Archive for July, 2011

What is Alcholism? More of a statistical view

Getting married when you are 18 years old is young, right? Now a days, I would have to agree and say yes.  Back when I got married in the mid 1970s, age 18 would have been a typical age most young women married. Time has passed. Through the years, I have amassed many stories I can tell.   The perfect medium is the Internet via my blog.  I have a lot of life lessons to share.  Alcoholism is but one topic I have gleaned personal experience on.

What is alcoholism?  If you search out medical literature in a quest to find the answer to that question, you would find alcoholism categorized as a chronic disease? Inner turmoil digs in and takes up residence when an individual has little or no information to understand alcoholism. It is that elephant in you life; so big it first overwhelms, then takes over. Alcoholism the ‘elephant’ that takes over your life.  From my perspective, I had the belief that a person could stop drinking anytime they wanted, that is, if they really wanted to, right?  Well, I have learned a lot through the years, rearranged my thinking a bit and educated myself regarding alcoholism and other addictions.

I have been a family participant on more than one occasion when inpatient and/or outpatient therapy was the ultimate resort to address/treat drinking behavior of a family member.  My husband went through inpatient treatment, not once, but twice (you would think he would’ve got it the first time around:).  I have participated as a family member for one of my daughters, who went through an intensive inpatient treatment for alcoholism in additional to an eating disorder. I have been the staunch ‘safe’ person and advocate for my oldest daughter, who sought outpatient therapy after 10 years of self-medicating with alcohol following the tragic accident/death of her 4-year-old son.  My list goes on.  Is there more drama yet to come within my family?  Maybe, but together we can face it.

Alcohol use is divided into two disorders: alcohol abuse and alcohol dependence. Alcoholism, the term typically used by the general public, has a definition that largely overlaps alcohol dependence.  Alcoholism is defined as a primary, chronic disease with genetic, psychosocial, and environmental factors that influence its development and manifestations (The Joint Committee of the National Council on Alcoholism and Drug Dependence).  This would appear to be a lot of verbage utilized to describe a debilitating disease that affects a person, their family and friends.  More simply put, an alcoholic is someone who has the following: impaired control over drinking, preoccupation with alcohol, use of alcohol despite adverse consequences and distortions in thinking, most notably denial.  And, if the ‘stars are aligned right’ with a first degree relative who is an alcoholic (such as your mom or dad), if you have other psychosocial conditions (i.e., depression, anxiety, loneliness, self-isolating) and/or certain environmental factors (loss of a loved one, divorce, no family support, no friends, no job etc), the stage is set for EL the elephant (AKA, alcoholism) to move in.  That huge animal that can overtake your home and space.  He is huge and once he takes up residence in your home, it will take a lot of work to get him out.

Interrelated medical conditions associated with alcoholism are depression and suicide attempts. Excessive alcohol consumption is the third leading preventable cause of death in the US. 70% of attempted suicides by college student involved frequent alcohol use in 1992. The lifetime rate of suicide attempts among frequent alcohol users in the US is 7%, well above the US adult population rate, which is 1%

Interesting and very pertinent to my family is the fact that alcohol abuse and dependence run in families. It is cyclic and unless the cycle is broken, it continues on from generation to generation.   First-degree relatives of individuals with alcohol use disorders have a three to four times higher prevalence of alcohol abuse and dependence than the general population

The literature reports a genetic influence on alcohol metabolism. The exact phenomenon is not known, but the alcohol metabolism may be mediated through the enzyme alcohol dehydrogenase (ADH), which is altered within the brain of an alcoholic making the metabolism, absorption and interactions of ethanol in the brain.  The greatest weapon against this disease is education.


If you think you (or a family member) have an alcohol problem, ask yourself the following:

  • Do you have failure to fulfill role obligations (eg, at work, school or home)
  • Do you have recurrent substance use in physically hazardous situations
  • Do you have recurrent legal problems related to substance use
  • Do you continue use despite alcohol-related social or interpersonal problems

If you have one (or more) of the above, occurring within a 12 month

period, you have a problem.


Do you have an elephant in your living room or in your life?



Acute withdrawal, protracted abstinence and negative affect in alcoholism: are they linked?  Heilig M, Egli M, Crabbe JC, Becker HC Addict Biol. 2010;15(2):169.


The definition of alcoholism. The Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism. Morse RM, Flavin DK JAMA. 1992;268(8):1012.


Genetics and the risk for alcoholism. Schuckit MA JAMA. 1985;254(18):2614.


DSM-IV criteria for substance abuse/American Psychiatric Association



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There is an Elephant in my Living Room


A little over 36 years ago, I would have never dreamt I would have married an alcoholic. Back then, I was in my ‘late teens’ and I had no idea of what an alcoholic was.   Alcoholism, for me, was not the picture of my blonde hair, blue eyed athletic looking ‘soon to be’ husband. Today, I remain married to this amazing man who has weathered his disease through years, alternating between active practice and stages of recovery. I have several remarkable children who have , and continue to, weather their own personal storms that range from alcoholism,  ADHD, eating disorders, depression/anxiety and the repercussions of PTSD.   Life has not been easy for them.  For myself, I have been on an endless quest to figure out this enigma.  I am the co-dependent in my family and as my husband often says, “I just don’t get it”!

I do believe this, addiction, like most things in life, is ever changing.  We all have good days and we all have bad days.  Some days, what is little becomes big like an elephant, and what is big can be little.  It is all in how we look at it. Perspective! Humor! Knowledge! Understanding! Love! Hope!  Just a few words that, when put into practice, give peace.



El  the Elephant

I do not understand addictions. I have been around addictions on the outside, sideways, around the side,  any way you can think of,  but not inside the head of the one who is addicted.  I cannot know or comprehend the inner turmoil, self-loathing, pain and suffering of those who are dependent on a substance or behavior.   The more I think I know, the more I don’t know.  My knowledge and understanding of this myriad of vast dependencies, called ‘addiction’, comes from what I have learned by personal experience (on the job training, otherwise known as flying by the seat of your pants), as well as within my profession that I continue to work in.  I am the outsider looking in.  Within my family I am called a ‘co-dependent’. At my job, I am a listener.

There is a vast spectrum of addictions.  The definition of various addictions seems to evolve as time passes.  For me, what was valid 35+ years ago, is no longer applicable.  Maybe it is my conceptualization of what an addiction is that has modified over time.   No longer do we think of those individuals as a pitiful, homeless person, whose body habitus is emaciated, the physical presentation disheveled and dirty (in the mind of the ignorant, such as me). By all appearances, many individuals who harbor an addictive lifestyle, range in age and represent an array of professions.  Today, there  is not the stigma placed on people who openly take ownership of their addiction.  More people with addictions are stepping forward, acknowledging their disease, along with the effect it has had on them, their family/friends and jobs.  How many high profile people have opening stepped forward, sharing their disease and have sought treatment.   In the past, addictions were hidden, shameful and not talked about.  What is ‘newsworthy’ today?   Dysfunction!  After all, pain and suffering sells. We see this in the reality shows, a funny sitcom, the ‘self-help’ talk shows and in the news.

Have you ever heard the story of the elephant?  Addictions are the elephant.  The story is of a group of blind men and an elephant. Through the years, it has been interpreted in diverse ways. Regardless, it provides a metaphor.  With the story telling, insight to an individual’s perception of truths and the impact of perception are gained.

The synopsis of the story is the tale of a group of blind men who touch an elephant to learn what it is like.  Each one feels a different part, but only part, such as the side or the tusk. They compare notes and learn that they are in complete disagreement. They all differ in their story. As result, conflict evolves.

How does this relate to an addiction?  Where a person is at in their addictive behavior and/or recovery, impacts an individual and his/her happiness and of their family.  Like the elephant story, addiction is ever changing.  Addictive behavior can be a downward spiral or an upward continuum towards recovery, which is constant process, never complete, and ever changing.

Addiction in my family and the effect on all of us, is like the elephant.  Together, we have gone through more than one treatment program, not all for the same person.  The elephant, El (for lack of a better name), lives in our home and at one time, took up the entire house.  We all stepped around this huge, obnoxious ‘animal’ and acted like it was not there.  Today, El remains in our home, but has become an open source of dialogue.

How big is the elephant in your home?


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July 2011
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