Fundamental Questions About Alcoholism in Society

Perhaps no medical topic arouses more confusion, dismay, and passion in both the public and the medical profession than alcoholism. Although alcohol is often associated with joy and celebration, ritual, and reverence, alcoholism is associated with sorrow and moral failing, disease, and death. No other disease entity can be conceived as having such extreme attributes.

Society’s decision to ban certain substances while allowing others to be freely available has little to do with the dangers inherent in any particular substance, and it has more to do with the emotional outcry that a particular substance engenders. For example, consider the seemingly benign over-thecounter medication acetaminophen, or Tylenol. Tylenol was first introduced in 1956. About 150 acetaminophen-related deaths are reported every year in the United States alone. Add to that the associated morbidity and mortality from those requiring liver transplants from Tylenol overdoses, and the numbers become even greater. Contrast that with Ephedra, a once hugely popular drug for weight loss and bodybuilding that has been linked to a grand total of 155 deaths. The deaths from Vioxx are more difficult to calculate because these deaths are primarily from patients already suffering from cardiovascular disease and not from the direct effects of the drug itself.

The estimates suggest up to 27,000 deaths since its introduction in 1999. The outrage leading to its removal had more to do with the company’s refusal to acknowledge the risks than the risks themselves. Alcohol, however, is responsible for approximately 85,000 deaths annually from injuries or diseases directly related to the use or abuse of alcohol. Thus, people often judge the risks and benefits of a particular substance based more on cultural, religious, and moral beliefs than on scientific fact. Alcohol is a prime example

Alcohol is the single most unique intoxicant because it is a legal, non-prescription, and culturally sanctioned substance that causes more devastating effects to human lives than any other known drug, whether available by prescription or over the counter or on the street. Prohibition, the one attempt in American history to prohibit alcohol use, was a miserable failure, with the cure being worse than the illness. Although it successfully cut the deaths from cirrhosis in half, it came at the cost of increased crime and social unrest.

Ingesting anything-medicine, an illegal drug, or even food-is an act that entails a degree of risk. Therefore, people should understand the risks and the alternatives before ingesting anything. Informed consent is both a legal and an ethical responsibility of healthcare providers to ensure that their patients are knowledgeable about the drugs they are ingesting, including over-the-counter medications, herbal remedies, street drugs, food, and alcohol.

Although the institution of medicine has accepted the concept of alcoholism as a disease, the larger culture with its personal values and beliefs, which includes healthcare providers themselves, continues to debate the issue, with many still viewing alcoholism as a moral failing.

Childhood Trauma, a Veritable Trigger for Addiction

A study, titled “Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population,” claims, “SUDs are also highly co-morbid with Posttraumatic Stress Disorder (PTSD) and other mood-related psychopathology.” It says that there are “strong links between childhood traumatization and SUDs, and their joint associations with PTSD outcome.”

The United States is grappling with growing incidences of traumatic life experience, such as physical and sexual abuse as well as neglect which is considered a top public health problem in the country. It is increasing at an alarmingly high rate. A visit to any drug rehab centers in your area would vindicate this reality.

Another study by researchers at the University of Texas claims that childhood trauma can raise a child’s odds of developing depression and addiction later in life. Traumatic experiences cause disruptions in certain neural networks of the brain causing depression and substance use disorder in teens. The researchers conducted the study on 32 teens, out of which 19 had a history of abuse during their childhood. They followed up these teens every six months for an average of three and a half years. The study revealed that nearly half the maltreated children had either a diagnosable drug problem or depression or both, three times the rate seen in normal teens.

How do early life events shape our lives?

Our brains and bodies are programmed by our respective early life experiences. A child coming from a calm and well nurtured environment will have a rosy outlook towards the world. It will strive in every condition in life. On the other hand, a child subjected to abuse and exposed to traumatic experiences during early age will grow up predisposed to adverse conditions. It is only likely that such a child would take to substance abuse and get afflicted with other mental conditions.

Any overwhelming stress which is too unpredictable or something over which the person has little or no control becomes a hazard and trauma. Moreover, early neglect or an absence of parenting are also tantamount to trauma for a child.

The risk of substance use disorder increases in people with early traumatic experience because of their attempts to self-medicate. They tend to dampen mood symptoms associated with a deregulated biological stress response by using illicit drugs. To make it worse, early adolescent onset of substance use or abuse may further disrupt the biological stress response by increasing plasma cortisol levels. It substantially contributes to the risk for posttraumatic stress disorder or PTSD and co-morbid depressive symptoms.

It is also established that gender plays a key role as another study suggests the existence of a gender difference in co-morbidity. While exposure to traumatic events increases risk for SUDs for young women, it does not for young men.

The study “Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population,” found differential effects of abuse type on substance use. Like sexual abuse in childhood is associated with cocaine and marijuana use only while emotional abuse was associated with cocaine use.

Prevention and cure

The study suggests an “enhanced awareness of the co-morbidity between PTSD and substance abuse is critical.” It will help people in understanding the mechanisms of substance addiction as well as in improving prevention and treatment.

Short Term Satisfaction, Long Term Misery

Taking a slightly more philosophical turn from the usual health/fitness agenda despite this being considered a health ‘issue’ to some extent. It’d be my pleasure appearing as a hypocrite to justify a life of excess for anyone in need of their own realisation.

Most of us seem to rationalise the occasional ‘blow-out’ into our ever-so vacant calendar, in the attempt to cleanse the urges and behaviours that would limit our capacity to function during that which seem to grant us fulfilment in the day to day. In theory the plan is to dose ourselves with enough endorphins to fill the void of we are now, and where we want to be. Whilst time is the entity that can either allow an idea to blossom or wither, it’s also the one thing most of us ambitious folk still can’t quite seem to fathom, conceptually not numerically. Plain and simply we are so dissatisfied with the time it will ultimately take to ‘succeed’ in whatever is it we think will provide us with absolute content, the short term ‘reward/high’ slowly registers even more gloriously than your realistically UNREALISTIC goal.

So whether poker your poison or boozing your burden, it wouldn’t take long for this ‘temporary’ substitution of your time to taint or even overshadow the goals that you’re subconsciously putting on the back-burner. Such goals referring to an ideology defining success for YOU, this isn’t monetary and will not be attained by any another currency besides hard work. I am certainly not the most ideal ambassador to the whole ‘clean’ lifestyle/fashion trend but I do make a conscious effort to satisfy long term goals slowly but surely. Besides, even though the journey to ‘success’ in whatever you aspire to become will be unsettlingly precarious, it should more importantly be enjoyed nonetheless. I personally am a firm believer in the value of adjusting your outlook toward others on their own ‘journey’ and you too may find this even more rewarding than something only you can reap the benefit from.

Calming the perceptions of those around you when you suddenly go ‘off the radar’ socially will give you a better opportunity to channel every effort necessary to create a bigger void between you and your competition whilst maintaining a sufficient support network. If ‘the lads’ have enough respect for you they’ll know when not to mither for your attendance simply out of boredom. If it just so happens that one of the more sensitive chaps in the group is having girl trouble, an emergency shindig will suffice but won’t justify a full week of binging out to the point of it damaging three.

On a serious note, if it seems to be that such instances have become paramount in your overall ‘wellbeing’ regardless of whether they are as destructive as mentioned, just remember that all you’re doing is desensitizing the component of potential success with false reward. If you believe a ‘blowout’ every so often is going to be constructive then by all means. I’m clearly a degree short of offering any credible physiological insight that you can quite easily Google yourself. If it’s knowing the technicalities involved, thus altering your approach to breaks in your routine, such may provide you with a big enough incentive to apply appropriately. Ultimately, if you find yourself in this vicious cycle of demotivation through false reward not only will recognising it shed light on your true aspirations that have been cast aside for short term social appeal, the sensation of achievement will return in full flux of colour over the greying sense of plateau or self-doubt.

Bodybuilding aside, it saddens me to see friends set for such great things in sport with SO MUCH MORE raw talent than the average guy busting his balls week in week out would kill for, throw it all away by destructive means. I too unfortunately have the bug of being overly ambitious and feeling demotivated when I don’t quite cut somewhat unrealistic goals- whether training related or otherwise, hence using immediate means of ‘reward’ that requires minimum effort yet yielding an adequate state of contentment.

Deflecting self doubt can only develop further and even project itself onto relationships, where the outlook of ones insecurities can be just as telling to potential partners as one would view those of others. I can’t think of anything worse than those bitter, drinking bitter; ‘could’ve’, ‘would’ve’, ‘should’ve’ guys, the same flock that failed to channel their efforts sufficiently enough to achieve their potential, the instance where complacency would be the issue of fulfilling potential.

I would finally like to add that just to give you an idea how much you’ll be consciously assessing the depth of your own fulfilment, when you’re next out trying your best to convince everyone how much of a piss can you are, notice how even the extremes of ‘pleasure’ in the form of alcohol/substances only heighten your internal desire of ultimately reaching your potential even more so. This may present you a realisation of needing an immediate lifestyle change, a strong enough one stop you demolishing a kebab whilst simultaneously chewing an ear about diet again.