Alcoholism

In most head-on automobile collisions where people are seriously injured or killed, it turns out that the driver at fault has a higher-than-allowed blood alcohol level; that is, he or she was driving a lethal weapon while intoxicated. Statistics from the National Institute on Alcohol Abuse and Alcoholism show that in 2004, lightly less than 40 percent of all traffic fatalities (not just those that resulted from head-on collisions) involved alcohol. This figure is down from 60 percent in 1982, possibly reflecting the effect of seat belts or decreased societal tolerance for drunk driving. Perhaps the message, "Don’t drink and drive," is finally getting through. But 40 percent is still too high a figure.

 

Alcohol has also been, historically, an important factor in domestic arguments that end in homicide. In the state of Oklahoma, about half of all victims of homicide have high blood alcohol levels, and it could easily be assumed that most of their killers were also drunk. Between 5% and 50% of all suicides, depending upon the age level looked at, were people with elevated blood alcohol levels.

 

A drunk is a danger to far more people than himself, including the people he doesn’t kill but seriously damages, whether physically or emotionally. Typical victims are his family (and we use the pronouns "he" and "his" advisedly; two-thirds of all alcoholics are male). A high proportion of child-batterers and wife-beaters are alcohol abusers or alcoholics. Somehow, the alcoholic must be made to control his drinking before he does his damage. If any drinker is unable to control his consumption, he must stop it completely.

 

But how?

The drunk must want to get rid of his habit.

Even though quitting destructive habits is often hard to do, and one of the hardest to get rid of is the craving for liquor, many alcoholics are crying out for someone to stop them. They may be drunk, but they have lucid moments when they know what demon rum is doing to them.

 

There are various tools to help the drinker quit, but he must first be motivated to want to quit. Others may appeal to him to stop, and the appeals might work, but they work only if he realizes what he stands to lose if he doesn’t quit the sauce and what he stands to gain if he does. Why is this a difficult habit to break? What causes the habit to begin with? We’re not sure.

 

When Is a Drunk a Drunk?

One can be considered inebriated if his blood alcohol level exceeds a certain set level. For purposes of testing whether one is sober enough to drive a motor vehicle, each state has set a level beyond which it defines a driver as being drunk, and these vary from state-to-state. Because most people do not carry breathalyzers on them or have blood alcohol test kits in their medicine chests at home, there needs to be an easier way to determine whether they’re drunk. And there is: your speech tends to slur, your balance is off – it’s difficult to walk a straight line, at first you’re happy but – with a few more drinks – you start to get obnoxious, and at some point your sober friends will probably tell you you’re drunk. Get drunk often enough, and they might begin calling you an alcohol abuser, though probably not to your face.

 

It’s beginning to look like genetics has a lot to do with the drinking habit; having alcoholic biological parents increases your risk of becoming one, too. But other factors play a part:

The Causes are Myriad

• Social influences of family, friends, co-workers, and society
• The availability of alcohol
• An imbalance of brain chemicals, producing a greater predisposition to alcoholism
• Elevated levels of stress, anxiety, depression, or emotional pain
• Low self esteem
• Falling prey to the idea of there being "glamour" in drinking
• Poor coping mechanisms
• The encouragement of other alcohol abusers
• Physical changes to the brain caused by drinking. Alcohol alters the balance of some pleasure-producing chemicals in the brain that affect behavior. Over the long term, it takes more and more alcohol to produce these same results.

Between 10 and 20 percent of alcohol-consuming individuals are considered alcoholics. More are considered alcohol abusers and, yes, there is a difference. According to the Penn State University Milton S. Hershey Health Sciences Center, alcohol abusers regularly drink to the point that their judgment is impaired, resulting in recurring problems in daily life. Done long enough, the abuse turns into alcoholism. Thus, an alcoholic is an abuser who develops a craving and becomes addicted to liquor.

 

Chronic alcoholism leads to death by diseases, conditions, and actions too numerous to list in this short article. (You can find them listed in the article by Dr. Thompson listed in the Resources section below.)

The Three Stages of Kicking the Habit

Treatment for alcoholism is a lifelong process that requires medical treatment, psychological services, behavior therapy, and a strong support system. If possible, treatment programs should have family participation. Treatment proceeds in stages:

1. Detoxification:

The first stage is detoxification, ridding the body of the toxic effects of alcohol. The experience is similar to drug withdrawal, and can be just as painful. Severe withdrawal is treated in a hospital setting with sedatives being administered and fluids given intravenously to replace those lost through vomiting. Lost minerals are added to the drip.

2. Medical Treatment

Drugs are administered. Naltrexon curbs the craving for alcohol, disulfiram creates unpleasant effects when alcohol is consumed, and a drug which has just been approved for use in the United States, acamprosate calcium, may be prescribed. Acamprosate calcium has been used in Europe for 15 years to ease the withdrawal pains of going on the wagon. Behavior therapy is another treatment modality used for alcoholics, but it is also applied with alcohol abusers to move them away from their bad habit. Ondansetron, a drug used to counter the nausea caused by chemotherapy, is now being tested at the University of Texas Medical Center in San Antonio for its possible use in reducing the craving for alcohol. UT researchers are also looking into topiramate, used for many years as an anti-seizure medication, reporting that heavy drinkers are six times more likely to "stay clean and sober" for a month on even small doses of the medication.

3. Rehabilitation:

Physical and mental health both get massaged in rehab, and peer support comes through such programs as Alcoholics Anonymous. AA, as do many physicians, insist that total abstinence from alcohol is the only way to beat the habit.

 

Rehab is a slow and tedious way out of the alcohol swamp, which is why something called Rapid Opiate Detoxification (ROD) has gained a foothold in the treatment of alcoholism over the past ten years. The best known of these programs puts the alcoholic under general anesthesia for anywhere from 6 to 48 hours. During that time, drugs are administered which cleanse the body of opiates, and the patient supposedly wakes up feeling well and having no memory of the experience.

 

A number of patients have died during this procedure, however, and its effectiveness, as well as safety, is being called into question. It’s thought that the process puts the body under severe stress and strain, and those who do come through have a high chance of slipping back into alcoholism within six months.