Alcohol abuse is a serious problem in the United States and in many countries throughout the world. Those afflicted with alcoholism suffer from a variety of problems that negatively impact upon many aspects of their lives. It is estimated that between 9 to 13 million people suffer from alcohol abuse. The statistics are quite frightening. Alcohol is responsible for half the annual deaths due to automobile accidents, and for more than 70% of adolescent suicides (Landy, 1987).
Over time, alcohol abuse leads to a variety of serious health problems. These can include chronic liver disease, decreased sex hormone production, pancreatitis, kidney disease, and brain damage. Psychiatric problems include depression, paranoia, and low self-esteem. It is difficult for individuals with alcohol problems to be productive and many lose jobs or cannot be successful in their area of work. Perhaps the most devastating effects of chronic alcohol problems are the social problems which manifest directly from alcoholism: domestic violence, child abuse, marital conflict, deconstruction of the family and of community cohesion.
Alcoholism Defined
There is a difference between alcoholism and problem drinking. Alcoholics are both physically and psychologically dependent, while problem drinkers are psychologically dependent.
The physiological dependency can be seen in the high tolerance that drinkers develop - that is, the need to drink more and more to obtain the same effects. Research has shown that over time (with regular alcohol use) the body adjusts to having the chemical in its system. The body then becomes “normal” only with alcohol. The alcohol is required for basic functioning, and many alcoholics need a drink in the morning just to get out of bed.
The physical nature of alcoholism is also seen in compulsive behaviors (the inability to stop drinking once started). This is what is referred to as the “out of control” behaviors of the alcoholic.
One of the psychological aspects of dependency is the obsessive thoughts about drinking. Another is the use of alcohol to relieve tension and anxiety. Typically the heavy drinker has difficulty coping with negative feelings and discovers that alcohol relieves worry and distress. A pattern of drinking to ease daily tension and life problems escalates leading ultimately to physiological dependence. In this way, the problem drinker becomes an alcoholic.
Alcoholism and Black Women
Those at risk for developing alcohol addiction are individuals who experience a lot of stress in their lives, have difficulty coping, have easy access to alcohol, and are encouraged to drink by their social environment. Alcoholism is especially likely when individuals grow up with one or more alcoholic parents.
White men have among the highest rates of alcoholism in the U.S. Black males experience less alcoholism than White males, but still have rates high enough to be of concern (15% in 1984 and 1995 surveys). Black women have a much lower rate (5% in both surveys) which is equal to White women (Caetano & Clark, 1998).
While the rates of alcoholism are relatively low amongst Black women, they do face the challenge of coping with the alcoholism of their male spouses. It is suggested that they may be affected by “codependency”, the tendency of family members to protect the alcoholic and take on alcoholic-like characteristics, such as denial, blaming, and rationalizing dysfunctional behaviors.
Black women must also be aware of some of the stresses and sources of depression unique to them which contribute to turning to alcohol as a coping mechanism. Causal factors of stress and depression for Black women often cited are racism, sexual exploitation, alienation from traditional African and African American values (such as spirituality and community), and increasingly poor relationships between Black women and men.
Could You Be in Danger of Alcoholism?
If you or someone you know is questioning whether drinking habits are a problem, then it will be worthwhile to complete the test found below. How you answer the questions may give you the answers you seek.
Directions: Please take a few minutes to respond to the following questions by answering “yes” or “no.”
| Yes | No | |
| ___ | ___ | 1. Do you occasionally drink heavily after a disappointment, a quarrel, or when the boss gives you a hard time? |
| ___ | ___ | 2. When you have trouble or feel under pressure, do you always drink more heavily than usual? |
| ___ | ___ | 3. Have you noticed that you are able to handle more liquor than you did when you were first drinking? |
| ___ | ___ | 4. Did you ever wake up on the “morning after” and discover that you could not remember part of the evening before, even though your friends tell you that you did not “pass out?” |
| ___ | ___ | 5. When drinking with other people, do you try to have a few extra drinks when others will not know it? |
| ___ | ___ | 6. Are there certain occasions when you feel uncomfortable if alcohol is not available? |
| ___ | ___ | 7. Have you recently noticed that when you begin drinking you are in more of a hurry to get the first drink than you used to be? |
| ___ | ___ | 8. Do you sometimes feel a little guilty about your drinking? |
| ___ | ___ | 9. Are you secretly irritated when your family or friends discuss your drinking? |
| ___ | ___ | 10. Have you recently noticed an increase in the frequency of your memory “blackouts?” |
| ___ | ___ | 11. Do you often find that you wish to continue drinking after your friends say that they have had enough? |
| ___ | ___ | 12. Do you have a reason for the occasions when you drink heavy? |
| ___ | ___ | 13. When you are sober, do you often regret things that you have done or said while drinking? |
| ___ | ___ | 14. Have you tried switching brands or* following different plans for controlling your drinking? |
| ___ | ___ | 15. Have you often failed to keep the promises that you have made to yourself about controlling or cutting down your drinking? |
| ___ | ___ | 16. Have you ever tried to control your drinking by making a change in jobs, or moving to a new location? |
| ___ | ___ | 17. Do you try to avoid family or close friends while you are drinking? |
| ___ | ___ | 18. Are you having an increasing number of financial and work problems? |
| ___ | ___ | 19. Do more people seem to be treating you unfairly without good reason? |
| ___ | ___ | 20. Do you eat very little or irregularly when you are drinking? |
| ___ | ___ | 21. Do you sometimes have the “shakes” in the morning and find that it helps to have a little drink? |
| ___ | ___ | 22. Have you recently noticed that you cannot drink as much as you once did? |
| ___ | ___ | 23. Do you sometimes stay drunk for several days at a time? |
| ___ | ___ | 24. Do you sometimes feel very depressed and wonder whether life is worth living? |
| ___ | ___ | 25. Sometimes after periods of drinking, do you see or hear things that are not there? |
| ___ | ___ | 26. Do you get terribly frightened after you have been drinking heavily? |
Scoring: Those who answer yes to any of these questions may have some symptoms of alcoholism and should seek help. Yes answers to several of the questions indicate these stages of alcoholism:
Questions 1-8: early stage
Questions 9-21: middle stage
Questions 22-26: beginning of the final stage.
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Source: From the brochure, What are the Signs of Alcoholism? Published by the National Council of Alcoholism.
Seeking Help
Treating the alcoholic woman requires an understanding of the complex nature of her problem. For one thing, alcoholics are in need psychological healing. This includes developing a better self-understanding, increased “emotion regulation” skills, and improved impulse control. Given the obstacles every African American woman must face, adequate coping skills are critical for prevention of alcohol problems. Positive social supports are needed as well.
Because the alcoholic often compromises her principles and morals due to her compulsive behavior, she can feel spiritually empty. The alcoholic drinker experiences feelings of guilt and shame due to her inability to keep promises to herself (and others) not to drink. In addition, because she has used alcohol to escape negative emotions, she may have failed to learn how to be responsible and may be emotionally immature. Most alcoholics tend to be in denial of their problem and blame and manipulate others to maintain their lifestyle and avoid consequences of their drinking.
Treatment
Treatment must be complex to met the challenges of healing the alcoholic, including breaking through denial and building a vision of a healthier lifestyle. There are many professional treatments for alcoholism. Individual therapy or inpatient treatment are the typical methods of healing. These make a logical first step because of the benefit of being in a controlled environment safe from temptations to drink. Treatment programs that focus on the unique needs of African Americans do exist (though rare). Alcoholics Anonymous (A.A.), a twelve-step support group, is not professional-based, but has a very good success rate for healing the alcoholic who is motivated to change. One caveat for African American women who participate in A.A. is that its emphasis on “accepting powerlessness” may lack the empowering effect it has for others. For Black women who typically do not feel powerful in U.S. society “Surrendering” to the idea of being an alcoholic may be a more appropriate attitude.
Healing begins with admitting that drinking is out of control and recognizing the destructive consequences of drinking on the self and on others. The next step is to contact A.A. or a substance abuse treatment facility in your community. The road to recovery for African American women often leads not only to the ability to abstain from drinking, but to a new found sense of spirituality and increased self-awareness and self-esteem
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