Alcohol: Social and Community Factors
Social and Community Factors
The problem of excessive use of alcohol has social cultural as
well as psychological dimensions. The values
and customs of the community influence attitudes toward
drinking.
In the past, problems of alcohol use
were extremely frequent among certain ethnic groups,
such as the Irish and Swedish, relatively infrequent for
Italians, and particularly infrequent for Jews.
Today, however, alcoholism is decreasing among Irish and
Swedish-Americans but rising among second and third
generation Italian-Americans and Jews. Changing social
customs within the cultural group seem to be a significant
factor in these patterns of alcohol consumption.
Rates of alcoholism are low in groups in which
the groups customs, values, and sanctions are well
known, agreed to by all, and consistent with the rest of
the culture. The social cultural conditions that minimize
alcohol problems are the following.
Exposure of children to alcohol at an early age in a
strong family or religious setting. The alcoholic beverage
is served in diluted wine as opposed to distilled spirits,
for example and in small quantities. The beverage is
considered a food and is served mainly at restaurants.
“U-Drinking” is not considered either a virtue-for example,
a proof of manhood or virility-or a sin: abstinence is socially
acceptable but excessive drinking or drunkenness is not.
A variety of social and interpersonal factors also
influence alcohol cons . These include the level
of stress in the community and in the individual's personal
life. Among the personal factors are friendships, family situation,
and employment and financial status.
(Linsky and others, 1985).
Treatment
The first step in treating an addicted alcohol user is
detoxification, or "drying out." Physiological withdrawal
symptoms often begin 6 to 24 hours after heavy
drinking has stopped, although they can occur
when alcoholics simply reduce their intake of alcohol. Withdrawal
signs can include tremors, delirium, sweating,
confusion, increased blood pressure, and agitation
There is no established sobering agent-nothing that
counteracts the effects of alcohol or speeds its breakdown
and passage out of the body.
Many alcoholics can withdraw on their own, but some
are so severely dependent that they have to be
detoxified-supervised as they go through a gradual
withdrawal. Detoxification is complete, insomnia, depression,
and anxiety may persist for weeks or months however, these
usually receive no treatment after the detoxification period has ended.
Most recovery from alcoholism is not the result of
treatment. Probably no more than 10 percent of
alcohol abusers are ever treated at all, but as many as 40 percent
recover on their own. Alcoholics with a stable job and
family life have the best chance; The sex and the duration
of alcohol abuse matter less. An important step to
overcoming alcoholism is the alcoholic's acknowledge of the
disorder. Alcohol abusers, feeling ashamed
and guilty, often refuse to admit the problem to themselves
and try to conceal it from their families and
friends, who in turn may avoid acknowledging it for
fear of being intrusive or having to take responsibility.
This is valuable in clinical interviews to determine the
patient's willingness to admit the seriousness of his or her
drinking problem.
Denial and obliviousness are not the only sources
of misunderstanding. In a society that has so many
heavy drinkers, it is not always easy to decide when a
drinking problem has become so serious that special
help is needed. Alcoholism can be hard to observe day
by day, even if it 's easily recognizable over a period of
years. Patterns of abuse through a lifetime are variable.
The symptoms come and go. Alcoholics are not always
drinking uncontrollably; some drink only on weekends,
and many succeed in remaining abstinent or nearly
abstinent for months at a time. In the following sections
we describe several treatment programs for problem
drinkers and detoxified alcoholics.
The problem of excessive use of alcohol has social cultural as
well as psychological dimensions. The values
and customs of the community influence attitudes toward
drinking.
In the past, problems of alcohol use
were extremely frequent among certain ethnic groups,
such as the Irish and Swedish, relatively infrequent for
Italians, and particularly infrequent for Jews.
Today, however, alcoholism is decreasing among Irish and
Swedish-Americans but rising among second and third
generation Italian-Americans and Jews. Changing social
customs within the cultural group seem to be a significant
factor in these patterns of alcohol consumption.
Rates of alcoholism are low in groups in which
the groups customs, values, and sanctions are well
known, agreed to by all, and consistent with the rest of
the culture. The social cultural conditions that minimize
alcohol problems are the following.
Exposure of children to alcohol at an early age in a
strong family or religious setting. The alcoholic beverage
is served in diluted wine as opposed to distilled spirits,
for example and in small quantities. The beverage is
considered a food and is served mainly at restaurants.
“U-Drinking” is not considered either a virtue-for example,
a proof of manhood or virility-or a sin: abstinence is socially
acceptable but excessive drinking or drunkenness is not.
A variety of social and interpersonal factors also
influence alcohol cons . These include the level
of stress in the community and in the individual's personal
life. Among the personal factors are friendships, family situation,
and employment and financial status.
(Linsky and others, 1985).
Treatment
The first step in treating an addicted alcohol user is
detoxification, or "drying out." Physiological withdrawal
symptoms often begin 6 to 24 hours after heavy
drinking has stopped, although they can occur
when alcoholics simply reduce their intake of alcohol. Withdrawal
signs can include tremors, delirium, sweating,
confusion, increased blood pressure, and agitation
There is no established sobering agent-nothing that
counteracts the effects of alcohol or speeds its breakdown
and passage out of the body.
Many alcoholics can withdraw on their own, but some
are so severely dependent that they have to be
detoxified-supervised as they go through a gradual
withdrawal. Detoxification is complete, insomnia, depression,
and anxiety may persist for weeks or months however, these
usually receive no treatment after the detoxification period has ended.
Most recovery from alcoholism is not the result of
treatment. Probably no more than 10 percent of
alcohol abusers are ever treated at all, but as many as 40 percent
recover on their own. Alcoholics with a stable job and
family life have the best chance; The sex and the duration
of alcohol abuse matter less. An important step to
overcoming alcoholism is the alcoholic's acknowledge of the
disorder. Alcohol abusers, feeling ashamed
and guilty, often refuse to admit the problem to themselves
and try to conceal it from their families and
friends, who in turn may avoid acknowledging it for
fear of being intrusive or having to take responsibility.
This is valuable in clinical interviews to determine the
patient's willingness to admit the seriousness of his or her
drinking problem.
Denial and obliviousness are not the only sources
of misunderstanding. In a society that has so many
heavy drinkers, it is not always easy to decide when a
drinking problem has become so serious that special
help is needed. Alcoholism can be hard to observe day
by day, even if it 's easily recognizable over a period of
years. Patterns of abuse through a lifetime are variable.
The symptoms come and go. Alcoholics are not always
drinking uncontrollably; some drink only on weekends,
and many succeed in remaining abstinent or nearly
abstinent for months at a time. In the following sections
we describe several treatment programs for problem
drinkers and detoxified alcoholics.