Alcohol abuse is the primary drug problem in American society. Americans spend more than $90 billion dollars on alcohol each year. An average American may drink 25 gallons of beer, 2 gallons of wine, and 1.5 gallons of distilled spirits each year. 15 million Americans are dependent on alcohol. 500,000 are between the age of 9 and 12. Alcohol related problems are costing the American economy at least $100 million in health care and lost of productivity every year. About 1 out of 4 Americans admitted to general hospitals are abusing or dependent on alcohol. Undiagnosed alcoholics are being diagnosed for alcohol related illnesses and injuries every day. Alcohol abuse is the third leading cause of death in the US, 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 3-5% of cancer deaths. 40% of all industrial fatalities and 47% of work related injuries can be linked to alcohol consumption and alcoholism. A 2001 survey shows 25 million Americans reported driving under the influence of alcohol, a number that grows each year. Among young adults age 18 to 25 years, almost 23% have driven under the influence of alcohol. The latest death statistics released by the National Highway Traffic Safety Administration (NHTSA), show that 17,488 people where killed in alcohol related traffic accidents in 2010. This report represents nearly 800 more people where killed than the previous year. In 1996, local law enforcement agencies made an estimated 1,467,300 arrests nationwide for DUI offenses. Four of ten criminal offenders report alcohol as a factor in violence. Among domestic violence victims, three quarters of incidents were reported to have involved alcohol use by the offender.
Alcoholism is a mental health disorder that is characterized by an uncontrollable compulsion to drink. A combination of social and biological factors may lead to alcohol dependence. One primary risk factor is a family history of the disease. This is due to both the influence of psychosocial and cultural factors of being exposed to and effected by alcohol abuse, alcoholic behavior. Also biological factors, chemical imbalances and possible genetic predisposition. People who suffer from alcoholism become mentally and physically dependent on the drug. Alcoholics build up a tolerance, needing more and more alcohol to get the desired effects. Without alcohol, symptoms of withdrawal can present within a couple of hours. These symptoms include irritability, nausea, tremors, anxiety and insomnia. Severe withdrawal symptoms can include heart arrhythmias, seizures, delirium and death. It is advisable that someone who needs to detox, do so under supervised medical care.
Excessive alcohol consumption may lead to permanent biological abnormalities. For the developing brain, alcohol consumption is particularly dangerous because during adolescence baseline chemical balances are being established. Glucocorticoid hormones are released under stress. Chronic stress can make the nucleus accumbens, a part of the brain sensitive to high levels of dopamine, a neurotransmitter. Dopamine is important for survival instinct, taking action and desire for more of something. Seratonin exists to regulate dopamine. Dopamine levels rise with consumption of alcohol as baseline seratonin levels may be low, creating a pathology of addiction.
Alcohol interrupts key receptors in the brain that effect the ability to create memories. This can lead to alcohol induced amnesia commonly known as a blackout. Additionally this interruption effects cognitive abilities for days after the drinking has stopped, so if alcohol consumption persists, it takes a toll on the hypocampus, an important emotional center of the brain. Alcoholic depression may worsen with time as do the chances of making poor choices that negatively effect the life of the alcoholic. Life becomes unmanageable, home and career being effected and physical health declining.
Most Alcoholics do not voluntarily seek treatment until they ‘hit bottom’. Even if the alcoholic does seek help, recovery takes a lifetime. Treatment for the disease of alcoholism is a multi step process. First the addict must detox. Withdrawal symptoms are harsh and at it’s worst may include heart arrhythmias, seizures, delirium and death. Medications can help reduce withdrawal symptoms but may pose the risk of becoming the replacement addiction. Disulfiram (Antabuse) causes vomiting if alcohol is ingested. It is commonly used to prevent relapse, an immediate return to drinking. Naltrexone is an opiate antagonist that helps reduce cravings by blocking pleasure producing effects. These are both helpful for preventing alcohol consumption. Valium or benzodiazepines ease withdrawal symptoms, overcoming motor excitement, nausea, vomiting, convulsions, tension and anxiety, but they must be used with great care and close supervision because they can be addictive as well. It would do an alcoholic no good to replace one addiction with another, but it happens.
Residential alcohol rehabilitation centers are live in programs for individuals undergoing the earliest stages of alcohol detox and returning to sobriety. Licensed counselors, medical staff and other professionals care for and guide addicts toward a healthier life, treating the addiction, the mental health afflictions and the possible physical ailments caused by alcohol dependency.
Psychological Treatment is the next necessary step to help keep an addict sober. The aim is to control abusive behavior and to learn healthy coping mechanisms for life’s challenges. Group therapy such as meetings of Alcoholics Anonymous or family therapy sessions can be helpful in providing social support and giving the addict some clarity and perspective. Behavioral and cognitive therapies are diverse in nature. Aversive conditioning, a form of classical conditioning pairs alcohol consumption with negative stimuli such as drugs to induce nausea, vomiting or electric shock treatment. Learning social skills, modeling behavior, modifying cognitions, stress management, life skills and spiritual practices are all important to long term recovery.
Environmental Intervention seeks to assimilate an institutionalized addict back to society. Sober Living Environments, also known as half way houses. When people leave the strictly regimented alcohol rehab facility, they may not be ready to return to independent living. Sober houses provide an environment for addicts to live, providing structure, recovery planning and other tools, allowing them to have limited freedom while readjusting to life in society. Sober houses, employment training and job placement programs enable a recovering addict to get back on their feet and become productive members of society once again.
Alcoholics Anonymous is the original Twelve Step Program that provides a structured path toward recovery from alcoholism. It is the primary model upon which many alcohol and drug rehabilitation programs are based. It combines a group therapy type of environment, with meetings and individualized support for it’s members by it’s members, with sponsorship. It’s premise is spiritual growth and personal accountability. The program is fully self supporting and self sustaining, which are powerful reasons why it works for those who work it. AA meetings can be found in virtually every community in the United States and around the world.
Alcoholism is a family disease. To help a family cope and to possibly break the cycle, support and prevention programs for families do exist. 43% of Americans have been exposed to alcoholism in their families. Although people can not stop their loved ones from drinking, help is available that can provide support and guidance for those effected by alcoholics. Al-Anon and Al-Ateen family groups are twelve step programs related to Alcoholics Anonymous. Al-Anon members are able to recognize codependent, enabling behavior patterns that may do more harm than good for themselves and the addict. Through peer support and literature provided by the program, families can learn healthier ways to deal with the problems that arise due to alcoholism. Members do not dispense advise or directions, rather they share their experience, strength and hope. Members come to understand problem drinking as a family illness that affects everyone. By listening to members speak at meetings, one can hear how they came to understand their own role in this illness. The insights gained put them in a better position to play a positive role in the future. Research shows that when problem drinkers enter a recovery program, their chances for success are improved when they are supported by family members who are in a family recovery program. Al-Anon meetings can be found in communities nationwide and around the world.
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