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Alcohol Abuse and Addiction Essay

addictionAccording to the DSM-IV Manual, the Diagnostic Criteria for Alcohol Abuse is, in my own words, as follows:  a pattern of behavior related to alcohol that leads to substantial impairment and suffering.  This condition or pattern of behavior manifests itself in regards to any of four behaviors that occur with in a twelve-month period.

Recurrent drinking of alcohol to help cope with difficulty in fulfilling obligations at home, school, or work is a criterion of clinical alcohol abuse.  This behavior often leads to absence due to drinking, poor performance levels at work, suspensions from school, and poor performance of household duties, such as neglect of spouse or children.

The second criterion relates to the recurrent use of alcohol in situations that endanger the abuser or others around the abuser.  This includes drinking and driving, and operating heavy machinery while under the influence of alcohol.  In my mind, this could extend back to the first criterion, in which the abuser may be caring for a baby or small child while decisions and actions are influenced by alcohol consumption.

The third criterion describes recurring legal situations that stem from abuse of alcohol.  These legal problems can include arrests for alcohol related disorderly conduct, arrests for open containers in a vehicle or driving under the influence, legal matters involving the home, such as divorce or custody battles for children, and domestic disputes which ultimately involve the police.

The fourth and last diagnostic criterion for alcohol abuse involves continued drinking despite obvious recurring social problems that arise or become worse due the influence of alcohol.  This criterion describes situations such as arguments and physical fights with spouse, family members, or friends due to the influence of alcohol.  The DSM-IV Manual relates these arguments or fights to discussion of the consequences of intoxication, but I believe its definition can be extended to include any altercation that occurs due to the presence of alcohol abuse.

While any one of these diagnostic criteria that occur once or more in a twelve-month period can be a sign of alcohol abuse, the DSM-IV makes the distinction that the symptoms must never have met the criteria for alcohol dependence to be regarded as alcohol abuse.

Addiction is a multi-staged process that ultimately ends in dependence.  The first stage is Experimentation, in which a person starts to dabble with an addictive substance without experiencing any negative consequences or emotions.  Often times this stage occurs as a social phenomenon.  The second stage is Misuse, in which an individual begins to experience some negative consequences of substance use.  Although not yet an addict, a misuser may suffer a DUI or some other negative consequence that is a sign of possible addiction in the future.  The third stage is Abuse, in which an individual frequently misuses a substance despite the negative consequences that occur.  At this point, the use of a substance for euphoria or inebriation becomes an emotional escape and is a sign of the possibility of full-blown addiction.  The final stage of addiction is Addiction itself, which can be physical, psychological, emotional, or any combination of these three.  Once tolerance to a substance has been achieved, the individual must consume more to receive the desired effects, which quickly leads to physical addiction.  At this point, when the body must have a substance to continue to function normally, I believe it is safe to say that all three forms of addiction are prevalent.

The physical effects of alcohol abuse and addiction on the body become more serious as the amount of alcohol ingestion increases and as the time-span of abuse increases.  In an immediate sense, at 0.05 blood alcohol level, an individual’s inhibitions become reduced, causing risky behavior not normal for the individual.  At a level of 0.10, loss of muscle control begins.  This will manifest in slurred speech and accidents, such as car wrecks.  As the level of alcohol in the blood increases, memory loss and blackouts occur.  When an individual nears 0.40, the person is seriously impaired to the point of non-function, also known as stupor.  At 0.50 blood alcohol level, the individual is at risk for coma, respiratory failure, and death.

Long-term alcohol abuse can lead to malnutrition due to the consumption of empty calories and a reduced appetite.  Since alcohol destroys liver cells, an individual can develop inflammation of the liver and cirrhosis of the liver.  Other physical affects include:  high blood pressure, increased heart rate, nerve damage, pancreatitis, esophagus bleeding, ulcers, erectile dysfunction in men, fetal alcohol syndrome in women, insomnia, depression, and increased risk of cancer.

Emotionally, an alcohol addict often has a strong desire to reduce or stop the abuse of alcohol.  It can cause many problems in the home, work, or school.  Since the abuse often begins as an escape from failure in these situations, the individual only exacerbates the problems.  This can easily lead to depression and an overwhelming sense of failure in life, which can often cause continued and increased abuse.  Many abusers of alcohol have a tendency towards anger, due to suppressed feelings and the inhibition of behavior.   This can lead to more depression and shame for an individual’s actions while under the influence.

Socially, alcohol addiction leads to risky behaviors that a person would not take part in under normal circumstances.  These behaviors can include fighting in public places or risky sexual encounters.  Some addicts will do the opposite, in which they reduce or stop many of their favorite social activities due to the time spent on acquiring, drinking, and recovering from alcohol.  Some may even lose their jobs, families, and homes due to the time spent with alcohol.

There are many methods for alcohol recovery, some of which are:  Detoxification Programs, Inpatient Treatment, Outpatient Therapies, Therapeutic Communities, and Support Groups.  Detoxification Programs can be found at hospitals and inpatient treatment centers which aid in the cessation of alcohol by helping to reduce severe withdrawal symptoms through the use of sedatives.

Inpatient Treatment helps to develop self-awareness about reasons for drinking and how to develop coping skills to not return to self-destructive behaviors.  Through a stay at a hospital or treatment center, an alcoholic can receive cognitive and physical therapies in a protected environment where there is no access to alcohol.  One example of an inpatient treatment center is the Mayo Clinic.

Outpatient Therapies help addicts through the use of addiction counselors.  The relationship between counselor and addict allows for the creation of treatment goals and behavior modifications while the patient is allowed to stay home and continue to work without interruption to their life.  In this situation, the counselor refers the client to support groups and educational materials and offers counseling to others affected by the alcoholism, such as family and friends.

Therapeutic communities are drug-free centers shared by other recovering addicts with an emphasis on relearning normal social practices.  By allowing patients to leave and return of their own free will, patients can still be employed and enjoy other aspects of life while choosing to recover and discover reintegration procedures.

Support Groups offer addicts a safe place to share their experiences with other addicts.  The most common of these is the twelve-step group Alcoholics Anonymous.  Through fellowship with other addicts in a spiritual setting, alcoholics learn how to function in society without alcohol with the support of discussion groups and talks by speakers whom themselves have used the program to recover from their addictive behaviors.

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