What are the causes, consequences and treatments for alcoholism and alcohol addiction? Evaluate the problems and effectiveness of campaigns designed to stop young people indulging in ‘binge drinking’.
It can be argued that no relationship has created as many deep rooted individual and social problems as that of alcohol addiction. Widely recognised as one of the most destructive and yet most readily available of humanity’s dependences, no substance abuse in history has generated such masses of inquiry and discussion. Perhaps, however, it is important to note the expansive differences between the moderate and habitual drinking patterns of the masses, and the chronically dependant minority of alcohol addicts. This essay intends to focus on the latter, with a view to examining firstly the many suggested causes of alcoholism, the consequences and effect on the individual and society as a whole and finally to evaluate the efficiency of treatments and campaigns now being made available.
Although the sheer volume of possible theories and explanations for alcoholism is astounding, many would agree with the view of Velleman (2001, p10) that ‘there is no evidence that any one of them provides all, or even most, of the answers.’ Keeping this presumption in mind, perhaps it is more beneficial to outline several general and widely accepted causes, keeping in mind that no two cases of alcohol abuse are the same, and where an individual may display one, or indeed several of such generic hypothesis’, it is guaranteed that the situation is a culmination of many more undefined factors.
Possibly the most recognisable factors to the observer (not by any means the addict), are personal and within the individual. The term ‘alcoholic personality’ is used to explain a person who is genetically predisposed to alcoholism. Some, who are 100% predisposed to alcoholism, in theory are alcoholic from the first drink, however there is a shortage of consistent evidence to support this view. Others, who may be only slightly predisposed, may have to drink a certain amount for a certain period of time before becoming alcoholic, and the majority of evidence collected favours this idea. The difference in these two examples form what is known as the ‘time-dosage line’. Alcohol is one of the two contributing factors of alcoholism–not a symptom. The predisposition to alcoholism is the other contributory factor.
Other factors which have been named as a potential causes contributing to addiction are within a social – not personal – context. One theory which is backed by solid research evidence is that of modelling from parents. As a recent survey showed, between 30 to 40 percent of alcoholics report one or both parents are/were also problem drinkers’ (Cooper, 2000). Velleman (2001, p12) offers a possible explanation for this pattern of hereditary drinking- ‘parental attitudes and behaviour create expectations and values about drinking.’ Whilst the quantitative research outcomes further support these ideas, it is important to note that the majority of addicts do no come from such households.
Also within the social context, and a hypothesis which is rapidly attraction interest is that of the link between alcoholism and genetics- are certain individuals more vulnerable to lapsing into alcoholism than others? Research in the area continues to remain steady due to costly biological studies, however when trying to identify a single gene or group of genes that could be held responsible, Goodwin (1994, p92) reported that ‘one such gene, involving the neurotransmitter called dopamine, was found associated with alcoholism in several studies.’ Outcomes of such research, whilst valued, can be deemed nil and void if there is a distinct shortage in comparative studies, and implies only an increase in probability, not a direct risk.
Whilst the factors already studied tend to be on a small level- i.e. only encompassing the individual or others directly around them, the next probable cause leans on the effect of a much larger set of people- society as a whole. Where national and even cultural problems may seem slight to the observer, continued study shows the linkage between these factors and excessive drinking habits. It can be strongly argued that culture has a complex and lasting impact on beliefs, values and norms.
These help individuals to apply what Cooper (2000, p112) calls ‘social signposts’, markers on what is right and wrong, acceptable and not. Firstly, how certain cultures handle the introduction of alcohol to younger generations and its effect on their drinking patterns. A good example is seen in Britain, where it can be said that the restriction of alcohol sales and the zero tolerance approach to teenage consumption has led to a trend in binge drinking and widening the gap already caused by alcohol between generations. In contrast, the Mediterranean countries such as Greece and Italy, whilst consumption is present in youngsters, it is in a controlled and social environment due to acceptability and lifestyle differences.
Another way of examining cultural influences on alcohol use is to look at how cultural problems and inequality have had a negative effect. Factors such as unemployment, inadequate education and poverty issues being linked with geography, are said to be some of the many problems modern society creates- Alcohol, the means of escape. Returning to the earlier idea that alcohol addiction is usually the result of several factors, it is now clear to see why, in the study of this type of substance abuse, it can be extremely difficult to support all such theories with hard evidence and figures. How the individual lapses into alcoholism can be impossible to see, however, the problems caused when they get there are very much clear.
Where defining a cause or causes for alcoholism needs proof and substantial evidence which can be hard to locate, for the majority of people involved with alcohol themselves or who witness it in others, the problems and consequences of its abuse are abundant. The author believes Goodwin (1994, p33) when linking the addiction to its effects, captured the relationship perfectly- ‘A tree is known by its fruit; alcoholism by its problems.’ Again, since the quantity of problems is so immense, generally they can be split into two sub-headings- Psychological and Physical. Whilst medical analysts would describe the tremendously diverse and sometimes life threatening effects of alcoholism as appalling, one internet site described it as ‘plague-like’, many alcoholics would argue it is the lesser of two evils.
For most struggling back from addiction, it is the vast menu of emotional disorders that proves unbeatable. Compulsions such as the addicts’ preoccupation with alcohol, and how its importance takes over ‘normal life’. Self deception, where the individual’s need to conceal his/her addiction extends to lying to themselves as well as others. Overwhelming guilt, where the individual knows no matter how careful he/she is to deceive themselves that alcohol is something they can beat, but choose not to. They are not victims; they are the architect of their own destruction. Perhaps the hardest battle to fight- the ‘hangover’, the hyperactive state of intoxication is replaced with an anxious and dire come down. Continual experiences of such negativity linked to the addiction can cause depression and a vicious and uncontrollable cycle of events.
Perhaps one consequence of alcoholism which is wedged between these two sub-headings of mind and body is lapses in consciousness and memory, commonly known as ‘blackouts’. Alcoholic ‘blackouts’ are periods of intoxication during which the individual is unable to form or store new memories, though he or she appears to be awake and alert. Because the individual does not store memories during this period, he or she has no recollection of what went on during that period, sometimes even after attaining sobriety.
The cause of blackouts is poorly understood, and studies show that there are no clear patterns in connection with consumption levels or other variable factors. When looking at the derogatory effects on an individual’s health, it is alarming to discover that almost anything that can go wrong almost certainly will with continued excess alcohol consumption. Stomach problems such as ulcers, bloating, nausea and gastritis are almost certain to occur with sustained alcohol abuse. Liver problems, most commonly portal cirrhosis, damage cells and cause the liver to swell, increasing the risk of fatal haemorrhages. Less hazardous but none the less undesirable effects include impotency and a constant need to urinate.
Having examined some main causes of this addiction, as well as a handful of the endless lists of things that can go wrong both physically and psychologically, it can be argues that it is easy to see why there is a need for such an enormous amount of different methods of treatment, and why some will prove more effective than others depending on individual circumstances.
It is argued by Kessel and Walton (1965, p15) that the study and treatment of alcoholism remains difficult to grasp because the antics of the ‘inebriated’ are entertaining and society remains unaffected as a whole- ‘What is in fact a considerable medical and social problem is thus eased out of consideration with a smile.’ However, with an increasing trend leaning towards the idea of alcohol addiction as a ‘disease’, there is a growing demand for better researched, funded, executed and widely available treatments. Some of such treatments have been long standing, however a combination of such methods being evolved, along with some entirely new and perhaps unethical approaches, has created a huge market for the management of alcoholism- and there is always, always a niche, however small, for such healing.
It can be said when looking at substance abuse treatment, it is impossible to know where to begin. Perhaps the most readily available and some may argue most effective of such treatment is that of psychotherapy. This type of counselling usually involves one or perhaps a small group of individuals discussing to roots of their alcoholism with a trained therapist, who analyses the information given. The generic outcomes of such sessions are usually dependant on what type of school the psychotherapist follows- for example Psychodynamic therapy in relation to Freudism, where its ideas on masculinity and oral conflicts are borrowed and lent to the subject of alcohol dependency. Other stemmed techniques include Transactional analysis which is dependant on group therapy as opposed to individual treatment.
Behavioural therapy is derivative from conditional therapy, and is used to provide alcoholics with a dislike for alcohol, for example by administering a drug inducing nausea before drinking or smelling alcohol. Although this method continues to prove extremely effective in comparison with others, Goodwin (1994, p127) argues that because treatment involves sustained physical discomfort, ‘few would undergo therapy who were not strongly motivated to stop drinking’. Another method of rehabilitation which is proving popular particularly in positive therapy focused countries such as America is Cognitive therapies, which focus at changing a persons attitudes and behaviour and tries to focus the recover patient on positive thinking.
Treatments are endless, some more universal as others, some like AA which continue to grow and others such as conditioning which is lapsing due to ethical issues. Like most addictions, the complexity of alcoholism has yet to be solved with the jackpot of a solitary method of treatment, but as society gradually accepts this problem cannot and will not solve itself, the burden of responsibility is weighed out to not only the individual and their families, but to local communities, regional councils and even national governments. As well as trying to quash the issues and problems faced by the current generation, an even bigger challenge lies ahead… the next one.
A source on the HEBS website (2001) reports that by the age of seven, most children in Scotland know that alcohol differs from other beverages. This statistic, it can be argued, along with countless others, supports the argument that educating about alcohol and abuse of it and other substances should begin as early as primary school level. There is an increase in government funded bodies organising health promotion events both in schools and within other community based groups.
A new advertising strategy by the Health Education Board for Scotland in 2002 saw the introduction of chain smoking girl bands and teenage romances shattered by binge drinking induced nausea. The campaign proved popular and whilst it might be too soon for figures to support its success, the government argues that the battle is already won on some level if such promotions attract young peoples’ attention. On a more formal government level, the new Licensing Bill (Scotland) has also received wide support- Finance and Public Service Reform Minister Tavish Scott argues the Bill would put in place a licensing system for the 21st century that would improve health and break the link between binge drinking and crime in under 25’s.
Whilst those concerned with promoting safe drinking with young people admit there is still a long way to go, it appears the effort of educating the UK is proving valued, and it is speculated that it won’t be long before the country is reaping its rewards. The current problems the government and the community face are with older age brackets, who believe education and amendment to their dinking habits would be unfruitful and wasted. New campaigns introduced involving more GP related help and the increase of occupational health professionals hopes to see figures improve. Critics and even just realists know this will take a vast amount of money, resources, time and most of all, patience. Until then, the battle against alcohol addiction rages on.
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