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.