1.
The person is addicted - they do not get through a day without drinking. If they do not drink, more anxiety returns, than they are prepared to bear .2.
The alcohol drinking has gone on over so long a time, or in sufficiently large amounts that the body organs, particularly the liver, the heart, eventually the brain, are damaged, so that they cannot do their work.
What is the 'normal' purpose of alcohol drinking,
Generally it is to allow convivial meeting between people who are not constantly in touch, but who have to come together on occasions. They may bring with them unresolved anxieties, and this is a time to set them on one side. Alcohol relieves the carrying over period when people have to establish an agreeable meeting, 'to level with each other'.
All cultures seem to have one generally used substance serving more or less the same 'social'function.
Problems can arise when cultures come together bringing different historically acceptable usages of the cultural sunstances.
Cultures use different 'sedatives' and develop different rules of behaviour to govern drinking behaviour or whatever other substance is used
People who work and live in common, are familiar with each other's ways, are usually supportive of each other, and are generally not anxious when together; or they are unable to use alcohol for their anxieties because of the sanction against it, in that particular company.
People are addicted, when the brain is not able to clear itself of having to adapt to 'swimming' in alcohol. The brain adapts to the sedative that is alcohol, by 'pushing up' - upraising its level of 'sensitivity'.
A practical test of addictive alcoholism, is if the brain cannot, overnight, clear itself of the effect of alcohol overnight.
When it does not do this, the person is anxious in the morning, and the normal tremor is exaggerated with 'jumpiness'., till another 'drink' comes along.
A practical test of the alcholism from chronic drinking, is the test of liver and heart enzyme activities, and perhaos the 'queasiness' in eating, perhaps because th stomach lies next to the liver.
Prevention.
Give the brain, enough time free from alcohol [ and its sedative class members,sleeping pills , benzodiazepines- valium - etc ] so as to be able to clear itself of the need to adapt upwards to its sedative effect. In effect this means leaving two to three days in the week when no alcohol is taken: or restricting the amount drunk each day, to a quantitity which allows the brain to clear itself of alcohol overnight. Restricting alcohol consumption to three units and less a day is deemed effective, in doing that.
Some times alcohol is taken to excess as a medicament for temporary flooding anxieties, that have suddenly become worse - e.g worry over weight gain - or a sudden loss of supporting companionship - or the initial anxiety that precedes and accompanies the 'milder' levels of medical depressions.
In general the depression that accompanies alcoholism is not usually that of the medical kind that will respond to the appropriate medication treatment for 'illness' depression.
Treatment
of withdrawal symptoms
These ar an exaggeration of what happens when a night's sleep does not allow alcohol intake to get up to the before night blood level; sensory sensitivity, jumpiness, trembling - the 'shakes ': if untreated by further alcohol or a substitute from the same class of drugs - sedatives, as they all are - then the sensitivity and distraction goes up to hallucinations and disorientation - delirium tremens. When that is untreated there is the danger of brain damage to the memory area - the hippocampus - which can lead to permanent short term recency memory. The treatment is a medical emergency and is the replacemnet of the alcohol level by a sedative substitute - usually valium, sometimes added to by a magnesium supplement. The substitute sedative is gradually reduced and withdrawn, and after-care proceeds to the attempt to prevent alcohol intake for at least over three months duration
The brain 'wave' changes that go with addiction take three months or more - depending on the duration and degree of addiction - to revert to a normal pattern, suggesting that return to addiction is likely if alcohol is taken during these months. So three months abstinence is a 'without which' no progress is possible. After that, the temptation lessens. Generally separation from the temptation, re-inforcd by the opprobrium of those who are setting on the same path - in residential Units, or by taking anatabuse tablets daily under supervision which deters by producing a violently unpleasant reaction when alcohol is taken, due to acetone, histamine etc release - or group pressures in Out Patient meetings, or meetings like Alcohol anonymous etc for those who have moved off alcohol and are afraid they might go back, or who wish to give a good example to others.
There is no evidence that any of these offers of treatment are any better in outcome than others.
Unfortunately Antabuse is rarely prescribed nowadays. The favourite option is empire building for psychotherapy engagements, expensive counselling, and challenges, within a 'specialist' service
Anything which accomplishes an abstinence for threee months plus, has a reasonably good outcome.
Anything less fails.
The supporting necessity is a change in life-style and network.back to Index home page
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