COMMON TRAITS OF ADULT CHILDREN OF ALCOHOLICS

Adult children of alcoholics may:

·         Have difficulty identifying normal behavior

·         Have difficulty following a project from beginning to end

·         Lie when it would be just as easy to tell the truth

·         Judge themselves without mercy

·         Have difficulty having fun

·         Take themselves very seriously

·         Have difficulty with intimate relationships

·         Overreact to changes over which they have no control

·         Constantly seek approval and affirmation

·         Fell that they are different from other people

·         Be super-responsible or super-irresponsible

·         Be extremely loyal, even in the face of evidence that the loyalty is undeserved

·         Tend to lock themselves into a course of action without considering the consequences

Experts agree that adult children of alcoholics who believe they have come to terms with their feelings can sometimes face lingering problems.  Support groups to contact include Al-Anon, Adult Children of Alcoholics Foundation.

CURRENT ALCOHOL CONCERNS

Adult Children of Alcoholic  Parents

In recent years a new dimension of alcoholism has been identified – the unusually high prevalence of alcoholism among adult children of alcoholics (ACOAs).  It is estimated that these children are about four times more likely to develop alcoholism than children whose parents are not alcoholics.  Even the ACOAs who do not become alcoholics may have a difficult time adjusting to everyday living.  Janet Geringer Woitiz, author of the best-selling book Adult Children of Alcoholics, describe thirteen traits that most ACOAs exhibit to some degree.

In response this concern, support groups have been formed to help prevent the adult sons and daughters of alcoholics from developing the condition that afflicted their parents.  If a stronger link for an inherited genetic predisposition to alcoholism is found, these groups may play an even greater role in the prevention of alcoholism.

Women and Alcohol

For decades, women have consumed less alcohol and had fewer alcohol-related problems than men.  At present, evidence is mounting that a greater percentage of women are choosing to drink and that some subgroups of women, especially young women, are drinking more heavily.  An increased number of admissions of women to treatment centers may also reflect that alcohol consumption among women is on the rise.

Studies indicate that currently there are almost as many female as male alcoholics.  However, there appear to be differences between men and women when it comes to alcohol abuse: (1) More women than men can point to a specific triggering event (such as divorce, death of a spouse, a career change, or children leaving home) that started them drinking heavily. (2) Alcoholism among women often starts later and progresses more quickly than alcoholism among men.  (3) Women tend to be prescribed more mood-altering drugs than men.  So women face greater risk of drug interaction or cross-tolerance.  (4) Nonalcoholic men tend to divorce their alcoholic spouses nine times more often than nonalcoholic women divorce their alcoholic spouses.  Thus alcoholic women are not as likely to have a family support system to aid them in their recovery attempts.  (5) Female alcoholics do not tend to receive as much social support as men in their treatment and recovery.  (6) Unmarried, divorced, or single-parent women tend to have significant economic problems that may make entry into a treatment program especially difficult.  (7) women seem to be more susceptible than men to medical complications resulting from heavy drinking.  In light of the generally recognized educational, occupational, and social gains made by women during the last two decades, it will be interesting to see whether these male-female differences continue.  What’s your best guess?

Alcohol Advertising

Every few years, careful observers can see subtle changes in the ways the alcoholic beverages industry markets its products.  Recently, the marketing push appears to be directed toward minorities (through advertisements for malt liquor and fortified wines), women (through wine and wine cooler ads), and youth (through trendy, young adult-orieted commercials), and spiffy websites.

On the college campus, aggressive alcohol campaigns have used rock stars, beach party scenes, athletic event sponsorships, and colorful newspaper supplements as vehicles to encourage the purchase of alcohol.  Critics claim that most of the collegiate advertising is directed at the “below age 21” crowd and that the prevention messages are not strong enough to offset the potential health damage to this population.  How do you feel about alcohol advertising on your campus? If you’re a nontraditional age student, do you find the advertising campaigns amusing or potentially dangerous.?

PROBLEM DRINKING AND ALCOHOLISM

Problem Drinking

At times the line separating problem drinking from alcoholism is difficult to distinguish.  There may be no true line, with the exception that alcoholic is unable to stop drinking.  Problem drinking is a pattern of alcohol use in which a drinker’s behavior creates personal difficulties or difficulties for other people.  What are some of these behaviors? Examples might be drinking to avoid life stressors, going to work intoxicated, drinking and driving, becoming injured or injuring others while drinking, solitary drinking, morning drinking, and occasional blackout, high-risk sexual activity, and being told by others that you drink too much.  For college students, two clear indications of problem drinking are missing classes and lowered academic performance caused by alcohol involvement. 

Problem drinkers are not always heavy drinkers; they might not be daily or even weekly drinkers.  Unlike alcoholics, problem drinkers do not need to drink to maintain “normal” body functions.  However, when they do drink, they (and others around them) experience problems sometimes with tragic consequences.  It’s not surprising that problem drinkers are more likely than other drinkers to eventually develop alcoholism.

Alcoholism

In the early 1990s a revised definition of alcoholism was established by a joint committee of experts on alcohol dependence.  This committee defined alcoholism as follows:

Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.  The disease is often progressive and fatal.  It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial.  Each of these symptoms may be continuous or periodic.

This definition incorporates much of the knowledge gained from addiction research during the last two decades.  It is well recognized that alcoholics do not drink for the pleasurable effects of alcohol but to escape being sober.  For alcoholics, being sober is stressful.

Unlike problem drinking, alcoholism involve a physical addiction to alcohol.  For the true alcoholic, when the body is deprived of alcohol, physical and mental withdrawal symptoms become evident.  These withdrawal symptoms can be life threatening.

Uncontrollable shaking can progress to nausea, vomiting, hallucinations, shock, and cardiac and pulmonary arrest.  Uncontrollable shaking combined with irrational hallucinations is called delirium tremens (DT), an occasional manifestation of alcohol withdrawal.

The complex reasons for the physical and emotional dependence of alcoholism have not been fully explained.  Why, when more than 100 million adults use alcohol without becoming dependent on it, are 10 million or more others unable to control its use?

Could alcoholism be an inherited disease? Studies in humans and animals have provided strong evidence that genetics plays a role in some cases of alcoholism.  Two forms of alcoholism are thought to be inherited: type 1 and type 2.  Type 1 is thought to take years to develop and may not surface until midlife.  Type 2 is a more severe form and appears to be passed primarily from fathers to sons.  This form of alcoholism frequently begins earlier in a person’s life and may even start in adolescence.

Genetics may also help protect some Asians from developing alcoholism.  About half or all Far East Asians produce low levels of an important enzyme that helps metabolize alcohol.  These people cannot tolerate even small amounts of alcohol.  Genetic factors pertaining to the absorption rates of alcohol in the intestinal tract have been hypothesized to predispose some Native Americans to alcoholism.  It is likely that more research will be undertaken concerning the role of genetic factors in all of chemical dependence.

The role of personality traits as conditioning factors in the development of alcoholism has received considerable attention.  Factors ranging from unusually low self-esteem to an antisocial personality have been implicated.  Additional factors making people susceptible to alcoholism may include excessive reliance on denial, hypervigilance, compulsiveness, and chronic levels of anxiety.  Always complicating the study of personality traits is the uncertainty of whether the personality profile is a predisposing factor (perhaps from inheritance) or is caused by alcoholism.

Codependence

Within the last decade, a new term has been used to describe the relationship between drug-dependent people and those around them – codependence.  This term implies a kind of dual addiction.  The alcoholic and the person close to the alcoholic are both addicted, one to alcohol and the other to the alcoholic.  People who are codependent often find themselves denying the addiction and enabling the alcohol-dependent person.

Unfortunately, this kind of behavior damages both the alcoholic and the codependent.  The alcoholic’s intervention and treatment may be delayed for a considerable time.  Codependent often pay a heavy price as well.  They often become drug- or alcohol-dependent themselves, or they may suffer a avariety of psychological consequences related  to guilt, loss of self-esteem, depression, and anxiety.  Codependents may at increased risk for physical and sexual abuse.

Researchers continue to explore this dimension of alcoholism.

Denial and Enabling

Problem drinkers and alcoholics frequently use the psychological defense mechanism of denial to maintain their drinking behavior.  By convincing themselves that their lives are  not affected by their drinking, problem drinkers and alcoholics are able to maintain their drinking patterns.  A person’s denial is an unconscious process that is apparent only to rational observers.

Formerly, it was up to alcoholics to admit that their denial was no longer effective before they could be admitted to a treatment program.  This is not the case today.  Currently, family members, friends, or coworkers of alcohol-dependent people are encouraged to intervene and force an alcohol-dependent person into treatment.

During treatment, it is important to chemically dependent people to break through the security of denial and admit that alcohol controls their lives.  This process is demanding and often time-consuming, but it is necessary for recovery.

For family and friends of chemically dependent people, denial is part of a process known as enabling.  In this process, people close to problem drinker or alcoholic inadvertently support drinking behavior by denying that a problem really exists.  Enablers unconsciously make excuses for the drinker, try to keep the drinker’s work and family life intact, and in effect make the continued abuse of alcohol possible.  For example, college students enable problem drinkers when they clean up a drinker’s messy room, lie to professors about student’s class absences, and provide class notes or other assistance to a drinker who can’t keep up academically.

Alcohol counselors contend that enablers are an alcoholic’s worst enemy because they can significantly delay the onset of effective therapy.  Do you know of a situation in which you or others have enabled a person with an alcohol problem?

Alcoholism and the Family

Considerable disruption occurs in the families of alcoholics, not only from the consequences of the drinking behavior (such as violence, illness, and unemployment), but also because of the uncertainty of the family’s role in causing and prolonging the situation.  Family members often begin to adopt a variety of new roles that will allow them to cope with the presence of the alcoholic in the family.  Among the more commonly seen roles are the family hero, the lost child, the family mascot, and the scapegoat.  Unless family members receive appropriate counseling, these roles may remain intact for a lifetime.

Once an alcoholic’s therapy has begun, family members are encouraged to participate in many aspects of the recovery.  This participation will also help them understand how they are affected by alcoholism.  If therapy and aftercare include participation in Alcoholics Anonymous (AA), family mambers will be encouraged to become affiliated with related support groups.

Helping the Alcoholics: Rehabilitation and Recovery

Once an alcoholic realizes that alcoholism is not a form of moral weakness but rather a clearly defined illness, the chances for recovery is remarkably good.  It is estimated that as many as two-third of alcoholics can recover.  Recovery is especially enhanced when the addicted person has a good emotional support system, including concerned family members, friends, and employer.  When this support system is not well established, the alcoholic’s chances for recovery are considerably lower.

AA is a voluntary support group of recovering alcoholics who meet regularly to help each other get and stay sober.  Over 100,00 groups exist in 150 countries worldwide.  AA encourages alcoholics to admit their lack of power over alcohol and to turn their lives over to a higher power (although the organization is nonsectarian).  Members of AA are encouraged not to be judgmental about the behavior of other members.  They support everyone with a problem caused by a alcohol.

Al-Anon and Alateen are parallel organizations that give support to people who live with alcoholics.  Al-Anon is geared toward spouses and other relatives, and Alateen focuses on children of alcoholics.  There are 28,000 Al-Anon groups and 3000 Alateen gropus worldwide.  Both organizations help members realize that they are not alone and that successful adjustments can be made to nearly every alcoholic-related situation.  AA, Al-Anon, and Alateen chapter organizations are usually listed in the telephone book or in the classified sections of local newspapers.  You can locate Al-Anon and Alateen on the Web at www.al-anon.alateen.org.

For people who feel uncomfortable with the concept that their lives are controlled by a higher power, secular recovery programs are becoming popular.  These programs maintain that sobriety comes from within the alcoholic.  Secular programs strongly emphasize self-reliance, self-determination, and rational thinking about one’s drinking.  Secular Organizations for Sobriety (SOS) and Rational Recovery are examples of secular recovery programs.

Drugs to Treat Alcoholism

Could there be a medical cure for alcoholism? For nearly 50 years, the only prescription drug physicians could use to help drinkers stop drinking was disulfiram (Antabuse).  Antabuse would cause drinkers to become extremely nauseated whenever they used alcohol.

In 1995 the Food and Drug Administration approved the drug naltrexone (ReVia) that works by reducing the craving for alcohol and the pleasurable sensations felt when drinking.  Combining naltrexone with conventional behavior modification has shown promising results.  Additionally, the use of antidepressants by some alcoholics has been especially helpful during treatment.

PROGRESSIVE STAGES OF ALCOHOL DEPENDENCE

Early

·         Escape drinking

·         Binge Drinking

·         Guilt feelings

·         Sneaking drinks

·         Difficulty stopping once drinking has begun

·         Increased tolerance

·         Preoccupation with drinking

·         Occasional blackouts

Middle

• Loss of control
• Self-hate
• Impaired social relationships
• Changes in drinking patterns (more frequent binge drinking)
• Temporary sobriety
• Morning drinking
• Dietary neglect
• Increased blackouts

Late

• Prolonged binges
• Alcohol used to control withdrawal symptoms
• Alcohol psychosis
• Nutritional disease
• Frequent blackouts

ORGANIZATIONS THAT SUPPORT RESPONSIBLE DRINKING

The serious consequences of irresponsible use of alcohol have led to the formation of a number of concerned citizen groups.  Although each organization has a unique approach, all attempt to deal objectively with two indisputable facts.  Alcohol use is part of our society, and irresponsible alcohol use can be deadly.

Mothers Against Drunk Driving

Mothers Against Drunk Driving (MADD) is a national network of over 600 local chapters in the United States and Canada.  This organization attempts to educate people about alcohol’s effects on driving and to influence legislation and enforcement of laws related to drunk drivers.

Students Against Destructive Decisions

Many students have known the acronym SADD to stand for the youth group Students Against Driving Drunk or Students Against Destructive Decisions.  Recently, the group has restructured itself to expand beyond drunk driving to include other high-risk activities that are detrimental to youth, such as underage drinking, drug use, drugged driving, and failure to use seat belts.  Founded in 1981, this organization now has millions of members in thousands of chapters throughout the country.  Remaining central to the drunk driving aspect of SADD is the “Contract for Life,” a pact that encourages students and parents to provide safe transportation for each other if either is unable to drive safely after consuming alcohol.  This contract also stipulates that no discussion about the incident are to be started until both can talk in a calm and caring manner.

BACCHUS and GAMMA Peer Education Network

BACCHUS (Boost Alcohol Consciousness Concerning the Health of University Students) began in 1975 as an alcohol-awareness organization at the University of Florida.  Run by student volunteers, this organization promoted responsible drinking among college students who chose to drink.  It was not an anti-alcohol group, but a “harm reduction” group.  Over the years, hundreds of chapters were formed on campuses across the country.

When supports of BACCHUS realized that many students interested in alcohol awareness were from fraternities and sororities, they developed GAMMA (Greeks Advocating Mature Management of Alcohol) to join BACCHUS to form a peer education network.  Campuses are now able to choose BACCHUS, GAMMA, or any other acronym or name for their groups.

With the broadening of the original BACCHUS organization has come an expansion of the health issues this group addresses. Originally, the focus was on alcohol abuse and prevention.  Now the BACCHUS and GAMMA Peer Education Network confront a variety of student health and safety issues.

Other Approaches

Other responsible approaches to alcohol use are surfacing nearly every day.  Even among college fraternity organizations, attitudes toward the indiscriminate use of alcohol are changing.  Many fraternity rush functions are now conducted without the use of alcohol, and growing numbers of fraternities are alcohol-free.

Another encouraging sign on college campuses is the increasing number of alcohol use task forces.  Although each of these groups has its own focus and tittle, many are meeting to discuss alcohol-related concerns on their particular campus.  These task forces often try to formulate detailed, comprehensive policies for alcohol use across the entire campus community.  Membership on these committees often includes students (on-campus and off-campus, graduate and undergraduate), faculty and staff members, academic administrators, residence hall advisors, university police, health center personnel, alumni, and local citizens.  Does your college have such a committee?

HOSTING A RESPONSIBLE PARTY

Some people might say that no party is totally safe when alcohol is served.  These people are probably right, considering the possibility of unexpected drug synergism, overconsumption, and the consequences of released inhibitions.  Fortunately, an awareness of the value of responsible party hosting seems to be growing among college communities.  The impetus for this awareness has come from various sources, including respect for an individual’s right to choose not drink alcohol, the growing recognition that many automobile accidents are alcohol-related, and the legal threats posed by host negligence.

Responsibly hosting parties at which alcohol is served is becoming a trend, especially among college-educated young adults.  The Education Commission of the States’ Task Force on Responsible Decisions about alcohol has generated a list of guidelines for hosting a social event at which alcoholic beverages are served.

In addition, using a designated driver is an important component of responsible alcohol use.  By planning to abstain from alcohol or to carefully limit their own alcohol consumption, designated drivers are able to safely transport friends who have been drinking.