Seven Myths About Alcoholism
By LeeAnn Kreigh '09
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Two Pacific researchers from the School of Professional Psychology have made a career studying alcoholism and addiction, including the leading treatments. What they've learned might surprise you
Most of us have been affected by alcoholism. The disease has hit us personally, it has impacted the lives of our friends or family members, or at a minimum, it has touched the lives of our acquaintances — our classmates, co-workers, and neighbors.
Through our own experiences and the experiences of those around us, we have learned about the disease. We have seen how it takes hold of individual lives, breaking down once-healthy bodies and minds. We know too how the disease spreads almost uncontrollably — inherited in future generations, but also causing immediate damage to families and strangers through drunk driving, sexual assaults, childhood neglect, and other abusive behaviors.
And yet, perhaps because alcoholism is so personal in nature and so pervasive in our culture, it is unique not only in how well it is known, but in how little it is understood. Our experiences and observations lead to mistaken assumptions, biases, and myths built on generalizations and misperceptions.
Two professors in Pacific's School of Professional Psychology have spent years studying addiction and working with alcohol-dependent patients. Jennifer Antick and Cathy Moonshine know the latest information about alcoholism — how it is caused, how it can be prevented, how it should be treated — and they spoke with us at length about seven of the most common myths that surround alcohol use and treatment.
As clinicians and teachers, Antick and Moonshine emphasized the need for greater understanding of the disease and the people it affects, as well as greater acceptance of the many facets of alcoholism that we — and scientists around the world — still do not understand.
Myth 1: We understand addiction.
Even after billions of dollars have been poured into addiction-related research, Antick is unequivocal about the scientific reality: "We do not fully understand addiction."
What the scientific community generally agrees on is the multifaceted nature of addiction, which is considered a bio-psycho-social issue. Alcoholism in particular appears to have a genetic component, although genetics alone do not account for all cases. Alcoholism is sometimes thought to occur because alcohol is a social drink and because, on the psychological side, it is a relaxant that may help self-medicate other mental health issues the drinker is dealing with.
Moonshine said, "What we know is addiction is complex, and it happens over time, and it doesn't remit over time." She added that alcoholism is considered a "chronic remitting relapsing disease" similar to asthma, diabetes and heart disease. As with those other diseases, a single cause — whether biological, social or psychological — generally cannot be isolated, and an effective way to prevent or cure all cases has not been found.
All that uncertainty, Antick said, leads to another problem: "How do you treat something you don't fully understand?"
Myth 2: Only alcoholics have a problem with alcohol.
Most of us know people with a range of relations to alcohol: non-drinkers, social drinkers, binge drinkers, heavy drinkers, alcohol-dependent drinkers. A given individual may, in fact, belong to many or even all of those categories at some point in their life.
Those who become alcohol-dependent are not the only ones who may have problems with work, life and family. One problem facing occasional users is they may develop an addiction. Antick said, "Over time, the statistical likelihood of having a drinking problem will increase, and those who drink will be more likely to have difficulty controlling their use."
More common than becoming addicted to alcohol is making a damaging choice while drinking, such as driving while intoxicated. "You can have problems with use without having a psychological addiction," Antick said. "Problems in your life related to substance abuse can happen at a relatively low level of use. And if you use a lot or on a regular basis, the possibility of having a personal, social or job-related problem related to that use is good — and it increases. The more you use, the more likely it is that one day you'll have a significant problem."
Myth 3: Alcoholics have less willpower than those who drink without becoming addicted.
Having spent years treating a wide variety of alcohol-dependent people, Antick and Moonshine are adamant that this myth be put to rest.
Antick said, "There's an expectation that everybody should be able to drink and everybody should be able to handle their liquor. And if you can't, there's something wrong with you, and it's a moralistic issue: ‘Oh, well, she has a problem.' I have to say as a practitioner and researcher, that's not a very helpful perspective. It's not getting us very far, and it isn't very accurate."
Researchers agree that addiction is a brain disease, not a failure of willpower. "The brain of an alcoholic responds differently to alcohol than the brain of a non-alcoholic," Antick said. "The brain can change over time, and any of us can become addicted."
Moonshine argues that a lack of willpower is also not to blame for any failure to overcome addiction. "I think there's a lot of judgment in the media and in the world about people who have drug and alcohol problems," she said, "but overcoming addiction is not easy and failure is often a part of the process."
"If it was all about willpower and strong moral character," Antick added, "I don't really think [alcoholism] would be that big a problem. Some of the people I've worked with have been such unbelievably strong and amazing people, and even they sometimes can't get a handle on their addition."
Myth 4: One type of therapy will work for every alcoholic.
In her private practice, Moonshine treats addiction with cognitive-behavioral therapy, dialectical-behavioral therapy, a technique called the "matrix model" and a strategy known as motivational interviewing.
The result? She said for her, and for most therapists, the success rate of any one or combination of therapies is about 50 percent.
One problem, Moonshine said, is that in a destructive way, alcohol is meeting some need for the client. "It's either fun and enjoyable, it's relaxing or it numbs the pain, whether the pain is psychological, physical, emotional, or interpersonal. They're using because they're getting something out of it, even when it's illegal and problematic and impairing their family functioning."
In response to this confluence of causes, Antick said, "every type of therapy is available for addiction," including cognitive-behavioral therapies, religious and spiritual therapies, and social-support programs like Alcoholics Anonymous. Separately and in combination, all of them work … sometimes.
"When your brain is going gimme, gimme, gimme in the background," Antick said," it's very, very difficult to overcome."
Myth 5: Addicts who fail therapy are a lost cause.
According to Antick, the average number of times a person has to go into treatment before achieving long-term sobriety is three. "Relapse," she said, "is an expected part of therapy."
Addiction is a disease, she said, that "we can't cut out, we can't irradiate, and we can't really medicate well enough to make it go away." As a result, Antick argues we should not be surprised that people relapse as often as they do. "We should stop being appalled and disappointed and angry with people when they relapse. It's like telling someone with diabetes or arthritis to get over it. You should expect relapse and remission throughout the disease."
In her private practice, Moonshine said, "When treatment doesn't work, I know it's the throes of the addiction and how much hold that has over them. I always have faith and hope that if it doesn't work this time it will work in the future, whether that's pretty soon or in the distant future."
Myth 6: Alcoholics can rarely resume "normal" lives.
Antick and Moonshine have seen the worst cases — homeless people, veterans, people with mental health disorders on top of alcohol and drug abuse — and after all they've seen, they remain optimistic.
"I think people sometimes think addiction will only get worse and worse. I think recovery is entirely possible," Moonshine said, listing three examples of people she has treated who have overcome remarkable odds. "We have to remember that people can make major changes in their lives and be productive members of society and live well beyond their drug and alcohol use."
Antick's treatment experience has focused on homeless veterans with substance abuse or alcohol-dependence issues. "I've seen them turn their lives around. I've seen the wonderful changes people can make," she said. "We do have to understand it often takes a long time, but people tend to be very resilient in terms of what they deal with and what they are able to overcome."
Myth 7: Alcoholism won't affect my life.
Perhaps because, as Antick suggested, every city block has a bar or liquor store and every other advertisement tries to sell us beer, wine or liquor, we begin to feel that alcoholism is a disease that affects someone else. Even if it has touched the lives of those around us, we sometimes assume it won't affect us or our inner circle of friends and family.
Unfortunately, easy access to alcohol and appealing ads do not negate the reality that alcoholism can affect us all. "Addiction," Moonshine said, "affects everyone. It crosses all racial and ethnic barriers, all socio-economic and education levels, all geographic areas."
In 2006, 19.5 million Americans aged 12 or older needed treatment for an alcohol use problem. That's 8 percent of the population, of which only 1.6 million people received treatment.
When Antick drinks, she said her body tells her when she's had enough. Together, her bio-psycho-social makeup appears to be such that she will never drink too much and will never become addicted. She said that is not because she's "better or stronger" than anyone else.
Rather, she said, "I truly believe, I'm probably just lucky. Anyone who doesn't establish a problem, I think we're lucky."
*National statistic from the Department of Health and Human Services' 2006 National Survey on Drug Use and Health.
Jennifer Antick is the director of psychological services and director of health psychology at Pacific, and has been involved for more than two decades in both behavioral medicine research and addiction-related studies. Her experience includes nine years spent working with alcohol-dependent veterans in VA hospitals.
Catherine Moonshine is a practicing clinician who teaches courses on the treatment of chemical dependency to doctoral-degree students in Pacific's psychology program. She began specializing in the study and treatment of addiction and chemical dependency about a decade ago, and has worked in outpatient and residential treatment for a wide variety of populations, including college students, the homeless, people involved in the criminal justice system and adults leading otherwise typical lives.