Position Paper - Alcoholism

1. Identification of the issue.

Alcoholism is a chronic, progressive and potentially fatal disorder which leads to physical and psychological harm, and impaired social and vocational functioning. It is characterized by tolerance, physical dependence and/or pathological organ changes, all of which are the direct/indirect consequence of the alcohol ingested (Light 5). Alcoholism, also known as "alcohol dependence," can be recognized by four obvious symptoms.

The four symptoms of alcoholism are loss of control, craving, physical dependence, and tolerance. Loss of control, which is the inability of an individual to limit his or her alcohol consumption, usually occurs when a person has experienced or entered an emotional segment of his or her life with which he or she does not wish to cope. When that segment of his or her life has past, he or she tries to quit drinking but the individual's craving, or strong need or compulsion to drink, compels them to continue. This need can be as strong as the need for basic necessities of life such as food, water, and air. Physical dependence, which is the body's need for a substance, in this case alcohol, is revealed by withdrawal symptoms that consist of sweating, shakiness, nausea, and anxiety. These symptoms occur when alcohol use is abruptly halted after a period of heavy drinking. With regard to alcoholism, the last symptom, tolerance, is when more than the average amount of alcohol is needed in order for a person to "get high" or feel the effects of alcohol. Although alcoholism can definitely be classified as alcohol abuse, alcohol abuse is not necessarily classified as alcoholism.

The difference between alcohol abuse and alcoholism is that alcohol abuse lacks the intense cravings, typical loss of control, and identifiable physical dependence. However, the definition of alcohol abuse is more complex. It is comprised of several situations that an individual can relate to or identify with. The situations are the inability of an individual to maintain in school, work, or home; drinking in places where a person is risking his or her safety and the safety of others, such as while operating machinery or driving a car; and having a significant number or reoccurring alcohol-related problems such as arrests. Even though alcoholism and alcohol abuse differ tremendously, there is still a level of similarity between the two.

In fact, levels of alcoholism are classified in four different, but specific areas. Those areas are:

* Alpha Alcoholism- is a psychological dependence upon alcohol; prodromal alcoholism (Light 9).

* Beta Alcoholism- long-term, daily heavy drinking with ensuing medical complications, often serious, but without, the overt behavioral and socioeconomic deterioration commonly seen in other forms of alcoholism; said to be common in France and Italy (Light 9).

* Delta Alcoholism- chronic alcoholism, so-called maintenance drinking; high daily level of consumption involving tolerance (may be evidenced by reverse tolerance in late stages) and physical addiction, and inability to abstain (Light 9).

* Gamma Alcoholism (including epsilon alcoholism)- binge-drinking; dipsomania; the so-called periodic alcoholic, in which bouts of uncontrolled drinking are followed by short to protracted periods of "controlled" drinking or complete abstinence. Physical addiction is present and is manifested by severe withdrawal following binges, often including hallucinations, seizures and/or frank delirium tremens (Light 9).

Just as the effects of alcoholism differ from person to person, so do the relationships of people and alcohol. Many individuals who suffer from this disorder are able to recover and remain "sober" without aid or guidance. However, the majority of alcoholics resort to clinics, treatment groups, and support centers to be assisted and counseled to the road of recovery. When alcoholics do recover and are able to maintain sobriety, then they can move on and rebuild the lives that alcoholism helped to destroy.

2. Identify the etiology of the problem providing the causative factors which contribute to the problem.

Alcoholism has been a major problem in society for a number of years. In fact, alcoholism should be compared to a virus. This is because a person can never be completely cured from alcoholism; they can only fight the battle, day to day, hoping not to relapse. When it comes to the etiologies, or causes, of alcoholism, there seems to be three distinct origins of alcoholism. These causes are genetic factors, dependency caused by brain chemical imbalances after long-term use, and social and emotional factors.

Genetic factors play a major and very pertinent role in alcoholism. In actuality, genetic factors may account for half of the total risk for alcoholism. Alcoholism is such a complex disorder that a single gene is not likely to be the main culprit. However, researchers are investigating a number of inherited traits that make some individuals more susceptible to alcoholism than others. Some of the examples are listed below:

* One 2001 study found that the amygdala is smaller in subjects with family histories of alcoholism, suggesting that inherited differences in brain structure may affect risk. The amygdala is an area of the brain thought to play a role in the emotional aspects of craving, which can lead to addiction (Asbury & Ketcham 121).

* Because alcohol is not found easily in nature, genetic mechanisms to protect against excessive consumption may not have evolved in humans as they frequently have for protection against natural threats. Some evidence, then, indicates that a lack of genetic protection plays a major role in alcoholism. Research suggests this factor may contribute to between 40% and 60% of alcoholism cases related to genetic factors (Asbury & Ketcham 122).

* Genes that regulate certain chemical byproducts of alcohol are under intense scrutiny. Alcohol is metabolized in a two-stage process: it is first converted to acetaldehyde (AcH), which is then converted into acetate. AcH is being researched because it plays a role in most actions of alcohol, including damaging effects on the liver and upper airway (Asbury & Ketcham 126).

* Some people with alcoholism may have an inherited dysfunction in the transmission of serotonin. This is an important brain chemical messenger known as a neurotransmitter. It is important for well-being and associated behaviors (e.g., eating, relaxation, sleep). Abnormal serotonin levels are associated with high levels of tolerance for alcohol. They are also linked to impulsive and aggressive behaviors, which can predispose people to drink and can increase the risk for dangerous behaviors