“LifeLines is a monthly column dedicated to addressing issues of mental, behavioural, and social health. The column appears on the 1st weekend of the month, and is written by professionals in the field of social work, mental health, and community medicine”.
By Dr. Mary Jo Cannon
Why is this important? It is important because attitudes and behaviors toward those afflicted rests upon the ability to provide a coherent answer. A common belief is that drinking is a ‘bad habit’ and that with enough discipline and willpower, alcoholics can stop or restrict their drinking. Unfortunately, this belief often prevents alcoholics from getting the help they need, since it is thought that they can do it “on their own if they really want to”. On the contrary, alcoholics, like other people who have a disease, are sick people who deserve to get treatment, and who have the ability to recover from their illness. If we understand that alcoholism is a disease, we can help those afflicted get the appropriate help.
What is a disease? Disease can be defined as a disordered or incorrectly functioning organ, part, structure, or system of the body. Diabetes is one disease we recognize. In diabetes, the organ involved is the pancreas. The defect is inadequate or absent insulin production, and the symptoms are high blood sugars leading to obliteration of blood flow to and damage to multiple organs, including the heart, brain, retina of the eye, the kidneys and distal extremities.
In alcoholism, the defect is a stress-induced/genetically-predisposed dysfunction of the limbic (emotional) brain—specifically, a broken ‘pleasure sense”. And the symptoms of greatest importance are 1) loss of control over drinking, 2) craving alcohol and 3) persistent use of the drug despite negative consequences. Alcoholism meets the standard definition of a disease better than multiple sclerosis or schizophrenia:- two diseases for which the pathophysiology is far less clearly understood; yet people with these diseases are recognized as qualifying to be ‘patients’.
So what does the ‘disease’ of alcoholism look like? It looks like this: choosing to drink alcohol (e.g beer, wine, hammond, rum, brandy) frequently and exceeding four and five drinks per session. It sometimes is periodic ‘binge’ drinking or drinking to ‘blackout’. It’s important to know that a ‘blackout’ doesn’t mean passing out, it means being awake and talking/walking and behaving without awareness of same. It means waking up the next day next to someone you have never met before. It means waking up and looking outside to see if your car followed you home. It means waking up to people telling you things you said and did, and you don’t remember, and what’s more…can’t believe you did! It means continuing to drink in spite of these things. It means losing someone you love because they don’t like your drinking habits. It means losing, or finding yourself unable to keep, a job. It means continuing to drink even when you hurt yourself or others by so doing.
Is drinking always a sign of disease? No. Lots of people drink without getting into trouble doing so. The problem does not stem from alcohol; the problem resides in the brain of the individual who suffers the disease. Not everyone who drinks will get into trouble with the substance. And, truth be told, the majority of people who find they do not fare well following a bout of acute intoxication with negative consequences eliminate the ‘problem’ and avoid future dilemmas. Not so the alcoholic! Research has shown indisputably that the incidence or expression of the disease affects one person in ten in our population. Of any ten adults chosen randomly from our Island population…whether white, black, yellow or red…statistically one will have the disease of alcoholism.
Are there risk factors for developing this disease? Yes, there are! The very first ‘risk’ factor is ingesting an alcoholic beverage! In addition to choosing to drink, if that choice is entered into by/before age fourteen, this is recognized as an additional risk factor. Having a first degree relative (e.g grandparent, parent, aunt, uncle, or sibling) who exhibits the above named symptoms is also a risk factor, and having a high capacity for holding your liquor is yet another risk factor. Yet for the majority of people, recognizing risk factors fails to stop them from trying alcohol themselves. They simply promise themselves they will never end up like those others whose drinking they believe is clearly is out of control! Eventually, however, many end up becoming ‘out of control’ themselves.
Alcoholism is a disease. It is chronic, progressive and fatal. And it is treatable. There is a way out. Recovery is not only possible, it is miraculous and available to the alcoholic who gets ‘sick and tired’ of being ‘sick and tired’, and who wants to get better. It is tough to see alcoholism as a disease when it simply looks like bad behavior. Yet the truth is that with recognition of the disease process, we can push those who have ‘it’ to get better! Where there is life there is hope.
Please call 469-2263 for more information on alcoholism help and recovery.
Dr. Mary Jo Cannon is a Professor, at International University of Nursing