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ALCOHOLISM

Although alcoholism is a common problem in modern society, it has been a serious concern for prior generations as well. In fact, documented cases of alcoholism date back thousands of years. What has changed over time is our understanding of alcoholism as a treatable disease, rather than a moral failing. Unfortunately, this change is still a work in progress, as many people still do not understand the disease mechanisms of alcoholism and view its sufferers simply as morally weak individuals without the willpower to cease their consumption of alcohol. The persistence of this incorrect understanding of alcoholism still negatively affects the thinking for many people today who have a drinking problem. This stereotype sometimes results in people feeling shame when they are not able to stop drinking on their own. The end result is many choose not to seek professional help and suffer the potentially dire consequences of alcoholism without a path to recovery.

Alcoholism in Ancient History

Archaeology and written history provides evidence of alcohol use going back to the dawn of civilization, thousands of years ago, in many cultures around the world. And, even in the ancient world, writers made note of some of the symptoms of alcoholism. As far back as the 5th century A.D. the Roman Cassius Felix wrote about the syndrome of “Delerium tremens” in an account based in part on even older ancient Greek sources. Clearly, even ancient people recognized that, for some, alcohol use could become a serious health issue. [1]

The Journey from Moral Failing to Treatable Disease

Unfortunately, for much of human history alcoholism has been seen as a moral failing rather than a disease. In fact, the term “alcoholism” is a relatively new one, dating to 1849 when Swedish physician Magnus Huss described a disease resulting from chronic alcohol consumption as “Alcoholismus chronicus.” The term did not immediately gain widespread usage, but the idea that alcoholism was a disease that could be treated gradually began to spread.

In the United States the first “inebriate asylum” was opened in Binghamton, NY in 1864 to treat alcoholism and addiction to other drugs such as opium, morphine and cocaine – with other institutions and groups following suit. However, scientific research into effective techniques for treating alcoholism was in its infancy, and many of these early institutions and mutual aid societies closed their doors in subsequent generations. One of the next major landmarks in the history of treating alcoholism as a disease was the founding of Alcoholics Anonymous in 1935. Further important milestones include the development of the “Minnesota Model” of chemical dependency treatment and the adoption of the “Twelve Traditions” (now the “12-steps”) of Alcoholics Anonymous in 1948 and 1950 respectively.

Later, in 1966 President Johnson became the first US president to address the country about alcoholism, stating “the alcoholic suffers from a disease which will yield eventually to scientific research and adequate treatment” and setting the stage for further progress in alcoholism treatment such as the American Medical Association’s 1967 resolution that identified alcoholism as a “disease that merits the serious concern of all members of the health professions.” [2]

Alcoholism as a Chronic Disease

Each of these steps represented progress toward a general understanding that alcoholism is a disease that can be treated through a combination of medical and psychiatric interventions and social supports. Current research has further expanded upon this idea to define alcoholism as a chronic disease similar to diabetes or other long-term conditions that can be successfully managed through lifestyle changes and medical monitoring and assistance. This view is particularly helpful in the way that it changes the conversation about the role of relapse in the alcoholism recovery process.

Prior to the adoption of the chronic disease model for understanding alcoholism, many recovering alcoholics viewed the all-too-common occurrence of relapse as a “failure” of their recovery from alcohol addiction. The chronic disease model helps to recast relapse as a setback that can be addressed as part of a continuing cycle of care that can improve the outcomes and quality of life for individuals suffering from a chronic disease. For many individuals who are struggling with alcoholism, 12-step programs and other forms of “extended treatment” can help provide lifelong support long after their initial period of alcoholism treatment. [3]

The Dangers of Alcoholism

Though the moderate consumption of alcohol is considered socially acceptable in certain settings, moderate use that transforms into alcohol abuse or addiction is extremely dangerous. Alcohol is one of the most physically and socially damaging substances one can use. Alcoholism often leads to the loss of physical health, family and social relationships, employment, mental stability, recreational activities, and can lead to illegal behaviors, such as public intoxication, driving under the influence, crime, and domestic violence.

The Direct Consequences of Alcoholism on Physical Health

Alcoholism can directly cause a number of physical health problems for the alcoholic. These include a variety of heart-related problems such as cardiomyopathy (stretching and drooping of heart muscle), arrhythmias (Irregular heart beat), stroke and high blood pressure. Alcoholism also causes a number of liver problems including steatosis (fatty liver), alcoholic hepatitis, fibrosis, and cirrhosis. Alcoholism can also lead to pancreatitis and damage to the immune system that makes the alcoholic much more susceptible to other diseases such as pneumonia and tuberculosis. [4]

The Indirect Health Consequences of Alcoholism

Alcoholism also has many indirect health consequences. For example, alcoholics are much more likely to become involved in vehicular accidents, opening them up to a wide range of potentially deadly injuries. Alcohol can also fuel violent behavior such as assault, producing any number of physical injuries to the alcoholic and those around them. In addition, alcohol’s ability to lower inhibitions makes an alcoholic much more likely to make risky sexual decisions, exposing themselves to STDs including HIV/AIDS.

Alcoholism and Mental Health

Alcoholism can also produce or exacerbate a diverse array of mental health conditions. These include depression and anxiety, and psychotic, sleep, sexual, delirious, and amnestic disorders, among others. In addition, many alcoholics begin and continue their drinking in order to “self-medicate” other mental health issues. This can often make difficult to “untangle” which issues are addiction-related and which existed before the addiction. Due to this reality, many alcoholics are in fact suffering from “co-occurring disorders” in addition to their alcoholism. This makes professional alcoholism treatment even more necessary so that the co-occurring mental health issues can also be addressed in treatment.

Successful Alcoholism Treatment

Alcoholism can easily destroy a person’s health and even lead to death. Death can occur during the active drinking period, during withdrawal, or later in life due to the physical consequences that are inextricably intertwined with an addiction to alcohol. That’s why it’s so important that people suffering from alcohol use disorders become involved with a form of treatment that involves withdrawal from the use of alcohol in a medically directed detox center, followed by intensive medical, psychiatric, and therapeutic treatment. Going through alcohol detox, “cold turkey,” without the assistance of physician-directed medical supervision can be extremely dangerous. Attempting alcohol detox alone can also lead to relapse, and its associated consequences.

The Importance of Medically-Supervised Detox

There is a pervasive and mistaken idea that those with a substance use disorder should, “just say no,” to drugs and alcohol and seek to quit their use on their own. Because of this, many alcoholics and their family members attempt to solve the problem without seeking the assistance of an alcohol detox or rehab. This is a potentially deadly mistake.

The medications given for alcohol withdrawal reduce physical symptoms such as high blood pressure, shaking, chills, sweats, nausea, vomiting, sleeplessness, and reduce the risk of seizure, hallucinations, muscle cramping, stroke, and heart attack. Additionally, medications ordered by the physician can also protect the brain from adverse long-term effects, such as forgetfulness, decreased cognition, prolonged post-acute withdrawal (PAWS), and the risk of seizures in the future. A medically-supervised detox is also much more likely to be successful than one attempted without proper supervision.

photo of patient having their blood pressure taken

The Difficulty of Confronting People with Alcoholism

With the dangers of alcoholism so apparent and the availability of effective, evidence-driven treatments – loved ones of alcoholics often seek to persuade them to enter into treatment. This desire is understandable and can have very positive results. However, confronting people with alcoholism can also be dangerous territory for those closest to them.

The human brain is programmed to seek rewards. Alcohol is highly rewarding and affects the dopamine reward system. When going from alcohol use to alcohol abuse to alcoholism, the reward system, as well as other systems such as GABA, become highly affected. The brain begins to seek out alcohol as a survival mechanism. Any threat to the availability of alcohol can be seen as a threat to survival, and the person is likely to exhibit behaviors such as aggressiveness, blaming, projection, denial, rationalization and others.

These defense mechanisms are meant to protect the psyche from unwanted anxiety, grief, blows to one’s self-esteem and other perceived dangers. Unfortunately, loved ones can often find themselves on the receiving end of these outbursts of the alcoholic’s self-defense mechanisms. When seeking to get a loved one into treatment for their alcoholism, be prepared to meet resistance and understand that it is just one more symptom of this complex and deadly disease.

How Treatment for Alcoholism Works

There are many ways to treat alcohol addiction and its complexities. Talk therapy, along with prescribed medications for anxiety and depression and other mood disorders have been shown to reduce cravings and to treat the underlying causes of alcohol use disorders. Medications to deal with the symptoms of withdrawal and detox are also very effective.

All patients are strongly encouraged to enter alcohol rehab after the detox period. Alcohol rehab allows an individual to assess his/her situation and develop a recovery maintenance plan. During alcohol rehab, a physician will be involved in overseeing the treatment provided by the facility staff. This includes medical and psychiatric treatment, therapy, and community-based services.

Ultimately, what’s important is that a person who suffers from alcoholism seeks treatment. Professional care has been shown to be the best way to treat these disorders, so there’s no good reason to resist treatment or put it off for another day.

Get Help for Alcoholism Today

If you or a loved one has fallen into the trap of alcoholism, BWR is here to help. Get started on the path to recovery by calling us, 24/7, at 800-683-4457 to gain the support of an alcoholism treatment program that has helped countless individuals confront this life-threatening disease head-on.

Sources:

[1] Journal of Addiction, https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1360-0443.1967.tb05335.x
[2] William White Papers, http://www.williamwhitepapers.com/pr/AddictionTreatment&RecoveryInAmerica.pdf
[3] Alcohol Research Current Reviews, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625994/
[4] National Institute on Alcohol Abuse and Alcoholism, https://www.niaaa.nih.gov/alcohol-health/alcohols-effects-body
[5] National Institute on Alcohol Abuse and Alcoholism, https://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm
[6] Centers for Disease Control and Prevention, https://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm

 

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