ALCOHOLISM

History and Symptoms
Alcohol has been a part of civilization since its beginning. "Breweries can be traced back almost 6,000 years to ancient Egypt and Babylonia" (Lutz, 1992). Problems resulting from the use of alcohol have quite a long history. It is only recently in our modern history have we been able to document alcohol related problems. It is certainly true throughout history that mankind has abused alcohol. An alcoholic is a term used to describe "someone who habitually uses alcohol to excess and detriment" (Morris 1993). Alcoholism is the state of a person who habitually uses alcohol to such a degree that major aspects of the individuals life such as work, family, relationships, and personal health and safety are interfered with. James E. Royce, in his book Alcohol Problems and Alcoholism, gives a working definition to the alcoholism;

We define alcoholism as a chronic illness or disorder characterized by some loss of control over drinking with habituation or addiction to the drug alcohol, or causing interference in any major life function: for example, health, job, family, friends, or the law (p10)

With alcoholism there is a loss of control, the alcoholic may be able to just take one drink, on one night, and think they have control. The problem is that sooner or later they will lose control again. Dependence on alcohol can be either psychological or physiological. Addiction is a physical dependence for a certain substance. We can easily overlook the fact that alcohol addiction can be both physical and psychological. The aspect of psychological addiction to alcohol can be devastating. It is difficult to understand this standing outside of an addiction. If you think of a compulsive gambler who will destroy his family by gambling, he is said to have a psychological addiction to gambling just like the alcoholics addiction to drinking.

Alcoholism cuts across every social and economic group in America. White collar workers and manual labor jobs have about the same amount of alcoholics among them, whereas professional and managerial jobs have twice the rate of other workers. Most problem drinkers, sometimes reported as high as 60%, are college graduates. This dispels the myth that only uneducated, skid row type people abuse alcohol.

Some problem areas or symptoms may be increased desire, looking forward to a time when you can drink, an increase in the amount of alcohol it takes to relieve tension, if one lies about or hides alcohol consumption. If there are times when one cannot remember where they have been or what they have been doing this should be a warning that alcohol is having an effect. Depression, feelings of isolation, guilt, sinking self-esteem, lack of productivity, confusion, loneliness, hopelessness and futility can all be a part of the symptoms and /or causation of alcoholism.

Etiology
To some people alcoholism is the result of a weakness of some sort, they might think of the person as having a weak will. Others will look to the biological field for an explanation citing a deficit of some kind, or a metabolic disorder, and to some it will be a psychological disorder of some type. There is no one cause to alcoholism. It is a multifaceted problem. There are many contributing factors.

The sociological factor believes that society encourages drinking. Alcohol is readily available and is seen by many as desirable. In our society availability of alcoholic beverages is seen as the biggest sociological factor. The more readily it is available the more it is consumed. Researcher Robert Reynolds of The Pacific Center For Violence Prevention says, " Not surprisingly that the number of alcohol outlets in a given area is directly related to how much alcohol that area consumes." The social implications of drinking also have an affect on the amount of alcohol consumed, if a community has high moral standards and looks down upon the use of alcohol, the amount used decreases. It can be said then that if our society as a whole were to change the social norms related to drinking the society could in fact have a positive influence persuading people not to drink excessively. Social reform would not entirely eliminate alcohol consumption but it is definitely a factor to be considered.

Another factor is the psychological factor. There are many schools of thought in psychology as to why a person is an alcoholic. The Freudian view states that alcohol abuse is a result of the unconscious tendencies, like self-destruction, oral fixation or homosexuality. Alfred Adler feels that people abuse alcohol because of a struggle for power. The general psychoanalytic view is that alcohol abuse is the result of an inner conflict between dependency drives and aggressive drives. Basically the psychoanalytic views reflect that the alcohol is symbolic of something. It may be different for each individual. It represents a value to the alcoholic symbolically. If one can find out what the alcohol symbolizes then one can help treat the alcoholic.

The theories of learning and reinforcement are also considered in the causation of alcoholism. If a person drinks in an attempt to release tension or anxiety and feels that this works for them it will have a reinforcing tendency. If others around them also have drinking problems they may reinforce drinking in each other. In learning theory, if the effect of alcohol has a positive effect on them in one way or another the continued use of alcohol seems likely to occur.

"A common pattern has been found in alcoholics that suggest a predisposition of personality traits can also be a factor. These include traits related to assertiveness, extroverted, and impulsive behaviors( Weisner p55)." This is not to say that everyone who is assertive, extroverted or impulsive will become alcoholic. It does suggest a correlation between the likelihood of those with these personality traits and alcoholism. If a person has a trait of aggressiveness or is extroverted, alcohol consumption may be seen as having a positive effect on them. It can be seen as an enhancement to their natural gifts or abilities. In doing so it perpetuates the myth or empowerment in their own minds.

Biological Factors are of great consideration as well. "It has been established that alcoholism runs in families" (Barbee et all. p.170). If your father was an alcoholic and his father or mother was an alcoholic the chances that you will have a problem with alcohol increases. Whether it is a genetic disposition or an environmental disposition or both one cannot be sure. There are varying degrees in which biological factors relate to environmental factors and it is difficult to find an exact causation. One biological factor relating to alcohol is that if one drinks enough, the body will become dependent on the alcohol content and will need continued consumption to retain equilibrium in the body. If your body gets used to alcohol at a certain level and you cut it off after prolonged use, the body will revolt with side effects like headaches, nausea, or tremors. It seems that anyone who drinks over a long period of time in this manner could become an alcoholic by virtue of bodily needs.

Current Research
In The Journal of Health and Social Behavior, M. Lynne Cooper writes,

Alcohol consumption has increased nearly 50 percent over the last generation. It is the most commonly abused substance in the United States. There are approximately 10.3 million people who are problem drinkers. About three fourths of alcoholics are men and one fourth women. College age men and women abuse alcohol more than any other age group.

The increase in the amount of treatment centers across the United States can give support to the fact of alcoholism continuing to be a problem. Constance Weisner states in The American Journal of Public Health,

Between 1979 and 1990, for example, the private system of treatment increased by 116% (with the number of for-profit treatments increasing by 604%, while the number of non- profit agencies increased by 80%) and the public sector by only 11%. (1995, p54)

It is difficult for many to understand why alcoholics continue to drink. Some feel it is because of a disposition to depression or the need to escape their feelings or pressures. Others feel it is a psychological cycle. They are depressed so they drink and then since alcohol is a depressant they drink more, and on and on it goes. Recently a new theory has been suggested by Gerald Rosenbaum in The Journal of Clinical Psychology, called the "Alcohol Paradox."

The paradoxical continuation of excessive drinking by chronicalcoholics despite extremely aversive personal deterioration is addressed by a two factor theory. The theory regards the increasing stereotypy of alcohol related behaviors as a function of: (a) primary neuropsychological impairments that result from alcohol abuse and (b) secondary fears of catastrophic failure attendant upon brain dysfunction, which leads to acquired aversion to situations that require adaptive behavior (1995, p.303).

It seems that prolonged use of alcohol abuse can damage the brain and reduce the ability of the alcoholic to perform certain behaviors such as memory tasks, abstract thinking and problem solving. This leads to the alcoholic having a feeling of being stuck, not able to progress and finally sinking into a mode of failure, self-loathing or depression. All of this continues the cyclical pattern.

Another new study shows that " Alcoholism may be linked in part to the presence of a particular gene on chromosome 11. The gene is apparently involved with the production of the receptor sites, on brain cells, of the neurotransmitter dopamine" (Groliers 1994 p.211). Researchers are beginning to find more evidence that alcoholism is a hereditary disease passed on from generation to generation. If this is true it will challenge a lot of preconceived ideas about alcoholism in general.

Helping people to stop drinking is no small job. One organization has been more successful than any other group, Alcoholic Anonymous.

With a membership of over 10,000 groups and well over 1 million members Alcoholics Anonymous has helped many alcoholics deal with their drinking problems. This is a non-professional, person to person approach to recovery. They have a 12 step program designed to help the person to stop drinking entirely. It encourages on a spiritual basis as well (Harris 1992, p.18).

Treatment
Alcoholism is a complex problem. Treatment is as varied as the individual alcoholic. Each one brings with him a certain unique set of problems that he must deal with in order to recover. So treatments vary in duration, scope, and method.

Historically alcoholics have been treated by locking them up in mental homes and jails. Society used to treat them as complete losers and condemn them to skid row and back alleys. Aversion conditioning was used in the 1930's by Charles Shadel, he would inject patients with the drug emetine which produces nausea, this would act like the conditioning of Pavlov's dogs, each time they would drink they would become ill at just the thought of it. Other drugs have been used in the past but they can produce damaging side effects. Many treatment programs discourage the use of drugs as treatment.

Alcoholics Anonymous as already mentioned is the most successful in treating alcoholics. It has been doing so since the 1950's. Psychotherapy, individual and group, has generally been effective in treating alcoholism. Hypnosis, relaxation therapy and bio-feedback have also been used as treatment. At one time even LSD was used in the hope that the psychedelic experience would give a self-actualized insight that would cut off the need to drink. Today under the care of a physician treatment centers such as the Betty Ford Clinic offer treatment through a combination of individual and group therapy as well as medication to those who are trying to become sober.

Alcoholism remains as one of our nations most critical problems. More people die because of alcohol related deaths than for any other reason. We must raise the social conscious of our nation through education and political policies in order to make a dent in our nations drinking problem. Until then alcoholism will continue to be a problem within our society.

Questions? Ask Bob

Bibliography
Barbee, et al (1995) American Journal of Public Health, Vol 85, No 1 p.170.

Cooper, Lynne (1994). Journal of Health and Social Behavior. Volume 35 Dec. p.291

Harris, M.(1992). Alcohol and Drug Use Journal of Management, Vol 4, p18

Lutz, H.F. (1992). Viviculture and Brewing in The Ancient Orient. Lepzeig: Hendrihs

Morris, William (1993) American Heritage Dictonary, Houghtin Mifflin: Boston p.28

Rosenbaum, Gerald (1995). Journal of Clinical Psychology. March, Vol LI p.303

Royce, James E.(1981) Alcohol Problems and Alcoholism, The Free Press: New York