Abuse of alcohol by non-alcoholics causes more injury and more damage than alcoholism:

Alcohol consumption impairs our safety in the following ways: 1) it slows reaction time; 2) it reduces coordination; and 3) it impairs our judgment about what the consequences of our actions will be and what is right and wrong.

In moderate amounts, no more than one drink per day for women and two per day for men, alcohol consumption can have health benefits. However, people who consume more than one or two drinks in a day put themselves, and everyone around them, at risk of injury or death.

Each year alcohol abuse is a substantial factor in:
  • 17,000 traffic fatalities
  • 1,400 other deaths
  • 500,000 injuries
  • 600,000 assaults
  • 70,000 sexual assaults.
Many of these injuries are caused by non-alcoholics who have a few too many drinks.

Alcohol is a factor in 25 percent (one in four) of the deaths among young people ages 15 to 29.

The physiological story:

Alcohol is a drug, not a food. Instead of being taken apart by the acids and enzymes that digest food, it passes directly through the walls of our stomach and small intestines into our bloodstream. Our bodies rely on enzymes in the liver to break alcohol apart into harmless chemicals. But the liver can process only a small amount of alcohol at a time. The remainder stays in our blood and depresses (stops or slows down) the activity of our central nervous system (including the brain). This is why alcohol slows reaction time, reduces coordination, and impairs judgment. The more alcohol in our bloodstream, the slower our mind works.

When we drink alcohol, we often feel more relaxed and lose our inhibitions. We may talk more and we may do foolish things. This occurs when nerve connections in our brains that would normally stop this behavior work more slowly. Large amounts of alcohol taken in a short period of time can cause alcohol poisoning, a serious and life threatening condition.

    1) Interferes with the ability to judge risk and make sound decision causing increased chances of:

      — accidental injury or death; each year about 5,000 people under the age of 21 die as a result of alcohol abuse and hundreds of thousands are injured; in many of these accidents, the teenager made poor choices that increased risk to a level at which death or injury occurred; (slower reaction time and reduced coordination also play an important role in increased accidents);
      — carrying out a physical or sexual assault;
      — being the victim of a physical or sexual assault;
      — engaging in risky sexual behavior leading to unwanted pregnancies and transmission of STDs, including HIV.

    2) Can cause permanent changes in the structure and function of the developing brain; the judgment and impulse control centers of the brain continue to develop into the mid-20s and alcohol abuse can affect that development (in this way alcohol abuse is particularly more dangerous for teenagers and young adults than for mature adults);

    3) Makes other problems worse, including difficulties at school and at home, as well as problems with the abuse of other drugs and with the law.

Alcoholism -- Mary's Tale:

Alcoholism affects a person's physical and emotional life. Here is a real life example. A woman we know, we'll call her Mary, started drinking when she was 12. She became an alcoholic. For thirty years the benefits of drinking outweighed the costs, including a series of lost relationships, three failed marriages, dropping out of high school, losing several jobs, and untold stress on her body. From the age of 12, any time Mary was in emotional pain she just drank it away.

At about age 45, Mary started having blackouts and waking up not knowing where she was or how she got there. One day she woke up in a hospital emergency room with a broken collarbone and no memory of what had happened. (When Mary realized that her last memory was of walking her beloved dog, she panicked, thinking that the dog was lost. Fortunately, a neighbor had found the dog wandering near Mary's apartment and kept it safe until Mary got home.)

"Hitting bottom" occurs when an alcoholic realizes that drinking alcohol is intolerable and makes a fundamental decision to fight the addiction. Some alcoholics never hit bottom and, eventually, they die of the disease after a life of ruined relationships and lost opportunities. Mary's visit to the hospital with a broken collarbone convinced her that she would die if she didn't do something about her drinking. She looked at her life. At the age of 45 she had no long-term relationships with men, no savings, and no skills. She started going to meetings of Alcoholics Anonymous (AA) and has been "in recovery" for the last ten years.

Mary tells us that when she stopped drinking she realized that in many ways her "emotional age" was around 12. As she explains it, "When I started drinking, I stopped learning how to deal with life. I didn't have to face disappointments or difficulties. I just took a few drinks. My development pretty much stopped at age 12. It's really strange being a 45-year-old teenager."

When we last checked, Mary was doing fine, but she's still working on putting her life back together. She has a new skill, training dogs, and loves her work. Her relationship with her family is much better. She is particularly happy that one of her nephews has forgiven her for biting him when she was in a drunken rage and he tried to restrain her from doing something dangerous. Mary has started taking care of her body and has completed three marathons. She still hasn't mastered the relationship thing and, every day, Mary still wants a drink of alcohol. So, she goes to AA meetings at least 5 times a week, follows the AA program, and lives "one day at a time".

Alcoholism -- some facts:

Alcoholics appear to have a particular chemistry in their brain which sets up an addictive reaction when they ingest the drug. Alcoholism occurs in people from any background and any social or ethnic group. Except for very young children, people of any age can become an alcoholic.

7.5% of the U.S. population can be classified as alcoholics, that is, about 22,500,000 people. This means that during their lifetime, 3 students in a class of 40 or 2 students in a class of 30 will become alcoholics, if they aren't alcoholics already.

Studies show that if you are drinking by the age of 14, there's a 47% chance that you will become an alcoholic.

Alcoholism is a disease that includes five symptoms:
    1. craving: a strong need or urge to drink;
    2. loss of control when drinking: not being able to stop drinking once drinking has begun;
    3. loss of independence from the drug: continued abuse of alcohol despite harm or personal injury;
    4. physical dependence: withdrawal symptoms such as upset stomach, shakiness, sweating, and anxiety after stopping drinking;
    5. Increasing tolerance: the need to drink greater amounts of alcohol to feel the effects of the drug.

Alcoholism is a progressive disease. It keeps getting worse. It may get worse in fits and starts, or people may notice it more at different levels, but it always gets worse if left untreated. Alcohol addiction is usually fatal if the alcoholic doesn't stop drinking.

Warning signs for problem drinking:
• You drink alone when angry or sad;
• Drinking makes you late to work or school;
• Other people tell you they are concerned about your drinking;
• You forget what you did while drinking; or
• You get headaches or a hangover when you stop drinking.

Alcoholism is a family disease:

(This section also applies to drug addiction. Note that 3.3% of the U.S. population, or about 1,000,000 people, have been sufficiently addicted to drugs to need treatment. That's between 1 and 2 students in a class of 40 and 1 student in a class of 30.)

Alcoholism affects the children, spouses, parents, and siblings of the alcoholic.

76 million American adults have been exposed to adverse effects of alcoholism in a family member or a friend. That's of the U.S. population.

One in four kids are exposed at some time before the age 18 to alcoholism or alcohol abuse in a family member.

Alcoholism causes more family problems than any other single factor.

How does a parent's alcoholism or drug addiction injure his or her children? Children need consistent caring interactions with their parents in order to learn how to have trusting relationships with others. A baby needs to know that when it is hungry it will be fed and when it is wet it will be given clean, dry diapers. Older children need to know that they are safe in their homes, that their parents care for them, and that they can rely on their parents. They need to know, for example, that their parents will pick them up on time and that their parents will not lash out at them for no reason. Alcoholics/addicts cannot consistently act in a caring way. They cannot be relied upon. Their commitment is to the feelings that the drug unleashes when they take it. When people are intoxicated their behavior is erratic and they cannot focus on the needs of a child. No matter how much a parent loves a child, if that parent is an alcoholic/addict, there will often be times when the parent chooses intoxication over the child. Not being able to trust their parents, children of alcoholics often have trouble trusting others. The mixed messages they receive from their parents also cause children of alcoholics to frequently have low self-esteem and various psychological disorders.

Symptoms suffered by children whose parents are alcoholics or addicts include: General psychological symptoms:
• fears of abandonment (the parent has psychologically and emotionally abandoned the child);
• difficulties with intimate relationships (the child fears being hurt by those the child loves, just as the alcoholic/addict parent has hurt the child);
• compulsive caretaking of all members of the family (this is an inappropriate role reversal; it occurs when the alcoholic/addict parent abandons his or her caretaking role and the child steps into the vacuum; the child is at risk to repeat this behavior in relationships as an adult);
• compulsive perfectionism in an attempt to please parents (for example, very good grades at school; this can be motivated by a desire to please the alcoholic/addict parent in a vain attempt to convince him or her to stop drinking; it can also be motivated by a desire to make up for disappointments caused to the non-addicted parent by the alcoholic/addict);
• feelings of helplessness (these can be overwhelming when the inability to do something becomes linked in the child's mind with the inability to help the person the child really wants to help, the alcoholic/addict parent or the parent without an addiction);
• feelings of guilt for failing to save either parent;
• uncertainty in knowing how to behave with other people (a child learns to predict behavior in others in large part from learning how to predict the behavior of his or her parents; the behavior of alcoholic/addicts is not predictable and therefore the child cannot learn how to predict behavior from this important source);
• difficulty in establishing relations with teachers and classmates (the alcoholic/addict parent has not shown the child how to establish meaningful relationships with people; for the alcoholic/addict, the most significant relationship is with the feeling of intoxication);
• low self-esteem (the child thinks that he or she is not lovable enough to make the alcoholic/addict parent abandon the addiction);
• behaviors that allow the alcoholic/addict to maintain an intoxicated lifestyle (these are "enabling" behaviors; they occur when the child tries to protect the alcoholic/addict from the consequences of intoxication);
• codependency (the child comes to have an emotional investment in the enabling behaviors and continues them for the child's psychological gain); and
• increased risk to be beaten or sexually abused by the alcoholic/addict parent. Manifestations of the distress (specific symptoms):
• frequent nightmares;
• bedwetting;
• excessive crying;
• loneliness;
• chronic depression;
• problems in school more frequently than other kids; and
• repeating grade levels or dropping out of school.
If children don't receive treatment they are likely to carry problems caused by a parent's alcoholism/addiction into adult life.

Fetal Alcohol Syndrome (FES): Alcohol crosses the placenta and damages the fetus' developing body and nervous system. In the U.S., 40,000 children a year are born with FES. Children with FES have:
• physical deformities to the head and face such as: small eye openings; a thin upper lip; a long flat face; and a long groove in the middle of the upper lip; • changes in the brain;
• loss of stature (being short);
• being underweight;
• difficulties in learning, including short attention span, hyperactivity, poor memory, and poor problem solving skills;
• poor judgment; and
• poor social skills.
The effects of FES are permanent! Women who are pregnant or who are trying to become pregnant should not drink alcohol at all!

Enabling and Codependence: The alcoholic/addict's goal is to live with the addiction, continue the substance abuse, and avoid all the changes and pain involved in the withdrawal process. Alcoholics and drug addicts are continually trying to manipulate family members and friends into: (1) denying that there is a problem and (2) protecting the alcoholic/addict from some of the unpleasant consequences of intoxication. This is called "enabling".

Examples of enabling behaviors are:
• fixing problems caused by intoxicated behavior and helping the alcoholic/addict get out of trouble caused by the addiction;
• cooperating in the alcoholic/addict's denial that there is a problem;
• helping the alcoholic/addict hide addictive behavior and its effects from others;
• providing financial support for the addiction; and
• avoiding making friends or bringing people home who might not be in on the "secret".

It is difficult for family members and friends to know which responses to an alcoholic/addict are nurturing and which are enabling. The agony of family members and friends is that no one wants to see a loved one become homeless, go to jail, become unemployed, or suffer the other unpleasant consequences of the uncontrolled use of intoxicants. However, protecting alcoholics/addicts from the dire consequences of intoxication only helps them continue their substance abuse.

Often enablers continue their behavior even though it interferes with their own life. When enablers stop supporting the addiction, the alcoholic/addict will have to find other enablers or accept a heavy penalty for his or her actions. Hopefully, when the enabling stops, the alcoholic/addict will see that the addicted lifestyle holds no future and will seek help through in-patient treatment or AA.

Sometimes family members or friends grow comfortable being in a relationship with an alcoholic/addict. They can develop an emotional need to enable the addictive behavior even when they sincerely object to it. This is called "codependency" and is itself a psychological condition that needs treatment. Warning signs for codependency in friends and family members include:
(1) encouraging an alcoholic to drink some alcohol but then objecting when the alcoholic becomes intoxicated; (2) putting the needs of an alcoholic/addict ahead of their own; and (3) devoting their lives to caring for an alcoholic/addict.

Al-Anon and Alateen are organizations that help family members of an alcoholic or drug abuser deal with the addict and the family members' reaction to the addiction.

For more, see Codependence in Family Systems with an Alcoholic or Addict -- Enablers in Chief, Family Heroes,Scapegoats, Lost Children and Mascots.

What does "recovery" mean?
Alcoholism is never "cured" in the way that an infection is cured when the microbes are killed. However, there are millions of alcoholics who are "in recovery" and who live normal, productive lives. A treatment program followed by attendance at AA meetings can help alcoholics give up their drinking. People "in recovery" from alcoholism do not pretend to have beaten the disease. They must work hard day by day to stay "in recovery". This is what is meant when recovering alcoholics and drug abusers say that they are living "one day at a time". In AA they have a saying that entering recovery is the beginning of a new life, a life that is not dominated by the drug.

Alcoholism has a genetic component:
Children of alcoholics are about four times more likely than the general population to develop alcoholism or problems with drinking. Scientists believe that there are both genetic and non-genetic components to the transmission of alcoholism. The drinking behavior that children see at home and the attitudes toward alcohol expressed by parents and older siblings, in addition to genetics, influence the way that children drink alcohol. Having an alcoholic parent does not mean that a child will become an alcoholic. More than 50% of children with alcoholic parents are free of the disease.

Conclusion: Moderate use of alcohol, no more than one drink per day for a woman (unless she's pregnant or trying to get pregnant) and two drinks per day for a man, can be part of a healthy lifestyle. However, any more than that puts the drinker and those around the drinker at great risk.

Sources for this article and further research: U.S. Centers For Disease Control and Prevention (CDC): Alcohol: Frequently Asked Questions; Website of the National Institute on Alcohol Abuse and Alcoholism and NIAA Study: One in Four Children Exposed to Family Alcohol Abuse or Alcoholism; Co-Dependency from; Surgeon General's Call To Action to Prevent and Reduce Underage Drinking - A Call to Action for Educators

This article on Alcohol and How it Affects Us was written by James Frieden.