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Alcohol
1. The development stages of alcoholism.
Introduction.
Alcohol abuse.
- repeating using of substances (drinking) resulting with problems with fulfilling duties at work or at school, (e.g. absence at work, reducing effeeness, neglecting children or home, absence at school, suspension or throwing away).
- Repeating usof alcohol (drinking)in situations which pose a physical threat (driving a car).
- Repeating problems with law (e.g. arresting for improper behaviour under the influence of alcohol or another psychoactive substance).
- Alcohol abuse, despite social problems which are the effects of substance (family quarrels, physical violence).
Warning symptoms.
- Reaching for alcohol because it brings relief, reduces stress and anxiety, reduces feelings of guilt, makes falling asleep easier
- Looking for, ating, organising possibilities for drinking, drinking out of need, repeating cases of getting drunk.
- Drinking alcohol despite doctor`s prescription suggesting the essity to restrain from it.
- The ability to drink huge amount of alcohol suggesting the increase of alcohol tolerance.
- Plem with remembering facts.
- Drinking alcoalone: people who used to drink only for social occasions but now they hide drinking.
- Driving a car under the influence of alcohol.
- Avoiding talks abdrinking and reacting with anger or aggression for suggestion the need to limitate the amount of alcohol.
- Reacting with anger when the access to alcohol is difficult.
- Trying to stop drinking in order to prove that you have the control over drinking.
According to Skali(1966) we can differentiate 4 stages of the development of alcoholism.
- Initial: drinkingohol only for social occasions. But the future alcoholic notices that alcohol brings relief. Thus he drinks more often.
- Warning: Alcohol drinks become the kind of medicine which is needed. Drinking alcohol in this stage doesn`t link the person with company. Voften there are some memory deficiencies. During the end of this stage the control over drinking becomes smaller.
- Critical: loss of control, even a small amount of alcohol is a need for drinking more and more.Gradually we can observe lack of critic, false beliefs system starts to form. It is connected with the reasons making us drink. Attention is paid to the problem with getting alcohol. There is a necessity to drink in the morning, in order to be able to work during the day.
- Final: there is the need to drink from the morning to the evening. Drinking lasts few days until physical exhaustion appears. Alcohol toleranc reduced. Psychical degradation occurs. Until alcohol is not drunk there is inability to make simple activities: smoke cigarettes, eat some soup. 10% of alcoholics undergo alcohol psychosis.
2. Why is alcoholism called a disease?
An alcoholic is an ill person.
Bohdan T. Woronowicz, M.D.Ph.D. has been a principal of the Center of Addiction Therapy in the Warsaw Institute of Psychiatry and Neurology for 30 years. He carries on an addiction therapy program in an Unlisted Health Care Facility - the Consulting Center AKMED. He`s been an author of many scientific articles. Moreover, he is the best friend of the AA Groups. Due to his help, in 1980, in Warsaw, the first AA Group was created. At the same time it was the fourth group in Poland. These AA Groups are functioning today.
Mr. Woronowicz, I`ve heard that during one of your lectures someone asked you if there was any difference between a drunkard and an alcoholic. You answered simply: A drunkard drinks because he wants to while an alcoholic drinks because he is ill. However, many people doubt if there is any alcoholic disease or if alcoholics just made it up in order to justify their willingness to drink.
The knowledge concerning the problem of alcoholism is still to weak in our society. I`m very sorry about it because addiction to alcohol is a disease, a disease in which no one is guilty, a chronic disease which at the end may lead to death. As far as scientific knowledge is concerned, it is not possible to fully recover from alcoholism. Specialist from the WHO also share this opinion. However, if we get to know this problem more deeply we can prevent people from many tragedies.
But how can we do this if the disease is incurable?
It is not possible to cure it for ever and in a way that someone who is addicted will never come back to controlled, sociable or normal drinking. However, the disease can be stopped and a non-drinking alcoholic can lead a respected and happy life. Millions of alcoholics in all over the world are able to do this. Of course, just like in case of other diseases, the success depends on proper treatment and the patient`s attitude to this.
Why can some people drink alcohol in small amounts and just occasionally while other people get drunk and can`t live without alcohol?What does it depend on?
There are many definitions of alcoholism. To say it straight addiction to alcohol is a psychical dependence which causes a pressure to drink; it is also a physical dependence (hangovers). Then drinking becomes the main aim of life and other matters and plans are not important. Although drinking causes in alcoholics` lives more and more problems, they still drink. Some people see in alcoholism the weakness of soul, body and mind. The problem of alcoholism usually touches sensitive people who are not able to deal with their emotions. As far as my knowledge and my work with alcoholics are concerned, I have to admit that the beginnings of the disease should be sought in situations in which someone drinks alcohol because he thinks that it will solve his problems. A young man who feels alienated in the society or less important, one day discovers that when he is drunk everything is great. All of his complecis and shyness disappear, he makes friends very easily, he is very clever. Some other one has family or material problems but after drinking some glasses of vodka he becomes free. Another one can`t stand the pressure in work, the competitions or the feelings of danger. He can`t sleep but after a big alcohol drink the world seems less horrible. Such a short relaxation can help to forget about problems. But in fact, problems are still present, moreover, they become bigger and more complicated. After sobering problems come back and become more difficult. And again in order to reduce them a person drinks another amounts of alcohol. It`s like a vicious circle which very often leads to addiction and its dramatic results. It`s no use in trying to find the answer why someone drinks. An alcoholic drinks because of one thing: because he is ill. Because he is a man who became addicted to a chemical substance which consists of 2 molecules of carbon, 5 of hydrogen and hydroxyl group (in other cases he became addicted to medicines or drugs). I want to stress that getting drunk is not a diagnostic symptom of an addiction to alcohol. Not only alcoholics get drunk but also non-alcoholics. There are many alcoholis who has never been drunk. Everyday drinking is not a symptom of alcohol disease. It`s not difficult to meet alcoholics who drink once or few times a year for few days and then for few days, weeks, months and even years abstinent. In the USA I have met an alcoholic who hasn`t drunk for 63 years.
We have said that alcoholism is an incurable disease. It sounds shocking when you call an alcoholic the old man who hasn`t drunk for 63 years!
He is an abstinent because many years ago he decided to stop the development of alcohol disease and he took care about it. If he drank alcohol now, his disease would return again and he would come back to more serious drinking just like these sober years have never existed. Alcoholics who don`t drink sometimes tell about people who are addicted and who many times tried to be sober. About people who undergo therapies, who come to AA Groups and then quit them, about people who alternately drink or do not drink. Some of them will become sober for ever but they will destroy their organisms. The others will die too early because of the disease.
Why is alcoholism a disease?
Addiction to alcohol is a disease because it fulfills 3 criteria: it destroys the balance between health and pathology, it is characterised by etiology, and among the pathological changes there is also a physical factor. Alcohol has an influence on a central nervous system (mainly on a brain)and this reacts on changes in chemical composition of blood (pathophysiological aspect); it is an anatomic base for psychical life (psychological aspect) and it enables the contact with other people who are subject to social impacts (sociological aspect). Psychoactive substances (alcohol also) have an influence on brain by their chemical properties and compete with chemical compounds which are produced by the nervous system in order to communicate inside the neurons system. At the same time these substances destroy brain structure. Neuropathological research showed that in comparison controlled group of alcoholics 30% of neurons in frontal lobes are destroyed. It is very important because these lobes are responsible for higher brain functions (e.g. foreseeing, planning) and forstopping other structures which are responsible for more instinct behaviour (e.g. aggression). It turned out that the brain of an addicted person has some functional deficiency even when there are no structural changes.These facts let us claim that addiction to alcohol is also a brain disease (dysfunctions) which is active no matter if someone is drunk or he is sober. When someone is abstinent the brain only ""sleeps."" According to many researchers changes in the brain are responsible for the remembering about addiction which is eternal. When carring out research on animals it is possible to clear the context of behaviour connected with addiction while other accompanying conditions are permanent.
Is it possible to recover from alcoholism?
Yes - because holding back from alcohol we can get back everything that we lost and even reach a higher emotional and spiritual development than before the disease. Alcoholics who has been sober for many years are evidence for this.
No - if we think about the possibility of controlled drinking because someone who once lost the ability to controlled drinking will never get it bac
The process of becoming an alcoholic as well as the process of recovering from alcoholism has its own dynamics and stages. V. Johnson lists 4 stages on a way to the recovery. I-awareness of the state, II- submission (taking the realities of the disease into account), III- acceptance (of the disease and taking responsibility for recovering) and IV - constant sobering (durability of abstinent behaviour, cultivation of emotional and spiritual development and of relationships with other people). Obsving quality changes in a life of a recovering alcoholic, it is easy to notice, how such a person defeats stages of sobering: I want to drink, I can`t drink, I don`t want to drink. It is difficult to go through the stages alone. That is why it is important to have help from other alcoholics, relatives and professional therapists.
3. The development of alcohol addiction and recovery from alcoholism.
The development of alcohol addiction and recovery from alcoholism.
4. The stages of recovery from alcoholism.
The stages of recovery from alcoholism.
The process of recovering from alcoholism is dynamic.A person who is addicted to alcohol focuses on being sober, obtaining knowledge about oneself and about the disease. He also focuses on learning about behaviour which enables him to be a non-alcoholic. Later he discovers his true needs and feelings, verifies norms and values and the new lifestyle - without alcohol. Next there is a time for the stabilisation of norms and values which is accompanied by emotional calm. It is also interspersed by tendencies to come back to alcoholism but it doesn`t mean the end of abstinence. There is a time for cultivating of achievements and for spiritual development. In this time own limitations are accepted, especially the truth, honesty, friendship. That is why relations with other people are more mature. Such a person can work out the ability to control his own emotional feelings and then critical situations are not such a serious danger for sobering but they become the opportunity to stronger psychical integration. The process of recovery is still progressing. In such a situation there is a question if a person addicted to alcohol should feel ill to the end of life? I know that each answer to this question will be controversial, but I suggest questioning people who have tried to follow the path from opposing to the disease for many years (I can drink until I tell I don`t want to drink). Treating non-drinking not as an obligation (just like it was in the initial period of holding back from alcohol) but like new own need encourages to taking care of oneself. When looking at the way of the development of the disease and the process of recovery, at the change of attitude towards alcohol and towards health, we can take a risk to say that a person addicted to alcohol doesn`t have feel ill to the end of life, although the disease is incurable. In this case it is difficult to talk about recovery. We should look at this like a recovery process which should last for all life, sober life and should lead to the improvement of its quality. The process of recovery may be accelerated by attending the professional program of psychotherapy for addicted people and/or the realisation of the Twelve Step Program for Alcoholics Anonymous.
Based on a Polish book by B.T.Woronowicz,Uzaleznienia, PARPAMEDIA
5. The return of the disease.
The return of the disease.
Lately the word "return" has become very popular. It is used in order to describe cases in which alcoholics quit the abstinency. This word is even used when an addicted person very often drinks alcohol and from time to time stops drinking. "I had the return of the disease" sounds nicer than "Sometimes I have a break in drinking alcohol". So what is the return? Defining it we can say it is a state characterised by the deviation from pro-health behaviour. It is connected not only with quitting the certain behaviour (resignation from chosen behaviour), but also its aggravation. It results in a completely diffrent behaviour than the chosen one. The length of the return is also very important, as well as its intensity measured by the degree of resignation from the chosen aim. Let`s talk about the return of the disease in case of the people addicted to alcohol because it`s a serious problem for patients and for their therapists. This problem concerns more than half of the patients who has undergone treatment. "Taking all of this into consideration, the return of the disease should be treated as to the old patterns of functioning which were present before the start of the treatment (thinking, feeling, behaviour, etc.). All of this can lead to the break of alcohol abstinence. Thus the return of the disease concerns mainly the people who have finished successfully at least the basic therapeutic program and have been using skills gained during the treatment. Any other breaks (before and during the treatment) should be treated as the continuation of drinking or the return to drinking. This return never apperas suddenly and accidentally but it is gradually proggressive. It is a process which started before someone had reached for alcohol. Thus it is possible to interrupt this process and stop the results which are sometimes dramatic. Taking actions will be possible only when the warning signals suggesting the return of the disease will be recognised. Alcoholics Anonymous protect themselves from coming back to drinking thanks to HALT program. (hungry, angry, lonely, tired) AA experience confirms that these states (improper diet, anger, loneliness and tiredness) very often preceedv the return to drinking. Jonathan Swift used to say "Calmness, Diet, Happiness are the best doctors in the world." In order not to allow to the disease it is advisable to:
- list your own warning signals, list specific symptoms suggesting the return of the disease
- compare your state and behaviour with the list of these signals
- ask relatives and friends to observe these signals because addic people have problems with recognising them and usu deny them,< /li>
- have a plan when some signals appear
- taking care of the spiritual development systematically and build and improve the life in sobriety because stopping the symptoms will not allow for the proper process of recovering from alcoholism.
- doubt in a possibility to sustaining abstinence or too much confidence in siety,
- dissatistaction from ""disability"" (it is seen as a necessity to restrain from alcohol),
- thoughts about sociable, occasional and normainking so about controlled drinking,
- doubt in addiction and telling yourself that you recovered from the disease,
- tiredness, depression or tenderness,
- irritability, anger, blaming society for problems and failure,
- irregular sleep, rest or diet,
- dealing with past or future than dealing with yourself,
- isolation tendenturning down help and reduction of number of contactsh friends and therapists,
- renewal of contacts with ""alcohol friends"" and visiting places where they used to drink,
- controlled drinking trials which sooner or later will end in the return of the dise.
How to make a list of your own warning signals?
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describe each signal in a few words,
at the beginning of each signal write a password - a word summing up its essence,
write what to do in case of appearing one of the signal,
show the list to the therapist, AA sponsor or a friend and ask for comments and if they are not able to understand the thoughts exactly- try to rewrite it.
Yoy can also talk it over with friends and ask m for observing if any signals appear.
Read the list every morning and every eveninga and check if any signal appeared.
Based on B.T.Woronowicz,Uzależnienia, PARPAMEDIA
6. Polish AA Groups in Ireland.
Polish AA groups in Ireland.
Galway-Chapel Common Room, Chapel of St Columbanus,
Limerick-Denmark Street, St Michael Church, Tel 857129492-Artur, 0876685370-Bogusia,
Cork-Washington Street, St Augustin Church, Tel.0851335667-Kate,0876469175 Zdzislaw,
