1.3 Some Medical Aspects of Alcoholism

Alcoholism leads to a vicious downward spiral, just as any indulgence in any sin does. It becomes both mentally and physically self-destructive. The liver metabolizes alcohol but is itself damaged by it, so that an alcoholic binge can produce illness and death through what is actually an acute hepatitis. Long term abuse of alcohol in large quantities results in cirrhosis of the liver- it is scarred and develops growths, leading to the possibility of cancer. The weak health of the alcoholic then leads to more depression and hopelessness, and therefore more drinking. Alcohol enters the bloodstream immediately and goes to the brain, where it affects the cortex of the brain- the location which has to do with memory, emotion, conscience and judgment. Straight away we see the moral issue which there is in alcoholism and being drunk. Alcohol is a depressant, so you need to be aware that it creates many other problems in the life of the alcoholic who is taking it regularly in large quantities. Because it is a depressant, the alcoholic will have problems sexually- impotence and difficulty in achieving orgasm. An alcohol-damaged liver causes hormonal changes, too. Testosterone is no longer broken down by the liver as it should be; and this can produce a 50% decrease in this male hormone. The testes wear away (testicular atrophy). For women, damaged livers result in an inability to adequately turn estrogen into estradiol, which interferes with vaginal lubrication and menstruation. The female hormones accumulate, causing enlargement of the breasts. Loss of periods is another feature of the disease. In both men and women,  these conditions lead to sterility and even impotence. The associated mood changes lead the alcoholic to sometimes be physically or verbally abusive in ways they would never dream of while sober. Alcohol is soluble in both water and fat, and therefore it invades the nerve cells very easily. This is why it may cause nerve damage or brain syndromes. Alcohol harms in other ways- injuries, tuberculosis, heart attacks and strokes are some of these complications. “Because alcohol contains empty calories he feels warm and full and therefore neglects proper food. Malnutrition sets in” ⁽⁴⁾, and so the vicious cycle of health breakdown continues. Regular and nutritious meals for the alcoholic are one way of helping him or her- although of course this will not completely prevent cirrhosis.

Alcohol has major effects on behaviour. Although drinkers think it is a stimulant because it makes them feel good (as alcohol is absorbed into the blood stream and moves on to the brain very quickly), it is in fact a depressant. It particularly damps down social restraints so that drinkers say and do things that they would never dream of doing while they were sober. They may become emotionally unstable, quarrel easily, be verbally and physically abusive and lose sexual inhibitions. Memory loss can be particularly distressing, because the nest day, drinkers may not remember what they have done. Who were they with? What did they do? Did they sleep with anybody, and, if so, who?

Thus bad behaviour resulting from alcohol means that families and relationships are damaged often irrepairably. And of course money often becomes an issue. The alcoholic is spending large sums of money on drink but risks losing his or her employment because of it. This fear often comes to dominate the family of a male alcoholic. The alcoholic rationalizes the drinking by blaming family and friends, and comes to avoid them.

Shakespeare lamented: “That men should put an enemy into their mouths to steal away their brains”. There is a physical component of the disease, often reflected in the craving response to a single drink, representing a metabolic reaction to the drug alcohol. Physical dependence develops. But we will keep emphasizing that alcoholism is largely a disease of the mind, in that the alcoholic keeps drinking because of a mindset which they are in; and therefore the cure is related to the things of the spirit / mind. As Hos. 4:11 says “Wine and new wine take away the heart / mind”. The alcoholic cannot trust himself, their thoughts, feelings or best intentions. They persuade themselves they will really only have one drink; and invariably they end up drunk. The desire for alcohol and the need to survive as an active alcoholic makes them totally self-centred; people become [sub-consciously] merely things to be manipulated to allow the alcoholism to continue. It’s a disease the mind persuades them has to be continued in at all costs. The strange thing is, our culture has exalted worship of the self; to lie to clinch a business deal is seen as smart; excesses of food, clothing, material possessions, homes etc. are seen as signs of success. Obsession with money and workaholicism are felt to be part of the wonderful capitalist dream. To rely upon a higher power, knowing we ourselves are incapable...is seen as weakness. But lies, obsession with self, excessive behaviour etc. are all just as much part of alcoholism. To break from alcoholism is therefore to do something counter-cultural. The teaching of Jesus, properly understood, is radical, counter-cultural stuff. This again is where ‘the truth of the Gospel’ can be at the cutting edge in overcoming alcoholism.

When quizzed as to their behaviour and why they did what they did, the genuine response is that they “just don’t know what happened”. When the family fire questions like “Are you stupid?... don’t you care?...Why can’t you just say no?”, they see the truth of it all but the mind tricks them into rejecting it all. They become increasingly less available to those around them, e.g. their children. Their thoughts become obsessed with obtaining and using alcohol. Their work suffers; they may lose their job and family. And thus the cycle deepens. Their person is being destroyed as well as their body. But they develop such low self-esteem that this doesn’t matter any more. When they finally come out of denial and realize this, the Bible’s tremendous emphasis on the value of the human person must be allowed to hit the alcoholic with full force. This will usually happen after a period, however brief, of sobriety.

When you do a blood test on an alcoholic when they are sober, there are no disease agents present in the blood as there are, e.g., in the blood of some other drug abusers. But as with any drug, the more alcohol is experienced, the greater tolerance is developed by the body, and more is required to produce the previous effect of calmness, relaxation, positive feeling, etc. This is why it’s not macho at all to say ‘I can take a lot of beers without being affected!’. The man who says that has a problem, and is fast heading for a tragic, pitiable self-destruction. As the alcohol is continually taken in by the body, a deep craving for it develops that has to be satisfied. It’s a living parable of our response to regular sinning. The body comes to depend upon the regular ingestion of alcohol. Drinking ceases to just be social; the alcoholic starts to drink alone. Eventually the person becomes totally dependent upon alcohol to the point of being more often drunk than sober. When drug addicts quit most drugs, even heroin, there are severe withdrawal symptoms but they are usually not life threatening. With alcohol, it’s different. A hard-core alcoholic who quits suddenly needs to do so in a proper detoxification unit staffed by professionals. Between 8 and 24 % of such alcoholics who suddenly withdraw from alcohol die from doing so very quickly ⁽⁵⁾. They are killing themselves to live. I mention this because it’s therefore no use screaming at such a person ‘Stop drinking immediately, totally, right now!!!’- especially if they are located in rural areas far from medical help. Physically stopping such a person having access to alcohol at this level of addiction can therefore easily be tantamount to murder. If you really are going to force them to stop drinking, you really must ensure that professional detoxification help has been organized. It would do all who drink ‘socially’ a lot of good to be allowed into a detoxification ward. You will see men- men often once happily married or successful businessmen- shaking so badly they can only walk by gripping on to a wall or rail, screaming from unknown fear as they do so; women crying out from vivid daydreams, convinced there is something crawling all over their skin... it might be enough to make you vow never to drink again, and certainly never to offer alcohol to someone whose background you don’t know. And there’s very little that can be done to stop this trauma. It has to be gone through. But this is what cleansing from alcohol requires. It’s not just so easy, therefore, as insisting the alcoholic quit drinking once and for all, “immediately!!”. If your hard-core alcoholic really did quit totally and immediately, the result on him or her would be so devastating and dramatic that you would likely be very scared and so wishing you had some medical help nearby. You simply wouldn’t know how to cope. Be realistic about what you are expecting from the alcoholic. And seek some outside, professional help.

Drugs

Much has been made of alcohol-antagonistic drugs. These make the body undergo a very violent negative reaction if alcohol is drunk. These drugs do not actually reduce the desire to drink; rather do they merely create a choice between two punishments. A spiritual approach, involving prayer to God, and taking strength from others, is the only way that permanent abstinence can be achieved. Alcoholism is all about yielding to temptation; and this is essentially a spiritual matter, which can’t be controlled by drugs.

Genetics

It has been observed that alcoholism tends to run in families. Where this observation can be dangerously misused is that the alcoholic justifies his or her sin with the notion that it’s inevitable; they are a helpless victim. By its nature, the psychology of alcoholism [and it is essentially a disease of the mind] seeks for justification. So the alcoholic tends to latch on to this genetic argument. Russian alcoholics often tell me that it’s something to do with what’s in the Russian blood. The family of the alcoholic should of course be able to point out that they aren’t alcoholics; and God will not so strongly condemn behaviour which is inevitable. There is no such thing as an inevitable sinner. We are not just mechanisms controlled by genes. We are each one uniquely created by the Father for Him to work out His specific glory in us. An effectively atheistic world has no sense or order or purpose. If alcoholism is simply genetic, some people ought to be able to drink and never become alcoholic. This is of course untrue. There seems to be a genetic predisposition; twin studies have indicated this. But it is not absolute. Some "nurture" element is also at play. This world has little concept of our connection with the far bigger plan of God, in which we each can have a vital and wonderful part. In Christ we are a new creation (2 Cor. 5:17). The alcoholic needs new life, a ‘higher power’ as Alcoholics Anonymous so [purposefully] vaguely expresses it; and this is only ultimately available in Christ. Thus Paul can triumph: “It is no longer I who live, but Christ who lives in me; and the life I now live in the flesh I live by faith in the Son of God, who loved me and gave himself for me” (Gal. 2:20,21).

We are in some sense taken out of Adam and baptized into Christ. We are removed from the "kingdom of this world," and translated into the "kingdom of the Son of God's love". "In Christ you were also circumcised, in the putting off of your sinful nature, not with a circumcision done by the hands of men but with the circumcision done by Christ". The “flesh” of the believer is cut off by Christ, in a process which begins with baptism: "...buried with him and raised with him through your faith in the power of God, who raised him from the dead, and when you were dead in your sins and in the uncircumcision of your sinful nature, God made you alive in Christ" (Col. 2:12). To live the alcoholic life is to fight against what the Lord Jesus is seeking and intending to bring about. In the flesh, we cannot please God. It therefore was ‘cut off’ in the perfect sacrifice of Jesus, and we identify ourselves personally with that achievement through baptism. But these words of Paul are hardly saying that repeated, ongoing sinful behaviour is inevitable and can’t be cured. In prospect, sin has been dealt with for the believing alcoholic. In prospect, the alcoholism has been cut off from him. We must “count ourselves dead to sin” if we are baptized (Rom. 6:11); and persistent drunkenness doesn’t achieve this. By continuing in sin, he ruins his  fellowship but not his essential relationship with the Father and Son. For once a brother in Christ, always a brother- at least, so far as we are allowed to judge. For all these reasons I heartily recommend the family of an unbelieving alcoholic to preach these things to him or her- yes, to make the time and space to explain these doctrines, the wonder of these things. For in the truth, in the reality of the real Christ, the concrete Hope of the Kingdom, the Hope of wayward Israel...in these things alone is there the ultimate ‘higher power’ to totally transform a life. And this is why I personally am not against the baptism of a confessed alcoholic. Indeed, if they have gotten to the stage of admitting their problems and desperately seeking for God’s grace to help in their need, it would seem to me essential as part of their healing process. So many alcoholics admit to having thoughts about God in their afflictions. They nearly all say that they believe in God and are willing to rely upon Him. Yet all they have in their minds is an idea of God that lacks power. Who He is, His actual personal reality, needs to be taught or re-taught to them. He isn’t an idea, a cultural artefact that lacks power. He is real. He is there. He is passionately interested in the lives and destinies of His children.