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WHATIS
AN ALCOHOLIC?
Derek Ru the rfo rd, director of Britain's Nationa l
Council on Alcoholism, was interviewed by senior writer
John Ross Schroeder on the abuse of alcohol.
W
hat is the difference
between a drunk and
an alcoholic?
A person who is drunk has
become temporarily incapaci–
tated by his alcohol intake. In
other words alcohol has become
for him a depressant of the cen–
tral nervous system.
1f you have taken a certain
amount of alcohol, you will have
depressed and anesthetized the cen–
tral nervous system. You fi rst begi n
to lose your judgment. Then you
begin to s lur yo u r speech. But
remember it is judgment first-your
inabi lity to make decisions in a sober
manner.
T hen comes your speech and gait.
l f you are really drunk, you will find
you have difficulty putting in your
ignition key or door key. If you
weren't an alcoholic and were an
average person not used to taking
alcohol and you have drunk a bottle
of whisky, you could go into a
coma- and possibly die. That is
drunkenness.
On the other hand, there is the
type of alcoholic who has become,
slowly, over the years, physically
dependent on alcohol, developing a
tolerance so that he or she can take
more drink than you and 1 can and
not show drunkenness. Alcoholics
pass through inebriety (the leve! of
alcohol that would make others
drunk], but he or she may never
show the signs of drunkenness. The
alcohol ic must always have a blood
alcohollevel that must be topped up.
Otherwise withdrawal symptoms
will set in. The alcoholic has become
a sick man.
What treatment is available for suf–
fering alcoholics?
18
Anyone who has a severe drink–
ing problem can get free help from
the National Health Service. ff you
were to come to a local Council on
Alcoholism, and present yourself to
a general practitioner, a doctor
would assess the degree to which
you had a problem.
Now it might well be that you
were at an early stage and all that
you needed was sorne therapy, indi–
vidual counseling or group counsel–
ing. So one would refer you to that
particular type of service.
Or it might be that the doctor
would like to give you a thorough
examination to see if there was any
damage to the liver, or whether you
had any other form of damage. Or
it might be that you need to be
referred to one of the wards of a
general hospital because you had
had sorne damage in one of the
organs of the body, and therefore
you would get medica! attention.
It might be that you had a very
severe alcohol problem with not only
a question of dependence, but per–
haps underlying disorders, perhaps
sorne psychiatric disorders. You
would be referred to a consultant
psychiatrist for help and support.
How many addic ted to alcohol stop
drinking of their own volition?
We don ' t know! What we do
know is that there will be those few
who are able to stop and to say no.
But the vast majority become
dependent. Those who are depen–
dent have to be motivated to come
off alcohol.
It
is their own motiva–
tion that wi ll , of course, allow t hem
to say no. But they need counseling
support, other forms of social sup–
port and even legal support.
And remember , the success rate
is very poor. Of those who go
through normal t reatment we
would say a third are able to
abstain. A third, perhaps, improve
their life-style. But the other third
are failures.
Why does an alcoholic return to
drink after the drying-out pro–
c ess?
T his is always a difficult question.
Most of us don ' t criticize tbe smoker
who says, " 1 shall give up smoking
for the holidays," and then goes back
to smoking with the same craving
and the same type of life-style. The
reasons why the smoker goes back to
smoking are the same ones for the
drinker going 'back to drink.
Remember, we live in a drinking
society. After a person is rehabili–
tated he is right back out in society.
But where are his friends? H is
friends are in the pub. His friends
are in the club. He comes horne, puts
on the television and he sees all the
gorgeous booze being extolled on
TV. You try to stop a man thinking
about drinking, but immediately he
comes back into a drinking society,
where there is absolute pressure.
What is the National Council on
Alcoholism doing about the problem
of alcoholic abuse in thi s country?
We have to look at a very wide
front of prevention. First, we have to
identify people who drink to the
extent of harming themselves and
their families. We must be prepared
to find them at an early stage by
alerting our primary care workers–
doctors and
nurses- before
such a
person needs a hospital bed for a
peptic ulcer or gastritis or cirrhosis.
Or befare they become a prob–
lem to social services, by the fact
that they have a battered wife, a
battered child or are looking for
alternative accommodatíon because
the mortgage has not been paid.
You can see the wide area there
is to cover. At the work pl'ace we
can identify people at the early
stage and perhaps put help there.
The PLAIN TRUTH