Introduction
In the age-old debate regarding the relative merits of alcohol, one of the most difficult issues has been the determination of what exactly causes some people to drink to such excess that they lose their reputations, their careers, their families and even their lives in their devotion to the substance. A number of theories have been brought forward over the years, many of which tend to place the blame for alcoholism on the weak will of the individual.
Alcoholics are widely accepted, even among the alcoholics themselves, as having some deep form of psychological issue that they are not able to deal with. As a result, they seek to drown these issues in an alcoholic fog. However, more recent science has suggested there is another, deeper cause to alcoholism that can only be found in the genes. In the book Beyond the Influence by Katherine Ketchum and William Asbury, the authors present their proof that the disease of alcoholism is a physiological disease rather than a psychological disorder.
The psychological disorders typically associated with the disease, they contend, are the effects of alcoholism on the brain rather than the other way around. The authors use scientific data to prove that alcohol affects different people differently based upon their unique genetic make-up by illustrating how it affects the alcoholic as opposed to how it affects the non-alcoholic.
Rather than attempting to provide the alcoholic with an excuse for his or her behavior, though, the focus of the book is on understanding the process of the illness and the various ways in which it might manifest itself in different individuals. In presenting this material, they enable individuals such as myself who have had some difficulties with alcoholism understand why it has the strong effect it does and provides some help in learning more about how to return to a more normal life pattern.
Main Body
The book begins by attempting to debunk some of the more common myths associated with alcohol. In relating the story of Terry McGovern, they seem to be attempting to point out They point out that each human body responds to different substances differently and alcohol is no exception to the rule. They call it a “selectively addictive drug” and insist that alcoholics have “basically the same psychological problems as non-alcoholics before they start drinking, but these problems are aggravated (and new disturbances are created) by addiction to alcohol” (5).
Because of the unique effect alcohol has on the brains of those who are genetically susceptible to it, people who are otherwise very strong-willed and responsible can easily fall into its trap and, once the susceptibility has been discovered, can never return to drinking again without restarting their brain’s addiction to it. Though this brief introduction into their material doesn’t seem to provide much proof for such strong refutation of long-standing myth, the rest of the book goes into an exhaustive study of just how the chemical alcohol affects the body, both in the non-susceptible individual and in the susceptible one.
There are, of course, a number of factors that determine how alcohol will affect the individual regardless of genetic susceptibility. These factors include a person’s weight and percentage of body fat. Weight has a strong effect upon a person’s ability to handle alcohol because higher blood volume helps to dilute the alcoholic content. However, it seems body fat has more to do with it as fat does not absorb alcohol as quickly. “Fat … is nonpolar, and alcohol has a difficult time getting into fatty tissues; … As a result, the greater the amount of body fat you have, the higher your BAC will be” (16). This has a number of effects.
First, body fat leaves alcohol alone, allowing it to collect in the bloodstream rather than processing it through the rest of the body. Women tend to have more body fat by proportion than men and are also affected by their menstrual cycles making it difficult to assess her capacity for alcohol at different times of the month. Older people gain more body fat and other body defenses grow less capable, affecting their ability to handle alcohol. Other important factors that contribute to a person’s ability to handle alcohol include their nutritional status, the health of their stomach and intestines, their emotional state, the drink strength, any mixers or food taken with the drink and the presence of carbonation.
The authors provide a long and often complicated explanation of how alcohol affects the body system on a chemical level, although one gets the sense that they’ve simplified the explanation tremendously. This discussion includes information about chemicals such as ADH and NAD+ that help the body to break down alcohol in the liver and the steps that are taken in this process. It also includes information about something called the microsomal enzyme oxidizing system, which is described as a backup system, “somewhat like an emergency generator that can be used when the normal circuits are overloaded” (24).
The basic message of this segment of the book is that it takes a number of different enzymes to process alcohol through the body and these enzymes are different in each individual body. Thus, everyone experiences alcohol differently. Because it is something experienced differently by different bodies, there are a number of effects that can be felt depending on the body, how much of what kind of drink is consumed over how long of a period of time and whether or not food was consumed with it. Alcohol can act as a stimulant and as a sedative, but it is not an effective tranquilizer, anesthetic or health boost. It is at this point in the book that I began to finally link the content to my own experience.
I have always known alcohol as a stimulant. It is what I rely on to help me loosen up for an evening on the town because it helps me to relax all those important social restrictions that I have to follow during my day. I always seem to have more fun when I’m out drinking and a night on the town seems to be missing something if we haven’t thrown back a few first. One of the things that make this particularly attractive to me is that I am able to drink much more than many of my friends even though I am not the biggest of the bunch.
Everyone expects me to be a lightweight, but I’m often the last one standing. Like many of the people mentioned in the book, I have always considered this element of my makeup a matter of pride, but the information presented in the book has made me reconsider this position. As the book got deeper into defining the characteristics of alcoholism, I found myself reassessing my drinking experiences and attitudes, wondering if perhaps this is something I need to watch out for.
The authors define alcoholism as “a progressive neurological disease strongly influenced by genetic vulnerability. Inherited or acquired abnormalities in brain chemistry create an altered response to alcohol which is turn causes a wide array of physical, psychological, and behavioral problems” (46). In providing this definition, they make a strong statement regarding the nature of the disease as something that progresses from a stage or stages that are almost never recognized to a much more serious stage at which it is finally recognized by the common definition.
I never would have considered myself as a possible alcoholic when just considering the normal definition because I don’t need to drink to feel happy, I haven’t lost any social status because of my drinking and I am still in control of whether I drink or not. The authors then go on to describe the stages of alcoholism that they recognize and it is this information that began to cause real concern for me.
The first stage of alcoholism described by the authors seems very harmless, but some of the things they describe can be applied to my situation. They indicate four main characteristics to this stage. These are “intense pleasure associated with drinking; lower-intensity reaction; acquired tolerance; and preoccupation with alcohol” (54). Assessing my own reactions to alcohol, I don’t really believe that I experience more pleasure than my friends seem to, but how would I know for sure? I know I have a really good time when I’m drinking and so do my friends, but is it the same? I just can’t answer that and that bothers me.
In terms of the lower intensity reaction, I’ve already noticed that I can consume a lot more alcohol and still function compared to my friends. “If your metabolism is speeded up, you get rid of alcohol faster, which means that alcohol does not build up in your bloodstream as quickly, which in turn means you will not feel as intoxicated as someone with a slower metabolic capability” (56). It is perhaps because I don’t really feel the effects of it so much anymore that I thought I was okay to drive the night I got my DUI. Everyone had been drinking that night and there really wasn’t anyone scheduled to be a designated driver.
We needed some more beer and I was just sure I was okay. I’d felt drunker before. I wasn’t sure how much I’d already had to drink. Honestly, I’d lost count, but I was just sure I could function fine. Obviously, I was wrong, but why didn’t I know better? The final characteristic identifying the early stage of alcoholism is a preoccupation with alcohol. My immediate response seeing this was relief since this, at least, was something that didn’t match my drinking habits.
Upon further reflection, though, I realize that there are some ways in which this is true. For instance, when I go out on the weekends, I am always concerned about how much beer we have on hand, whether this will be enough and spend a good deal of my evening trying to make sure there will be enough for me. Although this is only a concern to me when I’m going out instead of an all-the-time thing, the argument could be made that this constitutes a preoccupation.
Conclusion
To be honest, discovering that I identified so closely with these early stages of alcoholism disturbed me enough that I mostly skimmed through much of what the authors had to say about the middle and late stages to find out what the solutions might be. I did take note of the symptoms of these stages to make sure I wasn’t there yet, but I have never experienced a blackout and I have not noticed any personality disintegration, signs of withdrawal or denial.
Having recognized me at least a little bit in the early stage was sufficient for me to begin looking for a way to stop this process. Even after going through all the material provided in the book, I am unable to determine unquestionably whether I am or am not in the early stages of alcoholism. However, I am now much more aware of the dangers facing me if I continue to drink and have determined to find out whether or not I can really have a good time without drinking. I have also decided to learn more about alcoholism, work through this book a little more and begin to develop a healthier form of entertainment.
Works Cited
Ketcham, Katherine & William F. Asbury. Beyond the Influence. New York: Bantam Books, 2000.