ALCOHOLISM

Introduction

Alcoholism is a strong and uncontrollable desire to take alcohol (drink). It is often a priority of addicts to indulge in alcohol rather than work or tend to their families. An alcoholic is unable to manage his/her drinking habits and it becomes effectively difficult for such a person to undertake normal functions without alcohol. Morse and Flavin (1992) define alcoholism as “a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations”. From this definition, it can be seen that alcoholism is an element that arises out of the interaction of many factors including, genetic predisposition and the environment. 

The alcohol problem can be said to be deep rooted in the American context. According to the National Institute on Alcohol Abuse and Alcoholism (2017) more than 15 million individuals had an alcohol use disorder in the USA. Globally, the World Health Organization (2015) reports that close to 3.3 million deaths occurred in 2015 as a result of alcoholism. This paper will focus on understanding the role of genes, and the environment in turning a person to an alcoholic. The effects of the addiction on the individual and to their families will be put on the table for dissection as well as the options available to treat the addiction, both traditional and emerging. 

Genetic predisposition and alcoholism

From the definition of alcoholism offered there above by Morse and Flavin (1992), it is explicitly scientific that alcoholism is a problem that can be linked to the genetic write up of an individual. At this point it will be normal for someone to ask, “how?” The following is a simple explanation. There is an evolutionary advantage when an animal has predisposition for addiction for some foods. The animal with such predisposition will thus look for the type of food in future and thus survive if such a food is plenty. That is why Pandas like bamboo, bears like fish and so on. If the genetics in some families predispose the family members to alcoholism, it means that they will be more likely to alcohol addicts in future. Some people have a dislike for alcohol since they have genes that make their bodies react violently to alcohol. This assertion is supported by Enoch and Goldman (2001) who dug deeper into the science behind alcohol addiction and genes. Their study, after critically looking at identical and non-identical twins, acknowledged that alcoholism is 50% genes and 50% coping skills. This same finding had been put across earlier by Prescott and Kendler (1999) who confirmed that there is a correlation between genes and alcoholism.

Environmental reasons for this addiction

Back to the definition by Morse and Flavin (1992), addiction to alcohol can be as a result of environmental factors which include peer pressure, availability, attitude, and stress to mention just but a few. All these environmental factors can be referred to as stressors. In an attempt to debunk the relationship between alcoholism and gene-environment interaction, Enoch (2012), looks at the effect of stress especially at adolescence, among other environmental stressors. The article reviews the risk-resilience balance for addiction in the life of an addict and how well the same falls within genetic variation and environment stressors. Enoch (2012) categorized the environmental stressors into early-life stress which include childhood maltreatment, and stressful life events. The early-life stress factors are a recipe for drinking problems as observed in many alcoholics in the Enoch (2012) study. The later-life stressors were found to have lessor effects on alcoholism. Hughes et al., (2011), added that environmental factors such as a permissive environment, highly accessible and affordable alcohol, crowding and loud music are major environmental factors that make people indulge in alcohol. 

Alcoholism, the individual and the family

It is universal, alcoholism is a home-breaker. Alcoholism can separate two people who have formed a union before men and God. It can break the relationship parents have with their children and the other way round. Due to this notoriety, alcoholism has been labeled ‘a family disease’. To an individual, alcoholism has the effect of bringing along physiological problems such as blackouts, psychological problems such as an obsessive urge to leave everything for the bottle, and behavioral problems which disrupt health, work, social, and family life.

To the family, there are different levels. Parental alcoholism affects unborn children health wise and thus give birth to a child with birth defects, and to the born, it affects their growth since they are not well taken care of. Alcoholism destroys families by detaching spouses and adding on unnecessary burdens to one of the spouses. The quality of life of the family reduces. Parsons (2003) looks at what alcoholism does to a family. Parsons (2003) agrees that the effects of alcoholism run from the aspect of an individual and then extrapolates to the family starting from an unborn child to the life of spouses. 

Alcoholics who are parents exhibit inconsistent behavior which confuses their children. For instance, McGaha (1995) and Lang (1999) observed that alcoholics can be unreasonably harsh and abusive at one point and then extremely remorseful, kind and considerate the next minute. This behavior eventually ruins the growing up of such unfortunate children since their parents are not in a position to give their children the attention they need as well as the appropriate response. Such parents will often misperceive their children’s behavior and their ability to correct the same if often compromised. 

Treating alcoholism

Alcoholism can be treated using behavioral therapy, use of clinical drugs, use of emerging technologies such as computer programs and instruments, social support, and treating alcoholism like it is a chronic disease. Huebner and Kantor (2011) looked at the cascade of medical and non-medical interventions that have been there in the recent past. Using a descriptive methodology, Huebner and Kantor (2011) reviews breakthroughs in alcoholism treatment history. The study gives a chronology of what has been happening in the field till the modern day era where we have computers and mobile phone applications. In the 1930s, there was the introduction of spiritual and character development which led to the introduction of the famous 12 steps. In the 1950s, Huebner and Kantor (2011) notes that alcoholism was recognized as a disease and that it affected people physically, mentally and spiritually. To this end, dealing with alcoholism was supposed to be dealt with from the three approaches and the dealing of alcoholism on a clinical level was set in motion. In 1989, two projects were piloted by the NIAAA. The firsts project, Project MATCH used methodologies such as 12 step facilitation, cognitive-behavioral therapyor motivational enhancement therapy as recorded by Huebner and Kantor (2011). Project MATCH was a success. The next project was COMBINE and it aimed at combining both medications and behavioral interventions. The project showed success but cautioned that no single medication can solve alcoholism. 

When it comes to the use of emergent technologies to handle alcoholism, mobile phones have a role to play. On this, Gustafson et al., (2014) agrees that the problem of alcoholism requires the use of a multidimensional approach in handling the addiction. With this in mind, Gustafson et al., (2014) aimed at the use of smartphone applications and how well they can be integrated in finding solutions to alcoholism. Participants were requested to report their risky drinking days in the previous 30 days. Intervention was then offered in the following months similar days and a follow up was offered for the next 30 days. Gustafson et al., (2014) concluded that smartphones can be used beneficially to provide a continued care for alcoholics. 

In conclusion, alcoholism is a significant disorder that can be underestimated at the beginning. Its consequences to the alcoholic as a person can be fatal as seen by WHO statistics presented above. Professions have developed various means of handling with the problem and the same has been shown to work. It is important to handle the problem with professionalism, remorse, care and apathy since its cause might be right inside us, only the manifestation of such genes has not happened. To ensure that the same does not manifest, it is important to note the causative environmental factors and stressors and thus effectively avoid falling into the trap which has been shown to be an effective home wrecker. Alcoholism causes a lot of personal shame and strain and the effects of the same can boil down to unimaginable things which can only be thought to exist in movies such as homicide. 

References 

Enoch, M. A., & Goldman, D., The genetics of alcoholism and alcohol abuse. Curr Psychiatry Rep, 2001. 3(2): p. 144-51.

Enoch, M. A. (2012). The influence of gene–environment interactions on the development of alcoholism and drug dependence. Current psychiatry reports, 14(2), 150-158

Huebner, R. B., & Kantor, L. W. (2011). Advances in alcoholism treatment. Alcohol Research & Health, 33(4), 295.

Hughes, K., Quigg, Z., Eckley, L., Bellis, M., Jones, L., Calafat, A., … & Van Hasselt, N. (2011). Environmental factors in drinking venues and alcohol‐related harm: the evidence base for European intervention. Addiction, 106(s1), 37-46.

Gustafson, D. H., McTavish, F. M., Chih, M. Y., Atwood, A. K., Johnson, R. A., Boyle, M. G., … & Isham, A. (2014). A smartphone application to support recovery from alcoholism: a randomized clinical trial. JAMA psychiatry, 71(5), 566-572.

Lang, A. R., Pelham, W. E., Atkeson, B. M., & Murphy, D. A. (1999). Effects of alcohol intoxication on parenting behavior in interactions with child confederates exhibiting normal or deviant behaviors. Journal of Abnormal Child Psychology, 27(3), 177-189.

McGaha, J. E., & Leoni, E. L. (1995). Family violence, abuse, and related family issues of incarcerated delinquents with alcoholic parents compared to those with non-alcoholic parents. Adolescence, 30(118), 473.

Morse, R. M., & Flavin, D. K. (1992). The definition of alcoholism. Jama, 268(8), 1012-1014.

National Institute on Alcohol Abuse and Alcoholism. (2017). Alcohol facts and statistics. NIH Website. Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

Parsons, T. (2003). Alcoholism and its effect on the family. AllPsych Journal, 14.

Prescott, C. A., & Kendler, K. S., Genetic and environmental contributions to alcohol abuse and dependence in a population-based sample of male twins. Am J Psychiatry, 1999. 156(1): p. 34-40.World Health Organization. (2015). Alcohol. WHO Website. Retrieved from http://www.who.int/mediacentre/factsheets/fs349/en/