It’s thin line between drinking, alcoholism

So having cleared the air somewhat, the burning question still is, is alcoholism a disease? Many members of the public interviewed for this article gave an emphatic no! Others though were not sure.
Mr. Mike Muchiri, a nursing officer at the Chiromo Lane Medical Centre in Nairobi, however, gave an equally emphatic “yes” and he is joined in this by the World Health Organisation (WHO), the American Medical Association (AMA), the British Medical Association and others who have researched the problem of alcoholism and concluded that it is indeed a disease.
What then is a disease? A disease is anything that interferes with the biological ability of a human being to function normally. But many Kenyans I talked to are dubious about this idea. “Anakunywa kwa sababu anaiependa, si ati ni ugonjwa!” He drinks because he likes to, not because it is a sickness.
The majority of the opinions were in the same mien. Others were, “they are irresponsible, lazy.” John Wambua feels they drink to forget their problems, while Louisa Nndulu thinks it’s because they are wealthy, while some is due to peer pressure.
But why then if it’s because “he wants to” or “he does it to irritate” others does the alcoholic vehemently deny his condition? This even when there is ample evidence all around him of the destruction in all spheres of his life that have been caused by his drinking – why does he still deny the reality?
One reason could be how it works. In Carlotta McBride, a fictional study of an alcoholic by Charles Orson Gorman, there occurs the following excerpt. “One thing about alcohol, it works. It may destroy a man’s career, ruin his marriage, turn him into a zombie unconscious in the hallway – but it works.
“On short term, it works much faster than a psychiatrist or a priest or the love of husband for wife. Those things… they all take time. They must be developed…But alcohol is always ready to go to work at once. Then minutes, half an hour, the little formless fears are gone or turned into harmless amusement. But they come back. Oh yes, and they bring reinforcements.”
These reinforcements can be tremors, anxiety, agitation and later hallucinations, delirium tremens (DTs) and convulsions. But one of the most confusing aspects of alcoholism is that the alcoholic becomes most sick not when he is drinking, but when he stops.
So what kind of a disease is this then? In his extremely enlightening book, Alcoholism And You by Fr. Maurice Gelinas, he quotes “cunning, baffling and powerful”. These are the three words Alcoholics Anonymous (AA) use to describe alcoholism.
He further states that the alcoholic himself has no clear concept of what his disease is and that in any case, there are as many definitions as professionals in the field who write about this disease, lecture on it or counsel alcoholics.
Fr. Gelinas, however, defines alcoholism as “a disease which is chronic, progressive, of unknown origin, that affects the whole man and those around him, and whose characteristic is the loss of the ability to control one’s drinking of alcohol”.
Thus chronic or permanent or incurable, can only be remitted if kept in check. Non-alcoholics generally have no difficulty in accepting whatever advice they are given to keep their disease in check.
But not so the alcoholic. Because of his befuddled (by alcohol) thinking or as AA calls it “stinking thinking”, the alcoholic will not agree that his disease is permanent and incurable.
I remember how I tried time after time to “drink like everybody else”, but each time it ended up on a serious bender. I tried drinking on weekends only, after 5.00 p.m., at special occasions only, once a month, not in bars, carrying little money, the list is endless. But always at the end – unmitigated disaster.
So what then does the Kenyan public think of this hapless person called an alcoholic? Luisa Nndulu says they spend their nights in gutters, Joseph Jangima, “they are a nuisance”, Sara, “they need help” and Ted Nugi feels they should be discouraged from drinking as “they degrade the community”
What of the church? In 1804, Thomas Trotter, an Edinburgh physician wrote a paper stating his belief that habitual drunkenness was a disease. This paper created a controversy that continues to this day.
Society has since then been divided on the question: is alcoholism primarily a physiological disease or is it as was held a symptom of character inadequacy and emotional weakness? Today, this question still divides the alcoholism field.
In Under the Influence, Dr. Milam reasons that by shifting the blame from the alcoholic’s character to a ‘remote cause’ outside the alcoholics control, Trotter’s new theory confused the lines between “good” (that is will power, self-control and moderation) and “evil” (weakness of character, gluttony and intemperance).
It was to take a long time before alcoholics (or inebriates as they were then described) were even given separate facilities from the insane. But still, almost one hundred years after Trotter’s essay, attitudes were even more intolerant with the Temperance movement organising crusades against alcohol at national level. The Church insisted that the chronic inebriate was responsible for his happy state and needed its moral guidance to be reformed.
But finally after a lot of research as well as the emergence of AA, the Church was forced to modify its position such that one hundred and forty-two years after Trotter’s essay, the Presbyterian Church became the first religious Organisation to acknowledge formally that alcoholism is a disease.
But to date, blame and stigma are still attached to the victim for contracting this disease, with people still insisting that alcoholism is caused by heavy drinking, which in turn is caused by defects in the drinker’s psychological, social and cultural fabric.
Closer to home, a poster distributed by Islamic Propagation Centre International in Durban, South Africa, asks that “if alcoholism is a disease, then it is the only disease that is sold in bottles, is advertised in newspapers, magazines, radio and television, is contracted by the will of man, has licensed outlets to spread it, produces revenue for the government, brings violent death on the highways, has no germs or viral cause; propels one’s health to self-destruction, destroys family life and increases crime.” They end by stressing, “it is not a disease – It is Satan’s handiwork”
Fr. Gelinas puts it more succinctly. Alcoholism is “not a sin. A sin is something judged to be (a) wrong done (b) freely and (c) knowingly, with all three conditions fulfilled together. If any one of these conditions is absent, there is no sin.
(a) Drinking in excess of what is socially acceptable or to the point of intoxication is objectively wrong. No argument.
(b) Drunkards (given to the excessive use of alcohol: often drunk) are not necessarily alcoholic. Generally, the drinking alcoholic is a drunkard. The basic difference between the two is a matter of control: the alcoholic has lost his ability to control his drinking of alcohol (the main characteristic of the disease), while the drunkard still has the ability. If no ability to control, then no freedom of choice.
(c) The alcoholic does not intend becoming one, any more than the syphilitic intends his disease. In both cases, there could have been, and probably were, objectively sinful acts linked to the disease but the disease, itself that is linked to the act is not a sin.”
He thus concludes, “alcoholism is not a symptom of underlying problems. It is an illness by and of itself producing its own symptoms. Before the onset, of the disease alcoholism, the excessive drinking of alcoholic liquor generally is symptomatic of underlying problems.
Once the line has been crossed and the alcoholic has become an alcoholic drinker, his drinking is then symptomatic of that illness.
Unfortunately, there is no way of telling if you are predisposed to alcoholism (i.e. you have the X-factor). The only way you can find out is by starting to drink and waiting for it to be triggered.
If you don’t drink ask yourself, ‘why start?’ If you do drink, are you drinking responsibly? For the alcoholic there is only one solution. Abstinence! Any alcoholic who continues drinking, the end is inevitably insanity, an institution or death!
To paraphrase Fr. Gelinas, even if you do not drink, maintain an attitude of humility; it is no credit to you that you are not an alcoholic, and will never be if you never drink, no more than it is for not being a diabetic, or epileptic or moronic.
David Ogot is a freelance journalist and author with personal experience with alcoholism and can be reached at goinghomedotcom@yahoo.com