THE ETIOLOGY OR CAUSES OF ALCOHOLISM/PROBLEM DRINKING

Over the years there have been many theories as to the cause of alcoholism and what it is. In the past it was considered a sin, moral weakness, or lack of willpower.

Today it is considered a disease, chronic condition, or addictive behavior or disorder. Alcoholism, like cancer, is probably a number of different illnesses and conditions, and different things may trigger the condition in different individuals.

At present, various research reports suggest that alcoholism is caused by physiological, psychological, and sociological factors with no simple answer as to its etiology.

Physiological Theories

Genetic. Some types of alcoholism appear to run in families and are thought to be genetic in origin. As mentioned previously, studies in Denmark showed that when sons of alcoholics were adopted by non-alcoholic families, they were just as likely to become alcoholic as those reared by their biological families.

It is estimated that about 25 percent of the alcoholic population may have inherited a behavioral propensity that increases their risk for alcoholism.

Individuals manifesting this propensity are often rebellious, attention seeking, manipulative of people, impulsive, egocentric, and liable to abuse or overdo all types of substances and activities.

Stress. Some types of alcoholism are thought to be an adaptative mechanism in the response to stress. An individual under stress often feels anxious, tense, angry, lonely, bored, and/or nervous.

Drinking alcohol sometimes appears to reduce these negative feelings. This may then lead to a pattern of using alcohol in order to reduce these uncomfortable feelings when the individual confronts a negative experience.

Abnormal Metabolites in the Brain. A theory of the cause of some forms of alcoholism is that some individuals have an abnormal metabolite in the brain that may produce the addictive state in response to consumption of alcoholic beverages.

Genetictropic Theory. Genetictropic theory combines the concept of genetic trait and a nutritional deficiency. It is postulated that because of an inherited defect of metabolism, some people require unusual amounts of some essential vitamins.

Since they do not get these amounts in their normal diet, these people have a nutritional deficiency that results in an abnormal craving for alcohol by those who become acquainted with it. Some research indicates that when rats are fed diets deficient in the B vitamin group, they prefer alcohol to water.

Endocrine Theory. Endocrine theory suggests a dysfunction of the endocrine system. Similarities between alcoholic patients and patients with endocrine disorders suggest that some failure of the endocrines might be related to the onset of alcoholism. Experimental clinical evidence does not provide much support for this theory.

Psychological Theories.

Psychoanalytic Theory. Psychoanalytic theory in a Freudian framework explains the cause of alcoholism as self destruction, oral fixation, and a latent homosexual struggle for power. The view that alcoholism develops as a response to an inner conflict between dependency drives and aggressive impulses is also considered a cause by other psychoanalytic writers.

There is some evidence to suggest that frustrated ambitions may play a role in the development of an alcohol problem, as alcohol provides a sense of power and feeling of achievement. However, few studies have been carried out that confirm these theories.

Learning Theory. Learning theory explains alcoholism as being a learned behavior strengthened by reinforcement. Alcohol ingestion is considered a reflex response to some stimulus as a way of reducing boredom, anger, anxiety, loneliness, or depression.

Personality Trait Theory. Some research has attempted to define the causes of alcoholism in terms of an "alcoholic personality." Some of the characteristics found among alcoholics are low frustration tolerance, feeling of inferiority, fearfulness, and dependency.

Much research has attempted to identify an underlying personality disorder. However, being able to predict alcoholism by personality characteristics is still difficult.

Sociological Theories

Cultural Theory. Most cultures have used alcohol, yet different groups have higher rates of alcoholism than others. North Americans, northern French, Poles, Russians, Swedes, Swiss, and Irish, who tend to drink for the sake of drinking, have high rates of alcoholism.

Chinese, southern French, Greeks, Italians, Jews, Portuguese, and Spaniards, who tend to drink in religious celebrations or with the family, tend to have lower rates of alcoholism.

It is thought that the attitude toward drinking held by a culture, the degree that the culture provides suitable substitute means for satisfaction, and the degree to which a culture operates to reduce inner tensions or acute needs for adjustment for its members may influence the rate of alcoholism.

Deviant Behavior Theory. Alcoholism is viewed as deviant behavior by some. According to this theory, the alcoholic is a person who through a set of circumstances becomes publicly labeled as deviant and is forced by society's reaction into playing a deviant role.

In societies in which drinking customs, values, and actions are known and agreed upon by all members of the group, there is a lower rate of alcoholism than in societies in which there is no consensus of opinion on what constitutes responsible drinking.

Heredity Plus Environment Theory. This theory postulates that an individual is born with a genetic trait to become an alcoholic, and depending upon the family environment, he/she may or may not develop the condition. This is different than the "genetic" theory in that environment has an influence upon whether the person will become an alcoholic.

Individuals brought up in a warm, supportive emotional environment may not develop the condition, whereas persons raised in psychologically abusive or stressful family environments may readily develop the disorder. In summary, there is no generally agreed upon single cause of alcoholism, or, for that matter, of any other addictive behavior. See Section Nine for details concerning other addictions.

Co-dependency

Since alcoholism is often considered a family disorder, disease or dysfunction, a highly debatable condition called co-dependency has been suggested by some. Others feel that we are all co-dependent and this so called condition is a passing fad.

The co-dependent may be a spouse, parent, child, or close friend. Co-dependents are thought to have emotional problems of various degrees of severity. They develop these problems from long-term interaction with the alcoholic individual, especially as a child (See Appendix A for the CODE test).

HUMAN SEXUALITY AND ALCOHOL

Pregnancy. The fetal alcohol syndrome, in which babies born to women who are chronic heavy drinkers or alcoholics are deformed, has become widely discussed during the past few years.

The defects include mental retardation, small head, tremors, and other abnormalities. It is estimated that if a woman consumes below 2 ounces of 100 proof whiskey a day during her pregnancy, the chances of her drinking causing birth defects in her child are low.

If, however, she drinks between 2 and 4 ounces a day, the risks are 10 percent, and if she drinks 10 ounces a day or more, the danger of producing a child with abnormalities could be 50 percent or higher.

Sexual Activity. The drinking of small amounts of alcohol can lower inhibitions and make the person more relaxed and more apt to engage in social and sexual activities tht he or she might not engage in while not intoxicated. However, too much alcohol in males causes an inability to maintain an erection.

In persons with chronic alcoholism, there is degeneration and dysfunctioning of the sex glands and increased sex problems in both men and women.

SELF RESPONSIBILITY FOR ALCOHOL CONSUMPTION AND PARTY HOSTING

Responsible Choices Concerning Drinking

We are a nation of drinkers. About 80 percent of university-aged individuals reading this book drink at least once a year.

Drinking, like eating, or any social activity, has some guidelines to help the participant get more enjoyment out of the activity.

    [Photo: Bruce Willis and Halle Berry in "Perfect Stranger".]

Gobbling down half a chocolate cake at a party would not be considered responsible eating or even polite. The same goes for drinking. Responsible choices concerning drinking may mean not drinking, such as when a person is sick, taking medications or being the designated driver.

Responsible drinking means that you never have to feel sorry for what has happened while you were drinking. Basically, this means not becoming drunk. The following are some hints to help you drink responsibly and derive more enjoyment and pleasure from drinking if you choose to drink.

1. Know your limit. If you do not already know how much alcohol you can handle without losing control, try it out one time at home with your parents or roommate present. Explain to them what you are attempting to learn. Most people find that no more than a drink and a half per hour will keep them in control of the situation and avoid drunkenness.

2. Eat food while you drink. It is particularly good to eat high protein foods such as cheese and peanuts, which help to slow the absorption of alcohol into the circulatory system.

3. Sip your drink. If you gulp a drink for the effect, you are losing a pleasure of drinking, namely tasting and smelling the various flavors. This is particularly true for wine.

4. Accept a drink only when you really want one. At a party if someone is trying to force another drink on you, ask for ice or drink an alternative beverage.

5. Cultivate taste. Choose quality rather than quantity. Learn the names of fine wines, whiskeys, and beers. Learn what beverage goes with what foods.

6. Skip a drink now and then. When at a party, have a nonalcoholic drink between the alcoholic one to keep your blood alcohol concentration down. Space your alcoholic drinks out to keep the desired blood alcohol concentration.

7. When drinking out, if you must drive home, have your drinks with dinner, not afterwards. This allows time for the alcohol to be burned up and for it to be absorbed slowly into the circulatory system.

8. Beware of unfamiliar drinks. Such drinks as zombies and other fruit and rum drinks can be deceiving, as the alcohol is not always detectable, and it is difficult to space them out.

9. Make sure that drinking improves social relationships rather than impairs them. Serve alcohol as an adjunct to an activity rather than as the primary focus. Have a German night party rather than just getting together to drink beer.

10. Appoint a designated driver. Have someone available who will not be drinking and will drive all drinkers home.

11. Use alcohol carefully in connection with other drugs.

12. Respect the rights of individuals who do not wish to drink. It is considered impolite to attempt to get people to drink who do not wish to. They may abstain for religious or medical reasons, because they are recovering alcoholics, or they just may not like the taste and effect it has on them.

13. Avoid drinking mixed drinks on an empty stomach on a hot day. This might produce hypoglycemia, which can cause dizziness, weakness, and mood change.

Responsible Hosting

Most people love to go to parties, and most find that parties are fun to give. The following tips for being a responsible host will give more pleasure to you and your guests.

1. Plan people movement. Make sure that people can move around and meet each other. If it means putting the sofa in a corner, do so.

2. The bartender. If you plan to have a friend act as bartender, make sure that he or she is not an eager pusher who uses the role to put an extra shot in every's glass.

3. Pace the drinks. Serve drinks at regular, reasonable intervals. A drink-an-hour schedule usually means that good company prevails.

4. Don't double up. Many people count and pace their drinks. If you serve doubles, they will be drinking twice as much as they planned. Doubling up is considered rude.

5. Push the snacks. Make sure that people are eating along with drinking.

6. Don't push the drinks. Let the glass be empty before you offer a refill.

7. Serve nonalcoholic beverages also. Remember that one out of five university-aged individuals chooses not to drink. Make sure that you have something nonalcoholic to drink. If you are having a kegger, also include soda pop on ice.

8. Closing the party. Decide, in advance, when you want your party to end. At this time, stop serving alcohol and serve coffee and a substantial snack. This provides some nondrinking time before your guests drive home.

Alcohol has been used by most cultures and if you do chose to drink, please do so in a responsible, safe, and healthy way.

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Adapted from Engs, R.C. Alcohol and Other Drugs: Self Responsibility.