Chapter 13 – Drinking and Alcoholism

The Extent of Drinking and Alcoholism

• Despite the prevalence of binge drinking on college campuses, most Americans do not become alcoholics.
• Alcoholic definition: lost control over drinking and consequently have problems with health, work, or personal relationships.
• About 6% of U.S. adults are alcoholics.
  • About 63% drink alcoholic beverages such as liquor, wine, or beer and are considered moderate drinkers.
  • Moderate drinkers are men who consume no more than two drinks a day and women who consume no more than one drink a day.
  • 37% of adults are teetotalers, which means they are completely abstain from drinking (Blizzard, 2004a; SAMHSA, 2002).
• Americans on a global scale are not ranked with the heavy drinking nations or among the dry ones.
• Moderate drinking had become popular in the 1980’s, but since then abstinence has become more popular and heavy drinking has decreased due to health awareness and dangers of drinking and driving.
• Alcohol is used far more than illegal drugs.
• Alcoholism is one of our nation’s biggest health problems, just behind heart disease and cancer.
• Drunk driving is the number one cause of death among young people ages 16 to 24.

Myths about Alcohol Abuse

• Due to liquor commercial pushing this drug on the masses it isn’t viewed as a serious problem like marijuana, cocaine or heroin.
• Due to the lack of public concern about drinking, a number of misconceptions about alcohol and its abuse have been created for example:
  • Most alcoholics are homeless, but in reality the majority of alcoholics are ordinary people who live with their families.
  • Mixing different kinds of alcoholic drinks does not make a person drunk faster, but what does determines the speed someone gets drunk in is the amount of alcohol and the amount of time it is drank in.
  • Drinking black coffee is believed to help people sober up, but in reality there is no effective  method for getting over intoxication other than waiting for the alcohol to leave the body.
  • A popular misconception is that drinking beer doesn’t lead to alcoholism, but beer drinkers are more likely to become alcoholics because beer is less potent and people tend to drink it for longer periods of time.
  • Lastly, it is believed that sex becomes more exciting after drinking, but alcohol is a depressant rather than a stimulant and because of that a drinker may find it more difficult to perform sexually.

What Alcohol Does to Its Users

• Alcohol has been bringing both joy and grief to humankind.

Mental and Physical Impact

• Alcohol is a depressant that reduces our mental and bodily functioning.
• The general public believes that alcohol cause moral failings, but in fact this is not true.
• What is it that determines the different degrees of intoxication?
  • Muscle density affects the rate of intoxication and because alcohol dilutes in the bloodstream a 100-pound woman cannot tolerate as much liquor as a 200-pound man.
  • The higher the percentage of alcohol in a beverage, the quicker the intoxicating effect.
  • While food in the stomach can weaken the intoxication effect, drinking on an empty stomach does result in a quick absorption and quicker intoxication.
  • Someone that has a higher tolerance for alcohol will become less intoxicated than someone with a lower tolerance.

Health Effect

• A small intake of alcohol can be socially, psychologically, and even physically beneficial.
• Moderate drinkers are generally healthier, live longer, or have lower death rates than abstainers and are less likely to suffer from heart disease.
• Most common damage done to the body by heavy drinking involves the liver and a condition called cirrhosis, which causes premature death.
• Heavy drinking also cause heart disease and strokes.
• Heavy drinking combined with smoking increases the risk of developing cancer in areas that are frequently assaulted by alcohol.

Social Consequences

• Moderate drinking can bring social benefits like sociability and hospitality.
• Excessive use of alcohol helps bring negative social consequences like:
  • High rate of automobile accidents – leading cause of death among young people in the U.S.
  • High rate of criminal offenses – For example public intoxication, driving under the influence, and disorderly conduct.
  • Alcohol is implicated in 42% of all violent crimes in the U.S.

Social Factors in Drinking

• Social factors that impact the use or abuse of alcohol are gender and age, racial and ethnic background, religious affiliation, socioeconomic status, and regional location.

Gender and Age

• Men are more likely to drink than woman.
  • It’s is more socially acceptable for men to drink than women.
  • Younger men are more likely to drink heavier than older man because they are concerned over masculinity image of drinking like a man.
  • Younger women are more likely to drink more than older woman even though they are less concerned with masculinity-related issues.

Racial and Ethnic Background

• African Americans compared to whites as a broad group are less likely to drink but more likely to become alcoholics.
  • They suffer from higher rates of alcohol related diseases.
• Hispanic Americans like African Americans are also more likely than Anglos to drink heavily.
  • It was attributed to machismo, but more recent studies show that machismo affects heavy drinking among Anglos (Neff et al., 1991).
• Native Americans compared to Hispanic and African Americans have more serious problems with alcohol.
  • Higher rates of alcoholic cirrhosis, public intoxication, and alcohol-related accidental deaths.
• Irish Americans have one of the highest rates of alcoholism in the U.S.
  • Irish culture accepts heavy drinking as normal and treats the drunk as a lovable person.
• Italian and Chinese Americans have one of the lowest rates of alcoholism in the U.S.
  • Although both cultures drink often they normally do it with meals or for special occasions.

Religious Affiliation

• American Jews have one of the lowest rates of alcohol problems even though they start drinking at a young age.
  • Moderate drinking is a Jewish trait.
  • Moderate drinking since childhood is a practice that protects them from alcoholism
  • The disapproval of excessive drinking by their peers and support they receive
  • The Jewish make a conscious attempt to avoid excessive drinking even under social pressures.  
• Conservative Protestants such as Pentecostals and Southern Baptists prohibit the use of alcohol by the faithful.

Socioeconomic Status

• People of higher socioeconomic levels drink more compared to people of lower levels.
  • Drinkers of higher social classes seem more likely to use alcohol positively as means to smooth social intercourse.
• There are more problem drinkers and alcoholics in the lower classes.
  • Lower-class drinkers tend to drink negatively as a futile attempt to drown personal sorrows or problems.

Regional Location

• Highest alcohol consumption is in the Northeast.
• The Midwest and the West are intermediate.
• The South has the lowest rates.
  • Urbanized areas have higher consumption rates due to the greater stresses and strains of urban life.
• The South may have the lowest level of alcohol consumption, but they have the highest rate of drunkness.
  • They are less likely to drink than others, but if they drink, they are more likely to become problem drinkers.

A Global Perspective on Drinking

• More affluent societies consume greater quantities of alcohol than do poorer societies
  • Ex: -prosperous Western European and N. American societies consume more alcohol than do SOutheast Asia and Middle East
  • Ex: -France, Germany, Britain consume more alcohol than the U.S. and Canada
  • Ex: -Russians consume the most alcohol in the world
    • Drinking gives them a sense of freedom
    • Because of unemployment, poverty, prices of goods and services have gone up, and thieves and killers have proliferated, social life has become less active. Nowadays people tend to stay home and get drunk.

• Percentage of male drinkers slightly exceeds that of female drinkers
• Alcohol industry marketing to the youth making it look fun

What is Alcoholism?

• World Health Organization (1952): “Alcoholics are those excessive drinkers who dependence upon alcohol has attained such a degree that it shows…an interference with their bodily and mental health, their interpersonal relations, and their smooth social and economic functioning”
•  Problems can be classified into four types:
  • Excessive drinking over an extended period
  • Psychological addiction, an irresistible craving for alcohol
  • Physical addiction, experiencing physical discomfort when drinking stops
  • Alcohol-related problems,such as divorce, car accident, or inability to work because of uncontrolled drinking
• Different labels, including:
  • Alcoholism
  • Problem drinking
  • Chronic drinking
  • Abusive drinking
  • Uncontrolled drinking
  • Alcohol abuse

Becoming an Alcoholic

• Social Drinker
  • First, pre-alcoholic stage
  • Discover their ability to experience some relief from tensions
  • People in this stage can still control their drinking
• Psychologically Addicted
  • Second stage
  • Experience blackouts
    • Blackout in an attack of amnesia or memory loss
  • Have strong cravings for alcohol, will drink alone, a lot and in the morning.
• Physically Addicted
  • Third stage
  • When not drinking they begin to have withdrawls
  • Go on the wagon and end up falling off eventually, to prove a point
  • Begin to blame others for their drinking
• Hitting Bottom
  • Last stage
  • Becomes isolated and withdrawn from others
  • Total dependence
  • Must have a drink in the morning
  • Rarely eat, so they often suffer from malnutrition

College Students and Alcohol

• Binge Drinking in College
  • About 44.2% of college students engaged in binge drinking (2010)
  • Binge drinkers are more likely to run into trouble with police
  • Binge drinking became more of a problem in the 1980’s when the drinking age was raised to 21
    • Drinking before the 1980’s was more supervised
    • Students learned to drink moderately at college sponsored events
• A Social Profile of College Binge Drinkers
  • College binge drinkers tend to have the following characteristics:
    • Being male
    • Being white
    • Aged 18-23
    • Traditional, full time students, never married, and living independently of their parents
    • Having parents with a college degree
    • Engage in risky behaviors, such as smoking pot or cigarettes
    • Being involved in athletics
    • Being fraternity or sorority members
  • Bingers drink to get drunk
  • Four factors of binging
    • Stress from having to work hard for good grades
    • Social pressure to get drunk
    • Adoption of a party centered lifestyle
    • Belief that binge drinking is very common on the campus

Women and Alcohol

• Women are generally more vulnerable to alcohol and less able to hold their liquor
• Why More Women Drink Today
  • Latest national survey, among current drinkers 42% of females are aged 12 or older
  • Increased freedom and power
  • Rates of drinking among women are higher in Western societies where there is more gender equality
  • Women who are white, business executives, unmarried, and young are more likely to use alcohol
• Alcoholism Among Women
  • Women tend not to be diagnosed as alcoholics
  • Doctors often diagnose the problem are merely nerves, anxiety, depression or some other emotional ailment
  • Are prescribed tranquilities, antidepressants and other psychoactive drugs
  • Women alcoholics are twice as likely to be addicted to other drugs besides alcohol
  • At least 25% of alcoholics are women
  • Women are more likely to have a family history of alcoholism
  • Women are more likely to have experienced a stressful event
  • Women have their first drink and first intoxication at an older age
  • Women often drink abusively after their husbands or boyfriends have become heavy drinkers
  • Women drink more at home
  • Women have greater problems with both physical and social functioning, more bodily pain, and poorer physical and mental health

What Causes Alcoholism

• Medical scientist and psychiatrist believe that some people are genetically vulnerable to alcoholism to certain personality traits collectively called the alcoholic personality. And sociologist ascribe alcoholism to a unique set of environmental factors.
• A Biological Predisposition
• Assumed that alcoholism originates from various physical problems such as nutritional deficiencies, glandular disorders, and malfunctions of the central nervous system
• Scientists have been criticized for confusing effect with cause.
• The prolonged frequent, and heavy consumption of alcoholic beverages is very likely to damage the alcoholic’s health, bringing on those physical problems.
• Medical and psychiatric researchers have also argued that alcoholism is genetically determined.
• There is no direct evidence that the biological factor causes alcoholism.
• The biological factor can, at best, only serve as a predisposition to drink excessively, but whether people with predisposition will actually become alcoholics depends on social and psychological factors.

The Alcoholic Personality

• Negative personality traits include being, antisocial, rebellious, egocentric, gregarious, hyperactive, passive-dependent, depressed, anxious, and hostile.
• Alcoholics are also assumed to have weak ego, poor self-concept, low frustration tolerance, and neurotic guilt.
• Personality researchers focus on adults who have become alcoholics rather than using the prospective, longitudinal method of examining children and then reexamining them when they become adults.
• Result, the effects of alcoholism are often confused with the causes.
• Alcoholic’s need for dependency. Need for love – the need for dependence on others. Individual becomes overwhelmed with anxiety which turns a person to alcohol to get rid of the anxiety.
• Power as the cause for alcoholism.
• Heavy drinking can be said to provide an appearance of toughness to make the alcoholic feel like a powerful person. Which suppresses the alcoholic’s anxiety as a dependent person.

• Social and Cultural Forces

• Sociological theory useful for explaining why groups have higher alcoholism rates than others.
• Other theory is social-psychological explaining why some individuals become alcoholics but others don’t.
• Individual difference, factor that turns individuals into alcoholics is the fit between vulnerable personality traits, on the one hand and certain drinking- group values and activities, on the other.
• This fit will come about under the following four conditions.

1. Vulnerable personality features.
2. Drinking is a sign of masculine prowess.
3. Social value that encourages a person to drink like a man also emphasizes the importance of self control.
4. Abusive drinkers encourage each other to drink more and more, until finally they are securely locked into alcoholism.

• Psychologically vulnerable individuals and their drinking peers come together to generate a force that gradually causes the individuals to become alcoholics.

• Explaining group differences
• Three factors work together to create a high rate of alcoholism.

1. The production of acute inner tension in people by their culture.
2. A culturally induced attitude toward drinking as a means of relieving those inner tensions.
3. The failure of the culture to provide suitable substitute means resolving the inner tension.

Controlling Alcohol Use and Abuse

• Alcohol use or abuse has been subjected to various attempts to control it.
• Legal measures one way to control alcohol use involves the coercive power of the law.
• The past
• Prohibition, during the next 14 years, drunkenness did not disappear.
• Prohibition turned out to be such a failure that it was replaced.
• The present
• A crusade against teenage drinking and drunk driving has been quite successful. Organizations such as (Mothers Against Drunk Driving) and (Students Against Drunk Driving) have effectively aroused public outrage at drunk driving for cause of many traffic deaths.
• Drinking age
• Law has reduced drunk driving and fatal car crashes among teenagers.
• Binge drinking along with alcohol poisoning, continues to be relatively common among teenagers
• This problem can be largely attributed to the drinking age law. It unintendedly encourages binge drinking. Which underage young people consume large quantities of alcoholic beverages in private before attending a party or other event in public.

• Therapeutic Approaches

• The therapeutic way of dealing with drinking problems is based on the assumption that abusive drinkers are patients who need help.

• Detox and treatment centers

• Over 20 states that treat alcohol abusers as patients rather than criminals
• Taken to public detoxification centers for treatment. And then, if necessary, sent to halfway houses or aftercare facilities where they are helped
• Unfortunately many who have come out of detox centers or halfway houses will go back in again.
• For alcoholics, who do not violate the public drunkenness law, there are numerous community- based alcohol treatment centers. Theby provide outpatient services, offering hospitalization, psychological counseling and therapy, group therapy, electric shock or nausea- inducing drugs
• A more popular and effective method does not involve any professional therapist, but simply alcoholics and ex- alcoholics themselves.
• It’s the AA (Alcoholic Anonymous)
• AA  is today the largest and most successful organization for helping alcoholics.
• The only requirement for joining is the desire to stop drinking
• Sponsors are recovering alcoholics ready to come to a new member’s aid whenever needed.
• Attending a series of meetings
• Crucial part is that one admits to oneself and other AA members that one is an alcoholic and is powerless over alcohol.
• Can Alcoholics Learn to Drink Moderately?