Dr. Elena Kovács

I drink between a bottle and a bottle and a half of red wine a night and I am fifty-four years old. I am not an alcoholic. I run a small consultancy from a converted barn in Hertfordshire and I have two grown-up children who don't live at home anymore and a husband who matches me drink for drink and goes to bed at 10pm. I sit up on the sofa for another hour, on my own, drinking the last of the bottle. The thing that started this was my older sister Hannah. She is fifty-eight. Last March she found a lump and within four weeks she was on the table having half of one breast removed. The follow-up appointment, the one with the consultant where you find out about the lymph nodes, was on a Tuesday afternoon. I drove her there. She was holding my hand in the waiting room and I noticed I was sweating, and that I'd been counting down the hours until I could get home and open a bottle, while my sister was about to find out about her lymph nodes. That was the moment. That was the floor of it. I cannot tell you the shame of that moment. She was clear. We went out for dinner that night to celebrate and I drank a bottle and a half of red and woke up at 3am hating myself. I'd been trying everything for years. Dry January in 2021. Half a Dry January in 2023. The Try Dry app, which I deleted because it made me feel worse. This Naked Mind, which I read in three days and thought, yes, that's me — and then drank wine on day four. Three different kudzu products. A four-month run of milk thistle and B-complex that did absolutely nothing. Mocktails at home. Lyre's. The Aldi no-secco. A six-week course of CBT with a woman in Esher at ninety pounds a session who was lovely but couldn't reach the part of me that was thirsty at 5pm. I'd tried two days off — got headaches and bad sleep, drank on day three. I'd tried a week off — got the shakes on day two and was so frightened I drank to settle them. I'd thought about Antabuse. The thought of accidentally drinking mouthwash and being violently sick was worse than the wine. I gave up things one by one. The Saturday morning Pilates class at the village hall — cancelled three times in a row, never went back. Coffee with a friend on Sunday afternoons — I cancelled because I didn't trust myself not to suggest a glass after. The choir, the choir I used to love, because I was too tired in the evenings to want to sing. Not the wine. The shrinking. A few weeks after Hannah's surgery I went to the practice nurse for my smear test. She's been at our surgery for twenty-two years and she'd done my smear tests since I had children. She finished, I sat up, I started getting dressed, and she said quietly: are you alright. I said, in a slightly too-cheerful voice, oh, fine, fine. And she said: can I tell you something. You don't have to listen. She said she'd been a senior nurse on a liver ward in central London in the 1990s before she came back to general practice. She said she could see what most GPs couldn't — the puffiness under the eyes, the slight tremor when I'd held out my hand for the stirrups, the dryness of the skin around my mouth. She said two things were going wrong at the same time and unless I addressed both nothing would work. One, my brain had been getting its calm signal from wine every night for years, so the receptors that produced my brain's own calm had quietly retired. Two, my liver was so busy clearing the alcohol every morning that every milk thistle and B-vitamin I've taken had been broken down before it reached the part of me that needed it. She picked up the little bottle of hand sanitiser by the sink. Said: imagine this is your milk thistle. You swallow it. It goes into your stomach. It's absorbed into the blood that runs straight to your liver — the portal vein — and your liver does its job. It clears it. Sixty, seventy, eighty per cent of it. By the time it gets to the bit of you that needed help, there's almost nothing left. A research review at a leading university in [country] found that orally-administered kudzu lost up to 80% of its active compounds to first-pass hepatic metabolism in adults who drink most nights. She said: that's why the supplements you've been buying haven't worked. Not because you've failed. Because they couldn't get there. The protocol is the protocol. Mechanism. That word changed everything. Then she said something I will never forget. She said: there is one option none of them will tell you about because none of them have heard of it. A patch. Through the skin. It bypasses the liver entirely. Twenty-four-hour release. Kudzu and magnesium and B-complex and milk thistle. The mechanism is the same as the original 1979 motion-sickness patch developed for astronauts on Spacelab missions. Naltrexone has been licensed in this country for alcohol use disorder since 1994. Thirty-one years. Your GP won't bring it up until you call yourself an alcoholic first — and you're never going to, so she's never going to. She wrote Frimod on the back of an appointment card. I drove home with the card on the passenger seat. I ordered it the same evening. I didn't tell Hannah. I didn't tell my husband. I was too embarrassed by all my previous failed attempts. Night one. I put it on my shoulder under a jumper. I went into the kitchen at 5:30. I poured a glass of red. I drank about half of it. The second glass didn't happen. I sat on the sofa watching telly and didn't think about wine the way I'd thought about wine for the last decade. Day three. I woke at 6:50am without my alarm. I'd slept through. A 2015 placebo-controlled trial from a research team in [country] showed a single dose of kudzu extract was enough to reduce consumption in adults who drink most nights. Day seven. My husband, who had not been told, said over breakfast: you seem different. Calmer. Day fourteen. I phoned Hannah to check in on her. She said: you sound like you. You sound like my sister again. Day twenty-one. Sunday lunch at her house. I had one glass of red with the lamb. I left the second pour. We sat in the garden afterwards and she said, quietly: thank god. If you've sat in a hospital waiting room counting down to wine. If your GP did the units thing and moved on. If you've spent hundreds on supplements that did nothing. If you've tried every challenge book on Amazon. If you've been to a CBT therapist who couldn't reach you. Sarah Mitchell wrote her own story of this — twenty-five years of it — and what happened to her at the breakfast table on Day 7. It's the article my sister-in-law sent to me last week, three months after my own first patch went on. Read it. It explains everything I couldn't put into words. https://www.zynvista.com/UK/gray-area-drinking