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Monday, May 15, 2017

Alcohol, addiction, education… and the barbarians at the gate

(Originally on Addicted Minds)

Archaic, or ancient, Greece saw unequaled advances in art, medicine, poetry, science, technology, and philosophy. Before this period, around 800 BCE, people lived scattered in small farming villages. Around 1,000 BCE, villages grew. People became closer. Some villages built walls. Most built a market and a community meeting place, developed governments, and organized their citizens according to some of laws. It was the rise of the city-state humankind, being social creatures, was destined to populate. What did we know in Archaic Greek times? That alcohol is a toxin and some of our neighbors were no damn good when they drank alcohol. You couldn’t witness either when people were nomadic or living is sparsely populated villages.
Here are two important factors in which to frame the discussion of this drug:
A) Alcohol is a mood-altering drug. Case closed. Every physical and mental health professional since Hippocrates knows this clinically if not from personal consumption. This fact has been undisputed for millennia or the human race would have abandoned the relationship with this toxin and known carcinogen before the rise of the first city-state, Sparta.
B) Today exists a mountain of conclusive evidence that it is a mind-altering drug, impacting at the molecular level the organ that houses it, the brain. Evidence-based research in the later half of the 20th Century has demonstrated it damages or destroys other organs and tissues as well.
So why is this drug still so widely used today? Go back to A. It’s damn effective. Alcohol users, advertisers, brewers, distillers, and economic engineers who insists on alcohol’s pertinent role in commerce will do anything to preserve the dominance of A over B. There is no amount of wishful thinking, junk science, or fantasy those with a vested interest in alcohol use won’t embrace to preserve the status quo. Follow the money behind every observational study appearing in mainstream media in favor of this drug’s use – theorized health benefits, for example – and here’s who you’ll find writing the check: Alcohol users, advertisers, brewers, distillers, and economic engineers who insists on alcohol’s pertinent role in commerce.
Not physicians. Not mental health professionals.

David v. Goliath

It’s not that people trust ads more than doctors as much as that human nature supports keeping doing what we’re doing. Change isn’t on fleek.
What this spells is out is the David v. Goliath battleground onto which every puny addiction professional trods every day. Helping professionals aren’t just trying to reach an altered brain with no interest in stopping A. They also battle a culture, family, friends, and economy that are so immersed in A that they’ve become alco-centric when it is killing clients.
Nobody seeks out a helping professional because they want change. They seek out to keep doing what they’re doing and just feel better about doing it. I wrote that for 2012’s Every Silver Lining Has a Cloud in respect to how addiction runs counter to common disease procedure. When I have a tumor, I ache. So I see a professional to change. When my blood sugar is out of whack, I’m lethargic and achy. So I see a professional to change. When I am drinking, I feel crummy only when I stop. So I don’t really want to change because I don’t feel achy when I do it. To put it another way, when a physical system driven by the brain becomes dependent on a drug that alters the brain, the physical system is at dis-ease when it’s NOT getting the drug. The defense mechanisms to preserve A come out in full force despite B.
That alone is reason enough why addiction treatment isn’t immediately effective. Throw in alco-centric attitudes in society telling everyone ‘moderation is safe and even healthy’ and Goliath has an AR-15 compared to David’s slingshot. That’s why it sometimes takes two or four or fourteen kicks at the cat to make the transition to long-term recovery.
Succeeding against drug use requires a talented professional or para-professional who can battle through the defense mechanisms to demonstrate the consequences of B outweigh any benefit of A. That’s the case-by-case victory everyone in this profession takes on daily. A larger battle stays largely unfought. We fight tooth and nail to save the life of someone addicted, but expend very little energy in preventing use in the first place. It isn’t a desire to preserve job security that addiction pros will always have someone to save. Instead, it is unwinding centuries of accepted use of the drug that predate Sparta by about four thousand years.

Barbarians at the gate

We’ve already convinced most of the 7.5 billion people on this rock that this drug is ok, safe, fun, ceremonial, and celebrated. So what if some will use it and become addicted to it… it’s good for the economy, healthy, and a rite of passage. We fix the addicts or cast them out. We don’t prevent them from using the drug in the first place.
Have we created the same aura of safety around cocaine? A little use is ok… more, not so much? Is there a meth bar on Main Street? Have we identified a moderate use of heroin? Do we have crack and smack ads? What is the suggested daily intake of tobacco smoke as part of a healthy diet, two Pall Malls? No. Preposterous. We have prevention education that talks about health consequences beyond addiction or car wrecks for those drugs.
We lack meaningful prevention education for the world’s deadliest drug, alcohol. Alcohol advertisers provide their own at $1.5 billion a year.
The ‘alcohol-is-the-antidote-for-wellness’ message has been out there for decades on page three (if covered at all) buried behind the slick alcohol ads and front-page, above-the-fold article on alcohol health promises and underneath the announcements for the church beer tent at the fall festival. For the last 36 months, in fact, alcohologist.com has tracked that for every pro-alcohol study mention in an article on Google (109 studies, 10,419 mentions) there were three evidence-based research projects (320 studies) on adverse health consequences of alcohol released… but a 10th of the mentions (1,022).
Where the dialogue is moving is that it is not just the addicted who become sick. Every user faces an increased risk of physical illness and disease from any use of the drug. Even moderate users.
Prevention of alcohol use disorders starts with prevention of alcohol use. It is the same tape the tobacco industry has heard for the last two decades: We prevent substantial loss of life and productivity by keeping people from smoking in the first place. We still make cigarettes. And we’ll still make alcohol, even when it isn’t glorified any longer.
The tide began to turn against tobacco in 1964. The U.S. Surgeon General issued a landmark report on health problems related to a very popular thing to do: Smoking tobacco. Thirty-four years later, the U.S. had the unprecedented Tobacco Settlement, capping a shift in education. The anti-tobacco sentiment took 34 years to soak in sans the internet. Last fall, the U.S. Surgeon General issued a landmark report on the health problems related to a very popular thing to do: Drinking alcohol. The public sentiment toward the drug is beginning to shift as indicated in this very clear signal to change the current alcohol policy costing the U.S. economy $250 billion a year.
It won’t take 34 years this time.
To the citizenry of Archaic Greece, a barbarian was anyone who was not of their extraction or culture. Because these ‘strangers’ regularly challenged Greece’s established ways, ‘barbarian’ gradually evolved into a negative term… only because the history books were written by Greeks. The truth is that they were far from barbaric and they were actually enjoined with the Romans, who took over the joint. Those who challenged the established Greco lifestyle were of nutty acts and opinions, not welcome, and kept outside the gates… no matter what their beliefs… only because they didn’t drink the same KoolAid as the Greeks.
A weird bit of irony, the story of the leveraged buyout of RJR/Nabisco (a major tobacco stakeholder) is entitled Barbarians at the Gate. The real moment the barbarians arrived on the tobacco doorstep was the 1964 Surgeon General’s Report. The 2016 report is a barbarians-at-the-gate moment for the alcohol industry. The Surgeon General fired the starting gun for practitioners who have not already incorporated prevention into their practice to do so today and be at the forefront of change the way the American Legacy Foundation – today known as the Truth Initiative – is at the forefront of smoking education and prevention.
In 1967, 72 percent of adult men smoked. Today, 72 percent don’t. Those who challenged at the gates of the establishment won the public dialogue with facts. The same ones we all have at our disposal. Remember, Greece fell because the Romans outGreeked the Greeks. The ‘barbarians’ made the thing better than being Greek was being a non-Greek. As we figure new dimensions in treating alcoholism, we need to establish that the only thing better than being a drinker, is being a non-drinker.

Addicted Minds’ Editor-in-Chief, Scott Stevens, is the author of four alcohol books including the December 2016 release, I Can’t See The Forest With All These Damn Trees In The Way: The Health Consequences of Alcohol. Get the new BookLocker title now on Amazon (viewbook.at/prehab), alcohologist.com, and everywhere you buy books.  Click Alcopocalypse for the author’s 2017 Alcohol Awareness Month whitepaper. Image by Kevin Carden, used with permission.

Photo by Remy Musser, used with permission.