Alcohol: Personal and social consequences

Last modified: Wednesday, 24. December 2008 - 4:03 am

Alcoholism is a chronic, progressive disease that can be fatal. An Edinburgh physician described the disease concept of alcoholism as far back as 1804, but it wasn’t until 1956 that the American Medical Association defined alcoholism as a disease. In 1990, the National Council on Alcoholism and Drug Dependence along with the American Society of Addictive Medicine defined alcoholism as a chronic disease that has genetic, psychological, and environmental factors that influence it. Alcoholism is described as a loss of control over drinking — a preoccupation with drinking despite negative consequences to one’s physical, mental, and emotional makeup as well as one’s work and family life. Alcoholics can be rich or poor, young or old, male or female, white or black. Anyone can become an alcoholic, but children of an alcoholic parent are four times more likely to develop the disease of alcoholism than children of non-alcoholic parents.

People who drink develop a tolerance to alcohol. Tolerance is the result of the way in which the body handles alcohol as well as alcohol’s effect on the central nervous system. A non-alcoholic will have a consistent level of tolerance for alcohol, but an alcoholic’s tolerance for alcohol will constantly change, requiring him or her to drink more to get the desired result that lower doses of alcohol had once produced. Tolerance changes the alcoholic’s brain impulses, hormone levels, and the chemical make-up of cell membranes.

The alcoholic goes through several stages as the disease progresses. The stages of alcoholism were documented by E.M. Jellinek in 1952. The four stages are: the prealcoholic stage, the prodromal stage, the crucial stage, and the chronic or final stage.

The prealcoholic stage refers to that period of time when the individual has every intention of drinking socially but begins to use alcohol as a relief from stress and tension. This stage can last for several months to two years. During the prodromal stage the alcoholic continues to drink when others have stopped. He or she experiences blackouts — periods during which the individual continues to function (walking and talking) but has no memory of things that have been said or done. This stage can go on for four or five years.

The crucial stage is when the individual has lost control over the drinking — perhaps promising to stop, but unable to do so. The alcoholic may become defensive when confronted, looks for excuses to drink, blames others for his or her problems, and looks for relief in what is called “the geographic cure” — a new job, moving to a new location, or a change in marital status. At this stage the alcoholic’s moods change from being pleasant and understanding to becoming irritable and unreasonable without warning. The alcoholic may experience job loss or the loss of family and friends. Legal problems may arise.

The final stage of alcoholism is the chronic stage. The alcoholic begins to suffer physical decline as a result of drinking, and may develop illnesses like liver disease or heart failure. There is the risk of overdose or possible suicide as the individual sees no way out of this malady.

The personal consequences of alcoholism reach far beyond the alcoholic. An alcoholic’s drinking affects many people, especially the members of his or her family. Alcoholism is a family disease, and the members of an alcoholic family system develop roles that are unconsciously played out to draw attention away from the alcoholic. The spouse or partner of the alcoholic is called the enabler. The enabler’s role is to protect the alcoholic from the negative consequences of drinking. The enabler works hard to control life in an alcoholic family.

Children tend to take on one of the following roles:

• The oldest child in an alcoholic family most commonly assumes the hero role. The hero brings honor and respect to the family by being a good student, an accomplished athlete, being involved in school activities, and caretaking younger children at home as a substitute parent. The hero is a perfectionist who hopes that by doing everything well the family’s problem with alcohol will go away.

• The scapegoat tries to win the alcoholic’s attention by engaging in negative behavior. This child often does poorly in school, can have behavioral problems or attention deficit disorders that affect learning, and emotional problems that may lead to alcohol and drug use.

• The lost child in an alcoholic family system withdraws into the isolation of his or her own world. This child has difficulty making friends, lacks the ability to develop intimate relationships, and often turns to food for comfort from the loneliness.

• The mascot is the family member who uses humor to mask pain. This child feels a responsibility to lighten the family tension by being funny and quick-witted. This behavior becomes a handicap in the development of the child’s emotional maturity.

Without an understanding of the alcoholic family system, these children will often grow up and continue the cycle of alcoholic behavior. Through counseling and the help of support networks, these children can learn to break the cycle of family addiction and go on to lead healthy lives in adulthood.

Alcohol abuse in the United States costs an estimated $170 billion each year. Close to half of this figure is due to a loss in workplace productivity resulting from illness and work-related injury. Other contributing factors are alcohol-related health care expenses costing society over $26 million and automobile accidents estimated at $15 million. Fifty percent of the adults in prison are incarcerated for crimes that are alcohol related. Alcohol is involved in one-third of all suicides, one-half of all homicides, and one-third of all reported child abuse cases. Drinking can lead to physical injury. People who drink are four times more likely to be hospitalized than nondrinkers. Alcoholism can lead to family violence and physical abuse of children.

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