Alcoholism - Drug Abuse and Addiction

Alcoholism

Alcoholism is a leading cause of disease, physical disorders, and death throughout the world. Current estimates indicate that alcoholism affects at least 22 million people in the United States and causes 200,000 deaths each year, making it one of America's most serious health problems. As many as 88 million people in the U.S. are adversely affected by an alcoholic parent, family member, friend, or associate. A 1992 Gallup poll cited in the October 24, 1993 edition of the New York Times reported that approximately 81 million Americans have been directly or indirectly hurt by someone else's drinking problem.

Alcoholism is a complicated disease, partly because it involves several progressive stages, and because drinking (even excess drinking) is still socially acceptable. In the first stage, people develop a tolerance for alcohol and are able to drink it in great quantities without appearing to be drunk. In the second stage, their tolerance increases, and they require more alcohol to achieve the desired effect. During this stage, they often become sick from alcohol but deny that they have a problem. In the third stage, people cannot go without alcohol without experiencing severe withdrawal symptoms, and are at risk of developing several severe physiological disorders. Third-stage alcoholics often black out (alcoholic amnesia) for several minutes to several days during a prolonged drinking binge.

Physiological Effects of Alcohol.     The alcohol that humans drink contains a chemical called ethyl alcohol. Most alcohols, including ethyl alcohol, are toxic (poisonous) in small amounts. The human liver, however, is able to metabolize (break down) ethyl alcohol into carbon dioxide and water, which can be then eliminated. Excessive alcohol, however, does considerable damage to many different parts of the body before it exits. The specific damage varies with each individual and how much alcohol is consumed.

Alcohol is probably most damaging to the human brain because chronic drinking can cause the impairment of memory and degeneration of white brain matter, as well as brain damage and premature senility. Obvious signs of alcohol intoxication are drowsiness, judgment errors, loss of inhibitions, poorly articulated speech, uncoordinated movement, and involuntary, rhythmic movements of the eyes.

At one time, it was believed that chronic drinking killed nerve cells in the brain which, once dead, could not regenerate or be replaced. A 1993 study in Denmark cited in Alternative Medicine: The Definitive Guide, however, found that alcohol does not actually kill the nerve cells, but simply disconnects them. The Danish scientists compared the brains of 11 severely alcoholic men with those of 11 other men who were not alcoholics. Using a sophisticated technique, the scientists counted precisely the number of nerve cells in tissue-thin slices of the neocortex, the outermost region of the brain. The number of nerve cells, according to Dr. Bente Pakkenberg, director of the Neurological Research Laboratory at the Bartholin Institute in Copenhagen, was “almost identical in the two groups.” Nevertheless, the alcoholics did show significant damage to their white matter–the cells and fibers that support and nourish neurons, which carry signals throughout the brain. In the Danish study the alcoholics’ white matter was reduced by 11 % in the outer brain region and 30% in a deeper area that contains the memory center. The findings suggest that cerebral damage caused by heavy drinking may be potentially reversible.

Symptoms of Alcoholism.     Dependence on alcohol can be either psychological or physical. If you're psychologically dependent, you turn to it fairly continuously, as the main means to find relief. Some people abuse alcohol but are not dependent on it. For instance, if you usually don't drink, but every few weekends go on a drunken binge that makes you miss work for a day or two, or you drink even when a physician has told you it worsens some medical condition, then you are abusing alcohol.

Alcoholism also creates unhealthy patterns of communicating and relating. It can destroy a family, and separation and divorce rates are quite high among alcoholics. A common occurrence is “codependence,” the pattern by which close family members or friends encourage an alcoholic's problem by defending, rationalizing, or justifying it. Such behavior is harmful because it reinforces denial. Alcoholic individuals do not experience the full ramifications of their problem because members of their family often protect them from the consequences of their drinking.

Codependents often need help in acknowledging their own feelings and needs. National self-help organizations such as Al-Anon help adult family members recognize codependent behaviors in their relationships. Self-help groups such as Alateen, Adult Children of Alcoholics, and Adult Children of Dysfunctional Families provide a mutually supportive group setting in which family members can discuss their childhood experiences with alcoholic parents and the emotional consequences they carry into adult life. Through such groups or other forms of therapy, individuals may learn to move beyond anger and blame, to see the part they themselves play in their current unhappiness, and to create a healthier and happier future.

Children of Alcoholics.     Children who grow up with alcoholic parents normally must assume certain roles to cope. The adjuster or “lost child” does whatever the parent says. The responsible child or “family hero” typically takes over many household tasks and responsibilities. The acting-out child or “scapegoat” causes problems at home or in school. The “mascot” disrupts tense situations by focusing attention on himself or herself, often by clowning. Regardless of which roles they assume, these children of alcoholics are prone to learning disabilities, eating disorders, and addictive behavior themselves.

The consequences of a parent's drinking may affect the child long after he's grown up. Adult children of alcoholics, for example, are more likely to have difficulty in solving problems, identifying and expressing feelings, trusting others, and forming intimate relationships. In addition to being at increased risk for addictive behaviors and disorders themselves, they are more likely to marry individuals with a substance abuse problem and to keep on playing the roles assumed in childhood.

Advice for the Nonalcoholic Parent

• When children go off to be alone during or after a parent's drinking episode, seek them out and comfort them. Try to avoid letting them go to sleep under upsetting conditions. If this does occur, talk to them at the first opportunity.
• Avoid putting your oldest child in the position of being a confidant or surrogate parent. This places too much strain on a youngster and may anger your spouse.
• Avoid pressuring children, either verbally or with your actions, to take sides in conflicts with your spouse.
• Don't use your children's opinions about drinking or the alcoholic parent to “get at” your partner. This approach places youngsters in a difficult position, in which they may not be willing to share their feelings with you in the future.