1.3 Some Medical Aspects of Alcoholism
Alcoholism leads to a vicious downward spiral, just as any indulgence
in any sin does. It becomes both mentally and physically self-destructive.
The liver metabolizes alcohol but is itself damaged by it, so that an
alcoholic binge can produce illness and death through what is actually
an acute hepatitis. Long term abuse of alcohol in large quantities results
in cirrhosis of the liver- it is scarred and develops growths, leading
to the possibility of cancer. The weak health of the alcoholic then leads
to more depression and hopelessness, and therefore more drinking. Alcohol
enters the bloodstream immediately and goes to the brain, where it affects
the cortex of the brain- the location which has to do with memory, emotion,
conscience and judgment. Straight away we see the moral issue which there
is in alcoholism and being drunk. Alcohol is a depressant, so you need
to be aware that it creates many other problems in the life of the alcoholic
who is taking it regularly in large quantities. Because it is a depressant,
the alcoholic will have problems sexually- impotence and difficulty in
achieving orgasm. An alcohol-damaged liver causes hormonal changes, too.
Testosterone is no longer broken down by the liver as it should be; and
this can produce a 50% decrease in this male hormone. The testes wear
away (testicular atrophy). For women, damaged livers result in an inability
to adequately turn estrogen into estradiol, which interferes with vaginal
lubrication and menstruation. The female hormones accumulate, causing
enlargement of the breasts. Loss of periods is another feature of the
disease. In both men and women, these conditions lead to sterility
and even impotence. The associated mood changes lead the alcoholic to
sometimes be physically or verbally abusive in ways they would never dream
of while sober. Alcohol is soluble in both water and fat, and therefore
it invades the nerve cells very easily. This is why it may cause nerve
damage or brain syndromes. Alcohol harms in other ways- injuries, tuberculosis,
heart attacks and strokes are some of these complications. “Because alcohol
contains empty calories he feels warm and full and therefore neglects
proper food. Malnutrition sets in” (4), and so the vicious
cycle of health breakdown continues. Regular and nutritious meals for
the alcoholic are one way of helping him or her- although of course this
will not completely prevent cirrhosis.
Alcohol has major effects on behaviour. Although drinkers think it is
a stimulant because it makes them feel good (as alcohol is absorbed into
the blood stream and moves on to the brain very quickly), it is in fact
a depressant. It particularly damps down social restraints so that drinkers
say and do things that they would never dream of doing while they were
sober. They may become emotionally unstable, quarrel easily, be verbally
and physically abusive and lose sexual inhibitions. Memory loss can be
particularly distressing, because the nest day, drinkers may not remember
what they have done. Who were they with? What did they do? Did they sleep
with anybody, and, if so, who?
Thus bad behaviour resulting from alcohol means that families and relationships
are damaged often irrepairably. And of course money often becomes an issue.
The alcoholic is spending large sums of money on drink but risks losing
his or her employment because of it. This fear often comes to dominate
the family of a male alcoholic. The alcoholic rationalizes the drinking
by blaming family and friends, and comes to avoid them.
Shakespeare lamented: “That men should put an enemy into their mouths
to steal away their brains”. There is a physical component of the disease,
often reflected in the craving response to a single drink, representing
a metabolic reaction to the drug alcohol. Physical dependence develops.
But we will keep emphasizing that alcoholism is largely a disease of the
mind, in that the alcoholic keeps drinking because of a mindset which
they are in; and therefore the cure is related to the things of the spirit
/ mind. As Hos. 4:11 says “Wine and new wine take away the heart / mind”.
The alcoholic cannot trust himself, their thoughts, feelings or best intentions.
They persuade themselves they will really only have one drink; and invariably
they end up drunk. The desire for alcohol and the need to survive as an
active alcoholic makes them totally self-centred; people become [sub-consciously]
merely things to be manipulated to allow the alcoholism to continue. It’s
a disease the mind persuades them has to be continued in at all costs.
The strange thing is, our culture has exalted worship of the self; to
lie to clinch a business deal is seen as smart; excesses of food, clothing,
material possessions, homes etc. are seen as signs of success. Obsession
with money and workaholicism are felt to be part of the wonderful capitalist
dream. To rely upon a higher power, knowing we ourselves are incapable...is
seen as weakness. But lies, obsession with self, excessive behaviour etc.
are all just as much part of alcoholism. To break from alcoholism is therefore
to do something counter-cultural. The teaching of Jesus, properly understood,
is radical, counter-cultural stuff. This again is where ‘the truth of
the Gospel’ can be at the cutting edge in overcoming alcoholism.
When quizzed as to their behaviour and why they did what they did, the
genuine response is that they “just don’t know what happened”. When the
family fire questions like “Are you stupid?... don’t you care?...Why can’t
you just say no?”, they see the truth of it all but the mind tricks them
into rejecting it all. They become increasingly less available to those
around them, e.g. their children. Their thoughts become obsessed with
obtaining and using alcohol. Their work suffers; they may lose their job
and family. And thus the cycle deepens. Their person is being destroyed
as well as their body. But they develop such low self-esteem that this
doesn’t matter any more. When they finally come out of denial and realize
this, the Bible’s tremendous emphasis on the value of the human person
must be allowed to hit the alcoholic with full force. This will usually
happen after a period, however brief, of sobriety.
When you do a blood test on an alcoholic when they are sober, there are
no disease agents present in the blood as there are, e.g., in the blood
of some other drug abusers. But as with any drug, the more alcohol is
experienced, the greater tolerance is developed by the body, and more
is required to produce the previous effect of calmness, relaxation, positive
feeling, etc. This is why it’s not macho at all to say ‘I can take a lot
of beers without being affected!’. The man who says that has a problem,
and is fast heading for a tragic, pitiable self-destruction. As the alcohol
is continually taken in by the body, a deep craving for it develops that
has to be satisfied. It’s a living parable of our response to regular
sinning. The body comes to depend upon the regular ingestion of alcohol.
Drinking ceases to just be social; the alcoholic starts to drink alone.
Eventually the person becomes totally dependent upon alcohol to the point
of being more often drunk than sober. When drug addicts quit most drugs,
even heroin, there are severe withdrawal symptoms but they are usually
not life threatening. With alcohol, it’s different. A hard-core alcoholic
who quits suddenly needs to do so in a proper detoxification unit staffed
by professionals. Between 8 and 24 % of such alcoholics who suddenly withdraw
from alcohol die from doing so very quickly (5). They are killing
themselves to live. I mention this because it’s therefore no use screaming
at such a person ‘Stop drinking immediately, totally, right now!!!’- especially
if they are located in rural areas far from medical help. Physically stopping
such a person having access to alcohol at this level of addiction can
therefore easily be tantamount to murder. If you really are going to force
them to stop drinking, you really must ensure that professional detoxification
help has been organized. It would do all who drink ‘socially’ a lot of
good to be allowed into a detoxification ward. You will see men- men often
once happily married or successful businessmen- shaking so badly they
can only walk by gripping on to a wall or rail, screaming from unknown
fear as they do so; women crying out from vivid daydreams, convinced there
is something crawling all over their skin... it might be enough to make
you vow never to drink again, and certainly never to offer alcohol to
someone whose background you don’t know. And there’s very little that
can be done to stop this trauma. It has to be gone through. But this is
what cleansing from alcohol requires. It’s not just so easy, therefore,
as insisting the alcoholic quit drinking once and for all, “immediately!!”.
If your hard-core alcoholic really did quit totally and immediately, the
result on him or her would be so devastating and dramatic that you would
likely be very scared and so wishing you had some medical help nearby.
You simply wouldn’t know how to cope. Be realistic about what you are
expecting from the alcoholic. And seek some outside, professional help.
Drugs
Much has been made of alcohol-antagonistic drugs. These make the body
undergo a very violent negative reaction if alcohol is drunk. These drugs
do not actually reduce the desire to drink; rather do they merely create
a choice between two punishments. A spiritual approach, involving prayer
to God, and taking strength from others, is the only way that permanent
abstinence can be achieved. Alcoholism is all about yielding to temptation;
and this is essentially a spiritual matter, which can’t be controlled
by drugs.
Genetics
It has been observed that alcoholism tends to run in families. Where
this observation can be dangerously misused is that the alcoholic justifies
his or her sin with the notion that it’s inevitable; they are a helpless
victim. By its nature, the psychology of alcoholism [and it is essentially
a disease of the mind] seeks for justification. So the alcoholic tends
to latch on to this genetic argument. Russian alcoholics often tell me
that it’s something to do with what’s in the Russian blood. The family
of the alcoholic should of course be able to point out that they aren’t
alcoholics; and God will not so strongly condemn behaviour which is inevitable.
There is no such thing as an inevitable sinner. We are not just mechanisms
controlled by genes. We are each one uniquely created by the Father for
Him to work out His specific glory in us. An effectively atheistic world
has no sense or order or purpose. If alcoholism is simply genetic, some
people ought to be able to drink and never become alcoholic. This is of
course untrue. There seems to be a genetic predisposition; twin studies
have indicated this. But it is not absolute. Some "nurture" element is
also at play. This world has little concept of our connection with the
far bigger plan of God, in which we each can have a vital and wonderful
part. In Christ we are a new creation (2 Cor. 5:17). The alcoholic needs
new life, a ‘higher power’ as Alcoholics Anonymous so [purposefully] vaguely
expresses it; and this is only ultimately available in Christ. Thus Paul
can triumph: “It is no longer I who live, but Christ who lives in me;
and the life I now live in the flesh I live by faith in the Son of God,
who loved me and gave himself for me” (Gal. 2:20,21).
We are in some sense taken out of Adam and baptized into Christ. We are
removed from the "kingdom of this world," and translated into the "kingdom
of the Son of God's love". "In Christ you were also circumcised, in the
putting off of your sinful nature, not with a circumcision done by the
hands of men but with the circumcision done by Christ". The “flesh” of
the believer is cut off by Christ, in a process which begins with baptism:
"...buried with him and raised with him through your faith in the power
of God, who raised him from the dead, and when you were dead in your sins
and in the uncircumcision of your sinful nature, God made you alive in
Christ" (Col. 2:12). To live the alcoholic life is to fight against what
the Lord Jesus is seeking and intending to bring about. In the flesh,
we cannot please God. It therefore was ‘cut off’ in the perfect sacrifice
of Jesus, and we identify ourselves personally with that achievement through
baptism. But these words of Paul are hardly saying that repeated, ongoing
sinful behaviour is inevitable and can’t be cured. In prospect, sin has
been dealt with for the believing alcoholic. In prospect, the alcoholism
has been cut off from him. We must “count ourselves dead to sin” if we
are baptized (Rom. 6:11); and persistent drunkenness doesn’t achieve this.
By continuing in sin, he ruins his fellowship but not his essential
relationship with the Father and Son. For once a brother in Christ, always
a brother- at least, so far as we are allowed to judge. For all these
reasons I heartily recommend the family of an unbelieving alcoholic to
preach these things to him or her- yes, to make the time and space to
explain these doctrines, the wonder of these things. For in the truth,
in the reality of the real Christ, the concrete Hope of the Kingdom, the
Hope of wayward Israel...in these things alone is there the ultimate ‘higher
power’ to totally transform a life. And this is why I personally am not
against the baptism of a confessed alcoholic. Indeed, if they have gotten
to the stage of admitting their problems and desperately seeking for God’s
grace to help in their need, it would seem to me essential as part of
their healing process. So many alcoholics admit to having thoughts about
God in their afflictions. They nearly all say that they believe in God
and are willing to rely upon Him. Yet all they have in their minds is
an idea of God that lacks power. Who He is, His actual personal reality,
needs to be taught or re-taught to them. He isn’t an idea, a cultural
artefact that lacks power. He is real. He is there. He is passionately
interested in the lives and destinies of His children.
