A History of Alcohol Use Disorder and the American Society

Introduction

This perspective is intended to look at the history of alcohol and its impact throughout history on gender, age, and culture, particularly in the United States. It will examine how throughout American history irrespective of time periods, regardless of race, where or when a person was born, or under what circumstances; they faced the issues that has surrounded alcohol use, abuse, and dependency. This article will attempt to explore how the use alcohol and alcoholism has affected every element of society. The National Institute on Alcohol Abuse and Alcohol (NIAAA) points out that alcohol use affects every sector of society. Examining the impact of alcohol use on various segments of society is essential when attempting to better understand how to assess, diagnose, and treat alcoholism. However, to understand the nature of alcoholism and its historical development in the United States, it’s important to discuss aspects of its progression and treatment.

A Historical Perspective and its Impact

According to Alcohol Answers (2018) alcohol use, abuse and dependency can be traced back to the Bible. However, despite the Christian orientation of the founder of this nation since the early days of the United States as country, alcohol has been a part of the American cultural. This occurred mainly because alcohol was viewed as both a beverage and medicine. Alcohol, during this time, was not only viewed as an enjoyable drink but as having a health value. Over the years alcohol has been viewed from varying perspectives. As the United States developed over the years, alcohol became a greater part of cultural acceptability despite those who believed that it was essentially a dangerous substance that affected lifestyles in a negative manner. Wallace (2018) points out that there were those who used the bible as a reference point to demonstrate the evils of drinking. Though the Bible did not specifically prohibit the use of alcohol there were many scriptures that warned Christians against drunkenness and intoxication. He goes on to point out however in some Christian circle’s drunkenness was tolerated especially during colonial times by Bible believers if it did not interfere with an individual’s job or their religious responsibilities.

Over the years, the conflict over alcohol and those who saw it as a hindrance to a productive lifestyle, began to feel a need to push for alcohol prohibition. Hewitt (2006) explains that by the mid-to-late 19th century, a movement developed which began to make the case that an individual’s use of alcohol may not be controllable.  Therefore, there was a shift by those who opposed its use from trying to control the individual use to controlling the manufacturing of the substance itself. She goes on to point out that as the nation began to transform from agricultural society to an industrial one; social problem such as poverty and crime began to make itself more obvious and alcohol became the targeted cause. Many issues facing society were viewed as a direct result of alcohol use. A social reformed movement developed in response to the growing concern and its primary goal was eliminating alcohol use. It was believed that if the making, distribution, and sell of alcohol was eliminated, it would effectively eliminate its use and reduce or eliminate societies problems. Groups emerged such as the American Temperance Society, The Women’s Christian Temperance Union, and the Anti-Saloon League. The primary purpose of these groups was to eliminate alcohol use in the United States. As part of their campaign, they present alcohol as a demonic and evil substance which plagued society. The image of ax toting women became a symbol of the movement. These and other factors helped to change the general acceptance of alcohol use to one that led to it prohibition in the United States. This prohibition lasted from 1920 to 1933. Coincidentally, during this period American alcohol science was revisited as well as the beginnings of the Alcohol Anonymous (AA).

Though there were other groups that sprang up addressing the individuals and families suffering from the effects of alcohol dependency and withdrawal, many were based in the Christian religious dogma.  AA, although many of its members were Christian, opened its membership and meetings to anyone who had a desire to stop drinking and wanted to seek recovery. The early 20th century saw a movement towards viewing alcohol dependency as a medical and health issues rather simply a moral/spiritual issue. Roizon (2000) explains that one of the individuals that contributed to this movement was Dr. Norman Jollinek. According to Roizon, Dr. Jollinek managed a Carnegie Project a sub-group of the Research Council on the Problem of Alcoholism. From this group came the emergence of the new alcohol science. Roizon goes on to point out that Dr. Jollinek provided two significant contributions to this effort:” (1) a description of alcohol syndrome and (2) an alcoholism prevalence formula based on current cirrhosis mortality” (p.1).  

Since the early efforts to identify and treat alcoholism, treatment efforts have advance. The medical model is still the most prevalent school of thought; mainly because of the many ways alcohol use disorders affect the body and mind. The National Institute on Alcohol Abuse and Alcoholism (2018) explains that excessive alcohol use interferes severely with the brain’s communication pathways. Though alcohol at one time was viewed as moral issue and in some circles, the general professional medical society now and for some time sees alcoholism as a disease of the brain which affects its chemicals and the central nervous system. Alcoholism is therefore a disease of the brain and body. It is complexed with behaviors that feature compulsive use despite serious health and social consequences. Alcohol affects regions of the brain that are responsible for reward, motivation, learning, judgment, and memory. Because of this, when alcohol is abused, it creates dysfunctions that damages families, relationships, school attendance, and work.

Alcohol Use Disorder: The Gender Differential

Alcoholism is one of the leading causes of life dysfunction in the United States. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2017 it is estimated that 6.2 percent of adults over the age 18 have an Alcohol Use Disorder; this calculates to around 15.1 million. The Institute goes on to point out of these 15.1 million, 9.8 million are men and 5.3 million are women. The NIAAA reports that the National Survey on Drug Use and Health provides data that shows 86.4 percent of adults of 18 years old have used some alcohol in their lifetime. This demonstrates how much alcohol is engrained in the American psychic. There is an old saying ‘one drinks when they are sad, one drink when they are glad, one drinks when one is mad but most of all one drinks especially when they are bad”. Wilsnack et al (2010) conducted research into gender differential among men and women. It researched those who are mostly likely to drink alcohol, those who consume at higher rates, and those who are more likely to quit drinking related to gender. They posit that research demonstrate men are more likely to consume alcohol than women. They point out that drinking per se as well as consumption by volume is “more constant among men than women” (p.1). Their research also showed that among all those who responded to the survey, women were more likely to quit drinking then men. As it relates to consumption, the higher the age, the higher volume consumption is among men than that of women. However, the differential ratio is changing, and women’s usage is on the increase.

Although the use of alcohol is increasing among women, they are more likely to have difficulty receiving treatment than men. Green (2018) points out that among those diagnosed with a substance use disorder  (SUD), women are less likely to seek treatment. However, when they do seek it, they are more likely to face greater barriers than men. She posits that woman are more likely to seek help in mental health or primary care facilities than tradition treatment settings. As a result this situation tends to contribute to poorer outcomes among women. Some of the reasons for this are as follows:

  •  Economic barriers.
  • Greater Family responsibility that prevents regular treatment sessions attendance.
  • Non-assessable services after discharge such as housing, transportation, education, etc.
  • Feelings of guilt and shame resulting from the need for substance abuse treatment.
  • Anxiety and depression tend to more prevalent among women than men.

Green (2018) points out however that despite these barriers that contribute to preventing a successful outcomes, those women who do receive treatment in traditional treatment programs, outcomes tend to be better than that of men.

Legal Impact of Alcohol Use and Alcoholism

One of most prevailing issue related to the use of Alcohol and alcoholism is the number of individuals in America arrested for Driving Under the Influence (DUI). Although all arrests for this illegal act is not related to simply alcohol; many are. BACtrack (2015) explains that the FBI reports that over 1.4 million drivers are arrested for impaired driving a year. This figure is less than 1% of that total number of self-reporting impaired drivers incidences which is estimated at around 112 million. BACtrack goes on to point out that predictions by highway patrol departments of traffic fatalities related to drunk driving too often tend to be correct. This is especially true during holidays and special events. As it relates to the ratio of men and women, Schwart (2008) points out that reports derived from three diverse sources of evidence: the Center for Disease Control and Prevention, the National Highway and Transportation Safety Administration, and the Federal Bureau of Investigations shows that female DUI arrest has increased, and males has decreased although the gender gap remains constant. Statistics show that women’s overrepresentation in arrests in relationship to the overall share of offensives began somewhere around the 1990s and increased in 2000. Schwart attributes this to more stringent laws and enforcement which reduced the test levels indicating intoxication which determines a DUI violation. She believes that this increased vulnerability related to women has occurred because, though they tend to drink less their male counterparts, the lowered standard test result qualities contribute to their greater number of arrests for intoxication.

The rate of individuals who will be involved in a drunk driver’s accident and those arrested for DUI appears to be on the rise. BACtrack (2015) explains that one in three people during their lifetime will be involved in a drunk driver accident and at least 28 people a day die because of those accidents. In 2010 10,228 people died and 345,000 were injured in car accidents, and alcohol-related accidents contributed to over 1/3 of all accident-related deaths in 2010. These are staggering statistics. These reports demonstrate just how the universal acceptance of alcohol use has affected our entire society. Despite this most statistics indicate that millions of people are social drinker and basically control their alcohol intake and behaviors. There are strong statistical indication that too many people both men and women who drink alcohol tend to be irresponsible as it relates to concern for human life including their own.

Culture Differences and Alcoholism: Whites, Blacks, and Hispanics Males and Females

There tends to be many cultural differences related to alcohol use among Whites, Blacks, and Hispanics. Though all races are consumers of alcohol beverages, and all three cultures find the use of alcoholic beverages acceptable, their patterns of drinking tend to vary. Nyarong et al. (2009) points out that Hispanic man who are regular bar attendees tend to consume more drinks on annual bases as comparison to their black and white male counterpart drinkers. They go on to point out that Hispanic men prefer drinking at home and enjoy entertaining both friends and/or visitors. They point out that, in this regard, there is a great deal of similarity between the Hispanic and Whites. Nyarong also suggests that black male on the other hand who frequent bars tend to look very similar to their white male counterparts. However, they tend to consume less alcohol at restaurants and more at public locations like street corners and parks. They go on to point out that black male bar-plus consumes more drinks at home on a quiet evening, compared to women and other ethnic groups. In this respect  black men who are light drinkers tend to be very similar to their white- male drinking counterparts.

As it relates to women drinking patterns, Nyarong et al (2008) suggests that their drinking patterns reflect that of their white male counterparts. However, White women tend to drink less in most cases than White men. White men as well as White women who tend to be a part of the bar-plus cluster and drinks alcohol primarily in bars are less likely to drink outdoors, particularly, in large amounts. White women who drink larger amounts primarily drink at home on a quiet evening. Nyarong et al further point out that “Hispanic women bar-plus drinkers do most of their drinking both in bars and at others’ parties as well as a fair amount elsewhere but tend to resist drinking in public places”. They point out however Black women, on the hand, tend to do most of their drinking in bars, when friends are visiting, and/or on a quiet evening.

Conclusion

            It appears that without question alcohol has and still plays a major role in the life and the lifestyles of Americans. In examining the history of alcohol use in American it obvious that its use has had a love/hate relationship with the American people. There have been times when alcohol was viewed as the enemy of what was considered a good and wholesome lifestyle. There have been periods of religious dogma that demonized its use and there have been periods where it was viewed a medical enhancer. Yes, Americans have seen alcohol as a source of helping to save lives,  as a medication for emotional and mental distress as well as a destroyer of life demonstrated by tragic car accidents. One thing has been very evident is that throughout the general cultures of American society, alcohol has and is an acceptable tool for enjoyment despite it negative consequential results.

 References:

BACtrack (2015), DUI Statistics. Retrieved August 5, 2018, from https://www.bactrack.com.

Green, C. A. (2018), Gender and Use of Substance Abuse Treatment Services. Retrieved August 5, 2018 from https://www.pubs.naaa.nih.gov.

Hewitt, Brenda, G. (2006), the History of NIAAA. Retrieved August 5, 2018, from http://www.alcohlanswers.org

NIAAA (2018), Alcohol Effects the Body. Retrieved August 5, 2018, from https://www.niaaa.nih.gov  .  

Nyarong, D., Greenfield, T. K., Mc Daniel, P.A. (2009), Drinking Context and Drinking problems Among Blacks, Whites, and Hispanic Men and Women in the 1984, 1995, and 1995 and 2005 U. S. National Alcohol Survey. Retrieved August 5, 2018 from https://www.ncbi.nlm.nih.gov.

Roizon, R. (2000), Jellinek and All That! A Brief Look Back at the origins of post-Repeal. Alcohol Science in the United States, 20-36: University of California, San Francisco.

Schwartz, J. (2008), Gender Differences in Drunk Driving Prevalence rates and Trends: A 20-year Assessment Using Multiple Sources of Evidence. Addictive Behavior, 33(9):1217-22

Wallace, D. B. (2018), the Bible and Alcohol. Retrieved August 5, 2018, from http://www.bible.org

Wilsnack, R.W., Wilsnack, S. C., Kristjanson, A. F., Vogeltanz-Holm, N. D., and Gmel, G. (2010), Gender and Alcohol Consumption: Patterns from Multinational Genacis Project. Addictions, 104 (9): 1487-1500.

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