How many times has your loved one promised to stop or cut down their drinking only to relapse – again? How many times have they looked you straight in the eye and said, “No,” when you ask if they’ve been drinking? How many times have they driven, ruined a family gathering or hurt your feelings deeply when under the influence of alcohol?

Key information about alcoholism can help loved ones project themselves from secondhand drinking.

As someone who’s experienced the awful lies, broken promises, mincing of words, horrible/hurtful behaviors… over my four+ decades of secondhand drinking, my answer is “Hundreds and hundreds and hundreds of times!”

It wasn’t until I started studying the emerging brain and scientific research on alcohol use disorders in 2003 that I began to finally understand that all those broken promises, lies, minced words, hurtful behaviors…weren’t the “real” them. It was the disease (aka disorder) itself.

Understanding Key Information About Alcoholism

There is so much to the mystery of alcoholism, which is one of the alcohol use disorders by the way. Alcohol use disorders is an umbrella term to cover mild, moderate (abuse) and severe (alcoholism) drinking problems. Check out my article, “About the Terms Alcohol Abuse, Alcoholism, Alcohol Use Disorder” for more information.

For this article today, I’m zeroing in on severe alcohol use disorders, what the majority of society, medical professionals and insurance companies refers to as alcoholism.

1  Alcoholism is a Brain Disease (aka Brain Disorder)

• Why is it considered a disease?
  
  • Disease by its simplest definition is something that changes cells in a negative way. When cells are changed in a body organ, the health and function of that body organ changes. Cancer cells in the lungs, for example, causes lung cancer.
  • When a person’s drinking moves from mild to moderate, the excessive ethyl alcohol chemicals in alcoholic beverages cause chemical and structural changes in their brain. These changes make their brain more susceptible to the five key risk factors for developing alcoholism (see #2).
• But the difference between alcoholism and cancer in this analogy…
  • is the way alcoholism is treated and the fact it occurs in the brain — the organ that controls EVERYTHING we think, feel, say and do. Unlike some cancer treatments, for example, where a surgeon removes the cancerous portions and the patient undergoes chemo and radiation and other treatments to kill the cancer cells, surgeons can’t surgically remove portions of the brain involved with severe alcohol use disorder (alcoholism).
• Instead…
  • treating alcoholism requires the brain to be “rewired and mapped,” and the first step in that process is to remove the ethyl alcohol chemicals (stop the drinking). “Wires, maps and develops” means the way brain neurons (aka brain cells) connect (“talk”) to one another and then to and from others throughout the body via the nervous system. And these connections start in utero and continue through an average age of 22 for girls/women and 24 for boys/men.
  • And the first step in that treatment process is to stop drinking – to get the ethyl alcohol chemicals out of their brain. But that alone generally does not resolve what it takes to fully treat and recover from alcoholism. Effective treatment involves the hugely more complicated part of understanding what went into that particular brain’s wiring and mapping over the course of that particular brain’s development — INCLUDING when the person started drinking and when and what kinds of risk factors presented themselves along the way (see #s 2 and 3).

To learn more about brain wiring, mapping and development, check out this chapter from my latest book covering basic brain facts.

2 – Five key risk factors for developing alcoholism:

Notice I underlined “developing.” People are not born alcoholics, and it takes drinking alcohol to start the development. That’s because the ethyl alcohol chemicals in alcoholic beverages work on the brain’s pleasure pathways — the pathways that make a person feel good for having done what they just did. But as I said above, when a person’s drinking moves from mild to moderate, the excessive ethyl alcohol chemicals in alcoholic beverages cause chemical and structural changes in their brain. These changes make their brain more susceptible to the five key risk factors for developing alcoholism listed below:

• genetics (a family history of addiction). This is 40-60% of why someone who drinks too much can develop alcoholism.
• childhood trauma. This is also a huge risk factor because of its connection to toxic stress; toxic stress also changes brain health and function (see #3). Childhood trauma refers to extremely stressful or traumatic events occurring before age 18. This understanding came out of the CDC-Kaiser ACE Study, which studied the connection between 10 traumatic events and poor health outcomes. These traumas included:  emotional abuse, physical abuse, sexual abuse, substance abuse in the household, mental illness in the household, emotional neglect and physical neglect. There are many many other kinds of trauma that have since been identified and studied since the original study, such as intergenerational trauma, racism, poverty and growing up in an unsafe neighborhood. I urge you to read my article, “The Developing Brain & Adverse Childhood Experiences (ACEs).”
• mental illness (aka mental health disorder. These include bipolar, OCD, PTSD, anxiety, depression… — some of which can be outcomes of or exacerbated by trauma-related toxic stress.
• social environment. This includes interactions with people within one’s home, family, community or school, including the way alcohol was used.
• early use. This refers to drinking before 21 and is another significant risk factor because of key developmental brain processes occurring ages 12 – 25 (see above linked article on the developing brain).

The more risk factors a person has the more likely their alcohol use disorder will move from alcohol abuse (moderate) to alcoholism (severe).

3 – Other things that contribute to why/how a person develops alcoholism are:

• 

  Toxic stress causes many emotional and physical health consequences – consequences that can contribute to why a person uses alcohol or the use escalates.

  chronic pain – because of how that brain maps stress-related connections between the brain and body. So when it “feels” pain it goes to it’s “mapped” soother, which may be pain medication or alcohol, as examples

• co-occurring mental health disorder (anxiety, depression, eating disorder, cutting…) which are brain changers separate from alcoholism. Yet the brain can map alcohol as the soother that calms or numbs the feelings of the mental health disorder, for example.
• toxic stress – like that associated with childhood trauma, which then is compounded by all of the stressors we live with in our daily lives. Things like school, work, relationships, financial worries, traffic, one’s children’s health…. [Toxic stress occurs when person experiences ongoing triggering of their fight-or-flight stress response.] Because of the way the way the stress response works, there is a physical component that can exacerbate existing pain sites thereby contributing to chronic pain, which can cause the brain to map alcohol as its soother because of the way alcohol works in the brain. Additionally, toxic stress can cause the brain to seek alcohol as a soother of stress triggering feelings like those associated with a mental health disorder.

This is why effective treatment of alcoholism must include effectively treating chronic pain, a co-occurring mental health disorder and/or toxic stress if these conditions are present.

4 – It is a chronic disease – like diabetes…

• ... in that it won’t go away unless it’s effectively treated. BUT it is treatable and a person can live a joy-filled life when its effectively treated. The National Institute on Drug Abuse (alcohol is a drug) shares key principles of effective treatment at this link.

For more key information about alcoholism

Written to provide key information about alcoholism.

I realize I’ve packed a lot of information into this post. (I tend to do that, I’m afraid.)  So I suggest you check out my latest book, If You Loved Me, You’d Stop! What you really need to know when your loved one drinks too much.”

The first half explains alcohol use disorders (drinking problems) – how they’re developed and treated and what long-term recovery requires. In the case of alcohol abuse, for example, it’s possible to learn to “re-drink,” but in the case of alcoholism, it must be total abstinence from alcohol. Yet in both cases, there are other brain healing aspects necessary in order to address “why” a person finds themselves drinking to these extents in the first place (e.g., trauma, anxiety, depression, social environment…).

The second half explains what happens to family members and friends and what they can do to help their loved ones, as well as what they can do to take back control of their physical and emotional health and the quality of their lives. In other words, how they can recover from secondhand drinking.

The book comes in both paperback and Kindle (or other eReader formats). With the eReader or Kindle formats, you’re able to get it immediately, which may be helpful for right now. eReader formats have another advantage in that they allow you to read the book without anyone knowing, which may also be helpful.

As as always, feel free to contact me to arrange a free phone call to address your specific questions. There is no charge. Send an email to lisaf@BreakingTheCycles.com to schedule a time.

© Lisa Frederiksen, June 2021

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Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com

Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.

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