The Internal Need for Alcohol

Alcoholism is a very serious problem that is more common than what most people would expect. Alcoholism is a chronic, a progressive, potentially fatal disorder marked by excessive and usually compulsive drinking of alcohol leading to psychological and physical dependence or addiction (Definition of ALCOHOLISM, 2018). Just in my life alone, I know 6 people that identify as alcoholics, and possibly more that aren't aware or are secretive of their alcoholism. This count includes close family members, friends, and even myself. Substance Abuse and Mental Health Services Administration (SAMHSA) defines heavy alcohol use as binge drinking on 5 or more days in the past month, and defines binge drinking as 5 or more alcoholic drinks for males or 4 or more alcoholic drinks for females on the same occasion. SAMHSA also states that only 2 in 100 people drink within the low risk range (Drinking Levels Defined | National Institute on Alcohol Abuse and Alcoholism (NIAAA), 2018). Alcohol starts to become a problem when it interferes with relationships, careers, school, and other responsibilities. Unfortunately, most fail to recognize that they have a problem until one of those has been negatively affected. Alcoholism is a very complicated issue that has many different causes, outcomes, and signs of onset, each specific to the alcoholic. It is impossible to examine every cause and outcome, but we can at least elaborate on the main points. Alcoholism is a very serious and life ruining disorder that can even end in death.

The Internal Need For Alcohol

Alcohol can be very appealing for many reasons. Some people use it as a coping method, for fun, to fit in, and many other reasons that are specific to each individual. In most cases, alcohol is abused to self-medicate for depression or trauma. Alcohol itself is a depressant and therefore dulls the senses. People with depression can, in a sense, use alcohol as a way to dull their depressed feelings and ignore them. The problem with using alcohol to mask depression is that although alcohol may seem to be helping in the short term, it can actually make depression worse in the long term. Coping with depression with alcohol essentially creates a cycle of alcohol abuse to cure depression and depression caused by excessive alcohol use.
According to a study by Susan M. Hannan, individuals with a history of childhood sexual abuse (CSA) are more likely to experience both revictimization in adolescence and Post Traumatic Stress Disorder (PTSD) symptoms in adulthood, which may lead to alcohol-related problems via drinking to regulate emotional experiences, (Hannan, 2017). 579 women were the subjects for this study. There was a significant difference within those 579 women that showed that those who were sexually abused had an increased chance of developing alcohol abuse. The study further supports the idea of alcohol being abused as a way to cope with their trauma.

Post Traumatic Stress Disorder (PTSD) is a psychological reaction occurring after experiencing a highly stressing event (such as wartime combat, physical violence, or a natural disaster) that is usually characterized by depression, anxiety, flashbacks, recurrent nightmares, and avoidance of reminders of the event (Definition of Post-Traumatic Stress Disorder, 2018). Similar to depression, Post Traumatic Stress Disorder (PTSD) can also cause a false need to cope with alcohol. In the same sense as depression it is used as a way to dull the senses, and specifically, the memories and the pain of the memories from PTSD. According to the U.S Department of Veteran Affairs, Sixty to eighty percent of Vietnam Veterans seeking PTSD treatment have alcohol use problems, (NIMH - PTSD, n.d.). With there being such a high correlation between PTSD and alcohol abuse, it can not be assumed that there is a mere coincidence.
As stated earlier, alcohol abuse can also be a result of peer pressure. Many people use alcohol for the first time when in high school, which is also when we are usually very malleable to peer influence.

We are afraid that if we don't partake in drinking with our friends that are drinking then we may not fit in and possibly excluded from the group. Teenage alcohol use is also a very serious matter because the group mentality can lead to excessive drinking as a way to impress our friends. In addition, the prefrontal cortex is not fully developed until the mid-twenties and instead we rely on the amygdala to make decisions, which is a big reason we aren't legally allowed to consume alcohol until we are 21. Unfortunately, our amygdala is also what codes for our impulses. Adolescents are then not making responsible adult choices on the bases of drinking and may possibly decide to drink and drive, break the law, start fights, or drink more than they can handle. There are many causes to why alcohol is so appealing to some people, but each cause results in the same negative endings caused by alcohol abuse.

How Alcohol Maintains Its Control

Someone who is addicted to alcohol usually remains addicted due to a chemical and emotional dependence that is formed after repeated alcohol abuse. A chemical dependence develops because the body rewires itself to require alcohol to function. After long-term alcohol abuse, our bodies recognize alcohol as a recurring substance, thus rewires itself to use alcohol as a nutrient and produces more chemicals used in the breakdown of alcohol. There is also an emotional dependence formed from long-term abuse of alcohol. Once alcohol is used as a coping method, we learn through operant conditioning that alcohol makes us feel better. We subconsciously begin to think that alcohol is a cure all method to anything that brings us down. In time, the alcohol dependence manifests itself to the point where without alcohol, normal everyday issues seem insurmountable, and thus continuing the cycle.

Treatment Options

Alcoholism is a serious problem, but luckily there are many treatment options to help those suffering from it, and they have the possibility of getting back to a healthy and happy lifestyle. Recovery is possible, but overcoming alcoholism is difficult. Less than half of individuals relapse after achieving one year of sobriety. That number reduces to less than 15 percent who relapse after five years of sobriety (Galbicsek, 2018). For many, long-term sobriety is essentially a lifelong process. There is a greater risk of relapse if you don't go to or stop going to support groups or continue with counseling, even after years of sobriety. According to Galbicsek, there are some warning signs for when it may be necessary to seek treatment. These signs include frequent binge drinking, shifts in mood, poor performance at work or school, making excuses for neglecting responsibilities, denying their excessive alcohol use, acts of violence or crime, and decreased interest in hobbies. These warning signs are general and don't apply to everyone, and getting help is important even if none of these symptoms show.
The first step in treatment is alcohol detox, which is said to be the first and hardest step of the process. Detoxing involves eliminating the alcohol completely from the body. Because of the the dangers associated with detoxing from alcohol, it must be done in a medical setting. The next step is inpatient rehab, which is a structured treatment setting, usually requiring a 30, 60, or 90 day stay. The provided living environment is helpful to a lot of people because they are under constant care and watch. Treatment specialists provide you with information on how to stay sober in everyday life for once the program is complete.

Another type of treatment is called alcohol counseling, which is exactly what it sounds like. The patient meets with a counselor who is specialized in alcoholism, and is able to work on sobriety, and the underlying issues. This is helpful to learn triggers that the person might not have even realized existed. In the United States, there are a variety of government services that aim to help combat alcoholism. The most common one is called the Substance Abuse and Mental Health Services Administration (SAMHSA). They provide an abundance of information and act as a treatment referral service.

The three broad stages of the long process of recovery are treatment, rehabilitation, then maintenance. As mentioned above, maintenance is very important to ensure a long-term recovery. In a rehabilitation program, you don't really have any other option besides not drinking. When re-entering everyday life, chance of relapse is high especially without a form of maintenance for their sobriety.

The Dangers of Alcohol Withdrawal

Withdrawal basically means to remove, or to take out. Withdrawal symptoms happen when alcoholics stop drinking because their body develops a dependence to alcohol from being exposed to it frequently and or in large amounts. When your body is cut off from alcohol suddenly, unpleasant symptoms emerge as the body tries to figure out what chemical is missing. Alcohol suppresses certain neurotransmitters in your brain that make you feel at ease after drinking. After quitting the neurotransmitters are no longer inhibited by alcohol, so it causes hyperexcitability, the reason withdrawal symptoms affect you differently than alcohol consumption (Treating Alcoholism, 2018). Withdrawal symptoms can begin as soon as two hours after your last drink, and often peak between the first day or two. The first 24-48 hours are the worst of withdrawal because your body is simply very confused due to a built dependence. Symptoms during this time include insomnia, rapid heartbeat, changes in blood pressure, tremors and fever. Severity is different for everyone. One of the most severe side effects is a condition called delirium tremens. It consists of confusion, shaking, hallucinating, and high blood pressure. This is not so common, but it can be fatal. This shows the importance of being in a medical setting when seeking treatment because trained professionals can provide you with medications to make the process easier, and potentially even save your life in serious cases. Figure 1, below, shows the common timeline for initial alcohol withdrawal, as provided by Galbicsek.

Figure 1: The effects of alcohol detox after the last sip of alcohol (Alcohol Withdrawal, 2018)
One form of withdrawal is called acute alcohol withdrawal. This is a sudden onset of severe withdrawal symptoms. Acute alcohol withdrawal often happens in the first few weeks of sobriety. In this period, the sufferer is at most risk of temporary loss of consciousness, delirium tremens, or seizures. This is again another reason why recovery should always be done in a medical setting. Alcoholism is extremely serious and quitting cold turkey can be life threatening, especially without professional supervision. Another category of withdrawal is post-acute withdrawal symptom (PAWS), which is prolongation of side effects. This develops after acute withdrawal and can make life extremely difficult for some after they leave rehab. PAWS can last a range of time, from a couple weeks to an entire year. Symptoms of PAWS are irritability, anxiety, low energy, trouble sleeping, memory problems, dizziness, increased accident proneness, and delayed reflexes(Alcohol Withdrawal - Learn the Symptoms and Signs, 2018). Luckily, there are also some treatment options for withdrawal symptoms themselves. Inpatient treatment, outpatient treatment, medication-assisted therapy, individual counseling and support groups are all choices for those suffering from withdrawals. These programs each offer a variety of services to help people overcome these symptoms along the journey of recovering.

My Personal Experience Battling Alcohol Abuse

The struggle with alcohol abuse has been a very serious and difficult journey for me. My first sip of alcohol was in 11th grade, which compared to many other people my age, I was slightly late to the trend. I would always tell myself that I would never be consumed by alcohol or let it run my life, as I have seen with other family members. It's an easy thing to say when young, dumb, happy, and free. I went through a traumatic experience my second year of college and from that point, it has always been hard to drink responsibly.

At my bottom, I was up to 13 beers every night. My alcohol abuse had affected my relationships with my friends and family, resulted in my lowest GPA in college, and I was calling out of work all the time because I was hungover or had the need to drink. Also, due to my excessive alcohol use, most of my money was going towards alcohol rather than other necessities and I even had to cancel a trip to Montreal with all my childhood friends because I had used my savings for that trip to instead buy alcohol. I was using alcohol as a way to forget and ignore the depression and hurt that I had been dealing with. The saddest part was that my mom and sister, both on separate occasions, were crying about what I had become. Looking back, I hated what alcohol did to myself, but mainly that I let it do that to me. No matter how strong someone is or the life they come from, addiction can take over and if not contained, can possibly run your life, if not end it.

Conclusion:

In the end, alcoholism is a very complicated and ill-defined term that is not given the seriousness it deserves. There are many causes that bring about alcohol abuse and each individual is unique in the way that that experience influences their excessive alcohol use. This disorder ruins lives, careers, families, friendships, and self-esteem. It can do so so easily because it sneaks up on you and most times isn't plain to see until it has resulted in something negative. There is hope however thanks to many groups like AA or sanctuaries for alcoholics to seek help like rehabilitation centers.
Alcoholism and alcohol abuse is a very serious and massively overlooked issue and I was lucky enough to reign in on my alcohol abuse and break free from its control, but the sad truth is that many people aren't as lucky as I was.

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