Hotline Questions

I should start by letting you know that alcohol is not a stimulant; it is a sedative. Starting in the mouth, alcohol can be harmful when small cuts in the mouth do not heal correctly due to prolonged drinking, which causes irritation. This irritation, with time, might lead to cancer. For individuals who smoke and drink there is a 15% increase in the risk of developing lung cancer.

In the stomach, alcohol attacks the interior lining and it increases the secretion of hydrochloric acid, essential for the digestion process. Hydrochloric acid and alcohol mixed damage the interior lining of the stomach which in time causes hemorrhage and ulceration. It might also cause ulceration in the small intestine, causing pain. On the other hand, if the nerves in the intestine are damaged by alcohol, a person might still have ulceration but might not feel pain.

Alcohol disrupts all of the functions that the liver performs. Liver disease is the number one cause of death among alcoholics. When the liver has an overflow of alcohol, it is unable to detoxify the excess alcohol causing calories to accumulate. Those calories become fat that gets trapped in the liver, enlarging it. This disrupts all the functions of the liver. Usually, all of this leads to cirrhosis of the liver, which in most cases leads to death.

Alcohol also has tremendous effects on the circulatory system. It causes high blood pressure, increasing the chances of suffering a stroke. It causes the arteries of the heart to harden and thicken. Alcohol also causes the muscles of the heart to become soft and flabby.

Drinking during pregnancy is extremely dangerous to an unborn baby. Alcohol affects a baby in the womb as fast as it affects the mother. If a pregnant woman gets intoxicated while pregnant, that means that the child is also drunk. This practice causes fetal alcohol syndrome in unborn babies. They can also suffer from mental retardation and other irreversible physical abnormalities. Children of alcoholics are at greater risk of becoming alcoholics themselves.

The muscular, skeletal, and immune systems of the body are also significantly affected by alcohol. The muscles lose their tone, becoming weak and flabby, causing the loss of strength and energy. In the bones, it causes a depletion of calcium, decreasing bone density. In the immune system, alcohol disrupts the creation of red blood cells. Because of this, infections are more likely to happen and harder to get rid of.

Alcohol interferes with sexual functioning, especially in men. Alcohol is not a sexual stimulant. On the contrary, it might provoke desire but take away the performance. It makes the testicles shrink, which decreases the production of male hormone and can lead to impotence. Alcohol in women affects the ovaries.

The brain and nervous system are greatly affected by alcohol also. Many people do not know this, but unlike body cells, brain cells do not regenerate. This causes the brain to suffer and impairs all the senses. That is why more than half of motor vehicle accidents are caused by drivers under the influence. Alcohol-related traffic accidents are the leading cause of teenage deaths.

In conclusion, alcohol is a drug that affects not one or two but all parts of the body. If we were to list all of its effects this space would not be sufficient.

The issue of drug testing in the workplace is complex. If your employer has a written substance abuse policy in place which outlines where the employer and employees stand on this issue, explains what is expected of them, provides for drug and alcohol awareness and education, gives access to an employee assistance plan, and makes clear all drug testing requirements (where appropriate), then the answer would have to be “yes.”

Similarly, if an employer imposes the requirement of pre-employment testing, and it is clearly stated on the employment application form, the prospective employee must undergo testing if he/she wishes to pursue employment with the company.

Having said this, questions arise. For the already employed: (1) Is this a random test, or is testing on a “just & reasonable cause” basis? If random, how is it decided whom to test? (2) What levels of results are tolerated, if any? (3) Who will take the samples on the job?

For the potential employee: (1) If he fails the drug screen, can he/she re-apply? (2) Can an employer not hire a weekend pot user? (3) When and how in the hiring process will the test be conducted?

Drug testing raises serious legal, ethical and employer/employee relationship issues that should and can be dealt with, but you and your fellow workers have a right to a safe work environment. Your health and safety might be at risk when someone is using drugs or alcohol on the job. Think of it this way: would you want to be on the shop floor if a co-worker is using cocaine and swinging ten tons of steel around with a tower crane? Would you want to be the brakeman on a train if your engineer is high?

While this is not an easy question to answer with a standard formula, there are instances where an involuntary commitment can be done if the alcoholic/addict exhibits one or more of certain dangerous behaviors outlined in the law. They are:

• Danger to others by inflicting or attempting bodily harm.

• Danger to self by attempting suicide.

• Danger to self by substantially mutilating him/herself or attempting to substantially mutilate him/herself.

• Danger to self based on the fact, as shown by behavior within the last 30 days, that the person is unable to minimally satisfy the basic needs to sustain his/her life to the point that death or serious bodily injury or serious debilitation would result within 30 days without intervention.

Dangerous behavior, however, in and of itself, is not sufficient grounds to commit someone involuntarily if he or she is engaging in such dangerous behavior due to the influence of alcohol and drugs.

Where drugs or alcohol are involved (and mental illness is not present), it might be necessary to call the police and seek the person’s arrest, as in the case of an individual who is drunk and creating a public hazard or nuisance, or an individual stealing from his or her own family to support a drug habit. In such situations, criminal charges need to be pressed rather than attempts made to commit the person for involuntary treatment.

At this time in Pennsylvania, there is no way to force adult individuals to get treatment for only drug or alcohol addictions.

Alternatively, there is another option: Intervention. For the process to succeed, it is vitally important that the addiction professional be well trained in the intervention technique. An ill-prepared or botched intervention is worse than no intervention at all. (see Question/Answer #4 below).

An intervention is a group meeting at which family, close friends, possibly a clergyperson, doctor or business associate try to persuade the alcoholic (or addict) that a problem exists and treatment should be sought.

While an intervention is a confrontation, it differs in some very important aspects from the sort of confrontation with which most people are familiar – and which has little or no positive effect. It is not a punishment, nor is it an opportunity for others to clobber the alcoholic verbally. It is a loving process through which you stop caring for the alcoholic and start proving how very much you care about the alcoholic. Intervention is a profound act of caring. An estimated 9 out of 10 interventions succeed in getting the alcoholic into treatment.

Even if the intervention does not succeed, it does give the family members the feeling that at least they tried. To ensure success, it is vitally important that an addiction professional who is well trained in the intervention technique be consulted.

For information on professional interventions in Lancaster and surrounding counties call (717) 299-2831.

Let me describe an AA meeting at its most elementary level. A call to Compass Mark (717-299-2831) or AA Intergroup Office (717-394-3238) will tell you where meetings are and the referral specialist will try to find you a close and convenient meeting. Arriving a few minutes before meeting time, you will see people in the parking lot milling about and chatting before entering the meeting.

You will be greeted in a friendly and welcoming manner, offered a beverage, and if you give off vibes that you feel like talking, you’ll be introduced to other people by the greeter. If you don’t feel like talking, that is okay. AA members remember their own first meetings, and how nervous, scared and shy they were, so they will react to you as YOU wish. The meetings last an hour.

One person will lead the meeting, a topic is offered for discussion, and people join in sharing their experiences, strengths and hopes with each other. The meeting leader might ask if anybody is there for his first meeting, at which point you may raise your hand IF YOU WISH, give your first name and say you’d just like to listen. Of course, if you wish to say more about what brought you to an AA meeting, by all means do so. At the end of the meeting, a basket will be passed around for donations to help pay for the rent, literature and beverages. It is not mandatory to contribute if you can’t afford to or don’t wish to.

All meetings are similar but every one, like a fingerprint, is different. The common thread running through all meetings is the tremendous tolerance and willingness to help the newcomer. They are aware that you are angry, frightened, ashamed to be there, and very, very ill, just like each of them was at his or her first meeting.

No one will say to the newcomer: “You must,” or “You should.” This is taboo. The preferred way to help is to say: “This is what I did.” There are no papers to sign. Nobody puts an arm on people to join, or makes them speak or take a pledge of abstinence. No full names, addresses, telephone numbers, social security numbers, nothing like that. People simply go to a meeting. They sit there. They listen. They are there for a reason. The reason is not why they drank. The wrong question to ask is, “Why?” The question to ask is, “What can we do to stop and stay stopped?”

The power of experience and example demonstrated in and out of meetings cannot be overestimated. Even though an active alcoholic is reluctant to listen to someone in AA, somehow he knows that the AA member has been in the same dark place where the drunk still lives. He also quickly learns that he will not be judged and is not unique. For some, this is an astonishing discovery. About two million members worldwide can attest to the fact that it works. Give it a try!

Several years ago the television show 60 Minutes aired a story linking moderate drinking to a decrease in coronary heart disease among the French. It turned out that the study was commissioned by the French wine making industry. The argument for or against moderate drinking has been raging since then.

“Moderate drinking” is usually defined as one or two drinks a day, with a standard drink consisting of 12 ounces of beer, 4 ounces of wine or 1.5 ounces of 80-proof spirits.

The problem with this definition is that most drinkers have their own personal definition of “moderate,” allowing them to consume more than the standard drinks. There are those who begin to drink in moderation, but find they can’t stick with limited alcohol over the long run, and eventually end up as problem drinkers or alcoholics.

In the January 2000 issue of Alcoholism: Clinical and Experimental Research, a study conducted by Dr. Deborah A. Dawson, statistician with the National Institutes of Health in Bethesda, MD, found that the benefits of drinking moderately did not apply to alcoholics, and that furthermore, the choice of alcoholic beverage could affect mortality.

This study is the first to document that the health benefits associated with drinking alcohol decline as consumption and dependency increase.

Draw your own conclusions. If you ever had or now have a problem with alcohol, the smart money says: Don’t drink. There are other safer ways of getting healthy and staying healthy.

The dynamics of relapse vary widely and there are many causes. The initial thrill of sobriety is a unique experience. Active addiction is filled with such misery and distress that it is a dramatic contrast to the newly experienced sense of physical and mental well-being. The clarity of mind, the feelings of triumph and dignity, all combine in the euphoria of newly found sobriety.

When a person relapses and re-enters recovery, he or she is likely anticipating the same feeling of exhilaration he or she had the first time around. Alas, there is only one first kiss. There is no way someone can re-experience the initial thrill of sobriety. The person is, therefore, disillusioned and drops out.

When someone goes back into recovery the second or even the third time around after extended sobriety, that person sees neophytes who have a large number of people from among whom they can choose to identify with, whereas someone who is a recovering relapser does not. And yet, that person needs the wisdom and guidance of someone who has relapsed after a long sober period and is successful in achieving stable sobriety the second time around. These people do exist. A relapser needs to find these people who can share the same experience.

I am reminded of a story related by Dr. Abraham Twerski, the founder and medical director of Gateway Rehab in Aliquippa, PA: One frigid winter morning, his car wouldn’t start and he had to walk to the post office some distance away. In spite of his best efforts to stay on foot, he slipped, fell and bruised himself badly on the snow-and-ice-covered sidewalk. Obviously he could not stay on the sidewalk. Full of pain and hoping nothing was broken, he got to his feet and continued to his destination. Despite the pain of the fall, he could not deny that he was two blocks closer to the post office than he had been at the outset. The fall did not erase the progress he had made.

You see the similarities, I am sure. The important thing is that recovering alcoholics never give up. Any periods of sobriety are never wasted.