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Alcoholism, like many addictions, has long been considered a “social disease” caused by weakness of will, poor self-control or lack of faith. Today, alcoholism is seen as a biological disease, one that has had great effects on mankind for centuries. From Bible’s frequent mention of alcohol abuse, to early medical recognition and the Temperance Movement, to the forming of Alcoholics Anonymous and Mothers Against Drunk Driving, to current advances in treatment and genetic research, alcoholism has excited and continues to cause significant problems for people’s health, relationships, jobs and economy. Alcoholism is designed to provide a balance account of the disease in terms of its process and the impact it has had around the world, historically to present day.
Psychological Factors of Alcoholism
Most people consume alcohol and do not progress further. Progression from social drinking to dependence is influenced by the psychological state and expectations regarding alcohol’s effects, the setting in which alcohol is used and its pharmacological properties. Drinking alone or with others makes a difference in terms of alcohol consumption. For example, individuals are more likely to drink heavily when they are in a group than when they are alone.
Alcohol problems during adolescence and adulthood have been linked to antisocial behaviour in childhood. The relationship between alcohol and depression among adolescents, because alcohol produces mild euphoria and reduces anxiety, its use is reinforcing. There is a little relationship between one’s personality as an alcoholic and one’s prealcoholic personality (Gifford 56). The importance of personality as an explanatory concept with respect to alcohol involvement has moved in and out of favour for many years. Many people displaying antisocial behaviours in early life stages do not behave antisocially early in life. People’s expectations about alcohol have been shown to be predictors of alcohol dependence. Alcohol abusers anticipate the effects of alcohol to be positive. Likewise, if consuming alcohol is viewed as helpful to cope with the negative moods, the potential for abuse is higher. The adolescents are at the greatest risk for developing alcohol-related problems think alcohol is socially enchanting.
College students who expect positive outcomes from drinking alcohol likewise are heavier drinkers. However, individuals who expected alcohol to increase their sexual risk-taking behaviour did engage in more sexual risk-taking behaviours; alcohol is linked to it directly. Many adolescents expect alcohol to have disinheriting effect, and consequently, engage in risk-taking sexual behaviour.
Abuse or Dependence
People with alcohol dependence are physically addicted to alcohol and would suffer physical withdrawal symptoms if they stopped drinking. Alcohol abusers may drink chronically and get themselves into trouble with alcohol-related incidents, but they could stop suffering physical effects. However, that does not mean that alcohol abusers do not need treatment to help cope with underlying reasons for drinking and prevent the progressing to alcoholism. It is a risky assumption to consider alcohol abusers as less “in trouble” than people who are fully dependent on alcohol. As an analogy, consider someone newly diagnosed with a precancerous skin growth that can often progress to skin cancer. That person would not necessarily need the same intensive treatment as a person who already has skin cancer, however he or she will still be advised to see a dermatologists to have the growths examined and possibly removed, and to use the sun block and avoid the sun.
A person with a predependent form of alcohol abuse would likely be advised in the same way, to start receiving treatment before things get worse. Drinkers may overlap treatments for all types of problems. Brief intervention, counseling, and behavioral therapy may be the focus for alcohol abusers, with the addiction of medication or inpatient treatment foe actual alcoholics. An accurate diagnosis can prevent alcohol abusers from being overdiagnosed with a more dependent form of alcohol behavior and from being prescribed medications or rehabilitations they do not need (Gifford 121).
Substance abuse is thought of as a spectrum, with each level of use requiring different treatment approaches, and professionals who treat problem drinkers must make more careful assessments. Fortunately, many screening tools exist to help the doctors and therapists make an accurate diagnosis.
Aversion Therapy Utilizes Conditioning
?s a Treatment for Alcohol Abuse
Aversion therapy is applied from time to time. It uses classical conditioning. Conditioned stimulus might be images, smells or taste of alcohol. The unconditioned stimuli are pharmacological emetics. There have also been attempts of hidden impact that is a combination of thoughts related to alcohol and its consumption with the idea of discomfort or accompanying the other unpleasant scenes of drunkenness. The purpose of this method is to develop a persistent negative reaction against the use of alcohol by causing physical alcohol intolerance. This therapy is usually used in the third stage of alcoholism treatment - the stabilization phase of remission.
Aversion therapy is based on the use of medications that dramatically increase the body's sensitivity to alcohol. Most commonly, drugs of disulfiram group are used to influence the sensitivity of the body (teturamum, essperal, radoter). This drug is designed to reduce the metabolism of ethanol in the body and thus, causes a toxic reaction to the use of alcohol, which, in turn, leads to the formation of persistent reflection on the use of alcohol products. As a result, acetaldehyde accumulates in the body causing a lot of unpleasant symptoms and making it impossible to continue alcohol consumption. It is called acetaldehyde syndrome. Various reactions develop in 5-10 minutes after drinking that causes a rise in blood pressure, tachycardia, nausea and vomiting, flushing of the skin and pain in the heart, throbbing headache, tinnitus, dizziness, blurred vision, anxiety and fear of death. Hypertension may change the fall in blood pressure with the development of complications from reversal of the cardiovascular system in the severe disulfiram-alcohol reaction. Currently, a composite drug Lidevin and Cyanamide can be used for aversion therapy, besides various forms of disulfiram. Disulfiram effects can also be in some anti-protozoal and anti-parasitic drugs (Metronidazole, Decaris, etc.) (Allen 82).
Psychotherapeutic intervention improves effectiveness of the aversion therapy. By this it is meant that therapeutic program should include the trainings with stimuli monitoring, role-playing, communication skills and regular counseling that will significantly improve the outcomes of disulfiram therapy. The effectiveness of aversion therapy is significantly increasing in motivated patients, as well as during the psychotherapeutic intervention. Behavioral therapy should include behavioral training for strengthening motivation, "contract" with the patient and significant relation, social support (Allen 132).
According to Saxon, “ It is prudent to monitor transaminase levels before starting disulfiram treatment and every 3 to 6 months during disulfiram treatment, but the mild elevations in liver transaminase levels associated with alcoholism are not necessarily contraindications” (Saxon 61).Holding the disulfiram-alcohol tests are among the most difficult and time consuming methods of treating alcohol dependence; there may be such dangerous disorders during the trial as circulatory collapse, or hypertensive crisis, fainting, etc. Disulfiram-alcohol reaction may occur even after a long cessation of disulfiram.
Thus, abuse is more common among people who believe that alcohol enhances their social and psychological enjoyment, aggressiveness, sexual performance, responsiveness and social competence. Alcohol can devastate friends, neighbors and others with whom the drinker is involved. Alcoholics use alcohol chronically and are unable to control their drinking. Most alcoholics are unlikely to quit on their own, because of the psychological addictive nature of alcohol. Denial of any problem with alcohol, combined with reluctance to give up something their body carves so fiercely, can dampen the prospect for quitting permanently without help. Aversion Therapy is a significant method of treating the alcohol abuse. This therapy increases the body's sensitivity to alcohol and helps alcoholics live without alcohol.