An alcoholic is someone who’s life has become unmanageable due to their physical and psychological dependence upon alcohol. Almost everyone in society knows someone who is effected by this all to common illness. The causes of chemical dependency are many and not fully understood. It seems that there is no singular cause; rather a combination of genetic, biological and environmental factors contribute to one’s susceptibility to the disease. Statistics demonstrate the effects alcoholism has on economic burden and health disparities. Interventions can be taken at all levels ranging from individuals and communities to state and federal government in order to prevent or treat alcohol addiction. Research and education are key to understanding, preventing and treating this common and complex disease. The disease of alcoholism is an issue that seriously undermines the health and wellness of individuals, families, and communities thus vigorous action must be taken toward prevention and treatment of this disease.
The disease of alcoholism actually has little to do with alcohol. Drinking is but a symptom of a psychological problem. Mental disorders such as alcoholism occur in all racial, ethnic, and socioeconomic groups. About one in four adults in the United States suffer from a diagnosable mental disorder. Depression is the most common cause of disability for the age 15-44 demographic.(CDC, Genomics and Health) Other common mental illnesses include anxiety, bipolar disorder and schizophrenia. Many alcoholics suffer from one or more mental disorders in addition to addiction. This is called dual diagnosis. The specific causes of most mental disorders, including addiction are not completely known or understood. It seems that a combination of biological, genetic, psychological, social and cultural factors are involved. Having a family history of addiction and mental disorders increases the risk.
Millions of people are dependent upon alcohol. Alcoholics may drink to socialize, relieve stress, relax or sleep. They become dependent upon alcohol and it’s effects, developing an uncontrollable compulsion to drink. In time, an alcoholic develops a tolerance to alcohol’s effects; they need to drink more to feel the high. Psychologically, the alcoholic becomes unstable, exhibiting unexplained mood swings, anxiety, severe depression, angry outbursts, acts of violence, or suicidal tendencies. “If they do not have alcohol, they may begin to experience withdrawal symptoms in as little as two hours of not having a drink. These symptoms can include irritability, nausea, tremors and anxiety.” (rehab-international.org)
“A person who drinks too much alcohol may be able to perform complicated tasks, such as dancing, carrying on a conversation or even driving a car, but later have no memory of those escapades. These periods of amnesia commonly known as "blackouts," can last from a few minutes to several hours.” A study conducted at Washington University School of Medicine in St. Louis identified the brain cells involved in blackouts and the molecular mechanism that appears to underlie them. The report which appeared in the July 6, 2011, Journal of Neuroscience found that large amounts of alcohol does not kill brain cells, but interferes with key receptors that effect memory.
The receptors product steroid hormones that inhibit long-term potentiation “LTP”. This process strengthens the connections between neurons and is crucial to learning and memory. Some receptors become inhibited but later others activate, initiating a cascade of interference with synaptic plasticity in the brain's hippocampus, which is important in cognitive functioning.(Medline news, The Biology Behind Alcohol-Induced Blackouts)
Alcoholism is a danger to public health because people who are addicted to alcohol never know when to stop and they have no regard for any of the consequences of their excessive drinking. Irresponsible behavior by the alcoholic effects not only the health of the individual, but families, businesses and the community as well. Alcohol is the third leading cause of death in the nation, causing 35 to 40 percent of motor vehicle fatalities, as well as chronic liver disease and cirrhosis, home injuries, drownings, fire fatalities, job injuries, and 3 to 5 percent of cancer deaths. (Schneider, 220). Alcoholism can also result in cardiovascular problems, liver disease, pancreatitis, esophageal and oropharyngeal cancers. “People who consume excessive amounts of alcohol will also have an increased risk of developing arthritis, cancer, heart disease, hyper- and hypoglycemia, kidney disease, obesity, nervous disorders, psychological disturbances and malnutrition.” (Rehab-international.) A study conducted in San Francisco California between 2004 and 2007 found that 10% of premature deaths in the city were somehow related to alcohol. (Katcher et all)
Risky behaviors such as drunk driving endangers the lives of others, not just the alcoholic. Alcoholics who engage in risky behavior often wind up with legal problems. Statistically, there was an alcohol related auto accident resulting in fatality every 38 minutes in the U.S. (SAMHSA) In the state of California there were 203,866 DUI arrests in 2007. (DMV.gov) The number of drunk driving arrests grows yearly, unfortunately so does the number of drunk driving fatalities.
Alcoholism is the number one drug problem in America. It is estimated that 43% of Americans are exposed to alcoholism in their families. (drugrehabs.org) Families of alcoholics suffer emotional distress, financial consequences, and sometimes violence in the home. Unborn children of alcoholic mothers suffer serious medical consequences. Fetal alcohol syndrome is characterized by physical deformation, emotional and mental disturbances and sometimes mental retardation. Alcoholism tares families apart when left untreated. There is help available for alcoholics and for their families.
Alcoholics only go for help when they are ready. If they get into trouble, they may be forced into a treatment program, but in order to truly recover they have to want it for themselves. Twelve step programs are the primary model for alcohol rehabilitation, treatment, and help for their families. Alcoholism is a problem even when the alcoholic remains sober. They cannot function well without it. Their life can become a bigger mess when they are sober without some sort of program or active lifestyle management for the recovering alcoholic. They must take specific action to work on their problem. (rehab-international.org)
Alcoholism requires rehabilitative treatment. The withdrawal symptoms of alcohol detox are very intense and can be fatal without medical intervention. In 2006 thirteen percent of drug-related emergency department visits by minors were a result of alcohol, either on its own or after being combined with other substances. In the same year, two million five hundred thousand people were treated for alcoholism at rehabilitation centers. These programs are usually live in programs that offer a strict structured environment that combines twelve step philosophy, professional counseling, behavioral modification and medical care as needed. Rehabs are intended to pull the alcoholic out of crisis. Sober living environments also known as half way houses are a good option for the recovering alcoholic who is fresh out of rehab and still needs the structure of the drug free environment.
Prescription medications or holistic therapies are sometimes prescribed to individuals who are detoxing or recovering from alcohol addiction. The drug Ondanestron is currently used to help control nausia and vomiting for chemotherapy patients. An experimental study at the University of Virginia found that this drug has helped people with drinking problems to reduce the amount of alcohol they drink. It works by effecting serotonin receptors. Genetic variants of serotonin receptors have been found in people with severe drinking problems. (NIH News) Holistic therapies such as acupuncture and Yoga have also been found to be effective in helping alcoholics to find some relief in the form of energetic healing and spiritual guidance. After all, disease starts on an energetic level.
For lifestyle management the twelve step program Alcoholics Anonymous is by far the most popular organization. Twelve step groups put a strong emphasis on spirituality and personal accountability. Established in the 1950’s by Bill W. AA has grown to become a world wide network. AA meetings can be found in every community in the U.S. and in many other countries. Many other twelve step programs have grown out of the AA model. Al-Anon is also a twelve step program designed to support the families of alcoholics. It is believed that the families of alcoholics also suffer from the same disease, even if they do not drink, because they suffer from the consequences of alcoholic behavior, emotional distress, abuse, and develop unhealthy behaviors for survival. All twelve step programs use the same twelve steps and the Al-Anon member is encouraged to work the steps just the same as the alcoholic. (aa.org)
Twelve Steps of Alcoholics Anonymous and Al-Anon
- We admitted that we were powerless over alcohol- that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- Made a decision to turn our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed and became willing to make amends to them all.
- Made direct amends to such people whenever possible, except to injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as a result of these steps, we tried to carry this message to others, and to practice these principles in all our affairs.
(aa.org)
The old adage goes “an ounce of prevention is worth a pound of cure.” Public service announcements encouraging responsible behavior with alcohol are mostly aimed at preventing drunk driving and underage drinking. Laws against providing minors with alcohol or driving while intoxicated are strict, but their effectiveness is limited. The alcohol industry spends $2 billion on advertising each year and Americans spend $90 billion on alcoholic beverages. (DrugRehabs.org) Teenagers are susceptible to peer pressure and media influence. Parental involvement and modeling are probably the best defense against teen alcohol abuse. It is well known that alcoholism runs in families. If parents are alcoholics, the children are more likely to develop drinking problems themselves. The opposite may also be true. If children are brought up by emotional healthy adults who model responsible behavior and communicate openly with them, then the kids are less likely to give into media influence and peer pressure.
The disease of alcoholism is complex in cause and cure. The factors that contribute to alcohol addiction are a combination of genetic, biological, psychological, familial and social influences. This is not a disease anyone consciously chooses. Therefore it is important to have compassion for those effected by alcoholism and to understand that it is an illness that can be treated. Public Health must address prevention of alcohol abuse, protecting the community from the dangers of alcoholic behavior and treating those afflicted with the disease.
References
Alcoholics Anonymous, http://www.aa.org/?Media=PlayFlash, retrieved July 2011
The Biology Behind Alcohol Induced Blackouts, Medline News Today,http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=230582, 07 Jul 2011, retrieved August 2011
California Department of Motor Vehicles, http://dmv.ca.gov/about/profile/rd/duistats89_99.htm
CDC, Public Health Genomics, Mental Health Awareness,http://www.cdc.gov/genomics/resources/diseases/mental.htm, retrieved August 2011
DrugRehabs.org, http://www.drug-rehabs.org/alcohol-statistics.php
Katcher et all, Estimating alcohol-related premature mortality in san francisco: use of population-attributable fractions from the global burden of disease study,http://www.biomedcentral.com/1471-2458/10/682, retrieved July 2011
Medline News Today, Researchers Find Key Genetic Trigger of Depression,http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=204903 , retrieved August 2011
National Institute on Alcohol Abuse and Alcoholism,http://www.niaaa.nih.gov/Pages/default.aspx, retrieved July 2011
National Institutes of Health, NIH News, Wednesday, January 19, 2011 http://www.niaaa.nih.gov/NewsEvents/NewsReleases/Pages/Genevariantspredicttreatmentsuccessforalcoholismmedication.aspx, retrieved August 2011
Schneider, Mary-Jane, Introduction to Public Health, Jones and Bartlett
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