Alcoholism: A Progressive, Predictable Disease

One of the interesting things about alcohol abuse and alcoholism is the way one progresses into the other over time.  The progression runs in the same general sequence regardless of our age or gender.  Unless interrupted by some sort of incident that causes us to stop drinking, it is entirely predictable — in everything but the details — from the first signs of abuse to our final drink. 

Dr. Marc Schuckit and colleagues at the San Diego VA Medical Center recently completed interviews with over 600 alcoholics who were admitted for inpatient treaatment.  They ranged from their early 20’s to their late forties and, although they were all white males, the description of alcoholic progression that they determined to be the “norm” from the interviews has been found to hold across gender and racial boundaries as well.  Folks who start earlier tend to have longer runs, while those who begin drinking later tend to progress faster.  Those who have been abstinent and resumed drinking go down the fastest of all.

Here, then, is the slide down the rocky, slippery slope.

  • Having started off with some control and enjoyment, our drinking accelerates.  It becomes difficult or impossible to get and keep that nice “buzz.”  We have difficulty setting limits on our drinking.  We progress to staying drunk for longer periods, assisted by a hair o’ the dog in the morning.  We begin to have job problems related to alcohol: missed days at work, mistakes due to hangovers, irritability that makes it difficult to get along with co-workers.

  • Our alcohol-related problems increase rapidly.  Outsiders see, and may comment on, difficulties functioning in many areas of our lives.  We have our first alcohol-related arrests — DUI, public intoxication, fighting, domestic disturbances and so forth.  We may have morning shakes, auto accidents, accidents on the job, and begin drinking instead of eating properly.  Our bodies are totally addicted to alcohol, and we cannot function without it.  If we are unable to drink, we think about it constantly.  We hide our drinking from others.

    By this time most of us will have begun to suspect that there might be a problem.  We see our lives falling apart, but often fail to make the connection with our drinking.  (“Hey, if you had my problems, you’d drink too!”) We see the social damage increase in the form of lost jobs and ruined relationships. We get fired. We get divorced.  We get to know the booking officers almost as well as our bartenders.

  • Our medical problems begin, or increase. Falls, scrapes, broken bones, and big nasty bruises become more frequent.  The damage becomes more noticeable to others because of deterioration of our body systems that prevents efficient healing.  Diabetics find it impossible to control their blood sugar. We may have dangerous or fatal convulsions if we cannot get a drink, may have hallucinations, and may vomit blood or dark-colored material.  Normal bowel movements become only a memory.

  • In the last stages of physical deterioration, long-term medical problems such as hepatitis or pancreatitis occur.  Various cancers associated with alcohol abuse, such as esophageal or pancreatic cancer, may be part of our jackpot.  Hospitalizations are frequent.

Then, unless we are lucky enough to get into some form of recovery that involves complete abstinence, we die.  I got lucky, but that’s about the way it went for me otherwise.

My name is Bill.  I’m an alcoholic, and I approved this message.

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