Alcoholism

Who is susceptible and why?

Bio/Psycho/Social Model

1) Individual who responds to alcohol in a certain way. Positive reward.

2) Personality characteristics that encourage use. Impulsiveness.

3) Member of social group where – A) pressure to drink. College Fraternity.– B) confusion over drinking ground rules.

Drink with meals or drink to get drunk?

Physiological factors

Biological susceptibility Genetic evidence Family history Children of alcoholics (COA) If father alcoholic, 25% sons affected 5-10% of daughters

Genetic evidence

Twin studies MZ 100% genes DZ 50% genes Reared together Alcoholism in 55% MZ twins 28% DZ twins

Adoption studies

Original studies done in Denmark and Sweden.

Child adopted out. Father alcoholic: 18% sons affected. Father non-alcoholic: 5% sons affected. Daughters less affected.

Males particularly susceptible

Male limited. TYPE II alcoholism. More severe, early onset. Many negative consequences. Trouble with law, at school, on job. Environment plays less of a role but can

lessen the severity. Adopted COA’s did better than those

raised with alcoholic parent.

Milieu limited. TYPE 1 All women and 75% of men. Less severe, later onset. May not be treated. Personality factors important.

– Reward seekers. Psych dependence. Environment plays key role. Family and social groups. Intoxication as recreation. Good time depends on drinking.

What is inherited? High initial tolerance. Different rate of metabolism. Alcohol -> acetaldehyde ->

acetate -> CO2 and H20 COA’s higher levels of

acetaldehyde. Metabolize alcohol quicker. Hence higher tolerance

Acetaldehyde effects

Acetaldehyde may combine with brain chemicals to give opiate-like high

Acetaldehyde also toxic to liver and heart.

Medical complications

Brain response to novelty

Brain waves to novel stimuli.

P3 waves. Less reaction in

alcoholics. And in COA’s before

start drinking. Need more stimulation?

Psychological characteristics

Related to biology? Reward seeking. Impulsive. Easily bored. Risk takers Gregarious Push the limits Act out

Social factors

Alcoholism high in some cultures:

Americans, Swiss, Irish, Poles.

Low in others:

Chinese, Greeks,

Orthodox Jews

Alcoholism is low in cultures where Children learn alcohol

is a beverage. Served in dilute forms. Abstain okay. Parents model

moderate drinking Getting drunk not seen

as comical. Everyone knows

ground rules.

Alcoholism is higher in cultures where

No ground rules. Mixed messages from different

individuals and groups.

Getting drunk okay? Funny? Heavy drinking is encouraged. Drinking a sign of masculinity or

adulthood.

Media images of alcohol

Ireland has highest heavy drinking rates in Europe.

Youth bombarded with alcohol ads.

Have begun to restrict advertising.

Change the culture.