The Alcoholic Family

OPERATIONAL DEFINITION OF ALCOHOLIC FAMILY

“Alcoholism is a social problem that seriously affects millions of family across the United States and throughout the world,” (Steinglass 1976).  People who suffer from this illness are known as alcoholics. They cannot control their drinking even when it becomes the underlying cause of serious harm, including medical disorders, marital difficulties, job loss, or automobile crashes. Medical science has yet to identify the exact cause of alcoholism, but research suggests that genetic, psychological, and social factors influence its development. Alcoholism cannot be cured yet, but various treatment options can help an alcoholic avoid drinking and regain a healthy life. People tend to equate any kind of excessive drinking with alcoholism. But doctors and scientists recognize that disorders related to alcohol use lie along a continuum of severity.

Alcoholism is a disease that includes alcohol yearning and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. There are four symptoms related to alcoholism and they are craving, physical dependence, tolerance and impaired control. In craving, there is a strong fancy to drink; in impaired control, the alcoholic person can t control his drinking in any occasion; in physical dependence, the alcoholic is too dependent on drugs that is when he tried to withdraw symptoms shows such as nausea, shakiness, sweating and nervousness, withdrawal occurs when alcohol is discontinued or intake is decreased. and lastly tolerance wherein there is a need for markedly increased amounts of alcohol to achieve intoxication or the desired effect. Alcoholism is an illness marked by drinking alcoholic beverages at a level that interferes with physical health, mental health, and social, family, or occupational responsibilities.

Alcoholism is divided into 2 categories: dependence and abuse.

People with alcohol dependence, the most severe alcohol disorder, usually experience tolerance and withdrawal Alcohol dependents spend a great deal of time drinking alcohol, and obtaining it. Alcohol dependence develops differently in each individual.

Alcohol abusers may have legal problems such as drinking and driving. They may also have problems with indulge drinking (drinking 6 or more drinks at one sitting). People who are dependent on or abuse alcohol continue to drink it despite proof of physical or psychological problems. Those with dependence have more severe problems and a greater compulsion to drink. Alcohol dependence affects a broad cross section of society around the world. Statistics show that alcohol dependence touches successful business executives, skilled mechanics, laborers, homemakers, and church members of all denominations. Scientists have not identified a typical alcoholic personality, and they cannot predict with absolute certainty which drinkers will progress to alcohol dependence.

Alcohol use varies depending on an individual’s social, cultural, or religious background. Some individuals do not drink at all—about one-third of adults in the United States who are 18 and older, for example, abstain from alcohol. Others drink as part of social custom. Still others drink frequently and in substantial amounts. Those suffering from alcohol dependence drink to appease an uncontrolled craving for alcohol or to avoid experiencing the unpleasant symptoms of withdrawal.

Alcoholic families display behaviors of alcohol abuse, loss of control of drinking, denial, nicotine addiction, impaired communication, inappropriate expression of anger, and enabling behaviors. Family feelings indicate the presence of unhappiness, hurt, frustration, guilt, moodiness, powerlessness, loneliness, mistrust, anger, anxiety, and hopelessness guilt, moodiness, powerlessness, loneliness, mistrust, anger, anxiety, and hopelessness.

            People who are dependent on or abuse alcohol continue to drink it despite proof of physical or psychological problems. Those with dependence have more severe problems and a greater compulsion to drink. Alcoholic families display behaviors of alcohol abuse, loss of control of drinking, denial, nicotine addiction, impaired communication, inappropriate expression of anger, and enabling behaviors. Family feelings indicate the presence of unhappiness, hurt, frustration, guilt, moodiness, powerlessness, loneliness, mistrust, anger, anxiety, and hopelessness.

Ethyl alcohol, or ethanol, is present in varying amounts in beers and wines, and in distilled liquors such as whiskey, gin, and rum. When a person consumes alcohol, the stomach and intestines rapidly absorb it. From there alcohol travels in the blood throughout the entire body, affecting nearly every tissue. Moderate and high doses of alcohol depress the functions of the central nervous system, including the brain. The higher the alcohol level is in the blood, the greater the impairment.

As blood passes through the liver, enzymes break down alcohol into harmless byproducts, which are eliminated from the body six to eight hours later. But the rate at which alcohol accumulates in the body may be faster than the rate at which the body eliminates it, resulting in rising alcohol levels in the blood. Consequently, alcohol remains in the body, producing intoxicating effects hours after the last drink was swallowed.

Small amounts of alcohol may relieve tension or fatigue, increase appetite, or produce an anesthetic affect that numbs pain. Larger quantities inhibit or depress higher thought processes, bolstering self-confidence and reducing inhibition, anxiety, and guilt. As a person becomes intoxicated, painful or embarrassing situations appear less threatening and, as drinking progresses, speech may become loud and slurred. Impaired judgment may lead to incautious behavior, and physical reflexes and muscular coordination may become noticeably affected. If drinking continues, complete loss of physical control follows, ending in stupor, and possibly death.

COMMON CHARACTERISTICS AND PROCESSES OF THE ALCOHOLIC FAMILY

There are addicts of all sorts all over. Now with the neoclassical definition that many are proposing it would seem that every single individual is an addict of some kind and it is only the level of addiction that varies. Addiction is a persistent on-going condition where the individual or animal would crave for a particular substance(s) or seek to repeat certain behavior(s) in order to satisfy a need(s). As is being proposed this in itself is not a problem until the individual becomes physiologically or psychological unstable when that need is not satisfied (then there is no more self-control).

It is this lost of control on the part of alcoholics and other addicts that affect every single aspect of society. First and foremost the individual is affected in a variety of ways depending on his addiction. There are those addictions that are not obvious to anyone and may remain hidden and kept secret from those close to you as well as the outside world for several years (in fact others will only know of it after you have confessed). Then there are addictions that are a little more obvious but only to those who are close to you (friends and family members), and can only be kept secret for so long. Then there are addictions that you could see from a mile way (so obvious it stinks). At every level, the individual and by extension society is affected in some way or another.

Individuals who through abuse of alcohol have become addicted are more than likely to undergo a personality change. This change of personality will definitely affect anyone who is close to them. Some alcohol addictions lead to indifference to matters and issues that were once of serious interest to the alcoholic (a college education may no longer be their top priority!). Work ethics and the sense of responsibility that an addicted person once had would no longer be upheld. Personal pride (being neat and well groomed has now taken a back seat) and self-esteem would suffer, leading to actions that are uncharacteristic of the individual.

All of these effects of alcoholism would then be spilled over into other areas of their lives. Lack of work ethics and the continuous deterioration of the quality of work they produce may lead to them eventually losing their jobs, which in turn affects the finance and well being of their family. Uncharacteristic behavior of the alcoholic could cause them to become abusive (whether it be physical, emotional or mental) to their spouse and children. There is the factor of risk-taking where their life and that of those around them become less important and they are likely to place themselves and others in life-threatening situations. Alcoholism in many cases, may lead to disassociation from friends and family members in an effort by the alcoholic to either hide his addiction or avoid criticism from others about his addiction.

Alcoholism that has lead to the addict withdrawing from close friends and in particular family members could have serious emotional effects. In many cases family members who are close to the alcoholic are completely taken aback after becoming aware of the addict’s problem. This may seem rather impossible as there are obvious indicators of smell and lack of coordination among other things that would indicate that someone has been under the influence. While this may be true, and family members are aware of the signs of the individual being under the influence of alcohol; you often find that it is only late into the addiction that they become convinced that the individual is an alcoholic; as much effort is usually made by alcoholics to conceal their alcoholism from other individuals.

Then there is the abuse that close family members, in particular spouses and children, are likely to be subjected to. These are likely to have even longer lasting impact on the family. In many cases, after the alcoholism has been dealt with and treated, the scars from such abuse would remain as a thorn when trying to mend broken relationships. For many families involving alcoholism, the deal breaker is money. Some addictions may lead to job loss for the victims; and financial problems for their family. Studies have shown that many families under financial pressure can only hold on for so long before it all comes caving in. In some cases you may find that these very alcoholics, in order to sustain their habit, would initially deplete all of their own money (savings and joint-savings with spouse); and when that is done, try to do the same to other family members. With the alcoholic’s obvious indifference to such problems and the financial strain that would be created would result in unwanted consequences. This is likely to lead to delinquencies in meeting certain obligations such as mortgage payments and utilities, which would only serve to aggravate the family situation.

Alcohol abuse, like any other drug, also greatly increases the risk of individuals developing health problems. Complications with liver, kidneys and a whole lot of other vital body organs are a common side effect of alcoholism. This not only complicates the situation for the individual but the family at large, as limited financial resources are would have to used to remedy such ailments.

Even when there has been professed cases of overcoming alcoholism, the damage done prior to attaining that victory is usually so extensive and severe that many lives (in particular that of the individual and family members) would never be the same. Lifelong relationships may have become permanently severed and the alcoholic, for the most part, would have been left completely despondent and dejected after the ordeal. It may seem unfair to many victims of alcoholics and family members where addictions have brought total chaos and destruction that those alcoholics need their total love and support. It is true, alcoholics need every bit of their love ones that could be offered when recovering from alcoholism and even more so while they are still being controlled by it. So whenever possible be patient and loving towards those who need you most; even when it seems like that most difficult thing to do.

CLINICAL ARTICLES AND INTERVENTIONS

Sleep and Alcoholism

            Sleep in some ways restores normal activity and normal balance among parts of the nervous system (Guyton 1991, p 661). The standard adult sleeps 7.5 to 8 hours every night. Abundant facts demonstrate that lack of sleep can have severe consequences, including increased risk of depressive disorders, impaired breathing, and heart diseases. Alcohol dependents often find their sleep disturbed. It acts as stimulants of the central nervous system which interfere sleep. Alcoholics tend to sleep mostly during daytime thus affects his sleep at night.

Intervention

            Alcoholic persons must organize a schedule wherein his sleep time will not be reduced. Discuss possible causes that contribute to sleep disturbance. Think of self promoting technique and minimize the amount of alcohol taken and its accuracy as well. Sometimes music promotes sleep. Reduce environmental distractions in the room if possible.

Facts about Drinking and Driving

`Although alcohol-related traffic victims have been on the turn down in recent years, the guarantee of highway deaths due to alcohol impaired drivers is so unsurprising each holiday period many state highway patrol departments each year issue highway fatality “projections” that will turn out to be unchangingly accurate.

The government and its agencies as well as private companies are campaigning for road safety. Different advertisements and public signs are given to guide motorists. Training on road signs are also given to them.

The sad fact is motor vehicle wrecks are the leading cause of death in the United States for persons under age 34, according to the Centers for Disease Control and Prevention Morbidity and Mortality Reports.

Intervention

Drunk drivers must never drive especially during night time. Drivers must never take too much alcohol if they will drive later on. They must be responsible enough to know their limitations. Accident prone area must be lighted properly. If driving cant be avoided, try to rest a little while after drinking and if possible don’t drive alone.

Alcohol and Behavior Problems

Adolescents, age 12 to 17, who use alcohol, are more likely to report behavioral problems, especially aggressive, delinquent and criminal behaviors, according to findings of a new study released by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The new report, Patterns of Alcohol Use Among Adolescents and Associations with Emotional and Behavioral Problems, concludes that there is a strong relationship between alcohol use among youth and many emotional and behavioral problems, including fighting, stealing, driving under the influence of alcohol and/or drugs, skipping school, feeling depressed, and deliberately trying to hurt or kill themselves. These findings are based on adolescent self-reporting of behavioral/emotional problems that occurred the past six months.    The study further revealed that adolescent alcohol users — regardless of whether they are heavy, binge, or light drinkers — report they are more likely to use illicit drugs than non-drinkers.

Intervention

Adults should know their limitations when drinking alcoholic beverages. Friends and families must participate in observing behavioral changes of the alcoholic persons. Show concern and trust them that they still can change.  If their actions are found to be too destructive bring them to a therapy and intervention clinic.

Drunk in School

            An entire new crop of freshmen will arrive on campus at U.S. colleges this fall, many away from home for the first time, to join the free beer party.

            They will find a sub-culture on and around campus that will encourage all-out partying and binge drinking and where they will find, even if they are underage, alcoholic beverages cheap if not free.

            Some will die trying to keep up.

Someone will fall out of a window or over a balcony, get killed in a car wreck, or simply die from acute alcohol poisoning.

Intervention

Parents and school authorities must observe behaviors of alcoholic dependents. It is necessary to give understanding on the negative effects of alcohol on them. Ask them if something’s bothering them and why they crave for alcohol. Understand them by first giving them freedom to drink but to a limited amount only.

Alcohol Dependence in Elderly Population

Alcohol dependence in elderly populations is fast approaching. Elders tend to rely on alcohols for them to get the feeling of being secured. Elders nowadays are junked in to caregivers and geriatric homes. Their family seems to forget their responsibilities on elderly  Edelman and Mandle (1990, p539) found out that 14% of older males and 1.5% of older females had alcohol problems. Elderly alcoholics include those who began drinking alcohol in their youth. The cause for this is for them to cope up with changes, anxiety, feeling of being alone, and problems of their older years.

Intervention

            Elderly patients dependent on alcohols must not be prejudged. They should be accepted, ask if they have problems and offer them your help. The amount of alcoholic drinks that they are taking must be assessed and if the elderly is taking any medication, discuss with him the interaction of alcohol and medication. Relatives must give elders their attention, care, support and love.

References: 

            Taylor & Francis (2006) Psychology and Addictions Issue Volume

17Pages135-137

Steinglass, (2001).The Alcoholic Family

Barnard (1991).Families with an Alcoholic Member: The Invisible Patient

            Lawson and Peterson (2004) Alcoholism In The Family: A Guide to Treatment and Prevention

Bank and Kahn (1982) Family Relations p. 5-12

Kozier et al (2002).  Fundamentals of Nursing p. 657-658

Goodwin (2000 .Alcoholism: the Facts

Jellinek (1988) Disease C oncept on Alcoholism

Steiner (1981) Healing Alcoholism

Roberts (1990) Senior systems…older patients and their medications…sleep and sleep difficulties in life…, Part 46  Nursing Times 86:61-64

George (1951). Alcoholism

Rudy (1986) Becoming Alcoholic: Alcoholics Anonymous and the Reality of Alcoholism

Kissin and Begleiter (1972) The Biology of Alcoholism: Physiology and Behavior