Alcoholism, and Alcohol dependency Syndrome’s prevalence in today’s society has become an increasing problem. What makes this form of substance abuse gain so much attention from the scientific community is the fact that is relevant among all ages, races, educational and occupational backgrounds. Much progress has been made over the years in understanding this mental illness partly due to the research being done on how this illness develops genetically, environmentally, and behaviorally. Many in the mental health community have decided that several different forms of treatment being used concurrently with others is the most appropriate approach to understanding, and ultimately treating patients with alcohol dependency issues.
Part 1 : History Of Alcoholism
Throughout history, many substances have played a significant role in developing culture. The pre-Columbian world of Mexico and Peru were known to use early forms of Cocaine and Opiates dating back to ancient times, and Amphetamines like Benzedrine have been available since the early parts of the 1900’s. However, of all of these none hold as much historical relevance quite like the use of Alcohol does. “ People of many cultures, including Egyptians, Greeks, Romans made extensive and often excessive use of Alcohol” (Butcher, Mineka, & Hooley, 2008) Early forms of Beer developed in Egypt around 3000 B.C, and formulas for making wine are recorded as far back as half a century before the birth of Christ. Like all substances though, as far back as its creation dates, so does it’s first abusers. Cambyses, king of Persia in the 6th century B.C has often been noted as having been one of the first recorded alcohol abusers.
Today, Alcohol’s prevalence affects all ages, races, and cultures. The World Health Organization defines “Alcohol Dependence Syndrome” as “A State, psychiatric and usually physical characterized by behavioral , and other responses that always include a compulsion to take alcohol on a continuous or periodical basis to avoid the discomfort of its abstinence ; tolerance may or may not be present”. The American Psychiatric Association first defined Alcoholism/Substance abuse in the DSM in the 1980’s and split into to separate definitions, first there is “alcohol abuse” which is defined as a “Repeated use despite recurrent adverse consequences” and secondly, there is “alcohol dependence” which is defined as “alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink”.
The terms alcoholic and alcoholism however, have often been misconstrued by many. Popular culture has different views of what is considered acceptable in terms of alcohol consumption, as it seems many television shows are based around filming young adults in volatile social situations where alcohol is consumption is heavily involved and encouraged. Many times the often outlandish and embarrassing behavior is applauded and accepted, shows like “The Real World” , “Flavor Of Love” and “The Jersey Shore” are examples of this, with it’s participants gaining social acceptance and celebrity status by exhibiting clinically defined deviant behavior.
“In 2003, 22.6 percent of Americans aged 12 or older reported binge drinking, and 6.8 percent were found to be heavy drinkers” it continues, “the lifetime prevalence of alcohol abuse in the United States is 13.4 percent” (Butcher, Mineka, & Hooley, 2008) This type of risky behavior often leads to deadly consequences, most commonly alcohol related automobile fatalities. “32 perfect of drivers ages 16-20 who died in traffic crashes had a measurable amount of alcohol in their blood’ as also states, “51 percent of drivers age 21-24 who died tested positive for alcohol” (National Institute on Alcohol and Alcoholism, 2006) Obviously, these statistics show that even though popular culture may at times applaud the excessive use of alcohol, it’s damaging effects on society are not to be disregarded. This fact has remained persistent through out the course of hundreds of years, and still into today.
Part II - Current approaches to Alcoholism
Today the field of mental health has taken many different approaches to understanding alcoholism, alcohol dependence syndrome, and general substance abuse problems. Although in comparison to 30 years ago, when the DSM first defined these disorders, significant progress has been made in understanding the P effects of alcohol on the brain, and how genes, family behavior and social stressors play important roles. Many different approaches offer a wide range of possibilities for effective treatment, however these treatments may need to be tailored to meet a patients specific needs due to the high risk of discharge or relapse before treatment is completed. It is important for physicians to understand all the possible genetic, social and behavioral factors before decided an appropriate course of action and continuing research by the mental health community has certainly advanced it’s progress significantly.
One theory, based on genetic and environmental facts is how the age of when a person has his/her first drink may effect their susceptibility to alcohol dependence. “Drinking at an early age may create an environment where the individual can more easily transition from normative to problematic drinking“. (Agrawal, 2009 ) This theory states that an early first drink acts as a part of preconscious and non-formative behaviors such as conduct problems, drugs and social deviance. The theory also goes on to state that biologically, early drinking may induce changes in the growing adolescent brain, which may modify a persons genetic vulnerability to drinking disorders. The head doctor of this research study, Dr. Arpana Agrawal, who is also an assistant professor of psychiatry at Washington University school of medicine theorizes the solution and treatment of alcohol disorders lies in the encouragement of youth to initiate drinking at an later age, as it may reduce their likelihood of genetic vulnerability to late alcohol problems.
Although not all doctors see avoidance of a situation that may predispose one to alcohol dependence as an approach or solution. The National Institute of Health proposes the use of medication to aide in the recovery process. In the 1980’s, Disulfiram (Antabuse) was the only approved medication used to treat alcohol dependence. This drug produced an acute sensitivity to alcohol, and caused a highly unpleasant reaction when even small amounts were ingested by the patient. Today, many more medications are currently being used in addition to Disulfiram, drugs like Naltrexone, and Acamprosate are being used to reduce relapses in people who want to quit by normalizing their brain dysfunction caused by alcohol dependence.
Many doctors have also used the study of other pre-existing mental illnesses, and how they may play a part in substance abuse in hopes of advancing the knowledge of, And hopefully explaining Alcohol abuse. Recent research has suggested that there is a relationship between disruptive behavior disorders with both alcohol dependence and the use of other illegal substances. “Nearly three-quarters of the alcohol-dependent adolescents had at least one disruptive behavior disorder diagnosis. Attention deficit hyperactivity disorder (ADHD) typically occurred first, followed by conduct disorder. Substance use began with alcohol or tobacco, followed by marijuana and then other street drugs” (Kuperman, et al. 2001) the study went on to state “Disruptive behavior diagnoses, particularly conduct disorder, typically precede the initiation of use of a variety of substances that, in turn, precede the diagnosis of alcohol dependence in adolescents” (Kuperman, et al. 2001)
Lastly, it is thought that a quick intervention is the best way to ultimately stop the progression of alcohol decadency and give the patient the best chance of recovery. Since many young adults do not usually identify themselves as having problems related to alcohol abuse, many doctors believe that screening teenagers in locations such as hospitals, emergency rooms, worksites and college counseling offices provides them with an opportunity to find teenagers who may need treatment, as many of these teenager routinely seek these types of environments for treatment of alcohol related sicknesses. “Studies show that young adults who are drinking in ways that are harmful or risky may respond better to brief, intensive interventions, rather than long term treatments, which are usually designed for adults with longer histories of alcohol abuse” (Monti, Colby, &
Part III Value/Outcome Of Approaches
While many in the Mental Health community have taken different approaches with regards to explaining and expanding on our knowledge alcoholism, it’s important to remember that no single approach guarantees success in regards to recovery. The highest level of alcohol abuse comes at an age when parental restrictions are loosened, and the expectancies of adulthood have not fully presented themselves, this freedom and the possibility of predisposed environmental and personal characteristics place young adults at a high risk for developing alcohol dependency syndrome.
There are many prevention strategies that are useful in curbing young adult drinking habits, some include the strict enforcement of state laws, the raising of taxes in regards to the sale of alcohol, and limiting the social events where alcohol may be consumed. But state legalities can only go so far, and while many times they do help, many adolescents will find a way around them. Through my analysis of these scientific journals I believe the combined use of personal intervention, group therapy, and general awareness procedures provide the best chance to influence adolescents and young adults to either stop drinking, or seek help if they believe they have a problem. Groups like Alcoholics Anonymous, churches, schools, and guidance counselors, provide a good framework for what I believe would be the best course of action.
Alcoholism, and Alcohol Dependency syndrome is no doubt a disabling addictive disorder. Through out the course of history, time and time again we see the negative effects Alcohol has on those who overindulge. Even though from a technical standpoint, Alcohol is legal, I believe it to be far more dangerous than any other substances of its like deemed Illegal by the United States government. Whether it is Cambyses, King Of Persia, or Lindsey Lohan, Queen of tabloids it is easy to see where society should draw the line between moderate consumption of over indulgence.
While we find entertainment in those who exhibit deviant behaviors, it is clear society’s influence on the human personality, and other contributing factors such as genetic, environmental, and behavioral causes can lead many people down the path to alcohol abuse. I believe the continued research by the psychiatric community is providing a much needed greater understanding of all these factors, and all the many approaches to explaining, and treating these disorders are beyond a shadow a doubt helping many cope and eventually recover from their illnesses. Even though there is a long way to go in this process, the research thus far provides hope for a better future.
Butcher, James, Mineka, Susan, Hooley, Jill (2008) Abnormal Psychology, Core Concepts, Second Edition
Agrawal, Arpana Ph. D, (2009) “Early Age At First Drink May Modify Tween/Teen Risk For Alcohol Dependance” Medical News Today
National Institute Of Health (2009) Fact Sheet on Alcohol Dependence.
Monti, P.M, Colby, and O’Leary. (2001) Adolescents, Alcohol, and Substance Abuse : Reaching Teens Through Brief Interventions. New York, Guilford Press.
Samuel Kuperman, M.D., Steven S. Schlosser, M.A.T., John R. Kramer, Ph.D., Kathleen Bucholz, Ph.D., Victor Hesselbrock, Ph.D., Theodore Reich, M.D., and Wendy Reich, Ph.D. (2001) Developmental Sequence From Disruptive Behavior Diagnosis to Adolescent Alcohol Dependence American Journal of Psychiatry