Introduction
Education is the most powerful and effective tool in our efforts to tackle the substance abuse problem in the United States. It is estimated that 45% of the American population is being adversely affected by chemical dependency. But the devastating toll upon families, children, and friends cannot be calculated.
College students who drink excessively have higher rates of injuries, assaults, academic problems, arrests, vandalism, and other health and social problems, compared with their nondrinking counterparts. They disrupt their studies and threaten the health and safety of their peers.
Chronic
An acute disease has a relatively quick onset, and the affected person is very aware of its sudden presence. But alcoholism is a chronic disease, meaning that it develops gradually over a period of time - sometimes measured in years. This helps to understand why there may be a long period of time between being well and acknowledging the presence of the disease. Problems or symptoms are present, but they are typically attributed to some cause other than chemical dependence (i.e. bad marriage, working too hard, "unfair" supervisors, etc.) Affected persons and family members therefore deny that they have this disease for a long time. It is important to realize that such denial is not the same as lying. Rather, it is a matter of being convinced that problems or symptoms are due to something (anything) other than chemical dependency. Denial of the disease is part of the chronic disease process, and breaking through that wall of denial is an extremely difficult process.
Progressive
There is no cure for alcoholism, but there is treatment. Since alcoholism is a progressive disease, it always gets worse without treatment - it never gets better. Alcoholism causes biological, psychological, social and spiritual problems, and as the disease progresses, the affected person's ability to function along these dimensions declines. All body systems are affected (not just the liver as is commonly thought). Personality changes are resultant from neuropsychological impairments to the person's cognitive and affective functioning. They think, feel, and behave differently than previously, yet regard their functioning as normal. Social or relationship problems arise within the family, the community, and at work. Family life deteriorates to the point that treatment for family members is necessary for their own recovery. Education and support groups such as Al-Anon and Al-Ateen exist for this reason. The alcoholic may tolerate the loss of his or her spouse and family due to chemical dependency, and withdraw from social contacts which do not involve drinking. However, alcoholics typically do realize the value and need for their jobs, and strive to remain employed. As the disease progresses the job quality of worklife deteriorates in various ways: absenteeism and tardiness; job performance declines; interpersonal difficulties arise; physical appearance less cared for, etc. Alcoholics are sometimes motivated to seek treatment only when there is a threat of job termination. In summary, as the disease of alcoholism progresses all areas of life functioning become unmanageable.
Disease
Like diabetes and cancer, alcoholism is a primary disease. This means that it is not a symptom of another disease, nor is it a personality flaw, moral weakness, mental illness, or lack of willpower. Alcoholism is not the result of drinking too much. Rather, the body of an alcoholic responds quite differently to the ingestion of alcohol than does the body of a non-alcoholic. This is what is meant by powerless in Step 1 in the Twelve Steps of Alcoholic Anonymous, ("We admitted that we were powerless over alcohol..."). Ongoing research continues to document the metabolic differences which exist in the bodies of alcoholics versus non-alcoholics. In summary, alcoholics are not responsible for having this disease, but they are responsible for what they do about having it. (Diabetics and cancer patients are not responsible for having these diseases, but they are responsible for managing them once it is identified.)
You should know that these organizations support the disease concept of alcoholism: American Medical Association, American Medical Society of Alcoholism, National Council on Alcoholism, American Psychiatric Association, American Academy of Family Practice, American Public Health Association, American Hospital Association, the World Health Organization, and American Psychological Association.
Enabling
Enabling makes it easier for the alcoholic to continue drinking because enabling protects the alcoholic from the consequences of irresponsible behavior. Examples of enabling: A wife calls the employer to say that her husband is sick when he really has a hangover. The wife makes the "sincere" effort to spare her husband of any negative consequences, and thus enables his self-destructive behavior to continue. The alcoholic husband may therefore continue to deny that a problem exists since he has escaped the work-related negative consequences of his drinking. Enabling behaviors short-circuit the association between drinking and its painful consequences. Upon receiving the wife's phone call, the first-line supervisor has to cancel an important meeting, making the "necessary" excuses to his supervisor. In this scenario, both supervisors strongly suspect the employee's "real" problem, but lacking proper knowledge, continue to "cover" for the employee (who is quite effective and productive when he is at work). Nevertheless, they are "enablers" since they are protecting the employee from the consequences of his self-destructive behavior.
The course of unchecked alcoholism is predictable. The only variable is time - how long it will take for the person to hit "rock bottom" (lose the marriage, children, job, health, financial stability, etc.) Enabling behavior is "misguided benevolence" since it delays and hinders the person from getting treatment.