MODULE II: Awareness

Salient Features Concerning Alcoholism

 

Competency 1 - Be aware of the:
Generally accepted definition of alcohol and other drug dependence
Societal stigma attached to alcohol and other drug dependence

Competency 2 - Be knowledgeable about the:
Signs of alcohol and other drug dependence
Characteristics of withdrawal
Effects on the individual and the family (household)
Characteristics of the stages of recovery

Competency 3 - Be aware that possible indicators of the disease may include,
among others:
Marital conflict, Family violence (physical, emotional and verbal), Suicide, Hospitalization, or Encounters with the criminal justice system

Competency 4 - Understand that addiction erodes and blocks religious and spiritual development; and be able to effectively communicate the importance of spirituality and the practice of religion in recovery, using the scripture/sacred writings, traditions and rituals of the faith community

The following features of alcoholism are important for students to know as general information and an introduction to the disease.

1. Alcoholism/Addiction is a Pervasive Illness. Approximately one out of ten people who use alcohol end up having difficulty with the substance. Taken together with the other mood altering chemicals broadly classified as narcotics, depressants, stimulants, hallucinogens, cannabis, inhalants and prescription drugs, the number of people who have alcoholism and drug dependence is about 10% of the population. Alcoholism is the third leading health issue in the U.S., slightly behind cancer and heart disease and first in terms of the social problems that it creates. The illness affects all people irrespective of race, gender, religion, sexual orientation, age, social or ethnic background. In ministry, it is not a matter of "if" someone will have to deal with addiction, it is simply a matter of "when," and that is usually sooner rather than later in serving a faith community.

2. Alcoholism/Addiction is a Physiological Illness with, Psychological, Social and Spiritual Consequences. Alcoholism usually affects every aspect of a person's life. It is a "total disease" in that it affects every aspect of a person's being including his/her relations with family. More often than not, the addict's spiritual life is impacted and the person often abandons her/his faith community and the practice of religion. The alcoholic's social life is adversely affected as the disease progresses in the individual. Disgust, anger, despair and often rejection by significant other people in the alcoholic's life frequently lead to dissolution of relationships. Addiction results in marital conflict, including divorce, violence (physical, emotional, verbal and sexual) invading the household. Alcoholics are at a higher risk for suicide and engagement with the criminal justice system. Relationships with relatives, friends and coworkers are at risk. The person's emotional life likewise suffers as a result of alcoholism. Alcohol becomes the person's all consuming passion, as he/she goes to any lengths to secure and protect the supply. Emotions become jumbled, garbled and out of control. As a result of the chronic ingestion of alcohol, organic brain syndrome can develop and permanent brain damage results. The addict's physical life becomes severely compromised as the toxicity of the alcohol takes its toll on every organ and system within the body. Alcoholism can adversely affect succeeding generations. A pregnant woman should not drink alcohol, as it may affect the fetus and the infant may be born with Fetal Alcohol Spectrum Disorders (FASD).1

3. Alcoholism/Addiction Results in Denial. Despite the progress made in alerting people to the nature of alcoholism as an illness, it still carries a stigma. Those afflicted and those affected attempt to hide it because they experience the impact of disgrace shame.2 In the later stages of the addiction, the alcoholic will isolate him/herself and avoid public gatherings or confine her/himself to venues where alcohol runs freely. Any effort made to point out the deleterious effects of the drinking leads to vociferous denial of its being a problem. Typically the alcoholic will blame other people, the environment, the geographic location, the workplace or the faith community. A major hurdle for people of faith is to challenge the denial in a compassionate and loving manner. The ability to do this is predicated on having the proper attitude as noted in Module I.

4. Alcoholism/Addiction is a Progressively Fatal Illness. Alcoholism is a progressive disease which over time changes the brain and adversely affects the body's major organs. Due to the progressive nature of the disease the early intervention can help stop some of the damage caused by alcoholism. The illness can progress to its late stages, where without interruption of the disease one of three things may happen:

  1. The person is incarcerated for some offense or crime related to the procurement (robbery) or use of alcohol or drugs (e.g., DUI – driving under the influence) that involves the criminal justice system. The number of people who are in prison because of some crime committed while under the influence, in the procurement, sale or illegal manufacturing of mood altering substances may be as high as 80%.

  2. In the late stage of alcoholism, the person may experience a form of insanity, such as Korsakoff's syndrome.3 The capacity to think and reason is often severely compromised because the toxic effect of alcohol has destroyed enough of the brain so as to cause permanent and irreparable damage.

  3. The person may die as a result of an accident, renal or cardiac failure. Death may come as a result of the cessation of other critical bodily functions. (e.g., the liver, for example). Drug deals gone bad often result in violent deaths and the criminal justice system becomes involved.

  4. The goal is for the person to go into recovery. This is the preferred and logical option. Recovery allows the person to reclaim his/her life as health, functioning and relationships improve. The intensity of the denial may preclude the person from health and recovery. The power and tenacity of addiction itself is so strong that some people choose to die rather than forfeit their drug of choice. This may be a difficult challenge for religious leaders and can be viewed as completing a suicide on the installment plan. The spiritual implications of this illness involving life and death are legion!

The intent in providing ministry for the entire household is that all might come to experience sobriety with serenity. The knowledgeable religious representative or leader can and should articulate these options to impress upon all who are involved that this is a progressively fatal illness and interruption of the cycle is imperative if life is to be preserved, and this is the goal of intervention.

mod2_clip1 Clip from Recovering Nation

5. Alcoholism/Addiction Affects the Whole Household and the Wider Social Network. No one associated with the alcoholic or addict is unaffected by the illness. The degree of damage experienced is contingent upon a multiplicity of factors including how long, how often and how much the alcoholic person has been drinking, the resilience of significant others, the level of enmeshment in the household, the presence of varying kinds of abuse and the degree of support received from other people outside the household. Children growing up in this kind of an environment are too often adversely affected. They may respond by assuming one of the following roles in an attempt to maintain homeostatis in the family.

  1. Achiever (referred to in some literature as the 'hero.') The child can become an overachiever in an effort to redeem the family or the family's name. This child often assumes a great degree of responsibility and may function very well in the educational environment or may be very active in the faith community. Alert your students to the fact that a child who appears to be driven in her or his lifestyle and religious zeal may unconsciously be acting out this role.

  2. Mischiever (referred to in some literature as the scapegoat.) This is the child who becomes the identified problem in the system. This child often acts out in inappropriate ways in public, may get into trouble in school or with the police. An inordinate amount of anger towards others, particularly those in authority may manifest itself. This child may use alcohol as a form of rebellion or may reason, since you have pegged me as a problem, I will be a problem! Once again alert your students to the fact that among children in their faith communities, those who get in trouble or seem to be constant sources of agitation may have an unbearable situation at home that might involve addiction.

  3. Reliever (referred to in some literature as the forgotten child or one who withdraws.) This youngster may distance her or himself from others in the household and live in a fantasy world, or simply become invisible to the others. She/he is not working at a frenetic pace to save the household from disgrace shame nor about to get into any kind of trouble. This brings a modicum of relief to the system. Encourage students to take note of children in their faith communities who may be referred to as a wall flower or one who is very withdrawn.

  4. Receiver (referred to in some literature as the clown or the mascot) is the fourth way in which children might respond to the presence of addiction in the household. S/he breaks the tension by being cute or clever and so receives attention in that manner. S/he may be trying to put people at ease by making them laugh and diverting attention away from the addict in the household.

It is important to know that these roles are paradigmatic in nature and not rigidly determined. The roles can shift as the configuration of the household changes. For example, if one of the children leaves the household for college, the roles may adjust for the remaining children.

More recent literature has pointed out that not everyone growing up in an addictive household is destined to some kind of pathological designation, as discussed by Wolin & Wolin (2000) in their article on children of alcoholics.4
It is critically important to point out to students that a parallel process of decline occurs in the household and with significant others in the alcoholic's life. Unless the cycle of addiction is broken, the result will be as noted in the General Awareness Information Section tab of this module.

Alcoholism and addiction take their toll on the community and wider social network as well. The deleterious affects include: shoddy workmanship, chronic absenteeism, higher rates of injury on the job and a multiplicity of other problems created by those who drink or use. We are painfully aware of the tragic toll exacted when operating a vehicle while under the influence. More than 50% of all traffic fatalities are linked with irresponsible use of alcohol and drugs. News reports are replete with stories about people who operate vehicles of mass transportation, whether on the ground, on the water or in the air with devastating consequences. The astronomical emotional and economic toll is truly incalculable. Religious leaders and faith communities need to become more deeply aware of the ways in which use, abuse and addiction to chemicals exacts a high price on individual communities and on society as a whole.

6. Alcoholism/Addiction is Treatable and Recovery is Possible for the Entire Family. The good news about alcoholism is that it is treatable and recovery is possible. This message of hope is absolutely critical for those doing ministry. More often than not, the religious leader will first see someone who has been affected by the illness. This person will often categorically state that there is no help or hope, and will say, "She or he is a hopeless drunk!" This pervasive negativity is a result of ignorance, but certainly not helpful. It is imperative that all members of the household receive help in dealing with the consequences that inevitably leaves a path strewn with the casualties of broken relationships, broken promises and broken dreams.5

For a fuller explanation of how alcoholism/addiction can affect all members of a family, and most particularly the children, watch Children of Denial.

mod2_clip2 Clip from Children of Denial

Help and hope are available as over two million people worldwide have found sobriety with serenity by participating in Alcoholics Anonymous (A.A.). Al-Anon is a companion group designed to help members of the household and significant others deal with their own issues with regard to alcoholism. Alateen is for teenagers in the family. The final module will deal more in depth with this aspect of recovery.

The impact of addiction on children is incalculable. This brief video Tell Someone shows their pain. A screening test to be used with young people to determine the presence of alcoholism in the household has been devised. The CAGE test has been adapted to reflect concerns for a parent's drinking through the use of four questions:

  1. Do you think your parent needs to CUT down on his/her drinking?
  2. Does your parent get ANNOYED at comments about his/her drinking?
  3. Does your parent ever feel GUILTY about his/her drinking?
  4. Does your parent ever take a drink early in the morning as an EYE opener?

A more developed screening test for alcoholism designed for the alcoholic to do a self-assessment is contained in Module II, Handout 2 and may be discussed in class if there is time. This screening test may be duplicated for the student's reference for future ministry.

1. Fetal Alcohol Spectrum Disorders places the fetus at risk since the mother and fetus share the same blood stream. If the pregnancy is carried to term, the child may be born with mental retardation, the inability to establish healthy relationships and healthy boundaries with others, neurological impairments as well as physical anomalies bearing features similar to Down's Syndrome.

2. Robert Albers, Shame: A Faith Perspective. Binghamton, N.Y.: Haworth Press, 1995.

3. Korsakoff's syndrome is a severe mental disorder caused by damage to the nervous system because of the heavy and chronic use of alcohol. It is characterized further by vitamin deficiencies having an neurological impact that results in memory loss, disorientation and a variety of other problems.

4. Wolin, S. & Wolin, S. (2000). MORALITY IN COAs: Revisiting the Syndrome of Over-Responsibility. Stephanie Abbott (ed.). Children of Alcoholics: Selected Readings, Volume II, 223-233.

5. Ann Price and James Emshoff. Breaking the Cycle of Addiction: Prevention and Intervention with Children of Alcoholics. Stephanie Abbott (ed.). Children of Alcoholics: Selected Readings, Volume II, 61-75.

 

Module Home • Introduction • General Awareness Information • Salient Features Concerning Alcoholism • Stages of Alcoholism
Physiological Impact of Alcoholism • Other Options to Exercise in Conjunction with this Module