It is directly absorbed into the blood-stream through the walls of the stomach (2) and the intestines (3) (absorption). Unlike other foods, alcohol does not require digestion.Once alcohol enters the blood-streams, it circulates thrughtout the body. It reaches the brain (5) and goes along with the blood to every organ, including the heart (4), Liver (6) and pancreas (distribution).When alcohol reaches the liver, it is changed into cabon dioxide, water and empty calories. This process is called oxidation.A small amount of alcohol goes out of the body through breath, urine and sweat (8) (elimination).
The sick feeling (headache, upset stomach, mausea, unusual thirst) experienced after excessive drinking is called a hangover .If a person drinks excessively during night, the hangover will be felt next morning.Often people believe that a hangover can be overcome by :
Most people drink because a small quantity of alcohol taken produces certain short-term-effects :
People take medicines for many common health problems. When alcohol is also taken with these medicines, certain adverse effects will be experienced.
|Medicines taken for||Effect with alcohol|
|Cold and fever (antihistamines)||Drowsiness|
|Diabetes (insulin)||Can cause facial reddening, headache, weakness, vomiting, dizziness.|
|Heart problems (antianginal)||Sudden low blood pressure when a person stands up. Dizziness, loss of consciousness occur.|
|Pains and aches (analgesics)||Central Nerbous System slows down, Breating stops suddently.|
|Sleeplessness (sedatives)||Slowing down of central nervous system, Breating stops suddenly.|
When a person takes alcohol or drugs excessively, several problems arise. (These are clearly visible to others.) Yet, The person continues to say that he has not problem at all.This is called Denial.
Addicts deny their problem in order to protect themselves from hurt, sad or guilty and also to continue with their drinking/drug-taking. To friends, relatives and well-wishers of the addict, Denial will appear as a lie, or a method to avoid taking the responsibility for his own harmful actions. They therefore, become angry and hostile towards the addict. This chapter will reveal that Denial is part of the disease of addiction. Therefore, the prson who desires to help the addict should not get upset or angry over his Denial. The addict is not purposely telling lies, and he therefore needs compassion and understanding.
The addict may say that he has not problem with drinking or drug-taking. He claims he has only other problems like ill-health, debts, ack of family support, etc. However, the real problem is addiction which he denies (simple denial).Claiming that others are the cause for his addiction (blaming)
Often an addict would blame his wife or parents and say, I am forced to drink /take drugs. If you were in my position you would also do the ssame thing. Here, he blaming others for his addiction. Balan says, My wife is very arrogant. She does not respect me at all. I drink to forget my unhappy married life.Accepting the problem of addiction but claiming it is only a small problem (minimizing).
Here, the addict agrees that he takes alcohol or drugs, excessively. But, he believes it is only a small problem. Velan drinks one bottle of rum, everyday. One day, he suffers from severe stomach pain. When the doctor questions him about his drinking, Velan says, I drink only once a week and that too just a quarter.Produdcing intelligent excuses for addiction (rationalizing).
The addict here, gives reasons for his drinking or drug-taking. No reasons are justified when a person is an alcoholic or a drug-addict. Rekha says, Dilip promised to marry me. He cheated me and has married Meera. I take brown sugar to forget Dilip and the days we spent together.Avoiding any talk about his addiction (diverting)
Whenever someone talks about alcohol or drugs, the addict diverts the topic and talks about something else.Mithun is addicted to ganja. His brother wants to help him and says, Mithun! Youd better take treatment soon.Otherwise, you will ruin. Mithun does not even allow his brother to finish the sentence and asks, What about your ticket to Bombay ? Should we not get confirmed now ? Mithun feels ashamed, guilty and sad about his problem. So he prefers not to talk about it.Initiating fights and quarrels
(becoming aggressive and hostile) are also forms of denial. The quarrel provides an excuse to drink or take drugs. It makes the addicts feel less guilty.Rajan comes home from office. He rings the door bell. His wife, Sita, has been helping her son with his lessons. It takes some time for her to open the door. When she opens the door Rajan shouts, You deliberately made me stand here for so long. After a quarrel with Sita, he goes out to drink.Denial gets strengthened in an addict when family members, friends, co-workers and employees unknowingly ry to protect him or take responsibility for the consequences of his addiction. For e.g., friends lending money to buy brown sugar so that he culd avoid withdrawals. When a factory worker is drunk, his co-workers complete his jo so that the addict is not punished. Such people are called enablers.Family members normally do all the duties of the addict. The alcoholics wife plays the role of mother and father of children. She takes up a job and earns money, takes care of the children, does all the household duties, pays the bills, etc.Such people are called compensators.In such a situation, the addict finds life moving on smoothly due to the emabling and compensating behavior of the people around him. He is therefore never allowed to face reality. Therefore, his Denial gets strengthened.
When a person drinks alcohol, it passes through the walls of the stomach and intenstines directly into the blood steam. It mises with the blood and circulates throughout the body. It enters the brain, liver, pancreas etc.When happens when a person takes large quantities of alcohol on a regular basis? In this chapter, let us see the damage caused by alcohol to each system in our body.
|System affected||Symptoms as felt by the drinker||Problems observed by others||Name of the disease|
|Gastro-Intestinal System (stomach, intenstines)||Heart burn,Pain in the stomach,Nausea,Irritation in the mouth, throat and food canal,Vomiting blood,Blood in stools||Unable to eat properly, Sudden weight loss or gain, Vomiting blood in the mornings||Gastritis,
|System affected||Symptoms as felt by the drinker||Problems observed by others||Name of the disease|
|Brain and Spinal Cord (cntral nervous system)||Tingling feelings and numbers of feet, followed by acute pin pricks,Fatigue,Impairing memory, Lack of concentration,Pain in the calf muscles
Change in gaze blurred vision, Change in gait(without alcohol) Loss of memory,Speech disturbances
|Swelling in legs,Change in gait,Incoordination
Strange movement of eye-balls,Gait and speech disturbances,Loss of memory,Having unshakable wrong notions,(Confabulation)
|System affected||Symptoms as felt by the drinker||Problems observed by others||Name of the disease|
|Liver||Acute stomach ache,Vomiting blood,
Loss of appetite, Vomiting sensation, Blood in stools
Loss of appetite, Acute, stomach ache, Swollen feet, Bleeding through the nose/gums, etc.Vomiting blood
|Acute stomach ache,Vomiting blood
Loss of appetite, Poor eating, Yellowness in face, eyes, etc.
Poor eating, Bulging stomach Swollen feet, Vomiting blood, Yellowness of face, yes, etc. (Jaundice)
Jaundice (Alcoholic Hepatitis)
|Pancreas||Loss of appetite, Pain in the back, Fever ,Fatigue
Frequent urination,Excessive thirst
|Loss of weight, Fatigue
Drinign a lot of water
Chronic pancreatitis Diabetes
|System affected||Symptoms as felt by the drinker||Problems observed by others||Name of the disease|
|Cardio-Vascular, System||Chest pain Palpitation, Breathlessness||Breathlessness||Cardiomyopathy|
|Respiratory System||Sudden increase and decrease in the rate of respiration||-||Cancer of the lungs (This may even lead to death)|
|Skin||Dryness of skin Itching||Dryness of skin Itching||Dermatitis|
|Deficiency of the particular nutrient||Name of the disease||Symptoms|
|Vitamin B 1||Alcoholic beri-beri||Heaviness of legs, Swelling of feet Tingling feeling and numbeness of feet, Loss of appetite Tiredness, Cardiac problems leading to breathlessness|
|Vitamin B 3||Dermatitis
|Irritation in the skin Loose motion.|
|Vitamin C||-||Lack of resistance to infections|
|Minerals||Magnesium deficiency Zinc deficiency||Tremors, Fits, Loss of sense of taste, Slowness in healing of wounds|
As addiction gets worse day by day, the family is compelled to face several unmanagelable problems. Unable to cope with these problems, the family constantly lives under severe tension and pressure.This results in the family members becoming desperate, angry, frusterated, ervous, afraid and guilty. In many ways, they start behaving just like the addict, even though they do not take alcohol or drugs.
Vivek is an alcoholic. He has been irregular in attending office because of his drinking. Viveks wife, Latha, is finding life unmanageable. One evening she receives a telephone call from Viveks office. She learns that Vivek has been suspended from services due to irregular attendance and misbehavior at the work spot. She is shocked.Just then Vivek walks into the house. He is totally drunk. Viveks son runs to him and asks Daddy, have you brought chocolates for me? Vivek slaps the child. Trying to walk forward, Vivek falls down. Latha feels desperate. Oh! God! Whats happening here? This child is crying. This man is drunk! Doesnt even understand he may lose his job tomottow!
Instead of comforting the child, she also slaps him and shouts, Stop crying,; puts her husband on the bed and does not cook anything that evening. Though the children feel hungry, they do not ask for food. All of them go to bed without eating anything feeling scared, bitter, and totally confused!
While living with her addict, the family members deny the problem. They either say that there is not problem or give reasons for the drinking or durg-taking behavior of the addict.The wife says, My husband does not drink a lot. But, he never beats me. He never misbehaves. So he certainly has no problem with drinking.Similarly, a father may deny the drug addiction of his son. However, as the problem becomes worse, the family members take on various toles to cope with the situation.
The family members cover up or conceal the consequences of the addicts drinking or drugtaking behaviour.
1. It is the first death anniversary of Raghus father. The entire family has gathered to perform the religious rites. Howeverm Raghu is totally drunk and is sleeping at home. So, the wife protects Raghu saying, He has a lot of work in the office. His boss has refused to give him leave. That is wy he has not come over here.
2. Nikhils parents receive a letter from the college that their son has not attended classes regularly. Even though they are aware that Nikhil has been on ganja, they meet the principal and say, Nikhil has been sick frequently. That is why he has taken leave often. Please allow him to write the exams.
At this stage, the family members do not realize that the real problem is the addicts drinking or durg-taking. Their only focus is on concealing or covering up the consequences.
The family members may :
All these methods are adopted with the intention of controlling the quantity, time and place of taking alcohol or drugs. But, none of these methods work.
Now, the family members are totally frustrated and helpless. This leads to anger, bitterness and resentment towards the addict.
They say :
The family members neglect all their duties and blame the addict for every problem. This leads to total disorder in the family.
At home, tension and anger increase. The family members want to be left alone. They avoid visiting even their friends and relatives. Do any of these methods help the addict to recover ? No, certainly not.
At this stage, not only the addict, but also the family is deeply affected.
So the family members need a lot of EMPATHY, UNDERSTANDING AND HELP.
e.g. Rajan has become addicted to ganja. Every morning his mother his mother pleads with him to give up the habit. It does not work.So, she takes him to Tirupathy and asks him to promise in front of God that he will never smoke ganja again. Rajan does so. Rajans mother thinks, Now that he has promised in from of Lord Venkateshwara he will hereafter, be very scared to touch ganja.For a month, Rajan is fine. Then, on the college annual day, Rajan smokes ganja with his friends forgetting all about the promise he made. He comes home heavily doped. His mother is shocked. Do not cover up the consequences of his drinking or drug-taking. It reduces the crisic for that moment, but worsens the illness since this way, the addict never faces reality. If the addict is left to face a crisis all by himself, he will seek help.
e.g. George has borrowed a lot of money from few shop keepers to buy brown sugar regularly.One fine morning, some of the shop keepers are shouting outside Georges home! Better give back our money right now. If you dont pay us the money now, we will beat you up, on the road. Georges father pays them off and sends them away. He warns George, George! This time, I have paid off your dues. But dont ever touch brown sugar again. Have you understood ? George agrees but thinks, Whenever I have a crisis, dad will somehow pull me out of it.
Do not attempt to punish, threaten, bribe, preach or try to appeal emotionally to the addict.
These methods may seem to work temporarily. But in couse of time, they will have no effect.
Addiction is a disease. Accepting this fact will help the family members to understand the addicts problems better.
Since addiction is a disease, the addict has to be taken for treatment to recover.
Feelings of love, security and warmth which ae necessary for the normal development of children are not at all available in the families of addicts.
The children of addicts are governed by three unwritten rules :
They feel ashamed to talk about the confusion, the fights, and problems at home to their relatives, friends or to their teachers. They believe that by talking about this matter they are letting down their family.
The children do not express any of their emotions. They keep their joys and sorrows to themselves. Their father, under the influence of alcohol or drugs and their mother, always worried about the addicted father, never respond to the childs feelings.
Eg. Venu is addicted to alcohol. One morning, when he has not taken alcohol, his ten-year old child, Nitya says, Daddy can I attend a birthday party at my friends place, this evening ? Venu replies, Of course, you have every right to visit your friends, any time you want. Nitya is overjoyed and goes out to buy a gift for her friend. In the evening. Nitya is about to leave for the party. Her father enters the house totally drunk. He shouts, Where are you going now Nitya?. Nitya says, You gave me permission this morning to attend a birthday party.Venu shouts, Dont talk too much ! You shall not go out anywhere. Nitya goes to her room. She does not argue. She does not cry. She shows not disappointment. She changes her clothes and sits with a book, as if nothing has happened. She knows there is not point in expressing any of her feelings.
Often parents break their promises the children feel very hurt. They are disappointed. Also, the behavior of the parents is unpredictable. Sometimes, they are very kind. At other times, they are terribly rude. As a result, the children tend not to trust any one.
Eg. Chandran and his family are ready to leave for Ooty. His children are excited.Chandran goes out to bring an auto rickshaw. Instead of bringing an auto, Chandran goes to the bar. He drinks a lot and returns home drunk. He goes to sleep immediately. Chandrans wife is upset. The children are disappointed. This is not the first time that Chandran has broken his primise. Now, his children wonder, Can we ever trust Daddy? Will he ever do what he promises to do ? Do all elders behave like this ?
This child takes too much of responsibility much more than any child of its age. The child cooks, feeds the younger children and takes care of the drunken father. The child takes so much of responsibility, that he has no time to take care of any of his own needs. He loses all the joys of childhood.
This child quiently adjusts himself to any situation. He believes that silence is the best solution to every problem. This child always obeys his parents. He never shows disappointment when his parents break any promises. Adjusting to others becomes his second nature.
This child is highly emotional and easily hurt by the happenings in the family. He also tries to stop the quarrels and arguments at home. He always tries to please others and make others happy going out of the way sometimes.
This child is troublesome; disobeys his parents, does not attend school regularly, picks up habits like smoking, drinking or drug-taking. Feeling very neglected and being very angry with his parents, he lets out his emotions in destructive ways, both at home and outside.
The behavior and moods of the addict are unpredictable. When he is sober, the addict is kind and loving. After taking alcohol or drugs, he becomes angry and violent. The children of the addict are very confused.
Eg. Meena is studying in the second standard. Her father is an alcoholic. One morning, when Meena is leaving for school, her father kisses her and tells her, You must do very well in the test today. Ill buy you a big doll if you come first in class. In the evening, when Meena asks her father some doubts in her lessons, her father, who is drunk, replies, Shut up and dont disturb me! You are an irritating child. Meena feels terribly hurt. She thinks, I will not talk to daddy again, even if he is kind to me.
Unnecessary scolding and unjust punishments given to the child by the addicted and affected parents lead to low self-exteem of the child. That is, the child feels unloved and unworthy. He lacks self-confidence.
The addict does not follow the customs and norms of society. He is, therefore, not a good example or a model for his children.The mother takes care of the children, leaves them at school everyday, goes to work and arns money. She does al the work at home; she pays the electricity bill, buys milk coupons, does all the shopping. The father does not even go to office regularly. He does no work at home. The children, therefore, do not clearly know the roles they are expected to play in society.
The child also feels guilty thinking that he is the cause for the quarrels at home. Sometimes, he wonders if he is the reason for his fathers drinking.
When the children understand that addicts are not respected by the society, they feel diffident and ashamed. They do not like to go out with the addict. They feel bad to invite friends to their home.
There are often quarrels in the family. Thre may be physical violence also. In such situations, the children become tense or frightened. Even when there are no conflicts, the children feel very tense at home.
Addiction to alcohol or drugs is a disease. It is, however, a treatable disease. Harish Sharma, 34, was basically a good natured, successful businessman. He got into excessive, uncontrollable drinking and lost control over all that he did. As a result, debts mounted up and business closed down. His wife left him. He spent everything he had to buy alcohol. Finally, he become totally desperate and attempted suicide.
It was at this time that he was brought by his friends, Swami and Shah, to the Treatment Centre.
On the day he entered the Treatment Centre, Mr. Sharma was an absolutely frightened man.
Now, let us hear Mr. Sharma.
Yes! I felt terribly scared, indeed, because :
But now, looking back, I feel that it was a miracle that had happended.
People have many wrong ideas about the treatment of addiction. The following points will clarify such mistaken notions.
If the patient, who has all along been an addict, suddenly stops taking alcohol or drugs, he will experience amny unpleasant symtoms like tremors, fits, etc. these are called withdrawal symptoms.Medical treatment is given so that he will not suffer from a severe withdrawal. This part of the treatment is called detoxification (detox for short). During detox, specially trained physicians and nursing staff will be available to minimize the discomfort and suffering of the patient.In addition to this, the patient would also have developed other physical problem like gastritis, neuritis, damages due to malnutrition etc. these are also attended to during detox, and continued for a period of time, as necessary.
This treatment immediately follows detoxification. Psychological treatment is given not only for the benefit of the patient, but also for his family members. As for the patient, help and support is proided to lead a comfortable life without alcohol/drugs. Guidance is also given to make improvements in his life-style. The family receives a lot of understanding and empathy towards minimizing their sufferings. They are also trained to help the patient in his recovery.
The psychologist, counseller or social worker helps the patient and his family to overcome their problem in various areas of their lives. Guidelines are given to acieve positive changes in their attitude and thus improve their life-style.
Group therapy sessions are led by specially trained counselors. Here the patients and their families share their past experiences with others. This therapy helps them to realize that there are other people around with similar problem. They realize that they are not alone. This method helps them to get over their feelings of guilt, anger, hatred etc.
These are educative ectures providing information and guidelines. Topics like :
Are dealt with in great detail. Guidelines are also given as to know how one can cope with stress, anger etc.
These are groups formed by recovering alcoholics (AA), recovering drug addicts (NA) and the family members of addicts (Al-Anon).These are fellowships of men and women who share their experiences and solve their common problems. Those woho have recovered are able to help others in recovery by telling them how they managed to overcome their problems.The groups primary aim is to stay sober and help others to achieve sobriety. They have an enormous understanding of others problems because they had faced similar problem themselves. Any addict can become a member of AA or NA. Similarly, family members of any addict can become member of Al-Anon. There is no entrance fee. These are not connected with any sect, political party, organization or institution.Regular participation at these meetings helps a lot towards recovery.
Taking even small amount of alcohol or drugs after treatment will invariably lead to excessive drinking or drug-taking. This condition is recognized as relapse. Relapse can occur during the recovery of the patient. In case relapse occurs, the patient has to go back to go back to the Treatment Centre where he will be given medical and psychological support.John was a very bright student. He came across a group of drug-taking boys and tried chasing brown sugar just for fun. But he got hooked on to it. A warning letter for poor attendance and low marks was sent home. When Johns parents came to know about his drug addiction, they brought him to the Treatment Centre.John responded very well to treatment. He stopped taking drugs. His relationship with his parents and teachers started improving. So did his studies.After a few months, he developed a craving for brown sugar . He went back to his drugs-taking friends and to obsessive drug-taking again.Johns parents knew that relapse is a part of the disease. They continued to be compassionate and understanding and took him back to the treatment centre. This time, in the recovery process, John also learnt to identify symptoms that occur before the relapse and the preventive steps that could be initiated by him in good time. Relapse is a part of the disease of addiction. It does happen to many patients during recovery. Over a period of time, they learn to abstain totally from alcohol/drugs.
After-care is a very important part of the treatment programme.It is during after-care, that the patient really learns to leade a life without the need for alcohol or drugs.This is turn helps to prevent relapse.After-care includes regular contract with the Treatment Centre, periodic medical check-up, counseling and other psychological support.
We have now understood that addiction is a disease.We have also learnt about the symptoms of this disease and the process of treatment. With so much of awareness and knowledge, should we not now, start motivating the addicts to take treatment.Yes. We should.
By helping an addict to overcome his problem, we will be giving him a new life. In fact, the entire family will be ever grateful to us for the concern and care that we show towards their well being.
Well, it is relatively easy to help an addict who approaches us for help. But, most of the addicts may not seek such help; they may not even know that addiction is a disease which requires treatment.So, how do we, in the first instance, get to know a person having a problem of addiction ?
Since a strong social stigma is attached to addiction, the person will rarely accept that he is an addict or ask for help. So, as community workers, we will have to be alert and take note of situations like those listed below, which may be warning signals indicating addiction.
|A person with lots of debts around, in spite of having a job and a regular salary.||Common friends and acquaintances may provide clues as to what he is doing with all they money.Addiction may be cause. People close to him may know about it. We can find out through discrete enquiries.|
|Frequently absent from work without intimation or a valid reason. Absconding for short durations during work.||We can check with co-workers or Colleagues, whether he is given to drinking or any drug-taking.|
|A women visiting the health centre often for treatment of injuries and bruises.||This may be due to her husband being an addict. And this, in turn May lead to frequent fights at home. She may not disclose these facts voluntarily.|
|A younger meeting with accidents frequently.||His mother may say, This time he Was just getting down from the bus and the driver speeded up without stopping. The youngster, if present, may choose to simply keep quiet, allowing the mother to talk about the accident. He might have taken Ganja and got down from a moving but (refer Chapter 6) He may not have had any clue whatsoever as to what really happened to him!|
|Parents complaining about their childs unusual loss of appetite loss of appetite, loss of weight and sick look.||The real problem may be addiction to brown sugar. (Refer chapter 7)|
|Parents talking about their childs unusual desire to remain aloof Always, strange new friends coming home; but evasive when spoken to.||This may be due to drug-addiction and drug connections.|
|Parents worried if their child could be suffering from some mental illness because of the rrequent mood swings and biolent behavior.||The actual reason may be addiction|
The community worker has to be careful not to reach a hasty conclusion based on reports of a few isolated incidents. He has to gather adequate information before comng to the conclusion that a person is an addict.At this stage, it may be worthwhile to clarity who an addict is and what the symptoms of addiction are.An addict is one who has totally lost control over the time, place and quantity of talking alcohol or drugs, which in turn leads to continuous problems in one or more areas of his life, and yet he continues with his drinking/drug taking.
Once we have identified a person as an addict, we must meet the person often. We should enqire sympathetically about his problems and listen keenly.
A few hints to successfully motivate the addict are :Maintain individual dignity
We should not refer to him as drunk, drunkard, addict or dope. We must accept him as a person of dignity and worth.
We should not judge him as good or bad. We have to control our temptation to make any comments even when his actions appear totally unaccepatable.
We have to remember that denial is a part of the disease of addiction. So we must not argue when the addict says that he has no problem of drinking/drug-taking.\
We should not confront him with logic, reasoning or arguments. It would be best to approach the addict with a lot of compassion and understanding because he has a disease.
We should not be impatient to push him for treatment. We should listen patiently to all that the addict says. It takes time for a person or ask for help.
We should not lecture the addict or advise him about what he must or must not do.
Having listened to the addict and his family members talk about their problems, we must never spread these details outside. If we maintain strict confidence, the addict and his family will trust us more.
We must not break off the relationship with the addict at any time. Let him know that we are always available to probide support and help. We could tell him clearly, Im always there to help you. Please do not hesitate to contact me at any time.
In the process of listening, one can identify an area in which the addict has some special concern or interest. The addict may :
When this motivable area has been indentified, we can make ue of it to persuade the addict to accept treatment. (This persuation may be done in the same meeting or on a later occasion, whenever the addict is most receptive to some advice and guidance.)
After a few meetings when the family memvers accept that drinking or drug-taking is a problem, we can :
The addict may face a crisis like :
It is during a crisis, that the addict may be willing to see the problems arising out of drinking. So, this is the right time for any well wisher to persuade the addict to take treatment.It is very important no to vlame the addict for the crisis. When the addict talks about the crisis, listen with interest and concern.
During a crisis, we can persuade the addict to take treatment. We can say :
Now, that you have had an accident dont you think you can visit the treatment centre ? You can make sure that such a crisis does not occur again. Besides you can even improve your whole life-style..By this process, when the addict is motivated to visit the treatment centre, we should act immediately and take him to the treatment centre without delay.
So, we can render useful service by :