MIND OVER MATTER – bittman alcoholism

Alcoholism: when the problem hits home

by Barry Bittman, MD

While each of us knows at least someone who drinks too much, the overall impact of alcoholism in our nation has been poorly recognized until now.

New findings just reported in the January 2000 edition of the American Journal of Public Health are certain to jar your perspective about this disease. As a physician, I was frankly astounded by the recent National Institutes of Health (NIH) report that 1 in 4 U.S. children is exposed to family alcoholism or alcohol abuse while growing up.

Estimates suggest there are 14 million alcoholics in our nation and that 28 million children live with adults who have alcohol-related problems. When one considers that many of these children tend to develop alcohol-related problems, conduct disorders, emotional disturbances and poor school performance, the serious nature of this problem is easily appreciated.

Factor in the tendency to underestimate the statistics by concealing the embarrassment of alcoholism and the magnitude of the real problem becomes no less than overwhelming. It’s shocking to imagine that in a typical class of 28 students, approximately 7 children return home each day to an alcoholic environment. From an educational perspective alone, one cannot begin to assess the impact on learning and the future development of our nation’s youth.

While it’s difficult to imagine the overall ramifications of the NIH data, it’s easy to understand how such a problem tends to evolve under the surface. After all, drinking is one of America’s best-accepted pastimes. Excess is certainly unclear for many, and the dividing line between social drinking and alcoholism isn’t obvious to everyone. So let’s take a few moments to discuss what we really mean by “alcoholism.”

Basically there are 4 principal symptoms. According to the National Institute on Alcohol Abuse and Alcoholism, these include:

1. Craving¾ the compulsion to drink

2. Impaired Control¾ the inability to limit one’s drinking on any given occasion

3. Physical Dependence¾ withdrawal symptoms such as nausea, shakiness and sweating which occur when alcohol use ceases after a period of heavy drinking

4. Tolerance¾ the need for increasing amounts of alcohol in order to feel its effects.

If one reflects on the above list, it becomes readily apparent that the quantity of alcohol consumed is important. Yet it’s also important to understand that the symptoms are what really constitute the diagnosis. In medicine, this seems to be often overlooked, as health professionals tend to more often focus on the amount of alcohol consumed rather than the overt behavior associated with the practice. Coupled with the fact that many alcoholics deliberately attempt to conceal the disease, doctors are likely to miss the diagnosis, at least early on, in many cases.

Given the limitations of our healthcare system, the question that remains is how to identify the problem in its early stages in order to get the best help possible. You can learn a lot about yourself, a loved-one or a friend by simply responding to a short questionnaire proposed by Dr. John Ewing. Why not take a few moments to answer the following 4 questions?

1. Have you ever felt you should Cut down on your drinking?

2. Have people Annoyed you by criticizing your drinking?

3. Have you ever felt bad or Guilty about your drinking?

4. Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?

It might help to remember these questions by thinking of the word, “CAGE,” spelled by the first letter of each key word in the above sentences. Even one “yes” may suggest an alcohol-related problem. If you’ve responded “yes” to more than one of the above questions, it’s time to speak with your physician or contact your local Alcoholics Anonymous chapter.

While the statistics I’ve presented are highly disconcerting, your personal willingness to seek help has the potential to make a world of difference for yourself and those you love. For family members who recognize the problem, it’s time to stop covering up the issue, denying its existence, or making excuses for behavior that’s destroying what is most important to you. There’s no better time than the present to realize that alcohol is a serious disease that you can conquer¾ Mind Over Matter!