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Unaffected by Alcohol Abuse? Think Again.

William Van Ornum - published on 07/09/14

If you could prevent "preventable deaths," would you?

Alcohol kills. It kills alcoholics. It kills innocent third parties.

A recent blogpost in the New York Times noted that 10 percent of workers with alcohol abuse issues will end up dying from their addiction. It is the fourth leading preventable cause of death in the United States, after “smoking, poor nutrition and physical inactivity.”

In a report issued earlier this year, the Centers for Disease Control and Prevention (CDC) estimated that annually 88,000 highway deaths in U.S. can be attributed in some degree to alcohol consumption. That figure includes deaths from fetal alcohol syndrome, alcoholic liver disease and alcohol poisoning— where it is 100% responsible—and deaths from accidents, liver cancer, hypertension and stroke, where alcohol is a significant contributing factor.

An estimated 15,000 traffic deaths per year, out of about 35,000 total traffic fatalities, are caused by drunk drivers.

Children whose parents abuse alcohol or other substances are three times more likely to be abused and four times more likely to be neglected than children whose parents are not substance abusers.

Between 60 and 90 million Americans have an alcohol “problem,” although many more are directly affected because their family members are usually within the orbit of destruction.

Knowing how to recognize and help those suffering from alcohol or substance abuse should be the concern of every Christian. These individuals are in our parishes and neighborhoods, not thousands of miles away.

The New York Times recently published a presentation and discussion of two very different approaches to treating alcoholism: the abstinence approach, practiced by AA; and the “limited drinking” approach, now being offered to college students with drinking problems. This latter approach evolved out of  work of “thought changing” cognitive therapists, such as Albert Ellis.

The Times article notes that a group of researchers find the limited drinking approach to be particularly effective in treating young persons. They believe that the abstinence model  has certain negative aspects, such as the alienation from families and community that occurs in residential programs. They also cite a lack of empirical research evaluating the effectiveness of AA for this group, and the fact that many young people who display episodic alcohol drinking while young do not continue on this pathway into adulthood. Many adults give up excessive drinking on their own, according to the Times:

“A federally financed study of 43,000 randomly selected Americans, called the National Epidemiologic Survey on Alcohol and Related Conditions, or
NESARC, found that 75 percent of those who are heavy drinkers eventually regain control without rehab or AA, Dr. Peele said. The survey, which was conducted in the early 2000s and was designed to be representative of the larger United States population, was aimed at helping researchers understand high-risk drinking patterns, design better-targeted treatment programs and monitor recovery. It found that over half of those who recover managed to cut back instead of abstaining, Dr. Peele said.”

The Times describes the successful treatment of one young man through the controlled drinking approach. When their son took a medical leave from college because of excessive drinking, crippling anxiety and depression, two parents turned to this approach rather than AA. Since the young man began attending “Moderation Management,” he has been averaging 5 drinks a week, substantially fewer than the 14 drinks considered as the upper limit for young men.

Other specialists and centers of excellence continue to use the successful AA Model, including the Caron Centers and the Mayo Clinic. The Mayo Clinic’s approach centers on developing a life-long spirituality as part of the 12-step program commitment. In addition, Mayo has experimental programs involving genetic susceptibilities to alcoholism that use certain drugs to block these cravings.

Years ago I worked in the Alcohol and Substance Abuse program at Craig House Hospital, in Beacon, New York. This program used the following interventions: one week detox for those needing it; a 90-day program including 90 AA meetings; individual psychiatric therapy and alcohol counseling; stress management groups; cognitive therapy; assessment of other psychiatric problems such as depression, schizophrenia, or eating disorders occurring with alcoholism; and a balanced life each day with good nutrition as well as exercise and recreation.

The average success rate for those who attended the program at Craig House and a subsequent program for 2 years (3 AA meetings a week; monthly therapy appointments at Craig House; monthly family meetings), was 79%. Sadly, the 90-day treattment concept is now rarely available due to changes in insurance reimbursement.

Surely this debate regarding the most effective way to help people with alcohol problems is relevant to Christians. It would be interesting to know where parish priests refer parishioners who need assistance, and toward which approach?

Many of our young people in college see their education derailed by excessive drinking. How do we help them avoid a lifetime of alcohol or substance abuse?

Traffic deaths associated with drunk driving devastate the families of victims and drivers both.

In what ways can individual Catholics and our community of faith better educate teens and their parents about the danger of drinking excessively?

Your thoughts would be welcome.

William Van Ornum is professor of psychology at Marist College and director of research and development/grants at American Mental Health Foundation in New York City. He studied theology and scripture at DePaul University.

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