Alcoholism - Nature or Nuture?

INTRODUCTION: Alcoholism can affect anyone. It has enormous costs as it pertains to societies, families, and individuals. It is not prejudicial towards any race, color, sex, religion, or economic level. Although we do have ideas as to what alcoholism is, what we do not know is the exact cause(s) of this problem. Researchers are continually seeking answers to the long-standing nature versus nurture debate. Different views are split between a biological paradigm and a physchological paradigm. No one explanation seems to be better than another is. I will present views of the effects alcoholism has on society and an insight to the factors that serve to fuel the nature or nurture debate concerning alcohol abuse and alcoholism. STATISTICS: The abuse of alcohol alone is estimated at $144.1 billion dollars annually. Every man, woman and child in America pays nearly $1,000 a year to cover the costs of unnecessary health care, auto accidents, crime and lost of productivity resulting from alcohol abuse. Alcohol deaths account for approximately five percent of all deaths occurring in the United States. Alcohol is considered to be one of the most widely used drugs as it attacks the central nervous system. Two-thirds of all adults drink alcohol; one-third of those are under the age of eighteen. The term alcoholic is commonly used to refer to a person who is severely dependent on alcohol as a result of their drinking pattern. Not everyone with an alcohol problem becomes an alcoholic. If this is true then what differentiates the social drinker from the alcoholic? A novice explanation would be that social drinkers do not experience problems when they drink, however alcoholics develop a physical dependence on alcohol and lack control over how much they drink and what happens when they drink, resulting in social problems. Can it be this simple? Why doesn't a person just stop drinking when they notice that their lives are in a downward spiral? It has taken society and the medical community a long time to consider alcoholism as a disease. This may be in part because alcohol is used primarily for recreational or social purposes and is not viewed as something that cannot be controlled. CULTURAL: Styles of drinking and attitudes toward alcohol vary across cultures. In cultural groups such as the Chinese, Greeks and Italians, drinking are maintained by social customs. Children are introduced to alcohol at an early age, but are not associated with masculinity or social power. The abuse of alcohol is looked upon with strong disapproval. Conversely the American experience is just the opposite. In colonial America habitual drunkenness was not considered to be an uncontrollable disease. In those days drinking was a social activity that took place in a close-knit family environment. But during the early 1800s drinking moved into the male dominated saloons and alcohol became a symbol of masculine independence and violence. At this point, the rates of alcoholism began to increase dramatically. This was the first sign of what was to become 19th century America's view that habitual drinkers were unable to control their drinking. These early warnings would eventually lead to alcoholism being recognized as a disease. ABUSE OR ADDICTION? Several studies have confirmed that some chronic drinkers can still maintain control even when intoxicated. It is believed this is because when directed towards a goal such as job, family, etc. even the chronic drinker was able to regulate the amount of alcohol they drank. The problem with these studies is that while these chronic drinkers may be able to control their drinking, they are unable to guarantee when they can do so. They soon lose the ability to distinguish social drinking from drinking as a social crutch. As a result these chronic drinkers eventually break promises and commitments to their families and employers. In order for alcohol to become a contributor to alcohol addiction, a person must first use the 'drug' and continue to use the drug. What constitutes use from abuse with alcohol cannot clearly be distinguished. This is because alcohol taken in various amounts affects individuals differently. Some people may be considered an alcohol abuser early in their drinking experiences because of the adverse consequences they go through. From the early days that alcoholism was discovered to be a problem there has been a long-standing debate as to how one becomes an alcoholic? There are two sides of the story...that being that people inherit the trait and the other that it is learned. I will discuss the social aspect of the disease and then move to the genetic factors that may attribute to the problem. SOCIAL: Abraham Maslow describes a security need that is believed to exist in every person. We desire to be part of a group or community. We have a need to be loved, a part of a family, and the need for friends. We actually base our careers on this need as we tend to move places and take jobs based on friends, family, wives, children, social groups, and so on. That being said, people may participate in subgroups that encourage the use of alcohol. This cultural environment encourages, reinforces, maintains and increases the use of alcohol. Examples of this can be seem amongst teenagers who feel that it may be the 'in thing' to drink alcohol in order to be accepted. Alcohol use can also occur where no subgroup support exists. The orientation towards alcohol may have been acquired earlier on in life when the individual took part in subgroups that used alcohol. Some individuals continue their alcohol use long after ending their association with certain subgroups. This was the case for many that grew up in the 60s and 70s where experimenting with drugs and alcohol was the social norm. Some individuals drink alcohol by themselves. Interestingly these people associate themselves with groups who are opposed to excessive drinking. Professionals such as judges, nurses, doctors and lawyers have been documented as being 'loners' in their drinking patterns. Studies have shown that alcohol and drug use can be a result of oppressed social conditions, that being a lack of money, decent schools and sub-standard housing in communities that lack social services. The lack of education directly relates to the attitude that many alcoholics possess the reality that they may be able to only find meaningless work. People who live in these conditions cannot see anything good happening in their environment, thus they drink. Oppressive social conditions and limited economic opportunities are a fact of life for the high concentrations of inner city minorities. I would also like to add that poverty within rural communities, while lacking much of the violence and crime of urban areas, is no less oppressive than the inner city. To define the problem of alcohol to the urban poor would indeed be unfair. A person doesn't have to be a member of a racial or

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