{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.