Loosening the Grip: A Handbook of Alcohol Information

by Jean Kinney

This handbook is an attempt to partially remedy the situation. It contains what we believe is the basic information an alcohol counselor or other professional confronted with alcohol problems needs to know and would like to have handy.

Somewhere along the line, in casual conversation someone recounted a comment made by an alcoholic struggling to get sober. This person, discussing her drinking in a rather defiant and belligerent fashion, said, “If God didn’t want me to drink, He’d knock the glass out of my hand!” One of us jokingly commented that we hoped whoever was present had supplied the obviously perfect retort, “He will; all you have to do is loosen your grip.” Somehow that metaphor caught the simplicity and the complexity, the ease and the difficulty, the “holding on” and “being held” that are a part of alcohol problems.

Two . Anyone who is going to muck around in someone else’s life had better be knowledgeable about what is likely to be encountered.

alcohol is a topic on which we all consider ourselves experts of a sort,

Then there is the opposite problem, that a portion of the knowledge base for alcohol is drawn from the biological and medical sciences. This portion includes information that for most of us is not part of our fund of knowledge. Even the vocabulary is foreign to us. If we were to eavesdrop on a conversation of experts, we might suspect they were speaking Klingon.

In writing about the history of medicine, Jonathan Miller made an interesting observation. The big breakthroughs in understanding how the body works have occurred only after the invention or creation of something in our external world that provides an example. It was only after the invention of the pump that the heart’s function became obvious. It isn’t coincidence that the rapid strides in understanding the brain’s function followed the introduction of the computer.

Demographic Influences on Alcohol Use No single factor predicts either alcohol use or the potential problems that may emerge. Drawing on the public health model, Loosening the Grip considers the interplay of the multiple significant factors that need to be considered. It reviews the effects of the drug, alcohol, which invite its use. It examines individual characteristics, drawing on our rapidly growing understanding of genetic influences alongside demographic characteristics, be it age, gender, minority status whether based on race, ethnicity, or sexual orientation, being economically advantaged or disadvantaged, religious affiliation, education, and regional differences. Equal attention is directed to the family, the neighborhood, and the immediate community, as well as to larger cultural and social influences. This becomes the basis for later discussion of prevention, treatment, and policy, as well as comparing and contrasting alcohol and other drugs of abuse.

No one knows what kind of alcoholic beverage came first—wine, beer, or mead—but by the Neolithic Age it was everywhere. Tales of liquor abound in folklore. One story relates that at the beginning of time the forces of good and evil contested with each other for domination of the earth. Eventually the forces for good won out. But a great many of them were killed in the process, and wherever they fell, a vine sprouted from the ground—so it seems some felt wine to be a good force. Other myths depict the powers of alcohol as gifts from the gods. Some civilizations worshiped specific gods of wine. The Egyptians’ god was Osiris; the Greeks’, Dionysius; and the Romans’, Bacchus. Wine was used in early rituals as libations (poured out on the ground, altar, and so on). Priests often drank it as part of the rituals. The Bible, too, is full of references to sacrifices, including wine.

From ritual uses the drinking of wine expanded to convivial uses, and drinking customs developed. Alcohol was a regular part of meals, viewed as a staple in the diet, even before ovens were invented for baking bread.

The Assyrians received a daily portion from their masters of a “gallon” of bread and a gallon of fermented brew (probably a barley beer). Bread and wine were offered by the Hebrews on their successful return from battle. In Greece and Rome, wine was essential at every ...

a party—for example, the Roman orgy. Certainly it was a safer beverage than water, but surely its effects also had something to do with its popularity.

By the Middle Ages, alcohol was an integral part of life, accompanying birth, marriage, death, the crowning of kings, diplomatic exchanges, treaty signings, and councils. The monasteries became the taverns and inns of the times, and travelers received the benefit of the grape.

The ancients figured that what was good in these instances might be good in others, and alcohol came into use as a medicine. It was an antiseptic and an anesthetic and was used in combinations to form salves and tonics. It was used to treat a host of problems, from black jaundice to knee pain and even hiccups. St. Paul advised Timothy, “No longer drink only water, but use a little wine for the sake of your stomach and your frequent ailments.” Liquor was a recognized mood changer, nature’s tranquilizer. In the Bible, King Lemuel’s mother advised, “Give wine to them that be of heavy hearts.” The Bible also re...

and this is how alcohol became so popular

Fermentation is a natural process that occurs when yeasts combine with plants, be they potatoes, fruit, or grains. The sugar in the plants, exposed either to wild yeasts from the air or to commercial yeasts, produces an enzyme, which in turn converts sugar into alcohol. Fermentive yeast very rarely survives in solutions stronger ...

In the tenth century, a Persian physician and alchemist, Rhazes, discovered distilled spirits. Actually, he was looking for a way to release “the spirit of the wine,” which was welcomed at the time as the “true water of life.” European scientists rejoiced in their long-sought “philosopher’s stone,” or perfect element. A mystique developed, and alcohol was called the fountain of youth, eau-de-vie, aqua vitae. Usequebaugh, from the Gaelic usige beath, meaning “breath of life,” is the source of the word “whiskey.” The word...

Nineteenth-century temperance advocates tried to prove that the word “alcohol” is derived from the Arabic alghul, m...

Persia. Malcolm, in his “History of Persia,” relates that wine was discovered in that kingdom in the reign of Janisheed. He attempted to preserve grapes in a large vessel. Fermentation occurred, and the king believed that the juice was poison and labeled it as such. A lady of the palace, wishing to commit suicide, drank from it. She was pleased with the stupor that followed and repeated the experiment until the supply was exhausted. She imparted the secr...

This is a great story on how alcohol is poison when use wrongly

Distillation is a simple process that can produce an alcohol content of almost 93%.

Start with a fermented brew. When it is boiled, the alcohol separates from the liquid as steam. Alcohol boils at a lower temperature than the other liquid. The escaping steam is caught in a cooling tube and turns into a liquid again, leaving the juice, water, and so on behind. Voilà—stronger stuff—about 50% alcohol.

Proof as a way of measuring the strength of a given liquor came from a practice used by the early American settlers to test their brews. They saturated gunpowder with alcohol and ignited it: too strong, it flared up; too weak, it sputtered. A strong blue flame was considered the sign of proper strength. Almost straight alcohol was diluted with water to gain the desired flame. Half and half was considered 100 proof. Thus, 86-proof bourbon is 43% alcohol. Because alcohol dilutes itself with w...

In 1620, the Mayflower landed at Plymouth because, as it says in the ship’s log, “We could not now take time for further search or consideration, our victuals having been much spent, especially our bere.” The Spanish missionaries brought grapevines, and before the...

The Dutch opened the first distillery on Staten ...

In the Massachusetts Bay Colony, brewing ranked next in importance after milling and baking. The Puritans did not disdain the use of alcohol, as is sometimes supposed. A federal law passed in 1790 provided each soldier a daily ration of one-fourth pint of brandy, rum, or whiskey. The colonists imported wine and malt beverages and planted vineyards, but it was Jamaican rum that became the answer to the thirst of the new nation. For its sake, New Englanders became the bankers of the slave trade that supplied the molasses needed to produce r...

people from early times have devoted much time and energ...

and now?

Suddenly it seemed as if everyone drank something, sometime, somewhere.

They weren’t dropping dead at the first sip or getting into too much trouble that you could see. There may have been a few “incidents,” but people mostly laughed and brushed it off with “Aaah, he was trashed.”

this is the simplistic way we cheat ourselves

Those trying to explain drinking behavior have always been more interested in heavy drinking, what we now term “alcohol dependence,” than in explaining alcohol use per se.

“It calms me down, helps my nerves. It helps me unwind after a hard day.” This explanation can be thought of as the anxiety thesis. In part it is derived from Sigmund Freud’s work. Freud concluded that in times of anxiety and stress people fall back on things that have worked for them in the past. In theory, the behaviors you will choose to relieve anxiety are those you used when you last felt most secure. That lovely, secure time might last have been at Mom’s breast. It has been downhill ever since. In this case, use of the mouth (eating, smoking, drinking) is chosen to ease stressful situations.

Another version of the anxiety thesis came from Donald Horton’s anthropological studies. He observed that alcohol was used by indigenous peoples either ritually or socially to relieve...

with the advances in biological research on alcohol’s effects, it is now realized that alcohol does ...

Another theory that surfaced was based on the need for a feeling of power over oneself or one’s environment. Most people don’t talk about this, but take a look at the heavy reliance of the liquor industry on macho models, executive types, and beautiful women surrounded by adoring males. People in ads celebrate winning anything with a drink of some sort. The power theory was explored by researchers in the early 1970s, under the direction of David McClelland. They examined folktales from both heavy- and light-drinking societies. Their research indicated that concern with relief from tension or anxiety was no greater in heavy-drinking societies than in those that consumed less. To look at this further they conducted a study with college men over a period of 10 years. Without revealing the reasons for the study, they asked the students to write down their fantasies before, during, and after drinking. The stories revealed that the more the students drank, the more they felt bigger, stronger, more influential, more aggressive, and more capable of great sexual conquest. The conclusion was that people drink to experience a feeling of power— exhibited in two different patterns. What was called p-power is a personal powerfulness, uninhibited and carried out at the expense of others. Social power, or s-power, is a more altruistic powerfulness, power to help others. This s-power was found to predominate after two or three drinks; heavier drinking ...

Control theory, we want to control death

Another theory arose during the late 1960s at the height of the counterculture, with its wave of drug use, particularly psychedelic drugs. This approach, as discussed by Andrew Weil, before he became a health guru, claimed that people have a need for transcendent experiences

More recently a factor that has been considered to shed light on reasons for drinking is the role of expectations —that is, what individuals believe alcohol will do to or for them. (In the research literature this is referred to as “expectancies.”)

For the most part, researchers now are less interested in identifying factors within the individual that motivate alcohol use. More attention is being directed toward the social setting in which people find themselves, to identify factors associated with patterns of use. For example, attention is turning to the role of peers in determining adolescents’ decisions to use alcohol, the influence of parental standards in setting norms for their teenagers’ drinking, and the impact of legislative approaches.

One inescapable fact is that, from the very earliest recorded times, alcohol has been important to people. Selden Bacon, an early head of the Rutgers School of Alcohol Studies, made a point worth keeping in mind. He called attention to the original needs that alcohol might have served: to satisfy hunger and thirst, to medicate or anesthetize, or to foster religious ecstasy. Our modern, complex society has virtually eliminated all these earlier functions. Now all that is left is alcohol the depressant, the moodaltering drug, the p...

and maybe we need to make a better caring society

In thinking about alcohol use, remember that myths, a variant of expectancies, are equally important to people. Many think that alcohol makes them warm when they are cold (not so), sexier (in the courting, maybe; in the execution, not so), more manly, more womanly, cured of their ills (not usually), less scared of people (possibly), and better able to function (only if very little is taken). A...

The views of drunkenness as a sin or as a legislative matter often go hand in hand. The common denominator is the idea that the drunk chooses to be drunk and is therefore either a sinner or a ne’er-do-well, who can be handled by making it illegal to drink.

drinking became less family centered. Alcohol abuse became more open and more destructive.

a belief in the efficacy of law to resolve human problems.

human problems are resolved with human actions

Prohibition In 1919, Congress passed the Volstead Act, the Eighteenth Amendment, ushering in Prohibition. What exactly did Prohibition prohibit? This act made the commercial manufacture, sale, and transportation of alcoholic beverages illegal.

It did not ban the possession of alcoholic beverages nor make it illegal to produce either beer or wine for personal consumption. The act had 60 provisions, was messy and complicated, and no precedent had been set to force the public cooperation required to make it work. Prohibition remained in effect from 1920 to 1933.

Prohibition shaped much of the country’s economic, social, and underground life. Its repeal under the Twenty-First Amendment in ...

lo que constitucionalmente la rompe

When Prohibition was repealed, the problem of abuse was still there, and those dependent on alcohol were still there, along with the associated stigma of alcoholism. Possibly the major legacy of Prohibition was the development of underground crime syndicates. When no longer needed to provide alcohol, they took on...

As far back as the third century there are vague references that distinguish between being merely intoxi...

The word “alcoholism” was first introduced in 1849. Magnus Huss, a prominent Swedish physician, wrote a book on the physical problems associated with drinking distilled spirits, titled Chronic Alcoholic Illness: A Contribution to the Study of Dyscasias Based on My Personal Experience and the Experience of Others. (The term “dyscasias” is no longer used. Even when this work was published, the meaning of the term was a bit vague, covering a combination of maladies and generally used to describe those thought to have a “poor constitution.”) In using the term “alcoholism,” Huss was following the common scientific practice of using “ism” as a description of a disease, especially those associated with poisonings. While recognizing the host of medical complications, he thought that the culprit was distilled spirits, not fermented beverages.

The first serious medical considerations of the problem of inebriety, as it was then called, came in the eighteenth and nineteenth centuries. Two famous writings addressed the problem in what seemed to be a new light. Although their work on the physical aspects of alcohol became fodder for the temperance zealots, both Dr. Benjamin Rush and Dr. Thomas Trotter seriously considered the effects of alcohol in a scientific way. Rush, a signer of the Declaration of Independence and the first surgeon general,

A Comment on Terminology Over the years there has been an evolution in terminology. In the past year “alcohol use disorders” replaced “alcohol dependence” and “alcohol abuse,” which had replaced “alcoholism.” Alcohol use disorders will be the framework generally used throughout this book; with a few exceptions. The terms “abuse” and “dependence” will be used if these are used in a survey or research being discussed. “Alcoholism” is used in discussions of historical periods when it was the commonly used term. The word “alcoholic” too can be troublesome. In everyday conversations, “alcoholic” can be used in a way that seems to reduce individuals to nothing more than a disease. In referring to anyone in terms of a single characteristic—be it race, gender, ethnicity, sexual orientation, or a disease state—there is the danger of reducing individuals to stereotypes.

Early Treatment Efforts Around the 1830s, in Massachusetts, Connecticut, and New York, small groups were forming to reform “intemperate persons” by hospitalizing them, instead of sending them to jail or the workhouse. The new groups, started by the medical superintendent of Worcester, Massachusetts, Dr. Samuel Woodward, and Dr. Eli Todd, did not see inebriates in the same class with criminals, the indigent, or the insane. Between 1841 and 1874, 11 nonprofit hospitals and houses were set up. In 1876, The Journal of Inebriety started publication to advance these reformers’ views and findings. These efforts were taking place against the background of the temperance movement.

Another group briefly flourished. The Washington Temperance Society began in Chase’s Tavern in Baltimore in 1840. Six drinking buddies were the founders, and they each agreed to bring a friend to the next meeting. Within a few months, parades and public meetings were being held to spread the message: “Drunkard! Come up here! You can reform. We don’t slight the drunkard. We love him!” At the peak of its success in 1844, the membership consisted of 100,000 “reformed common drunkards” and 300,000 “common tipplers.” A women’s auxiliary group, the Martha Washington Society, was dedicated to feeding and clothing the poor. Based on the promise of religious salvation, the Washington Temperance Society was organized in much the same way as the ordinary temperance groups, but with a difference. It was founded on the basis of one drunkard’s helping another, of drunks telling their story in public. The society prospered all over the East Coast as far north as New Hampshire. A hospital, the Home for the Fallen, was established in Boston and still exists under a different name. There are many similarities between the Washington Society and Alcoholics Anonymous (AA): people helping each other, regular meetings, sharing experiences, fellowship, reliance on a Higher Power, and total abstention from alcohol.

The early AA

The founding of the Laboratory of Applied Psychology at Yale University and the founding of Alcoholics Anonymous, both occurring in the 1930s, were instrumental in bringing this about. Also in the 1930s, a recovering Bostonian, Richard Peabody, first began to apply psychological methods to the treatment of what he termed alcoholism. He replaced the terms “drunk” and “drunkenness” with the more scientific and less judgmental “alcoholic” and “alcoholism.” At Yale, Yandell Henderson, Howard Haggard, Leon Greenberg, and later E. M. Jellinek founded the Quarterly Journal of Studies on Alcohol. The journal continues publication, but the name was changed in 2007 to the Journal of Studies on Alcohol and Drugs. Unlike the earlier Journal of Inebriety, the Quarterly Journal had a sound scientific footing and became the vehicle for disseminating alcohol research.