Alcoholism and Other Drug Problems

by James E. Royce; David Scratchley

• ISBN13: 9780684823140
• ISBN10: 0684823144
• Format: Hardcover
• Copyright: 1996-03-01
• Publisher: Free Press

Summary

Alcoholism and Other Drug Problems offers a balanced and comprehensive account of the nature, causes, prevention, and treatment of the nation's number one public health problem. This edition of Royce's award-winning text,Alcohol Problems and

Author Biography

James E. Royce, S.J., Ph.D., is Professor Emeritus of Psychology and Addiction Studies at Seattle University. He is the author of Alcohol Problems and Alcoholism and coauthor of Ethics for Addiction Professionals.

Table of Contents

Contents

Preface
Acknowledgments

PART ONE
ALCOHOL AND OTHER DRUGS

1. Alcohol and Alcohol Problems
Drinking, drunkenness, alcoholism. Alcohol as a drug. Defining alcoholism. Alcoholic versus problem drinker. Alcohol causes more problems than alcoholism: statistics, estimates, and methodology.

2. Drugs Other Than Alcohol
Comonly used prescription and illegal drugs. Opiates, stimulants, nicotine, marijuana, hallucinogens, sedative-hypnotics, inhalants.

3. Sociocultural Aspects
Alcohol in various cultures. Alcohol in America. Prohibition.

4. Alcohol: Physiology and Pharmacology
A. What the body does with alcohol. Ingestion, absorption, excretion, metabolism.
B. What alcohol does to behavior. Stimulant or depressant? Tolerance. Polydrug, synergism. Effects of blood levels. How many drinks?
C. What alcohol does to the body. Short- and long-term effects on health. Action of alcohol on each major organ and system. Fetal alcohol effects.

5. Other Drugs: Physiology and Pharmacology
Drug interactions. Effects on behavior. Effects on health.

PART TWO
ADDICTION

6. Patterns and Symptoms
Types of alcoholics. Common characteristics. Symptoms. Progression.

7. Causality of Addiction
Sociocultural, psychological, physiological causes. Role of heredity as part-cause. Learning (habit).

8. Addiction as a Disease
Is there an alcoholic personality? Pros and cons of calling addiction a disease. Implications for prevention, treatment, counseling, rehabilitation. Can alcoholics be conditioned to drink socially?

9. The Spouse and Family of the Addict
Cause or reaction? Adjustment of the family to the crisis of alcoholism. Reversal of roles. Effects of other drugs on the family.

10. Children of Dysfunctional Families
Typical roles: Hero (Responsible One), Scapegoat (Acting Out), Adjuster (Lost Child), Placater (Mascot). Adult Children of Alcoholics (ACoA): a high-risk group.

11. Special Groups
Women. Youth. The elderly. Minority races. The military. Skid road. Professionals, dual diagnosed, other groups.

PART THREE
PREVENTION AND INTERVENTION

12. Prevention
Primary, secondary, tertiary prevention. Information versus attitudes and values. Decision-making skills.

13. Eap -- Occupational Programs
Alcohol and other drugs in business and industry. Policy versus program. Roles of labor and management. Training of supervisors.

14. Referral and Intervention
Diagnosis. Counseling into treatment. Knowing and using various facilities.

PART FOUR
TREATMENT AND REHABILITATION

15. Overview of Treatments
Continuum of care. Variety of therapies. Detoxification. Intensive treatment. Therapies for other drug addictions.

16. Rehabilitation
After intensive care: importance of long-term followup. Phases of recovery, relapses, the dry drunk.

17. Alcoholics Anonymous and Other Twelve-Step Groups
Development of AA philosophy. The Twelve Steps and Twelve Traditions. The three legacies. Twelve-Step groups for other addicts: NA, CA, and others.

18. Al-Anon and Alateen
The Twelve Steps as used by spouse and children of the alcoholic. Special traditions and problems.

19. Spiritual and Moral Aspects
Progression of addiction as a spiritual disease. Spiritual recovery. False guilt. Moralistic attitudes. Responsibility for drug-related behavior.

20. Drugs and the Law
Liability. Discrimination. Regulation of sale. Alcohol and traffic laws. The Uniform Act: drunk in public no longer a crime, legal responsibility not eliminated, problems of implementation.

21. The New Profession
Ethics: confidentiality, education, certification. The addiction professional. Dual role of AA member. Staff burnout.

Appendix: Sources for Literature on Alcoholism and Other Addictions
General Bibliography
Index

Excerpts

CHAPTER I Alcohol and Alcohol ProblemsMost are aware that drugs are a major factor in our biggest social problems: violence, crime, poverty, AIDS, family disintegration -- but many do not think of alcohol as a drug at all, only as a social beverage. We shall see that alcohol causes immense problems, of which alcoholism is only one. (The other drugs are dealt with in Chapters 2 and 5.)The facts about alcohol are distorted by our emotionally charged attitudes toward drinking, drunkenness, and alcoholism. Those attitudes are the result of many factors: family situation, sociocultural experience, biological differences, prohibition, differing religious beliefs, and political, economic, and personal feelings unique to each individual. Obvious as they may seem, we must spell out some distinctions that are ignored in most arguments on the subject.Drinking.Abstinence from alcohol is the opposite of drinking. Technically anyone who drinks alcoholic beverages, however rarely and moderately, is a drinker. About 60 percent of Americans over eighteen drink at least occasionally (down from 71 percent a dozen years ago); most are neither drunkards nor alcoholics. In fact, about 11 percent of drinkers consume 68 percent of our beverage alcohol, whereas many of those technically classed as drinkers have only a New Year's toast or the like. Less than half of American "drinkers" use alcohol more than once a month.Drunkenness.Temperance is the opposite of drunkenness. In Chapter 3 we shall see how the prohibitionists created untold confusion by assuming that everyone who drinks is a drunkard. Actually, anybody can get drunk on a given occasion; they might not even be a drinker in the usual sense of the term. To the naive guest at a wedding reception or the person honored at a retirement banquet, the champagne seems much like ginger ale; a subsequent arrest for driving while intoxicated is not presumptive of alcoholism. However, intoxication even by nonalcoholics is a major source of both civil and criminal problems: battered spouses and children, rape, fights, homicides, unwanted pregnancies, poor health, suicides, lawsuits, family disruptions, job loss, and a sizable share of accidents -- not only traffic but also home, boat, small plane, and industrial. The degree of intoxication need not be that required to be legally drunk, as we shall see in Chapter 4, Section B.Alcoholism.Alcoholism is the state of a person whose excessive use of alcohol creates serious life problems. An alcoholic may never get drunk, as in the Delta type (maintenance drinker) common in France and described in Chapter 6. They may not even drink, as in the case of the 2 million or so recovered alcoholics who still identify themselves as such (Chapter 8).AlcoholicsIn most minds, the word alcoholic conjures up an image of a skid-road bum. Yet only about 3 percent of alcoholics are on skid road. (Incidentally, Skid Road is the original term, named for Yesler Way in Seattle, where logs were skidded down to Yesler's mill; skid row is a later version, by analogy with Cannery Row.)What kinds of people are alcoholics? Alcoholics may be young or old, male or female, black or white, banker or bum, genius or mentally retarded. A large body of research data has accumulated on this subject, and there have been intensive educational efforts to make these facts known to the public. Yet the old stereotypes persist and must be dealt with before any meaningful discussion of alcoholism can occur.Skid Road?It is essential to eradicate right now the stereotype of the alcoholic as a skid-road, old, male, weak-willed, inferior derelict. If 3 percent of alcoholics are on skid road, the other 97 percent of American alcoholics have jobs, homes, and families. About 45 percent of alcoholics are in professional and managerial positions, 25 percent are white-collar workers, and 30 pe