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Counseling Alcohol Related Problems

by Charles Dailey
1. Alcoholism is a social problem of unbelievable proportions.
Statistics for the United States:

> It is involved in half of all fatal traffic accidents, fire deaths, drowning, arrests, murders, and incidents of child abuse and other violence in the home.

> Alcohol is involved in 41% of assaults, 34% of rapes and 30% of suicides.

> One family in four is troubled by alcohol.

> About 10 million Americans and 600,000 Canadians are alcoholics.

> One teenager in five and an increasing number of the elderly are drinkers.

> It ranks after heart disease and cancer as a major killer.

2. The use of beverage alcohol varies by countries. Some Muslim nations ban alcohol. In Europe, alcohol consumption is very common. In the US, two out of every three persons over the age of 15 drinks on occasion. This includes 95% of all college students.

3. Ten percent of all drinkers become alcoholics.

4. It should be noted that alcohol itself is odorless and tasteless. When we "smell alcohol" on someone's breath, we are really smelling the product of the grapes or the grain or other fermented item. This is why some alcoholics drink vodka, because it is made from potatoes and cannot be detected on the drinker's breath.

I. What is Alcoholism?

A. The popular view is that alcoholism is a disease. Given this definition, the one billion dollar alcoholism treatment industry can tap into health insurance funds for treatment revenue. Following this definition, alcoholism is a disease that interferes with one's health, social and economic functions. Gary Collins says,

"Physicians and many insurance companies accept alcoholism as a disease because it is predictable, progressive, physiologically debilitating and treatable. By calling alcoholism a disease, individuals are less likely to be condemned and more likely to get treatment that insurance companies will finance."

B. The World Health Organization gives a definition that avoids any reference to disease or morality. Their definition: Alcoholics are "those excessive drinkers whose dependence on alcohol has attained such a degree that it shows a noticeable mental disturbance or an interference with their bodily or mental health, their inter-personal relations, and their smooth economic and social functioning."

C. At the onset of a person drinking alcohol, the decision to drink is a moral choice and so ranks as sin. After becoming addicted, the disease model may be valid. This is why Christian leaders should set an example of not using alcohol and why they should also be outspoken in opposing its use by Christians.

II. The Bible and Alcoholism

A. The Bible does not teach abstinence, although it does teach temperance. This is especially true of the Old Testament era. Excessive drinking is always condemned. Proverbs 20:1; 23:20-21, 29-35. Drunkenness is among the works of the flesh that prevent eternal salvation. Galatians 5:19- 21. Ephesians 5:18.

B. Abstinence was required by the Nazarite vow. Numbers 6:2-4. John the Baptist was not to drink wine, either. Luke 7:33. Evidently Timothy abstained from alcohol in the light of 1 Timothy 5:23. It seems that in some places pure water was not available and light wine was substituted. Such a condition of scarcity of water is now rare and can be remedied in other ways.

C. The wines of the Bible were not distilled wines and consequently the strongest of them were 12% alcohol. Most were much lighter. The practice of distilling alcohol from one beverage and adding it to another was developed later.

D. The temporal consequences of alcohol consumption in Bible times were considerably less than in our increasingly sophisticated societies. Then, a caravan driver might at worst run his donkey off of the road. Today an alcoholic ship captain or pilot can destroy hundreds of lives and an intoxicated automobile driver can destroy an entire family.

E. There is little said about addiction to alcohol in the Bible which raises the question of whether they even knew alcoholism as we know it today. Then it seemed to be treated as moral choice and not an addiction that had to be treated with medicine and counseling.

F. Today, with the manufacture and sale of alcohol being a multi-billion dollar business and heavily advertised, it is wise for Christians to avoid its use altogether rather than set an example that will lead one in ten of his brethren who follow his example to an alcoholic's grave. 1 Corinthians 6:12; 8:9-13.

III. The Causes of Alcoholism

Alcoholism is caused by drinking alcohol and that is why we take the position of abstinence in modern society. If we don't begin drinking, we cannot become alcoholics. Guaranteed.

A. Physiology and Heredity. Some vulnerability is inherited. The children of alcoholic parents are four times more likely to become alcoholics. This holds true even when they are adopted into non-drinking homes at birth.

B. Environmental Influences

1. The Home. Children of alcoholics have a host of emotional scars. They often learn to live by three rules: don't talk, don't trust and don't feel. Many live with depression, eating disorders and the constant fear of alcoholism.

2. Cultural Expectations. In some cultures such as among Jews, drinking is common, but is confined to meal time. The family is present and forms a natural deterrent to drunkenness. Such restraints are not available in the US and drinking often takes place at taverns and on an empty stomach.

3. Stress. Since alcohol is a depressant and an anaesthetic, it relaxes the drinker, makes him more sociable (at first) and relieves his mind of pressing problems. (Which may be getting worse because of his drinking.)

4. Perpetuating influences.

a. Endocrine and biochemical changes occur, making withdrawal very difficult.

b. The alcoholic will not ask for help until they hit "bottom," hopefully while there is still life and something to salvage.

c. The alcoholic's family contribute by trying to forcibly control the alcoholic's drink or to help him hide his habit. This is illustrated by such practices as pouring out his booze or calling his employer to say that he is sick. The alcoholic should be forced to face the consequences of his own actions and neglect.

d. Society contributes to the problem of alcoholism by laughing at inebriation, tolerating drunken driving, excusing crimes committed under the influence of alcohol, using terms like "happy hour" to describe alcohol use and portraying alcohol use as an effective way to relax and cope with stress.

IV. The Effects of Alcoholism
A. Physical effects. The nature of the physical effects depends on the physical condition of the person, the amount of alcohol taken and the frequency with which it is used. Alcohol is a toxin (poison) that affects most body cells. Once in the blood, the brain's functioning is impaired temporarily, the drinker's balance, motor skills, thinking and emotional responses are influenced.

In about 1/3 of all heavy drinkers, liver cells are destroyed and the organ is no longer able to process the nutrients in food. The patient dies from cirrhosis of the liver.

Heavy alcohol use can permanently damage the brain and nervous system, lead to numerous gastrointestinal diseases, put extra pressure on the heart so that strokes or heart attacks are more likely, inhibit the manufacture of red and white blood cells, lead to impotence, and cause potentially serious risk to a developing fetus. Alcohol use can increase the risk of liver, stomach, colon and breast cancer.

B. Psychological-Social Effects. These include dulled thinking, inappropriate behavior and emotional responses, self-neglect, withdrawal, and loss of social inhibitions. Psychological defenses begin to build and excuse making begins, repression of bad memories, blaming others and even denial that the problem exists. Life is built around getting enough alcohol. All else is secondary.

C. Spiritual effects. Alcohol becomes a substitute for God, an idol that matters most. While the alcoholic may make the right statements regarding his relationship to God, his life does not match.

V. Counseling the Alcoholic

A. Things that do not work: Criticism, shaming, coaxing, making the person promise to stop, threats, hiding or destroying the alcohol, urging the use of greater will power, preaching, or instilling guilt.

B. Get the Alcoholic to admit the need for help. There is a well developed system of rationalization to deal with and the family may be a part of the problem. If the Alcoholic falls on the floor, leave him. If he breaks a lamp, don't clean it up for him. This makes it more difficult for the alcoholic to deny the problem.

C. To use the language based on Dr.E.M.Jellinek's famous chart, the Alcoholic must "hit bottom." Those near him may help him to hit a "high bottom" rather than a "low bottom" which may destroy his life. A spouse is often in a good position for this. She can say (and mean),"Dear, I love you very much, but unless you will enter a rehabilitation program, I am going to take the children and leave you." She must have decided that she can do this and absolutely must carry through if she says it. The shock may bring the Alcoholic to such a sense of loss that he will get help. Sometimes a knowledgeable employer or Human Resources Director can threaten job loss and get the Alcoholic to treatment.

D. Involve treatment specialists. These professionals can help the alcoholic face the need for voluntary treatment. This step can rarely be bypassed.

E. Stop the drinking. Involve a physician or other professional. Four problems remain after counteracting the alcohol.

1. Getting medical treatment for the damage done by alcohol.

2. Helping the counselee cope with stress without using alcohol.

3. Creating a new identity for the client without alcohol 4. Building or restoring self-esteem and dealing with guilt

F. Provide Support. Success will not be accomplished in one or two hours of individual counseling each week. This is the value of an alcohol treatment center such as a hospital that offers 24 hour care. A follow-up program would be like that of Alcoholics Anonymous (or related groups).

These organizations meet in cities and towns all over the world, are free of charge and offer the most effective approach for helping alcoholics and their families. A totally Christian alternative is Christians Victorious.

G. The family may need counseling as well. They may have, in their efforts to compensate for the addiction, unintentionally contributed to the social problems. These changes for the family can be risky and difficult.

H. Be prepared for relapses. Success with alcoholics is seldom simple. The counselor must be prepared to face setbacks.

I. Help the counselee get in touch and stay in touch with God. Regular prayer for help and reading of the Scriptures are basic to our success as Christian counselors.

J. This model is valid for many addictions such as other drugs.

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