Saturday: Reasons Why West Indians Should Care About Alcoholism (Part III)

Part I

Part II

I took a small break from writing Part III because I’ve been busy traveling and getting back into the swing of things with work. We need to talk really simply about the “why” when it comes to caring about alcoholism and alcohol addictions in our country. Caribbean people tend to fall into two camps — prohibitionists and deniers. Prohibitionists think that not only is alcohol un-Christian (or some other form of “pure evil”), everyone should feel this way too and be forced to act on it. Deniers believe that there is no problem and that all alcohol consumption is normal unless you are making yourself look bad publicly, in which case, this is not indicative of a wider social issue. There seems to be no in between.

I’m hardly a prohibitionist, but there’s clearly a problem with how alcoholism is treated, and I use many definitions of that verb at once, and the impact on our culture. Here are five reasons Caribbean people should care more about alcoholism. Whether or not you’re a prohibitionist, our culture surrounding alcohol needs some discussion and most likely some serious action whether this means increasing the drinking age, taking alcohol salespeople to task for who they sell alcohol to, or changing the culture within our homes and families. Everyone will have a different view of what should be done, but hopefully after today, we can agree on why.

Here are five reasons why West Indians should care about alcoholism:

1) Alcoholism poisons every organ in the body, affecting the health of our people

Clearly distressed drinkers love telling you that they feel “fine”. Yet many of those people who were so “fine” end up dying of complications directly correlated to their illness. Whether or not they accept these effects, they play a huge role in long term health outcomes. Alcohol consumption changes your mood and behavior, negatively impacts your memory and cognition. Alcoholism also increases your risk of heart problems, liver problems, pancreatic problems and significantly increases your risk of cancer diagnosis. Partially because of how it’s ingested and processed through the blood, alcohol has a wide impact on the body. Because the alcohol molecule itself is very small, it can travel throughout many different systems and both in the short term and long term, poisons them. A population with many alcoholics and binge drinkers will be signing on for the long term health impacts. Are we prepared to treat them?

2) We completely lack proper treatment and support systems for alcohol

While Alcoholics Anonymous has questionable efficacy for the majority of alcoholics, we lack both the medical and social treatments for alcoholism. I struggle to imagine “Alcoholics Anonymous” working in a country so small that anonymity is mythological. Could you really go to a meeting and confess harm you’ve done to your family when you may be sitting in a room with your wife’s second cousin? Additionally, even while volunteering in the health care system and speaking to health care professionals that I know, I haven’t heard of the medical treatment for alcoholism, naltrexone, either. If we do care enough about alcoholics in order to want them to get better, we’re left with a health care system without the adequate support for them. This indicates a huge public health problem which we should definitely care about. Even if you believe (which hopefully you don’t by Part III in this series) that alcoholism is a personal choice, shouldn’t you care about the non-drinkers who are affected?

3) Alcoholism and domestic violence are strongly linked

There’s a strong link between alcoholism and domestic violence and while there’s disagreement over whether alcoholism causes domestic violence or whether it’s simply used as an excuse by batterers, the prevalence of this link alone makes alcoholism an important women’s issue in a country where women have few resources and avenues of escape from violent partners. In a seminal 1986 study on alcohol dependence and domestic violence, one particular statistic sticks out.

“Findings indicate that 83% of alcoholic subjects behaved violently in past relationships, compared to 28% of the normal population.”

Several other researchers have noticed this link. To cite a more recent 2015 study, not only were people dependent on alcohol more likely to engage in “violence perpetration” which included: physical assault, psychological abuse, sexual abuse, [and physical] injuries”, women dependent on alcohol were more likely to be victimized for abuse. Especially due to the prevalence of alcohol abuse and dependence, it’s clear feminists need to pay attention.

4) We have no clear answers on the exact prevalence of alcoholism

Sadly, we have no clear answers on the exact prevalence of alcohol dependence in the Caribbean. How terrifying that no one has bothered to do the research on a population as large as ours and encompassing so many different countries. How troubling that rum has formed the backbone of our economies since Europeans enslaved our people, yet no one has bothered to study the impact this may have had at a cultural level.

The prevalence of alcohol dependence in the general American population is around 6.2%, yet alcohol dependence is often worse in poor and disadvantaged communities. The fact that we have no clear answers, yet face the likelihood that the prevalence is higher than we may expect, means we should step forward to tackle this issue and not just in the face of another highly publicized tragedy.

5) Alcohol abuse is linked to road accidents in teens

Alcohol abuse among adolescents is linked to high-risk driving among new drivers especially as well as more statistically significant cases of road accidents and encounters with the law. I believe that many feminists online (perhaps because many of us are young and do not have children) forget that children’s issues are integral in feminist praxis. Children have no one else in society advocating for them, so when an issue affects children, it typical becomes the responsibility of their primary caregivers (mostly women) to advocate on their behalf.

Of course, any men who want to pick up the mantle are more than welcome to. Anyway, given some of the highly publicized road accidents in Saint Lucia, as well as other news items across the Caribbean and anecdotal experiences which many of us share (I do view our “oral history” so to speak as important), road accidents involving alcohol abuse have the terrifying ability to destroy families and kill children who did not have to be killed. As adults, we shouldn’t blame the children and we shouldn’t blame their parents, but recognize this as a manifestation of a larger cultural issue. If we address the root causes of alcoholism, we will be able to reduce the incidents involving teens and children on the road.

Why do you care about alcoholism in the Caribbean? Or why don’t you? Comment down below and let’s talk about why you think this is important.

Thursday: 3 Things Most West Indians Don't Realize About Alcoholism (Part II)

Yesterday, I posted Part I of my series of posts on alcoholism and you can read that post right here. I’m not going to give much of an intro today, just dive into Part II:

What most people don’t realize about alcoholism

Not only do we believe many common myths about alcoholism, we’re missing some important information in understanding alcoholism as a disease rather than a moral failing. Make no mistake, empirical research agrees that alcoholism has a powerful neurological basis.

1) Cues to drink work differently for alcoholics than non-alcoholics

This is one of the strongest components of alcoholism that I learned during my Physiological Psychology class at Middlebury College. Before we engage in any habit a series of “cues” work at both the conscious and subconscious levels to prime us for the behavior we’re about to engage in. For example, waking up in the morning primes me to walk to my coffee maker and put on a pot of coffee. Sitting with my cup of coffee primes me to turn on my meditation app every morning. Cues exist all around us but for addicts, cues related to their addiction are “more salient”. In layman’s terms, alcoholics notice cues that prime them to engage in drinking more than non-alcoholics. The cues also have a stronger effect on them, releasing dopamine even before they’ve engaged in the behavior that they’ve grown accustomed to (having a drink).

Because of this, I argue that the presence of large billboard advertisements for alcoholic beverages along our highways in Saint Lucia poses a particularly strong danger to alcoholics. Keep in mind that not all alcoholics are aware that they have the disease and most are likely not aware of the myriad of cues in their environments priming them to drink. In some states in the US (which isn’t a perfect place, mind you) alcohol is kept in separate sections of the grocery store because the state realizes that alcoholics are not in control of how these cues affect them and even walking past a bottle of liquor in the grocery store can be enough to cue binge drinking in an alcoholic.

This also makes quitting alcohol difficult in a society with few social and medical support systems. When you drink alcohol, your friends, family, jobs and activities that you associate with drinking can all become cues that stimulate a powerful release of dopamine in your brain — all outside of your awareness. This is why a key part of Alcoholics Anonymous involves admitting that you have no control over alcohol. While there are some valid issues with AA (see the second point), the program touches on an important point about alcohol addiction. The addiction really does control you. The release of dopamine stimulates a strong reward for engaging in alcohol consumption and related behaviors that is legitimately stronger in alcoholics.

West Indians need to realize this because whether we are coping with our own relationship towards alcohol, larger cultural attitudes, or addictions that exist in friends or family members, we need to divest from the moral approach to alcohol addiction. For me, understanding the scientific facts allows me to do this best.

2) Faith based programs are not necessarily more effective than administering drugs

Christian cultures tend to have an intensely moral view of addiction that can be hard to shake. This isn’t a judgment, but a fact of our society that reflects beliefs that I’ve found to exist within myself and others. I was surprised to read about the inefficacy of AA, a program which I know has personally helped many individuals recover from their addictions, in contrast to treatments that view alcohol as a strictly medical problem. While I can’t divest completely from the social problems that lie at the root of addiction, I can’t ignore scientific evidence of superior treatments for alcoholism.

The Irrationality of Alcoholics Anonymous, an incredible piece published in The Atlantic highlights all the evidence that suggests we need to look for alternative treatments to alcohol addiction that don’t rely on blaming addicts and holding them wholly responsible for their “decisions” with regards to their illness.

I’m open to this view because in a country with few social support systems, especially with regards to mental health, we need to explore every option open to us. This article was SO GOOD that I couldn’t just pick one quote to post here so PLEASE, I urge you to read this article when you get a chance.

3) Alcoholism runs in families

Early onset of alcoholism is highly correlated to alcoholic families. The incident involving the drunken teenagers was not created in a vacuum, nor is this behavior entirely the fault of the party promoters and security. While I agree with the idea that there should be stricter management of 18+ parties, or any adult venues, the notion that this was “caused” by party promoters ignores an important truth of alcohol addiction. Teenagers that belong to families with alcoholics are more likely to begin drinking earlier. While this is entirely genetic or from learned behavior is up for debate. And remember, this does not mean that all individuals who are exposed to alcoholic families will mimic this behavior. This statement is simply a risk analysis and important to understanding the far reaches of what’s widely recognized as a family disease.

What’s interesting about this fact is that while it’s widely debated by those who tout anecdotal evidence of this one person whose parent is an alcoholic who never touches a drink, this facet of alcoholism has been noted as early as Plutarch and Aristotle’s time in Ancient Greece and has been confirmed by contemporary scientific research. Therefore, when we treat alcoholism, we cannot treat it as a problem with an individual and must address the multitude of familiar factors that contribute to early onset of binge drinking.

Up until this point, I have not discussed meaningful solutions for alcohol abuse, alcohol addiction and excess alcohol consumption amongst young people. How can we discuss solutions if we have not laid out the problem, understood the problem and what motivates it, and come up with an empathetic approach? I have cared deeply many alcoholics in my life at various stages of recovery as friends and family members. I have also cared deeply for many children of alcoholics who have suffered the brunt of their parent's disease. Before I touch upon any possible solutions on the individual level, familial level, and cultural level, tomorrow, I’m going to tug at your heartstrings a bit (hopefully) and explain why this issue is so important to me and why it should be important to you, even if you’re tempted to judge binge drinkers and alcoholics as “irresponsible” and therefore somehow deserving of their fate.