Sunday, September 29, 2013

Emotional Sobriety



The U.S. Department of Health and Human Services (www.hhs.gov) estimates that 8.3 million children, or 11%, live with at least one parent who abuses or is dependent on alcohol or other substances (2008). Given the prevalence of alcoholism, or alcohol dependence, in the United States, the number of children living with an alcoholic parent has only increased. A considerable amount of empirical research demonstrates that children of parents who abuse alcohol are at greater risk of developing behavioral problems. Moreover, as children reach adulthood, they are more vulnerable to negative mental health outcomes. For example, 37% of adult children of alcoholics (ACOAs) experience a period of depression (Kelley et al., 2010).


Scientific research links alcoholism to a genetic predisposition. These findings show that ACOAs are more likely--four times as much--than the general population to have alcohol problems (NIAAA, 2013). From a neurobiological standpoint, an August 2013 article from Medical News Today discussed a current study that found a dopamine neurobiological marker that can potentially predict risk for future drug or alcohol abuse. Terry E. Robinson, a Professor of Psychology and Neuroscience at The University of Michigan, was interviewed in the article. He stated that the finding of this study is significant in that "it suggests that individual differences in how the brain dopamine (DA) system is 'tuned' so to speak, may determine not only the response to alcohol but the propensity for later problems with its use." Robinson also went on to say that although the compelling finding showed a large dopamine response when drinking alcohol, the complexity of individual's brains and the interaction between environmental and genetic factors, is evident that "one size does not fit all" (MNT, 2013).


Alcoholism is not governed by genes alone. There are many factors that influence the development of alcoholism; some factors may raise the risk while others lower it.  Influences in the environment play a significant part such as positive, supportive relationships, or becoming educated on alcoholism either through parents, school, or the community. On the other hand, the family dynamics in the home or the parent-child interactions can also affect the risk for alcoholism. A study by Kelley et al. (2010) suggests that alcoholic parents are less equipped to provide "the nurturance and consistency necessary to form parent-child bonds that promote security and the ability to manage negative emotions". However, given genetic and environmental considerations, many ACOAs that are products of a dysfunctional environment do not develop drinking problems (NIAAA, 2013).


Al-Anon, founded in 1951
Alcoholism is a family disease. Even though having a family history of alcoholism or growing up in an interrupted household does not guarantee becoming an alcoholic, the emotional ramifications of being raised in an alcoholic home is sometimes unavoidable. Groups such as Al-Anon (www.al-anon.alateen.org) and the Adult Children of Alcoholics (www.adultchildren.org) were created for families whose lives were affected as a result of alcoholism. These recovery programs are based on the success of Alcoholics Anonymous by way of the Twelve Steps and the belief of a Higher Power. Many ACOAs contend with difficult challenges of trying to overcome the effects of parental alcoholism. Some may take on characteristics of the alcoholic without ever taking a drink. These programs can help heal emotional and psychological wounds and aid the path to recovery.


As the forefront of health care, nurses have the power to educate patients and families on various topics such as alcoholism. Not only are nurses responsible for providing prevention and treatment information to people with alcohol dependence, it is important that they seek help of their own if they are experiencing alcoholism within their family. It is also imperative that children at high risk for alcohol dependence get the proper education, and early, or the vicious cycle of addiction will persevere. Recognizing the risk factors and powerlessness over alcohol are important beginning steps; but reaching out for help can provide a safety net and a healthy life restored to sanity.


5 comments:

  1. Great post, Steffanie. You touched on so many ways people can have alcoholism triggered. I wonder, too, how much of an influence the media has on the development of alcoholism. We see a show, such as "How I Met Your Mother," and we consistently see the characters at a bar or elsewhere drinking. This is a popular show (I, for one, really enjoy it), and I know a few people who try to emulate the character Barney. Could others consciously, or subconsciously, be attempting to emulate the whole group of friends by constantly going out to drink?

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  2. The addictive nature of alcohol is a very interesting topic Steffanie. The effects of alcoholism "running in the family" can be seen, as you pointed out, in the children or adult children of alcoholics in many different ways. I do wonder if it is only alcohol that this idea applies to. In addition to the numerous environmental and social factors that could cause alcoholism, could it be simply the addictive behavior that is passed down in families? Therefore, children of alcoholics could be prone to any type of addiction including other drugs or even something like food perhaps. As nurses our skills, like motivational interviewing, are very important in changing some of these addictive behaviors.

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  3. When we were asked to attend an Alcoholics Anonymous meeting during our Psych course in the Winter I was intrigued and inspired by the positive attitudes of the individuals at the meeting. As hard as it was to face their problems head on, they still accepted outsiders (the numerous nursing students) and were even excited by the prospect of getting their personal stories and struggles out into the community with individuals that can have a positive impact. I personally have heard devastating stories of an individual's childhood with an alcoholic father and the impact this had upon him at the time, as well as the impact it continues to have after 9 years of his father's sobriety. However, I learned about the stability in his life with the presence of his mother and often wonder what the outcome had been if his mother had not had such a presence in his life. He is positive that he would be not the man he is today had he not been supported by such a consistent and nurturing mother. I agree that nurses should be at the front lines combating alcoholism, great points Steffanie!

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  4. Stef- great post. It’s interesting to hear the science surrounding a dopamine neurotransmitter marker and how it can genetically affect where a person stands in terms of developing alcoholism. I can personally think of several people who abuse alcohol, cigarettes, or other drugs and write it off on their “addictive personality”. Alcoholism IS a family disease and should be recognized as such. However, it is hard to accept abusing alcohol as a disease when it runs rampant in the media and is generally acknowledged as being socially acceptable. In this country, it is part of the culture to get together to have drinks just as it is to eat a meal. This makes it more difficult to prevent those who might be at risk from entering a downward spiral on the alcohol continuum. It would be interesting to see more research done on the social aspects of alcohol and how it has negatively affected those at risk.

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  5. This is an excellent post Steffanie that really makes one think about the effect of alcoholism not only on the individual but also on the family members, especially the children. I think the connection you made that alcoholism may be both a genetic predisposition as well as triggered by certain events is especially important because as nurses it is important for us to remember that alcoholism is a disease that may have multiple causes. Additionally, the fact that it is important to ensure that family members, especially the children of those dealing with alcoholism receive support was an excellent point to make. Therefore it is important for us as nurses to be aware of the various support systems available.

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