Wrestling the Flesh – Alcoholism and Other Substance Abuse

“I can’t let Sister J. drive my kids to ecclesial functions anymore. We never know when she’s going to be under the influence.”

“Bro. and Sister X. are getting divorced. She can’t deal any longer with his behavior while drinking. He con- tinues to drink, and becomes abusive to her and the kids when he does.”

These are paraphrases of real comments made by real members in Christadelphian ecclesias in North America. They are representative of comments regarding the problem of alcohol- ism and other substance abuse addictions world-wide.

The purpose of this article is to bring some light to bear on this challenging and devastating disease, to raise the level of awareness of the nature of the problem, awareness of resources available to help individual members and ecclesias to deal with the problem in the afflicted individual and/or their close family members.

This article reflects a professional interest on my part as a physician in the disease of alcoholism and substance abuse and the recovery from these diseases. There has naturally been a growing personal interest as well.

Though most of these comments will be directed towards alcoholism, other substance addictions (narcotics, nicotine, food, etc.) will have a similar pattern of compulsive behavior and have similar 12 step based support group recovery available.

First, just a few statistics that clarify the magnitude and nature of the problem:

Of those adults who drink more than occasionally, it’s estimated that 5-10% of them will become dependent on alcohol. This is in concert with the estimate by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) that currently there are approximately 13.8 million in the US who can be classified as dependent on alcohol.

Approximately 85% of current inmates of prisons could benefit from alcoholism treatment, according to The National Center on Addiction and Substance Abuse (CASA) at Columbia University. There are 75,000 preventable deaths yearly which are directly attributable to alcohol abuse.

Nationally, our young people are at risk: Some studies done by NIAAA have shown the following:

Prevalence in 8th graders:

• 51.7% have tried alcohol
• 43.1% have had an alcoholic drink in the past year
• 25.1% have been drunk

Prevalence in 10th graders:

• 70.6% have tried alcohol
• 63.7% have had an alcoholic drink in the past year
• 48.9% have been drunk
• 1.9% have been daily drinking for at least 1 month at some point in their lives

Prevalence in 12th graders:

• 80% have tried alcohol
• 73.8% have had an alcoholic drink in the past year
• 62.3% have been drunk
• 3.6% use alcohol daily

Alcohol and substance abuse are real problems for our members and our young people. Current statistics support this. A recent study in one of the journals devoted to alcoholism research showed that a religious environment does diminish the likelihood of alcohol abuse for those teenagers genetically inclined to its develop- ment. However, we know that these problems are present in the household. The reduced likelihood above notwithstanding, virtually every arranging board has had to deal with the fallout of substance abuse. Although positive, the increasing number of brethren and sisters in our midst who are recovering is also evidence of this disease in our household.

Our understanding is helped by consideration of the definition of alcoholism written by the leading US physicians in the field of alcoholism.

“Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic.”

Thoughtful consideration of this definition and especially of each of the bolded words can be edifying and of aid in recognizing and helping those among us so afflicted. While alcoholism may lead to morally deficient behavior, the alcoholic him or herself is best considered as ill. Here is it most productive once again if we can ‘hate the sin, but love the sinner’.

It is important to reemphasize that this discussion relates to those who are unable to stop drinking in spite of interpersonal, financial, legal, physical, or emotional alcohol-related problems, in spite of a strong personal desire and repeated attempts to modify or abstain from drinking.

The fatal aspect of this disease if left untreated is also commonly recognized. The only possible endpoints are death, incarceration, or mental illness and institu- tionalization. For those in covenant relationship, the eternal consequences are overwhelming; “they which do such things shall not inherit the kingdom of God.” (1Cor 6:10, Gal 5:21, Rom 13:13).

These are not “scare points.” They are simply the facts which can encourage us to do the right things and to make the difficult and sometimes unpopular choices of actions to take. Ignoring the problem cannot be our response.

The non-fatal behaviors of the alcoholic are protean,2 ranging from failure to complete vital family and ecclesial obligations to angry outbursts, to physical and emotional abuse of one’s family, to sexual misadventures, to poor school or work performance and job loss, to health problems including hypertension lead- ing to stroke or heart attack, pancreatitis, cirrhosis, etc. These are grim and often late manifestations. But even early on in the disease, there is severe distortion in the family. The continuing unpredictability in the behavior of our loved one, the marked self-centeredness, and the violent outbursts most often lead to behavior in the rest of the family members reflective of their great pain. There may be an obsession to “manage” the unmanageable alcoholic, anxiety for bills and the other family members, anger towards the ‘loved one’, denial (excuse-making, hiding the real behavior), feeling guilty as having caused the alcoholic behavior, and perhaps suffering the insanity of doing the same thing over and over again, expecting different results.

With this brief description of the disease and its impact, you may wonder “What can I do? I’m a lay person, not a professional or an expert here.”

You are taking the first step now as you read this article. We must educate ourselves, because help is available. Overcoming chemical dependency is possible, and you can direct someone to the help available. For problems with alcohol, the most effective method for recovery is by regularly attending Alcoholics Anonymous. While AA claims no monopoly on therapy for the alcoholic, it remains, in the most recent and most scientifically rigorous studies to date, the premier treatment modality for this disease. Apart from AA, results have been meager. Experience of many brethren and sisters now in recovery in AA reveals that AA participation is fully compatible with their walk in the Truth. They also note that AA’s 12 steps have a basis in Scriptural principles.

It’s easy to learn about this resource. There is a web site which will not only give you much additional info on the disease and recovery. It will let you find a meet- ing in your local area, no matter what part of the world you are in. Here is the hyperlink: http://www.aa.org

If you explore this link, you will find contact data for local AA in 60 countries in the world, including most of our outreach counties. There you will find meeting locations, literature resources, and, if necessary, a way for someone to arrange personal contact with a recovering person.

Read the first 164 pages of the book Alcoholics Anonymous. This book is inexpensive and widely available your local AA office, which may be found on the web or in the white pages. In reading this book you will find out much more about the disease and the program of recovery. Since you are part of the person’s ecclesial family, you may find the chapter entitled “The Family Afterward” especially interesting.

There are many brethren and sisters now who are recovering in AA. Get to know them if possible. Most of them are more than willing to help another recover if they are asked. If you find no one, call the Christadelphian Caring Network for a referral for a brother or sister in AA to talk to. This is available through the fol- lowing toll-free number: 1 866 823 1039.

For recovery from other forms of chemical dependency, there are other recovery groups available, e.g. Narcotics Anonymous, Cocaine Anonymous, Nicotine Anonymous, Overeaters Anonymous, and others. These all have websites which can be researched or consulted. Many are addicted to multiple substances includ- ing alcohol, so a start in AA, the most established recovery group that is available to them almost always greatly helps in this area.

For those family members (including young people as well as spouses) living with an alcoholic and suffering with it, a referral to Al-Anon can be especially helpful. They can regain some normalcy in their lives, whether or not the alcoholic recov- ers. The web link to Al-Anon follows: http://www.al-anon.alateen.org/

Problems with alcohol?

If you are sick and tired of being sick and tired, you may be an alcoholic and you may need help. The purpose of this message is to tell you that there is hope, that help is available, that it doesn’t have to be this way anymore, and that you do not have to do this alone. Here is a link to a questionnaire you can use to help de- cide if you really have a problem with alcohol: http://www.lakeweb1.com/mrp/ literature/20quest.htm.

So, please look at AA’s website, learn what it is and what it does and where the meetings are in your local area. If you decide, in all self-honesty, that you are powerless over alcohol and that you want to give up drinking, then make the first step. Call your local central AA office, find a meeting close by, and go to it. You’ll find others there like yourself, who are more than willing and able to help you begin your walk in sobriety. “You don’t have to do this alone, but you alone must do the work involved.” Bob Korbelak (San Diego County, CA)

Notes: 1. Morse RM, Flavin DK. The definition of alcoholism. JAMA. 1992;268(8):1012-1014. (free article) 2. Term meaning: “tending or able to change frequently or easily”.

There is a further resource on The Tidings web site with FAQ’s about Addictions: See http://www.tidings.org/2012/08/faq-addictions

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