Ethanol or ethyl alcohol is a sedative-hypnotic drug that acts on the human brain like other sedative-hypnotic drugs such as the barbiturates and benzodiazepine tranquilizers(Valium, Xanax, Ativan &etc.). All of these drugs can substitute for one another and prevent withdrawal symptoms from each other. Thus benzodiazepine tranquilizers are commonly used briefly to treat severe alcohol withdrawal.
Ethyl alcohol, like other sedative-hypnotic drugs in its class, can cause physical dependence in anyone who consumes enough of it for a sufficient period of time. The withdrawal syndrome from ethyl alcohol is identical to that for other drugs in the same class such as Valium, Librium, Xanax, Ativan, phenobarbital and other barbiturates(Nembutal, Seconal, Amytal &etc.). Individuals who have been regularly exposed to any of these drugs may develop the following physical symptoms upon abrupt discontinuation or drastic reduction of dosage:
Anxiety, restlessness, irritability and insomnia
Elevated blood pressure, temperature, pulse and respiration
Confusion, hypervigilance and disorientation
Visual and auditory hallucinations, acute psychotic behavior
Grand mal seizures
Infrequently, sudden death
Physical dependence and withdrawal symptoms from sedative-hypnotic drugs such as alcohol will develop in anyone exposed to the drug long enough, regularly enough and in a sufficient dosage if intake is suddenly curtailed.
Physical dependence is not addiction.
Addiction refers to a complex behavioral syndrome including abnormal importance of the drug or activity; use of the drug or activity to an extreme and often harmful degree; continued use or activity despite negative consequences; psychological defenses of denial, rationalization, minimization and projection of blame; and personality changes and life disruption as a consequence of use or activity.
Anyone can and will become physically dependent upon sedative-hypnotic drugs under the right circumstances of dose, duration and discontinuation. Only a small minority of psychologically and physiologically predisposed individuals will become addicted in the sense just described. Physical dependence is easily dealt with by a gradual reduction of dosage which avoids withdrawal symptoms; individuals manifesting the behavioral syndrome of addiction instead or decreasing escalate their drug or alcohol use, disregard medical advice, and consume quantities of their preferred substance far in excess of normal, conventional or even safe amounts, often indulging at times or in places that non-addicts would never think of doing. An addict is someone for whom a particular substance or activity has become harmfully important and who manifests rigid, repetitive and stereotypic behavior in pursuit of a substance or activity or both despite clear indications that he is harming himself and often others by doing so.
The following pages on Psychiatry & Wellness web site provide more information and links on the topic of alcohol addiction. Samples of each article are provided under the link leading to the complete text.
Abraham Lincoln on Drinking and Drunkards
"In my judgment such of us as have never fallen victims have been spared more by the absence of appetite than from any mental or moral superiority over those who have. Indeed, I believe if we take habitual drunkards as a class, their heads and their hearts will bear an advantageous comparison with those of any other class. There seems ever to have been a proneness in the brilliant and warm-blooded to fall into this vice - the demon of intemperance ever seems to have delighted in sucking the blood of genius and of generosity.
" What one of us but can call to mind some relative, more promising in youth than all his fellows, who has fallen a sacrifice to his rapacity? He ever seems to have gone forth like the Egyptian angel of death, commissioned to slay, if not the first, the fairest born of every family. Shall he now be arrested in his desolating career? In that arrest all can give aid that will; and who shall be excused that can and will not? Far around as human breath has ever blown he keeps our fathers, our brothers, our sons, and our friends prostrate in the chains of moral death. To all the living everywhere we cry, "Come sound the moral trump, that these may rise and stand up an exceeding great army." "Come from the four winds, O breath! and breathe upon these slain that they may live" If the relative grandeur of revolutions shall be estimated by the great amount of human misery they alleviate, and the small amount they inflict then indeed will this be the grandest the world shall ever have seen." From Lincoln's 1842 Address. Complete text at link above.
The Addict's Dilemma
"Addictive behavior attempts to repair a state of bad feeling but is a Faustian Bargain that perpetuates itself and often asks the ultimate price. Addiction can be compared to an unhealthy, fanatical love. Unnatural and arbitrary hedonic management by substances or stereotyped processes distorts and cripples the psyche and places the individual at a grave survival disadvantage. The addict is double-minded because he cannot really and truly desire recovery until he already has it. Recovery is about restoring natural, spontaneous and healthy regulation of mood and feelings. Because addicts may be seriously impaired in their pre-addictive self-care and self-management they often require prolonged help learning to feel well without resorting to the "tricks" of addiction." Abstract of article.
Addiction and Its Mechanisms of Defense
"Harmful and ultimately painful addictive behaviors require a bodyguard of lies, distortions, and psychotic denial to fend off the natural corrective consequences of cognitive and behavioral dissonance resulting from addiction. Without such an elaborate and often amazingly sophisticated array of mystificatory and obscuring defenses, the addictive process could not survive for long but would melt like a polar iceberg in Mediterranean seas, destroyed by its innate incompatibility with its environment. But when Benjamin Franklin tersely noted that 'Those things that hurt, instruct' he could not have been thinking of addiction: for it is precisely the lack of instruction in the face of cumulative hurt that suggests the operation of an addictive process concealed and protected by mental defense mechanisms that, having become perverted or detached from their natural survival-adaptive function of protection of the host, now operate as defectors and mercenary troops in the service of an addiction that is at best indifferent and at worst inimical to the prosperity and survival of the individual." From the article.
Addiction, Lies and Relationships
"As the addictive process claims more of the addict's self and lifeworld his addiction becomes his primary relationship to the detriment of all others. Strange as it sounds to speak of a bottle of alcohol, a drug, a gambling obsession or any other such compulsive behavior as a love object, this is precisely what goes on in advanced addictive illness. This means that in addiction there is always infidelity to other love objects such as spouses and other family - for the very existence of addiction signifies an allegiance that is at best divided and at worst -and more commonly- betrayed. For there comes a stage in every serious addiction at which the paramount attachment of the addict is to the addiction itself. Those unfortunates who attempt to preserve a human relationship to individuals in the throes of progressive addiction almost always sense their own secondary "less than" status in relation to the addiction - and despite the addict's passionate and indignant denials of this reality, they are right: the addict does indeed love his addiction more than he loves them." From the article.
Alcohol Addiction: A Psychobiological Approach
"The specific behavior that characterizes alcoholism is the consumption of significant quantities of alcohol on repeated occasions. The subjective motivating factor underlying this behavior is often obscure. When alcoholics are asked why they drink excessively, they will occasionally attribute their drinking to a particular mood such as depression or anxiety or to situational problems. Many times they simply describe an overpowering “need” to drink, variously described as a craving or compulsion. Just as often, however, the alcoholic is unable to give any plausible explanation for his or her excessive drinking(Goodwin 1993). Drinking relieves guilt and anxiety; however, it then also produces anxiety and depression(Davis 1971). The symptoms associated with depression and anxiety disorders, such as terminal insomnia, low mood, irritability, and anxiety attacks with chest pain, palpitations, and dyspnea often occur. Alcohol seems to relieve these symptoms, resulting in a vicious cycle of drinking followed by depression followed by drinking that ultimately leads to a withdrawal syndrome. Sometimes the patient succeeds in stopping drinking for several days or weeks only to “fall off the wagon” again (Goodwin 1981). Despair and hopelessness are common. By the time the patient contacts the physician, they have often reached rock bottom. Their problems have become so numerous that they feel nothing can be done for them. At this point they may finally be ready to acknowledge their alcoholism but feel powerless to stop drinking(Goodwin 1993)." From the article.
Drug Therapy of Alcohol Dependence
"Although the obvious treatment for alcoholism -just don't drink the alcohol!- seems and in fact is quite simple in theory, it is by no means easy in practice for individuals with the medical illness of alcohol dependence.
"The abnormal craving and mental obsession alcoholics have for alcohol causes them to return to it again and again even when their drinking has repeatedly caused terrible problems for themselves and others. Even when they finally reach the stage at which they genuinely want to stop drinking, many alcoholics find abstinence from alcohol difficult or impossible to achieve or to maintain. They may stop for a while only to resume drinking again later, usually with a recurrence of problems followed by another, often unsuccessful attempt to stop and stay stopped drinking. Mark Twain said that "It's easy to quit smoking - I've done it a hundred times." The same applies to alcoholics who stop drinking. Many, in fact most will stop drinking. But relatively few will be successful in staying stopped for a significant period of time. And length of time without a drink is very important for the alcoholic's recovery because time is required for his psychological and physiological(biochemical) processes to begin to return to normal." From the article.
Excuses Alcoholics Make
"By the time a chronic addictive process such as alcoholism has become frankly problematic it has invariably acquired a complex and sophisticated array of psychological defense mechanisms aimed at protecting its continued existence by minimizing the cognitive dissonance the addict experiences as a result of his progressively irrational self- and usually other- harmful behavior." From the article.
The Female Partner of the Male Alcoholic
"Abstinence may be as hard or even harder than drinking for the alcoholic because it reveals so many problems that were obscured by the family’s focus on alcohol. Denial remains as strong as ever as the family has to face the harsh realities of delusion, illusion and collusion that have dominated its reality during drinking and that are now revealed during the period of abstinence. In many families, the entire family system has been organized by alcoholism. Not every couple will or, for their own personal health should survive recovery. (Brown,1999). This could be a time of tremendous personal growth for all individuals involved or it could turn out to be a period of decline. It is this author’s contention that the approach for the female partner is as important in examination as that of the alcoholic himself. As Carl Jung stated:
"Seldom or never does marriage develop into an individual relationship smoothly and without crisis. There is no birth of consciousness without pain(Cambell 1971, pg.167)" From the article.
Getting Away With Addiction?
"Addiction is its own consequence because addiction distorts and stereotypes the psyche of the addict by enslaving the self to a false and unhealthy center -addiction- from which all radii subsequently emanate and around which the circumference of the addicted self is henceforth constructed and maintained. Freedom, flexibility, spontaneity and independence of thought are judgment are lost -actually sacrificed- to the interests and demands of the Idol of the addiction that has become the addict's jealous god. The addict's mind is in a sense no longer his mind but has become an agent and tool, however unwitting, of the addiction whose absolute and fundamentally irrational mandate the addict now exists solely in order to fulfill - even, if necessary, at the cost of his own life. But long before his physical life is surrendered to 'the Cause' of the addiction, the addict has sacrificed his soul and his individuality to satisfy the requirements of the addiction." From the article.
Intervention for Alcoholism and Addiction
"The technique of intervention gives those who care about the alcoholic-addict a tool and a forum by which they can express their concern in a structured, focused format that often leads to the first step in the direction of recovery. A well-organized and properly conducted intervention has been the gateway through which many an alcoholic-addict has passed from a deteriorating existence of addictive misery to a lifetime of healthy and rewarding sobriety.
"An intervention consists of a group of friends, family, co-workers or other important people in the alcoholic-addict's life who present in a non-accusatory way their observations and concerns about the individual's behavior as a result of his alcohol or drug use. This is done in a controlled, objective, and systematic fashion in order to overcome the denial and minimization of the addict and to present a unified front of support and care as the plea and recommendation is made by all present for the addict to get some help to stop his self- and frequently other- destructive behavior with substances." From the article.
Obstacles to Recovery From Addiction
"The principal obstacles to recovery from any addiction are ignorance, shame, dishonesty, and personal exceptionalism.
"Unfortunately for the addict these roadblocks to recovery are almost always cleverly situated and sited like military forts to provide mutual support in fending off all attempts at recovery." From the article.
Prolegomenon to the Metaphysics of Recovery
"Entering the world of recovery from addiction can be like exploring a vast, frightening and unknown continent without maps, guides or landmarks of any kind - despite the fact such such maps, guides and landmarks exist in bounteous plenty if only those in need of them were able and willing to make use of them. But usually it is not so; and the perplexed alcoholic or addict, a rugged and defiant individualist to the end typically insists upon making and discovering his own way. And perhaps at bottom this is the essential nature of the journey, which after all is as unique, individual and personal as the solitary soul making the trek.
"Addiction, both in its active and recovery stages, teaches nothing if not the limitations and boundaries of language and conceptual thought. In the last analysis recovery from addiction, like much if not indeed most of life, is experiential and performative, not abstract and theoretical. Words, ideas, theories, models and concepts can take one but so far. In most cases they serve well enough if they guide the explorer into the general ball park in which his own highly individual and personal discoveries must, if they are to be meaningful and valid, take place through his own frequently trial and error tactics. One learns to ride a bicycle, after all, by getting on the bike and struggling to make it balance and go where he wants, not by studying the craft of bicycle construction or the theory of bicycle riding." From the article.
Resistances to AA Attendance
"Given all of the powerful obstacles and resistances to AA attendance and acceptance, the wonder is not that so many alcoholics refuse to go to meetings or, if they go, decline to return - but that any at all do so and that at least some of these keep going back until they are able to connect with the program and begin to receive help from it." From the article.
What is Recovery?
"Recovery at its simplest and indeed in its essence is about nothing more or less than the recovery of life itself. It is about getting back something of value(life), not merely giving up something that is strongly desired(addiction). For addiction, which seems to be the friend and even the enhancer of life, is in reality its deadliest and most incorrigible adversary. Addiction by its very nature is a form of bondage, even slavery(L. addictere, to be bound to another). Recovery is the recovery of life and of freedom." From the article.
Why Is Recovery So Hard?
"Addiction invades and destroys the self the way a malignant tumor invades and destroys the body. Time is required for this process to develop, just as time is required for a tumor to spread and infiltrate healthy tissue. In the case of addiction, as in the case of most cancers, the longer the process has been underway, the more difficult it is to halt or reverse it. And also like most cancers, addiction may recur and spread further even after initial efforts to treat it appeared successful.
"As time goes on and addiction is continuously active, the self becomes progressively warped, distorted, and organized around the goals of the addiction rather than the normal and healthy goals of the free and growing personality. This resembles the shift from a pluralistic democratic society to a monolithic totalitarian dictatorship. At the extreme limit of the addictive process the individual has become an obvious and often pitiful slave of the addiction and has relinquished or subordinated every other interest and value in his life to his absolute ruler, addiction. But long before matters reach such an obvious stage, the personality has been under the spell of addiction and thus has been directed insidiously toward the goals of the addiction rather than the legitimate ends of the individual himself." From the article.
Worried Sick About His Drinking?
"The wife of the drinking alcoholic believes herself to be in a troubled relationship with the person who drinks too much. But, at least in the more advanced cases, she is actually in a relationship with the addictive process itself. And because the single and absolute goal of the addiction itself is sheer survival of the addiction, no matter how high the human costs may be, her emotional involvement and influence are hopelessly one-sided. Addiction is a natural, biological and fundamentally inhuman process that responds poorly, if at all, to common sense measures aimed at ordinary human rationality, compassion and concern." From the article.
Your First AA Meeting: An Unofficial Guide for the Perplexed
"Practically nobody looks forward to going to their first AA meeting. In most cases this in fact is an occasion of shame, dread and despair. The majority of individuals going to AA for the first time are doing so reluctantly, either because they have promised someone else to go or because they have been directed to attend by a judge, an employer, a therapist or an addictions treatment program. Even first timers who "go on their own" are usually in an intensely ambivalent and negative state. Nobody wishes to require the help that is provided by AA, and as a result virtually everyone attending their first meeting wishes that they were someplace else doing something else." From the article.
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