Table of Contents
- What is Alcoholism?
- Alcohol Dependency
- Who is an Alcoholic?
- The Types of Drinking
- What does Alcohol do to the Body?
- Alcohol & Pregnancy
- Alcohol & Psychological Disorders
- Alcohol & Cancer/Hepatitis
- How Does Alcoholism Effect the Family?
- How is Alcoholism Treated?
- Alcoholics Anonymous
What is Alcoholism?
Alcoholism is a progressive disease that impairs the psychological, emotional, and physical health of both the alcoholic and his or her family. Alcoholism has been labeled as a “family disease” because its effects lead to dysfunctional roles and behaviors of the alcoholic and their family members.
An education and understanding of alcoholism is the key to building a better environment within a substance abusing family. One of the most important things to understand is that alcohol is an addiction known as alcohol dependency. When a substance abuser drinks, it's because their body is emotionally and physically dependent on alcohol (Alcoholism, 1990). Classic signs of alcoholism include an increased tolerance to alcohol and withdrawal symptoms when the drinker tries to stop. Increased tolerance means the drinker develops a decreased sensitivity to the effects of alcohol the more they drink. The person will need to drink more over time to feel the effect of the substance. For the social drinker, this effect is a feeling of euphoria. This is because a social drinker consumes low doses of alcohol on an irregular basis, which is shown to reduce the distress of anxiety. Conversely, the higher the dose of alcohol, the more the body becomes uncoordinated and sedated. This is when alcohol becomes dangerous and greatly affects a person’s ability to think and make clear decisions (Carlson, 2005, p. 512,521).
Today, there are an estimated 10-15 million alcoholics living in the United States of multiple backgrounds, races, gender, and age. There’s no typical profile of an alcoholic or those who are affected by someone’s alcoholism. It’s estimated that 43% of U.S. adult citizens have been exposed to alcoholism in the family, while about 18% of adults lived with an alcoholic family member while growing up. There are currently 28 million Americans that are children of alcoholics, while 11 million of these children are under 18 years of age.
The Types of Drinking
Excessive alcohol use kills 75,000 people a year in the United States (National Association for Children of Alcoholics [NACoA], 2005). These deaths are a result of binge drinking, heavy drinking, or a combination of both. This number would in fact be much higher if it took into account the number of alcoholics who die from diseases caused by alcoholism. The Centers for Disease Control and Prevention (2006) defines binge drinkers as women who have more than three drinks in one sitting, and men who have more than four. A heavy drinker is either a woman who consumes two or more drinks a day on average, or a man who consumes three or more.
In order to define a drinker, it’s also important to understand what constitutes “one drink.” A drink is an alcoholic beverage that contains half an ounce of pure alcohol. This is equal to either 12 ounces of beer, 8 ounces of malt liqueur, 5 ounces of wine, or 1.5 ounces of 80-proof distilled liquor (Centers for Disease Control and Prevention [CDC], 2006).
Alcoholism progresses through a series of three phases.
- In phase one, the drinker may drink to cope with stress, personal problems, or feelings of inadequacy. In this phase, the person may drink daily at the same time and begin building their tolerance. After a while they might begin sneaking drinks, hiding bottles, and having difficulty stopping their consumption.
- Phase two is when the drinker begins to think about drinking and looks for as many opportunities as they can to abuse. They may gradually withdraw from friends and begin to drink in secret. The drinker becomes increasingly unreliable and they may promise themselves they will quit but prove to be unsuccessful. They may begin questioning their drinking and start blaming family members for every day problems. The drinker then reaches a stage of denial. At this stage, family members might become suspicious or even in denial themselves about the degree of substance abuse.
- In phase three, the drinker’s completely dependent and shows withdrawal symptoms when they’re denied alcohol. Alcoholic withdrawal is an uncomfortable, sickening, and sometimes painful, physical or mental change that occurs when the body is deprived of the amount of alcohol it’s used to receiving. Withdrawal symptoms occur four to twelve hours after an alcoholic slows down or stops drinking. These symptoms can last for days, and in extreme cases can lead to death. This serious fatal condition is known as delirium tremens or the “DT’s.” Symptoms of the DT’s include hallucinations, confusion, irritability, severe trembling, and seizures. Without hospitalization and controlled amounts of medicine, delirium tremens can kill a person that’s going through withdrawal (Bryson & Wendt, 2002).
- In this last stage, the alcoholic may have unpredictable behaviors and mood swings and they are no longer able to stop themselves from drinking. This stage is increasingly difficult on families, for many start feeling fear, anger, embarrassment, disappointment, and resentment towards the drinker. In this phase, the physiological effects of addiction may be causing very serious health effects (Alcoholism, 1990).
Excessive alcohol use is capable of producing short and long term health effects. Alcoholics not only risk their own health by drinking, but they also risk the well-being of those around them.
Alcoholism & Pregnancy
Drinking can cause a number of devastating health problems in a pregnant women, for example the mother may have a miscarriage, stillbirth baby, or cause mental and physical health defects in the fetus. Fetal alcohol syndrome is one of the leading causes of mental retardation in children, caused by consuming alcohol during pregnancy. Characteristics of fetal alcohol syndrome include growth retardation, facial abnormalities, central nervous system dysfunction, and learning or behavioral problems in the child as they age.
Alcoholism & Psychological Disorders
Psychiatric problems such as depression, bipolar disorder, and anxiety are influenced by excessive alcohol intake.
Alcoholism & Cancer/Hepatitis
The serious health effects to the abusers organs and organ systems can be detrimental and irreversible. They may develop painful conditions such as gastritis and pancreatitis. As the degree of alcoholism increases in the person, so does the risk of getting different cancers. Mouth, throat, esophagus, breast, liver, stomach, and prostate cancer are all associated with alcoholism (CDC, 2006). Organs such as the liver rid the body of harmful toxins, and the overuse of this organ can lead to alcoholic hepatitis. Hepatitis can then turn into cirrhosis, which is when healthy liver tissue turns to scar tissue. At least one in five heavy drinkers develop cirrhosis (Bryson & Wendt, 2006).
How Does Alcoholism Effect the Family?
As stated above, alcoholism is a family disease. One important thing families must understand is how they are not responsible for the drinker’s problem. Many families have a tendency to feel they must protect the alcoholic member by helping them hide their addiction. This leads to dysfunctional family roles and can severely hinder a child’s perception of what’s appropriate when it comes to alcohol (Alcoholism, 1990).
The Roles Taken by Alcoholic Children
- The Overly Responsible
- The responsible child is the one that becomes their own parent. Externally they look fine because this is how they want their environment to be. They have numerous characteristics such as being goal oriented, but they struggle to ask for help.
- The Placater
- The placater is emotional responsibility for all the family members. This is the warm, caring, child that’s emotionally closed to their own feelings because they’re interested in everyone else’s
- The Adjuster
- The adjuster is the child who shrugs their shoulders and says they aren’t bothered. They don’t draw attention to themselves and are flexible but emotionally withdrawn.
Most children, young and old, identify themselves with more than one of these roles (Black, 1990, p. 13-17). One very important factor to remember is that alcoholism is hereditary. Children of alcoholics are four times more likely to develop a chemical dependency with alcohol or drugs than any other group of people (NACoA, 2005). Children of alcoholics may also have troubles with depression, relationships, parenting, and the inability to actually experience their own accomplishments in a positive light (Black, 1990, p. 13-17).
- The Scapegoat
- The scapegoat is the child that acts out and has no problem telling everyone that something is wrong. These children are actually closer to seeing the truth of the situation, however, they question authority, can be exceptionally angry, and have a more difficult time entering into the mainstream society.
Partners/Spouses of Alcoholics
Married couples and partners also take on involuntary roles when living with an alcoholic. Numerous non-alcoholics go into denial about their partner’s addiction, or become afraid to confront the alcoholic in fear or losing them. The partner may then develop a high tolerance to the alcoholics odd behaviors. The partner will begin to feel depressed, confused, or even guilty.
When both partners are alcoholics, they often are in denial of their problem and neither believe they are chemically dependent.
A Non-alcoholic partner may develop something known as co-dependency, which means they have a people pleasing attitude, a need for approval, the inability to express anger correctly, and are terrified of abandonment (Straussner, 2004, p. 268-270). Adults and children often don’t see themselves in many of these discussed roles, which is why it’s extremely important for families to be a part of the alcoholics recovery process.
How is Alcoholism Treated?
Treatment of alcoholism works best when the family and the alcoholic are all involved and working together. Recovery is a life long journey and an alcoholic relapse can happen at any time. There’s a wide variety of treatment options available, including Alcoholics Anonymous, Al-Anon/Alateen, and individual or family therapy. Often times, alcoholics need to begin in rehab centers in order to detox and be away from the pressures that cause them to drink. Since alcoholics have different reasons behind their drinking, it’s important to look into which options meet the substance abusers needs. Some things to consider include motivation of the drinker to quit, cost, physical condition of the drinker, and their personality (Alcoholism, 1990).
Al-Anon & Alateen
- Alcoholics Anonymous is the most widespread group alcoholic program. The only qualification to be a member is the desire to quit drinking.
- On average, an open A.A. group meeting lasts one hour and has two or three speakers who share their experiences about alcoholism and recovery.
- A.A. uses a Twelve Step program that serves as a guideline to follow as the alcoholic surpasses each day of sobriety (Alcoholics Anonymous [A.A.], 2006). While many see A.A. as a program solemnly for drinkers, family members and friends are allowed at meetings in order to support their loved ones and learn how other families have coped (Alcoholism, 1990).
- Currently, there are over two million people in 150 countries that attend A.A. meetings on a regular basis.
- There is no charge to attend meetings, no records of who attends, and everything is kept entirely confidential (A.A., 2006).
- Al-Anon and Alateen are programs that branched off of Alcoholics Anonymous. These programs are for families and children of substance abusers, and are geared towards helping family members regain control of their lives (Alcoholism, 1990).
- According to the Al-Anon Family Groups (2000), Al-Anon helps with families “common problems of fear, insecurity, lack of understanding of the alcoholic, and the warped personal lives resulting from alcoholism”.
- These meetings are also free of charge and are of course, confidential.
- Individual and group therapy are used in order to promote an understanding of alcoholism as a disease and the problems associated with it.
- Unlike A.A., Al-Anon, and Alateen, therapy is conducted by a professional who has had subsequent training in substance abuse.
- Therapy will give the alcoholic and their family an education on the disease, problems they can expect, and ways to cope.
- Studies have shown that alcoholics who participate with their families in therapy treatment have the highest success rates (Alcoholism, 1990).
Alcoholism & The Family: Related Links
National Association for Children of Alcoholics
Alateen & Al-Anon
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Last Update: 5/10/2007
© Copyright 2007 Meg Hevey, University of Massachusetts Lowell
ALL RIGHTS RESERVED
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