The Tribune

By DR MIKE NEVILLE

ALCOHOL has been with us for a long time, with such beverages apparently very popular in Greece about 2,000 BC.

It is a drug that has become part of our culture so we need to learn to live with it rather than hope it will vanish; past attempts like the American prohibition had very limited success.

I like a drink myself and at times have had more than my better judgment should allow. Alcoholism is different in many ways, it causes terrible destruction to individuals, families and society. It can be difficult to diagnose in the early stages but the full blown disease process of the later advanced alcoholism is hard to miss. E M Jellinek published “The Disease Concept of Alcoholism” in1960, his work is credited with moving attitudes towards drunkenness to a medical rather than a moral matter. That said there is likely to be more people in prison for alcohol related offences than in rehab at the mental hospital. Mr Jellinek used the Greek alphabet to describe different types of alcoholism; in truth everyone drinks differently and I am sure we would run out of Greek letters trying to describe them all. There are four simple questions that you can ask yourself that give a good indicator of a drinking problem.

1. Have you ever felt you should cut back your drinking?

2. Do you get angry when people criticise your drinking?

3. Do you feel guilty about your drinking?

4. Have you had an early morning drink to settle your nerves?

A bad score suggests it is time to do something about your drinking.

Alcohol is a central nervous system depressant, I always thought it made me high and was upset to discover it is an illusion. Alcohol systematically shuts down parts of the brain. The first to cease functioning is the area involved with social inhibition, with that gone we feel relaxed, talk more and even think we can dance better. There is then a gradual but continuous impact on our brains so that if you drink enough you will end up in a heap on the floor.

The damage that excessive drinking does to our bodies would guarantee that if it was just invented today there would be no hope of approval as a drug or food. Excessive drinking can damage so many of our organs and is responsible for many admissions to hospitals around the globe. Impaired judgment leads to car crashes and other accidents, work related and in the home. It increases the incidence of domestic violence and sexual assault and damages families.

The liver has the job of detoxifying the alcohol that we drink, but it cannot manage too much, eventually destroying itself leading to cirrhosis and death. It is linked to many types of cancer, high blood pressure stroke and other cardiac problems. Our brains are slowly destroyed leading to a type of dementia, (Wernicke-Korsakoff syndrome) peripheral nerves are also destroyed.

With no feelings in their legs, a rat bite whilst sleeping on the wharf can lead to a prolonged hospital admission. Stomach ulcers and other gastro intestinal problems are common. It leads to a variety of sexual problems, I think it was Shakespeare who said “Alcohol increaseth the desire but taketh away the performance.”

Treatment can be successful but the illness is chronic and relapsing. Alcoholics Anonymous thrives around the world using its 12 step programme to help sufferers. The programme has been designed by alcoholics and has good results. Medical care tends to be hospitalisation for detoxification and the intensive rehabilitation. Programmes can be expensive and not always covered by insurance, the programmes often insist that you want help, which is bizarre when the reality is the more severe the illness the less insight into needing help is there.

And then alcohol said: “Put it on Facebook it’s hilarious”

Alcohol was wrong, so very wrong.

• Dr Mike Neville is a forensic psychiatrist who has practiced for more than 40 years in The Bahamas, working at Sandilands, the prison and in private practice. Comments and responses to mneville@tribunemedia.net.