Excerpts from "Under The Influence"

[GreenTea]

That's a good and interesting question... Sorry it took so long for me to see it...

I think societal factors are the primary driver when someone starts to use alcohol. I don't think anyone spontaneously sought to use alcohol based on their genetics... In other words, alcohol use is held and presented as a viable option, whether it be in the form of peer pressure, social convention, or just simple advertising...

The message is "using alcohol is okay"... So when faced with something, using alcohol is considered an acceptable method of dealing with it. It doesn't matter what your particular "something" is -- "Are you happy? Have some booze!"... "Are you sad? Have some booze!"... "Are you lonely? Have some booze!"... "Are you bored? Have some booze!"... "Don't have any booze? Get some booze!"... "Got booze?"

For the majority of people this is no big deal, (we alcoholics are a minority in society, afterall, just as people who are allergic to peanuts are).

For me, that was certainly what got me started. I originally saw using alcohol as no big deal. It was on about a par with eating birthday cake, the only difference being that no one cared whether or not you ate cake because cake didn't get you buzzed, (well, most cake anyway!)... At that time and in that place, drinking beer was not only considered acceptable, but it was also practically expected.

Once I started using alcohol, I found that it was good, (or so I thought). It made me feel good, it provided me with social acceptance, and it also allowed a "momentary escape" from my life and the problems I was facing.

I think that once a person *starts* to use alcohol, then genetic factors start coming more strongly into play. I think that the crucial difference is whether or not the "early stage adaptations" begin, as described earlier. I also think that there are certain "threshold values" which must be met for those early-stage changes to start, and that the "thresholds" are set differently for everybody.

Some people are hooked by their first drink. Others don't get hooked until after years of moderate drinking. Some people, even with a genetic disposition, don't get hooked at all, (and social factors may be responsible).

I know with me, the way I learned it, "...if you aren't drinking to get drunk, then you're just wasting the beer...", (did someone else's genetics turn me into an alcoholic? LOL)... Social issues may have gotten me started on saturating my system everytime I drank, but the fact remains that *I* choose to saturate my system.

With me, somewhere along the way I crossed a line. I'm not sure exactly where it was, but it was pretty early. At that point social factors weren't what caused me to drink -- it was my alcoholism that did. Social factors merely condoned it, (and perhaps encouraged it). It was my alcoholism that kept me drinking, and as I progressed through the stages, kept me drinking more and more.

Social factors then stopped condoning it, but that didn't stop me from drinking. Heck, I didn't even *notice* the negative social feedback! Over many years time, protecting my "right to drink" was very important to me because it was very important to my disease.

I kept crossing more lines. At some point, whenever I'd go out, I simply could not get drunk enough no matter how hard I tried. I can only see this as the result of genetics and my own sad choices years earlier. I simply cannot see how there is *any* social factor which results in the phenomenon of craving, and looking back, my craving steadily increased over time, (oh how I hated wrestling with that!).

Then I started to hit the third, deteriorative stage. I knew there was a serious problem, but I no longer really cared anymore. Alcoholism already had me firmly in its grip, and had for a long time. It merely turned up the heat.

So, I guess the short answer is this... I think that social factors started me drinking, but that once I did chose to start, then genetic factors kicked in and kept me drinking, and drinking more and more despite any social feedback to the contrary... I agree that alcohol should be classified as a "selectively addictive drug", with its selectivity based primarily in genetics, but that social factors are what get you to *try* alcohol in the first place.

Hope this makes sense. Thanks!

[KenL]

I have read Under the Influence and it is a wonderful book that started my education about alcohol. I have found another and I am sure you know of it. If not then here is the title, Beyond the Influence: Understanding and Defeating Alcoholism. It is written by Katherine Ketcham and William Asbury (an admitted alcoholic). This is a wonderful fount of information as well and should be read by anyone who thinks they may have alcoholism.

[palmbeachsooner]

All I can say is WOW, and I (will) owe my life to you Tea. I haven't gone through the steps but you certainly have spoken to me as if you know me.

I can't wait to get clean, all. THANK YOU SO MUCH!!

I am at the next meeting. I swear on my soul, I will be and will owe it to you!

[GreenTea]

PalmBeach... No, no, no... Don't thank me... It isn't me...

Thank our Higher Power!

[Bard]

Good thread, nice to read some from that book. I just ordered a copy from Amazon, you can find one on there for a whole whopping penny. The follow up is a bit more but not by much. I'll probably order that as soon as I'm done with the first. Thanks for posting this!

[Dime]

Those excerpts are fascinating. The descriptions of the genetic factors and what happens to those with a genetic predisposition seem very consistent with my own experiences. The chemical differences described should be easy to measure with a controlled study to establish solid precursor conditions scientifically. But I have never heard of any such study of tests performed by the medical community to do such. Is anyone aware if controlled studies have ever been done and why such tests are not done by the medical community? I suspect that the reason is that the correlation is not strong enough to warrant such testing. I want to get a copy of the book in either case and will try to find a cheap source to pick up a copy.
Good Stuff!

[CarolD]

Amazon usually has both 'Under" and it's sequel
"Beyond The Influence" by Ketcham and ???
very inexpensively.

[Dime]

Thanks Carol,
You are always so helpful here! I managed to find a used copy in good condition on EBay for under $5 including shipping to the USA. It does have the ISBN number of 0-553-27487-2 which matches the one GreenTea posted for "Under The Influence". There are more available there by various sellers if anyone else is looking for an inexpensive copy. I can't wait to get it, I love reading stuff like this. More evidence that it is a disease and we do not have a choice in drink!!

Found a good article on the effects of acetaldehyde in the human body and the differences between alcoholic and non alcoholic people. What's particularly interesting is that it apparently has dual role effects and it's presence in the brain has the reverse effect as it does peripherally in the rest of the body. The article review "Genetic polymorphism in ethanol metabolism: acetaldehyde contribution to alcohol abuse and alcoholism" is found under the Molecular Psychiatry site.

[CarolD]

Perhaps the new research will eradicate addiction
in the future. Wouldn't that be totally awesome?

Until then...I will continue to be
an AA recovered alcoholic....

[littlebrr]

I read this sticky a few weeks back and immediately ordered the book. I read it from cover-to-cover in less than two days. As an ACOA, this book opened my eyes and my mind. The information on the genetic disposition of alcoholism was a huge eye opener for me. I had a lot of "AH-HA!" moments reading it.

[californiapoppy]

Great to read about "blackouts", I called them my black holes, missing portions of my life. That was and is the scariest part of alcohol as far as I'm concerned !! I wonder what drawer my brain put all that info in...

[Dime]

I received my copy of "Under The Influence" and finished it in two days also. I had a hard time putting it down. I highlighted a lot of the text just like I did in the Big Book and I am making note of page numbers as I am going to use this as a reference. This is the most detailed fact filled description on alcoholism that I have ever seen. It literally changed my whole concept of the cause of alcoholism. Here's the clinker; every sentence and page of this book made sense immediately and I could identify with everything. No need to study it or read it a second time.

If you have a drinking problem or are already an alcoholic this should considered required reading!

[CarolD]

Please check out the eating plan and supplements near the back.
I did that for about 6 months and consider it instrumental
with getting me back in balance ...mentally and physically.

.....Hope you too will benefit.

[Dime]

Thanks Carol,
I definitely am more concerned about nutrition after reading the book. At sixteen months of sobriety I have episodes that are described to a "tee" under PAWS. Perhaps nutrition may be a factor.

[electrickery]

Wow! Thanks so much for that. Such incredibly useful information to digest... I will be ordering the book ASAP!

Perfectly describes why when me (long time moderate then turned binge drinker) and my partner (light drinker) have such different reactions to alcohol - me wanting to drink drink drink.... and keep going all night and he just to go to bed after two glasses of wine.

and the blackouts, and the hangovers....

Thanks again.

[CarolD]

electrickery.......
Apples and orages ...for sure

Good to know you will be buying this resource.

"Beyond The Influence" is the sequel
I've not read it but other members found it helpful.

[BloodnbonE]

Originally Posted by GreenTea

{Page 33}
At some point, however, the drinking patterns of both groups begin to diverge. The alcoholic starts to drink more, and more often. He does not want to stop drinking once he has started. In the later stages of his drinking, he may keep a six-pack of beer in his desk drawer or a pint of whisky in the glove compartment. He may stop regularly at the corner tavern for a few quick ones after work. He may gulp his first drink or switch to martinis or straight whisky.

The alcoholic appears to be using alcohol to solve his problems. His drinking appears to be an effort to drown his depression, forget work or marriage difficulties, obliterate loneliness and insecurities, and ease mounting tensions.

The reality, however, is very different from the appearance. In reality, an abnormal physiological reaction is causing the alcoholic's increasing psychological and emotional problems. Something has gone wrong inside.

{Page 34}
In other words, while psychological, cultural, and social factors definitely influence the alcoholic's drinking patterns and behavior, they have no effect on whether or not he becomes alcoholic in the first place.

Physiology, not psychology, determines whether one drinker will become addicted to acohol and another will not. The alcoholic's enzymes, hormones, genes, and brain chemistry work together to create his abnormal and unfortunate reaction to alcohol.

{Page 35 & Others}
(I'm going to grab a few things here and there starting on page 35)

Acetaldehyde, the intermediate byproduct of alcohol metabolism, appears to be one of the major villians in the onset of alcoholic drinking. The trouble probably begins in the liver ...

... found that the same amount of alcohol produced very different blood acetaldehyde levels in alcoholics and nonalcoholics. Much higher levels were reached in alcoholics. Lieber theorized that this unusual buildup of acetaldehyde was caused in part by a malfunctioning of the liver's enzymes.

... took this acetaldehyde difference in alcoholics one step further. His studies confirmed that, in alcoholics, the breakdown of acetaldehyde into acetate -- the second step in alcohol metabolism -- is performed at about half the rate of "normal" i.e. nonalcoholic metabolism. It is this slowdown in metabolism which apparently causes acetaldehyde to accumulate.

... Heredity is clearly implicated in these studies ...

In summary, addiction to alcohol may, in part, be traced back to a liver enzyme malfunction which results in a buildup of acetaldehyde throughout the body. In the brain, these large amounts of acetaldehyde interact with the brain amines to create the isoquinolines. These mischievous substances may trigger the alcoholic's need to drink more and more alcohol to counter the painful effects of the progressive buildup of acetaldehyde.

... Accumulated evidence clearly indicates that alcoholism is hereditary ...

... The weight of evidence clearly links alcoholism to heredity ...

Goodwin's studies provide compelling evidence that alcoholics do not drink addictively because they are depressed, lonely, immature, or dissatisfied. They drink addictively because they have inherited a physical susceptibility to alcohol which results in addiction if they drink.

Furthermore, this evidence has profound implications for treatment. While it may be possible to teach the problem drinker how to drink in a more responsible way, the alcoholic's drinking is controlled by physiological factors which cannot be altered through psychological methods such as counseling, threats, punishment, or reward.

In other words, the alcoholic is powerless to control his reaction to alcohol.

{Page 48}
Because the early alcoholic shows no sign of disease, the logical but wholly mistaken idea persists that alcoholism begins only when the drinker does suffer from drinking and does show some deterioration in physiological functioning, such as severe withdrawal symptoms, personality disintegration, or inability to control his intake.

Before these visible symptoms appear, most people assume that alcoholics and nonalcoholics experience precisely the same physical reaction to alcohol. In fact, they do not. The alcoholic reacts physically in an abnormal way to alcohol, and his disease begins long before he behaves or thinks like an alcoholic.

The reactions or adaptations of the body's cells to alcohol remain hidden in the early stages of the disease, but they are nevertheless happening. In months or years, the cells will have been so altered by alcohol that the alcoholic's behavior and thought processes will be affected. Then the disease will no longer be hidden, and the alcoholic will clearly be in trouble with alcohol.

In the early stage, however, the disease is subtle and difficult to recognize. It is characterized by adaptations in the liver and central nervous system, increased tolerance to alcohol, and improved performance when drinking.

wow now the bit i have bolded astounds me. i would never have believed this.

great posts btw thanks very much its extremely informative

[BloodnbonE]

Originally Posted by GreenTea

{Page 33}
At some point, however, the drinking patterns of both groups begin to diverge. The alcoholic starts to drink more, and more often. He does not want to stop drinking once he has started. In the later stages of his drinking, he may keep a six-pack of beer in his desk drawer or a pint of whisky in the glove compartment. He may stop regularly at the corner tavern for a few quick ones after work. He may gulp his first drink or switch to martinis or straight whisky.

The alcoholic appears to be using alcohol to solve his problems. His drinking appears to be an effort to drown his depression, forget work or marriage difficulties, obliterate loneliness and insecurities, and ease mounting tensions.

The reality, however, is very different from the appearance. In reality, an abnormal physiological reaction is causing the alcoholic's increasing psychological and emotional problems. Something has gone wrong inside.

{Page 34}
In other words, while psychological, cultural, and social factors definitely influence the alcoholic's drinking patterns and behavior, they have no effect on whether or not he becomes alcoholic in the first place.

Physiology, not psychology, determines whether one drinker will become addicted to acohol and another will not. The alcoholic's enzymes, hormones, genes, and brain chemistry work together to create his abnormal and unfortunate reaction to alcohol.

{Page 35 & Others}
(I'm going to grab a few things here and there starting on page 35)

Acetaldehyde, the intermediate byproduct of alcohol metabolism, appears to be one of the major villians in the onset of alcoholic drinking. The trouble probably begins in the liver ...

... found that the same amount of alcohol produced very different blood acetaldehyde levels in alcoholics and nonalcoholics. Much higher levels were reached in alcoholics. Lieber theorized that this unusual buildup of acetaldehyde was caused in part by a malfunctioning of the liver's enzymes.

... took this acetaldehyde difference in alcoholics one step further. His studies confirmed that, in alcoholics, the breakdown of acetaldehyde into acetate -- the second step in alcohol metabolism -- is performed at about half the rate of "normal" i.e. nonalcoholic metabolism. It is this slowdown in metabolism which apparently causes acetaldehyde to accumulate.

... Heredity is clearly implicated in these studies ...

In summary, addiction to alcohol may, in part, be traced back to a liver enzyme malfunction which results in a buildup of acetaldehyde throughout the body. In the brain, these large amounts of acetaldehyde interact with the brain amines to create the isoquinolines. These mischievous substances may trigger the alcoholic's need to drink more and more alcohol to counter the painful effects of the progressive buildup of acetaldehyde.

... Accumulated evidence clearly indicates that alcoholism is hereditary ...

... The weight of evidence clearly links alcoholism to heredity ...

Goodwin's studies provide compelling evidence that alcoholics do not drink addictively because they are depressed, lonely, immature, or dissatisfied. They drink addictively because they have inherited a physical susceptibility to alcohol which results in addiction if they drink.

Furthermore, this evidence has profound implications for treatment. While it may be possible to teach the problem drinker how to drink in a more responsible way, the alcoholic's drinking is controlled by physiological factors which cannot be altered through psychological methods such as counseling, threats, punishment, or reward.

In other words, the alcoholic is powerless to control his reaction to alcohol.

{Page 48}
Because the early alcoholic shows no sign of disease, the logical but wholly mistaken idea persists that alcoholism begins only when the drinker does suffer from drinking and does show some deterioration in physiological functioning, such as severe withdrawal symptoms, personality disintegration, or inability to control his intake.

Before these visible symptoms appear, most people assume that alcoholics and nonalcoholics experience precisely the same physical reaction to alcohol. In fact, they do not. The alcoholic reacts physically in an abnormal way to alcohol, and his disease begins long before he behaves or thinks like an alcoholic.

The reactions or adaptations of the body's cells to alcohol remain hidden in the early stages of the disease, but they are nevertheless happening. In months or years, the cells will have been so altered by alcohol that the alcoholic's behavior and thought processes will be affected. Then the disease will no longer be hidden, and the alcoholic will clearly be in trouble with alcohol.

In the early stage, however, the disease is subtle and difficult to recognize. It is characterized by adaptations in the liver and central nervous system, increased tolerance to alcohol, and improved performance when drinking.

doesnt the statement i have bolded contradict the point of this whole site and alcoholic councelling? please correct me if im wrong

[Dee74]

I don't believe there's any way, or method of treatment, to teach an alcoholic to 'drink responsibly', no.

There is a way to recover though - don't drink alcohol

D

[NewBeginning010]

Originally Posted by BloodnbonE

doesnt the statement i have bolded contradict the point of this whole site and alcoholic councelling? please correct me if im wrong

The conclusion/summery is right under what you put in bold "In other words, the alcoholic is powerless to control his reaction to alcohol."

I believe they are referring to the people who continue to try & drink even though they cant drink responsibly.

[SCRedhead]

I believe it is mostly genetics that ultimately cause a person to become an alcoholic. That is, of course, my own personal opinion based on my background and my experience.

[BloodnbonE]

Originally Posted by Dee74

I don't believe there's any way, or method of treatment, to teach an alcoholic to 'drink responsibly', no.

There is a way to recover though - don't drink alcohol

D

Originally Posted by NewBeginning010

The conclusion/summery is right under what you put in bold "In other words, the alcoholic is powerless to control his reaction to alcohol."

I believe they are referring to the people who continue to try & drink even though they cant drink responsibly.

ok thanks for clearing it up

[Midton]

I've just read this and am quite baffled. I'll also have to get the book.

It makes me wonder if I am an alcoholic or a problem drinker/alcohol abuser. Most of my pals growing up used to go on about how they couldn't remember the night before and I would always complain that I remembered every sorid little detail of whatever I said or did. That has changed over the last few years or so. It also seems that a large proportion of my friends and the people in the community and even the culture that I grew up in are alcoholics.

According to this book alcoholism is down to genetic factors. Does this mean that you can't make someone an alcoholic? Does this mean that alcohol is inherently different from other addictive drugs or are these drugs addictions also related to genes.

If I give someone (or a country), say, opium that person will eventually become addicted. Is this book saying that if I constantly give someone alcohol over a long and continued period then a person with no genetic disposition to alcoholism will never become an alcoholic.

Apologies if I've mis-read the excerpts or if my queries seem dumb.

[McGowdog]

No I think your queries are right on. Many people don't seem to agree with this stuff, but I do.

Only something like 10% of the world is alcoholic. Some that have drank alcohol the longest (Jewish and Italian societies) have had the alcoholics die off until they got down to the 10%. Those that are late comers to the game (American Eskimo and Native Americans) got started with the "hard stuff" brought over by the Scottish and Irish and they've not yet had time to die off to that 10%. Their percentage is very high.

So I agree. Not everybody can nor will become an alcoholic. There seems to be a fine line between the alky and the hard drinker. The hard drinker can seem to do one of two things that the real alcoholic cannot; it's an issue of control. The hard drinker can... if they really want to or if they are given a sufficient reason, control the amount they drink once they start OR can stay away from the 1st one. The alky can do neither.

I am of the belief that anybody can be an addict... to drugs. And anybody can be a non-addict. Maybe there's such a thing as a real addict that separated them from the hard drug user. Maybe once addicted, they lose control like alkies do. IDK.

[CarolD]

Midton......glad you will be reading the book
There is also a sequel ....."Beyond The Influence"

As far as I am aware....there has been no absolute
definite answer as to why people become addicted.
There are many studies....concepts...ideas ...and
new research continues to seek the answers.

Regardless of how one becomes addicted to alcohol
abstience will improve your life. Alcohol damages
your brain and body...even those who are not addicted.

Congratulations on your new sobriety.....

I certainly hope you will find a way to enjoy a healthy
productive future without useing mind altering substances.
All my best....