Alcoholism | Introduction
Before recorded history, human beings discovered that grape juice, when exposed to naturally occurring yeasts, becomes wine. Scientists would eventually describe this process as fermentation, thousands of years after wine and other alcoholic beverages had become an integral part of many cultures’ meals, celebrations, and religious ceremonies.
Unfortunately, alcoholic beverages have also contributed to a considerable portion of human misery. Data from the National Center for Health Statistics indicate that excessive alcohol consumption causes more than 100,000 deaths per year in the United States alone, primarily through cirrhosis of the liver, drunk driving, and alcohol-related homicide and suicide. According to The Columbia University College of Physicians and Surgeons Complete Home Medical Guide, alcohol use is involved in half of all murders, accidental deaths, and suicides; half of all crimes; and almost half of all fatal automobile accidents.
The problem most often associated with heavy drinking, however, is alcoholism. Simply put, alcoholism is addiction to alcohol, but beyond this basic definition the symptoms of alcoholism can be difficult to pinpoint. They include a craving for alcohol, lack of self-control when drinking, a high tolerance for the effects of alcohol, and physical withdrawal symptoms, such as sweating, shakiness, and anxiety, when alcohol use ceases. Alcoholics often continue drinking despite repeated alcohol-related problems, such as losing a job, harming friends or family, or getting into trouble with the law.
There are approximately 14 million people with alcohol problems in America alone, somewhat less than half of whom are alcoholics. Such estimates are very rough because many people who drink heavily do not develop the physical and psychological dependence on alcohol that characterizes true alcoholics. The terms “problem drinking” or “alcohol abuse” are used to describe these drinking patterns, which may not lead to alcoholism but are nonetheless often destructive both to the drinker and to others.
In fact, nine out of ten people who drink do not become alcoholics. Researchers posit many explanations for why some people seem prone to alcoholism, while others are able to drink responsibly—or even to habitually abuse alcohol—without becoming dependent on it. Yet, despite decades of research, the exact mechanisms behind alcoholism remain poorly understood. Most scientists agree that alcoholism has at least some genetic basis, but they are also quick to warn that biology only explains part of the problem. Psychologists point out that while alcoholism does tend to run in families, this may be because children learn harmful drinking behaviors from their parents. Other researchers point to cultural influences, arguing that people from certain religious, ethnic, or socioeconomic backgrounds are more prone to alcoholism than others.
Controversy over the causes of alcoholism, however, is a relatively recent phenomenon: The term “alcoholism” itself was not coined until 1860, and the theory that it is a medical disease was only postulated in 1930. Historically, controversy over compulsive drinking has dealt not with what causes it, but rather with how to prevent it; those most concerned about alcoholism have not sought to study the condition, but instead to reduce alcohol consumption. This is especially true of the United States.
In colonial times, the states imposed fines on citizens for drunken behavior, or for selling alcohol to known drunks. Alcoholic beverages themselves, however, were not frowned upon until the end of the 18th century, when the temperance movement began in earnest. Led by religious leaders such as Cotton Mather and John Wesley, the temperance movement first preached against the evils of “ardent spirits,” or hard liquor. But by the early 19th century, leaders like the Irish priest Theobald Matthew and groups such as the American Temperance Society began advocating complete abstinence from alcohol. At the end of the Civil War in 1865, there was a clear conflict between “drys,” who favored the banning of alcoholic beverages, and “wets,” who did not. Groups such as the Woman’s Christian Temperance Union, founded in 1874, and the Anti-Saloon League of America, founded in 1895, steadily gained political influence. By 1913, nine states had instituted complete prohibition of alcohol, and many other states had severely restricted alcohol availability.
Finally, in 1917, temperance groups persuaded Congress to adopt national prohibition. In 1919 the 18th Amendment was ratified by the states, and the National Prohibition Act, also known as the Volstead Act, went into effect on January 27, 1920. Prohibition lasted for thirteen years, during which time the manufacture, sale, transportation, or importation of alcoholic beverages was illegal in America.
Prohibition, sometimes called “the noble experiment,” was a failure. Rather than eliminating alcohol consumption, it forced it underground into illegal speakeasies; by the late 1920s there were more speakeasies than there had been saloons. Bootlegging liquor became a lucrative practice, controlled by gangsters who bribed local police and public officials. Violence and corruption soared, while the problem of alcohol abuse only worsened. Prohibition was finally repealed on December 5, 1933, with the passage of the 21st Amendment. The government’s attempt to solve alcohol problems through law alone had failed. But the problems remained, and, after the repeal of Prohibition, other types of strategies were developed to deal with alcoholism. The most famous of these is Alcoholics Anonymous. Founded in the 1930s, it still strives today to teach alcoholics how to overcome their addiction and stay sober. More recently, psychological counseling techniques have been developed and organizations besides AA have formed to help people overcome alcoholism. Moreover, public awareness of the problem has increased substantially; rather than being seen simply as sinful or irresponsible behavior, as it was prior to Prohibition, since the 1930s more and more people have begun to view alcoholism as a medical problem rather than as a vice.
Although compassion for alcoholics has increased, the problem of alcoholism has not gone away, and Americans’ views toward alcoholic beverages remain mixed. After Prohibition was repealed, most states maintained laws that restricted alcohol availability. In the 1970s many of these laws were strengthened: Taxes on alcoholic beverages were increased and the legal drinking age was raised to 21. Many observers speculated that America was entering an era of “neo-prohibitionism”—a shift in public policy back to temperance ideals. Then, in the mid-1990s, widespread media coverage of the possible health benefits of moderate drinking led many to theorize that attitudes had shifted once again, and that the United States was beginning a renewed “love affair” with alcohol. Whatever Americans’ current attitudes toward alcohol may be, one thing is certain: Millions of them continue to become alcoholics, while countless more experience the devastating problems associated with alcohol abuse.
The authors in Alcoholism: Current Controversies debate the nature of alcoholism and the extent of alcohol-related problems, as well as what should be done to prevent them, in the following chapters: How Serious Are the Problems of Alcoholism and Alcohol Abuse? Is Alcoholism a Disease? How Effective Is Alcoholics Anonymous? Does the Alcohol Industry Market Its Products Responsibly? How Can Alcohol-Related Problems Be Prevented? It is hoped that by exploring the issues surrounding alcoholism and alcohol abuse, readers will better understand why, despite thousands of years of experience with the effects of alcoholic beverages, these problems continue to plague human society.
