The overall objective of this research paper is to identify and address those aspects of alcoholism, which contribute to it as a medical disease. True, alcoholism has many ramifications for society as well as the economy, but the focus of this paper shall be, for the most part, on the medical aspects. In the way of background, alcoholism refers to the drinking of alcoholic beverages to such a degree that major aspects of the individual’s life -such as work, school, family relationships or personal safety and health, above all, are seriously and repeatedly interfered with. Alcoholism is considered a disease, meaning that it follows a characteristic course with known physical, psychological, and social systems. The alcoholic continues to consume alcohol despite the destructive consequences. Alcoholism is serious, progressive, and irreversible.
If not treated, it can be fatal. It is generally thought that once the disease has developed, the alcoholic will not drink normally again. An alcoholic who abstains from drinking, however, can regain control over the aspects of life with which alcohol interfered. The alcoholic is then said to be “recovering” not “cured” of the disease. It is important to note that the particular symptoms and pattern of drinking problems may vary with the individual. Alcoholism is, therefore, a very complex disorder, and it is this very complexity which has led some recent researchers to question the accuracy of the disease concept of alcoholism. A person does not have to drink every day to be an alcoholic. Moreover, someone who drinks frequently, or sometimes gets drunk is not necessarily an alcoholic. It is possible to abuse alcohol for a short or contained period of time without developing alcoholism. For example, some people may drink abusively during a personal crisis and then resume normal drinking. College students tend to drink more heavily than other age groups. It is often difficult to distinguish such heavy and abusive drinking from the early stages of alcoholism. How well the person can tolerate giving up alcohol for an extended time, and the effect of the drinking on family, friends, work, and health, may indicate the extent of the alcoholic’s problem. More than ten million Americans are estimated to be alcoholics.
Alcoholism is found among all age, social, cultural, and economic groups. In terms of its symptoms and causes, which is more in the medical tract, I feel, some common signs of alcoholism in the early stages are constant drinking for relief of personal problems, an increase in a person’s tolerance for alcohol, onset of memory lapses while drinking, (“blackouts”), surreptitious drinking, and an urgent need for the first drink (“craving”). In the middle and late phases, dependence on drinking increases and memory blackouts become more frequently. A physical dependence on alcohol first appears with early warning tremors and agitation that require a drink for relief. In the late stage, drinking bouts are usually very frequent. There is an acute withdrawal syndrome, delirium tremors or DT’s, when drinking ceases. This includes agitation, tremors, hallucinations and possibly seizures. (American Medical Association, p.7)
As this author is primarily concerned with the relationship between medical diseases and alcoholism, I should like to focus my attention at this time towards this topic. For example, recent studies have raised questions about the role that dietary fat and cholesterol play in cardiovascular disease, the number one killer of American citizens. Can low cholesterol be unhealthy? Certainly it has been established that high cholesterol can, at least the bad cholesterol. Some studies found that people with the lowest cholesterol levels were less likely to die of coronary heart disease than people with higher cholesterol levels but they had higher mortality rates from other causes, such as lung cancer, digestive diseases and accidents. However, there is no evidence that low cholesterol causes diseases, according to Dr. Rosser. He speculates that very low levels may result from health problems, such as cancers, liver disease and alcoholism. (Michaels, p. 24)
At this point, I should state that new research into alcoholism, and particularly its relationships to medical diseases, are ongoing. For example, new research into the baffling causes of alcoholism is revealing even deeper clues that it is largely in the genes. Researchers are making headway in their search for genetic markers that can predict whether an individual is predisposed to alcoholism. If they succeed, children of alcoholics could be warned. A recent discovery by researchers at the University of California’s Ernest Gallow Clinic And Research Center in San Francisco may help identify potential alcoholics. Led by Dr. Ivan Diamond, a team collected white blood cells from alcoholics and non-alcoholics. They cultivated six generations of cells and compared the two groups. Those from alcoholics showed significantly higher levels of a messenger molecule that alters cell activity. Says Diamond: “This suggests there is a biochemical marker that can actually distinguish alcoholics from the rest of the population.” The Gallow scientists are now examining the cells of children of alcoholics to see if they can find conclusive prove that alcoholism is hereditary as previous research had suggested. The studies, says Dr. Carlton Erickson, executive director of the Texas Research Society On Alcoholism in Austin, “Enhanced evidence that alcoholism is a disease, not a character defect.” The American Medical Association and many others already believe this. Conclusive proof, however, will be needed to convince the doubtful. (Hiroshi, p.8) With the American Medical Association (AMA) behind the belief that there exists a direct causal relationship between alcohol and medical problems, much research is continuing in this vain. Many agree that more money needs to be spend on research, and I agree that this would have many benefits. For example, alcoholism has clearly impacted society in a most deleterious manner, with corporate America experiencing the highest rate of absenteeism than it has ever before, thus costing both corporate America as well as the taxpayers hundreds of billions of dollars yearly.
Similarly, many biological afflictions are clearly associated with alcohol, from brain disorders, to cirrhosis, to circulatory disorders, etc.
It is my belief that individual case studies tend to bring the problem home. This problem, i.e. alcoholism, (and especially its medical consequences) has been researched and researched ad infinitum. It continues to, at this writing, and no doubt will indefinitely continue to be a subject of ongoing research. However, individual case studies do tend to bring the larger theoretical or broad based understanding of alcoholism home, to which I should like to cite one of the more salient.
Citing one case study, you would have to be an opposing pitcher still carrying a grudge to wish anything but the best for New York Yankee’s slugger Mickey Mantle during his recovery from an emergency liver transplant in Dallas. But ‘The Mick’s’ exploits with the bottle are as legendary as those with the bat, raised the question of whether an alcoholic, even a recovered alcoholic – – should get the same consideration for a liver transplant as a patient with a more conventional lifestyle. Gut reactions aside, there is one viable conclusion. Dangerous behavior, provided it is in the past – should play no part in transplant decisions. Medical ethicists decided long ago that a patient’s social worth is irrelevant. The prospects for improvement in a patient’s health should be the only criterion. In short, it is the future, not the past that counts. Mantle’s case study shows why. Competition for organs is intense. Last year, 674 patients died while waiting for a liver, while 3,650 succeeded. Candidates are rated according to the severity of their conditions by the United Network For Organ Sharing in Richmond, Virginia. When organs become available, they are allocated as close to where the donor is as possible, by matching blood types, size and compatibility. Patients in the worst condition gets treated first. That is why Mantle, who had two weeks to live, got to replace a liver damaged by cancer, hepatitis and forty years of drinking. He was the first patient with the most urgent need. Furthermore, his past drinking is not a good indicator of his future prospects. Studies, including one by Dr. Ruud A. F. Krom at the Mayo Clinic in Rochester, Minn., show that the chances for short and long term success are about the same for patients transplanted for alcohol liver disease and those for other liver diseases. Physicians and hospitals try to guard against future abuse. They treat transplant patients before they are put in line for new livers. Patients are interviewed by physicians, substance abuse counselors, social workers and psychiatrists. The University of Pittsburgh Medical Center, a major transplant center requires alcohol abusers to abstain for six months before it will put them on a waiting list. But punishing patients for their past is taboo. And good reason…if patients with a history of alcoholism are automatically disqualified for a transplant today, what next? Tomorrow people who have quite smoking could be denied lung transplants, those who let their weight get out of hand could be denied new hearts. (Schwartz, p.B-14) Today, there are really no rigid guidelines, at least according to medical ethicists. There do not exist any kind of punitive disqualification of people with alcoholism, but the decision as to who will live and who will die largely lay within the purview of the judgement of local physicians and transplants centers.
Alcoholism has a direct relationship to medical and physical diseases, as previously indicated. Similarly, it is also a source of problems such as domestic violence, fatal car accidents, child abuse, and whole litany of other problems. Although the focus of this research paper has been on the medical relationship to alcoholism, it is undeniable that these other problems, although not immediately ‘medically relative,’ do in fact portend emotional and physical medical maladies for many individuals who suffer both directly and indirectly from alcoholism i.e. parents, friends, etc. At any rate, there is no doubt that much more research needs to be done on this subject. Many have speculated that alcoholism may be a genetic disease, rather than an environmental one. At the same time, the complexity of alcoholism and disease portends so many ramifications, that far more research needs to be done in this area, and indeed as in centuries, even millenniums gone by, there is little doubt that individuals will continue to imbibe, and even abuse alcohol.