovery than never-smokers on measures of learning, and both former smokers and active smokers recovered less than never-smokers on processing speed measures. In addition, after eight months clean and sober, active smokers performed worse than never-smokers on most measures, and former smokers performed worse than never-smokers on just a few tests. The most telling finding, however, was that those who never smoked at all showed full recovery on every measure after eight months clean. Which means that if you smoked but don’t own a time machine so that you can go back and stop smoking before you start, you’re going to have to wait a little while to clear up.
“Cigarette smoke contains a tremendous number of toxic compounds that affect multiple organs in the body, including the brain,” researcher Timothy C. Durazzo, Ph.D has said. “The active-smoking (subjects) stopped drinking, but continued to smoke, which may have damped their recovery because of continued exposure to the various chemicals in cigarette smoke that promote oxidative stress. The diminished recovery of former-smoking (subjects) may represent the residual effects of long-term oxidative stress; however, this is all speculative.”
There have been a number of studies conducted in recent years that show that quitting smoking does not increase an alcoholic’s desire to drink, and some even suggest a slightly higher recovery rate for those who quit both at the same time. However, given that the same studies indicate that 80 percent of alcoholics seeking recovery are active smokers, asking a population that is not exactly known for their mature behavior to give up their two favorite things at once can, in my opinion, be a bit much to ask.
While nobody in their right mind (except tobacco company shareholders) thinks smoking is a good idea, and studies say that you can quit both at once without increasing your chances of relapse, the fact remains: It’s really fucking hard to get sober, without the added stress that quitting smoking will heap onto that shit show. So I’m a subscriber to the old school of thought: “Take care of things in the order that they will kill you.” When I put down the booze and drugs, I substituted smokes and sugar until I could stop obsessing about the stuff that would surely kill me within the year (I have cirrhosis and was becoming increasingly suicidal). Marlboro Lights and Ben & Jerry’s were my saving graces in early sobriety, and I stopped smoking at four years clean and have learned to (sort of) handle my sugar addiction as well.
I took an unscientific poll of a random dozen people from my home group (about half of that dozen are under 18 months sober) and I asked them if they thought they would have a harder time getting clean if they quit smoking while they were getting sober. Every one of them said yes. One guy quit smoking at eight months sober last month, but picked up (smoking) again because he was “going insane.” Another (whose one year anniversary is tomorrow as I write this) said he never would have made it, because the anxiety was unbearable when he tried to quit early on. The last thing you need in early sobriety is another source of anxiety and irritability, because that’s what usually leads to wanting to pick up a drink or a drug.
Sometimes the medical model is not the best model for recovery. For starters, most scientists aren’t going to be prescribing prayer as an answer for anything, despite mountains of anecdotal evidence that it works in 12-step programs. I say, if you’re in early recovery and you think smoking is helping you stay sober, smoke. Just don’t fucking drink or take drugs or you’ll never clear up.