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To understand the effect that alcohol addiction has on the drinker and in turn their family, one must first understand alcoholism in and of itself. The Oxford English Dictionary defines alcoholism as being “the addiction to the consumption of alcoholic drink; alcohol dependency.” Although the term alcoholism is somewhat easily defined, the aetiology of alcoholism is a much more nebulous concept with many theories attempting to establish a clear cause and effect relationship between an individual and their relationship with alcohol. By understanding the potential factors that may cause alcoholism whether they be physiological, psychological or sociological, one can discover links between what alcoholism is and what kind of effects it may have on a family.
One popular theory amongst counsellors, physicians and recovering alcoholics, especially those affiliated with Alcoholics Anonymous is Elvin Morton Jellinek’s “Disease Concept” first posited in his book, “The Disease Concept of Alcoholism”, in 1960. Jellinek’s main conceptions were that there were multiple “species” of alcoholism; Alpha, Beta, Gamma, Delta and Epsilon, with Gamma and Delta alcoholics progressing through an ever-worsening series of stages which culminate in the premature death of the alcoholic, if they do not seek treatment. These stages include: the “pre alcoholic symptomatic phase” where a person drinks for relief, the “prodromal phase” wherein alcoholics resort to surreptitious drinking and experience guilt for their intoxicated behaviour, the “crucial phase” whereby one drink leads to the next, which leads to the “loss phase” wherein the alcoholic’s health, relationships and employment suffer. Finally, the alcoholic enters the “chronic phase” which is the last phase before death, where they are utterly obsessed with alcohol.
The disease concept has garnered widespread support, mainly on account of its ability to be easily understood and its relatively straightforward approach to treatment; total abstinence. However, it is often misunderstood with many believing all species of alcoholism are a “disease”. Even if entirely understood, the theory remains fallible, for example; the progression of alcoholism is not inevitable and the “loss of control” is not supported by scientific evidence. The disease concept is useful nonetheless as it helps to clearly outline the fact that there is not merely one type of alcoholism. In doing this, it has encouraged therapists to inspect clients on a case by case basis which has, in turn, led to many discovering sobriety on this path.
There are many other physiological theories. Some believe that alcoholism can be inherited genetically. Although genetics may affect one’s propensity to develop an alcohol use disorder (AUD), there is no single “alcoholic gene” that predetermines the fate of an alcoholic. For example, some who have inherited genes making them susceptible to alcoholism, are responsible drinkers or never take a drink in their life.
“Research shows that genes are responsible for about half of the risk for AUD. Therefore, genes alone do not determine whether someone will develop AUD. Environmental factors, as well as gene and environment interactions, account for the remainder of the risk.” - National Institute of Alcohol Abuse and Alcoholism (USA)
In the majority of family studies of alcoholism, it has been shown that relatives of alcoholics have much higher rates of alcoholism than the general population. However, hereditary patterns of alcoholism may also be purely behavioural and not linked to individuals’ genetic make-up. It is essential to question whether these patterns are as a result of an inherited propensity for alcoholism or can they be explained through learned attitudes and behaviours that are passed down from adults to their offspring? Due to contradictory genetic research and the difficulty in establishing a cause and effect relationship, it seems best to understand that genetics play a role in affecting one’s predisposition towards alcohol but that to develop alcoholism there need to be many other factors at play.
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