Alcoholic Abuse as a Disease - Assignment Example

Introduction Alcoholism is a chronic, progressive, and often fatal disease. It is a primary disorder and not a symptom of other emotional problems. The chemical of alcohol allows it to affect nearly every type of cell in the body, including those in the central nervous system. After prolonged exposure to alcohol, the brain adapts to changes alcohol makes and becomes dependant on it. (Alcoholism) Two decades ago, Texas researcher Virginia Davis noticed during autopsies of skid row alcoholics that the brain contained an opiate that she fist mistook for heroin. This was puzzling because the indigents did not have the money needed to support such an expensive drug habit. The heroin like substance turned out to be THIQs that have been manufactured inside their brains when acetaldehyde from the breakdown of alcohol had combined with neutral neurotransmitters. Davis' data support the concept of alcoholism as a true addiction stemming from specific biochemical events leading to the formation of an addictive substance similar to opiates such as heroin. We now know that in heavy drinkers, THIQs displace endorphins and bind with the opiate receptors in the brain. In so doing, they signal the brain so stop producing endorphins. As the natural endorphin supply declines, more and more alcohol is needed to produce more THIQs to replace the natural endorphins and bind with the opiate receptors to create feelings of well being. (Larson) The severity of this disease is influenced by factors such as genetics, psychology, culture, and response to physical pain. (Alcoholism) Genetic factors play a significant role in alcoholism and may account for about half the total risk for alcoholism, although alcoholism is so complex that it is unlikely that any single gene will ever be identified as a major culprit. 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 suggests that a natural lack of genetic protection plays a major role in alcoholism. Such studies have found that people with a family history of alcoholism tend to "hold their liquor" better than those without such history. Experts suggest some people may inherit a lack of those warning signals that ordinarily make people stop drinking. Research suggest this factor may contribute between 40 per cent and 60 per cent of alcoholism cases related to genetic factors. (alcoholism). Alcoholism in parents increase the risk for violent behaviour and abuse toward their children. Children of alcoholics tend to do worse academically than others. I will be using the Wisconsin Psychometric test as a measuring tool to test this hypothesis on my targeted sample of Children of alcoholic parents, against children of parents who are not alcoholics. I will be using the statistical package for the social sciences (SPSS) for inputting my collected data, which will do the correlations, multicollinearity, and hypothesis. I will assess the incidence of depression, anxiety, stress, self-esteem and criminality, of those who are the off spring of alcoholic parents against those who are not. The kind of clear-cut model of the genetic sources of alcoholism perceived by the public and presented in the public tracts does not accurately reflect the state of knowledge in this area. No persuasive genetic mechanism has been proposed to account for accumulated data about alcoholic behaviour, social differences in alcoholism rates or the unfolding of the disease. Biological findings about the offspring of alcoholics have been inconsistent and grounds exist to challenge the notion of an enhanced genetic liability for alcoholism that has been accepted wisdom for the last decade. Genuine attempts to forge data and theory into genetic models have been limited to men alcoholics and to a minority of severely afflicted alcoholics with other special characteristics. However, several investigators dispute the idea of a special type of inherited alcoholism affecting only such groups. Even for these populations, balanced genetic models leave room for the substantial impact of environmental, social and individual factors (including personal values and intentions) so that drinking to excess can only be predicted within a complex, multivariate framework. The denial of this complexity in some quarters obscures what has been discovered through genetically oriented research and has dangerous consequences for prevention and treatment policies. (Stud 1986) A tremendous amount of attention and research has recently been concentrated on the inheritance of alcoholism and on the possibility of accounting genetically for drunken behaviour. The major impetus for this research was the adoption studies conducted in Scandinavia in the 1970's which found reliable genetic (but adoptive) transmission of alcoholism. This contemporary research focuses on the offspring of alcoholics and on the biochemical or neurological abnormalities they inherit may lead to pathological drinking. Or, alternatively, investigations may focus on a gestalt of personality traits (centering on impulsiveness and antisocial activity) that can culminate in alcoholism or other psychopathology. In the words of one popular article on the topic, A decade ago such a theory [of inherited antisocial personality and alcoholism] would have been dismissed out of hand". (Holden, 1995, p.36). What will we find when we place social and biological theories in a combined model Alcoholism is caused probably by genetic factors which interact with environmental factors (like early life home instability, low self-esteem, and long hospitalization in a neonatal care unit ((Cloninage et al, 83) to produce risk. An integration of biological and environmental causes is made easier by a nine-stage model of alcoholism that Abrams and Mura (XX) propose. (1) the individual learns to drink-given the culture, exposure to alcohol and social drinking while young is the norm (modeling) especially if he/she has alcoholic parents. (2) individual factors and situations (social, bio, or interaction) determine initial patterns of alcohol consumption (multiple pathways). Crucial stage-beginnings of physiological tolerance without psychological/ social difficulties resulting. (3) alcohol use is reinforced, either positively through its social reward and euphoric effect, or negatively through the fear of withdrawal. If biological theories of different absorption rates are true, the predisposition may increase or decrease the euphoric effect resulting in equal effects from small amounts of alcohol in some and large amounts of alcohol in others. Chronic stage-increased psychological tolerance with increasing psychological/social difficulties resulting. (4) if the person's perceived ability to cope is weak, alcoholic use may replace normal use. Miller discusses the neurological defects that may be a predisposition to alcoholism. Alcoholics have more difficulty changing cognitive sets and may maintain old cognitive sets even when they are no longer reinforced. Thus, alcohol use is as a response is initiated and reinforced, and becomes a standard response. Switching cognitive sets to explore different responses may be more difficult. (5), (6) and (7) all describe aspects of a vicious cycle. Continued use of alcohol will increase tolerance, decrease the euphoric effect, and inspire further consumption. Continued use results in physical addiction increasing the severity of the withdrawal symptoms. Thus, if the alcoholic stops drinking, the severe withdrawal symptoms occur and increase the craving and the negative reinforcement effect of alcohol. Continued use of alcohol also develops into psychological dependence as well as alcohol may decrease one's resources and become a stress by itself. This may increase the problem of the alcoholic and result in increased use of alcohol as a coping skill. Tolerance, withdrawal, and craving of alcohol may be different from individual to individual simply due to the factors like drinking experience, body weight, and percent of body fat. A biological disposition may enhance tolerance and increase consumption, increase severity of withdrawal and psychological dependence, and intensify craving and enhance psychological dependence. The predisposition may specifically facilitate the over use of alcohol as a coping response. (8) the severity of the cycle will vary across individuals and within an individual across time. Thus, the biological disposition may play a small role during little stress, and a large role at other times by lowering the amount of stress needed to overwhelm the person. This may vary from time to time and person to person. (9) recovery depends on ability for self-control, insight, reflection, resources, family support, and situational factors as well. Given that alcoholics have problems with abstractions (Miller 90), insight might be difficult. Problems changing cognitive sets could result in many resources left untapped because the alcoholic never considered them resources. What does Biological research tend to examine (1) animals (2) children of alcoholics adopted out of the home (3) twins and (4) families of alcoholics to compare alcoholic and non-alcoholic relatives to better understand habitability. Adolescents who would later become alcoholic had poorer grades in school, higher truancy, higher dropout rates, and higher rates of impulsivity and hyperactivity than adolescents who wouldn't later become alcoholics, although there were no significant differs on measure of IQ. Would be alcoholics had a higher rate of anti-social behaviour too, which may have been a result of problematic homes or whatever factors caused alcoholism, or may be a factor leading to alcohol use. The would be alcoholics grew up in homes with higher marital conflict and less contact with parents. This may be the cause of higher marital conflict in the adult alcoholic's home, resultant from learning higher conflictual ways of maintaining relationships as well as from their own use of alcohol. Alcoholism runs in families. Even before researchers showed how and why some people are predisposed to becoming alcoholic, simple observation showed that when one or both parents are alcoholic, the children are at risk. Until recently researchers couldn't be sure whether the familial link was environmental or both. Do people drink because they "learn to" at home or do they drink because they are genetically programmed to become alcoholic While the environmental influence certainly cannot be discounted, new evidence strongly suggest heredity plays a much stronger role in alcoholism than was once thought. Much of the new evidence comes from identical and fraternal twins. Since identical twins develop from a single fertilized egg that divides after conception, both have the same genetic make up and can be expected to be alike in most respects. For example, identical twins are always the same sex, always have the same hair and eye color, and usually reach the same adult weight and height. Studies of identical twins separated at birth and raised in different families have produced compelling evidence of the power of their genetic bond. In addition to their strikingly similar physical development, the twins have remarkably similar tastes, preferences and interests. Fraternal twins develops from two different eggs fertilized by two different sperm. Fraternal twins are no more closely related than siblings born separately. If environment was the sole cause of alcoholism, the route of alcoholism among twins raised in drinking families should be the same regardless of whether they are identical or fraternal. But if the genetic disposition were responsible, the rate of alcoholism would be similar for both identical twins, who have exactly the same genes. Studies have shown that when one identical twin is alcoholic, the other is four times more likely to be alcoholic than when one fraternal twin is alcoholic, indicating that genetics play a part in alcoholism. There have been many other studies aimed at showing whether nature or nurture is to blame for alcoholism. One of the first (Donald Goodwin 1978) compared 133 sons of alcoholics adopted and raised by non-alcoholic parents to a similar group of adoptees with no genetic history of alcoholism. The sons of alcoholics were three times more likely to become alcoholic than the sons of non-alcoholic parents. A larger study in Sweden (C. R. Cloringer, M. Bohman and S. Sigvardsson, 1981) followed 3,000 adoptees separated from their biological parents at an early age and raised by non-relatives. The risk of these children becoming alcoholic was two and a half times higher when one biological parent was alcoholic. Researchers have also studied what happens to the children of non-alcoholics who are adopted into households where one partner is alcoholic. They have found no evidence that being raised by an alcoholic parent predisposed a child to alcoholism (Larson) This, it is noted that the conclusions that Vaillant and Molofsky (82) don't quite conform to the data, and that personality factors and background factors must play a large part in the etiology of alcoholism. (Niolon) It is clear that I am a proponent of the genetic and environmental contributors in predisposing an individual to alcoholism. Another important and critical phenomena which I have yet to mention is that of the "skip phenomenon". The incidence of this phenomenon can account for a reduction in Ireland's drinking rates during the late 80's and early 90's. The phenomenon has been recognized as a common mechanism in family strains with relatively high rates of alcoholism. Members of a given generation may drink and be destroyed by alcoholism. The shock of this tragedy may cause survivors and members of the next generation to totally abstain from drinking. Members of the succedent generation, not as directly affected by the earlier alcoholism in the family, may see no good reason for abstinence and take up social drinking, thus innocently Precipitating another devastating wave of alcoholism. Of course the "skip phenomenon" Is still prevalent because of the general cultural ignorance of the genetic basis of Alcoholism. Alternate generations walk blindly into the trap. Convinced by the prevailing cultural belief that sensible, moderate children of normal parents are not likely to become alcoholics. (Epidemiology) I will present some base line data, which was taken from a variety of sources to further illustrate the scope of the teenage drinking problem in Ireland. (Cookstown, Newry and Mourne, The Lisburn Area, Seymour Hill and Conway, Halftown; Lamberg, and Areema. The results of these surveys though not startling to anyone who has observed or read about the dilemma, does present an enlightening overview of the magnitude of this emerging trend on Ireland's youth population. In Cookstown, the research came out of the work by the Cookstown teenage interagency drink group. Which was spawned in reaction to the increasing incidence of teenage drinking in the community. The respondents were students from two-primary schools, where fifty three percent were females and forty seven per cent were male. 72 % of the pupils had tasted alcohol. The most common age for first tasting was between 10 and 13 years. While the majority had tasted alcohol (72%), 30.5% of those no longer take alcohol. 43.5% of the respondents had their first drink (while) with their parents at home. Of the 40% of respondents who continue to use alcohol, the majority consumes alcohol once a month and 20% have been drunk at least once. The respondents have access to alcohol from a number of sources, the most common being from home (36%) and from older friends (17%). 4% of the respondents get their alcohol from off license. Beer and wine are the most popular. Alcopops and similar spirit mix drinks are also popular. The main reasons given for drinking were 'to celebrate', 'because others were drinking' or 'just to taste it'. Newry and Mourne involved 145 students aged 16 years. The sample group was made up of 17% from training agencies, 19% from secondary (controlled) schools, 22% from grammar schools and 42% from secondary (maintained) schools. The sample comprised of 43.3% males and 56.4% females. 95.7% admitted to having used alcohol. 28.2% had used alcohol by age 12 and 76% had used alcohol by age 14. 83% stated that they were still using alcohol. The following represents information which was correlated from four audits. This was a survey of 419 adults, around two-thirds were female and the vast majority were parents: 77% of the respondents considered underage drinking to be a problem in their area and the highest level of concern was around 13-15 year old age group. In the Craigavon area the sample consisted of 100 males aged 12-18 years. It was conducted in schools and in youth centers in the area. 92% of those questioned had tried alcohol. 84% still used alcohol. 54% stated they first tried alcohol between the ages of 11-13 years. Almost half of the current users (43%) drink alcohol once a week, while 8.6% drank more than once a week. The research showed that Friday and Saturday were the main days when alcohol is consumed. Over 15% of the respondents spent over 15 pounds per week o9n alcohol. The biggest proportion of expenditure was in the 5-10 pound category, which accounted for 52% of those questioned. The source of the money for the majority of the users was through their parents (pocket money) and employment, or a combination of both. The drink of choice for the sample included beer (65.6%), fortified wine (56.9%) cider (53.4%), and alcopops (43.1%). 56.9% of the sample chose "I like to get drunk", as their main reason for drinking. In the Board area, the sample consisted of 157 young people aged between 18-21 years. These young people were randomly selected from a range of provisions through the Board area. They were surveyed via a postal questionnaire: 87% to 90% of the respondents had tried alcohol. 84% to 89% of these respondents continue to drink on a regular basis. The most popular alcoholic drink cited by respondents was ordinary strength beer/ lager/ cider and young women for spirits. The main reason for drinking was 'to have a laugh or have fun'. Alcohol was seen as a social aid or prop too young people as substantial percentages used it to help forget worries; to give confidence and 'to help relax with the opposite sex'. 63% of youth organization and postal respondents and 55% of HE respondents drank alcohol at least once per week. Sizeable proportions of respondents exceeded the recommended intake of alcohol (of those who drank alcohol 47% males, 53% females in youth organizations, 44% males, 26% females in the postal survey and 26% males, 26% females in HE). 56% of youth organizations, 43% of JE and 35% of postal respondents who drank alcohol said they had drank alcohol on their own, eg. before joining friends. Most alcohol was consumed at the weekend. (Local surveys) Young people give many reasons for drinking alcohol. A study from the University of Strathclyde found that these changed with age. Children aged 12 and 13 years used alcohol to experience the adult world or to satisfy their curiosity. It also enabled a number of them to socialize and to say that they had been drinking. Those 14 and 15 were testing out their own limits and having fun. They enjoyed losing control every once and awhile. They preferred their drinks to be strong, cheap, and pleasant tasting. For them drinking to get drunk was important as was sharing the experience with others. Those age 16 and 17 were anxious to show their maturity and experience with alcohol, drinking more like adults. The attitudes and behaviours of children are initially shaped by families. Parents are powerful role models for children, as the family is the primary source of socialization. A sensible drinking example set by parents seem to be particularly important in protection of children against alcohol misuse, as both abstainers and heavy drinkers are more likely to have heavy drinking children. (Misuse) Peer influences are strong in older children. Ferguson et al reported that association/affiliation with substance using peers at age 15 independently predicted abusive or hazardous alcohol consumption ay 16 years old. (Ferguson) Works Cited Abrams and Niura ed (xx), Closing in on Addiction New Findings suggest a biochemical common ground, Social and Biological Theories in a combined Model, National Clearing House For Alcohol and Drug Information. Retrieved on line on March 4, 2006; from www.ruetersheath.com/wellconnected/doc56.html Alcoholism: At A Glance; Effects of Alcohol Medical Problem, Retrieved on line on March 4, 2006, from www.ruetersheath.com/wellconnected/doc56/html Bohman, M., Cloringer, C. R., and Sigvardsson, S., 1991 Ferguson, D., Horwood, J.,and Lynskey,M., The prevalence and risk factors associated with abusive of hazardous alcohol consumption in 16 year olds, Addiction 1995: 90: 935-946 [medlink] Holden 1985, Journal on Studies on Alcohol, 47: 63-73, retrieved on line on March 4,2006 from www.peele.net/lib/genetics.html Larson, Joan Matthews, seven weeks To Sobriety, Alcoholism A Physical Disease, Retrieved on line on March 4, 2006 from 204.147brecovery/Not_All_In_Your_Mind.html Local surveys drugs, alcohol-Ireland, Retrieved on line on March 8, 2006, from www.drugsprevention.net/alcohol Miller, Neuropsychological studies ed. Niolon, Richard, Closing In on Addictions New Findings Suggest Biochemical Common Ground Niolon, Richard, Closing In on Addiction New Findings Suggest a Biochemical Common Ground, National Clearinghouse for Alcohol and Drug Information Retrieved on line on March 2, 2006 from www.psychpage.com/problems/library/alcohol,html Robson J.,Alcoholism Misuse, 84 (2) 95 Retrieved on line on March 8,2005 from http://adc.bmjjournals.com/egi/content/full/84/2/95 Stud, J., The Implications and Limitations of Genetic Models, Journal of Studies on Alcohol 47: 63-73, 1986, Retrieved on line on March 2, 2006 from www.peele.net/lib/genetics,html The Emergence and Comprehensive Concept of Alcoholism-Epidemiology http://aaw.com/ecca/epidem.htm Vaillant, George E. The Natural History of Alcoholism, Retrieved on line on March 2, 2006 from 204.147.8.67/brecovery/Not_All_In_Your_Mind.html Zucker and Gomberg, Evaluation of 1982 Valliant and Milofsky's would be alcoholics. Read More