Being addicted to alcohol doesn’t make you an alcoholic, said Neal Berger, executive director of The Cedars at Cobble Hill treatment centre in Vancouver.
That might seem contradictory to most. But the distinction between addiction and alcoholism is important, he said.
In the 1950s, McGill University studied a group of people who were asked to drink until they were addicted to the stuff.
“But how many of them had alcoholism? None,” said Berger.
The true sign of alcoholism is after a binge.
“If you asked any of them to do the study again, they would have punched you in the face,” he said.
Normal people act dumb, hurt themselves and crave more alcohol when they’re intoxicated, he said.
“We don’t learn a lot about alcoholics and drug addicts when they’re using,” he said. “The difference is with the person who develops alcoholism at a time when their brain is straight. They can know, based on their history, that if they start drinking it could cause no end of trouble and, for some reason, the brain works in a way that they will drink anyway.”
The physiological addiction to alcohol is not the only thing that makes an alcoholic. It requires the person “have no functional defence against having that first drink,” said Berger.
While alcoholism can seriously damage every organ in the body, it all starts in the brain and the central nervous system.
“You basically trick the brain in a way because, initially, alcohol and drugs give you an effect you’re looking for – an anesthetic effect, or an m.o. to shut down, to not feel,” said Daryl Samson, who works at the Orchard Recovery and Treatment Centre in Vancouver.
“It rewards you and hits the reward-pleasure centre of the brain and it’s absolutely perfect because it works,” he said.
Alcohol is a psychoactive drug classified as a depressant. That means it slows, weakens or shuts down parts of the body’s functions.
Booze has a profound effect on the neurotransmitters that regulate the central nervous system – how you feel, touch and move.
But like any depressant, the neurotransmitters eventually develop a tolerance.
“Alcoholics cross the line with that and that differentiates a drinker from an alcoholic,” said Samson.
A genetic predisposition to having those neurotransmitters more easily affected and the tolerance more quickly developed is the leading indicator someone will develop alcoholism.
Sons with alcoholic fathers are four times more like to drink, said Berger.
“But you inherit risk, you don’t inherit the disease,” he said.
And once alcoholism has developed, there’s little turning back.
“Once you activate the disease, even if it can be held in remission for three months, once you take the drink you have an allergy of the body followed by an obsession of the mind and it says, ‘I need more,’” said Samson.
That’s why the Orchard and the Cedars, which use Alcoholic Anonymous’ 12-step program, believe abstinence is the best treatment.
Harm reduction, which involves lowering alcohol consumption instead of abstinence, is another school of treatment currently used in wet houses and at Vancouver’s Insite Centre, in the case of drug addiction.
While treatments have been around for centuries, Alcoholics Anonymous’ methods have been popular since the 1930s.
In the 1980s, there was a breakthrough in the treatment field, said Berger.
“We found out that the adage, ‘Addicts and alcoholics need to want help in order to get help,’ was just a complete myth,” he said.
The family intervention, a non-voluntary way of beginning treatment, gained adherents.
“That was huge in terms of getting people help,” he said.
In the last decade, increasing monitoring with professionals who are alcoholics – like airline pilots and physicians – began to show strong results.
“The monitoring would go on for two years and, quite often, for five years and when we did that, the relapse rate went down to only five to 10 per cent,” said Berger of his treatment centre’s results.
Now treatment centres are bringing heavier monitoring to other socioeconomic settings.
“We’ve now transferred that into treatment with other groups, like people in safety sensitive positions,” said Berger. “If they’re in noncompliance with their continuing-care plans then there’s going to be consequences, up to and including losing their jobs.”
However, there is little success in treating all the secondary diseases that alcoholism causes, Berger added. Alcoholism-related illness, like cardiovascular disease and cancers, are rarely tackled at once, he said.
And alcohol is involved in 70 per cent of emergency room arrivals between Friday afternoon to Monday morning across North America.
“How often is an addictions specialist called to emerg? Probably never.”
Less quantifiable are the social effects of alcoholics. Violence, sexual abuse, family neglect and crime can all be caused by alcoholic surroundings.
But alcohol has less social stigma than other drugs, making its damage acceptable, even if its affect on the body is heavier than most illegal drugs.
“In terms of coming off these drugs, alcohol is the most dangerous drug we take people off of,” said Samson. “Nobody dies from coming off heroin. Nobody dies when coming off cocaine. But alcohol they do.”
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