Introduction: Alcoholics/addicts drink and drug for the same reasons as the non-alcoholics/non-addicts. They drink & drug to feel euphoric, stimulated, relaxed or intoxicated. They drink & drug to relieve tension & stress, to gain confidence or to socialize.
The alcoholic/addict like the non-alcoholic/non-addict:
· Is influenced by the way he/she drinks or drugs
· Where he drinks/drugs
· How much he drinks/drugs
· And how often
which are affected by psychological, social or cultural factors.
Again like the non-alcoholic, the alcoholic learns to drink a variety of alcoholic beverages and he develops preferences among beers, wines and liquors. The addict uses a variety of different drugs until he develops a drug of choice (marijuana, cough syrup, Tylenol #3, heroin, morphine, etc.) He learns how well he can hold his “liquor” or drug use without getting too high.
The alcoholic/addict may change their pattern of use because of life changes:
· Death of a loved one
· Divorce
· Loss of a job
· Loneliness, depression, fears and insecurities
At some point the pattern changes and the alcoholic/addict begins to use larger amounts, more frequently and at inappropriate places.
Particular personality traits may become intensified or may undergo bizarre transformations. For example:
· The sensitive may become insensitive
· The extrovert introvert
· The gentle become violent
· The tactful belligerent
· The compassionate uncaring
· Mildly depressed become suicidal
· Those who are dual diagnosed (with psychiatric disorders) can no longer control the disorder because of the alcohol/drug being used interferes with medication needed to control the psychiatric disorder
· Moodiness caused by withdrawal
· Display of anger when loved one points out how much, how often and where you use
I. Predisposing Factors
A. Abnormal Metabolism
*Acetaldehyde is the byproduct of alcohol when metabolized.
*Charles Lieber (Chief of Research at Veterans Adm. Hospital) found that the same amount of alcohol produces different levels of Acetaldehyde in alcoholics and non-alcoholics.
*The unusual buildup of acetaldehyde in alcoholics causes malfunctioning of the liver enzymes.
*Marc Schuckit (a psychiatrist & researcher at Univ. of California in San Diego) studies confirmed the breakdown of acetaldehyde into acetate (the second step in alcohol metabolism) is performed at half the rate of the non-alcoholic, causing acetaldehyde to accumulate.
*Liever discovered the liver mitochondria in alcoholics are abnormal and unable to change acetaldehyde into acetate. This low capacity was evident even in the early stages of heavy alcohol consumption, indicating the alcoholic’s cells are altered before he starts drinking heavily and continually.
*The accumulation of acetaldehyde is a dangerous substance that hampers cellular activities. The harmful effects of acetaldehyde are not confined to the liver. High levels of acetaldehyde can inhabit:
a. The proteins in heart muscle which impair cardiac function.
b. In the brain which can lead to bizarre & complicated chemical reactions such as:
1. competing with other chemical substances (neurotransmitters)
2. blocks enzymes from accomplishing their primary duty of inhibiting the amine activity
3. amine interact with acetaldehyde to form compounds called “isoquinolines”
4. isoquinoline are like opiates and affect the opiate receptor sites thus contributing to addiction to alcohol
B. Preference
*Everyone has a different reaction to the taste and effect of alcohol (effects of drugs).
a. Some people appear driven by the desire to drink/drug.
b. Some enjoy the taste & effect so they drink/drug whenever they have the chance.
c. Others like a drink/drug every once in a while, but prefer non-alcoholic beverages most of the time.
d. Others feel sick to their stomachs, dizzy, flushed or drunk after just one or two drinks. These people will generally avoid drinking.
*Preference for alcohol/drugs is regulated by complicated chemical activities in the brain.
a. In a 1968 experiment, rats reduced or completely stopped drinking alcohol when given a chemical substance which depleted the brain’s supply of serotonin (a brain amine responsible for relaying messages from one brain cell to another).
b. Serotonin is only one of many chemical substances which regulate how much you will drink.
c. THP (Tetrahydropapaveroline) the product of the interaction between acetaldehyde and dopamine (a brain amine similar to serotonin). When rats were injected with THP, they drank to the point of intoxication and suffered withdrawal symptoms when they stopped.
*Initial liking or disliking for alcohol is clearly only one factor involved in a biological predisposition to alcoholism. The THP study shows that preference is not a necessary factor (since rats refused to drink could be made to drink when THP was injected into their brains).
C. Heredity
*In a study performed by psychiatrist and researcher Donald Goodwin provides clear and strong corroboration that alcoholism is passed from parent to child through the genes.
a. Goodwin was able to separate hereditary influences from environmental influences by studying the children of alcoholics who were taken from their parents at birth and adopted by non-relatives.
b. The children have a much higher risk of becoming alcoholics themselves (four times greater) than that of non-alcoholics despite having no exposure to their alcoholic parent.
c. The children of non-alcoholic parents showed low rates of alcoholism even if reared by alcoholic foster parents.
*A second study, Goodwin compared the sons of alcoholics who were adopted and raised by an unrelated family with their brothers who have been raised by the alcoholic parent.
a. He found that the children raised by the biological alcoholic parent were no more likely to become alcoholic than their brothers who were raised by non-relatives.
b. This study shatters the theory that children of alcoholics become alcoholics themselves because they learn bad habits from their parents.
*The study failed to find a connection between alcoholism and problem drinking.
a. Alcoholics do not drink addictively because they are depressed, lonely, immature or dissatisfied. They drink addictively because they have inherited a physical susceptibility to alcohol which results in addiction.
b. Heavy or problem drinking appears to be caused by psychological, emotional or social problems.
*The alcoholic is powerless to control his reaction to alcohol.
D. Prenatal Influences
*When a pregnant woman drinks/drugs the fetus drinks/drugs with her.
a. FAS (fetal alcohol syndrome) the children of alcoholic mothers suffer from mental retardation, stunted growth, and facial disfigurement (flattened noses & narrow eyes).
b. When the fetus is subjected to large amounts of alcohol/drugs it may also become addicted while still in the womb, and experience withdrawal symptoms when the umbilical cord supply is severed.
c. The newborn is in fact an alcoholic/addict.
· Years later when he/she takes their first drink/drug, he experiences an instant reactivation of this addiction.
· He will experience immediate tolerance changes, cravings and withdrawal symptoms if they stop.
E. Ethnic Susceptibilities
*Extreme differences in alcoholism rates have been found among various ethnic groups.
a. Jews and Italians have low alcoholism rates, about 1%.
b. Native Americans have extraordinarily high rates, around 80-90%.
*Once again, physical factors NOT psychological, social or cultural factors explain these different ethnic susceptibilities.
*Dr. Bert Vallee at Harvard Medical School studied biochemical and genetic aspects of alcoholism.
a. He isolated fifteen different forms of alcohol dehydrogenase (ADH) liver enzyme and discovered that the number and variety of these enzymes vary widely from person to person.
b. The complex patterns appear to be genetically controlled.
c. Different racial groups have a typical variation of the number and type of these isoenzyme.
d. Each combination of isoenzyme reacts with alcohol differently and determines the person’s specific physiological response.
1. Native Americans were unable to oxidize and eliminate alcohol as quickly as Caucasians.
2. Japanese, Koreans and Taiwanese had aversive reactions (flushing, mild to moderate intoxication) with alcohol doses causing no obvious reaction in the majority of Caucasians.
e. The discovery that a direct relationship exists between the length of time an ethnic group has been exposed to alcohol and the rate of alcoholism within that group.
1. Jews and Italians have had access to large amounts of alcohol for more than 7,000 years and their alcoholism rate is very low.
2. Native Americans who suffer from extremely high rates of alcoholism, did not have large supplies of alcohol until approximately 300 years ago.
*The longer an ethnic group is exposed to alcohol, the lower its members’ susceptibility to alcoholism.
Conclusion: The scientific evidence clearly indicates an interplay of various hereditary, physiological factors (metabolic, hormonal and neurological) which work together to determine the individual’s susceptibility to alcoholism and drug addiction.
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