Alcoholism is a very widespread problem in the United States. Recent research indicates that the use of alcohol has increased significantly and children are using alcohol as early as age 12. It has become an increasing problem among the high school and college population. Use of wine, beer and liquor dates back to 3000 B.C., but the distillation process was applied to fermented beverages about 800 B.C, making possible the preparation of the highly potent liquors. There are about 200,000 new cases of alcoholism each year, and in this last decade teenage alcoholism has greatly increased. In older studies male alcoholics outnumbered females but this gap is gradually reducing, and it has been found that women’s consumption of alcohol is increasing. Our mental health centers and treatment facilities for alcohol and substance abuse problems are now full with alcoholics. It has also been found that high way accidents are linked with alcoholism. It can be a factor in airplane crashes, industrial accidents, and mishaps in the home. Alcohol also presents law enforcement problems and we see that the legal system handles many cases of arrests for using alcohol while driving, marital discord, divorce etc. Over half of all murders are committed under the influence of alcohol. In addition, child abuse, and sexual abuse crimes are often done under the influence of alcohol. College dorms, fraternity houses have reported these crimes when the students got drunk and committed such crimes. Children are being placed in foster care homes due to parental alcoholism and substance abuse. The family harmony is seriously impacted with the impending problem of alcoholism.
In order to understand alcoholism, it is important to make a distinction between alcohol dependence and alcohol abuse. Alcohol dependence is diagnosed when the person shows classic signs of addiction—either tolerance or withdrawal reactions, such as morning shakes and malaise which can be relieved by only taking a drink. The pattern of drinking in both the diagnoses is out of control drinking. Individuals will need to drink daily, being unable to stop or cut down despite repeated efforts to abstain completely. They are also unable to restrict drinking to certain periods of the day. They may go on occasional binges, and suffer “blackouts” of the events that took place during a bout of intoxication. Sometimes their cravings may be so overpowering that they are forced to drink alcohol in a non beverage form, such as hair tonic, cough syrup etc. Such drinking causes social difficulties, problems at work, family quarrels, violence, and arrest for intoxication.
Short -Term and Physiological Effects of Alcohol
Alcohol is a drug which affects the central nervous system. Alcohol acts as a depressant. It first numbs the higher brain centers. The initial effect of alcohol is stimulating. It helps reduce the tension and inhibitions so that the individual may experience an expansive feeling of sociability and well being. Some people become violent and paranoid. If the person consumes large amount, it interferes with the complex thought processes, motor coordination, balance, speech, and vision.
There are behavioral effects of the use of alcohol too. Jones and Parsons found in one study that abstract problem solving capacity and short term memory are also affected by alcohol. In addition, alcohol can also impact sexual functioning in a negative manner for both men and women. Moreover, it has been found that aggression is also provoked when individuals ingest a large amount of alcohol. People often use it to reduce anxiety but the long term effects of alcohol outweigh the initial reduction of anxiety.
Long term effects of Prolonged Alcohol Use
The prolonged use of alcohol results in the person’s failure to focus on academics thus resulting in being expelled from school, repeated offense sending the person to jail back and forth, and drunken driving. The individual is unable to hold a job resulting in impaired relationship with family. Additionally, it also negatively impacts the individual’s interpersonal relationships with family and friends due to violence, aggression, and legal troubles. When alcoholics are sentenced in jail, they sometimes pick fight with the staff and this leads to additional punishment and longer duration of stay in jail. This, in turn, affects the family bonding of the individual.
There are four stages of addiction, according to Jellineck
- The Pre alcoholic stage: This stage is marked by social drinking. The person tries to relieve tension and escape from problems.
- Prodromal Stage: In this stage, drinking becomes furtive and often the individual gets black out. The individual is conscious, talks coherently, and engages in activities, without appearing greatly intoxicated. However, he is unable to recall the events.
- Crucial Stage: In this stage, the alcoholic is in the danger of losing things that they value in life. Person starts with a single drink but continues to drink until he is too sick. In this stage, the social adjustment begins to deteriorate as he begins to drink during the day time and his employer, family and friends can notice this. The alcoholic becomes negligent of his health, diet, and nutrition. He may also experience hallucinations and delirium when he stops drinking. At this stage, he still has the ability to abstain. He can give up drinks for a month but the whole pattern begins to emerge if he takes one single drink.
- Chronic stage: In this stage, the individual continually drinks. His bodily systems have become so accustomed to alcohol that they must be supplied with it in order to prevent withdrawal symptoms. People in this stage become so desperate to drink that they can drink shaving lotion, hair tonic, and medicinal preparations. The person begins to suffer from malnutrition and other physiological changes. He feels no remorse for his behavior and loses his self esteem. He finally ceases to care about his family, friends. Occupation, and social status.
Physiological Effects of Chronic Use of Alcohol.
Chronic alcoholics suffer from malnutrition. Almost every cell of their body is affected by the consumption of alcohol. Calories provided by alcohol are empty and have no nutritional value but the alcoholics stop eating when they drink. Due to malnutrition, and deficiency of B- complex vitamins, they begin to lose their memory. A drastic reduction in the intake of protein causes cirrhosis of the liver, which ranks eighth among causes of death in the United States. Alcohol damages liver functions and cells. Prolonged use of alcohol damages brain cell in the frontal lobes, causing cortical atrophy. Alcohol also damages the endocrine glands and pancreas. In addition, alcoholics are at a high risk of heart failure, hypertension, capillary hemorrhages, which causes swelling and redness in the face of chronic alcoholics.
Moreover, heavy alcohol use during pregnancy can affect the fetus and infant and also cause cranial, facial, and limb anomalies as well as mental retardation. The effect of the abrupt withdrawal of alcohol may cause the individual to become frightened, depressed, weak, restless and insomniac. The person sweats profusely and has tremors of the muscles, especially of the face, fingers, eyelids, lips and tongue. An alcoholic may also suffer from delirium tremens (DTs) when the level of alcohol in the blood drops suddenly. He begins to have tremulousness, hallucinations, especially visual and tactile. If body heat continues to rise, there is a risk that a significant amount of brain cells may be destroyed. Breathing may stop and the person could have convulsions. The person needs to be hospitalized immediately and given medical care to prevent death.
Alcohol is addictive and there is increased tolerance too. Looking at all the side effects discussed, we see that the alcoholic’s functioning level is severely disrupted and it affects the people he interacts with. Every one suffers and the cost of rehabilitating an alcoholic is tremendous.
Treatment of Alcoholism
There are many rehabilitation centers for alcoholics all over the country. These centers admit the alcoholics in an inpatient setting where they are offered individual and group therapy. They are provided supervision and given a “dry out” period. The withdrawal from alcohol called detoxification is done professionally under medical supervision. They are also given tranquilizers to ease anxiety and discomfort of withdrawal. The alcoholics also need carbohydrate solutions, B vitamins and perhaps an anticonvulsant. Antabuse or Disulfiram is prescribed to discourage drinking. The effect of Antabuse lasts about four days. If the alcoholic patient agrees to take Antabuse every four days, he will abstain from alcohol. This helps the patient to occupy his mind on other things like watching a foot ball game without alcohol, and having a social hour without cocktail drinks.
Alcoholic Annonymous (AA)
This is a self help group that was founded in 1935 by two recovered drinkers. It has many chapters and typically the AA meetings give a chance to the alcoholics to become a part of the recovery group. They come and announce that they are alcoholics. The sober and recovered members give their stories and how they overcame their addiction and kind of inspire the new comers to remain sober. The group provides emotional support and also offers a chance for the alcoholics to socialize with each other. They also have sponsors who offer emotional support to the addicts and help them in their recovery. There is a spiritual component to the AA groups as evident in their twelve steps of recovery. AL Anon is another related group where relatives of alcoholics meet and support each other.
Behavioral therapist use covert sensitization in which the alcoholic is instructed to imagine being made violently and disgustingly sick by his drinking. In aversion therapy, a problem drinker is shocked or made nauseous while looking at, reaching for, or beginning to drink alcohol. By pairing the aversive stimulus with drinking, the alcoholic learns to abstain from drinking because he is reminded of the pain that is associated with drinking. However, the therapist has to consider ethical use of using aversive procedures.
Sometimes alcoholics are given a behavioral contract in the outpatient and inpatient settings in which the alcoholic agrees to abstain from alcohol to earn particular rewards, such as week end passes or better living condition in the ward. Outpatient programs also offer this behavioral contracting to improve attendance and prevent no show rate.
Treating the Mental Illness Associated with Drinking
Alcoholics resort to alcohol when they are depressed, have difficulty solving their problems like unhappy marriage, stress at work, family problems, financial problems, and many more. The therapist has to make a good assessment of these problem areas and offer treatment accordingly. It is important to get to the core of the problem and tailor treatment for the individual’s specific need. They need to be referred for adequate mental health treatment also to help them empower with adequate tools to address these problems before you can address the alcoholism. There are mental health treatment facilities in every city and the person needs to be treated for these conditions as an adjunct to treatment for alcoholism. Women who are too passive and lack assertiveness will benefit from assertiveness training. Depressed people who have been withholding feelings, need to be offered support and empathy to help them vent their feelings along with the treatment for alcoholism. Marital therapy needs to be offered to couples who are having marital problems. There are outpatient facilities who also offer mental health therapy in group and individual settings to treat alcoholism.
In this way, we see that the holistic approach to treatment is necessary for optimum results. It is important to seek professional help before the problem is multiplied. Alcoholism has destroyed many intact families, marriages, and career. If left untreated, it can result in severe agony to the individual. Children also imitate their parents and they learn to deal with their stress with alcohol. It can become a multi generational issue unless the cycle is broken, and something is done about it.
Hypnosis can also help reduce addiction to alcohol. Please visit our Blossom Hypnotherapy page to learn how hypnosis can help reduce symptoms of Anxiety disorders.
Reference: Abnormal Psychology, fourth edition by Davison/ Neale